Hearing Loss Help  

by Neil Bauman, Ph.D.

From time to time the news media reports that scientists have identified yet another gene that causes deafness, and always there is the statement that this will help end hearing loss, as though a cure for hearing loss was right around the corner.

Here’s an example of one that just came out, “Scripps research scientists identify genetic cause for type of deafness. Discovery could lead to new therapies for progressive hearing loss.”

The article begins: “A team led by scientists from The Scripps Research Institute has discovered a genetic cause of progressive hearing loss. The findings will help scientists better understand the nature of age-related decline in hearing and may lead to new therapies to prevent or treat the condition.

The findings were published September 3, 2009, in an advance, online issue of the American Journal of Human Genetics, a publication of Cell Press.”

This release is like many before it—sounds good, but promises little. However, this article contains an interesting gem of information. A bit further down it states, “It is thought that mutations in several hundred genes can lead to deafness,” said team leader Ulrich Mueller, a professor in the Department of Cell Biology and member of the Skaggs Institute for Chemical Biology at Scripps Research. “However, for many forms of deafness, we don’t know what effects the genes have.”

The truth is, hearing loss is a complex condition. There are not just one or two or even a few genes associated with hearing loss, but hundreds of genes and combinations of genes. At present, scientists are nowhere near close to identifying all these numerous gene combinations, let alone understanding how they cause deafness, or how they can use this information to reverse or prevent hearing loss in the future.

I’m glad researchers are busy investigating the many genetic causes of hearing loss. Every little discovery is a step in the right direction, and I’m all for it. However, just don’t hold your breath believing that a cure for your hearing loss is going to be forthcoming any time soon.

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.

Hearing loss is typically misunderstood by the general population. Thus, it is not surprising that many hearing people have bought into the following 7 myths regarding hearing loss and the people with these losses.

Myth No. 1. Hard of hearing people are less intelligent than “hearing” people. Thus, they attach this social stigma to having a hearing loss. This myth is so deeply ingrained in the general population that even today most hard of hearing people refuse to wear hearing aids for fear of being thought stupid. The truth is, hard of hearing people are just like other people. Some are smart and some are not. Don’t blame any perceived lack of intelligence on hearing loss. Place the blame where it should be—on communication difficulties.

Myth No. 2. Wearing hearing aids returns hearing to normal. Not true. Hearing aids can improve hearing—typically reducing the hearing loss by half—but never bring it up to normal. Thus hard of hearing people still have a hearing loss even when wearing their hearing aids. They often need to supplement what they hear by using assistive devices, by speechreading and by using other effective hearing loss coping strategies.

Myth No. 3. Hard of hearing people have selective hearing. They only hear what they want to hear, but they can hear if they really want to. While it is true that hard of hearing people do indeed have selective hearing, it is not because they don’t pay attention. Rather, it is because their ears do not hear certain frequencies of sounds. They have no choice over which sounds they hear and don’t hear.

Myth No. 4. Only old people have a hearing loss. Not true. Because of excessive noise exposure, taking medications that damage ears, ear infections and other factors, hearing loss affects children, adults and seniors alike. One study showed that on any given day, 15% of the children in elementary schools have a significant hearing loss.

Myth No. 5. When you have a hearing loss you somehow (magically) become a good lip reader. Thus, since hard of hearing people can read lips, it doesn’t matter whether they hear or not. Fact: lip reading, (now more correctly called speechreading) while invaluable, is far from perfect. Only about 30% of English sounds can be easily read on a person’s lips. That leaves the hard of hearing person guessing at the remaining 70%. While a few are remarkably good at this, no one is perfect.

Myth No. 6. If a hard of hearing person can’t hear you, raise your voice at them. The truth is, most hard of hearing people need you to speak up just a bit, but they really want you to face them, then speak slowly and enunciate clearly. This is because when you lose some of your hearing, you hear people talking, but often you can’t understand much of what they are saying.

Myth No. 7. Hard of hearing people understand sign language. Therefore, in order to accommodate people with hearing loss at meetings, you just need to provide a sign language interpreter. Fact: of the 70 million people with hearing loss, fewer than 1% know how to sign. Hard of hearing people typically need to use, in addition to their hearing aids, various assistive devices and real-time captioning (CART).

And one bonus myth—Myth No. 8. If you speak normally, you obviously can’t have much of a hearing loss, therefore you are really faking it when you speak properly but say you can’t hear. The truth is, the vast majority of hard of hearing people speak normally. Some people that have more severe hearing losses and don’t wear hearing aids talk louder than normal. Other people with profound hearing losses speak in a flat tone (deaf speech). And surprise, some people with severe to profound hearing losses speak perfectly normally too. I’m one of them!

 by Neil Bauman, Ph.D.
A man wrote:

I was browsing on a website and want to know whether what it said about sound therapy is true. The website said that:

‘The Sound Therapy Program is a rehabilitation of the inner ear muscles, thanks to high frequencies.

It can help in all ear disorders as:
· Hearing loss
· Tinnitus
· Meniere’s disease, vertigo and dizziness
· Cocktail party syndrome (difficulty hearing in noisy places)
· Noise sensibility (hyperacusis)
· Short term memory loss
· Language disorders (dyslexia, stuttering)
· Learning (ADD, ADHD, autism, Down’s syndrome)
· Sleep disorders
· Brain damage (accident, stroke, Alzheimer’s, Parkinson’s)’

The above “blurb” came from near the bottom of this web page. It’s quite an impressive list of conditions that sound therapy is supposed to cure, isn’t it?

You are right to be cautious, and want to know whether it is real, or just a bunch of hype.

I’m not an expert in sound therapy, but I have investigated and written about it in the past, and even have the sound therapy tapes myself so I know a bit about it.

First, let me say that the above blurb is somewhat misleading (just like much of the advertising today is). Yes, sound therapy does work for all those conditions to some degree or other for some people, but no, is is not the cure for all those conditions for everyone.

If sound therapy did indeed work for everyone and cure hearing loss or tinnitus, then everyone would be using it, As a result, no one would need hearing aids or have tinnitus anymore—and we know that is not true. Thus, you have to
understand what sound therapy realistically can and cannot do for you.

Sound therapy is indeed a valid treatment for certain conditions, especially for children with learning disabilities, ADD, autism and related conditions. In fact, this is where sound therapy excels.

One lady just wrote me and stated, “I have seen incredible results in all 3 of my children with special needs from listening [to sound therapy music using an] 80 GB iPod with bone conduction headphones.”

This lady is now herself a sound therapy practitioner. When I asked her how it had helped her tinnitus, she told me that although she had been using sound therapy on herself for the past 9 months, she hadn’t seen any difference in her tinnitus. This reinforces my point that sound therapy does not work for everyone, not even for some firm believers in the program. On the other hand, it does work miracles for some people. Thus, you really can’t know if it will work for you unless you try it.

I found, that with my particular reverse slope hearing loss, listening to the tapes grated on my nerves, so this therapy isn’t for me either.

In general, for the average person with conditions such as hearing loss, hyperacusis, tinnitus and Meniere’s disease, I don’t think sound therapy by itself has a very high success rate. However, if you have certain particular variations of the above conditions, for example, certain conductive hearing losses rather than sensorineural hearing losses, then sound therapy can do amazing things.

Sound therapy is simple to use. It consists of listening to special tapes/CDs/iPods of classical music that have been specially electronically altered to give your ears a “workout”. You can listen while you are working or relaxing.

Sound therapy was developed by French ENT, Dr. Alfred Tomatis in the early 1970s, so it has been around for about 40 years.

Another doctor, Guy Berard made some modifications to the sound therapy program and called it “Auditory Integration Training”. He brought this program to the USA in 1992.

The mother and daughter team of Patricia and Rafaele Joudry made yet another variation to the sound therapy program and explain it in their book, “Sound Therapy: Music to Recharge Your Brain”. It explains how to listen, and what benefits you can expect for conditions such as tinnitus, fatigue, insomnia, stress and anxiety, hearing loss, sound sensitivity (hyperacusis), dizziness, Meniere’s syndrome, jet lag and learning, memory and concentration problems.

Rafaele also authored, “Triumph over Tinnitus”. This book explains sound therapy’s role in helping people with tinnitus. You can get these books through her Sound Therapy International website.

Sound therapy is one of the many tools you should have in your “ear repair” toolbox, and take it out and use it when appropriate. If it works for you, great. If not, put in back in your toolbox and try another “tool”.

You can read more about Sound Therapy, Auditory Integration Training and Biomental Home-Retraining Therapy and how they specifically apply to tinnitus in my book, “When Your Ears Ring! Cope With Your Tinnitus—Here’s How“.

If you have tried sound therapy or one of its variations, I’d love to hear how it worked for you.

by Neil Bauman, Ph.D.

Shanna Groves, herself hard of hearing, and one of our HearingLossHelp eZine readers has just completed her first novel about a hard of hearing family.

Here’s your chance to read this brand new novel. (She just finished the final chapter on December 24th!) You’ll find the first chapter grabs you, and before you know it, you’ll have read the entire novel in one sitting—all 30 chapters. At least, that’s what happened to me!

To read the pre-publication version, simply email Shanna and ask her for access to her “Lip Reader” blog, because access to this blog is “by invitation only”. She’ll gladly send you the invitation link so you can enjoy it too. Let her know you learned about her novel right here in the HearingLossHelp eZine.

Now, here’s the “official” blurb on “Lip Reader”.

Young Woman Shares Hearing Loss Journey in Book, Blog

OLATHE, KS - Most people don’t expect to deal with hearing loss until their old age, but one person has years of experience and she is in her mid-thirties. Shanna Bartlett Groves has dealt with hearing loss in online support groups, speaking engagements, relationships and now in a new novel.

Groves, a freelance writer, completed the novel “Lip Reader” based on her own experiences with hearing loss. “I wrote ‘Lip Reader’ to tell the story of a family dealing with hearing loss. This is a story that not only tells about their experiences with being hard of hearing in a hearing world, but also some of the reactions that other people have had with their deafness.

“My own hearing journey inspired the two main characters in the story, 12-year-old Sapphie Traylor and her mother Rea. The extended family—the grandparents, uncles, aunt and cousins—were inspired by my father’s family, some of whom still live in the Fort Cobb/Anadarko, Oklahoma, area where I was born.”

She has written about her hearing loss journey in Hearing Loss Journal, The Kansas City Star, MOMSense and the book “A Cup of Comfort For Nurses”.

Read the Full Story here.

by Neil Bauman, Ph.D.

In the March, 2008 issue, I reported on an interesting treatment for hearing loss. There has been a fair bit of interest in this treatment as evidenced by the various comments on the HearingLossHelp blog. You can read the original article and comments here.

In part, here is Rick Walter’s comment (#15) on what has been happening with his ears since he began taking Aldosterone two months ago. He writes:

I’ve been taking Aldosterone therapy for about 2 months now. My hearing loss came from many things. Much came from loud noise over my lifetime, but I came down with Meniere’s disease about a year ago, and the hearing loss greatly accelerated.

The Aldosterone gave me back clarity of hearing, but only a little volume. Make no mistake any improvement is huge when your ears are as bad as mine are. Also my drop attacks and weird dizziness are completely gone!

Obviously, Aldosterone is not a complete cure for hearing problems, but just improving clarity of hearing (improved discrimination) is a wonderful blessing in itself.

Also, it seems that Aldosterone can help fix a damaged balance system. For example, reducing the frequency of, or totally eliminating, drop attacks is certainly another blessing. (Drop attacks are where, without warning, you suddenly lose your balance and fall to the floor. This typically happens in people with severe cases of Meniere’s disease.)

If you are interested in Aldosterone therapy either contact Dr. Jonathan Wright (see above link) or work with your doctor while you are on this therapy so bad things don’t happen to you. With Aldosterone, as with other body hormones, too much of a good thing can quickly become a bad thing.

by Neil Bauman, Ph.D.

A man asked:

When the microscopic hair cells are damaged and break off in the cochlea, what happens to them? Are they harmlessly absorbed, or do they float around and impair the action of the remaining hair cells?

Great question. Most people have the misconception that the tiny hairs “break off” from being exposed to loud sounds, or other causes—much like tree branches breaking in a hurricane. This is not the right analogy.

In actual fact, as I understand it, the tiny hairs don’t “break off”. Rather the whole hair cell itself dies—taking with it the bundle of “hairs” numbering between 30 and 300 tiny stereocilia per bundle (what we colloquially call “hairs”) that stick up from each hair cell. These dead cells are then absorbed by the body.

What causes these hair cells to die? One mechanism is being “zapped” by “free radicals” released as a result of loud noise or ototoxic drugs for example. The hair cell either dies from a “direct hit”, or if mortally wounded, programs itself to die through a process called apoptosis.

In addition to dying hair cells, another mechanism is that as we age, the stereocilia seem to slowly disappear—becoming shorter and shorter and finally the whole hair cell is “overrun” by adjacent supporting cells and “disappears”.

In any case, the dead cells are not left to float around and cause havoc with the remaining hearing mechanism.

by Neil Bauman, Ph.D.

Kissing causes hearing loss? You’ve got to be kidding!

Actually, it’s true. Not all kissing, mind you, but kissing someone on their ear can be dangerous to their hearing health. Here’s the incident that brought this fact to light.

A mother and her 4-year-old daughter were sitting on the floor watching TV. Impulsively the child hugged her mom and vigorously kissed her. Unfortunately, the kiss landed directly on the opening to the mother’s left ear canal.

This sudden (and considerable) suction applied negative pressure to the ear drum. (1) As the mother related, “While she was doing it, it felt like she was sucking the air out of my head.” (3) “When she finished, I had no hearing in that ear.” In addition to the total hearing loss, “she had a very intense screeching tinnitus. She had a lot of facial twitching, muscular twitching and pain.” (2)

Fortunately, most of her hearing returned a few hours later, but she was left with a permanent 35 dB hearing loss in the lower frequencies, “screeching tinnitus” that later subsided to a permanent soft rushing sound, hyperacusis (normal sounds are now too loud—”any loud sound would jostle her and send her through the roof”) (2), dysacusis (distorted hearing) and facial twitching. (3)

About a year later, she contacted Dr. Levi Reiter, professor and head of the Audiology program, at Hofstra University in New York. Dr. Reiter’s testing revealed that she had no auditory reflex in that ear any more. The auditory reflex is where the tiny stapedius muscle (actually the smallest muscle in the human body) contracts and pulls the tiny stapes (or stirrup) (the smallest bone in the human body) away from the oval window to reduce the volume of sudden loud sounds. (2)

In addition, “she had another interesting symptom, whenever she would turn her head from side to side, it felt like something was loose in her middle ear.” (2)

Further investigation by Dr. Reiter indicated that what likely had happened was that the ligament that fastened the stapedius muscle to the stapes had ripped apart, leaving her with a non-functioning auditory reflex in that ear. Since the auditory reflex could no longer dampen louder sounds, she was left with permanent hyperacusis.

Interestingly enough, this mother only experienced sensorineural hearing loss. There was no conductive loss whatsoever. You would have thought the middle ear bones would have been dislocated causing a conductive loss, but nothing of the sort happened (apart from the ligament on the stapedius muscle being ripped apart—which doesn’t cause hearing loss).

Initially the press reported this event as the “Kiss of Deaf”, but due to Dr. Reiter’s ongoing research in this area, this phenomenon is now going by the moniker of “Reiter’s Ear-Kiss Syndrome” (REKS).

Ever since the first reports came out in the media, Dr. Reiter has been receiving calls and emails from people all over the country who also have experienced hearing loss from a kiss on the ear. (4) Rather than it being a strange and unique occurrence, Dr. Reiter told me that REKS is much more common than it first appeared to be.

He emphasizes that you must never kiss anyone on their ears, or let them kiss you there. (Nibbling on someone’s ears is an entirely different matter!) He writes: “My biggest concern as far as warning the public and getting this out is regarding newborns and infants. Mothers and fathers, and even sisters and brothers and grandparents love to smooch up that little baby—give him a whole kissing frenzy.” (2)

Note that this may be especially true when little children try to kiss a baby sibling. They aren’t discerning where they kiss, and may forcefully kiss them on their ear. (Adults may inadvertently do this too.)

Dr. Reiter continues, “The ear canal of an infant is very small, so that negative pressure you’re applying to the ear canal is going to have a much greater impact than on an adult. I’m afraid there are infants out there who are experiencing this, but they can’t say ‘Mommy, I can’t hear in one ear,’ and the net result is that five years later, when they have a hearing test, no one will know to relate it to this.” (2) Therefore, for the sake of everyone’s ears, confine smooching to other parts of the body.

If you have had any hearing loss or other ear problems resulting from a kiss on your ear, Dr. Reiter would love to hear from you for his ongoing research into this phenomenon. His email address is ears@drreiter.net.
_________

(1) “The Kiss of Deaf”: A Case Study by Levi A. Reiter. The Hearing Journal. August 2008. Vol. 61, No. 8. pp. 32-37.

(2) Interview with Levi Reiter, Ph.D., CCC-A, Professor of Audiology, Hofstra University. Topic: The Kiss That Caused Hearing Loss, or Reiter’s Ear Kiss Syndrome (REKS). 7/28/2008.

(3) Little Girl Gives Mom Kiss Of Deaf. Hearing Review, The Insider. July 31, 2008.

(4) Ear Kiss Causes Rare Syndrome by Dee Naquin Shafer, the ASHA Leader. August 12, 2008.

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 asked,

My son is 5 years old and will be entering Kindergarten in the fall. We are currently trying to fit him with new hearing aids. His left ear has reverse slope loss. 65db @ 250 60db @ 500, 45 @ 1000, 25 @ 2000-8000. His current ear mold has a vent to allow natural high sounds to enter.

His right ear has the more common ski-slope. loss from 40 @ 500 all the way to 110 @ 4000 The right ear mold is completely closed.

My audiologist told me that in order to obtain the correct amount of low frequency amplification in the left ear she would need to close the mold. Somehow that seems less than perfect and doesn’t sit right with me.

It may be theoretically true that he needs to have an ear mold with no vent so lots of low frequency amplification can be pumped into his left ear, but it doesn’t work out in practice. This is because people with reverse slope hearing loss don’t want or need all the low frequency sounds. Amplifying these sounds to “normal” is actually counterproductive. This is because it makes it so we can’t understand speech as well. All the research shows, and those of us with reverse slope losses firmly declare, that we need less low frequency amplification than what is theoretically true.

Few audiologists apparently know how to properly fit people with reverse slope losses—so they go by the theory—and it is wrong. All the adults with reverse slope losses that I have heard from have told me the same story—their audiologists insist on setting their aids wrong to begin with (too much low frequency amplification and not enough in the high frequencies). They insisted that their audiologists adjust them in the reverse before they were happy.

She then asks: “Do you agree that it may be the only way to achieve help in the low frequencies? Does it matter that the mold had an opening and now it will need to be closed but that the high frequencies have good hearing?”

Here’s the problem. With reverse slope losses, we hear the highs. When we wear hearing aids, there are only two ways we can do this. One is if the ear molds have large vent holes. The second way is if the hearing aids are wide band aids (and almost none are) and amplify up to 16,000 Hz or so. (Most hearing aids only amplify up to 6,000 Hz or so.) Thus, by wearing hearing aids, we hear less than we should—unless provision is made for us to hear the high and very high frequency sounds upon which we so much depend.

You would do well to read my unabridged article on the subject of reverse slope hearing loss, The Bizarre World of Extreme Reverse-Slope (or Low Frequency Hearing Loss—especially the final section—which gives tips for properly setting hearing aids for reverse slope losses. Be warned, it’s 32 pages long—but it is very easy to read.