By: Crystal L. Chalmers, Au.D. North State Audiological Services
Chico, CA 95928 www.nsaudiology.com
Crystal Chalmers, Au.D., is an AudigyCertified™ Doctor of Audiology, the owner of North State Audiological Services in Chico, and a member of AudigyGroup, the nation’s largest member-owned association of independent hearing care professionals.
Though its medical name is cerumen, most of us refer to it as “Earwax”.
While I agree that neither term sounds very attractive, I will argue that earwax has gotten an undeserved bad reputation as something equivalent to dirt that we need to remove from our bodies.
So before reaching for the cotton swabs, you should know that earwax performs several important functions for our ears and hearing system.
That’s right. Earwax – unless it is in excess and blocking our ear canal(s) or has plugged and disrupted the proper functioning of hearing technology – is a good thing.
Here are some positive functions of earwax:
● It provides a protective barrier to the skin of the ear canal
● Assists in lubricating and cleaning the outer portion of the ear canal.
● Provides protection against insects (it is a natural insecticide), fungi, and bacteria – all of which like to dwell in dark, moist places … just like the ear canal!
So don’t be so quick to want to remove all of your earwax. Oftentimes, excess earwax will work its way to the outer portion of the ear canal and simply fall out on its own. To clean your ears, NEVER use cotton swabs as these can push the wax down further into the ear canal. Simply rinse your ears with warm water while showering and/or use a damp cloth with mild soap to gently wash the exterior of the ear. In cases where earwax is excessive, it should only be removed by a medical doctor as this is a delicate procedure. In fact the ear canal is the only place on the body where skin is in direct contact with bone, so improper cleaning of this area could result in infection with serious consequences.
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!
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!
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.
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!
