Hearing Loss Help  

by Neil Bauman, Ph.D.
 

A man wrote:

My question is about hearing aid effectiveness. I notice that some people talk about having hearing aids but still having problems hearing. At the price that hearing aids go for, while I don’t expect to have Superman’s hearing, I thought I would be getting rid of the mumbles. I would expect issues such as background noise, certain sounds amplified that you don’t want to hear etc, but I do expect to understand what people are saying at a conversational level, even on the phone. Why are people having problems understanding conversational speech?

That is a good question. Let me explain. You need to realize that when hearing loss occurs, a number of things happen.

First, obviously, there is a hearing loss. If this was all that happened, then hearing aids could easily fix this problem by providing exactly the right amount of amplification at each frequency to make up for the hearing loss.

But this is not all that happens. Coupled with hearing loss is a decrease in the ability to discriminate between similar sounds. Thus speech, even when at a comfortably loud level, sounds “fuzzy” or “muddy”. You hear people talking, but just can’t quite understand what they are saying. Amplifying this just makes louder “fuzzy”. It does little to make it clearer.

It’s analogous to wearing glasses. If your glasses are ground wrong (fuzzy) you see everything fuzzy. But if your glasses are ground correctly, you expect to see clearly. But this does not always happen because the “fuzzy” may be in the lens of your eye. The light passes clearly though your glasses, but then gets “messed up” as it passes through your “fuzzy” lens.

This is exactly what happens with hearing. The amplified sounds may pass clearly through your hearing aids–but then they hit the “fuzzy” cochlea and you hear distorted speech. This is not the fault of the hearing aids, but of a damaged auditory system.

This is why we call hearing aids “hearing aids“—they are aids to better hearing, not the cure for poor hearing.

The worse your discrimination scores, the less you can expect hearing aids alone to help you. For example, with my hearing aids, my discrimination is approximately 62% or so. This means that out of every 100 words spoken, and when amplified properly for my hearing loss, I still don’t understand 38 of them. That is why I always speechread at the same time—to fill in the “fuzzy” words.

by Neil Bauman, Ph.D.
 

A teacher asked,

I’m a high school teacher. I have a severe bilateral sensorineural hearing loss. I wear 2 digital hearing aids. I’m trying to find a way to assist myself in my job. I’ve been researching and not having much luck. I’m wondering if you have any suggestions on any technology that could help me?

You betcha! I’m assuming that your biggest problem is hearing your students in the classroom. There are a number of tricks of the trade that can help you.

Depending on the age of your students, you can:

1. Ask them to speak a bit louder, slower and clearer and look at you when they are talking.

2. Go right up to them to hear them, rather than just standing at the front of the room.

3. When you miss something, ask a student near the front (and one whose voice you know you can hear) to repeat the missing information.

I’ve done all three of these as the situation requires it.

However, you asked about technology to help you. One thing I recommend is a super-directional microphone that was designed for a teacher in just your position.

When you want a student to reply, you simply point the microphone at them. That is their cue. Because it is super-directional (+/- 15 degrees), it really cuts down any other sounds in the room. Thus you hear the student talking loud and clear.

Here’s how to use it. You will need hearing aids with good t-coils in them, a PockeTalker (or other personal amplifier), a neckloop or Music Links and the directional microphone.

(If you don’t want to wear hearing aids for whatever reason, you can dispense with the hearing aids, neckloop or Music Links and simply use earbuds instead. I do this quite often myself.)

Plug the microphone into the microphone jack, and the neckloop or Music Links into the earphone jack (the Music Links require a stereo to mono adapter), switch your hearing aids to t-coil mode, adjust the volume on the PockeTalker for the volume you need, point the microphone at the student you want to hear and voila—you hear him or her loud and clear.

To give you an idea of just how well this works, recently I was at a conference and was visiting the exhibit hall. With both my hearing aids on and their mics in the directional mode, I was having a tough time hearing the salesperson in the booth because of the cacophony in the background. I had to speechread and still strained to understand.

When I had enough of that, I took my hearing aids off, got out my PockeTalker, plugged in the directional mic and my favorite pair of earbuds, barely turned the volume on, aimed the mic at the salesperson and WOW–the salesperson’s voice was loud and clear while the background noise dropped dramatically. It was actually a pleasure to talk to people under those conditions, whereas a minute before, it was almost impossible.

I’d certainly give this arrangement a try. You may be thoroughly pleased with the results.

Here are the links to the various pieces of equipment I mentioned above.

PockeTalker (personal amplifier)

Neckloop

Music Links

Directional Microphone

by Neil Bauman, Ph.D.

An audiologist wrote,

I have a patient who is in the nursing field and has a severe-profound hearing loss (70-90 dB). I have recommended amplified stethoscopes before, but I’m not sure if they would be strong enough for her loss.

Another lady asked,

Do you have a reference or a source for the purchase of an amplified stethoscope? I’ve looked online, and they’re really pricey: $300 and up.

Yet another person asked,

Do you know if there are stethoscopes that you can use with a cochlear implant? I have looked on the Internet but can’t find what I am looking for.

The good news is, yes there are amplified stethoscopes readily available to help hard of hearing medical professionals do their jobs. Just do a Google search for “amplified stethoscopes” and you will find a number of suppliers. The bad news is that they can be quite pricey—ranging in cost from $200.00 to over $1,000.00—but you get what you pay for.

If you don’t wear hearing aids, then a “plain Jane” amplified stethoscope may be what you want.

However, if you want to link your hearing aids or cochlear implants to the stethoscope, then you need one with an output jack so you can plug in a patch cord to your cochlear implant, or plug in a neckloop for your hearing aids.

Some of the fancier stethoscopes also have digital displays so you don’t even have to hear at all in order to take blood pressure readings.

Here is probably the most complete source for amplified stethoscopes.

They have a 30 day “walk and wear” guarantee—so if you buy one and then realize it won’t work for you, you can return it for a full refund.

by Neil Bauman, Ph.D.
 

A lady explained,

I’ve been diagnosed with S.A.D—Seasonal Affective Disorder, a depression/chemical imbalance related to the seasons and environment, and also related to serotonin imbalance. I’m still discovering what this is about and getting counseling. I have been recommended a low grade serotonin anti- depressant and wonder if this will in any way disturb or cause vertigo as I have a history of vertigo and vestibular imbalances.

Generally, the SSRIs as a class are not good for our ears. They are all quite ototoxic in my opinion. I’d definitely stay away from SSRIs such as from Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine and Sertraline if you value your ears.

All of the above can cause ataxia, dizziness and vertigo plus most can cause hyperacusis, hearing loss, ear pain and tinnitus. Not the kind of drug I’d want to take, and probably not a drug you’d want to take if you are already predisposed to vertigo.

Personally, I wouldn’t take a prescription “low-grade” antidepressant in the first place. There are alternatives that are not damaging to your ears. However, if you really do need an antidepressant, why not consider the herbal St. John’s Wort. Numerous studies have shown it works as well as the prescription antidepressants for mild and moderate depression yet doesn’t have any ototoxic side effects. This is what my wife takes when she needs some help and it definitely works for her. You might want to check it out for yourself.

You can get St. John’s Wort in most drug stores and health food stores. Just check that it is “standardized to 0.3% hypericin”, then follow the directions that come with it.

Note: if you are on other prescription drugs, run this by your doctor or pharmacist before you take it to be sure there are no unwanted interactions between the St. John’s Wort and your other medications.

You can check out the ototoxic side effects of the SSRIs and any other drugs before you take them in “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs known to damage ears.

by Neil Bauman, Ph.D.
 

Viagra (Sildenafil) is quite ototoxic. I have listed it in my book “Ototoxic Drugs Exposed” for several years as known to cause hearing loss, tinnitus, ataxia, dizziness, vertigo and ear pain.

Now it seems it is even more ototoxic than previously thought. On October 18, 2007, the FDA issued a special warning not only for Viagra but also for Cialis (Tadalafil) and Levitra (Vardenafil) that these drugs can cause sudden hearing loss. (1)

Sudden hearing loss (partial or total) can occur within hours to two days after taking Sildenafil or similar drugs. So far, 29 cases of sudden hearing loss have been reported. For some reason, hearing loss usually occurred in just one ear. The hearing loss was sometimes accompanied by tinnitus, dizziness and/or vertigo indicating that these drugs damage not only the cochlea (hearing system), but also the vestibular (balance) system.

The hearing loss was noted as temporary in 1/3 of the cases, leading me to believe that in the remaining 2/3 of the cases, hearing loss was permanent.

What the report doesn’t tell you, is that these drugs also have a good number of other side effects—for example eye problems including blindness. I can’t think of anything much worse than becoming both deaf and blind at the same time. Another side effect is death.

Therefore, I suggest you carefully investigate all the side effects of these drugs before deciding whether to take one of them or not.

However, on a lighter note (and with tongue firmly in cheek), if you do decide to use them, although you may die deaf, you will die happy!

(1) FDA Announces Revisions to Labels for Cialis, Levitra and Viagra

by Neil Bauman, Ph.D.
 

Meniere’s Disease is actually a syndrome (collection of symptoms) including a fluctuating hearing loss, vertigo, tinnitus and a feeling of fullness or pressure in the affected ear. Meniere’s Disease affects in excess of 2.6 million people in North America and Europe. For most people with Meniere’s, the vertigo is the most debilitating aspect of the disease.

Meniere’s Disease is thought to be caused by excessive fluid (called endolymph) in the inner ear. (The fancy name for this is endolymphatic hydrops.) Therefore, typical treatments have focused on things to reduce fluid retention in the body such as a very low sodium diet, eliminating or greatly reducing both caffeine and alcohol consumption and typically also taking a diuretic (water pill).

If these measures don’t work, then doctors have a number of other things they can try, but all of them can have nasty side effects and may not work. Some of these include intratympanic corticosteroids (injecting steroids through the eardrum), endolymphatic sac shunt (invasive and not found to be very effective) and intratympanic Gentamicin (injecting Gentamicin through the ear drum which can result in hearing loss while controlling the balance problems). If all else fails, doctors may cut the vestibular nerve to totally destroy balance on the one side (vestibular nerve section) or surgically remove the whole balance system on one side (labyrinthectomy). These are rather drastic measures and leave the person with a weakened balance system as the other ear’s balance system has to do all the work.

In recent years, there has been another treatment that has proven to cut the frequency and severity of Meniere’s attacks way down, yet is only minimally invasive (tube in eardrum) and has not shown other negative side effects. This is called Meniett Therapy.

With Meniett Therapy, the person first has a tube placed in the eardrum on the affected side. Then, 3 times a day for 5 minutes at a time, the person uses the Meniett device (a digitally- controlled, pager-sized low-pressure pulse generator) to deliver low-pressure pulses to the middle ear via a clear plastic tube with a special ear tip that you put in your ear. These low- pressure pulses act on the round window membrane. Doctors believe that the energy of the low-pressure pulses displaces the perilymph (the other inner ear fluid), which in turn stimulates the flow of the endolymph, and results in a reduction of the endolymphatic fluid, thus relieving the symptoms of Meniere’s Disease.

If you have Meniere’s Disease and are having problems keeping the attacks under control, you might want to investigate whether Meniett Therapy will help you. The doctor best able to help you is an ear specialist called an otologist.

To learn more about Meniere’s Disease and how you can help bring it under control click on the above link.

by Neil Bauman, Ph.D.
 

Loud sounds damage our ears. But how loud is too loud? Which devices produce sounds that are too loud? What can we do to protect our ears from loud sounds?

Excellent questions. The Oregon Museum of Science and Industry and the Oregon Health & Science University have put together a fun web site for you called “Dangerous Decibels” It consists of 8 modules that you interactively work through and learn as you go.

This site is suitable for both kids and adults.

As the web site explains, “This is a collection of games, demonstrations and activities that will answer three important questions:

1. What are the sources of dangerous sounds?

2. What are the effects of listening to dangerous sounds?

3. How do I protect myself from dangerous sounds?”

Intrigued? Get started. Click on “Dangerous Decibels” and have fun!

by Neil Bauman, Ph.D.

 Loud sounds damage your ears. That is no secret. Furthermore, the longer you expose your ears to loud sounds, the greater the chances of damage. That is just plain common sense.

What has this got to do with hockey? Canadians (and Americans too) love their hockey games. Unfortunately, the sound levels in hockey arenas often exceed safe levels. Therefore, unless you wear ear plugs, your hearing is at risk.

Just how bad is it? Let’s look at the sound levels observed during the 2006 Stanley Cup playoffs between the Edmonton Oilers and the Carolina Hurricanes played in Edmonton, Alberta

During the 3 hour game, noise levels almost never fell into the safe zone (sound levels below 85 dB). In fact, the average sound levels for 3 of those games was 104, 101 and 103 dB respectively. That’s loud! Peak levels recorded when goals were scored topped out at 122 dB. (1) That’s equivalent to a jet plane taking off! At that level, without ear protectors, you risk damage to your ears in just 1/8th of a second!

In these games, it only took 6 minutes to reach the maximum daily allowable noise dose. And remember, this sustained racket went on for 3 hours, not just 6 minutes! Looking at it another way, each person that attended these games exposed their ears at each game to 8100% of their allowable daily noise dose! And you wonder why so many people have hearing losses and ringing in their ears?

Therefore, if you are a hockey fan (or other sports enthusiast for that matter), wear the little foam ear protectors you can get at any drugstore for a couple of bucks. They have a rating of 25 to 30 dB. Wearing these ear protectors will bring the noise level down to below 80 dB where no hearing damage is likely to occur.

$2.00 ear protectors are certainly much cheaper than shelling out $2,000.00 each for the hearing aids you will eventually need if you don’t wear the ear protectors!

(1) Can Hockey Playoffs Harm Your Hearing?

by Neil Bauman, Ph.D.
 

Here’s a shocking statistic.

Next to the common cold, ear infections are the most commonly diagnosed childhood illness in the United States. More than 3 out of 4 children have had at least one ear infection by the time they are 3 years old. (1)

This high incidence of ear infections in totally unnecessary as the solution to reducing the incidence of ear infections in babies has been known for decades, namely breast-feeding your baby for a minimum of 6 months, and preferably 1 year or longer.

You see, breast-feeding is the natural way to help fight infections in your baby. Researchers have discovered that antibodies passed to the baby by a nursing mother help lower the occurrence of many conditions including ear infections, respiratory infections, allergies and asthma. Breast-feeding also contributes to the infant’s immune system by increasing the barriers to infection and decreasing the growth of bacteria and viruses. As a group, formula-fed babies have more infections and more hospitalizations than do breast-fed babies. (2)

Another benefit to breast-feeding is the way you hold a baby to breast-feed it. Breast-feeding keeps the baby at an angle which helps keep the Eustachian tubes clear and hence, fewer ear infections. In contrast, bottle-fed babies tend to lie flat and that allows “gunk” (to use a fancy medical term) to get in the baby’s Eustachian tubes and run up to the middle ear where it causes infections. (1)

Now researchers have found even more evidence of the efficacy of breast-feeding. They have found that breast-feeding protects children otherwise made susceptible to ear infections by abnormalities in specific human genes.

About 19% of children are prone to chronic and recurrent middle ear infections (Otitis media). Although researchers have long known that genetics plays a part in this increased vulnerability, they never knew the exact mechanism involved.

“We know that the tendency to get this infection runs in families, and so we decided to look for small variations—what we call ‘single-nucleotide polymorphisms,’ or SNPs—in three important genes that produce inflammatory signaling molecules for the immune system,” said Janak Patel, a professor in the infectious disease division of UTMB’s Department of Pediatrics. “Two of them stood out on their own as signals of increased risk.”

The two identified genes generate the immune proteins known as tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6). SNPs in each individual gene were enough, the researchers found, to create increased risk for childhood ear infections, and simultaneous SNPs in both genes created even more risk. The researchers believe that the particular variations detected cause greater production of inflammatory signaling molecules and reduce immune system effectiveness. But the UTMB scientists found that the effect could be counteracted with a practice long known to increase immune resistance: breast-feeding.

“This is a major finding, that breast-feeding neutralized the effect even in kids who had all the genetic polymorphisms,” Patel said. “Not only that, they were protected from recurrent infections even later in childhood, long after they stopped breast-feeding.” (3)

Therefore, if you want to give your children the best chance at normal hearing, start them off right—breast-feed them. The benefits will last for years.

(2) Breast-feeding vs. Formula Feeding

(3) UTMB Researchers Discover Breast-Feeding Overcomes Genetic Tendency to Ear Infections