Hearing Loss Help  

by Neil Bauman, Ph.D.

A number of hard of hearing people have asked me to explain exactly what the difference is between hearing dual mono sound and hearing stereo sound.

With mono sound, there is only one microphone involved in picking up the sounds. Since there is only one microphone picking up the sound, there is only one sound amplifier, and one sound heard in the earphones.If you are wearing dual earphones, you hear exactly the same sound in each ear. This is dual mono.

With stereo, there are two microphones picking up the sounds, Since there are two microphones picking up separate sounds (with some overlapping to be sure), there are two sound amplifiers and if you are listening to a stereo device and wearing stereo earphones, you will hear different sounds in each ear. This is true stereo sound.

Stereo is what gives sound directionality–sounds seem to be coming from one side or the other or in front of you.Mono sound has no directionality associated with it. It is just “there.”

Most assistive devices are mono devices, so you will hear the same sound in both ears. However,in the hearing world, most audio devices–radios, TVs, DVDs, CDs, iPods, MP3 players, etc are all stereo devices.

If you want to hear true stereo sound, you need to learn how to couple your hearing aids to the various portable stereo devices. The article, “Using T-Coils to Couple Your Hearing Aids to Various Audio Devices” explains what you need, and how to do this.

This article also explains what you need to do if you want to use a mono coupling device (such as a neckloop) to couple to a stereo system so you don’t accidentally short out one of the stereo amplifiers.

by Neil Bauman, Ph.D.

A lady asked:

I am interested in coping with my hearing loss. What all does it involve?

Successfully coping with hearing loss includes all the things we do in order to communicate as well as possible in spite of our hearing losses. There are 5 basic steps or areas of coping that are necessary for you to include in your coping strategy program.

These five steps include:

1. Grieve for Your Hearing Loss

Hearing loss throws your emotions into a turmoil–especially if your hearing loss is quite rapid. In order to get yourself on an even keel again so that you are ready to successfully cope with your hearing loss, you first need to grieve for your hearing loss.

This step is very important–yet often overlooked. I strongly recommend reading the article “Grieving for Your Hearing Loss,” or even better, the short, easy-to-read book “Grieving for Your Hearing Loss–The Rocky Road from Denial to Acceptance” to help you through this process.

2. Get Hearing Aids

The next step is getting and wearing properly-fitted hearing aids. Be aware there is an adjustment period. To help you adjust I highly recommend reading the excellent article “Becoming Friends with Your New Hearing Aids.”

3. Use Hearing Assistive Technology

Because hearing aids do not work well in all situations, you need to supplement their use with various assistive listening devices (ALDs) and alerting devices. Two such ALDs are personal listening systems such as the PockeTalker and Room Loops. You can learn more about the value of the PockeTalker in the article “Hear In Noise? You Bet You Can! Here’s How” Room loops are explained in the article “Loop Systems–the Best-Kept Secret in Town.”

4. Learn to Speechread

Speechreading (the old term was lipreading) is watching a person’s face to “see” what they are saying. Speechreading is most valuable for filling in the gaps you miss with your hearing aids, or for when you are not wearing them. Learn more about speechreading in the article “Speechreading (Lip-reading).”

5. Use Everyday Coping Strategies

Everyday coping strategies include all the little things you need to do in order to best understand what people are saying. Many of these coping strategies are explained in the short book, “Talking with Hard of Hearing People–Here’s How to Do It Right!” Still more are contained in the article “Practical Coping Strategies for Hearing Loss.” These coping strategies are all free and just involve a bit of effort.

Following all the above will let you communicate ever so much easier than if you do not follow them. The difference is like night and day. I know. I’ve used them every day of my life!

by Neil Bauman, Ph.D.

A mother asked:

What is a conductive hearing loss?

There are two main kinds of hearing losses. One is called conductive and the other is called sensorineural.

Conductive losses are “mechanical” hearing losses, that is, something prevents the eardrum and/or the 3 tiny bones in the inner ear from vibrating freely. Conductive losses occur in the outer and middle ear.

In contrast, sensorineural hearing losses occur in the inner ear and are more “electro-chemical” in nature.

There are two common causes of conductive hearing losses. The first cause is wax or other “stuff” blocking the ear canal and preventing sound from getting to the eardrum. A variation of this would be wax or other material touching the eardrum preventing it from vibrating freely. Incidentally, a hole in the eardrum or scar tissue on the eardrum can also prevent it from vibrating as freely as before, thus resulting in some degree of conductive hearing loss.

The second common cause of conductive hearing losses is middle ear infections–often associated with getting a cold. When you have a middle ear infection, the middle ear, normally an air-filled cavity, fills up with a thick puss-like fluid. This fluid prevents the bones of the middle ear from vibrating freely. The result is reduced hearing of a conductive kind. The fancy medical term for a middle ear infection is “otitis media.”

Having your doctor clean your ear canals typically fixes the first kind of conductive loss.

Fixing the second cause is not as easy. Typically, once the cold goes away, the fluid in the middle ear slowly drains away via the Eustachian tube that connects the middle ear to the back of the throat. This process can take from a few days to a couple of months. When the fluid drains completely, hearing generally returns to normal again.

If this fluid won’t drain away on its own, doctors often intervene and put “tubes” in the ear drum to let the fluid drain into the ear canal.

by Neil Bauman, Ph.D.

A woman wrote:

I read your article on the Pocketalker and found it helpful. I am encouraged by the fact that although you have a severe hearing loss, (and my loss is “moderate to severe”) yet you are able to use the Pocketalker with earbuds. Although I hear well through headphones, I would prefer to use earbuds, as you do.

I have dual earbuds, but they keep falling out of my ears. And I only hear through one of the earbuds. What do you suggest? I would certainly appreciate your advice.

PockeTalkers and other similar personal amplifiers are certainly wonderful little devices for some difficult listening situations.

You have two separate issues. First is the fact that you only hear from one earbud. This could be caused by a broken wire going to one of the earbuds. In that case, you need to get new ones.

However, assuming that both of the earbuds are working properly (and you can hear in both of your ears), this problem is most likely caused by plugging stereo earbuds into the mono jack on the PockeTalker. When you do this, you short out one earbud to ground and thus hear nothing in that ear.

The earbuds that come with the PockeTalker have mono plugs so you can hear in both ears. In contrast, almost all earbuds sold in consumer stores have stereo plugs.

You can easily tell whether you have mono or stereo plugs. Just look at the plug. If it has two metal sections separated by one plastic ring, it is a mono plug. If it has three metal sections separated by two plastic rings it is a stereo plug.

If you have stereo earbuds, the solution is very simple. Just go to any Radio Shack store and pick up their little stereo to mono adaptor (Part no. 274-882, $3.99, or Part no. 274-368, $2.99). Plug the adaptor into the PockeTalker and the stereo earbuds into the adaptor and you will hear in both ears.

Your second issue is keeping the earbuds in your ears. Earbuds just don’t seem to stay in some people’s ears. You may be one of these. You need to try various earbuds and find the ones that best fit your ears.

My favorite earbuds of all time came with my Sony Walkman a number of years ago. They have a shape more like a hearing aid ear mold. Not only are they very comfortable, but also they stay in place and never fall out. Unfortunately, I have looked high and low to find similar earbuds but can’t find any.

I suggest you go to Radio Shack, Walmart and other consumer electronics stores and actually try out their different earbuds until you find a pair that fits your ears comfortably and stays in place. Any of these stereo earbuds will work with your PockeTalker with the above-mentioned adaptor.

by Neil Bauman, Ph.D.

A man asked:

What is your opinion regarding ear candling? Do you consider it to be safe or not?

The plain truth is that ear candling is not effective. Proponents claim it can cure conditions such as hearing loss, tinnitus, vertigo, Meniere’s disease and a host of other conditions.

A number of years ago, I investigated ear candling. In the course of my research, I couldn’t find any proven good that it does. As a result, I don’t recommend anyone wasting their money on ear candling.

As to its safety, you are literally playing with fire–and when you play with fire you can get burned as a result. Don’t kid yourself, it does happen.

Audiologist Heather Shenk has written an excellent article on ear candling called “Ear Candling: A Fool Proof Method, or Proof of Foolish Methods?” Her article gives the history of ear candling from ancient times to the present, its supposed benefits and what really happens when you ear candle. Read this article before either your wallet or your ears get burned.

Her article is at http://www.audiologyonline.com/articles/arc_disp.asp?article_id=1501.

by Neil Bauman, Ph.D.

A lady asked:

What I would like to know is how would I find a local class that teaches speechreading. I am on a fixed income and cannot afford the CD.

The best way to learn to speechread is to find a class that teaches speechreading. Unfortunately, these are few and far between in my experience.

I suggest that you ask around at the HLAA (SHHH) chapter nearest you. If there are any speechreading classes going on, they should know about it. Go to http://www.hearingloss.org/StateChap/states_and_chapters.html and click on the state you live in. It lists all the chapters in that state. Contact the chapter of your choice for more information.

Apart from a live class, I think the next best solution is to get the CD called “Seeing and Hearing Speech“. This is an excellent tool to learn speechreading right in the privacy of your own home. All you need is the CD and your computer. You can also learn more about speechreading in my article at Speechreading.

If you cannot afford the above excellent CD, I suggest that you join the Captioned Media Program at http://www.cfv.org. The only requirements are that you live in the USA, and that you are either deaf or hard of hearing.

If you have a VCR, you could borrow their 6 tape set of speechreading videos called “Read My Lips” (#9366 in their catalogue). A nice thing is that they pay the postage both ways so won’t cost you a cent!

I suggest that you just borrow one or two of these tapes to start with to see what you think. There is a lot of stuff on them–and you want to practice with them quite a bit before you advance to the next tapes.

You can register and then watch these tapes on-line too if you like. I have tried it in the past, but wasn’t successful in getting it to work then. You may have better luck than me.

You’ll find these tapes are helpful, but to me they are quite boring in contrast to the versatile CD mentioned above, but at least the price is right!

by Neil Bauman, Ph.D.

A man explained:

I had a hearing test conducted last week where an audiologist used a Tympanometry test. When he did this test in one of my ears there was a loud popping noise that occured and I felt pain in my ear. Can this type of test cause any damage the ear drum?

It shouldn’t. Here is what I suspect happened. Your eardrum normally is slightly concave. However, your eardrum may have been slightly convex (bulging out)–typically indicating that your Eustachian tube is clogged. If this was the case, then the slight increase in air pressure during this test may have pushed your eardrum back into its rightful concave position and forced your Eustachian tube to open–hence the loud popping sound you heard. The pain you felt would likely be from the temporarily increased air pressure in your middle ear as this was happening.

If your ear is now hearing at its normal level, I don’t think there was any damage at all.

by Neil Bauman, Ph.D.

A lady wrote:

A few years ago I had a virus that apparently attacked my vestibular system. Besides various balance-related problems, I now have hearing issues. I was told that I had some hearing loss on the left (I don’t remember how much) but I also find that I am very sensitive to certain sounds and pitches (clapping, crowds, high pitches). Because of the hearing loss, my husband wants me to go to an ear specialist, but I feel that there is nothing they can do for me, and the sound sensitivity would be worse with any sort of hearing aid. I’m not sure whether to pursue these issues. If there is anything that can be done, and if I do peruse them, what sort or specialist I should see? Can you point me in the right direction?

You bet. I’ll tell you which specialist you should see in a moment, but first, I’d like to address some of the interesting points you bring up.

Viral attacks can indeed cause balance problems. In addition, they can cause hearing loss and distorted hearing. Sometimes the balance system is harder hit, and other times the virus mostly attacks the hearing system. In fact, viral attacks can result in massive hearing loss. Fortunately, your hearing loss isn’t as bad as that.

However, you have another problem besides just not hearing as well as formerly. You are now super-sensitive to various normal sounds that never bothered you before. This is a real pain–literally.

The fancy names for these kind of conditions are hyperacusis and recruitment. Recruitment accompanies hearing loss, whereas hyperacusis can occur whether you have a hearing loss or not.

In any case, the result is basically the same no matter which one you have–certain normal sounds now sound much too loud. If you want to learn more about recruitment see my article “Recruitment Explained.” In addition, you might want to read a short book called “Supersensitive to Sound? You May Have Hyperacusis.”

Recruitment is no fun. I know. I have severe recruitment myself. Just putting a glass on the table can blow the top of my head off (figuratively speaking of course) as it sounds so loud to me.

The hearing specialist you want to go to is an audiologist (Au.D)–not a medical doctor (M.D.) Your audiologist will do a complete audiological evaluation and can recommend (and fit) hearing aids if they are appropriate.

The surprising thing is that hearing aids (properly adjusted) can actually help your sound sensitivity–assuming you have recruitment associated with your hearing loss. Your audiologist can set your new hearing aids to “compress” the recruiting sounds so they no longer bother you.

For example, I just got new hearing aids in the last month or so, and for the first time in 50 years of wearing hearing aids I can now stand certain sounds that always were too loud before. I’m still working on “tweaking” them to cut out all recruiting sounds. So far, I’ve eliminated about 90% of the formerly troublesome sounds. You may find the same thing happens with you with the right hearing aids. The latest technology is amazing.

At the very least, you should investigate whether this will work for you too. I think its well worth a trip to an audiologist.

by Neil Bauman, Ph.D.

One hard of hearing lady lamented:

For the last 3 years I have avoided like the plague a candlelight dinner that my husband and my friends go to each year at the holidays. Does a hard of hearing person hate anything more than a dark room with flickering candles and everyone talking at different tables while trying to eat? My heart is pounding as I type this even though everyone talks about how nice it is, how romantic, how fun, etc.

If I told my friends the reason I don’t go, they would immediately call for lights on and hang everybody else! This year they are planning it again, and I will again have to come up with a realistic excuse. That, or try it and see if I live through the experience. Should I advocate for me–one person, at the expense of everyone else?

I know how you feel. I used to feel the same. To answer your question, no you should not spoil it for everyone else, but yes, you should advocate for yourself. The trick is to find a solution that meets both needs.

Believe it or not, there are some tricks that can actually make a candlelight dinner a reasonably enjoyable experience in spite of the low light. Here’s how.

First, who said you could only use 1 or 2 candles per table? Use lots of candles, the more candles–the more light! (Let’s not get carried away and have an inferno burning on your table–but 6 or 8 candles gives you much more light than 1 or 2 candles and yet doesn’t spoil the romantic ambience.)

Second, the placement of the candles makes all the difference. Traditionally, you place candles in the center of the table. Unfortunately, this means that you you, the hard of hearing person, have a candle shining right in your eyes making it difficult to speechread the person across the table from you.

A much better way is to arrange the candles to the sides. For example, you could line up several candles in two rows–one on each side of you. Now you have adequate light in order to speechread your partner, and at the same time you don’t have any candles shining directly in your eyes.

One final tip. Try this out at home some time. See how many candles you need and their best placement for you. Then, when you are dining out, you can ask the waiter for the number of extra candles you need. As an added bonus, you now already know how to quickly arrange them for the best effect.

Just doing these two things can make dining by candlelight possible–especially if it is just the two of you. It works for me.

by Neil Bauman, Ph.D.

A young man wrote me:

I am a 3rd year student at college. I am also a part time DJ [disk jockey], thanks to my very deep love and passion for music. Before I started working as a DJ, I had taken very good care of my ears, and I can assure you I had perfect hearing until recently. I have been working as a mobile DJ for over 6 months now, and have done a large number of shows.

After every show I do, I experience temporary tinnitus and hearing loss for a few hours. Now, with every show I do, the resulting tinnitus and hearing loss is lasting longer and longer.

My hearing used to return to normal in the morning after gettting up from sleep or resting. However, since the last two shows, it just feels the same even after sleep or rest. It does not seem to be coming back. I am really worried now that I have caused some permanent damage to my hearing.

Although I had the possibility of hearing damage in mind before I started DJing, to be honest, I was willing to give it a shot because I did not really think the loud sounds would affect my ears so quickly.

As a very passionate music lover, the last thing I want is to lose even the slightest bit of hearing. I am willing to give up DJing for it if necessary. Is it possible to continue DJing (with some precautions) and not damage my hearing any further?

Personally, I doubt it. Let me explain. Your ears are obviously quite sensitive to loud sounds. That is why you lost your hearing faster than you ever expected.

When you have been around loud noise, you typically get tinnitus (your ears ring) and sounds seem muffled. Technically, this is called a temporary threshold shift. At first, as was your experience, this goes away in a hour or two.

With continued exposure to loud sounds, you notice that the tinnitus lasts longer and longer and finally the tinnitus becomes permanent. At the same time, the temporary threshold shift also lasts longer and longer. Finally, your hearing doesn’t recover. Now you have a permanent threshold shift. In other words, you have permanently lost some of your hearing. You have just joined the ranks of hard of hearing people.

The more you expose your ears to any loud sounds in the future, the worse your hearing will become (not to mention, putting up with loud incessant tinnitus).

You need to protect your ears. The best way is to avoid loud sounds completely. If you are going to be around loud sounds, you need to wear good ear plugs with a rating of about 30 dB. This would drop the volume your ears hear sounds by 30 dB.

Unfortunately, even then, some of the loud sounds may penetrate to your inner ears, as they will reach your inner ears through your skull via bone conduction and continue damaging your hearing. Don’t get me wrong, the ear plugs will certainly help, but they do not offer complete protection from loud sounds.

The sensible way is to turn the music down to a reasonable level–one that will not damage anyone’s ears. If you set the music level to a maximum of 80 dB, you wouldn’t ever have to worry about damaging your ears.

He then asks:

I am worried about my current tinnitus and hearing loss. Is there anything I can do now to cure it, and thereafter prevent anymore of it?

If the hearing loss is permanent, it is now too late to do anything about getting it back. Your aim needs to be in preventing any more hearing loss in the future. The simple answer is that you need to avoid loud sounds in the future (or wear ear protectors).

Incidentally, it is not well known, but smoking and noise can team up to really damage your ears–more than either alone would do. Your ears may be particularly sensitive to this combination, and since “90% of my gigs gigs are at clubs, or places where a lot of people in the room are smoking,” this could be a contributing factor to your hearing loss.

Finally, he asks:

I am rather curious how everyone else in the industry, including musicians and DJs (not to mention regular club-goers and loud music listeners) who have been doing this for a long time still manage to (or at least appear to) be hearing fine? Is it that they DO suffer from hearing loss but are unaware of it? Or is it that they’re much too young to actually start feeling the damage?

Good questions. I’ll bet they have some permanent hearing loss and likely tinnitus too–but maybe they don’t care. However, loud sounds do not affect everyone the same.

For example, each person’s ears are different. Some people have “delicate” ears and others have very “robust” ears–so loud sounds that damage one person’s hearing may not do the same amount of damage to another person’s hearing. Perhaps you have more sensitive ears than most. (Or perhaps you are just more aware of the damage–because you care about your hearing and are watching for any loss.)

I don’t think many don’t suffer any hearing loss. Did you know that studies show that even kids in elementary school have a lot of noise damage to their ears. I think it affects something like 15% of them. Studies of college age people show significant noise damage in considerable numbers of them so you certainly are not alone.

Also, you might be surprised that numbers of musicians now wear special musician’s ear plugs so they don’t damage their ears when putting on loud concerts. Maybe you should ask around those that have been in the business for a number of years and see if any of them wear earplugs to protect their ears.

There is actually a website for musicians who have lost some of their hearing from playing loud music. It is called H.E.A.R. (Hearing Education and Awareness for Rockers). Their website is at http://www.hearnet.com/index.shtml. You might want to check it out.