Hearing Loss Help  

by Neil Bauman, Ph.D.

A man asked:

Is there anywhere on the web, or a resource that you could direct me to, where I can learn to improve my lip reading skills?

The real secret to becoming better at speechreading (lip reading is the older term) is to always “stare” at the person to whom you are talking. In other words, practice, practice, practice. I’ve been doing this all my life. That’s how I
learned.

You may find it helpful to read my article on speechreading. However, if you want to really speed things up, there is an excellent speechreading CD available to help you improve your speechreading skills.

by Neil Bauman, Ph.D.

You don’t want to be taken in my ads that claim you will hear well with the latest hearing device. NewsChannel 5 ( WTVF) recently wrote a story that begins:

If you’re having trouble hearing, you might be tempted to buy a new product called the Loud ‘N Clear.

It promises to help you hear better and even hear things you might not ordinarily be able to.

But, can the Loud ‘N Clear really do all that its ads claim?

NewsChannel 5 Investigates put it to the test, and consumer investigator Jennifer Kraus found the answer is… Click here to read the rest of this story.

This expose’ is itself a bit misleading. It asks whether you can hear across a street, or what people are saying in a crowded room with lots of other noise, etc. The answer to that is no, the Loud ‘N Clear can’t do that, but surprise, neither can my fancy hearing aids. You have to have realistic expectations of what hearing aids and assistive devices can and cannot do for you. One thing they won’t do is restore your hearing to normal. In quiet situations you can expect to hear much better, but in noise, or in groups, you will still find that you typically miss a lot.

You see, there are two factors in hearing loss. First, obviously, since you have lost some hearing, you need a device to make sounds louder—and hearing aids and other devices can do that without any problem. However, they cannot fix the second factor that also accompanies hearing loss, namely, poor discrimination.

In other words, speech may be loud enough for you to hear people talking, but you may still miss a lot of what they are saying because your ears can’t hear many of the high-frequency speech sounds that give speech much of its “intelligence”.

In noisy situations you can’t rely solely on devices or hearing aids unless you can get the microphone right up to the speaker’s lips. (This is why FM systems work so well in these situations—you have the remote microphone right at the speaker’s lips.)

Trying to hear a person talking through noise and at a distance just isn’t going to work, whether you are using your “big buck” hearing aids, or the Loud ‘N Clear, or any other assistive device unless you have a remote microphone at the speaker’s mouth. That’s just the way it is.

by Neil Bauman, Ph.D.

A mother asked:

My daughter has bilateral LVAS and is begging to play an instrument. Do you have any advice or experience with what instruments are safe for children with LVAS to play?

Some people with LVAS (Large Vestibular Aqueduct Syndrome, sometimes called EVAS—Enlarged Vestibular Aqueduct Syndrome) are very sensitive to changes in air pressure. For them, even blowing on a brass instrument (trumpet, trombone, tuba, etc.) can result in further hearing loss. For these people, any musical instrument that does not require them to blow is safe in that regard.

As far as I know, hearing loss from people with LVAS playing musical instruments is quite rare. Therefore, playing a woodwind or brass instrument probably won’t affect her hearing.

Fortunately, there is a way you can figure this out. It is simply this. If your daughter’s hearing is affected by changes in air pressure (low or high pressure systems moving in rapidly, by going up or down hills in vehicles, by flying, or exerting or straining herself—running very hard, pressing weights, etc.) then the exertion needed to blow a brass instrument will also likely cause a hearing loss.

However, if the above things do not affect her hearing, then it is highly unlikely that playing a woodwind or brass instrument would affect her hearing either.

In short, if you’ve watched what activities have caused hearing loss in your daughter in the past, then those and similar activities will likely cause more hearing loss in the future if she takes part in them. Other than that, you shouldn’t unduly restrict her activities. You should be able to make a good judgment call on this issue by applying the above to her situation.

Finally, one caution, and this is for everyone, not just people with LVAS, the volume of sounds in bands and orchestras can be dangerous to your hearing. Therefore, it is wise to use ear protectors to keep the sounds down to an acceptable level and thus preserve your hearing. There are special musicians’ ear protectors that reduce the volume without affecting how you hear pitch. Many professional musicians wear them. You would do well to do the same.

by Neil Bauman, Ph.D.

A lady explained:

If someone has an automatic t-coil on their hearing aid, they will have problems hearing on their cell phones if they want to do so in t-coil mode. They will need a magnet glued to the phone’s earpiece in order to activate the automatic t-coil.

I don’t have a t-coil switch on my digital hearing aid. As a result, for a year, trying to hear on my cell phone was horrible. I couldn’t put a magnet next to the earpiece to kick in the t-coil because it was a flip-phone and it wouldn’t close otherwise.

I just brought a new cell phone—not a flip phone this time. I glued a magnet next to the earpiece and the t-coil kicked in properly. I can hear great now!

You have just exposed one of my chief complaints concerning automatic t-coils—they need a manual override when using them with devices that do not provide a strong enough magnetic field to activate them. This includes devices such as cell phones, neckloops and room loops.

It’s a shame that after paying the big bucks for your hearing aid, you still have to fool around to make the automatic t-coil work with your cell phone. Your work around is great—you just have to find a small magnet that’s powerful enough to activate your automatic t-coils and then glue it to the right place on your phone so it will activate when you hold the phone up to your ear (hearing aid). That’s a pain.

I don’t like, or recommend, automatic t-coils unless they have a manual override. With a manual override, you don’t have to fool around with a magnet. You just manually put your hearing aids into t-coil mode. Then they will work with your cell phones and neckloops and room loops too.

With your automatic t-coils, you can’t hear via your t-coils when using loop systems unless you stick magnets to your hearing aids to activate their automatic t-coils. That’s another pain. (Also, you need to have those magnets with you at all times so you have them when you need them.) Furthermore, you can’t glue the magnets to your hearing aids because you have to remove the magnets when you are finished with the looped device so your hearing aids will return to microphone mode again. Otherwise, you won’t hear a thing until you do. What a pain!

It’s so much better to insist on a manual t-coil, or an automatic t-coil with a manual override. Then you never have to fool around with magnets on your phone or your hearing aids. As you can tell, I’m solidly for “pain-free” listening.

by Neil Bauman, Ph.D.

A concerned daughter wrote:

My dad is 74 years old, in great physical condition, slim and active. Within the past 5 months he has developed a loss of hearing, ringing in his ears and balance impairment. He has been taking Prozac for the past 20 years. He adjusts the dose to his own liking. He also has been taking blood thinners because of a heart bypass operation. Might the Prozac be guilty?

Fluoxetine (Prozac) might be guilty, but I really wouldn’t expect it since he has been taking it for 20 years without previous side effects (unless now he has suddenly upped the dose significantly). To be sure, Fluoxetine (an SSRI) can, and does, cause hearing loss, tinnitus and/or balance problems in some people.

On the other hand, I’m sure he was given lots of drugs at the time of his heart bypass operation, and they could have caused his hearing loss, tinnitus, etc. Also, maybe the blood thinners are the problem.

Look at any other drugs he is taking, or has been taking, for the past 6 months or so. I’m always suspicious when side effects show up in the weeks/months after beginning a new medication or upping the dose on an existing one. If you can correlate his ototoxic side effects with a drug he began taking shortly before they occurred, that is the likely culprit.

by Neil Bauman, Ph.D.

If you have a severe hearing loss, hearing your name being called in a busy doctor’s office is stressful to say the least, and can be an exercise in futility when you keep being “missed” because you never heard your name called.

The good news is that it doesn’t have to be that way. Even when the doctor’s office isn’t set up to be “hearing friendly”, you can do things to make yourself stand out and thus get your needs met. Here’s what Mary did.

Mary was having cataract surgery in a large, busy outpatient clinic. She was having the pre-op, surgery and post-op all the same day so was going to be “called” a number of times throughout the day. She had tried some strategies before, but this time she hit the jackpot in discovering something that really worked.

Before she went to the clinic she got a bright yellow sheet of paper and printed on it in big bold letters:

PATIENT IS HARD OF HEARING

MAY NOT HEAR NAME CALLED

WEARING YELLOW TOP TODAY

Then she color-coordinated her “top” with the paper color.

When she checked in, she gave the paper to the receptionist and had her clip it to the outside front of her chart. Here’s what happened. Mary wrote:

It was a huge success! I was able to see the sheet on the outside of the chart several times so I got up before they even called my name. (Note: You need to do your part too and be proactive—watch for someone coming with your “yellow” chart.)

I had 2 people come directly to me, and one lady just had the yellow sheet in her hand when she was coming my way. (Wearing the yellow top really helped them find me.) One time I saw my yellow chart in the box outside one of the offices so I knew that was my chart when they pulled it.

When Mary went back for follow-up a week or so later she did the same thing—took her yellow card and wore a yellow top. She explains:

I saw the yellow sheet as the first technician called my name, so stood up. She laughed. The same thing happened when the second person called my name. However, when the third girl called out into the large waiting area, she was behind me. It didn’t seem that she was looking for a yellow shirt. She seemed to be looking over the heads of people, but I turned around and said, “Did you just call Mary?” and then I saw the yellow sheet so I knew she really was calling me. She commented on what a great idea that was. Everyone remembered to clip the yellow sheet back on top of my chart, ready for the next person. This has been a successful and positive experience in advocating for my hearing needs.

Thanks for the tip Mary!

Next time you are in a similar situation, adapt Mary’s strategy to fit your needs. It worked for her. It should work for you too!

by Neil Bauman, Ph.D.

A man wrote:

I am somewhat hard of hearing. I can never hear my cell phone when it rings , even when it is my pocket. Do you have a remote little light that would blink when my phone rings?

Sorry, I’m not aware of a portable blinking light device for cell phones. However, there are some things you can do. First, most hard of hearing people have a high-frequency loss—which means they don’t hear the higher-frequency cell phone ring tones very well. Therefore, to make it easier to hear your cell phone ringing, download (or choose) the lowest frequency ring tone that is available for your phone. You might be surprised how much better you can hear a lower-frequency ring tone.

Second, why don’t you leave your cell phone on vibrate so you can feel it ring, even if you can’t hear it?

Third, if you regularly put your cell phone down—for example, on your desk, or on your bed table at night, I do have a nifty gizmo for you. This device flashes a light, produces a loud audible alert, and, if you are in bed, shakes your bed to get your attention whenever your cell phone rings. You can see this cool cell-phone ring alerter here.

by Neil Bauman, Ph.D.

A lady asked:

Do you have an opinion on which antidepressants are the safest for our ears—e.g. Pamelor, Desipramine, Zoloft, Lexapro, Celexa, etc. Is there one that is significantly less ototoxic than the others?

For my money, I wouldn’t use any of the above. Why? Because there is a much safer alternative—St. John’s Wort. You see, this herbal is not ototoxic at all. Furthermore, according to numerous studies, it works as well as the above drugs for mild to moderate depression. In addition, it doesn’t have all the other bad side effects the above drugs have either.

If you decide to take St. John’s Wort, do two things. First, run it by your doctor or pharmacist. You want to make sure it won’t interfere with any of the other drugs you are currently taking. Second, be sure it says on the bottle that it is standardized to 0.3% to 0.5% hypericin. (Hypericin is the active ingredient.) When you use a standardized formulation, you know exactly how much of the active ingredient you are getting. Otherwise, the active ingredient may vary all over the place, and you don’t want that.

by Neil Bauman, Ph.D.

Most people know that if you have diabetes, you run the risk of microvascular complications that can affect the retina of your eyes and your peripheral nerves, especially in your feet. Diabetes can also damage your hearing. That is not new.

What is new is just how many people with diabetes also have resulting high-frequency sensorineural hearing loss. Here is what a couple of studies have revealed.

The first study (1) revealed almost six times the odds of high frequency hearing loss associated with peripheral neuropathy and coronary heart disease. In addition, this study of 472 people showed that sub-optimal glycemic control (defined as a hemoglobin A1c level (HbA1c) greater than or equal to 7%) was associated with almost 3 times the odds of high-frequency hearing loss.

The second study (2) compared the hearing of 50 people with diabetes to 50 controls matched for age and sex.

The results of pure tone audiometry found that 94% of the people with diabetes had hearing loss compared to just 18% in the control group. That’s a pretty significant difference!

When comparing people with a glycemic control of 7% or greater to people with a glycemic control of less than 7%, those with a glycemic control of 7% or greater all had hearing loss. Their hearing losses broke down this way: mild to moderate loss, 56%; moderate to severe, 35%; and severe to profound, 9%.

Of those people with a glycemic control of less than 7%, only 40% had hearing losses and all their hearing losses were only mild to moderate. Thus, it appears that it is vitally important to your hearing health to keep your glycemic control (hemoglobin A1c levels) to less than 7% if at all possible.

When comparing severity of hearing loss to the length of time a person had diabetes, the results generally revealed that the longer you have diabetes, the more severe your resulting hearing loss. For example, for those people with diabetes for more than 8 years, 8% had mild to moderate losses, 75% had moderate to severe losses and 17% had severe to profound losses. The corresponding hearing losses for those with diabetes for fewer than 8 years were 69%, 18% and 5%.

Notice the enormous shift from those with mild to moderate losses in the fewer than 8 year group (69%) to moderate to severe losses in the more than 8 year group (75%).

Although these are preliminary findings, it appears that getting your diabetes under control as soon as possible, and maintaining a glycemic control of less than 7%, will give you the best chance of retaining your hearing and preventing increasing hearing loss the longer you have diabetes.

(1) Bainbridge, Kathleen, and Catherine Cowie. “Correlates of Hearing Impairment in the U.S. Population with Diabetes, National Health and Nutrition Examination Survey, 1999-2004.” Bethesda, MD. Abstract No. 957-P. American Diabetes Association.

(2) Ismail, Mohammed, and Prcasanna Venkatesan. “Diabetes and Auditoryneuropathy” Mangalore, India. Abstract No. 28-LB. American Diabetes Association.

by Neil Bauman, Ph.D.

A man asked:

Which is better, hearing aids or cochlear implants?

The true answer is “It depends.” You see, it’s not hearing aids or cochlear implants, rather its typically hearing aids first and then, when your hearing aids no longer significantly help you hear, its time to see about getting cochlear implants.

If hearing aids can significantly help you, you are typically not eligible for cochlear implants. However, when your hearing aids no longer significantly help you, its time for you to investigate getting cochlear implants.

To be eligible for cochlear implants, as a rule of thumb (and the rules keep changing), the hearing in your better ear has to be severe or profound, your word recognition has to be under 40% and hearing aids cannot significantly help you.

Incidentally, some new research has revealed that getting a cochlear implant in your worse ear and wearing a hearing aid in your better ear can produce better directionality of sound, better understanding of music and speech and more natural sounds than getting two cochlear implants—at least in some people. Therefore, the answer to your question may be—get one of each if you are eligible.