Hearing Loss Help  

by Neil Bauman, Ph.D.

Here’s an easy way to separate the doctors who are truly trying to help you from the doctors that just run “patient mills.”

It’s based on the astute observation of J. Apley who, back in 1978, wrote:

Doctors who treat the symptom
tend to give a prescription.
Doctors who treat the patient
are more likely to offer guidance.

No matter what condition you have–whether its hearing loss, balance problems, tinnitus, or anything else, if you want to get better, you and your doctor need to root out the source of the problem, not just cover over the symptoms and whitewash it.

by Neil Bauman, Ph.D.

If you need a bit more volume when listening to audio devices such as FM receivers, iPods, MP3 Players, etc (but not telephones) when using neckloops, Music-Links or earbuds, you can get the boost you need with a neat little amplifier I just discovered at Radio Shack.

I had trouble hearing women’s voices on my new iPod–even at full volume when using earbuds. I just needed a bit more volume to make their voices understandable. The Radio Shack “3-Way Headphone Volume Booster” (Part No. 33-1109; $24.99) did the trick. You just plug this amplifier into wherever you’d plug in your Music Links or earbuds and plug the Music Links or earbuds into the amplifier, switch it on and you’re in business.

Note: since this amplifier has no volume control, turn down the volume on your audio device before you switch it on so you don’t inadvertently blast your ears with the increased volume. This is especially important if you are just wearing earbuds like I mostly do.

My iPod has lots of power to drive a neckloop or Music Links if I am wearing my hearing aids and using their t-coils. Its just when wearing earbuds that I can have problems. Mind you, I have an 80 dB loss so I need lots of amplification in order to hear in the first place. If you have normal hearing this kind of volume will damage your hearing. For us, it is the only way we can hear.

by Neil Bauman, Ph.D.

A man wrote:

I received the T-Links and hooked them up to my ClearSounds amplified telephone model CSC50. They function as advertised however in my particular case the sound that I get is just not quite loud enough. This is true even though the telephone amplification is turned to its high limit and my BTE hearing aid volume controls are set at the highest level. What do you suggest? Is there some way of amplifying the signal? The other party has no problem hearing my voice. The sound is useable but I miss a lot of the words. If I could just amplify the T-Links a bit I would be satisfied.

I hear you. Sometimes I’m in the same boat, just need a bit more volume and not able to get it. Here are two things for you to consider.

1. Not all phones are created equal. Some don’t have as loud a signal on to the t-coil jack as others do. Thus you need more volume to run them. You can try plugging the T-Links into other phones and see which one gives you the most volume.

2. Not all t-coils are created equal. The t-coils in your hearing aids may not be strong enough in the first place, or are not set up to provide full volume. This is an internal adjustment done by your audiologist.

For example, using my new hearing aids with their t-coils on my Walker Clarity amplified phone is a waste of time. There is just not enough volume to hear with, but my old hearing aids have wonderful t-coils and I have lots of volume when using this same phone.

Obviously, I need to get different t-coils in my new hearing aids to bring them up to “snuff.” You might need to do the same. Also note that many dispensers never set the t-coils up properly in the first place.

In addition, orientation is important. If your t-coils are oriented in the wrong plane, you won’t hear well if the T-Links require a different orientation. (This is true for all devices that use t-coils such as phones and room loops as well.) Some t-coils are oriented to pick up better from vertical loops and others from horizontal loops. With my new hearing aids, I have to have the ear hooks raised off my ears about half an inch before the sound comes in loud and clear. But when they are sitting down on my ears, I don’t hear much at all. With my old hearing aids, I hear wonderfully well with the T-Links seated properly.

by Neil Bauman, Ph.D.

A concerned mother explained:

Our daughter is 8, and has a bilateral vestibular disorder. She has trouble reading and if she reads too much she will get horrible vertigo spells. Even her gait is affected. When she comes home from school on Friday, her stance is wider than normal and she tends to plop her feet down. This abnormal gait disappears by Saturday.

Other than balance and hearing difficulties that come and go, she appears fairly normal. I liken my daughter’s brain to ‘RAM’ on a computer. It seems her brain does not have enough ‘RAM’ to hold several ‘programs’ open at once, unlike a computer (and most people’s brains) which can hold open, and use, several ‘programs’ at a time.

For example, if she’s using her vision program, her hearing and motor programs may shut down. If she’s using her hearing, her vision and motor programs may shut down. If both her vision and hearing programs are taxed beyond their limits, her vestibular program can’t operate either.

If she’s in a busy place such as a grocery store, or even at school, her vision goes first, then her hearing, then her muscle control and finally her balance. She literally slithers out of her chair to lie prone on the floor for which she gets into great trouble at school for ‘refusing to listen’ and get back up in her chair, going to her room to get some quiet, etc.

Her inability to keep more than one program open at a time also leads to very high distractibility. For example, if she’s looking, she can’t hear. If she’s listening, she’s not looking. If she’s walking and hears a noise, she drops whatever is in her hand.

Do you know of anyone that has a child who even remotely behaves like this?

Your daughter’s behavior seems so strange so as to be almost unbelievable–but similar things happen to other people too.

Although your daughter has several health problems, if she had just lost her balance system, she could have similar experiences.

You see, normally our balance (vestibular) systems work automatically and subconsciously behind the scenes. However, is something destroys our vestibular system, then the conscious parts of our brain have to take over for the subconscious parts (in this case, the vestibular parts) and try to keep us upright. This requires a lot of RAM (to use your analogy) and when too much is used for balance, then the other systems suffer (and may fail). Symptoms of a  damaged/destroyed vestibular system may include memory loss, fatigue, nausea, blurred vision and other visual problems, and in extreme cases, sensory shut-down.

A lady recently told me about her sister, an RN, who had something similar happen to her. This sister had taken Gentamicin drops in her ear on her doctor’s orders–but she had a hole in her eardrum and the Gentamicin got into her middle ear, and from there totally destroyed the balance in her inner ears.

She wrote:

My sister has been diagnosed with vestibular damage [balance problems], nystagmus [eyes jerking horizontally], and oscillopsia [bouncing vision]; she experiences all the gamut of symptoms you mention–the vertigo, dizziness, nausea, vomiting, and ataxia [staggering gait]. She even experiences motor function shut-down, and a loss of consciousness when in an environment that becomes too challenging for her brain–too much visual stimuli.

Particularly notice that last sentence. This is somewhat similar to what your daughter is going through. Notice that this nurse experiences too much sensory overload, she too, “slithers to the floor” so to speak–totally out of it.

Thus, if a person has vestibular system problems such as both your daughter and this lady have, the answer is twofold. First, try to cut down on the amount of sensory stimulation that you receive at any given time. This may mean simplifying your environment so as not to overload your brain and cause it to shut some systems down in order to cope. Second, schedule a number of “quiet time” breaks in a less challenging atmosphere throughout the day in order to give your brain time to recover before it shuts some things down.

by Neil Bauman, Ph.D.

A hard of hearing person asked:

Is the noise damage threshold the same for me as it is for a person with normal hearing? Do I just add my decibel loss (by frequency) to the noise damage threshold for normal ears? [approximately 80 to 85 dB] If sustained noise at 90 dB is bad for a person with normal hearing, does my noise damage threshold start at 150 dB because I have a 60 dB hearing loss?

Excellent question. I used to wonder about this too. It sounds so plausible on the surface–hard of hearing people can stand far more noise than hearing people because of their underlying hearing loss.

Although this is generally true for people with conductive hearing losses, it certainly is not true for the vast majority of us since we have sensorineural hearing losses.

Here is why. Think about this logically. The mechanism of damage is the same whether we have normal hearing or are hard of hearing. Excessively loud sounds damage our ears by destroying both the minute hairs (cilia) on the hair cells, and the underlying hair cells themselves too. When this happens, that hair cell no longer sends a signal to our brains. As a result we end up with a hearing loss at the frequency of sound that hair cell was sensitive to.

At first, if we have normal hearing, the few destroyed hair cells would not produce noticeable hearing loss. But when enough hair cells are destroyed, the message being sent to our brains is riddled with “gaps” which we notice as hearing loss. The actual damage to our inner ears is the same whether we have near normal hearing or have a profound hearing loss.

However, if we have a severe or profound loss, we may not seem to lose much more hearing from being exposed to loud sounds. This is not because we have a higher tolerance for loud sounds, but because there are not many hair cells left to be destroyed! (I’ve seen pictures where whole banks of hair cells are completely missing. This is quite striking when compared to pictures with all the hair cells present.)

Therefore, in answer to your question, “No, you cannot add the amount of your hearing loss to the noise damage threshold to find the amount of noise you can stand without further damaging your hearing.” For example, it is absolutely wrong for me to think that since I have an 80 dB loss, I can stand noise at 90 dB plus the 80 dB I am missing for a total of 170 dB before I do any further damage to my ears. This loud a sound will definitely instantly destroy more of my remaining hearing.

Not only that, in actual fact, I will be writhing in pain long before I hear a sound that loud. Why? Most of us with severe or worse hearing losses usually have severe recruitment as well. As a result, our tolerance for loud sounds is actually much less than for those with normal hearing. A sound of 110 dB, while very loud to a person with normal hearing will actually cause us pain because we perceive it an too loud to stand!

by Neil Bauman, Ph.D.

A lady asked:

Have you ever heard of epidurals used during labor and delivery being ototoxic? The reason I ask is because I met a woman whose child was born deaf 6 months ago. She had received 4 different epidurals during her labor and delivery because none of them seemed to be working effectively. She was wondering if the drugs used in the epidurals could have caused the hearing loss in her infant.

Good question, but I’d need to know exactly which drugs she was given before I could give you/her a specific reply.

However, in general terms, yes, some of the drugs used for epidurals can be ototoxic. When I looked them up, some of these drugs are listed as causing hearing loss, tinnitus and/or various balance problems.

In addition, doctors sometimes use a drug that is not normally an epidural to help the effects of the basic epidural drug. Unfortunately, some of these drugs are also ototoxic. There are any number of these additional drugs that they use.

Then too, researchers are experimenting with a drug that I consider highly-ototoxic as an epidural. I just hope they don’t use it because it could destroy a baby’s hearing and balance.

Furthermore, some drugs are not necessarily ototoxic as such, but cause problems that could result in ear problems in the infant. For example, some epidurals cause the mother’s heart to slow way down. The result is that the baby doesn’t get as much oxygen as it should, and this could cause hearing loss in the child.

Other epidurals can cause what they euphemistically call CNS (central nervous system) problems in the child–and since hearing loss is technically a CNS problem, hearing loss may be included (and thus hidden) under the generic term “CNS problems.”

Finally, the epidural dose is calculated on the weight of the mother, and since the mother is about 20 times the weight of the baby, the baby is getting a gross overdose of these drugs–and because the baby’s liver is not working efficiently at this point, it cannot metabolize these drugs well. As a result, these drugs can float around in the baby’s body doing all kinds of mischief including damaging its ears.

So based on all the above, I wouldn’t be surprised one bit if some epidurals result in hearing loss and/or balance problems in newborn babies. When it comes to drugs, you can’t be too careful.

If you would like more information on the ototoxicity of the 763 drugs known to damage ears, click on Ototoxic Drugs Exposed.

by Neil Bauman, Ph.D.

A man asked:

While it is common knowledge that smoking is harmful to the lungs, I have been told that smoking may damage hearing as well. Is this true? I could not find a reference to this in your list of ototoxic drugs on your website.

The Hearing Loss Help website does not contain a complete list of the many ototoxic drugs–only a small representative sample–thus nicotine is not included there. The complete list (single-spaced) would be 43 pages long! (The book “Ototoxic Drugs Exposed” is the only source that contains a reasonably complete list as far as I know.)

There are several aspects to consider when discussing smoking and hearing loss:

1.  When people think of smoking, they think of the side effects of nicotine. Nicotine is indeed an ototoxic drug and has been associated with such unwanted ototoxic side effects as hearing disorders, tinnitus, dizziness and vertigo.

2.  Most people know that smoking constricts the blood vessels. This means it also constricts the tiny blood vessels in your inner ears. This cuts down the blood flow (and life-giving oxygen) to your inner ears. In turn, the lack of oxygen makes the hair cells “sick” (to use a fancy medical term) and thus temporarily reduces hearing.

3.  Another aspect of smoking that few think about is that it produces free radicals in our bodies. Anything that produces free radicals in our bodies can damage our hearing if the free radicals end up in our inner ears where they “zap” the hair cells and sometimes damage or kill them. This results in permanent hearing loss.

4.  Finally, and this is also not well known, smoking makes your ears even more sensitive to loud noise. Thus, if you smoke and are around loud noise, the damage to your ears will be even more severe than it would have been had you not smoked.

So no matter how you slice it, smoking is not good for your ears (or the rest of your body either).

by Neil Bauman, Ph.D.

A young lady wrote:

My boyfriend and I were in a motorcycle accident in July. Since then he has had deafness in the left ear. His ENT told him he had a skull fracture and now has permanent hearing loss in the left ear, and that there is no chance of recovery. Would hearing aids help in a case like this?

I see no reason why a hearing aid wouldn’t help your boyfriend hear better from his bad ear since he still has some hearing in that ear. His hearing won’t be perfect with hearing aids, but it will be “better” than before. There are a few conditions that might preclude his wearing a hearing aid, but I don’t anticipate any problems.

The person to see regarding whether hearing aids will help him or not is an audiologist, not an ENT. Some ENTs have audiologists on staff. Talk to him/her, or find an audiologist in private practice (look in your yellow pages under audiologist).

If the audiologist suggests a hearing aid, have him try one out. He may be surprised at how much better he will hear with it.

by Neil Bauman, Ph.D.

A man asked:

It seems like everyone is getting vaccinated with the Twinrix Hepatitis virus vaccine. Do you know how safe it is? Does it affect hearing?

I have no information indicating Twinrix causes hearing loss. However, it can cause dizziness, vertigo, tinnitus and middle ear pain–so you might want to watch out for those side effects if you decide to get it.

If you would like more information on the ototoxicity of the 763 drugs and vaccines known to damage ears, click on Ototoxic Drugs Exposed. 

by Neil Bauman, Ph.D.

A man asked:

How can you get a stereo signal (say out of an iPod) split into a right and a left channel for bilateral cochlear implant (CI) recipients? The female plug from the iPod is 1/8” stereo. Each CI processor has a DAI [direct audio input] patch cord ending with a 1/8” mono male plug. Do you know of a splitter that can be plugged into the iPod and then have each DAI from each C.I. plug into it such that there is a receptacle (female plug) for the right channel and the left channel?

The gizmo you need is Radio Shack’s Y adapter Model #274-375. It costs $4.99. Plug the Y adapter into the iPod, then plug the male plugs from the CI cords into the female ‘Y’s. Now you will be able to hear true stereo with bilateral CIs. That’s all there is to it.