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The Sound Void: How Hearing Loss Sneaks Up on You

The Sound Void: How Hearing Loss Sneaks Up on You

When you come to your first appointment with us, we encourage you to bring a companion, someone who spends a lot of time with you. Why is that? Because they’re able to give us a different perspective on your hearing loss. In fact, your companion probably noticed your hearing loss — and how it was affecting you — before you did.

But how is that possible if you’re the one with hearing loss?

 

How Sound Works

To begin with, it helps to understand how sound works. Most people think hearing loss is a question of volume. But that’s only part of the story. Sound is a combination of frequency (also called pitch) and intensity (also called loudness).

Frequency

Frequency measures how fast (or how frequently) a sound wave vibrates. High frequency means a high pitch, like the notes on the right side of a piano, and low frequency means low pitch, like the notes on the left side of a piano.

Intensity

Intensity measures loudness. A whisper has low intensity, and a shout has high intensity.

Frequency and Intensity Together

Each sound is a combination of these two qualities.

  • A baby screaming has high frequency and high intensity.
  • A man shouting has low frequency and high intensity.
  • The sound of leaves rustling has high frequency and low intensity.
  • A rumble of thunder has low frequency and high intensity.

 

The Sound Void®

Knowing how sound works helps us understand Sound Voids. We use the term Sound Void to refer to any moment lacking in clarity. Sound Voids have a lot to do with why your companion probably picked up on your hearing loss before you did.

Sound Voids happen all the time: Allergies or a cold affect your ears, leading to increased chance of misunderstanding what people say. Even a buildup of earwax can lead to an increase in Sound Voids.

But Sound Voids are also common with noise-induced or age-related hearing loss. Early on in these types of hearing loss, when someone speaks to you, you miss the high-frequency sounds, such as s, sh, c, ch, p, f, and h. These sounds help you identify words. With those sounds missing, “cat” could be mistaken for “hat” and “pickle” for “fickle.”

With this type of Sound Void, the intensities aren’t the problem — it’s the frequencies. In other words, you can hear people speaking just fine, but sometimes you misunderstand them.

At this early stage, what is actually a hearing loss truly seems to you like a momentary lack of clarity. You assume someone mumbled a little, or there are more people than usual at the restaurant. Loved ones probably think the same thing.
 

The Sound Voids Increase

But as time goes on, the Sound Voids become more frequent, and those closest to you start to notice subtle signs: You turn up the volume on the TV or radio, you need statements repeated more often, and you get tired more easily while socializing in public venues.

Your companion, by this point, has started to wonder if you have hearing loss. Because you’ve developed coping skills, you probably haven’t truly realized how it’s affecting you or your loved ones.
 

The Sound Voids Take Over

Eventually, enough of your hearing is damaged that you’re not just missing frequencies — intensity is now a problem, too. You’re more likely to miss the low-frequency sounds of speech, the ones that provide volume, such as o, i, and j.

At this point, your companion has probably wondered aloud whether you have hearing loss, and you’ve started to realize how your hearing loss is affecting others. This is when many people consider getting their hearing tested.
 

The Hearing Evaluation

This is why the companion is such a key part of the hearing evaluation: They’ve witnessed the early Sound Voids, the gradual behavior changes, how your hearing loss affects those around you, and your realization that you might have hearing loss. Their outside observations are an important complement to your internal observations.

Why Should You Bring a Companion?

Hearing Care Q & A

Question:
Why Do You Encourage Us to Bring a Companion?

Answer:
The simple answer is that everyone benefits, including your audiologist.

 

Let’s unpack some of the reasons for this:

  1. Hearing loss affects your companion, too
    Once someone suspects they have hearing issues, they’ll wait, on average, seven years before getting a hearing evaluation. One reason is they don’t think it affects the people around them.

    But a study by The National Council on Aging had surprising findings: After study participants with hearing loss began using hearing aids, their family members reported better relationships at home, better feelings of self-worth, better relationships with children or grandchildren, and even better physical health.

    Inviting a loved one shows you recognize that it affects them. It also shows you respect their insight, thoughts, and feelings about this important step you’re taking.

  2. Your companion provides a complementary perspective
    Whether it’s a spouse, a good friend, or a niece, your companion spends a lot of time with you, and their perspective will be a valuable complement to yours. They definitely notice things you don’t, such as how often and how much you turn up the TV. Your companion will also have their own questions based on their experiences with you, which can inform the discussion in ways you’d never have considered otherwise.
  3. Your companion learns more about you
    No matter how close you and your companion are, you probably haven’t discussed in detail how your hearing loss affects you. Sitting in the appointment with you provides them an intimate window into your world. Also, the audiologist can provide your companion a simulation of hearing loss, helping them understand better what you experience day to day.
  4. Your companion is an extra set of ears
    A typical new-patient appointment lasts 60–90 minutes — that’s a lot of information! We explain how hearing works, your specific type of hearing loss, and the best options for moving forward. If we decide together that hearing technology is the best solution, we’ll discuss different styles of hearing devices as well as accessories.

    Having a companion with you means you can focus on what’s being said while they take notes. Alternatively, you can both take notes and compare them afterward; you’re each sure to jot down things the other didn’t.

  5. Your technology can be tailored to the voice you hear the most
    If we decide technology is the best solution, you can bring whoever you’re around the most — a sibling, spouse, a child — to the fitting appointment so we can optimize the technology for their voice.
  6. Your companion can be involved in financial considerations
    Many people want to consult their significant other about major medical decisions. If your significant other is in the office with you, they can be a part of the conversation from the start and ask their questions directly.
  7. Your companion helps us, too
    For us to truly understand your situation and, therefore, truly be of optimal benefit, we depend on the perspective of someone close to you. They know where you thrive, where you struggle, what noises you don’t even realize you’re missing, and how your hearing loss affects others in your life who may not have the heart to tell you how its affecting them. Your input and their input are two sides of one coin, and each is crucial to our understanding of your listening lifestyle.

Cognitive Decline is a Real Risk With Hearing Loss

Dementia a Real Risk With Hearing Loss

If you think of hearing loss as just an inconsequential part of getting older, you’re not alone.

The truth is, however, that the condition can strike even the youngest among us ó more than one in 1,000 babies screened has some form of hearing impairment, per Centers for Disease Control and Prevention data ó and it can trigger other health problems, too.

Take cognitive decline, for example, which can lead to Alzheimer’s disease or another form of dementia. Research has long pointed to links between hearing loss and reduced brain functioning over time, but the statistics may surprise you.

Consider these startling findings:

  • On average, seniors with hearing loss experience significantly reduced cognitive function 3.2 years before their normal-hearing counterparts.
  • Hearing-impaired seniors experience thinking and memory problems 30 to 40 percent faster than their normal-hearing counterparts.
  • Older adults with a hearing disability may lose over a cubic centimeter of brain tissue annually beyond normal shrinkage.
  • Those with hearing loss are two, three, or nearly five times as likely to develop dementia, depending on the severity of the hearing impairment.

So what’s the connection between hearing impairment and cognitive decline? It’s not completely clear how hearing loss, which is also associated with diabetes, cardiovascular disease, and other common public-health challenges, contributes to development of dementia.

What is clear, however, is the importance of regular hearing checkups to help stave off the threat of cognitive impairment. Tackling risk factors such as hearing loss earlier on could cut dementia cases by a third, according to a research collaborative led by UK psychiatry professor Gill Livingston and involving the Alzheimer’s Society, Alzheimer’s Research UK, and other individuals, institutions, and organizations.

As one of your most crucial senses for communication and perception, hearing not only helps you stay connected to the world but helps keep your brain sharp. Give your hearing health and overall wellness a hand by staying active, eating a diet rich in important nutrients, avoiding excess noise, and scheduling regular hearing checkups.


Munch to Better Hearing

Hearing power is brainpower, and some key foods can help! Certain vitamins and minerals can go a long way toward supporting your hearing wellness, according to HealthyHearing.com. In honor of National Nutrition Month in March, check out these examples:

  • Bananas

    These reliable delights are rich in potassium, an important mineral for regulating blood and tissue fluid levels ó including in the inner ear, which plays an important role in hearing and balance.

  • Broccoli

    This versatile vegetable with an edible stalk and green flowering head provides folate, which studies have linked to healthy outcomes such as decreased risk of hearing impairment among older men.

  • Tomatoes

    These juicy fruits ó easy to grow and delicious cooked in a sauce or served raw ó offer magnesium, which, combined with vitamins A, C, and E, help thwart noise-induced hearing loss.

  • Dark-Meat Chicken

    This flavorful part of the bird ó along with other foods such as beef, oysters, and legumes ó delivers zinc, which supports the immune system and may help fight tinnitus or ringing in the ears.


Sources:
Johns Hopkins Medicine. Hearing Loss Accelerates Brain Function Decline in Older Adults. https://www.hopkinsmedicine.org/news/media/releases/hearing_loss_accelerates_brain_function_decline_in_older_adults. Accessed Feb. 5, 2018.
Johns Hopkins Medicine. Hearing Loss Linked to Accelerated Brain Tissue Loss. https://www.hopkinsmedicine.org/news/media/releases/hearing_loss_linked_to_accelerated_brain_tissue_loss_. Accessed Feb. 5, 2018.
The JAMA Network | JAMA Neurology. Hearing Loss and Incident Dementia. http://jamanetwork.com/journals/jamaneurology/fullarticle/802291. Accessed Feb. 5, 2018.
U.S. National Library of Medicine/National Institutes of Health. A Prospective Study of Vitamin Intake and the Risk of Hearing Loss in Men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853884/. Accessed Feb. 5, 2018.
U.S. National Library of Medicine/National Institutes of Health. Free Radical Scavengers Vitamins A, C, and E Plus Magnesium Reduce Noise Trauma. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1950331/. Accessed Feb. 5, 2018.
U.S. National Library of Medicine/National Institutes of Health. The Role of Zinc in the Treatment of Tinnitus. https://www.ncbi.nlm.nih.gov/pubmed/12544035. Accessed Feb. 5, 2018.

What Is Reverse-Slope Hearing Loss and How Can It Be Treated?

Reverse-Slope Hearing Loss

Your Refrigerator Is Running – Can You Hear It?

You’re probably familiar with the many telltale, well-known signs of hearing loss ó asking people to repeat themselves frequently, turning up the TV to uncomfortable levels for others in the room, or leaning into a conversation on one side to use your ìgood ear.î

But what if speech is clear to you and you never turn up the TV ó but you can’t hear whether the car you’re standing next to is running? This is an actual type of hearing loss, called reverse-slope hearing loss (RSHL), and people with this type often don’t realize they have a hearing impairment.

What Is Reverse-Slope Hearing Loss?

Hearing Loss Basics

The most common type of hearing loss ó the kind most people think of when they think of hearing loss ó is characterized by loss of sounds at higher frequencies and is sometimes called high-frequency hearing loss. These frequencies correspond to what we think of as high notes or high-pitched voices. As such, when someone first notices this type of hearing loss, it’s usually because they’re having trouble hearing women’s voices or those of the children in their life, and having difficulty hearing conversation in a restaurant.

Because this particular kind of hearing loss doesn’t affect lower frequencies but does affect mid-level and high frequencies, it has a distinct appearance on what’s called an audiogram ó the graphical representation of the results of a hearing test. On an audiogram, the graph starts in the upper-left-hand corner and may slope downward steeply, like a ski slope or more subtly as a gradual decrease across this frequency range. This is where this type of hearing loss gets its most common name: ski-slope hearing loss, sometimes shortened to simply sloping loss.

Reverse-Slope Hearing Loss

RSHL is so named because its shape on an audiogram is the reverse of ski-slope hearing loss. In this type of hearing loss, the low frequencies are affected far more than the higher ones. This gives the audiogram the opposite shape ó the graph starts in the lower-left-hand corner and slopes upward steeply. Because it affects mainly the lower frequencies, it is also known as low-frequency hearing loss.

RSHL is rare: It affects only 3,000 people in the U.S. and Canada. Put differently, for every 12,000 cases of hearing loss, only one person has RSHL. Like ski-slope hearing loss, there are different degrees of RSHL.

Causes of Reverse-Slope Hearing Loss

Many people don’t suspect they have RSHL unless someone in their family already has it, which underscores one of the main sources of RSHL: genetics. Wolfram syndrome, Mondini dysplasia, and inheritance through a dominant gene have all been identified as sources of RSHL.

Certain diseases have been implicated as well, mainly those affecting the hair cells, which are responsible for sending sound information from the inner ear to the brain. Examples include sudden hearing loss, MÈniËre’s disease, and viral infection.

The third most common source of RSHL is anything that causes a change in the pressure of the endolymph, a fluid in the inner ear. This includes things such as spinal or general anesthesia, intracranial hypertension, and a perilymphatic fistula.

How Is Reverse-Slope Hearing Loss Diagnosed and Treated?

From symptoms to industry norms, hearing care is focused chiefly on ski-slope hearing loss, so RSHL can be difficult to recognize, diagnose, and treat. Because it is often hereditary or genetic ó that is, because they were born with it ó many who have RSHL don’t realize that the way they hear is different, so they may never seek out a hearing appointment.

Symptoms of RSHL
  • Difficulty understanding speech on the phone. The aspects of speech that give it clarity (the consonants) are in the higher frequencies, the treble side of sound, but the aspects of speech that give it volume (the vowels) are in the lower frequencies, the bass side. Because RSHL involves the lower frequencies, speech loses its volume but retains its clarity. Face-to-face conversation, therefore, is not usually a problem. But the phone mainly delivers the low and middle frequencies, so it can pose a problem for RSHL.
  • Ease understanding women and children but not men. Again, because RSHL affects the lower frequencies, those with RSHL more clearly understand higher-frequency speech ó that of women and children ó than lower-frequency speech, such as that of men.
  • Inability to hear low-frequency environmental sounds. Thunder and a refrigerator humming are examples of low-frequency environmental sounds. Because the click of a refrigerator is a high-frequency sound, someone with RSHL might hear their fridge click, but they wouldn’t know if the hum was the fridge turning on or off, even if they were standing right next to it.
Diagnosing RSHL

Because of the prevalence of ski-slope or other high-frequency hearing loss, diagnostic tools focus on that type. Therefore, many with RSHL may ìpassî a hearing screening or are treated as though they have other issues. Naturally, this leads to frustration for all involved.

Key to diagnosis is a well-educated patient. Because this condition is rare, many in the hearing care field simply haven’t encountered it. RSHL has a distinct set of characteristics that an audiologist will look for but is not limited to:

  • Unusually good speech
  • Sensitivity to high-frequency environmental sounds
  • Poor speech perception in the absence of visual cues
  • High speech-detection thresholds
  • Pure-tone hearing losses
  • Inability to adjust to standard ski-slope hearing technology settings

A simple test any hearing care provider can use as an initial screening for RSHL is the Ling sound test performed while standing behind the patient. RSHL is most likely present if the ìsî and ìshî sounds are heard at a much softer sound level than the other sounds.

Treating RSHL

Those with RSHL tend to have high expectations of hearing aids, which can lead to frustration. An audiologist who hopes to successfully fit an aid for RSHL has to build the settings from the ground up, for several reasons.

  • Manufacturer-recommended hearing aid settings are meant for high-frequency hearing loss. As previously mentioned, only 3,000 people in the U.S. and Canada have RSHL; many millions have high-frequency hearing loss. It makes sense that the industry would weigh toward the type of hearing loss with the highest incidence but still allow audiologists to customize individual aids for rare types of hearing loss.
  • Hearing aids may be programmed based on computer settings that are based on the audiogram. These computer settings assume the most typical situation: ski-slope hearing loss. These settings rarely work for RSHL.
  • Hearing aids are built with the expectation of a high-frequency hearing loss. Often high-frequency losses need amplification in the high frequencies. The shape of the aid complements the shape of the typical ear canal, and this combination dependably treats high-frequency loss very well. But RSHLs require different amounts of amplification across a different range of frequencies.
  • People with RSHL have already successfully adapted to their speech needs. Having been born with this condition, many with RSHL develop the ability to navigate speech easily.

Treating RSHL means parking industry standards and theoretical fitting curves. It requires taking time to really listen to the patient, and then build the settings channel by channel, frequency by frequency, to what they find comfortable, audible, and helpful.

But there are certain starting points that may help in the treating of an RSHL. A study by Kuk et al. determined that

  • A digital, multichannel, nonlinear hearing aid is optimal
  • Wide dynamic range compression, a low compression threshold, and high-level compression might more effectively preserve hearing and comfort
  • Amplification in the lower frequencies is preferred, but gain may vary depending on input levels
  • A broad bandwidth with individualized amplification customization is desirable
  • The paired comparison technique may help customize individual settings
Why Is It Important to Treat Reverse-Slope Hearing Loss?

You may well be thinking, ìThose symptoms don’t sound so bad ó why bother putting myself through all the frustration of getting diagnosed and fitted?î

The key reason is safety. Much of what you lose with RSHL is environmental sound. If you can’t hear a car coming, you can’t avoid it. If someone some distance from you is trying to warn you away from something, you might not hear it, because volume is a product of the lower frequencies.

Another reason is enjoyment. There are many aspects and nuances in music that you might be missing out on if you have RSHL, because you’re missing the low-frequency sounds ó for example, much of what is below middle C.

Contact us today if you think you or someone you love might have reverse-slope hearing loss.

Sources:
Kuk F, et al. Changing with the Times: Managing Low-Frequency Hearing Loss. Hearing Review. November 2003. http://www.hearingreview.com/2003/11/changing-with-the-times-managing-low-frequency-hearing-loss/. Accessed Feb 2, 2018.
Bauman N. The Bizarre World of Extreme Reverse-Slope Hearing Loss (or Low-Frequency) Hearing Loss. http://hearinglosshelp.com/blog/the-bizarre-world-of-extreme-reverse-slope-hearing-loss/#characteristics. Accessed Feb 2, 2018.

Common Symptoms of Hearing Loss and When to Get a Hearing Test

Give Yourself and Your Health the Best Possible Start in 2018. Know the Signs of Hearing Loss and Get Your Hearing Tested!

Hearing Loss Is More Common Than You Think

About 48 million Americans have some degree of hearing loss. We share the common signs or hearing loss and what to do to get your hearing tested.

When it comes to communication, hearing is our most critical sense. Even a relatively mild hearing loss can seriously disrupt how we interact and connect with others.

Healthy hearing requires a number of processes in the inner ear and brain to work properly and correctly interpret the sounds you hear. Inner-ear problems, or ear problems in general, can prevent crucial sound information from reaching the brain, leading to confusion and an inability to hear and understand speech.

Quick Hearing Loss Statistics

  • About 48 million Americans have some degree of hearing loss
  • Hearing loss is more common in those with a history of smoking, binge drinking, and circulatory disorders such as high blood pressure, cardiovascular disease, and diabetes
  • Hearing loss is 5.5 times more common in men than women
  • Approximately 50% of Baby Boomers (individuals aged 45 to 64) have a hearing loss

 

How Do I Know If I Have a Hearing Loss?

The most common type of hearing loss is noise-induced hearing loss (NIHL), which is caused by continual exposure to noise levels greater than 85 dB. NIHL usually occurs slowly over time, and you might not know that you have a hearing loss until it’s been established for several years. Even then, you may assume it’s only a temporary problem, but most of the time, NIHL is permanent.

In the early stages of hearing impairment, the highest frequencies are usually the first to go. Symptoms include difficulty hearing or understanding high-pitched voices, and understanding speech in background noise. People with hearing loss often have difficulty differentiating between words that sound alike, and in particular words that contain S, F, SH, CH, H, TH, T, K, or soft C sounds. These consonants are in a much higher frequency range than vowels and other consonants.

You should contact an audiologist or hearing care provider if you are experiencing any of the following symptoms:

  • Asking people to repeat themselves often
  • Difficulty following conversations that involve more than two people
  • Thinking that others are mumbling or speaking quietly
  • Difficulty hearing speech in noisy situations
  • Stress from straining to hear what others are saying
  • Withdrawing from normally enjoyable social situations more often

If you suspect you or a loved one is experiencing any of the above symptoms, let us help! [Contact our practice today] to schedule a hearing evaluation.

Rheumatoid Arthritis’ Connection to Hearing Loss

What does rheumatoid arthritis (RA) have to do with hearing loss? Quite a bit, according to a new study released by the Open Rheumatology Journal.

Hearing loss has been linked to a decrease in overall mental and physical health. Research has proven connections with age, smoking, cognitive decline, heart health, and a diminished quality of life — and now rheumatoid arthritis.

This is the first study of hearing impairment in RA. The study’s conclusion: Those with rheumatoid arthritis are at a higher risk of hearing impairment over the course of the disease. In addition, the study suggests it’s obvious that hearing impairment in RA is a multi-factorial disease because environmental factors like smoking, disease characteristics like rheumatoid nodules, and patient characteristics like age can affect it. However, it’s still unclear if these factors affect one another both directly and indirectly.

One environmental factor found in this study to increase chances of both RA and hearing loss was smoking. Researchers stated, “there is a strong correlation between smoking and rheumatoid nodules in RA.” They recognized that passive smokers as well as active smokers are at a higher risk of hearing impairment.

Though more investigation is needed to determine a consensus regarding the management of hearing impairment in patients with RA, researchers stated, “… regular audiometric test and [otoacoustic emission test] is advisable and can diagnose hearing loss at an early stage.”

An estimated 48 million Americans — about one in five people — have some form of hearing loss, according to a Johns Hopkins study. It’s a chronic public-health challenge that, if left untreated, can have far-reaching consequences for physical, mental, social, and even financial health.

Hearing loss especially affects older adults, many of whom don’t seek hearing help. Only 30 percent of adults ages 70 or older who could benefit from hearing aids use them, according to the National Institute on Deafness and Other Communication Disorders.

If you believe you or a loved one could benefit from a hearing test, contact us today to schedule a hearing screening. We can help get you on a path to better hearing and better health.

Why Can’t My Loved One Hear Me? They’re Wearing Aids!

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.

The Truth About Hearing Aid Prices

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!

Hearing Loss Myths: Treatment Solutions and Hearing Technology

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!

Hearing Loss Myths: Living with Untreated Hearing Loss

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!