Hearing Loss Help  

by Neil Bauman, Ph.D.

In our January 9th, 2008 blog article, a lady wanted to know how to hear both stereo channels in a single ear bud as she only had one working ear. I wrote, “The neatest would be if you could find a single earbud wired to a stereo plug.”

At that time I was not aware of any. Fortunately Barry Leeper of Scan Sound, Inc. saw this article and wrote:

“We have developed a single earbud, called “1- BUD,” that mixes both the left and right channels of stereo audio into one ear. This will be especially helpful to those who have lost their hearing in one ear and want to use a single earbud for both audio channels from their iPod [or other audio device] in their other ear.”

I’ve not tried it, but their “1-BUD” looks like the real McCoy for this application.

by Neil Bauman, Ph.D.

A lady wrote:

I have a progressive loss rated at “severe” currently. At the rate I’m going, I’ll probably not be helped by hearing aids within 10 years. Many of the ALD’s I have purchased have not really been enough help, I am getting more desperate about means to stay in the “hearing world”.

I have looked into the implantable hearing aid trials by Otologic. I have “passed” their criteria as a candidate and await an opportunity to ask pertinent questions before proceeding with the costly implant. What is your opinion of this device?

Many people have been eagerly waiting for a fully-implantable hearing aid. They cite the benefits of being able to wear it in the shower, or while swimming and while sleeping. Of course the real push behind totally implantable hearing aids is that they would be totally invisible so no one could tell you are hard of hearing by looking at you.

However, there are some down sides and problems with implantable hearing aids. Let’s look at these so you can make a more informed decision how you want to proceed.

First, implantable hearing aids (at least the current ones in trials) will only work if you have a functioning inner ear. Basically it just vibrates (more vigorously) the bones in the middle ear—so if your cochlea is not working well, it will only be of limited help—just like conventional hearing aids.

Unfortunately, most hearing loss (90+% in adults) is sensorineural. In other words the inner ear is damaged and no matter how vigorously you vibrate the middle ear bones, you cannot completely make up for the missing hair cells in the inner ear.

Second, tests reveal you won’t hear as well with the internal microphone of implantable hearing aids as you would with an external microphone. The internal microphone is hidden behind skin so it can’t pick up the sounds as well as one open to the air.

Third, there is the problem of replacing the batteries whenever they ultimately die. This would require minor surgery to replace the whole internal “hearing aid”.

The current crop of implantable hearing aids will be more useful to people with more moderate, stable hearing losses, and to those with certain middle ear problems that can be overcome by vibrating the bones more vigorously.

At present, I think this is much more of a vanity device than any improvement in the quality of hearing.

Because you have a progressive hearing loss, and because the worse your hearing gets, the less any hearing aid will help you including implantable hearing aids, I fear you would be wasting good money on it. The way things are going, in a few years you will likely need a cochlear implant anyway.

Personally, I’d stay with powerful BTE hearing aids, supplemented with assistive devices, until the time comes for a cochlear implant.

by Neil Bauman, Ph.D.

Clinical trials for invisible (internal) hearing aids are underway. They are seen as a boon to those people who refuse to get a hearing aid because of the negative social stigma attached to wearing hearing aids.

In addition, these hearing aids are also waterproof (unless your head leaks!) and obviously will work while you sleep (so you could hear the baby crying—good if you are the caregiver—bad if you are trying to sleep)!

One such device is the Carina, developed by Otologics, of Boulder, CO. The microphone, implanted beneath the skin behind the user’s ear, picks up the sound. The sound signal is processed and amplified and sent to a tiny vibrating transducer that is attached to one of the bones of the middle ear. From there the signal works through the rest of the auditory system the normal way.

According to an article in the Hearing Review,

The device is powered by a battery that is recharged when the user places a small radio transmitter against the head for 60 to 90 minutes. The transmitter is held to the skin by a magnet in the implant. An inductive coil in the implant converts the radio energy to electricity and recharges the battery with it. The battery can stay inside the body for at least 5 years, according to the company, before it needs to be replaced. The implanted components are hermetically sealed together to protect against leaks, so the electronics, microphone, and inductive coil are replaced as well. However, the piston in the middle ear remains in place. (1)

I find the results of the Phase I trials rather revealing. The above article reports,

Twenty subjects with moderate to severe hearing loss were implanted in one ear. (Seventeen of the subjects had worn conventional hearing aids prior to the study.) The subjects did somewhat worse than with the hearing aid they had previously worn: their ability to hear a range of single-frequency tones dropped between 5 and 12 decibels, and mean word-recognition scores dropped from the low 80 percent range to the high 60 percent range.

Notice that not only did they not hear as well, they also lost a fair amount of discrimination. In other words they couldn’t understand as much of what they heard as compared to wearing conventional external hearing aids.

Rather interestingly, “a satisfaction survey found that the subjects felt that the device not only improved their hearing, but also sounded more natural than their old hearing aid” even though the clinical testing results showed otherwise. This reveals just how desperately hard of hearing people want to appear “normal”.

The big question is whether the Carina is worth the extra cost ($19,000.00 in Europe) and the risks associated with the surgery to implant it when compared to conventional hearing aids.

Gerald Loeb, a professor of biomedical engineering at the University of Southern California, is the voice of reason. He argues that:

Implanted hearing aids should outperform conventional ones before they can be considered worth the extra cost and risk. He also questions the emphasis on making an invisible device: “How big an issue is it to have a little appliance on your ear when the whole world is walking around with cell-phone headsets and iPod earpieces?”

I’m certainly not against this new technology. I just think it prudent to wait until all the bugs are worked out, and the cost/risk to benefits ratio improves.

(1) “The Hearing Review”, September 11, 2007

by Neil Bauman, Ph.D.

A lady explained,

Our Senior Center has two rooms looped: the computer room where people learn computer skills, and the “lipreading room” where a lipreading class is held. These rooms are next to each other. Each has a separate loop that was installed a few years ago.

My friend that is taking a computer class said she can hear the jokes they are telling in the lipreading class next door when she is in the computer room and has her t-coil turned on. It could be distracting. Maybe she should just enjoy hearing jokes the other computer students are missing.

Is this normal and to be expected or is something wrong with the loop setup? I was under the impression that one must be inside the loop to hear what is being said using the loop.

It is a misconception that you must be inside the loop in order to hear its signal. You can hear outside loops—typically just not as loud.

Some t-coils are just better than others at picking up loop signals—so some hear outside loops quite well and others don’t.

Although sound rapidly diminishes the farther outside the loop you are. I’ve been in looped areas where I could still hear very well when I was 12 to 15 feet outside the loop.

Therefore, there is nothing wrong with the above-mentioned loop systems themselves. It is just that the people installing them need to realize that spillover happens (unless you use very specialized and expensive loop mats), and thus not set them up in adjacent rooms, or the people sitting near the common wall will be able to hear both systems at once.

(If this ever happens to you, change your seat to as far away from the common wall as possible and likely you won’t hear the other system.)

Another point that many don’t realize is that you mustn’t loop rooms directly above or below each other either. In your example, if the two looped rooms were on different floors located directly above/below each other, both loop systems would blanket both rooms. Therefore, when installing loop systems, you need to adequately separate room loops both horizontally and vertically if you want to avoid spillover.

by Neil Bauman, Ph.D.

A lady wrote,

I am almost deaf in one ear. I have trouble hearing music via headphones that play different parts in each ear piece—specifically when I am listening to my iPod with the earbud headphones. Is there a product out there for people who can only hear out of one ear that will play both stereo channels out of just one ear piece? I’ve searched the Internet and couldn’t find anything. Surely I’m not the only one with this issue.

Excellent question. You definitely are not alone. Fortunately, I have the answer you need.

What you want to do is feed both stereo channels into a single earbud that goes to your good ear. (You won’t be hearing true stereo—as that takes 2 ears—but you will hear everything on both stereo channels combined together into the one earbud).

Here’s how you do this. There are two options.

The neatest would be if you could find a single earbud wired to a stereo plug. I’m not aware of any so it may not be possible to find any. (However, if you were hard of hearing and wore a hearing aid in your better ear, you could switch to t-coil mode and use a single Music Link (which is wired to fit a stereo jack).

The other way is to get two things—a single mono earbud (with a mono plug), and a stereo to mono adapter from Radio Shack (Part No. 274-374, $2.99). Then plug the adapter into your iPod and the earbud into the adapter. Now you’ll hear both channels in the one ear.

The earphone you need is a single mono earbud (EAR 013). Scroll down to the 6th picture from the top. Note that there are two versions—the EAR 013 and EAR 013T. The EAR 013T has an extension tip that better fits into your ear canal. However, any single earbud with a mono plug will work if you happen to have one kicking around.

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Addendum: For a more elegant solution—source of an earbud with stereo jack—see the January 24th, 2008 blog article.

 by Neil Bauman, Ph.D.

Real-time captioning (CART) at meetings and events is a blessing for those of us who can’t hear/understand everything the speaker is saying. Sometimes we just glance up at the screen to catch the odd word we miss. Other times, we rely almost exclusively on the words magically appearing on the screen in order to get the speaker’s message.

The question is, “Where can you find the people that provide the real-time captioning services?”

Here is the link to the National Court Reporter’s Association. They list the CART providers for each state in the USA (and in Canada too). Just click on your state and see all the CART providers in your area.

Can’t find a CART provider in your area? Not a problem. Use remote CART instead. In this case, just click on the “Remote CART Providers” link.

With remote CART, the CART provider can be anywhere in the country as long as they, and you, have a computer hooked to an Internet connection. For example, your CART provider could be on a terrace in southern Florida overlooking the Caribbean Sea, while you are in a remote oil camp in northern Alaska. Whatever anyone says will appear on your screen just as though the CART reporter was there captioning in person. Even better, your CART provider could be in Alaska (Hi Sandy!) and you could be the one in the meeting on the terrace overlooking the Caribbean.

I have used both CART and remote CART many times and the quality is the same either way.

 by Neil Bauman, Ph.D.I received this interesting email,

I’ve had tinnitus for about two years caused by a combination of noise exposure and an over-zealous nurse giving an ear lavage. It can be a real problem at times, especially when I don’t watch the sugar intake in my diet. The only thing that I’ve found that provides relief within a short period of time when it gets going are dietary enzymes like Bromelain and Papain. My theory is that these enzymes help break down sugars and eliminate them efficiently from my system? If my system is overloaded with sugars, it leads to louder and more intense tinnitus.

You are perceptive in realizing that too much sugar is related to your increased tinnitus. Few people realize that sugar and tinnitus can go hand in hand. As you now know, your tinnitus is indeed sensitive to too much sugar in your system. The more sugar you have in your system, the louder your tinnitus. This happens to other people too.

As the American Tinnitus Association reports:

Some people find that foods with a high sugar content make their tinnitus louder. Monitor how you respond, and find a healthy balance where you do not eliminate all the foods that you love, but also where you do not unnecessarily exacerbate your tinnitus.

Too much sugar is bad for your body as a whole (think diabetes), not just your ears, so you should watch your sugar intake anyway. However, in your case, you are fortunate to have a built-in alarm system that alerts you when you ingest too much sugar. Now all you have to do is heed it.