Hearing Loss Help  

by Neil Bauman, Ph.D.

Researchers are busy looking for ways to reduce tinnitus. A recent study (1) that caught my eye, and one that shows promise, consists of listening to your favorite music for about 2 hours a day for a year. How hard can that be when one of the benefits is reducing the volume of your tinnitus?

In order for this to work, there are two conditions you must meet. First, your tinnitus must be a tonal kind of tinnitus that stays at a constant frequency. Second, the music you listen to must be digitally modified to take out the frequency of your tinnitus—hence the term “notched music”—as you have a notch where there is no sound at your tinnitus frequency.

(The way the researchers created this “notch” was to filter out a whole octave of sound centered around the frequency of the person’s tinnitus.)

Then, you just listen to your music for about 2 hours a day for the next year. By the end of 6 months, you’ll notice that the volume of your tinnitus is dropping significantly.

After 12 months, the people in this study found their tinnitus had dropped in volume by about 28%, and their annoyance at their tinnitus had dropped around 22%. In contrast, those in the placebo group (who listened to their favorite music without the notch) actually had their tinnitus increase about 9% and their annoyance at their tinnitus increase about 7%. (There was no indication as to what kind of music people listened to, nor at what volume.)

The reason this notched music therapy appears to work is that our brains are “plastic”. That means they can adapt and change their responses over time. Apparently our brains are more amenable to changing based on listening to sounds we like rather than to ones we dislike—hence the need to choose music you particularly like.

Researchers are beginning to understand that tinnitus arises when the auditory cortex in our brains inadvertently changes in inappropriate ways.

Researchers feel that tinnitus is “associated with a relative excitatory-inhibitory cortical neural network dysbalance, at the expense of the inhibitory system.” Say what? In plain English, what this means is that when everything is functioning properly, some auditory neurons in our brains may get too excited and “talk” out of turn so to speak. When they do this, the surrounding neurons tell them to “shut up”. This maintains order in the auditory cortex.

However, when too many begin to talk out of turn and not enough tell them to “shut up”, things get a bit wild and the result is tinnitus. If this situation is allowed to continue, it becomes the new norm and you end up with constant tinnitus.

Furthermore, if you have a hearing loss, some neurons in your auditory cortex are deprived of normal sound signals. Since neurons are not happy doing nothing, they “rewire” themselves so that they are no longer excited by the frequencies they were originally tuned to. Instead, they tune in to the frequency of their neighboring neurons. When a bunch of them do this, the resulting synchronized spontaneous neural activity apparently results in what we call tinnitus.

The good news is that previous research has shown that this “rowdy” behavior can be modified by behavioral training. The way the researchers did this in this study was to eliminate sounds at the frequency of the person’s tinnitus. Now, since there was no “sound stimulus” at the frequency of the “tinnitus neurons”, but at all other frequencies, the “neurons that weren’t stimulated were suppressed via lateral inhibitory inputs originating from surrounding neurons.” In other words, enough of the surrounding neurons told the “tinnitus neurons” to “shut up” and thus the volume of their tinnitus went down, and things became more normal once again.

It appears that notched-music therapy may prove to be an enjoyable, low-cost and casual (relaxed) treatment for reducing tinnitus a significant amount.

If you want to learn more about tinnitus and some of the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

(1) “Customized notch music training reduces tinnitus loudness” by Henning Stracke, et. al. Communicative & Integrative Biology 3:3 pp. 1-4, May/June 2010.

by Neil Bauman, Ph.D.

A man asked:

Is it possible for hearing aids to be programmed to deal with “recruitment”, the loud “bursty” elements of sound?

This seems to be quite a common problem for those of us with more severe hearing losses. Few audiologists seem to take the time to properly test for recruitment, and then specifically adjust our aids so they don’t cause recruitment.

The proper way to test for recruitment is to check the uncomfortable loudness levels (UCL) where sounds go from being too loud to hurting for each test frequency.

Typically, audiologists just do a “broadband” check of the UCL, rather than frequency by frequency. In fact, only one time in my life has an audiologist ever done a proper frequency by frequency recruitment check, and that was because I specifically asked her to do it.

After testing for the UCL frequency by frequency, your audiologist then needs to set the compression on your hearing aids for each frequency to limit the maximum sound level for those frequencies such that they always remain below your recruitment level.

This sounds simple in theory—but may be harder to do in practice depending on the number of compression bands your hearing aids have. Because of the placement of my recruitment along the frequency spectrum, and since by hearing aids only have four compression bands, my audiologist has to “detune” half of my channels in order to fix the recruitment problem. The result is that my comprehension goes down significantly. This is not good.

Thus I have two choices: either fix most recruitment problems, but don’t understand as much of what I hear, or understand more of what I hear, but yank my hearing aids out of my ears when sounds start recruiting. Either way, I don’t hear as much as I should. The next time I get hearing aids, I’m going to look for hearing aids where the compression can be set for each frequency—not just by broader bands.

Totally eliminating recruitment isn’t easy. There is a fine line you have to walk when adjusting the hearing aids to get the best of both worlds at the same time. It won’t be perfect, but with patience, your audiologist should be able to get pretty close.

by Neil Bauman, Ph.D.

A student wrote:

I am a senior in college and have had single-sided deafness since birth. I coped with my hearing loss fairly well, although I do not know what it is like to hear with both ears.

The reason I’m writing you is because I have a problem I’d like your help with. I’ve realized that I mishear and mispronounce certain words. I put in a lot of effort in order to make sure I don’t make mistakes in my presentations or at formal meetings. However, I will soon graduate from my university. What I am worried about is that this problem will negatively affect me in the future—during job interviews, for example.

Are there any techniques I can use in order to solve this problem? I know about sitting with my good ear in the general direction of the speaker, and directly facing the speaker, but is there any way I can boost my ability to comprehend what people are saying better, and also not mess up what I am saying at the same time?

I realize this is an odd question, but I would greatly appreciate your help.

Actually, this is a very good question, one more people should ask.

The problems you are facing are not unique to people with single-sided deafness. They affect most hard of hearing people too. I’ve struggled with these same problems myself.

There are a number of things you can do to help yourself.

First, consider getting some sort of hearing aid that pipes the sounds from your deaf side to your good ear. There are a number of devices you could consider. The BAHA (bone anchored hearing aid) is the current industry “darling”, but there are other less expensive solutions such as CROS hearing aids, or the TransEar, and even sophisticated regular hearing aids. You can read more about these various solutions in my article “Options for Single-Sided Deafness“. This will help you hear better from your deaf side, but it is not the total solution.

Second, make family, friends, classmates and teachers aware of your hearing loss and consequent problem with mispronouncing certain words. Ask them to tell you whenever they notice you are mispronouncing a word. Then have them show you how to pronounce it correctly. Repeat it back to them until you can do it properly.

Third, for words you come across when reading but have never heard pronounced, either ask someone who knows how to pronounce them correctly, or check the dictionary for pronunciations. Many dictionaries have pronunciation guides in them. You can also do this on-line. In fact, several on-line dictionaries actually pronounce the word so you can hear how it is supposed to sound.

Fourth, as necessary, use assistive listening devices such as an FM system to pipe the speaker’s voice right to your good ear. In practice, the person you want to hear (teacher, professor, boss, etc.) wears the FM microphone (wireless transmitter) and you wear the FM receiver. You plug an earbud into the earphone jack and place it in your good ear. A good FM system for this purpose is the Motiva.

When you do this, the sound is transmitted from the speaker’s mouth right to your good ear without any interference from background noise around you. As a result, you should hear beautiful, clear speech. Thus you will know exactly how words should sound.

When you have hearing problems (and single-sided hearing loss is a kind of hearing problem) noise and distance are your enemies. Therefore, anything that cuts down the background noise you hear, or effectively closes the distance between the speaker and your ears will help you understand speech better.

An FM system effectively closes the distance to about 6″ or so—the distance from the teacher’s mouth to the microphone. This fixes the “distance enemy”. At the same time, since the microphone is ever so much closer to the teacher’s mouth than the sources of noise in the room, you have effectively fixed the “noise enemy” too.

by Neil Bauman, Ph.D.

Distance and noise are two enemies of hearing aids. That is why hard of hearing people often need to use assistive devices coupled with their hearing aids in order to hear beautiful, clear sound.

There are many “generic” assistive listening devices that couple with hearing aids via their built-in t-coils. This is the industry “standard”.

However, each hearing aid manufacturer wants people to purchase their hearing aids (understandable—that is why they are in the business) so they come up with proprietary innovative ways to connect to various audio sources such as TVs, iPods, computers, etc.

This means when one of their customers (that’s you and me) buy their hearing aids, we are locked into their line of assistive devices (and they are not cheap). Then, if in the future we want to buy new hearing aids from a different manufacturer, we lose all our investment in the assistive devices we have purchased for our previous hearing aids.

This may be good business for the hearing aid manufacturers, but it is definitely bad for our pocketbooks! We now have to shell out big bucks, not only for new hearing aids, but for new assistive devices as well.

This should not be. Connectivity to assistive devices should be “open source” so all manufacturers can use the same modes of connectivity.

I’m all for innovative designs and advances in technology. I’m just against all the mutually incompatible proprietary devices we have to purchase in order to use the latest technology with our hearing aids.

What brought on the above diatribe is GN ReSounds new Alera hearing aid with yet another proprietary set of assistive devices.

The press releases are long on hype and short on hard facts, but from what I can gather, the Alera has a built-in (presumably FM) receiver operating at 2.4 GHz. Then, the customer purchases various proprietary transmitters that connect to the audio devices he wants to listen to. So you buy one so you can listen to your TV and another to listen to your computer, etc.

It sounds like cool technology. The FM receiver is built into the hearing aid so there is no need for using boots, neckloops or remotes. This makes for a “cleaner” design.

You hook up the appropriate transmitter to the audio device you want to listen to—and voila, you hear beautiful, clear sound. With the Alera, you can be 21 feet away, which is about the same distance as the effective range of the Bluetooth technology that is already out there.

If the “hypewriters” are correct, this new technology will deliver “unique sound quality” by employing ReSound’s “revolutionary” Surround Sound technology which delivers a rich and crisp 360-degree sound.

The Alera and its assistive devices will be available in June, 2010. If any of you try them, I’d love to hear how they work for you. Just be sure that the Alera comes with a standard t-coil, or, when you go to places that use loop technology, you’ll be left “out of the loop” and thus your fancy new hearing aids will be essentially useless.

Learn more about the Alera here.

by Neil Bauman, Ph.D.

In a previous article “Nodding Chime Tinnitus“, a woman explained that she heard chiming tinnitus whenever she nodded or shook her head.

I asked anyone reading that article if they had ever had somewhat similar experiences. Here are five responses I received.

One lady reported:

I also have the same type of thing when I shake my head. At the same time, I have a constant sound in one of my ears regardless of what I am doing.

A man explained:

This is one of my symptoms. The note is slightly different for yes and no—yes is higher-pitched. I think I’ve experienced this for many years, but only started to notice continuous tinnitus at the age of 50, about 8 years ago. I have been wearing higher-frequency hearing aids since then, have had tests for acoustic neuromas, and have undergone tinnitus retraining therapy with some success.

In addition to the nodding/shaking symptoms, I get similar chimes when I jog. I can also reduce or increase my steady- state tinnitus by pressing quite hard on various parts of my jaw. Pressing the jaw into the joint tends to decrease the tinnitus, pushing my chin to one side tends to increase it. The effect is quite dramatic.

A lady wrote:

I also have a type of tinnitus that happens when I shake my head up and down or side to side. It’s not chimes to me but more like a static or buzzing. I can’t remember when it started, but I have a progressive hearing loss that resulted in my surgery one year ago for a cochlear implant. I can provoke it at will—pretty much all the time.

Another phenomena I’ve had for a few years—worse before the CI—has what I’ve found on the web as an “audible wakening”. Basically when changing consciousness stages I sometimes hear a “wraaanggg” type of almost screaming “sound”. Can’t explain it much better—sorry. I wonder whether others have reported this to you.

Another lady reported:

I’m writing regarding the woman who hears a chime sound when she nods or shakes her head.

In addition to ongoing mild tinnitus, I experience movement-induced sound as well. Unfortunately, the sound is not a pleasant chime tone, but a very startling loud buzz—like a noisy fly or bee right inside my ear! The first time I heard it I was terrified that an insect had flown into my ear and would sting me or get stuck and have to be removed surgically. The sound (so far) only happens when I shake my head from side to side to signify “no”.

I hear a variety of other tinnitus sounds intermittently that don’t seem to be related to any particular activity or situation—loud squeals, clicks, and the occasional whooshing noise. They are irritating when they happen, but aren’t terribly disruptive.

Still another lady explained:

I identify with the “chime” tinnitus report—I just tested myself by nodding my head vigorously. I confirmed that indeed, the movement changed the volume of my tinnitus, especially on the head upward movement of a “yes” head nod, and a leftward head movement in a “no” nod. (The ‘yes’ movement yields more dramatic results.) I have unilateral sensorineural loss in my right ear, with tinnitus that is not bothersome—it’s simply “there”.

When I wear my hearing aid, it plugs that ear with the ear mold, and this somehow calls attention to my tinnitus—when I walk, I get a modulation of the tinnitus that reflects the rhythm of my footsteps. That’s annoying. This is akin to my ability to “ding” my head—if I plug my right ear, and flick my finger just so around my cheekbone, I can produce a “ding” sound in my head. (Fun, huh?)

Interesting, isn’t it? Thank you all for sharing some of the weird tinnitus sounds you experience. This once again proves the enormous variety of tinnitus sounds we hard of hearing people experience.

by Neil Bauman, Ph.D.

An audiologist explained:

 I have a client who needs to use a neckloop at work, but his multi-line work phone is over 15 years old and doesn’t have a jack for his neckloop. Any suggestions?

You bet. I’m assuming that your client is using a passive neckloop such as the Williams Sound neckloop?

There may be other solutions, but this one will work with almost any desk phone (analog or digital) as long as it has a handset cord that unplugs from the phone base.

To make this solution work, you need two other pieces of equipment. First, you need a Mini-recorder control from Radio Shack (part no. 43-1237) which costs $19.99.

You unplug the handset cord from the base of the phone, and plug the mini-recorder control phone cord into the phone base instead. Then you plug the phone handset cord into the jack on the mini-recorder control. Set the switch on the mini-recorder control to “REC”. Now the phone is back to “normal” and can be used normally, but has the mini-recorder in-line ready for instant use as desired.

Second, you need a personal amplifier such as the PockeTalker. Plug the mini-recorder control’s 1/8″ plug into the MIC jack of the PockeTalker and the neckloop into the EAR jack.

Now, whenever you want to make or receive a phone call, you simply put the neckloop over your head, switch your hearing aids to t-coil mode, turn the PockeTalker on and set the volume to a comfortable level and lift the receiver.

You hear via your t-coils and neckloop. Thus you don’t have to hold the phone’s receiver up to your ear, but you do have to speak into the mouthpiece.

A good thing about this gizmo combination is that it uses standard parts. Thus it will work with almost any desk phone (digital or analog) as long as the handset cord can be unplugged from the base (really old phones don’t have this). Furthermore, since this gizmo combination is light and portable so you can use it almost any place when you need to hear on a phone. Cool, huh?

by Neil Bauman, Ph.D.

Going to the movies isn’t much fun when you can’t hear or understand the dialogue. This is the case with multitudes of hard of hearing people. Thus, you want a simple way of finding captioned movies playing near you. This is where Captionfish comes in.

One year ago, I wrote about the debut of Captionfish, the web site that finds captioned movies near you if you live in the USA.

Captionfish has lived up to its expectations and now one year later is going strong and is adding new features.

Following is a letter Captionfish founder Chris Sano wrote on the first anniversary of Captionfish (1).

One Year of Fishing for Captioned Movies

“When we launched Captionfish a year ago, the vision was simple. We wanted to provide a service that would allow people to conveniently find captioned movies playing in theaters near them. It would no longer be a laborious effort. You would not need to visit a handful of theater/ticketing web sites, dig through page after page of data, mentally build up a schedule of what is available and where, and finally decide whether there was anything appealing to go to. Instead, you could go to Captionfish and have all this information available at your fingertips, immediately upon arriving at the site. The faster you could get what you were looking for, the better.

To date, Captionfish has picked up over 465,000 captioned show times for 150 titles playing at 498 theaters. We kicked off 2010 by introducing foreign movies available with full English subtitles. Since then, we’ve added 97 new theaters and picked up an additional 33,263 accessible show times. We’ve provided captioned show times for over 15,000 unique locations across the United States.

Over the past year, we’ve expanded the site based on the feedback we got from many of you. One such example of this is the inclusion of descriptive audio show times, of which we’ve found 105,408 since November 2009. We’ve increased the visibility of our data to provide you with a high level overview of the current state of captioned movies in theaters. We’ve become staunch advocates for equal access in theaters and we continue to work with people in the industry to help understand how we can become stronger players in the movement to improve captioning accessibility for everyone.

Moving forward, we will be expanding into all forms of live entertainment, starting with our new Live Plays feature. We are currently working with several different production houses to include their accessible show times. We hope that this will eventually become large enough for us to integrate with our movie offering so that you will be able to do a search for and find all captioned entertainment in the area of your choosing.

In addition to that, we’re wrapping up work on our new platform that we’re currently calling MovieShare. We envision this being used to build a comprehensive ecosystem of applications and widgets that will help us spread awareness about the availability of accessible movies in theaters across the United States and other regions as we expand into them. The first application to leverage this platform will be our iPhone application. We currently have a working prototype and are very excited about what we’ve come up with. While we’re not quite ready to go into too much detail about the application yet, we’ll definitely let you know when we are, and we’ll be doing a beta program, so be on the lookout for that!

Chris Sano May 18, 2010″

If you are a movie goer, give Captionfish a try. You may be surprised at all the captioned movies playing in theatres in your area.

(1) http://www.captionfish.com/letter

by Neil Bauman, Ph.D.

Millions of people take anti-inflammatory drugs (typically Non- Steroidal Anti-Inflammatory Drugs [NSAIDS]) to reduce pain and inflammation in their bodies. Unfortunately, these drugs can also damage their ears.

Non-steroidal anti-inflammatory drugs include drugs in the following drug classes. Note: in order to give you an idea of the drugs we are talking about, I’ve listed one or two representative drugs under each class (generic drug name first followed by a brand name in brackets).

Acetic acids (12 ototoxic drugs in this class)

• Diclofenac (Voltaren)
• Ketorolac (Toradol)

Cox-2 inhibitors (5 ototoxic drugs in this class)

• Celecoxib (Celebrex)
• Valdecoxib (Bextra)

Fenamates (3 ototoxic drugs in this class)

• Mefenamic acid (Ponstel)

Oxicams (5 ototoxic drugs in this class)

• Meloxicam (Mobic)

Propionic acids (13 ototoxic drugs in this class)

• Ibuprofen (Advil)
• Naproxen (Aleve)

Salicylates (13 ototoxic drugs in this class)

• Acetylsalicylic acid (Aspirin)
• Mesalamine (Asacol)

These NSAID drugs can have numerous ototoxic side effects. Some of the more common ototoxic side effects include ear pain, hearing loss, tinnitus, and vestibular (balance) side effects such as ataxia (staggering gait), dizziness and vertigo (spinning sensation).

People have asked me how they can both control the pain/inflammation they have, and yet not suffer from these ototoxic side effects.

The good news is that changes in diet go a long way towards reducing inflammation (and thus the need for such drugs).

Incidentally, inflammation is not a minor problem, but is a “well- known contributor to chronic health conditions such as heart disease, diabetes, cancer and dementia.”

In order to reduce inflammation you need to greatly reduce your intake of foods that cause inflammation. According to nutrition expert Dr. Andrew Rubman, ND, the 10 worst inflammatory foods include (1):

• “Desserts made with lots of sugar (cookies, candy, ice cream and so on).
• Sweetened cereals.
• “White” carbohydrates (white bread, white rice, white potatoes, English  muffins, etc.).
• Non-diet soft drinks.
• Anything containing high-fructose corn syrup.
• Processed meats (bologna, salami, hotdogs, sausage and others made with preservatives and additives).
• French fries, potato chips and other fried snack foods.
• Fast foods, most specifically the ones that are high-fat, high-calorie, high simple carbohydrate—which describes most of the inexpensive offerings at quick-serve restaurants.
• Margarine, because it contains processed sterols called stanols that have been implicated in both atherosclerosis and various fatty-deposit diseases.
• Organ meats such as liver, because these often contain undesirable products including antibiotics, fertilizer and other unwanted residues.”

At the same time, you want to include (greatly increase) your intake of the 10 best anti-inflammatory foods. These include:

• “Wild salmon, mackerel and other omega-3-fatty-acid-rich fish.
• Berries.
• Green, leafy vegetables (e.g., spinach and kale).
• Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, etc.).
• Deeply pigmented produce, such as sweet potatoes, eggplant and pomegranate…along with carrots, plums, oranges, peppers, peas and red grapes.
• Nuts.
• Whole grains.
• Tea—specifically black, green and white teas.
• Cold-pressed fresh oils, including avocado, flaxseed and olive oils in particular.
• Spices (specifically, garlic, ginger, turmeric, saffron).”

Note: wolfing your food down also increases the inflammation index of the foods you eat, so slow down, chew your food completely before swallowing.

Since making drastic lifestyle changes is difficult, and prone to failure, start by choosing to make wiser decisions. Thus, consciously choose to substitute one of the foods in the “worst” list with one of the foods in the “best” list. As you continue to do this, over time you will realize you have almost eliminated the worst inflammatory foods from your diet—and surprise—you’ll notice you feel ever so much better in the process, and thus likely won’t need to take anti-inflammatory drugs anymore.

(1) The above information was extracted from the article “10 Best and Worst Foods for You” contained in the April 22, 2010 issue of Bottom Line Secrets “Daily Health News” newsletter. I find this newsletter an excellent source of information on a variety of topics including health issues. If you’d like to sign up for this free newsletter from Bottom Line Secrets, click here.

by Neil Bauman, Ph.D.

A lady wrote:

I was diagnosed with Meniere’s disease. I have horrible tinnitus and can tell my hearing has gone horribly downhill. My question is, can a hearing aid help with the tinnitus to shut it out or anything? When I’m in a room with stuff going on I don’t usually hear it AS well as I do in a quiet room, but it’s still enough to really bug me.

Excellent question. Hearing aids in and of themselves do not affect the loudness of your tinnitus as such. Rather, they amplify sounds so you hear more (and louder) sounds. The good news is that this partially masks your tinnitus so you don’t notice it as much.

It is basically the same effect as you have already found when in a noisy room—your tinnitus doesn’t appear to be as loud because your brain has lots of real sounds on which to concentrate. Furthermore, in a noisy situation, the contrast between the background sound level and your tinnitus is much less than if you were in a quiet room.

However, when you are in a quiet location there is nothing to mask your tinnitus sounds. Thus, you perceive them as louder and more intrusive. Wearing a hearing aid in a quiet room will pick up the softer sounds you can no longer hear and thus help mask your tinnitus.

When your tinnitus is bothering you and you are in a quiet place, you need to enrich your environment with real sounds—turn on the TV, listen to a radio, stereo, iPod or MP3 player, and/or wear hearing aids.

This is especially important at night when the room is quiet. Some people find that just having a fan running, or a clock radio playing music really helps take their focus off their tinnitus. Use whatever works to give your brain real sounds to listen to so you don’t focus on your tinnitus.

You see, if you focus on your tinnitus, you will perceive your tinnitus as becoming louder and louder and more and more intrusive as the days go by. Therefore, you want to focus on the loves of your life, and the things you are doing, rather than on your tinnitus. When you do this, you’ll notice, if you stop at that point and think about it, that your tinnitus now appears softer and much less intrusive. This should be your goal.

If you want to learn more about tinnitus and the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.