Hearing Loss Help  

by Neil Bauman, Ph.D.

Someone asked me:

Can you tell me where to find a comprehensive list of definitions of terms used in the hard of hearing community?

Sure thing. I know of three such (on-line) lists.

The first (and most complete) one is the glossary on the Hearing Loss Help website at http://www.hearinglosshelp.com/glossary.htm. (There is a link to this glossary from every page in this website.)

The second one contains short simple definitions. It is put out by audiologist Brad Ingrao, AuD. You can view it at http://bradingrao.com/hearterm.htm.

The third one contains much more comprehensive definitions, but unfortunately, it is only about half completed at this time. It is slowly being complied by Steve Barber on the NC HLAA website. You can view it at http://www.nchearingloss.org/gloss.htm?fromncshhh. (Note: Any terms with a asterisk (*) after them have not yet had definitions written for them.)

by Neil Bauman, Ph.D.

One person asked:

How concerned should we be about MP3 and other personal music players? What should we define as “too much or too loud?”

Loud sounds, whether music or noise, damage our ears. There are two factors, the volume of the sound, and the length of time you expose your ears to this volume of sound.

You can combine these two factors and express them as a “Noise Dose” or “Time-Weighted Average” (TWA). I gave these figures in my March 17, 2006 article “What Are the Safe Levels for Louder Sounds?”

The above time-weighted averages are for industrial noise. However, since music has different characteristics than industrial noise, these industrial time-weighted averages do not reflect the safe time-weighted averages when applied to listening to music through various MP3 devices such as the iPod.

Brian Fligor, D.Sc.has measured the volume of sound the iPod Nano actually pumps into our ears. Based on his studies, the following table reveals the safe time-weighted averages for listening to the iPod Nano at various volumes.

If you do not want to damage your hearing, you would do well to heed the above safe times. As you can see, if you keep the volume below 50% you can very likely safely listen to your iPod virtually all the time.

In contrast, if you insist on listening to it full volume, just one minute will give your ears their safe daily dose. If you exceed this time, expect hearing problems in your future because that is almost certainly what will happen.

(The information in this article came from the article “Portable Music and Its Risk to Hearing Health” by Dr. Brian Fligor.)

by Neil Bauman, Ph.D.

A lady asked:

In your article of December 5, 2005, Super-Sensitivity to Sounds you discussed recruitment, from which I suffer severely. I have been unable to find an appropriate hearing aid, although audiologists have said that newer aids might benefit even my profound deafness. Would you tell me the type of hearing aid you use, so that I could try that make and model. I am quite desperate, unable to converse even with my family, and terrified of cochlear implantation-any advice would be welcomed.

When you have a profound loss, recruitment can really be a problem. For some people, as soon as any sound becomes loud enough to hear, it is already too loud to stand. If that is your situation, then hearing aids won’t help you.

However, if you have a bit of dynamic range in which to play (even 20 or 30 dB) then properly fitted hearing aids should be able to help you. (Your dynamic range is the area between the softest sound you can hear and the loudest sound you can stand for any given frequency.)

In order to have hearing aids properly adjusted for you, you need a recent audiogram and you need to have your recruiting levels measured for each frequency and plotted on your audiogram. (In 50 plus years of wearing hearing aids, I think I’ve only had this done once!)

To find your recruiting level at each frequency, your audiologist uses the same pure tones used to find your degree of hearing loss, and continues to raise the volume until all of a sudden your recruitment kicks in and you blink/jump/wince/whatever. They plot these results on your audiogram.

Whoever fits you with a hearing aid then knows that they have to set the compression on each frequency band so that the output of that band never exceeds this figure. In fact, it should be set a bit below this level.

Once you have your recruitment levels plotted on your audiogram, you can go to the same place I got my hearing aids. You likely won’t be able to use my exact model as it won’t have enough power for a profound loss. Mine are medium power (MP), not high power (HP) aids. Mine are also WB–wide band–aids as I have a reverse slope loss and can take advantage of my hearing in the frequencies above 8,000 Hz. (These aids can amplify sounds up to 16,000 Hz.)

I got my hearing aids from America Hears. Look over their website. They produce the Freedom line of hearing aids. All their hearing aid models and prices are listed there–no hidden charges. You’ll want the BTE aid, but the HP model, not the MP model I have.

Email audiologist Kelly Malick at America Hears and tell her I sent you, and that you have severe recruitment like I have. You’ll also have to either mail or FAX her your recent audiogram with all the above info marked on it. (You could phone her at 1-800-492-4515 if you can hear on the phone.)

When she gets your audiogram, she can tell you whether their hearing aids can likely help you or not.

One of the things I like about this company is that they don’t charge you anything if they can’t help you–no restocking charge for returned hearing aids for example.

Another nice thing is that their hearing aids are only about half the price of comparable hearing aids from other companies so you can expect to save $2,000.00 or more on a pair of aids.

Still another nice feature is that they can program your hearing aids over the Internet so you never have to physically go there to be “fitted.” It can all be done on your computer, and over the Internet, and, if you can’t hear on the phone–via email. This is a wonderful (and unique) service. In addition, if you are computer savvy and want to tweak your hearing aids, you can do this yourself on your own computer. However, if you are scared to do this, they will do it for you, and then you can immediately download the new programs into your hearing aids. I love this service.

by Neil Bauman, Ph.D.

A lady wrote:

I need some emotional support for my hearing loss. Could you recommend a hearing loss support group near me?

There are very few support groups in the USA that are focused on emotional support where you sit around and share experiences. All is not lost though. There are two kinds of groups that I can heartly recommend.

If you want a physical group where you meet monthly, join the local chapter of the Hearing Loss Association of America (formerly Self Help for Hard of Hearing People). To find the closest chapter to you, go to http://www.hearingloss.org/StateChap/states_and_chapters.html, click on your state and then contact the chapter of your choice.

If you would like a cyber (on-line) support group, the SayWhat Club (SWC) is the best support group there is for hard of hearing people. The SWC is divided into a number of subgroups or “families” with different “personalities.” You join the one that best suits your needs. In each group or family, all emails are automatically distributed to all members via a listserv.

You can learn more about the SayWhat Club at http://www.saywhatclub.com/. To join the SWC, click on the “Subscribing to SWC” button and then follow the directions. You will be contacted by someone from the hospality committee and they will lead you through the membership process. Incidentally, the SWC is a closed group–that is, you have to apply and then be accepted to get in. However, it is definitely worthwhile if you want help and support and friendship. (You might even get more than just friendship. I met my wife in the SWC a number of years ago.)

If I were you, I’d join both of these groups. Each serves a slightly different purpose–but their goal is the same–helping hard of hearing people live successful lives in spite of their hearing losses.

by Neil Bauman, Ph.D.

A young man asked:

What is the safe range of sounds for human ears? How long can a person be in a dangerous range range before damage occurs? Are we talking about hours, minutes or just seconds?

The current wisdom is that sounds that always remain below 80 dB are safe for our ears and will not cause any damage no matter how long we listen to them.

Above that, OSHA has set the following rules for workplace exposure. You should take these guidelines for all noise exposure–whether it is recreational noise, traffic noise, workplace noise, or the noise you pump into your ears listening to iPods, MP3 players and related devices.

Here’s how it works. For each 3 dB (decibels) you increase the sound, you need to cut the time your ears are exposed to loud sounds in half. Here is what the maximum safe time and sound level chart looks like.

Some iPods can produce sounds up to 117 dB–but how many people do you see wearing them for only 15 seconds? That’s how many people are damaging their ears if they have them cranked wide open.

If you want to be safe, and want to listen to your iPod for say 2 hours a day, then make sure you set the volume to limit the peaks to 91 dB or less, and for the other 22 hours in the day, you give your ears a rest and keep all sounds below 80 dB.

by Neil Bauman, Ph.D.

A lady asked:

I’d like to know if nerve damage can cause loss of sense of pain, say from ear infections. There are times when I have water in my ears, and don’t realize it until I use my hearing aids.

Good question. Let me explain. Nerves have specific functions. Some carry pain signals from pain sensors. Some carry signals for muscle movement. Others carry the sensations from one of our five senses.

In this case, the auditory nerve is just that. Its has only one function–sending hearing related signals to and from our ears to the brains.

It is not a pain sensor nerve, nor does it control the tiny muscles in the middle ear. So, having “nerve” deafness (which is really a misnomer in almost all cases–the proper term is sensorineural hearing loss) will not affect the sense of pain in your ears. That job is relegated to other nerves.

by Neil Bauman, Ph.D.

A grandaughter wrote:

My grandmother is 93 years old. She is deaf in one ear and uses a hearing aid in the other. For the past month she has been calling and complaining about the upstairs neighbor and all the noise and “music that goes on all night long.” We have complained to the management company that runs the senior’s complex about the noisy neighbor because my grandmother is completely sane and not suffering from any kind of dementia in any way.

We believed her and supported her allegations until I finally stayed overnight with her on several occasions. Within an hour of going to sleep, she would awake abruptly, get up and tell me to listen to the horrible music. There was nothing! I could not hear a thing.

This happened regularly every hour or so. Again and again she got me up to hear it now! Always, there was nothing. When I told her there was nothing, she was furious. She told me there was something wrong with me!

I began to think that dementia of some sort was finally, after 93 years, beginning to affect her–until I found the article on MES on your web site. Whew! What an incredible relief to find out that her Musical Ear syndrome is real.

Is there a remedy for this?

As you now know, these musical sounds are totally real to the person “hearing” them. This is because they occur in the auditory circuits in the brain where a person perceives sound. Thus these phantom sounds are absolutely indistinguishable from real sounds.

That is why your grandmother was acting totally rational (to her), and at the same time seemed to be acting totally irrational (to you).

I think you can now understand her confusion. The music sounds real and wakes her up–yet it is totally phantom.

What is the remedy?

Perhaps the most important thing you can do is to explain to your grandmother what is really going on. Explain that she is neither going crazy, nor does she have some dreadful brain tumor. These are the two biggest fears of people who experience Musical Ear syndrome.

Just setting these two fears at rest goes a long ways towards bringing peace of mind to such people.

You can explain that her brain is playing “tricks” on her, and that she needs to realize that music she hears in the night is almost certainly phantom no matter how real it sounds. (After all, she does live in a senior’s complex where people are typically quiet.) She needs to use logic now to try and determine if a sound is real or not, rather than just accepting sounds at face value.

In my book, “Phantom Voices, Ethereal Music & Other Spooky Sounds,” I explain 7 other things you (and she) can do in order to help bring her phantom sounds under control.

In addition, by reading it, or you reading selected portions to her, she will discover that she isn’t the only one experiencing these phantom sounds. She’ll feel right at home as she hears about the many other people that have similarly strange experiences.

by Neil Bauman, Ph.D.

Finding a cell phone that is loud enough for people with severe hearing losses can be a challenge. Following is what Sarah discovered when she went looking for a new cell phone she could hear.

Sarah wrote:

I love my new bluetooth-equipped LG 8100 flip-style cell phone. It has really good volume and tone for me. With my hearing aids in, I can hear much better on my new phone than I could on my old one. Also, it has a pretty good Speakerphone with dual speakers on it–much better than most cell phones have. I’ve noticed I can hear on the earpiece a lot better with no “whistling” from my hearing aid. However, I always need more volume.

One more thing that is great about my LG8100 is that when it rings a little strobe light flashes, so even if I don’t hear it, I can see it flashing! It’s great for me! Also, the ringer on this phone is very loud.

I am also very impressed with my husband’s new LG 4650 flip phone from Verizon. It has a spectacularly-loud Speakerphone on it–the best I’ve ever heard! I can even hear through the Speakerphone and also the earpiece on that phone when I don’t have my hearing aids in, which is remarkable for me. I’m amazed. It’s even louder than the LG8100 I purchased.

I would have gotten the LG 4650, but I wanted one with Bluetooth and a camera. Unfortunately, the LG 4650 doesn’t have either, but it is a very good phone in all other ways, including a nice interior color display. It is tri-band (picks up both digital and analog signals), so has very good reception. The LG 4650 would be a great phone for hard-of-hearing people–in fact, when I’ve listened to voice messages played back on his phone through the Speakerphone with the volume turned up high, it was so loud it actually hurt my ears when I was wearing my hearing aids!

If you are having difficulty hearing on a cell phone, and are in the market for a new phone, you might want to check out either of these phones. Like Sarah, you also might be pleasantly surprised.

by Neil Bauman, Ph.D.

A couple wrote:

We found your writing on Large Vestibular Aqueduct Syndrome (LVAS) and other topics extremely helpful.

We are wondering if the information on LVAS is up to date, or if there are recent developments since 2002 when you did the write up. We are also wondering which centers in the US, and the world, are working intensively on this problem.

Glad my article on Large Vestibular Aqueduct Syndrome (LVAS) helped you.

I’m not aware of any major breakthroughs in either the understanding of LVAS or its treatment–so the information is generally still up to date.

However, one thing that seems to have changed is the definition of exactly how large the vestibular aqueduct (VA) has to be in order to be considered enlarged. In my article it was defined as being 1.5 mm or larger at the midpoint of the VA. Currently, some doctors say this is much too large, and think the correct definition should be more like 0.8 mm or so.

I really don’t have an opinion on this as there doesn’t seem to be any clear correlation between the size of the VA and the resulting hearing loss. Thus there must be other factors that need to be discovered and evaluated.

The only major study on LVAS of which I’m aware is being conducted here in the USA at the National Institutes of Health. When it is completed (hopefully in the next 3 or 4 years), I think we will have a much better idea about LVAS than we do now. Until then, I guess we just have to wait.

by Neil Bauman, Ph.D.

A man explained:

I want to order the T-Links. Although your website suggests getting the dual model, I may order the single ear model because I think I may be fumbling around too much trying to put a T-link behind each ear. I’m not on the phone all the time at work and envision putting the T-Link on as needed.

I understand. It is a bit of a hassle when the phone rings to put the T-links on, switch your hearing aids to t-coil mode, and answer the phone all before the person hangs up.

However, if you have trouble hearing and understanding on the phone, hearing with two ears will give you much better comprehension than just hearing with one ear.

Here’s a way to still hear with two ears and yet answer the phone quickly.

Get the dual T-links and when the phone rings, quickly put one T-link over one ear and flip the t-coil on that hearing aid on. Leave the other ear hook dangling while you answer the phone–then, once you are all connected and are talking you can leisurely hook the other T-link over your other ear and flip that t-coil on so your second ear can join in on the conversation. You should notice a dramatic increase in both your comprenhesion and ease of listening.

If the call is going to be short, and you can hear the person well with just one ear, just leave the second t-link dangling for that call.

This way, you can always get the benefit of both ears when you need it and yet still answer your phone reasonably fast.

Learn more about T-Links here, or order T-Links for yourself here.