April 30th, 2012 - Categories: Advice, Common Hearing Loss Myths - Tags: advice audigy, communication issues, community awareness, hearing loss, hearing loss and cognitive function, hearing treatment, patient care, sound void - No Comments
SoundVoids™ can cause unnecessary frustration in visiting with your loved ones.
Here at Advanced Hearing Care, I spend a lot of time counseling patients and their families and friends on realistic expectations for hearing treatment and rehabilitation. Some of the conversations can be quite passionate, especially when the family can’t understand why their loved one cannot seem to hear them, even though they’re wearing their hearing aids. After all, hearing aids are supposed to fix the problem, right?
Well, no, not really. Hearing aids are wonderful devices that supplement bad hearing. They help a person make the most of the hearing that they may have left. But they are not a substitute for good hearing. Nothing, no magic pill or surgery, can restore a person’s hearing to the way it was before the hearing loss occurred.
How Hearing Works
One of the biggest reasons why people have this misconception of hearing aids and hearing treatment is that they don’t really understand how hearing works or what is happening when someone has a hearing loss. After all, your ears just work, right? And you don’t have to think about it to make them work. So, most people just don’t have reason to think about it.
Like most of your senses, hearing requires a means of collecting stimuli and a method of delivering the data from those stimuli to the brain for processing. Your ears act as a funnel to collect sound waves in your environment and then both amplify and transform those sound waves into an electrical signal that can be processed by your brain. This process involves the outer ear, called the pinna; the ear canal; the middle ear, which is made of the ear drum and the ossicular bones; the inner ear, or cochlea; and the auditory nerve and brain. Along the way, the ear drum converts sound waves into mechanical energy, the stapes and cochlea convert the mechanical energy into hydraulic energy, and the cilia in the cochlea converts the hydraulic energy into electrical energy, which is finally processed by the auditory cortex in the brain.
A Matter of Physics
Sounds are formed anytime an object creates a vibration. These vibrations are called sound waves and they happen at a molecular level in every substance that has matter and mass. A good way to visualize this is to drop a pebble in a pond and watch the waves it creates. As mentioned above, the ear collects these sound waves in order to amplify and transform them into signals in the brain.
Generally speaking, the less complicated the sound environment, the easier it will be for the brain to sort through the sound waves available. In a small quiet room, there is very little interference from other sources of sound waves, there are fewer barriers to sound wave transmission, and the sound waves don’t have to travel very far to the ear. This is an ideal situation for hearing. The larger the space, the more sources of interfering background noise, the farther away you are from a reflective surface, the harder it will be to hear, even with normal hearing. Imagine again the pond and the pebble. The sound waves are a lot easier to “see” in a small pond with just a few pebbles than they are in an ocean during a rain storm.
Hearing aids cannot change the physics of environmental sound. There are certain properties to background noise, such as frequency ranges and harmonic patterns, that a hearing aid processor can be programmed to reduce, but it doesn’t work like a pair of noise-cancelling headphones. Those headphones have a distinct signal input from an audio device and a distinct sound pattern for the noise collected through a microphone. The headphones produce an inverse sound wave that cancels the noise. With hearing aids, the signal is mixed in with the noise and there’s no way to produce that inverse sound wave.
Mucking Up the Works
When hearing loss occurs, something happens to the anatomy of the ears and brain that causes the sound wave conversion and amplification process to not work the way it’s supposed to work. One of the most common problems is that the cilia in the cochlea, the part of the hearing that sends those electrical signals to your brain, begin to die. This is called sensorineural hearing loss. It is nerve damage and it is permanent.
This kind of hearing loss also often involves an issue with sound clarity in addition to the inability to detect certain sounds. In the case of someone who has those sound clarity issues, something is happening in the brain that causes the electrical signals that the brain receives to become garbled and distorted. When a person is experiencing this distortion, simple amplification of sound doesn’t help as much as you might think. After all, making a garbled sound louder does not improve its clarity. Since the distortion is actually happening in the brain, it is different for each person who experiences it and it cannot be easily measured or quantified, making compensation practically impossible.
So What Can I Do?
There are small things that you can do while you are speaking to make it easier for your loved one to understand you. Slow down and speak clearly; don’t shout! Shouting only distorts your speech. Rather than repeating a misunderstood word or phrase to the point of frustration, use different phrasing to avoid that misunderstanding. Make sure that you’re not speaking with your mouth full or obstructing your mouth with your hand or another object.
The best thing that can be done to help someone who has sound clarity and processing issues is to make the listening environment as simple as possible. First, turn off all potential sources of interfering noise. If it can’t be turned off, then turn it down or adjust its position to minimize the interference. Get on the same level as the person with the hearing loss and face them so you can speak directly to them. Move closer to them and stay within 4 to 6 feet. Never walk away from them while you’re talking or try to talk to them from another room in the house. Small environmental changes can do a lot to assist someone who is having trouble understanding speech.
In Closing
It’s very important to remember that hearing loss is a permanent impairment and the goal of any hearing loss treatment process is to make the most of an individual’s remaining hearing. In even a best-case scenario, there are limitations to what hearing technology can do as far as speech enhancement and background noise reduction in very complex listening situations. No matter how much the technology advances, no matter how far it develops or how sophisticated it gets, it will never be a replacement for the hearing that you or your loved one enjoyed had before the hearing loss. For more tips and tricks, feel free to visit our Communication Tips page, or Contact Us with any questions you may have.
October 20th, 2011 - Categories: Advice, Common Hearing Loss Myths, News - Tags: advice audigy, hearing loss, hearing treatment, patient care, personalized solutions - No Comments
Hearing Treatment is much more than just wearing hearing aids.
In a consumer market where supermarkets and the internet are the kings of the one-stop bargain shopping trend, it might be easy for the hearing impaired person to think that purchasing their technology from those “Big Box” stores and saving a few bucks along the way is a good idea. After all, a hearing aid is a hearing aid, right? But what the cost-conscious consumer may not realize is that the bargain they think they’re getting isn’t that much of a bargain after all.
One of the ways that the Big Box and internet retailers like Costco can offer their products at often very low prices is that the solutions they offer are close-out sales of older technology. There are dozens of manufacturers who each make dozens of different models of hearing aids in multiple tiers of investment and these manufacturers produce new technology almost every year. Because of this, Big Box stores can sell based on brand recognition rather than technological advancement and count on the fact that their customers can’t recognize a truly new premium instrument from one based on an older platform. They can sell premium technology at a low price with a low profit margin because that premium technology is several years behind the times and generally has a lower cost-of-goods. In order to make the small profit margin work better for themselves, they also cut corners by scrimping on service and care for their customers, particularly when prearranged agreements with manufacturers expire and they no longer sell the technology most of their customers have purchased.
This kind of buying power works extremely well at supermarkets and big box retailers. In today’s world of disposable products, you just don’t have to take as much time to research and consider options when you’re buying a vacuum cleaner or a microwave. If something goes wrong, the average toaster oven can be replaced fairly easily. But hearing is our most important social sense and is an integral part of our overall well-being, and hearing aids themselves are so costly that they cannot truly be considered disposable, so hearing solutions should be treated with more care than picking out a toaster or buying batteries.
The truth is that price is only an issue in the absence of value. It’s hard for some to see the value in investing thousands of dollars in something they think they can find down the street for less. In the case of hearing technology solutions, the old adage “you get what you pay for” applies. There are literally thousands of different hearing technology options and what’s good for the goose might not even fit the gander at all.
Hearing Professionals take the time to get to know you and your unique hearing needs.
The perception and treatment of hearing loss is a highly individualized problem, and no two cases are the same. A qualified and licensed hearing professional is in the business of learning about all of the options available and working with the many different types of technology to tailor a solution to the needs of the individual patients they see. Each successful solution takes time and patience, from both the patient and the hearing professional, to properly fine-tune and adjust appropriately to the patient’s needs and desires. It is this attention to detail with each individual person to give them what they specifically need to address their unique problems that determines the success of the recommended solution.
A true professional will work with their patients to deliver an elite level of care and make sure that their patients are not just satisfied, but that they are delighted. Audiologists and Hearing Instrument Specialists take the time to understand their patients’ individual needs and lifestyle requirements. These professionals are highly skilled at correctly fitting and adapting technology and apply these skills to meet those demands. Hearing loss is very personal and each patient has his or her own individual needs for successful treatment. Because each patient is unique, it’s vital that a qualified hearing health professional be involved in the process.
At Advanced Hearing Care, we specialized in providing that elite level of patient care to each person who comes to us seeking solutions to their hearing health care needs. We’d like to invite you to experience the difference. With each patient, both new patients and existing patients, we take the time during our Four-Step Process to get to know those unique concerns. We work with our patients to assure them that they are getting the best treatment possible for their hearing care. Come experience the difference. Reintroduce yourself to a world of sound!
June 30th, 2011 - Categories: Common Hearing Loss Myths, Technology - Tags: advice audigy, community awareness, hearing loss myths, hearing treatment, patient care, personalized solutions, tech features, technology - No Comments
Some of the strongest misconceptions about hearing health care involve the treatment of hearing loss. For many years, limits of technology and sound mechanics restricted the ability to successfully treat hearing loss. Because of these limitations, hearing technology was often ugly and bulky with very poor sound quality. Despite recent developments that have reduced the size, improved the sound quality and increased the aesthetic appeal of hearing technology, many people shy away from hearing treatments because they still believe that they either can’t be helped or that the recommended hearing aids will make them look old. Today, we’ll take a look at a few of the most common objections people bring to us regarding hearing treatment and technology.
RIC aids are tiny and treat mild and high frequency losses.
Myth: My hearing loss cannot be helped.
Fact: In the past, that may have been true. Until relatively recent breakthroughs in hearing technology, there were certain types of hearing loss that could not be treated successfully. These included high frequency losses, mild losses, sensorineural loss with decreased speech discrimination, or monaural deafness. The limits in hearing technology in the past made it difficult, if not impossible, to help people with these conditions. However, most of those limits no longer exist. Open-fit and receiver-in-the-canal solutions were a major breakthrough that allowed for easy treatment of high frequency and mild losses. The most recent speech enhancement features available in most hearing technology greatly help those patients who have difficulty with understanding speech sounds. Wireless CROS and Bi-CROS hearing aids are now available for people who only have one functioning ear. The truth is that the hearing industry is tackling some of the toughest hearing losses and producing solutions that can help many people who were previously told, often by their doctors, that they could not be helped.
Myth: Hearing loss and hearing instruments are a sign of old age.
Fact: Not anymore. Today’s most extraordinary hearing technology is smaller and more discreet than ever before. Many of them are either invisible or nearly invisible when worn. They simply do not look like the hearing aids our parents and grandparents had to wear. Also, the occurrence of hearing loss is more prevalent in the Baby Boomer population than it is in those over the age of 65, which means that people with hearing loss are younger than has been typical in the past. These people are finding it more and more difficult to function in the workplace with hearing impairments. They are treating their hearing loss with amazing technology that gives them confidence to move through their day without calling attention to their condition.
Myth: Really good hearing instruments are prohibitively expensive.
Fact: While it is true that premium instruments require premium investment, that premium instrument is usually too much hearing aid for most lifestyles. Most manufacturers produce different levels of their technology at different levels of investment. These levels of investment and technology tend to correlate with and be built around different levels of lifestyle activity. The question to ask yourself is how highly you value your quality of life and how much impact your potential hearing loss has on that quality.
The brain relies on both ears to hear the world of sound.
Myth: Wearing two hearing aids is not necessary.
Fact: One hearing aid can certainly get you by. You will notice some benefit, but it won’t be nearly the benefit that you will experience by treating both ears. The first reason is that binaural, or two-eared, hearing helps us localize sounds, helps us understand speech in noisy situations, and helps our brains process everything that’s going on around us in the world of sound. As I sit and type this, my right ear is sending different sounds to my brain than my left ear is sending. My brain relies on the different signals it receives from each side of my head in order to fully process my environment. Without one of my ears, all sounds would appear to be coming from the side of my head that does hear and I would be missing a lot of sounds that are necessary for understanding speech. Another argument for treating binaural loss with binaural amplification is that anytime there is a binaural hearing loss that is only treated with one hearing aid, the brain tends to start ignoring the ear that doesn’t hear as well. In this case, it is very likely that the patient will develop more problems at a faster rate in the untreated ear. Additionally, when there are two ears working at the same level, sounds seem louder than if one ear doesn’t hear. We call this an additive therapeutic effect where 1+1=3 or more, due to the exponential power of the brain in processing auditory signals. If a person wears two hearing aids, those aids do not have to be made as loud as if the person were only wearing one hearing aid, allowing for more severe losses to be treated more successfully.
Myth: I can just have surgery like my friend did and that will fix my hearing.
Fact: There are several different surgical procedures available for hearing loss and all of them address a different problem. Of all the hearing loss cases, only a very small percentage are candidates for corrective surgery. Usually these surgeries involve taking some action to prevent hearing from getting worse rather than making it better, as is the case in a stapedectomy or mastoidectomy, and only if the patient is experiencing chronic infections or complications from other medical issues. Other surgical procedures involve the removal of abnormal growths, cholesteatomas, or acoustic neuromas. Some improvement may be seen after these kinds of procedures, but it is unusual for there to be a complete recovery of normal hearing. The procedures designed to improve poor hearing are implant procedures, either cochlear implants or small mechanical implants behind the ear. Cochlear implantation candidates have very profound losses and do poorly with hearing aid amplification. Mechanical implants may benefit a broader range of cases than cochlear implants, yet the surgery tends to be invasive and often involves breaking healthy ossicular bones in the middle ear. Often, healing times after these procedures can be quite long and the implant can generally not be used until the healing process is complete. The treatment process and recovery times for these procedures is longer and more arduous than the process of selecting and fitting hearing aids, which provide immediate benefit without involving any surgical procedures.
The only way to truly know whether or not there are options for treating your hearing loss is to discuss those options with a trained and experienced hearing professional. Audiologists and hearing instrument specialists can test your hearing and make recommendations for successful treatment of most types of hearing loss. These professionals have a focused commitment to stay up to date on all of the new developments in hearing health care and technology. Don’t let the limitations of the past keep you from living your life today and in the future. Call us today and reintroduce yourself to a world of sound!
June 23rd, 2011 - Categories: Common Hearing Loss Myths - Tags: advice audigy, community awareness, hearing loss myths, hearing treatment, technology - No Comments
We’re taking another look at some common misconceptions in today’s post. A lot of people simply put up with the impact of untreated hearing loss in their lives, thinking that they don’t have a problem or that the problem that they are having is “normal.” Worse still, some may believe that nothing can be done for their hearing loss without ever having a comprehensive audiological evaluation to diagnose their personal situations. These misconceptions are encouraged by well-meaning primary care and family doctors who may not know about the advancements made in a specialized field, like audiology and hearing technology. Today we’re going to be making the argument that there’s no reason to not have your hearing evaluated and explore the treatment options available.
Your family doctor might not notice you have hearing loss.
Myth: If I had a hearing loss, my family doctor would have told me.
Fact: There are only a few family physicians who are equipped to electronically measure hearing, and they will usually only utilize that equipment if a patient complains about not being able to hear. Additionally, many people with hearing loss can still pick up certain words and guess at the words they missed, and they do so well enough that the doctor may not notice any indications of hearing loss. The average time that a patient spends face-to-face with his or her doctor during a routine physical is limited, and usually the conversation is not extensive enough for the doctor to observe hearing difficulty. The doctor may simply not notice that their patient is having difficulty, particularly if the listening environment in the office is quiet and the patient has a mild or high frequency loss.
Myth: My hearing loss is normal for my age.
Fact: Well, there are a lot of conditions that are “normal” or common for people with certain risk factors. It’s “normal” for people who struggle with obesity to have high blood pressure, diabetes, and heart disease. They still must seek treatment for those conditions. It’s “normal” for smokers to have lung cancer. It’s “normal” for those who drink heavily to have liver disease. While hearing loss may not be as life-threatening as any of the above conditions, it arguably has a bigger impact on lifestyle and well-being, because a loss of hearing can cut us off from our friends, families and loved ones. Just because it’s “normal” for hearing loss to develop as we age, it does not mean that we have to live with that condition untreated.
Myth: It’s better to try to hide my hearing loss than to wear hearing aids.
Fact: That’s a heavy price to pay for vanity or pride, especially when untreated hearing loss is far more noticeable than wearing hearing technology, which is constantly getting smaller and more discreet. You are potentially missing more than just the pleasant sounds you used to hear. You might be missing important conversational cues. If you respond inappropriately to your family or friends in conversation, your mental acuity and social skills may be questioned. That untreated hearing loss could reduce the quality of your life by keeping you from the things you used to enjoy, like symphony concerts or dinner out with friends. In turn, this encourages isolation from social situations, which has been linked to dementia in the elderly by a Johns Hopkins study
Myth: My hearing loss cannot be helped.
Fact: Many people with hearing loss have been told, usually by a doctor, that they cannot be helped. They either have a monaural (one-eared) hearing loss, a high frequency hearing loss, or nerve damage due to trauma or loud noise exposure. This opinion is based on old information and the limitations of older hearing technology that was not ideal for mild or high frequency hearing losses. They truth is that an audiologist can treat almost all kinds of hearing loss, at almost any level of severity, with today’s extraordinary technology. This may not mean that treatment will be easy, and it is true that no amount of money spent on technology can restore your hearing to what it was when you were 20 years old. There are options, however, that can make a vast improvement in your hearing and help you maintain the life that you want to live.
How loud are everyday sounds? Click for larger image.
Myth: It’s fine for me to turn up their television or radio or to be around loud sounds. I can’t hear it anyway, so there’s no danger.
Fact: Actually, it’s potentially more dangerous for a person with untreated hearing loss to be exposed to loud sounds or to blast their radios or televisions. Damage to the auditory nerve occurs when you’re exposed to a certain level of loudness for a certain amount of time, and those variables don’t change for people with hearing loss. In fact, those who have hearing loss may not be able to recognize that they’re in danger of further damage to their auditory system because they can’t tell exactly how loud those sounds are. Turning up the television or refusing to wear hearing protection around loud machinery sounds like an excellent way to further damage the auditory nerve, causing even more hearing loss over time.
The impacts of hearing loss can be far-reaching and dramatic. Helen Keller once said that the loss of hearing “means the loss of the most vital stimulus &emdash; the sound of the voice that brings language, sets thoughts astir, and keeps us in the [...] company of man.” You don’t have to let hearing loss cut you off from the company of your friends and family. With the treatment options available, there is no reason to wait to hear what you’ve been missing. Call today and reintroduce yourself to a world of sound!
June 9th, 2011 - Categories: Common Hearing Loss Myths - Tags: advice audigy, communication issues, community awareness, hearing loss and cognitive function, hearing loss myths, sound void - No Comments
SoundVoids™ can cause unnecessary frustration in visiting with your loved ones.
In the continuation of our Hearing Loss Myths series, we’re looking at some of the common misconceptions regarding communication with people who are hard of hearing. The perception of SoundVoids™ can cause problems in conversations, some of which are not easily treated. Many people may be surprised to find out that they’re overcompensating for those lingering problems that hearing technology does not easily address.
Myth: If my loved one wears hearing aids, they should be able to hear me when I’m speaking to them and understand everything that I say to them.
Fact: Please be aware that hearing technology is a supplement to poor hearing, not a substitution for good hearing. Nothing can restore the damage that causes a permanent sensorineural hearing loss. Today’s digital hearing technology can do wonderful things to help in compensating for hearing loss, but they do not restore a person’s ability to hear and understand speech. Hearing technology cannot compensate for nerve damage that involves a loss in speech discrimination ability. Technology can make improvements, but “cake” may still sometimes sound like “take,” or “tough” like “puff,” or “road” like “rose.”
Myth: You have to repeat yourself many times before someone with hearing loss can understand what you’ve said.
Fact: Actually, repeating the misunderstood words will cause more frustration rather than providing clarity, especially when trying to communicate with someone whose loss involves a compromised ability to understand speech. You can tell them your “chicken was tough” until you’re blue in the face and they’ll most likely always hear that your “sicking was puff.” It’s a much better idea to rephrase your words to communicate the same idea in a different manner, avoiding those words that are misunderstood. Telling them that your “meat was not tender” might be much easier to understand.
Myth: People who are “hard of hearing” have selective hearing. They only hear what they want to hear, but they can hear perfectly well if they really want to.
Fact: This is partially true. However, people who have hearing difficulties cannot hear certain frequencies of sounds until they are at elevated levels of loudness. They have no control over which sounds they hear and which ones they don’t. The difficulty does not originate with a lack of attention but rather with an inability to discern that their attention is desired. They may be able to hear in diverse listening environments, but it takes them a lot more energy and concentration to fill in the Sound Voids™ they’re experiencing using contextual or visual cues.
Myth: You have to shout or over-enunciate your words when speaking to people who have hearing loss.
Fact: Too often, the problem is not a simple matter of sound volume. A lot of hearing losses involve a distortion in sounds due to the degradation of the cilia in the cochlea. This degradation can cause problems regardless of how loud a person is speaking. Shouting or over-enunciating words makes the perception of this distortion worse because you’re distorting your speech, making your loved one’s perception of distortion even worse.
At Advanced Hearing Care, we recognize that hearing difficulties can make communicating with your loved ones difficult. To make things a little easier, we have a page listing some wonderful tips for successful communication. If you or your loved ones are struggling to hear clearly, please call us for an appointment. There’s no reason to continue to be frustrated when trying to visit with your family and friends. Don’t wait until it’s too late to hear what you’ve been missing! Call today and reintroduce yourself to a world of sound.
May 26th, 2011 - Categories: Advice, Common Hearing Loss Myths - Tags: advice audigy, community awareness, hearing loss myths, patient care, personalized solutions, sound void - No Comments
Here at Advanced Hearing Care, we often find that there is a lot of misinformation about hearing loss and hearing health care. We’d like to take an opportunity to address some of these misconceptions over the course of a few blog posts in our Hearing Loss Myths series. To start things off, we’re tackling the hard issue of mild hearing losses. Here are a few of the most commonly believed myths about mild hearing loss.
Myth: A mild hearing loss is not bad enough for a hearing aid.
Fact: Actually, many people with mild losses are finding that their hearing loss is indeed “bad enough” to require amplification. Mild hearing loss is an average of 25-40 decibels of loss. Patients who are experiencing this degree of loss often miss sounds like the tick of a watch, bird calls, water dripping in the kitchen sink, leaves rustling, and will usually have difficulty hearing the voices of some women and most small children. Even a mild degree of loss can make it very difficult for these patients to understand speech in a noisy restaurant or in a conference room. Everyone has a different perception of whether missing these sounds is “bad enough” for them to seek help. By working with an audiologist or hearing instrument specialist, you can determine if you need amplification for your specific case and how much it will help you with your individual needs.
Myth: Living with a mild hearing loss is not a big deal.
Even a mild hearing loss can create the perception of Sound Voids and can be damaging if left untreated.
Fact: Even a mild hearing loss will cause the perception of Sound Voids™ that can interfere in conversations with family and friends, decrease enjoyment of social situations, increase stress in the workplace, and cause frustration during important conversations. The increased stress from straining to fill these Sound Voids™ without assistance can lead to the typical symptoms associated with high stress: fatigue, headache, tense muscles, sleeping difficulties, and even increased blood pressure. Because our hearing is our most important social sense, even a mild loss can lead to detrimental consequences. This can indeed be a “big deal,” especially for someone with a very active and vibrant lifestyle.
Myth: I’ve waited this long and still have a mild hearing loss. I can wait a few years more before I need hearing aids.
Fact: Are you familiar with the saying “If you don’t use it, you lose it?” When hearing loss is left untreated, the perception of Sound Voids™ tends to progress. The longer a person waits to treat their hearing loss, the more likely they are to experience phonemic regression, or a loss in the ability to understand speech. This phenomenon occurs when the ability to understand speech is compromised to a greater degree than the associated age-related pure tone hearing loss. It’s not just that the sounds of words become more faint. The damage to the nerve cells in the inner ear causes a permanent distortion to all sounds. When there is a loss in speech discrimination, even amplification may not compensate for this distortion. By delaying treatment for hearing loss, a person may find that the rate of phonemic regression has increased, making words seem more distorted and unclear. For this kind of distortion, making speech louder with hearing aids does not make it more clear and understandable even when they are eventually purchased.
When it comes to mild hearing losses, the only way to truly know if hearing devices are needed is to have a comprehensive audiological evaluation. At Advanced Hearing Care, we employ a Four-Step Process with each patient in which we take the time to assess, diagnose, and counsel each patient according to his or her individual needs. If you think you have any degree of hearing loss, it’s always a wise idea to see an audiologist to determine the nature and severity of the loss.
Don’t wait until old age to hear what you’re missing! Don’t let phonemic regression ruin your chances for successful treatment of your hearing loss. Don’t lose your most important social sense! Call today and reintroduce yourself to a world of sound!
