Hearing Loss Help  

by Neil Bauman, Ph.D.

An audiologist wrote,

I am a newly qualified Audiologist who frequently sees patients that suffer from tinnitus. Most of the patients I see have had tinnitus for quite some time (more than 6 months). We have a very long waiting list at the hospital at which I work, and sadly patients suffering from tinnitus, as I’m sure you know, are missed, referred inappropriately or put off seeking treatment all together.

Many of my patients report that their tinnitus started after their ears were syringed, or after a middle ear infection. I am aware that the two are commonly linked, but I am not sure how to answer the patients’ questions about how and if there is some explainable physiological reason for the tinnitus beginning at this time. I have not been able to get any satisfactory information from the net, and my colleagues are also interested in finding out about this. I would appreciate it if you could enlighten me on this subject.

These are two good questions and I’ll certainly try to help you understand why tinnitus is associated with these two events. Let’s look at them separately.

First, why is tinnitus sometimes associated with syringing out a person’s ears?

Many people may be surprised to learn that having their ears syringed to remove wax can CAUSE tinnitus. The same is true if you shower and aim the shower-head directly into your ear canals.

John Currie at T-Gone in South Africa mentions that syringing out ears with too strong a stream of water can indeed cause tinnitus (and hyperacusis too).

I have not experienced any long-term tinnitus from doctors syringing my ears, although I’ve had doctors use so much force that the water hitting my eardrum temporarily wrecked my balance.

Since then, and for a couple of decades now, I let the water from a reduced-flow shower head spray into my ear canals each time I shower. This has not caused me any tinnitus or balance problems. My existing tinnitus never changes.

The trick in avoiding tinnitus is to use a gentle spray, not a high pressure jet of water, whether syringing or showering.

She then asked,

What I’m still not entirely clear on is what is happening in the ear as a result of this syringing which would result in tinnitus. Does it have something to do with the tensor tympani going into spasm?

I doubt it is any of the tiny ear muscles going into spasm as the tinnitus lasts for weeks or months and I’d think a spasm would be of short duration. Rather, what I think happens is that the sudden “wham” of the water hitting the eardrum gives a similar reaction as a loud noise like a gunshot would—and that often results in tinnitus.

Actually, anything that violently moves the eardrum whether water pressure or air pressure (from a loud noise) can result in tinnitus, hearing loss, hyperacusis and temporary balance problems.

That is why, for some people, syringing or showering is the root of their tinnitus. John Currie recommends taking out wax using other means—not water and not suction—so you don’t push (or pull) the eardrum too much, and thus cause tinnitus.

Now to answer the second part of your question, “Why do middle ear infections often leave people with tinnitus, even after the infection clears up?”

You further explained, “What I found interesting is that even once the ear infection had cleared up and PTA [pure tone averages] revealed hearing within normal limits they were left with tinnitus. Could it be that the temporary threshold shift had made them aware of the tinnitus and even once their hearing returned they had formed a negative association with the sound and became fixated on it, or could there actually be some physiological damage to the middle ear during the infection which would cause this.”

I think there are two different factors. First, since ear infections cause some hearing loss, and since tinnitus often accompanies hearing loss (about 70% of the time), it should be no surprise that tinnitus can be associated with ear infections as a secondary cause.

Although your conventional testing revealed that hearing had returned to normal, this may not be entirely true because you typically only test hearing to 8,000 Hz., and not up to the upper limit of hearing around 20,000 Hz. Thus you don’t know how much hearing was lost and not recovered in the very high frequencies. Hearing loss in those high frequencies can also cause tinnitus.

Since tinnitus supposedly is often at the same pitch as the person’s greatest hearing loss, if a person has high-pitched tinnitus, I’d check their very high-frequency hearing to see if that might be the cause. (When you only test to 8 K, you could give a person a clean bill of health hearing-wise—and yet they could have severe hearing loss above 8,000 Hz—resulting in tinnitus.)

Second, and I think you hit the nail on the head when you mentioned a person fixating on their tinnitus, is that when a person fixates on their tinnitus, their limbic (emotional) system flags the sound. As a result, the tinnitus sound seems to become louder and even more intrusive, and consequently harder to ignore. At the same time, as I understand it, the brain grows “connections” that “lock in” the tinnitus.

Thus, whatever caused tinnitus in the first place starts the ball rolling—but the ball continues to roll on, even if the original cause is taken away. That is why it is so important for people that get tinnitus not to form any negative emotional attachments to their tinnitus. This only makes the “connections” stronger and much harder to break. It is ever so much better to nip this in the bud before these connections form.

by Neil Bauman, Ph.D.

Recently a man phoned me and explained,

My boss suddenly lost the hearing in one ear due to a virus. My question to you is—is he contagious? In other words, can I lose my hearing from being near him?

I’ve answered thousands of questions related to ears, but this is the first time this particular question has ever come up. Even though no one has asked it before, it is an excellent question.

There’s good news and bad news. First the bad news. Yes, he is contagious—in exactly the same way as if he had a cold or flu. If your immune system isn’t up to par, you could catch his cold or flu from being around him—because that is likely the kind of “bug” he has.

Now for the good news. The chances of your having the same reaction to his virus if you get it is minuscule. For example, I’ve heard of family members having sudden hearing loss from a virus, but I’ve never heard of another family member also getting the virus and having a sudden hearing loss. I’m sure it is possible, but it must be extremely rare if it does occur.

The virus that causes sudden deafness is not some strange, esoteric virus, but just the regular viruses that are around us like cold viruses, flu viruses, Chicken Pox (Varicella) viruses, etc. Normally they cause all the symptoms you know well, but sometimes, for whatever reason, they get into the inner ear and wreak havoc there resulting in sudden hearing loss and/or balance problems.

Personally, I wouldn’t be at all worried about “catching” sudden hearing loss from your boss.

by Neil Bauman, Ph.D.

A lady wrote,

While I was on beta-blockers for inappropriate sinus tachycardia I developed tinnitus. Initially it seemed intermittent, but as I had to increase my dose the ringing became constant. The ENT doctor tells me that he has never heard of beta-blockers causing tinnitus, but upon his evaluation found that I have a high frequency hearing loss in both ears, and that can cause tinnitus. Funny that it happened only 3 months after I started the beta-blockers. Is it possible that the beta-blockers caused the hearing loss and this caused the tinnitus?

I’m always amazed at the apparent ignorance of doctors regarding ototoxic drugs. For example, 15 out of the 18 ototoxic beta-blockers I have listed in my book “Ototoxic Drugs Exposed” have tinnitus listed as a side effect. In addition, 6 of the 18 have hearing loss listed as a side effect.

Your doctor could have easily checked this out for himself in his Physicians’ Desk Reference (PDR) if he had wanted to know the truth.

In answer to your question, there are two possibilities. First, yes, beta-blockers can cause tinnitus. I suspect this is what happened in your case since the tinnitus began after you began taking beta-blockers, and then got worse when you increased the dose. That is strong circumstantial evidence that the beta-blocker was the culprit.

On the other hand, the beta-blocker could have caused the high frequency hearing loss—and that in turn could have resulted in the tinnitus. Either scenario is possible, but I tend to favor the first one in your case.

Be aware that you are not alone in having ototoxic effects from taking beta-blockers. I’ve had other people tell me of their ear problems from taking beta-blockers, so it really does happen.

If you want to check out the ototoxic side effects of the beta- blockers (or any other ototoxic drug for that matter) look them up in “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs known to damage ears (and a number of chemicals too).

by Neil Bauman, Ph.D.

A lady explained,

I have an ear infection, tinnitus, and a history of hearing loss in my family. My MD has prescribed a medication that I can not find any information about, ‘Augmomyn’. He says it is a “type of Amoxicillin”. Do you have any information about that? I could not find it in Ototoxic Drugs Exposed, or in searching the Internet.

I’m not surprised you can’t find a reference to “Augmomyn” since the name of this drug is actually Augmentin. Trying to interpret the doctor’s hieroglyphics is a bit of a challenge, isn’t it?

Augmentin is actually a combination of two drugs—Amoxicillin and Clavulanate potassium.

The reason Augmentin is not listed in my drug book is that it is not known to be ototoxic. It is actually one of the very few antibiotics of which I know that is not reported to be ototoxic.

by Neil Bauman, Ph.D.

A lady asked,

I wondered if you knew about the ototoxicity of food products such as decaffeinated tea. I read that tea is high in Salicylates, as are also a lot of fruits. Does this mean that drinking/eating these things can make my existing tinnitus worse?

Interesting question. It is true that Salicylates occur naturally in a good number of foods, and in some in some spices, in quite high concentrations. So the question is whether you can ingest enough Salicylates in your food to cause the typical ototoxic side effects of too much Salicylates in your system such as tinnitus, reversible hearing loss, dizziness and vertigo.

Some people are allergic or sensitive to Aspirin (acetylsalicylic acid) and foods high in Salicylates. These people may indeed suffer the above side effects. However, for the majority of people that ingest foods higher in Salicylates, I’d be surprised if they notice any change in their tinnitus.

For example, the average “Western diet” has an estimated Salicylate intake ranging from 10 to 200 mg. a day. In comparison, the average dose of (adult) aspirin contains 650 mg. of Salicylic acid, while a baby aspirin contains 81 mg. of Salicylic acid.

Conventional wisdom says that a person has to take 5 or 6 adult Aspirin tablets a day before they notice a change in their tinnitus.

Foods high in Salicylates include fruits, vegetables, dried spices, tea and food flavorings. In addition, Salicylates are used in a wide range of cosmetic products.

Let’s compare 4 foods high in Salicylates to a person taking a single baby aspirin (81 mg.) a day. Here’s how it stacks up.

Curry powder has the highest Salicylate content of any food—218 mg. per 100 g. To get 81 mg. of Salicylate, you would have to ingest 1.31 oz. of Curry powder at a sitting if you could stand it!

Or how about Worcestershire sauce, at 64.3 mg. per 100 g. You would have to dump almost half a bottle (4.5 oz.) of this stuff on your food to equal the Salicylic acid in just one baby aspirin.

As far as fruits go, raisins are high in Salicylates (6.62 mg. per 100 g.). To even get just one baby’s aspirin worth of Salicylic acid, you’d have to eat about 3 pounds of raisins—at one sitting mind you.

Almonds are also considered high in Salicylates at 3 mg. per 100 g. To get one baby’s aspirin worth of Salicylic acid, you’d have to chomp your way through 6 pounds of almonds at one sitting! That’s just not going to happen!

Thus, even though you eat foods high in Salicylates, unless you are particularly sensitive to Salicylates, typically you would not ingest enough Salicylates each day to either cause tinnitus or affect your existing tinnitus.

However, if you are sensitive to Salicylates, you need to watch your intake. You would do well to read the article “Salicylates“, and “Salicylate Content in Foods“.

by Neil Bauman, Ph.D.

Are you intrigued by old hearing aids and hearing devices? Have you ever seen a “pen” hearing aid that you wore in your shirt pocket? Or a barrette hearing aid you wore in your hair? Aren’t you glad you don’t have to lug around a heavy table top hearing aid that took so much power it had to be plugged into a wall receptacle?

Would you be embarrassed to use a giant ear trumpet over two feet long? Or would you insist, like many people today, that you wanted a much smaller and more invisible “hearing aid” like the tiny ear horns and auricles that are only a “minuscule” 3 inches long.

These are just a few of the many interesting and different hearing aids to be found in the Hugh Hetherington On-line Hearing Aid Museum, now the largest on-line hearing aid museum in the world.

This museum is owned by Neil Bauman, the director of the Center for Hearing Loss Help and his friend Hugh Hetherington, probably the foremost authority on old hearing aids alive today.

Although it currently contains well over 200 hearing devices, the on-line museum is far from complete. At present, only about 30% of the hearing devices in Hugh’s personal collection are actually illustrated on-line. However, more are being added every week so the museum is a fun place to come back to from time to time.

If you have any questions on old hearing aids, feel free to email Dr. Neil.

by Neil Bauman, Ph.D.

If the chief executive at Phonak, Valentin Chapero, has his way, hearing aids as such will soon be a thing of the past. “Phonak’s new Audeo device comes in 15 fashionable colors, looks more like a sleek ear phone than an old-fashioned hearing aid and is being marketed as a ‘personal communication assistant’”.

According to Chapero, “We’ll only get close to baby boomers if we take away the stigma and show them a product that is high-tech and hip and easily improves the quality of their lives.”

Just be aware that in spite of the hype, and no matter what you call them, these devices are still aids to hearing—what we’ve always called “hearing aids”.

If the big hearing aid manufacturers have their way, it appears we’ll soon all have a PDA (personal digital assistant) in our pockets, PCAs (personal communication assistants) in our ears, and a big hole in our wallets! Let’s hope the improvement in our hearing is worth it!

by Neil Bauman, Ph.D.

Here in the United States a house catches fire every 74 seconds! That’s scary. Even more scary for those of us who have hearing losses is the fact that most fires occur at night when we are sleeping, and our hearing aids and cochlear implants are also peacefully “sleeping” on our bed tables beside us. Thus we often cannot hear the smoke detector blaring its warning to us from our bedroom ceilings.

This happened to Harold Waterer and his girlfriend Heather a few months ago. Because they were deaf, neither heard the smoke detector warning them their trailer had caught fire. Tragically both died in the fire because they failed to provide for themselves the “gift of life”.

Fire is not the only danger to which we are exposed. Carbon monoxide is an insidious killer that can silently sneak up on us and snuff out our lives while we sleep because again our hearing aids and cochlear implants are reposing on the bed table. Thus, we do not hear our CO detector’s shrill warning of impending doom.

This happened to the Mazins just two years ago. Blair and Anita Mazin both had severe hearing losses. They had come home one evening and somehow forgot to turn the ignition off when they parked their car in the garage under their townhouse.

The carbon monoxide from the car’s exhaust eventually seeped into their bedroom and snuffed out their lives while they slept. They were totally oblivious to their CO detector futilely screaming its warning to them. Tragically, they too failed to give themselves the “gift of life”.

If you live in “Tornado Alley” a tornado may sweep through your neighborhood, but you may never know it because you can’t hear the weather warning blaring from your NOAA weather radio. Instead of immediately taking shelter in your basement, you may become another tragic statistic on the next newscast if you fail to give yourself the “gift of life”.

What Is the “Gift of Life”?

Just what is this “gift of life”? The “gift of life” I am referring to are alerting systems that are designed specifically to truly meet the needs of hard of hearing and deaf people. Too many alerting systems just give “token alerts” that are often missed—for example, the ineffective flashing lights I’ve seen on many door knockers and smoke detectors.

In contrast, “gift of life” alerting systems are designed to waken you—not only by sounding a loud alarm, but also by flashing a bright light and shaking your bed. It is almost impossible to sleep through this triple whammy assaulting three of your senses (hearing, seeing and feeling) at the same time. When working properly, these wonderful alerting systems can give you the “gift of life”—alerting you in time to escape with your life.

Not only do these alerting systems alert you to life-threatening situations, they also make your life as a hard of hearing person easier—alerting you when your phone rings, when someone is at the door, when the baby is crying in the back bedroom, if grandpa just fell out of bed and needs help, or even if a burglar is breaking into your house.

Intriqued? Want to know a good “gift of life” system? If so, read the rest of this article (it’s too long for this eZine). Among other things you’ll learn the four key features you should look for in a “gift of life” system. Click here and give yourself the “gift of life”!

by Neil Bauman, Ph.D.

A man wrote:

I had sudden hearing loss and need your help. If you had to have a cochlear implant today, which implant would you have, and where would you have it done?

Fortunately for me, I live close to one of the best cochlear implant surgeons, Dr. John Niparko at Johns Hopkins in Baltimore. (It’s only about 50 miles away.) Therefore, that would be my first choice. Don’t get me wrong. There are good CI centers scattered around the country, but Dr. John is one of the top rated CI surgeons anywhere.

As for which brand to select, you have three choices—Cochlear Americas, Advanced Bionics or MedEl. All three are about equal—that is, you will hear about the same with any of them.

Be sure to check out the reliability and track record of each of the CI manufacturers. They are all different. Decide which seems best for you.

Also, since the CI manufacturers are always coming out with new features, and leapfrogging over each other, the CI I’d choose today may not be the same make or model I’d choose tomorrow. Therefore, when the time comes that you need to make your decision, look carefully at the features that are available for each make. Then consider which features are important to you for your own specific lifestyle and situation.

For example, if you will need MRIs in the future, you may want to choose the CI with the highest Tesla rating without having to have the internal magnet temporarily surgically removed before you can have an MRI.

Some CIs have much longer battery life than others, so this may be a consideration.

Also, if music is important to you, then you may want to choose the CI with the most electrodes (currently 120 “virtual” electrodes) and the best music strategies (maps).

Perhaps the appearance of the external parts is important to you, or the specific controls, or the accessories available, or the kind of maps provided. There are so many features—and only you know which of them are important to you.

You also want to check to see if the model you choose can be upgraded when new technology becomes available without having to have the implanted part taken out and replaced.

The above are some of the “physical” things to look for. However, these are relatively minor when compared to two major things you want to check out.

First, of course, is getting an experienced CI surgeon. Get one that has done many cochlear implants and has an excellent track record.

Besides having a good CI surgeon, the next most important thing is to have an audiologist that is experienced in the brand of CI you are getting. You want someone that can program the best maps for you, because this is what ultimately gives you your hearing back. At the same time, you want your CI audiologist to be located reasonably close to you since you will be going back for a good number of mappings in the coming months and years. You don’t want to have to fly across the country every time you need your map changed.

Sometimes some of the above decisions will already have been made for you. For example, certain doctors and implant centers only implant certain makes—so if you want a given doctor, you have to go with the makes he implants. Likewise, your CI audiologist may have expertise in just certain makes—so choose a make that they are expert at mapping.

This is just a sampling of some of the things I’d consider. As you can see, there are a lot of factors to consider. All things being equal, go with the CI that comes out on top in your rating of each of the above factors as you see it.

by Neil Bauman, Ph.D.

Several people have asked me to address the issue of cochlear implants (CI). Although I don’t have a cochlear implant, I know hundreds and hundreds of people that do have cochlear implants.

My friend Denise Portis is one of them. She also has a way with words. Here is her witty assessment of what a cochlear implant is not, and then what it is. (Used by permission.)

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Many people think a cochlear implant “fixes” your hearing. They may think that now that you have a cochlear implant, you have perfect hearing and are “normal”. I realize that most people talk about how things are different by discussing things “alike” first, followed by how things are “different”. However, since I believe there are many misconceptions about CI’s, I’ll start with what they are not.

What a Cochlear Implant is Not

1.  A cochlear implant does not make you Jamie Sommers. You are not the Bionic Woman (or man) and can hear things 4.2 miles away!

2.  A cochlear implant does not make you a lightning rod. Someone with a cochlear implant is not more likely to be struck by lightning than someone else. Sure, if you are playing outside in a lightning storm on a hill without cover, holding a golf club in your hands, then yes, you might be hit by lightning. But it’s not because you have a cochlear implant in your head!

3.  A cochlear implant does not provide crystal clear hearing so the recipient never has to say “huh?” again.

4.  A cochlear implant’s magnetic coil is not a “plug”. I realized my sister must have thought this when she winced when I took it off to show her. There is not an opening to your brain. It doesn’t “plug in” like a cord in an electrical socket. There are no gruesome wires or frankensteinish types of protruding pieces of metal.

5.  A cochlear implant does not make someone begin to have balance problems—at least not usually—although I have heard it can happen. That is why good surgeons always run a battery of tests which include ways to detect if you already have vertigo problems. I have always been “dizzy” (though never blond) and I almost failed the tests at Johns Hopkins on vertigo. I have a mild version of Meniere’s disease, and looking back, I think it began when I was around 18 years old. I did not begin losing my hearing until I was 25.

I have a history of accidents a mile long. Every emergency room doctor knows me by name. I break bones, fall a great deal, and run into things. I actually have no memory of not being this way. Growing up, I was told I was “clumsy”. My CI didn’t make me dizzy. I was already dizzy. I realize that some people begin having balance problems after receiving a CI, but as I understand it, this is the exception to the rule, and not common for CI recipients.

6. A cochlear implant does not allow you to hear every kind of environmental sound. There are still things I don’t hear at all, or don’t hear well.

What a Cochlear Implant Is

1.  A cochlear implant is a bionic type of device surgically implanted into the cochlea of your inner ear. Some consider it a prosthesis. The recipient is “mapped” frequently in the beginning (sort of like being programmed) and then usually once a year for life after receiving one. Each mapping allows adjustments to enable you to hear things more clearly. At the same time the electrodes are tested and checked.

2.  A cochlear implant can be worn anywhere except in the water. One cannot scuba dive after receiving a CI (due to increased pressure). Some, like my own Nucleus Freedom, are “splash resistant”. I can get caught in a rain-storm without an umbrella, or hop into the shower accidentally without removing it and not destroy it. Certainly, should those things happen, I would promptly put it in my Dry ‘n Store (an electronic drying device), nor would I ever do those things on purpose. I mean I do shower on purpose, but I don’t jump into the shower with my CI on with the intent of destroying it. (In hindsight, I thought I should assure you that I do shower, and do so on purpose!)

One can swim with a CI, but not with the outside components attached. Water tends to ruin them. As long as you are not scuba diving, you can still enjoy swimming, snorkeling, and rain showers. You just “play smart” and take off the external speech processor.

3.  A cochlear implant allows you to hear again—when you have reached the point that you no longer can. “Hearing again” and “hearing perfectly” are two different things. One doesn’t grouch that they aren’t “normal” when they can hear after they could not. I can talk on the phone now (in a quiet room with my own phone), I can hear in church, talk to people face-to-face and in small groups. I do not do well in restaurants, large groups, concerts, etc. without special assistance from infra-red or FM assistive listening devices. Loop systems are my favorite way to hear in these “tough” environments. You walk into the room, switch your CI to t-coil mode, and you “hear” without the background noise.

4.  The magnetic coil of my implant connects to another magnet securely embedded in my skull. The magnets connect very well through my skin. Nothing shows, and I try very hard not to appear “gory”. I’m rather proud of the fact, that I’m probably one of the few people I know who can lean into the refrigerator and “lose” their ears.

The weirdest place I ever lost my CI was at the grocery store in the pickle aisle. I was leaning down to try and find the specific type of pickles my family likes when “whoosh” off my CI flew to stick to the metal lid of a pickle jar. As I was desperately looking for my CI, a lady came by, smiled and said, “Are you pregnant honey? Looking for pickles?”

I was so astonished that I replied, “No! I’m looking for my ear!” Needless to say she shrieked and ran.

5.  A cochlear implant can sometimes mask tinnitus, a common symptom and side effect of a progressive hearing loss. Tinnitus may be a humming or ringing sound in your ears. The CI can mask this “sound” and keep you from hearing it. However, I have also met some people that now have tinnitus (when they remove their CI) whereas they did not have it before.

I’m used to the ringing. When I take my CI off at night, the ringing begins, but it doesn’t bother me, and I go right to sleep. When hearing the ringing sound, I no longer shout, “Hello? Who’s there?”

6.  My experience with my cochlear implant is not like anyone else’s. I still hear new sounds every day. But my experience— what I can hear and what I don’t hear—is as unique as my “map”. No two recipients have exactly the same map or the same experience with their cochlear implants.

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You can read the original of this article on Denise’s blog here.