Hearing Loss Help  

by Neil Bauman, Ph.D.

Hearing loss in a spouse adversely affects marriages. This should be no surprise. In fact, according to a recent survey of baby boomers with hard of hearing spouses, 48% “of the respondents feel that their marriage has suffered because of their spouse’s hearing loss.” (1)

This does not have to be. Hearing loss can bring about changes in a marriage, but these changes do not have to adversely affect the marriage itself. Let’s look at this a little closer.

One of the findings was that 65% “feel annoyed when their spouse can not hear them.” Instead of being annoyed and letting that affect the marriage, why don’t these spouses practice good hearing loss coping strategies so that their spouses do hear them the very first time? When they do this, the annoyance factor fades away.

A second finding was that “another 16% feel ignored”. I think this applies much more to family gatherings rather than just spouse to spouse communication. In groups its so easy to ignore the person that misses what is said. Because they miss things, they often don’t respond—and thus become “invisible” to the group. The hard of hearing person is not intentionally ignored—it just happens. This is why practicing good coping strategies, including being assertive, is so important. So too are using hearing aids and any assistive listening devices (ALDs) that will help the hard of hearing person hear better.

A third finding was that “8% feel sad or hurt.” I’m surprised this figure is so low. Hearing is important to us. We value it, so when we lose it, we feel the loss—and therefore must grieve this loss. Some of the emotions we experience during the grieving process include sadness and feeling hurt. These feelings should go away as we work through the grieving process and learn to become well-adjusted hard of hearing people. In addition, the hearing spouse must also grieve—not for the hearing loss since they don’t have any—but for the loss of the free and easy communication they once had with their now hard of hearing spouse.

To learn more about the grieving process in relation to hard of hearing people read our short book, “Grieving For Your Hearing Loss—The Rocky Road From Denial To Acceptance.”

A fourth finding was that 60% “find themselves in recent years talking louder daily so their spouse can hear them.” I don’t see that talking louder as such, is a problem, but a sign of using an effective coping strategy. Speaking louder so a spouse can hear you the first time has got to be far less annoying than endlessly repeating yourself in your regular voice, and in the end your spouse still doesn’t get it. Of course, the hard of hearing spouse should do what he/she can to help this situation—and that means getting hearing aids if they will help, and/or using assistive listening devices.

A fifth finding was that denial often rears ins ugly head. In fact, 57% “feel their spouse is reluctant to get his or her hearing checked.” Why? Well, “46% feel that denial is the number one reason” their spouse refuses to have a hearing test. I have heard the shocking statistic that 6 out of 7 hard of hearing people either deny they have a hearing loss, or do nothing about it. that is what causes problems in marriages. If the hard of hearing spouse would acknowledge that he/she has a hearing problem (and a hearing test will confirm that), then together the marriage partners can work on finding effective solutions so that hearing loss will not harm their marriage.

There are ever so many effective coping strategies that spouses can employ to make communicating with each other easier. Some of them involve using assistive devices and hearing aids, while others don’t cost a cent. There are a good number of these freebie effective coping strategies in our very readable book, “Talking With Hard of Hearing People—Here’s How To Do It Right!”

(1) “Being Hard of Hearing Can Cause Hard Feelings Between Spouses” in: Advance for Audiologists, April 11, 2008.

by Neil Bauman, Ph.D.

A lady wrote:

My biggest wish right now is to be able to hear better in a noisy place like a restaurant, or at a social gathering where I am moving around. I know the PockeTalker works, but that means carrying it, and I like to have my hands free. I was wondering if I should trade my current hearing aids in for ones that have t-coils and directional microphones.

I am looking for that magic device that I can carry with me and set down and be able to have the person’s voice come right up to my ears. It does not have to have a very large range.

That is some magic device alright. Trouble is, it doesn’t exist. There are good assistive listening devices (ALDs)—some work well in some situations, while others work well in different situations. However, there is no single device that works well in all situations.

The secret to better hearing is just this—the noisier the place, the closer you need the microphone to be to the speaker’s mouth. It’s that simple. This is why placing a microphone in the center of a table doesn’t work well. It picks up too much of the noise in the room.

When it comes right down to it, you have two basic choices. One is to get new hearing aids that cut out most background sounds while zeroing in on the voice of the person to whom you are speaking. The second is to use an ALD, either alone, or in conjunction with your hearing aids.

Hearing aids with directional microphones can be wonderful. About 5 years ago, Siemens came out with their BTE Triano. It had three microphones on each aid—and when set in full directional mode—boy was it great! I tried it in a crowded exhibit hall, and it cut out all the racket except the voice of the guy I was talking to. I was totally impressed!

However, most hearing aids do not have wonderful directional microphones. For example, my current hearing aids have directional microphones (2 mics on each aid), and in directional mode they do cut down noise from the sides and back by about one third, but that is not enough so that I can have an easy conversation in noisy situations. I still have to try to hear through the remaining racket.

The problem with full directional mics (as opposed to semi-directional mics) is that you have to be facing the person to hear them. For example, a person could be yelling a warning to you from behind and you’d not hear a thing; or in a group, if you are looking at the person who is talking and another person chimes in, you won’t hear them—so you won’t be able to follow group conversations; nor will you be able to hear questions at meetings because you never know which direction to turn to before the question is half over, not to mention getting whiplash from all that head spinning!

However, if you are only talking to one person, having full directional microphones makes it possible to hear the person with whom you are chatting without all the background racket.

Many modern hearing aids combine both noise cancellation and directional microphones to help you hear better in noisy situations. Naturally, some work better than others, so you have to try them out to see which works the best for you.

Your second basic option is to use an assistive device. In noisy situations, my choice, because it is relatively cheap, yet works with any hearing aids with t-coils (or without hearing aids when wearing earbuds) is the PockeTalker with a super-directional microphone or lapel microphone—depending on the situation.

For example, in noisy restaurants, I just put the PockeTalker on the table and clip the lapel mic on the person I want to hear—and wear either my hearing aids and neckloop or no hearing aids and earbuds. This decimates the background noise.

Just to give you one example. One time I was with my wife in a steakhouse restaurant. We were seated near one end—but at the other end was the bar and large-screen TV. As it happened, a ball game was on. Every time the game got exciting, there were loud yahoos from the bar patrons. This made it most difficult for me to hear my wife. However, with the PockeTalker and lapel mic, the background level dropped dramatically. I could hear my wife’s voice with ease.

I like using this combination when in restaurants or, in the car—places where you are seated and remain seated for a time.

If I am standing up and walking around—such as at receptions, or wandering around in noisy exhibit halls, my choice is a PockeTalker and handheld super-directional microphone.

Let me show you the difference. A few months ago I was in an exhibit hall talking to the various salesmen at their booths. When I started, I had my hearing aids on, but the racket was not only making it very hard for me to understand much, it was also giving me a headache. So I hauled out my trusty PockeTalker, super-directional microphone and neckloop.

I just aimed the microphone at the salesperson’s mouth and wow! It was just like he was talking right into both of my ears at the same time. The background roar almost became a whisper. That is what a properly used assistive device can do for you!

If you are interested in the PockeTalker and/or the specific microphones I use, here are the links to those wonderful devices. (They are all on the same web page—so you can just scroll down if you like.)

PockeTalker

Neckloop (NKL 001)

Lapel Microphone (MIC 054)

Super-directional microphone (MM400-S)

 by Neil Bauman, Ph.D.New research reveals that for some people with hearing loss, the tinnitus associated with hearing loss stems from over-active sensory nerves in the face and neck.(1) After hearing loss occurs, for some reason, touch-sensing nerves in the face and neck step up their activity in the brain. The result is that some neurons in the cochlear nucleus become hyperactive. This increased activity has been linked to tinnitus.

For these people, treatment for their tinnitus may be as simple as acupuncture targeted at the nerves in the head and neck.

These findings may also reveal why many people with temporomandibular joint syndrome (TMJ) also suffer from tinnitus.

(1) The Hearing Review, Vol 15, No. 2, February 2008. p. 60.

 by Neil Bauman, Ph.D.

A lady asked:

One question about the implantable hearing aid…Is there any “volume control?” In checking Otologics’ website, it does not appear to have one since it’s all internal. I would be fearful that it could be turned up too loud and do damage to the hearing.

Actually, I was just looking at the Otologics’ web site, and I find that there is a remote that turns the device on and off and sets the volume. Go to Otologics web page . The last sentence beside the bottom picture tells you this.

 by Neil Bauman, Ph.D.

A man wrote:

I recently was diagnosed with hypothyroidism (underactive thyroid). I have also been noticing an increased hearing loss. My doctor tells me that there is a connection between hypothyroidism and hearing loss, but I haven’t had other symptoms associated with the problem such as fatigue, lethargy and weight gain. I have also checked the Internet and found similar references to hearing loss. My doctor has put me on the lowest possible dose of Thyroxine and will be monitoring me every six weeks until the proper dosage is established. My main question to you is whether or not Thyroxine is considered an Ototoxic drug. Will stopping the Hypothyroidism, which is assumed to be contributing to my continued hearing loss, only cause more hearing loss because of the medication?

You can set your mind at rest. As far as I can tell neither Thyroxine (a natural hormone) nor Levothyroxine (Synthroid) (a synthetic drug) are ototoxic in any way.

Hypothyroidism is a condition in which there is too little thyroid hormone in the bloodstream. Numerous medications can affect thyroid production.

Hypothyroidism is commonly linked with hearing loss. In fact, “about half of the people with low thyroid function have hearing losses. Moreover, about 3% of the people with Meniere’s syndrome have hypothyroidism; and in some, control of the thyroid disease eliminates the symptoms of Meniere’s syndrome.” (1)

Both sensorineural and conductive hearing loss can result from hypothyroidism. So can tinnitus and vertigo. Doctors believe that things such as serous otitis media (middle ear infections), edema and swelling of the nerves may contribute to hearing loss in hypothyroidism. (2) Hearing loss is also a common symptom of Pendred’s syndrome, another thyroid-related disease.

(1) eHealth MD

 by Neil Bauman, Ph.D.

A lady explained:

In your book ‘When Your Ears Ring‘ you speak of black cohosh as a possible tinnitus treatment. I have tinnitus and I am trying to get off HRT [hormone replacement therapy drugs]. I looked at a lot of web sites and it seemed that black cohosh especially as the product Remifemin might be a help to a lot of my problems.

After four days on Remifemin it seemed my tinnitus was a lot louder. Today, I found a few web sites that say that black cohosh contains salicylates and should not be used by people who need to avoid aspirin. (I believe that aspirin worsened my tinnitus several months ago when I took some for back pain. At that time I took about six or seven 325 mg. pills over the course of one day to try to fight a disk problem in my back. I had had steady tinnitus for five years before this, then developed a second noise in my left ear four days after taking the aspirin. Since then both ears have become louder.) Do you think the Remifemin is causing this increase? I sure thought I did my homework on this one.

I think you are wise in getting of the HRT. HRT is pretty harmful to your whole body from everything I’ve read. I’d never consider it if I were a woman. It’s just not worth the risk. I think that Remifemin is a much safer alternative. And yes, I think you did your homework very well.

Remifemin contains an extract of black cohosh (roots and rhizomes) equivalent to 20mg that is standardized to contain 1 mg of the active ingredient—triterpene—so that leaves 19 mg for anything else in the black cohosh.

There are a LOT of chemical compounds in black cohosh apart from triterpene glycosides. These compounds include phenolic acids, flavonoids, volatile oils and tannins. In addition, there are several acids such as acetic, butyric, formic, oleic, palmitic, and salicylic acids. Thus the amount of salicylates in Remifemin must be a very small part of the remaining 19 mg.

I don’t think that Remifemin tablets even contain 1 mg of salicylic acid. But even if they were ALL salicylic acid—the dose would still be well below what is needed to cause tinnitus in the typical person.

Let’s compare the salicylate content in Remifemin to that of a typical aspirin. Standard adult aspirin contain 325 mg of acetylsalicylic acid. It is generally accepted that it takes about 6 aspirins a day to cause tinnitus in the typical person—that would be about 1950 mg.

Since the normal dose of Remifemin is 2 tablets a day, the most salicylic acid you would be getting is maybe 2 mg a day—a far cry from the 1950 mg needed to cause tinnitus in the typical person.

However, having said that, everyone is different, and for some people maybe even small doses of salicylic acid can cause tinnitus—but I wouldn’t think it would be very common.

The good thing about tinnitus from aspirin (and related salicylates) is that typically the tinnitus only occurs while you are taking the drug. Once you have stopped, in 3 or 4 days the tinnitus should disappear. (Unfortunately, for a few people this is not true and they are left with permanent tinnitus, but this is not the norm.)

 by Neil Bauman, Ph.D.

Did you ever wonder why as people become more and more inebriated, they talk louder and louder? You probably thought they were just losing their inhibitions—and rightly so—but that is not the whole story.

The surprising truth is that the more intoxicated people become, the worse their hearing gets. That is why as people become more and more intoxicated, their voices get louder and louder. They just don’t hear as well when inebriated. (1)

No wonder “watering holes” become so noisy as the evening progresses. They even have a name for it, “Cocktail Deafness”. Fortunately, the hearing loss is temporary. When you sober up, your hearing returns to normal again.

Another interesting finding is that hearing loss from drinking is mostly in the lower frequencies. No wonder patrons on the dance floor want the bass cranked up so loud.

(1) Healthy Hearing

 by Neil Bauman, Ph.D.

A man wrote,

I currently have an in-the-ear hearing aid that is not bluetooth compatible, and I need a replacement. I want a behind the ear hearing aid that is bluetooth compatible. I was hoping to find an aid that is around $900.00. The bluetooth attachment adds another $400.00. Could you help me with locating an aid that is adaptable to a bluetooth attachment.

You sure don’t want much do you—a hearing aid for $900.00 with all the bells and whistles attached?

The first hearing aids with bluetooth attachments required a DAI (direct audio input) boot to attach a bluetooth gizmo called the ELI (which stood for “Ear Level Instrument”). Unfortunately, the ELI had a number of drawbacks. First, it was quite expensive. Second, it could only attach to certain makes and models of hearing aids thus limiting its usefulness. Third, it could only work with one hearing aid so you could never have binaural hearing via a bluetooth connection. This was because Bluetooth pairs with the remote bluetooth device—thus one aid pairs with your bluetooth device (phone, etc) and the other aid is locked out. Fourth, it had limited battery life.

Current technology places the bluetooth circuitry in a remote control, not in/on the hearing aids themselves. The remote then “talks” to both hearing aids at once. However, hearing aids that use this arrangement are high end aids and cost several thousand dollars each. At the same time, if you change your aids, you need a new bluetooth remote.

A much cheaper solution (which does my Scottish heart good) is a bluetooth neckloop that can be used with any hearing aids that have t-coils. This way you don’t have to throw out the bluetooth neckloop when you get new hearing aids. Furthermore, you don’t have a “pairing” problem as the neckloop couples to both aids via their t-coils.

What I’d do is keep my options open and get a bluetooth neckloop. That way you can hear with both aids (via their t-coils). The bluetooth “dongle” at the end of the neckloop pairs with your cell phone, MP3 player, etc. This way you are not tied to any brand of hearing aid—just that you need t-coils—which you should get in any case.

Personally, I like the MaxIT bluetooth neckloop.

by Neil Bauman, Ph.D.

A man asked,

I am inquiring whether any of your home loop (or similar) systems is reasonably OK for my mother who has a modern pacemaker for her heart? I could place the loop wires 8 feet from the floor. Any advice you can give me will be appreciated.

As far as I know there has never been a problem with assistive devices affecting pacemakers—although some assistive devices carry warnings about not getting them too close to a pacemaker. I’ve even asked assistive device manufacturers, and they tell me they have never had a case where their devices interfered with a pacemaker.

Thus I think it is highly unlikely that loop systems (or other assistive devices) will cause a problem.

With room loop systems, the room loop is typically on the floor or above the ceiling and far enough away to not cause problems. Now, if the room loop wire ran right across her chest and pacemaker, that might be different.

If I had a pacemaker, I sure wouldn’t worry about a loop system upsetting my pacemaker. The loop only puts out a magnetic field—not a radio frequency signal.

I believe assistive devices to be perfectly safe for use near pacemakers—but its possible under certain conditions, with certain assistive devices and with certain people there could be a problem—but like I said, I’ve never heard of one ever occurring.

 by Neil Bauman, Ph.D.

A man wrote:

I have recently read a number of articles involving the use of Acamprosate (Campral) in treating tinnitus. One Brazilian study showed pretty positive results in giving tinnitus sufferers some relief using this drug.

I am going to see my ENT soon for my annual hearing test. While there, I am going to show him some articles I have printed to see if he would allow me to try this drug to see if I too can achieve some relief.

Prior to seeing him, I thought I would e-mail you to see if you have any thoughts or viewpoints regarding the use of this drug in the treatment of tinnitus. It seems as though the side effects are generally mild and well tolerated. After suffering with tinnitus for seven years, I would certainly welcome a trial with anything that may provide me some relief!

I hear you. There are millions of people in the same boat that would love to get rid of their tinnitus with a magic “tinnitus pill”, but that is not very likely in the near future.

First, be aware that at the present time there is not a single drug approved by the FDA for the treatment of tinnitus. To me this is a pretty strong indication that drugs are not the answer to curing tinnitus. Many drugs have been tried as possible tinnitus cures, but none has been very successful so far.

Now let’s look at Acamprosate (Campral). Acamprosate is approved for helping people overcome their alcohol addiction.

In the Brazilian study you mentioned, the figures sound impressive. After 90 days on Acamprosate there was a significant overall improvement rate of 87%. Nearly half stated their tinnitus had declined by at least 50%. Wow! Impressive results, right? But this was one small study involving only 25 people taking Acamprosate.

The results of this single study have been picked up and spread far and wide. What bothers me is that the research was done 4 years ago, and IF the results of this study were so wonderful, why haven’t many other studies been done in the past 4 years verifying the results of this study? Why aren’t doctors prescribing this drug to help people with tinnitus? Why hasn’t the FDA moved to approve this drug for tinnitus treatment, and thus help the 50 million Americans that have tinnitus?

The truth is, Acamprosate is not without serious side effects including suicide and depression. In addition, it can be ototoxic. It has been implicated in hearing loss, tinnitus, dizziness and vertigo as well as [auditory] hallucinations.

When it comes to drugs, it is better to not be on the leading edge because most (about 51%) serious side effects are not discovered in the studies drug companies do—but only become apparent after the drug has been approved by the FDA and is released to the public. Do you really want to be the guinea pig?

One of the problems in finding a drug cure for tinnitus is that we so often think of tinnitus as a single condition—whereas it is really a number of different things that cause the annoying phantom sounds. Since there are a number of causes, it stands to reason that one treatment that not will work for everyone. The treatment has to fit the cause.

For example, some studies show that the herb, Ginkgo biloba, alleviates tinnitus, and other studies show it doesn’t. Who do you believe?

In actual fact, if your tinnitus was the result of lack of blood flow to your inner ears (cochlea), then Ginkgo may indeed “cure” your tinnitus. But, if your tinnitus was caused by ototoxic drugs, or wax in your ears, or a glomus tumor in your neck, then obviously Ginkgo is the wrong treatment.

Therefore, if and when Acamprosate has stood the test of time as an effective treatment for tinnitus, and if its benefits far outweigh its side effects, then, and only then, is it time to give it a try if you value your health.