Hearing Loss Help  

by Neil Bauman, Ph.D.

One of the reasons many people are not happy with their new hearing aids is because their hearing aids have not been properly adjusted to fit their specific hearing losses.

Often, the audiologist or hearing aid dispenser adjusts your hearing aids according to the manufacturer’s fitting algorithm for your hearing loss. Unfortunately, this algorithm does not necessarily reflect the hearing prescription you really need.

If your audiologist does not do “real-ear testing”, she will never know whether or not your hearing aids are set up properly for your ears.

With real-ear testing, your audiologist puts a tiny microphone into your ear canal, then inserts your hearing aid. A computer runs some automatic tests and the results are shown on the screen.

The output shows both a graph of what your prescription should be, and what your hearing aids are really putting out. Now your audiologist can see what she needs to “tweak” in your hearing aids to properly give you the amplification you need at each of the speech frequencies.

How important is this? Consider this. A recent study using one hearing aid manufacturer’s fitting algorithm was compared with the results of real ear testing. The shocking results show that less than 12% of the time were the results judged to be “clinically similar” when comparing the manufacturer’s values to the actual real-ear measurements.

Nancy Aarts, Ph.D., the author of this study asserts:

This study suggests that adult hearing aid fitting protocols should include the use of actual real-ear probe-microphone measures to verify hearing aid fittings. Reliance on [the manufacturer's protocols] may result in insufficient output of most hearing aid users, as well as over-amplification of high level inputs for some hearing aid users.

What this means is that if you want to know that your hearing aids are fitted properly, you need to insist on having real-ear testing. If your audiologist doesn’t do real-ear testing, find one that does. It’s that important.

The above study was reported in the article “The Accuracy and Clinical Usefulness of Manufacturer-Predicted REAR Values in Adult Hearing Aid Fittings” The Hearing Review. November, 2005.)

by Neil Bauman, Ph.D.

If you live in Canada, you may be interested in a free 32 page publication called “Canadian Consumer Guide to Hearing Loss & Hearing Aids” put out by the Canadian Hearing Instrument Practitioners Society (CHIPS).

This publication covers the basics of hearing loss, hearing testing, hearing aids and communication coping strategies.

The last 6 pages are a good source of provincial and national resources including, for each province, where you might be able to find financial assistance for hearing aids.

You can download your copy in pdf format from http://www.hearcanada.com/Consumers/Consumer_Guide.pdf.

by Neil Bauman, Ph.D.

Press “1″ for sales. Press “2″ for service. Press “3″ for accounts… How often have you encountered one of those ubiquitous voice menu systems? You make a futile attempt to understand what “the voice” is saying. With your poor hearing and limited ability to discriminate sounds on the phone, you are in Voice Menu hell. Vainly you search for the magic button that will connect you with a live human. Whatever happened to that “Press ‘H’ for human” button?

When you are hard of hearing, it is difficult enough just talking with a live person on the phone. At least with a live person you can ask them to repeat what they said, or spell it out, or use different words that you understand better. Not so when you reach one of those ubiquitous voice menu systems, otherwise knows as IVR or Integrated Voice Response systems.

However, you are not totally at the mercy of these Voice Mail systems. According to Paul at http://www.paulenglish.com/ivr/info.html, here are some things you can try to reach a live human.

1. Press 0 or 0# repeatedly, sometimes quickly, ignoring any “invalid entry” messags.

2. Say “agent” or “representative” (or sometimes your favorite four letter word).

3. Just hold, pretending you have only a rotary phone.

4. Connect to sales; they always seem to answer quickly, then have them transfer you to the department you need.

5. When you find a human, ask them how to connect directly the next time.

What do you do if the above don’t work for you? Wouldn’t it be nice if you had a “cheat sheet” of how to get through to a live person at various companies? Look no further. Paul has done exactly that. He has created a “cheat sheet” that contains the secret ways to reach live humans at 111 of the biggest companies in America. Here you are–Paul’s “IVR Cheat Sheet to Find a Human” (http://paulenglish.com/ivr/).

Thanks Paul. This is a real help to all of us hard of hearing people!

by Neil Bauman, Ph.D.

I receive a number of emails from people who have a feeling of pressure (or blocked feeling) in their ears . Here is a recent example. A man wrote:

I am 33 years old and have never had any trouble with my hearing. I woke up about a month and a half ago with what felt like a bubble (pressure) in my left ear. It also sounded like everyone was talking in a bubble for a few days. Several weeks ago the pressure returned and I went to my internist. She said I did not have an ear infection and thought that it might be a Eustachian tube problem. She prescribed Nasonex and said that if it didn’t clear up in a week or so to call an ENT. It didn’t so I called the ENT.

The ENT did a pressure test, visual observation, and a hearing test. It turns out I have a mild loss in the lower tones for my left ear. He said that I most likely had a viral infection in my inner ear and that the only way to treat it was with steroids and Valtrex. He also said he wished I’d have come in much sooner, but how the heck was I supposed to know it was more than congestion or an ear infection?

Good question. The thing you have to determine right away is whether you have a middle ear infection that will resolve itself in a few weeks without any treatment and won’t cause any lasting damage to your hearing, or whether you have something destroying your hearing which requires immediate treatment.

With the former you can take a wait and see attitude. The latter is a medical emergency and needs to be treated as such.

When you go to a doctor and complain of a feeling of pressure in your ear, or that your ear feels blocked, the doctor typically uses his otoscope to inspect your ear canal and eardrum. If he sees any signs of inflamation, infection or fluid behind your eardrum, he diagnoses it (correctly) as a middle ear infection.

The typical treatment is to take decongestants, take antibiotics, or do nothing and let nature run its course.

However, when the doctor doesn’t see any signs of middle ear infection, he assumes that either there is Eustachian tube dysfunction, or there is nothing wrong and you are complaining about nothing. This attitude is wrong and could cost you your hearing.

For some reason, doctors can’t seem to understand that there are two reasons for the “blocked feeling” or “feelings of pressure.” The first one, described above, is real physical pressure from either a middle ear infection or blocked Eustachian tube, or because the “infectious gunk (fluid)” in your middle ear is truly blocking sounds from reaching your inner ear as they would normally do.

The second kind is a psychological feeling of blocking or pressure. Since the feeling is psychological, not physical, doctors can’t find anything wrong, and typically write it off as being nothing.

In actual fact, when you rapidly lose some hearing, whether you realize it or not, your brain senses that it is not getting the normal sound signals from that ear. It “reasons” that obviously that ear must be “blocked” or else it would hear, wouldn’t it? Thus it generates a psychological feeling that people variously describe as a blocked feeling or a feeling of pressure in their ear, or ears.

This feeling of pressure is an important symptom warning you that you have rapidly lost a significant amount of hearing, and you need to find out why right now!

Thus, if your doctor can’t see any signs of middle ear infections or Eustachian tube dysfunction, hurry to an otologist (find an otologist near you) or knowledgeable ENT and get effective treatment for whatever is causing the hearing loss. You do not have any time to waste if you want a chance of getting this lost hearing back.

by Neil Bauman, Ph.D.

A lady wrote:

In May of 2004, while watching a Law & Order program on TV, I lost the hearing in my left ear. It was replaced by ringing, various other noises and about one week of vertigo.

After many tests and a long regimen of Prednisone, my doctor basically told me my hearing loss was permanent and I could get a hearing aid to assist with what little hearing I have left. The problem is I was born deaf in my right ear.

My question is, Isn’t there anyone who has advanced the treatment for this condition? Am I destined for complete deafness and a cochlear implant?

Unfortunately, the kind of hearing loss you experienced is the result of the tiny hair cells in your inner ear dying. These hair cells are critical to hearing as they pass the sound signals from your inner ear to the auditory nerve which in turn sends them to your brain. When some of these hair cells die, there is no way to get those sound signals into the auditory nerve, so you don’t hear those frequencies of sound anymore. If all the hair cells die, you are left totally deaf.

What you want is a miracle–bringing dead cells to life again. Only God can do that–if He so chooses.

However, researchers are busy trying to discover if there is a way to regenerate hair cells in humans. Hair cell regeneration occurs naturally in some animals and birds. Unfortunately, for humans, hair cell regeneration is still a ways off–at least 20 years or so, if it ever happens.

You can read the present state of hair cell regeneration research in the following two articles, “Hair Cell Regeneration–Looking Beyond the Hype” and “Hair Cell Regeneration–Overcoming the Challenges.”

Since your hearing has stabilized, I don’t think that you are necessarily destined for complete deafness. Permanent hearing loss–yes. Complete deafness–not necessarily. It really depends on the cause of your sudden hearing loss.

For example, if you had a viral attack and never get another one, your hearing shouldn’t change much in the next 20 years. Ditto, if you had a mini-blood clot in an artery leading to your inner ear.

If wearing a hearing aid in your better ear doesn’t really help you hear, then you are likely a candidate for a cochlear implant. Cochlear implants work because they effectively bypass the dead hair cells and directly stimulate the auditory nerve so you can hear again.

Although hearing with cochlear implants is not “normal,” I know hundreds of people that are very happy with their cochlear implants. They tell me that their cochlear implants have given them back their lives again! This very likely could be your experience too. Thus, I strongly suggest you investigate getting a cochlear implant if you are eligible for one.

by Neil Bauman, Ph.D.

A man recently shared with me why he so desperately wants a visor card. He wrote:

In the past, the Delaware State Police have been one of the top offenders, as far as discrimination against hard of hearing or deaf people is concerned.They simply dont believe me when I tell them I am 90% deaf.

I have actually been held at gunpoint, because they would not allow me to reach into my pocket for my hearing aid, and was therefore unable to understand the commands they were giving me.

This is scary and should never happen–but obviously it does. So if you are deaf or hard of hearing, having your visor card handy can help bridge the initial communications gap with the police.

Anyone can download the article “Visor Cards—Bridging the Communications Gap When Stopped by the Police” and free visor cards (one for hard of hearing people and one for deaf people) from the Hearing Loss Help website.

Don’t forget about the associated Wallet Card. It is very useful too. A lady explained:

I downloaded and laminated the large visor card and the smaller one for my wallet, which I placed next to my license. It is a perfect solution to communication difficulties, in the daytime and at night. By putting the wallet card next to your license, it helps in all situations, not just with the police.

Excellent idea. When a police officer (or anyone else–such as at security checkpoints at airports) asks to see your driver’s license, just hand them your Wallet Card at the same time. That way they will know your communications needs without your even having to say anything.

by Neil Bauman, Ph.D.

A man wrote:

A year ago I developed permanent, severe tinnitus from the antibiotic Clarithroymcin (Biaxin). I took the 500mg sustained release tablet twice a day for two weeks. The amazing thing is that this macrolide antibiotic seems to act the same way as the aminoglycosides. By this I mean that it displays delayed ototoxicity combined with a danger of synergistic and permanent side effects after being exposed to loud sound.

This is what happened. I developed tinnitus 4 days after finishing the drug. Three days later the tinnitus went away completely. Three days after that, I attended a Christmas Eve service and was exposed to 90 db of music for 25 minutes. The next day my ears were badly stuffed. The following day I had incredible tinnitus. The rest is history. Permanent damage which would have reversed if I had not been exposed to the sound.

Have you heard of others who had hearing loss or tinnitus from taking Clarithromycin (Biaxin)?

Clarithromycin can cause either temporary or permanent tinnitus and hearing loss (among other things). See Ototoxic Drugs Exposed. However, your story is the first one I have heard demonstrating that taking Clarithromycin can leave your ears supersensitive to noise damage. Supersensitivity to noise damage is a known side effect of taking Aminoglycoside antibiotics such as Gentamicin, Neomycin and Tobramycin. They can leave your ears super sensitive to noise damage for up to a year after you stop taking the drug.

If anyone has experienced Clarithromycin causing tinnitus and/or hearing loss, I’d love to hear from you? Also, did you notice any tie-in with subsequent loud noise?

by Neil Bauman, Ph.D.

A lady wrote:

I have had tinnitus for many years, but would consider it irrelevant to this point. Recently, I took one quinine sulfate pill and woke up the next morning with severe tinnitus. It has not gone away and I am scared that I will have this forever from just one pill. At first, I thought it would clear up since I never took another dose.

My rheumatoid arthritis doctor had prescribed quinine sulfate for leg cramps. I am sure he did not expect this result, nor did I. I have been miserable and don’t know what to do. I just want the tinnitus to go back to what I had before. I am having trouble believing that I might have this permanently and I’m also having trouble coping with the high pitched noise. Can you offer any help to me?

Like you, I wouldn’t have expected the first (and only) dose of Quinine to give you permanent tinnitus. At the same time, I am not totally surprised. Some people can take ototoxic drugs such as Quinine, and don’t seem to have any problems, while other people get hammered on the very first dose. Doesn’t seem fair, does it?

In my book, Ototoxic Drugs Exposed, on the page about Quinine, I note, “some Quinine derivatives cause significant and long-lasting tinnitus. As a result, you should not take Quinine if you already have tinnitus.”

Since you already had tinnitus, I’m afraid that you unfortunately fell into this category.

I understand what it is like. I’ve had tinnitus for more than 35 years now. However, the good news is that I don’t let it bother me. It is always there–but I keep it more or less in the background. Hopefully, you can learn to do the same.

Probably the easiest and fastest way to do this is to learn more about tinnitus and the many things you can do to help yourself. Some things work for some people and others work for others. The book When Your Ears Ring–Cope With Your Tinnitus–Here’s How gives you all the latest information on all kinds of tinnitus treatments, including how to become habituated to your tinnitus.

One of the best ways to cope with tinnitus is to ignore it. I’m assuming that your previous tinnitus didn’t bother you much if at all. This is because you didn’t form any emotional attachment to it.

If you get upset (to put it mildly) at your tinnitus, your limbic (emotional) system then thinks that it must be important–after all, mistress is getting upset about it, and she wouldn’t get upset about something that wasn’t important, would she? Thus, your limbic system then attaches a “red flag” to this tinnitus sound, and sends it up to your brain. When your brain receives this red-flagged sound, it, in effect, turns up its internal volume control so you hear it as even louder and more intrusive. Thus begins a vicious circle.

What you need to do is exactly the opposite–completely ignore your tinnitus by remaining emotionally detached from it (neither liking or disliking it), and instead, focus on the loves of your life. This will allow your limbic system to “deflag” it and slowly (hopefully) it will fade into the background like your other tinnitus.

This is not easy to do. For example, every time I think about tinnitus, my tinnitus gets louder. Right now, since I am writing to you about tinnitus, and it is otherwise quiet, my tinnitus is screaming at me. But when I go on to other things, it will soon quieten down. Just the nature of the beast.

In addition to learning to ignore your tinnitus, use any of the other tinnitus “remedies” listed in the above tinnitus book that you want to try. Together, something should work. Unfortunately, there are no guarantees. The good news is that the remedies in this book have helped many people. I am hopeful they will work in your case too.

by Neil Bauman, Ph.D.

A lady recently wrote:

My sister, who is 75 years old, woke up one morning with her hearing in her left ear completely gone. Now she says being in a crowd makes her very nervous and anxious as she can’t tell which way the voice is coming from when people talk to her. Do you have any suggestions I can give her for more help?

When you can only hear in one ear, you totally lose your stereo hearing which enables you to tell from which direction sounds are coming. Thus, you need to learn how to compensate for this loss.

One way is to use your eyes more. Don’t just rely on your ears. Become more aware of you surroundings though your eyes.

Also, use logic, where possible, to determine from which direction sounds are coming. For example, if you are walking on a sidewalk and hears a car horn honking, you can be almost certain it is on the road side, not the building side of you. Thus, you look in the roadside direction first. Likewise, if you hear kids screaming as your are walking past a playground, the sounds you are hearing very likely are coming from the playground, not the other side of the street.

In other words, learn to anticipate from which direction specific sounds will likely be coming, and look in that direction first.

When surrounded by people, it is very difficult to know who is talking. However, logic still prevails. Say you are in a line at the grocery checkout counter. If you hear a person talking to you, it is likely either the person in front of you or the person behind you. Since normally the person in front would turn to face you before talking, if that isn’t the case, you can assume it is the person behind you doing the talking, and thus, you should turn that way first.

Another tip to use when around people is to have them identify where they are when speaking to you. For example, say you come home and call out as usual, “Honey, I’m home.” If your spouse calls back, “I’m in here,” this doesn’t help you at all. A person with normal hearing could tell from the direction of the voice where they are. Not so when you only have one ear. So you need to tell your spouse to say where they are when they answer. For example, “I’m in the kitchen.” or “I’m in the bedroom.” so you know where to go.

Here is a cool trick if for when you are riding in a car, bus, train or plane. You don’t want people talking to your deaf side, so preclude this by sitting with your deaf side to the window. That way anyone sitting beside you is automatically sitting on your hearing side. This makes conversations ever so much easier.

This same trick can be adapted to various other listening situations at home, church or other meetings. For example, in church or meetings, always sit with your deaf ear towards the wall. For example, if your left ear is deaf, sit on the left side of the room. That way anyone speaking from the audience has to be speaking towards your good ear.

In addition to doing all of the above, you could try a special kind of hearing aid called a CROS aid. CROS aids come in two parts. You wear what looks like a hearing aid in each ear. The hearing aid on the deaf side picks up the sound from that side and automatically transmits it to the hearing aid on the good side where it is fed into your good ear. The ear mold on the good side is loose fitting so normal sounds from that side are not obstructed.

With a CROS aid, you will be able to hear people talking to you from both sides. Some people love their CROS aids. Others don’t. So you have to try them out and see for yourself how they work for you. Unfortunately, CROS aids still doesn’t let you hear true stereo, so you still have trouble telling the direction from which sound is coming, but at least you no longer have a deaf side.

These are a few of the tricks you can employ to help yourself successfully deal with single-sided hearing loss.