Hearing Loss Help  

by Neil Bauman, Ph.D.

More and more children are being found to have a hearing loss due to what is called Large (or Enlarged) Vestibular Aqueduct Syndrome (abbreviated to either LVAS or EVAS).

LVAS is passed on from generation to generation by recessive genes. That much researchers know. How many genes are involved in LVAS? No one knows.

So far researchers have now traced the gene thought to be responsible for LVAS to a location on chromosome 7q31 in a region that overlaps the area containing the gene responsible for Pendred syndrome (PDS).

As I wrote back in 2002, “This suggests that different mutations in the PDS gene can cause a variety of related conditions ranging from nonsyndromic recessive hearing loss (NSRHL) with enlarged vestibular aqueducts (basically LVAS) to the severe Mondini deformity and Pendred Syndrome. Some people with Pendred Syndrome have fluctuating hearing loss similar to that observed in people with LVAS.

Another theory is that a separate gene responsible for LVAS may exist close to the Pendred gene, and that mutations in both are required for full Pendred syndrome, whereas a mutation in only one of these genes may result in hearing loss associated with a variety of cochlear abnormalities.” (1)

The truth is, many more genes may be involved in LVAS than the one or two related to Pendred syndrome that have been discovered so far.

Did you know that of the approximately 20,000 genes in the human body, “more than 4,500 genes participate in the development and maintenance of the human inner ear, making it the most genetically complex organ in the human body.”

Researchers also know that hundreds of genes are involved in hereditary hearing loss, leading to syndromes such as Waardenberg, Usher and Pendred.” (2)

From the above, it is obvious that researchers still have a long ways to go in order to identify all the genes that go into making up LVAS. I say this because hearing loss (and balance problems) do not seem to correlate with the size of the vestibular aqueducts or anything else so far. In fact, some people don’t have an hearing loss at all in an ear with LVAS. Thus some critical information is still missing.

Until then, and with so many unknown variables related to LVAS, it will continue to be very difficult to effectively diagnose and manage LVAS.

(1) Large Vestibular Aqueduct Syndrome (LVAS)by Neil Bauman, 2002.  

(2) In “Advance for Audiologists” (July 22, 2008) by Jess Dancer, Ed. D.

by Neil Bauman, Ph.D.

A human services specialist contacted me and explained:

I was recently contacted by a woman interested in a neckloop for her cell phone (via t-coil setting). She finally tried one out, and didn’t like the fact that she couldn’t hear herself speaking. She has a hearing aid in one ear, and a cochlear implant (CI) in the other. Do you have any suggestions on how to hook up a system where she’d be able to hear herself as well as have access to the t-coil amplification? I’ve racked my brain and am out of ideas! Any help you can offer would be greatly appreciated.

Unlike land line phones, cell phones don’t have “side tone” which allows you to hear your own voice in the receiver. If you have normal hearing, when using a cell phone, you hear your own voice via your other ear.

However, when you want to use a cell phone with a neckloop or T-links, the hearing aid’s (and/or cochlear implant’s) microphones are turned off. Thus you can no longer hear yourself talk. As a result, you don’t know if you are talking too loud or whispering.

There are two ways to address this problem (apart from designing cell phones with side tone—but that would be too easy).

The simplest/easiest solution as I see it is to program her hearing aid (and/or CI) to the “MT” position (both microphone and t-coil on at the same time) instead of just the “T” position. Then she could hear her own voice as the microphone in her hearing aid (and/or CI) would pick her voice up and amplify it in that ear.

The other solution involves more technology—to create a pseudo-side tone. Here is one way she could do it using an independent system in tandem with the phone system.

For this to work, she’d need a PockeTalker (or other personal amplifier), a lapel microphone and a second neckloop or Music Links.

In practice, she would turn the PockeTalker on, place both neckloops around her neck and clip the lapel microphone to her collar. With her hearing aid and cochlear implant in their t-coil modes, she’d hear her cell phone via the one neckloop/T-links, and hear her own voice via the second neckloop/Music Links via the PockeTalker.

Most hard of hearing people just learn how much vocal effort it takes to talk at sufficient volume that the person on the other end can hear them, and yet not so loud they are blasting everyone within earshot. If this doesn’t work for her, then one of the above two solutions should.

You can get information here on a PockeTalker, neckloop and lapel microphone here  and information on the T-Links and Music Links here.

by Neil Bauman, Ph.D.

A lady asked:

What causes ringing in both ears?

There are a good number of causes of ringing in the ears—what we call tinnitus. Here are some of them.

• Exposing your ears to loud sounds
• Taking any of the 450 drugs that can cause tinnitus
• Hearing loss, especially sudden hearing loss
• Exposing your ears to various chemicals and heavy metals
• Eating certain “foods” such as alcohol, nicotine, caffeine, monosodium glutamate (MSG) and some spices
• Head trauma—blow to the head, head injury
• Whiplash, neck injuries
• Barotrauma (sudden pressure changes)
• Certain illnesses
• Allergies
• Colds/sinus infections
• Viral ear infections
• Middle ear infections (otitis media) or other ear problems
• Surgery
• Acoustic neuromas
• Meniere’s Disease
• Otosclerosis
• Diabetes
• Stress, anxiety, depression
• Extreme fatigue

In addition to the above, there are various somatic (body) kinds of tinnitus. Somatic tinnitus can result from such things as moving your head/neck, bending over, clenching your teeth, TMJ, moving your eyes, pulsatile tinnitus—tinnitus in unison with each heart beat and related to vascular causes. You can also get tinnitus from ear wax, or if the stapedius or tensor tympani muscle “spasms” in your middle ears.

The first three in the above list are probably the most common causes of ringing tinnitus.

I always like to find out what happened just before the tinnitus started. Often that gives a clue as to the cause of the tinnitus. For example, if you begin a new medication and 3 days later you get loud tinnitus, that could be the cause, or perhaps you are under extraordinary stress—then that could be the cause, etc.

by Neil Bauman, Ph.D.

I have just written a new article called “The International Phonetic Alphabet—A Boon to Hard of Hearing People (If You Know and Use It)”.

This article begins, “Among most hard of hearing people, the International Phonetic Alphabet seems to be a deep, dark secret. This should not be, as the International Phonetic Alphabet is a most useful communicating aid.”

The article goes on to teach you why the International Phonetic Alphabet is such a great communication aid for us (hard of hearing people), and how to effectively use it. Click here to read the rest of this article.

After you’ve read it, don’t stop there, put what you have learned into daily use.

by Neil Bauman, Ph.D.

A lady wrote:

Strange things are happening now with my eyesight. I used to get a head-size black spot in front of one eye. Recently I got a large white one. On Sunday, when I took a bath, it had changed suddenly to a real face. I opened and closed my eyes again and again, it did not disappear. I just laughed at it. What else could I do? I did not let it frighten me.

You have Charles Bonnet Syndrome. This is when you see things that are not there, especially when you have vision problems like you have. It is analogous to Musical Ear Syndrome—which is where you have hearing loss and hear things (music, voices) that are not there.

It’s nothing to be frightened about, especially once you know what is happening. Some people see the wall of their room disappear and be replaced by a field of sheep, or a children’s playground and the kids playing there.

Actually, a high proportion of elderly people with certain vision problems “see” such things, (around 30%) but seldom talk about them for fear of being thought crazy. (This is exactly the same as those who hear phantom music and don’t want to talk about their phantom sounds for fear of being thought crazy too!)

Some people even have both conditions at the same time.

I’ve written a book on Musical Ear Syndrome so people don’t have to needlessly worry about the phantom sounds they are hearing. In it there is even a chapter on Charles Bonnet Syndrome.

Learn more about Musical Ear Syndrome here,  or get my book “Phantom Voices, Ethereal Music & Other Spooky Sounds” here.

by Neil Bauman, Ph.D.

A lady wrote:

Someone just gave me a copy of your book, Ototoxic Drugs Exposed, and now I know why I lost my high frequency hearing while I was in my 40s. When you are very verbal and love music and talking, this is a pretty traumatic thing.

Starting in my 30s, I took Prozac [Fluoxetine] for 10 years, plus I get migraines and have used Imitrex [Sumatriptan] regularly since it came out. Finally, subsequent to a year or two off of Prozac, I took Wellbutrin [Bupropion] on and off for two years.

It ticks me off that, about 6 years ago, when I went to an ENT because I thought allergies were “stuffing” my hearing, they tested my hearing and determined that I had significant high-frequency hearing loss. When I asked why, because I thought I always took good care of my ears and didn’t listen to loud music, etc., they just answered “sometimes we just don’t know why these things happen.” They didn’t give me a list of products and ask, “Have you taken any of these in the past? Are you on any of these drugs now?”

Shouldn’t an ENT be on the lookout for that kind of thing? In the past six years, I could have been “not” taking Wellbutrin and maybe avoiding Imitrex a little more, and preserving more of my hearing.

Thanks again for your invaluable book. Talk about a “light bulb” moment!

Yes, doctors should be on the lookout for drug damage in their patients. Unfortunately, many don’t seem to be doing it.

I think there are two reasons doctors don’t tell you about the ototoxic side effects of drugs. First, they don’t believe that drugs are the culprit—they buy into all the pharmaceutical hype that drugs are safe when that is just not true. The FDA is on record as saying that “every drug has adverse side effects” and some of those side effects damage ears.

Second, since doctors are the ones that prescribe the drugs in the first place, they don’t want to admit that the very drugs they are prescribing are hurting their patients. By doing so, they’d obviously open themselves up to lawsuits.

Thus, it seems to be the rare doctor that knows much about ototoxic drugs and advises his patients accordingly.

Although many ENTs seem to be downplaying the ototoxic effects of drugs, there is some good news out there. More and more audiologists are regularly asking their new patients about the drugs they are taking, then consult “Ototoxic Drugs Exposed” to see whether their ear problems could be explained by the adverse side effects of the drugs they are taking.

In any case, I am a strong advocate of taking control of your own health and not relying on your doctor. This means learning about the harmful side effects of drugs and how they can affect your ears.

You can learn about such drugs by reading my book “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs known to damage ears (and information on 148 ototoxic chemicals too).

by Neil Bauman, Ph.D. 

A recent study revealed that the incidence of hearing loss in the USA has been grossly under-reported. Four or Five years ago when everyone was quoting 28 million hard of hearing people in the USA, I proclaimed that the true incidence of hearing loss was about double that (56 million). As a result, I caught flak from a hearing loss organization for not being a “team player” and reporting the “accepted” figures.

Now I have been vindicated. In a study done by Dr. Yuri Agrawal and colleagues, of Johns Hopkins Hospital, Baltimore, MD, and reported in the July 28 issue of the Archives of Internal Medicine, an estimated 55 million Americans have high-frequency hearing loss.

Here’s more details. The results were based on hearing tests “administered to 5,742 Americans age 20 to 69 from 1999 to 2004. Researchers assessed hearing loss of 25 dB or higher at speech frequencies (0.5, 1, 2 and 4 kilohertz) and at high frequencies (3, 4 and 6 kilohertz).” (1)

Sixteen percent “(an estimated 29 million) American adults had speech frequency hearing loss in one (8.9%) or both ears (7.3%). Thirty-one percent of participants (equivalent to an estimated 55 million Americans) had high-frequency hearing loss [12% in one ear and 19% in both]. High frequency hearing loss was found in participants age 20 to 29 (8.5% prevalence) and in those age 30 to 39 (17% prevalence).”

Suddenly the accepted figure for hard of hearing Americans has jumped from 31.5 million (today’s previously accepted figures) to 55 million. Now notice something important. This study just included people ages 20 to 69. What about the millions of hard of hearing people younger than 20, and older than 69? Obviously the true figure is much higher still.

Fortunately, Dave Albert, MD noticed this and explained, “I want to clarify some confusion about the Johns Hopkins article in the Archives of Internal Medicine on the demographics of hearing loss.

(1) They only looked at people age 20 to 69

(2) People 70 and over have an increasing incidence of high frequency hearing loss.

(3) Therefore, the real number of people in the US with significant hearing loss is significantly higher than the 55 million they estimate in the article.

A back of the envelope estimate would be take the 55 million (ages 20-69), add 1 million for ages 0-19 and 10 million (at least) for ages 70 to death and you will have 66 million. It is probably closer to 70 million but I am being conservative (which I am not very often).”

Notice that, now we have jumped from 31.5 million to 70 million—more than double the previously accepted figures. I think we are finally getting much closer to the truth. There is no doubt about it. Hearing loss is at epidemic proportions in the US today! The US population is just shy of 305 million people. This means that 23% of the population—almost 1 in every 4 people—has a significant hearing loss according to this study. I think it’s time we get serious about protecting our precious hearing!

(1) The Hearing Review July 31, 2008.

by Neil Bauman, Ph.D. 

A lady wrote:

You have been the greatest help in the past and I come to you once again with a question. With your help, I am currently using the Bluetooth MaxIT neckloop with great success on my cell phone. I also own a personal Williams Sound Hearing Helper [FM system] given to me when I retired. It’s great for personal conversations in the car and of course in some group settings.

Here’s my question. I am currently looking for part time work, but most require juggling telephone calls on business phones. If their phones are not Bluetooth compatible (in which I would hope the MaxIT could be used), what adaptations can be made so I can hear with both hearing aid t-coils?

You have several options available to you. Here are four solutions—two use your MaxIT Bluetooth neckloop, and two use a standard neckloop (and both of your t-coils of course).

Solution 1: There is the odd Bluetooth land line phone. An example is the Uniden ELBT595 phone. If I understand the spec sheets correctly, you can simply use your MaxIT with it. This phone is about $165.00. If you are interested, use PriceGrabber (see Solution 2 below for the details on how to use PriceGrabber) to find places that sell it. There may be other makes around too. I’ve never tried any so know nothing about them. This could be a good solution if this phone is compatible with the phones where you work—but it is obviously not a multi-line business phone.

If you want to use the physical phone already at your place of work, then solutions 2 or 3 could work for you.

Solution 2: You can also use your MaxIT Bluetooth neckloop—since that works so well with your hearing aids already (and cell phone)—with the phone at your place of work.

In order to do this, you need to convert the land line phone on your desk into a bluetooth phone. You can do this with a bluetooth “hub”. I’d recommend getting the Jabra model A7010 Bluetooth Hub. (Prices range from about $77.00 to $120.00 plus shipping).

Here is how you set it up. First, unplug the handset cord from the phone base, and plug the hub into the base instead. Next, plug the handset cord into the hub. That’s all there is to it. Now your phone is back into its original configuration and you can use it normally—but you can now also use it with your MaxIT Bluetooth neckloop. (One nice thing about using this Bluetooth hub is that it will work on almost any phone, whether home or business, analog or digital, as long as it is a phone with the dialing buttons in the base and not in the handset.)

To use the Bluetooth hub with your MaxIT Bluetooth neckloop, you first need to “pair” the MaxIT with the Bluetooth Hub, just like you paired it with your cell phone (and it’s just as easy). Once you have them paired, when the phone rings, you just pick up the handset and lay it on your desk. The Bluetooth will activate and you will hear via your MaxIT and t-coils in your hearing aids. When you are finished, just hang up the handset. That’s all there is to it. Neat, huh?

You can get the Jabra A7010 Bluetooth hub at various stores. I like to use PriceGrabber as it tells you where it is available on-line and who has the best price. To find this item, go to PriceGrabber and in the big green “Shop For” box, type in “Jabra A7010″ and click on “Find It”. PriceGrabber will then list the various places you can get it and their prices. The one with the best overall price (including shipping) has “Your Best Price” in red above the price. As of this writing, prices range from $76.84 to $120.00 plus shipping. You may find other on-line sources that are even cheaper—just be careful that you only deal with reputable outfits. (Check out the “user ratings” to get a feel for how that company treats its customers.)

Solution 3: A third method is to use your land line phone combined with a PockeTalker, or your Williams Sound Hearing Helper receiver if you have the PFM350 system. This system uses the Model R31 receiver, which has two volume controls and an external microphone jack. It is really both a PockeTalker and an FM receiver combined in one case. (This solution won’t work if you have the PFM300 system which uses the R32 receiver and only has one volume control and no external mic jack.)

For this method, the equipment you’ll need is a PockeTalker or R31 receiver, a standard neckloop or Music Links and a Mini-recorder control which you can get from Radio Shack (part number 43-1237, $17.99).

To set things up, unplug the handset cord from your phone base, and plug the Mini-recorder control into the base instead. Next plug the handset cord into the Mini-recorder control. This gives your phone its original functionality. Now to soup it up, you plug the 1/8″ plug from the Mini-recorder control into the microphone jack on your PockeTalker or R31 receiver. (Make sure the switch on the Mini-recorder control is set to “REC”, not “PLAY”.) Finally, plug the neckloop (or Music Links) into the earphone jack and you are all set. (To use the Music Links, you’ll require a stereo to mono adapter from Radio Shack—Part No. 274-368 $2.99.)

When the phone rings (assuming you already have the neckloop or Music Links in place), you just turn the PockeTalker or R31 receiver on, switch your hearing aids to t-coil mode, pick up the handset and speak into it as you normally would. (Note, you don’t have to hold the receiver up to your ear as you will hear via your t-coils, not via the phone receiver, but you do have to hold the mouthpiece up to your mouth so the person on the other end can hear you talking.)

Solution 4: Some phones have 1/8″ jacks on the phone base so you can plug in a standard neckloop or Music Links (with adapter) and hear that way. This is a very simple solution if you have such a phone. Unfortunately, these phones tend to be special amplified phones for hard of hearing people and not the phones used by businesses.

One of the nice things about using Solutions 2 or 3 is that it doesn’t matter what kind of a phone you have—whether it is single-line or multi-line, whether it is a digital or analog phone or whether the phone is hooked up to a PBX or not. Also, it is very easy to move your equipment from phone to phone if someday you change positions or get another job.

by Neil Bauman, Ph.D.

This is the third of three tinnitus stories, illustrating different effective coping mechanisms used by each of these three people. No one thing works for everyone—so you have to see which coping strategies work the best for you in reducing your tinnitus.

Here is “Sandra’s” story. She explained,

My tinnitus is quite loud on the average—around 6 or 7 (out of 10). Some days it’s at a 8 or 9, and will last at that loudness for a couple of days.

My tinnitus was triggered 10 hours after getting a flu shot. I truly believe it was the mercury that is used in it that did it. I have had it ever since. For weeks after the shot it was at a 10 and I thought I would lose my mind. Fortunately, after a few weeks it started to lower to a 7 or 8.

I tried to function and tried many methods to lower it further. For me, the tranquilizer Xanax [Alprazolam] helped tremendously. I take it still and my tinnitus is down to 5-6 most of the time. But there are certain things that will make it to go higher.

For me stress and anger are biggies. When I first get up it is the loudest. In fact some mornings I feel this humming feeling in my body right after I wake. Then the noise escalates immediately. When I am not stressed that does not happen at all. I will just get a 5 level upon awakening, and then increase to a 6 or 7 as I get busy. But on stressed days, only taking Xanax helps.

When I need to get something off my chest as in anger it gets very loud. It will not diminish unless I get rid of the anger or hurt. But it had not ever gone down below a 5 or 6 in the 4 years. that I have had it.

What helps the most is if I take a Xanax and change my environment by going out, or visiting my daughter or grandchildren. My mind is switched from my previous thoughts to feelings of pleasure being with family. Hence the noise comes down a peg or two. I have got myself adjusted to the noise level of 5-7, but if it goes above that I begin to get scared, and that makes it even worse. It takes a lot of coping and family support to get through the “loud” days.

Certain drugs also greatly affect my tinnitus. For example, Pepto Bismol (the pink stuff) can increase it two-fold. [Pepto Bismol has the same basic salicylate ingredient in it that is in Aspirin and related products.] Today I had to take the Pepto Bismol and sure enough the ringing is getting louder by the hour. By tomorrow it will be full blown 9-10, and I’m not looking forward to it. But I had to take it to help my stomach. Then by the next day it will start to go back to around a 6 or 7.

There are some things that make my tinnitus worse besides stress and drugs. Salt, too much sugar, chemicals, cleaning agents, bug killers, if the TV is too loud for too long, if I am overtired and my mind is thinking a lot to name a few.

My tinnitus drops to a 5 when I occupy my mind on something pleasant. Other things that help my tinnitus is not harboring resentment, and getting enough sleep.

From “Sandra’s” story we learn how closely tinnitus can be associated with our emotional and mental states, and how important it is for us to “keep an even keel” and not harbor anger and resentment, or get stressed out over things. Deliberately changing the environment and thinking “good” thoughts works for her. You might be surprised how well it can work for you too.

I don’t advocate taking drugs such as Xanax (Alprazolam) because this drug belongs to the Benzodiazepine class and is dependence-forming. (Trying to get off such drugs can make your tinnitus “awful” so it is better never to get hooked in the first place.) However, taking a anti-depressant occasionally when you find it most difficult to cope with your tinnitus is not all bad as “Sandra” found.

Also, observe which drugs, chemicals, cleaners, etc. aggravate your tinnitus and avoid those things. There are ever so many tinnitus triggers, and it is up to you to find which ones make your own tinnitus worse.

If you are interested in learning more about tinnitus and the many things you can do to help bring it under your control, you would do well to read my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

This is the second of three tinnitus stories. In contrast to “Jim’s” gradual drift into tinnitus, “Audrey” was suddenly plunged into it. Here is her story.

I developed tinnitus very suddenly in 1993 when I was 38 years old. Before that day, I had excellent hearing and balance. I was in graduate school at the time, and just before class, my Professor asked me if I felt OK. She said I didn’t look good—but agreed with me that it might just be the usual end-of-the-semester exhaustion typical of a grad student.

At 11:10 while I was sitting in class, I suddenly got a little single tone ringing in my right ear. Over the next 10 seconds, it was as if a wave rolled over my ear and killed it. In that 10 second span, I lost 100% of my hearing in that ear, and the noises got VERY loud and included 3 or 4 different tones simultaneously. I also became a little dizzy. The dizziness became worse all day and I eventually lost 100% of my balance on the right side, too.

My right inner ear just “up and died” that day. So, I suddenly got all 3 problems—deafness, tinnitus, and balance loss.

As the otologist who treated me said, I was the “classic case” of Sudden Hearing Loss Syndrome—the sudden death of the inner ear for no apparent reason—and for which there is no proven treatment. In my case, we suspect that an otherwise asymptomatic virus wiped it out.

Over the next year or so, the tinnitus and the balance problems improved a little, but my hearing is still a100% loss. Fortunately, my left ear remained normal.

The sudden loss of hearing in one ear was the easiest thing for me to adapt to. The balance loss and the tinnitus were tougher. Fortunately I had a great otologist whom I trusted. She advised me to figure out (through trial and error) which foods and activities made my tinnitus worse and then make my lifestyle decisions accordingly. She also emphasized being tough and simply not giving in to the temptation to let it make me an invalid.

I discovered that caffeine is a huge “no no” for me—but that’s the only food that I avoid because of my tinnitus. Stress, sound, and wind are the other big stimulators. For example, after a good night’s sleep, I will wake up with very little tinnitus (maybe a level 2 out of 10). Then I get up and go to the bathroom, and when I flush the toilet—ZING!—the tinnitus “turns on” and jump up to a 5 or 6. It’s at its worst after I have been outside on a windy day. I’m not sure why that is, but the wind increases my tinnitus dramatically.

Over the years, I have coped well by learning how to focus my attention on what I want to hear while simultaneously not focusing on the tinnitus I don’t want to hear. I still “hear” it. I just accept it as background noise, and live life with a permanent sound track. It’s kind of like living in a busy restaurant—in which there is always background noise that is sometimes very loud—but I choose to focus on my companions and my food, not on the background racket.

I decided to simply accept the noise as a part of my way of experiencing the world and got used to it—though I do try to avoid things that stimulate it, and I use relaxation techniques to try to lower it a bit when it gets really loud.

I have more trouble whenever I don’t get enough sleep. I also limit my use of NSAIDs as they dramatically increase my tinnitus. In addition, as soon as I think about my tinnitus, it increases noticeably.

“Audrey’s” story reveals two more great coping strategies where tinnitus is concerned. First, notice that she learned to accept her tinnitus—not fight it. She, as much as is humanly possible, put it out of her mind. As a result, her limbic (emotional) system didn’t “flag” her tinnitus and make it even worse. Dwelling on your tinnitus almost always makes it worse, so follow “Audrey’s” example.

Second, she learned which lifestyle changes affected her tinnitus. Thus she could prevent her tinnitus from “taking over” by avoiding those things—such as caffeine and NSAIDs (non-steroidal anti-inflammatory drugs) for two. She also learned that stress was a big factor (and is with many people with tinnitus), so by limiting her stress, she also effectively was able to control her tinnitus to some degree.