Hearing Loss Help  

by Neil Bauman, Ph.D.

If you want to find if any captioned movies are showing in movie theatres near you, you just need to ask Fomdi, a cute little guy that lives at http://www.fomdi.com.

Fomdi is a handy new on-line tool. All you need to do is enter your state, city or zip, the maximum distance from your location you want to travel (5 to 40 miles) and the day you want to go, click “find”–and in a few seconds Fomdi will produce a list of the captioned movies near you. Cool!

The results may not be perfect, but they are far better than nothing. The Fomdi website further explains:

Most sites do not yet add captioned films beyond 7 days.

Fomdi finds captioned films at sites that advertise captioned films, and tells you about it. However, Fomdi is not responsible if the films are not captioned, as the sites advertise them to be.

If too few or no showtimes are found in your area, increase the search radius around your zipcode. Also, try different dates. Some theaters are known to show captioned films, for example, on Tuesdays and Thursdays only.

Try it out. I think you’ll like it if you are a moviegoer.

by Neil Bauman, Ph.D.

A mother wrote:

Do most hard of hearing children also have auditory processing issues? It would seem to me that since most hearing losses are sensorineural that the processing would be difficult. Are hard of hearing children referred to as auditorily impaired?

Yes, hard of hearing people have auditory processing issues, but not in the way you are thinking.

We really have speech processing issues. For example, the reason we call ourselves “hard of hearing” is because hearing is “hard”. It is not easy to process the fragmentary sounds our ears hear, the speech movements our eyes see and put this together with what we know about language and the subject being talked about and come up with the correct answer. This speech processing takes a lot of brain power and leaves us tired.

But this is not what they call CAPD–Central Auditory Processing Disorder. There is nothing wrong with how our brains process sound–assuming we hear enough for them to process something!

You are trying to put too many labels on us. Incidentally, the term “impaired” when referring to us is not our favorite term by any means. The terms we like people to use when referring to us are “people with hearing loss” or “hard of hearing people”. Leave the impaired out of it. (I always think of a “hearing impaired” person as someone with normal hearing that gets pulled over by the cops for drunk driving!)

by Neil Bauman, Ph.D.

A man wrote:

I have tinnitus and I would assume some age-related as well as other hearing loss related to my work. I have had three different hearing tests and each result is terrific, but does not explain why in a crowded room (bus or restaurant or something loud) I cannot hear the person right in front of me (always too low) talking to me because speech seems drowned out.

My hearing tests do not account for this. My ENT says it’s due to age, and that men cannot mulit-task as they grow older, but this sounds way to unscientific to me.

There are two issues here–what you are expecting from your ENT, and what is happening to your hearing.

First, let’s deal with your ENT and his knowledge of hearing loss. The truth is, few ENTs seem to know much about hearing loss and its ramifications.

Typically, ENTs are only concerned (and knowledgeable about) the medical aspects of your ears. To them, sensorineural hearing loss, such as you have, is not a medical thing. Thus, they don’t have the knowledge or skills to help you.

The professional trained to help you deal with your hearing loss is called an audiologist. These are the people to see about the problems you raise.

Now let’s move on to your second issue–your problem hearing in noise. You admit to having some “age-related” and “other” hearing loss, yet you claim your hearing test results are “terrific.”

This doesn’t make sense to me. How can your audiogram be “terrific” if you have some known hearing loss? It would mean a lot more if you had said exactly what your audiogram showed–giving the dB loss at each frequency tested.

I suspect your ENT meant that your results are “normal” for a person of your age and background–not that your results show no hearing loss. These are two entirely different things.

The obvious reason why you have difficulty hearing in a crowded room, bus, restaurant or other noisy place is that you have the “normal” high-frequency hearing loss that typically shows up in seniors. I’ll bet that your audiogram actually shows considerable hearing loss at 6,000 Hz and higher.

When this happens, you hear sounds just fine. The problem is that you have trouble understanding what you hear. This is because most of the volume of speech occurs in the low frequencies which you hear very well. At the same time, most of the intelligence of speech lies in the high-frequency consonants which are not very loud to begin with. If you have a high-frequency loss, you don’t hear them well, if at all. This is why you hear people talking, but have trouble understanding them.

In fact, one of the first symptoms of high-frequency hearing loss is that you begin to have more and more trouble hearing (technically trouble understanding) in noisy situations such as you are experiencing.

Also, with hearing loss comes another insidious problem. Your ears/brain can no longer separate the speech you want to hear from the background noise. When your audio filtering system doesn’t work well, all these sounds hit your ears in one loud cacaphony of sound. This makes it very hard to understand speech in noise.

The worse your hearing loss, the worse this effect typically is. For example, I have a severe loss, and in noise, I basically just speechread. The speech sounds I really need just never reach my ears.

Although you say that your “hearing tests do not account for this,” I think carefully looking at your audiogram will show that you really do have a significant high-frequency hearing loss.

When your ENT says it’s due to age, he is really saying that you have the typical high-frequency hearing loss often found in older people. What he fails to realize is the enormous impact this high-frequency hearing loss can have on your ability to communicate in noisy situations.

Putting your hearing problems down to “men cannot mulit-task as they grow older” is a bunch of baloney. Some men multi-task very well, while others cannot do this no matter how young they are.

What really is happening is that you cannot easily multi-task when you have a hearing loss and one of the tasks is listening to speech. For example,I typically have to stop everything I am doing in order to concentrate on the person talking if I am to understand anything they say. That’s just one of the facts of life when you have a sensorineural hearing loss.

by Neil Bauman, Ph.D.

A man wrote:

My daughter was just diagnosed with Large Vestibular Aqueduct Syndrome (LVAS) in one ear. Is this condition typically limited to only the currently infected ear, or can it “spread” to the other, presently uninfected, ear in the future?

Large Vestibular Aqueduct Syndrome (LVAS) is a hereditary genetic condition so it cannot “spread” or “infect” anything. Either you have it or you don’t.

However, at present, just diagnosing the presence of LVAS seems to be a matter of opinion among doctors. For example, one doctor can read your MRIs or CT scans and declare you have LVAS in one (or both) ears. Another doctor, looking at the same films, can just as emphatically declare you don’t have LVAS.

What this means is that until more is known about LVAS and how it develops in young children, your daughter’s diagnosis is open to interpretation. Thus, it is possible that your daughter may have LVAS in both ears now, although it has not been diagnosed as such at this time.

To read more about LVAS point your browser to http://www.hearinglosshelp.com/articles/lvas.htm.

by Neil Bauman, Ph.D.

Cochlear implants have come a long way in the past 25 years. Now, instead of just implanting one ear, doctors are starting to implant both ears, since having both ears implanted gives even better results than just having one implant. (After all, God gave us two ears for good reasons.)

Here is Heidi’s story of her young daughter’s oddessy into the world of cochlear implants and her amazing results.

Mallory was 26 months when she got her first implant. She only had 3-5 words when she went into the surgery. However, she quickly increased her vocabulary into the hundreds of words over the first month or two. The quality of her speech was also amazing!

Even with her unbelievable success, she still had problems localizing sounds, hearing at a distance and definitely had trouble in noisy environments.

She wore a hearing aid in the unimplanted ear (which fluctuated between 70-85 dB). After a while, we had our audiologist do 3 different hearing tests: one with just the implant, one with the implant and hearing aid and one with just the hearing aid. The results showed that Mallory was hearing about 95% from just the implant and only about 5% from the hearing aid by itself. We were pretty surprised.

We had read some articles about kids with unilateral hearing loss (which essentially she had if she was only getting 5% benfit) being at possible risk for learning difficulties–I guess because of the difficulty localizing sounds, following the spontaneity of conversations, etc., so we started looking into getting a second implant.

Basically we thought, “If we have two ears, why shouldn’t she?” At that time we knew three other families who were getting second implants for their children, so we let them go first. They were all very happy with the decision and the consensus was that their children all did much better localizing sound and hearing in noisy environments.

Since the world is a noisy place, that was enough for us to make our decision. Mallory got her second implant and now one month post implant, she is doing fantastic! She had speech recognition with just the second implant within 1-2 weeks, and now can have a conversation with just the new implant on!

Almost immediately we noticed a difference in how quickly she responds to us, how much “incidental” speech she hears (she actually “overhears” our conversations and chimes in) and really hears a lot better in noisy environments. Her speech has cleared up even more with the second implant. Her pronunciation is amazing. She is now using plurals, etc.

The best was the other day when I was standing outside waiting for the kids’ school bus in the morning and they both had winter coats AND HATS on and Mallory suddenly said “Mommy, do you hear the bird go tweet tweet?” The bird was in a tree next to a house across the street! It was pretty amazing.

Cochlear implants areindeed wonderful devices and can tremendously increase the quality of life for those that have them. I know hundreds of people with cochlear implants, and with 2 or 3 exceptions, all said that knowing what they know now, they would do it all over again in a heartbeat. That alone should tell you something!

by Neil Bauman, Ph.D.

A mother asked:

My son has Large Vestibular Aqueduct Syndrome (LVAS). I know that LVAS is genetic, but is it only the result of getting a gene from both the father and mother, or is it now a strong possibility that when my son, who has LVAS, has children, that they will have LVAS even though the mother does not have the gene? If so, is there an estimated percentage of chance that his kids will have LVAS?

Excellent questions. In order to answer this, we need a brief lesson in genetic inheritance. Here’s how I understand genetics and LVAS.

Genetic conditions may be “dominant” or “recessive.” LVAS is thought to be recessive. This means that both the father and the mother have to carry this gene and pass it on, in order for a child to have LVAS.

(In contrast, if the condition was carried by a dominant gene–then only one parent needs to pass it on. For example, I have a dominant genetic hearing loss. Thus, I have, and pass on, this gene (on the average) 50% of the time. In my case, this is exactly what happened. Of my two children, one has normal hearing and the other has my rare kind of hearing loss.)

Here’s how recessive genetic inheritance works. Each parent has two genes for any given characteristic. These genes may both be either dominant (RR), or both recessive (rr) or one of each (Rr). However, each parent only passes on one of these genes in each child. Which gene is passed on is totally random for each child.

Since LVAS is recessive only a person with “rr” would have LVAS. A person with “Rr” would be a carrier of LVAS but would not have any symptoms of it, and a person with “RR” would not have LVAS, nor carry it.

Thus, each child ends up with one of these three possible combinations. Either:

1. The child receives no LVAS gene from either parent. Result, child does not have LVAS, nor is child a carrier of LVAS (RR).
2. The child receives one LVAS gene from one parent and none from the other. Result, child is a carrier of LVAS and thus can pass it on, but does not have LVAS himself (Rr).
3. The child receives one LVAS gene from each parent. Result, child has LVAS himself (rr), and, of course, could also pass it on to his children (but only if the child’s spouse also passes on an LVAS gene at the same time).

Now let’s look at this from the standpoint of the probability of any given child inheriting LVAS. There are five possibilities.

• If neither parent carries an LVAS gene (RR), then, of course, the child will not have LVAS either. The probability of Number 1 (RR) occurring is 100%.

• If One parent carries the LVAS gene (Rr) and the other doesn’t (RR), the child will not have LVAS but may carry the LVAS gene. The probability of Number 1 (RR) occurring is 50% and the probability of Number 2 (Rr) occurring is 50%.

• If one parent has LVAS (rr) and the other does not (RR), then there is no chance of the child having LVAS, but he would be an LVAS carrier (Rr). The probability of Number 2 (Rr) occurring is 100%.

• If one parent has LVAS (rr) and the other is a carrier of LVAS (Rr), then the child will either have LVAS (rr) or be a carrier of LVAS (Rr). The probability of Number 2 (Rr) occurring is 50% and the probability of Number 3 (rr) occurring is 50%.

• If both parents have LVAS (rr), then each parent HAS to pass on an LVAS gene to the child, and thus the child has will have LVAS (rr). The probability of Number 3 (rr) occurring is 100%.

The above make two assumptions. One, that LVAS is carried by a recessive gene (which is almost certainly the case), and two, that there is only one gene involved in causing LVAS (which is not likely to be the case). If there is more than one gene involved in causing LVAS, then the probabilities are obviously much more complicated than shown above.

The fact that your son has LVAS (rr) means that both you and your husband either also have LVAS yourselves (rr), or you are carriers of LVAS (Rr). This means that only possibilities C, D or E apply in your case.

If you want to learn more about LVAS and how it can affect a person’s ears, point your browser to http://www.hearinglosshelp.com/articles/lvas.htm.

by Neil Bauman, Ph.D.

A lady asked:

Could you please tell me if the drugs called Zolmitriptan (Zomig) and Rizatriptan (Maxalt) can affect hearing? I have found that my hearing declining and I’m trying to figure out what’s causing it. My ear doctor doesnt know so I’m looking for the reason.

According to my information, neither of these drugs is known to cause hearing loss. However, that is not to say they are not ototoxic.

Both of them can cause hyperacusis (where normal sounds are now too loud), tinnitus (ringing in the ears), and balance problems such as ataxia (staggering gait), dizziness and vertigo (spinning sensation), as well as ear pain.

However, looking at the drugs in the “triptan” class, I find that two of them, Naratriptan (Amerge) and Sumatriptan (Imitrex), are listed as causing hearing loss. Since drugs in the same class tend to have the same side effects, it wouldn’t surprise me in the least if Zomitriptan and Rizatriptan will someday be found to cause hearing loss too.

In fact, you may be one of the first people to report such a side effect for these drugs. This isn’t at all surprising for two reasons. First, most serious side effects of drugs are not discovered during the clinical trials, but afterwards as people report side effects. Second, few drugs are specifically studied to determine their ototoxicity during clinical trials. Typically, it seems that ototoxic side effects are noticed “accidentally.”

by Neil Bauman, Ph.D.

The following is part of the reply Christa sent to my LVAS group. It was in reply to a mother’s question about her young son who is now deaf in one ear from the results of Large Vestibular Aqueduct Syndrome (LVAS). (If you want to learn more about LVAS or join this wonderful group, click on Large Vestibular Aqueduct Syndrome (LVAS).)

The information in Christa’s reply fits not only those with LVAS, but any child with a severe or worse hearing loss in one ear. In fact, much of what Christa says also applies to any hard of hearing child, not just children with hearing losses in one ear.

Here is her excellent summary of what it is like to live with only one working ear.

If your son is now deaf in his right ear, that means he no longer has directional hearing, as this requires two working ears. (This is a subject close to my heart, as I was deaf in one ear all my life.)

• He can’t hear direction, so when you call him, don’t just call him and say, “Come here.” He can’t tell where you are, no matter how hard he tries. Instead, you need to tell him where you are. For example, “Parker, please come here, I’m in the kitchen.” I used to feel really bad as a child because my parents thought I was being naughty when actually I had no idea which way to go.

• It is best to avoid games of being blindfolded or closing eyes, as again, he can’t hear direction. As a result, you are setting him up for failure if he plays games such as “Blind Man’s Buff” or “Marco Polo” (or whatever the version is in your country).

• When he is old enough for school, make sure he is placed where he can see the teacher all the time. Hearing aids just don’t give perfect hearing, and he won’t hear anything behind his back. Also, make sure that his teachers know that he cannot follow group discussions, as he can’t figure out which person to turn towards before they have finished speaking.

• He can’t focus on one sound over another. A person with normal hearing can focus on a conversation, even if there are other conversations or background noise around. A person without directional hearing just can’t do this. Therefore, minimize background noise wherever it is possible in the home and places you visit. For example, turn off the TV and radio when he is not directly listening to them.

• Get the family to speak one at a time. If he has older siblings who find this hard to remember, get an object (like a wooden spoon) and, at the family dinner table, only the person with the wooden spoon can speak. If two or more people speak at once, you are effectively (deliberately or not) excluding your son from the family conversation. Unfortunately, this is really, really hard for people not used to it. My own original family can’t speak one at a time, even though my mom was an audiologist and my dad himself wears a hearing aid. I just sat there and got a glazed look on my face after a while.

• A lot of social interactions and rules are normally picked up by overhearing what people around you say. However, I missed out on a lot of this and your son might too. So, if he seems socially awkward, try some role playing in private, acting out what to do in certain situations. Don’t assume he knows how to say hello, goodbye, how to excuse himself or how to introduce himself to others and start a conversation. I never realized how much kids learn by overhearing until I had one of my own. (My girls are now aged 5 and 3). Carmel had better social skills at 4 years old than I had at 25 years old!

• Be aware that your son cannot hear what direction things are coming from. I know he is too young right now, but when he gets old enough to cross the road by himself, he has to be extra careful about checking visually for traffic, and only crossing with the lights etc, as he cannot hear which direction a vehicle is coming from and, indeed, may not hear it at all until it has passed, if it is coming from his deaf side. Also clue him in to watch for reversing lights in shopping center parking lots and not walk behind those vehicles.

Thanks for the excellent advice Christa!