Hearing loss most often physically occurs in the ear but also affects our brain and how we interpret and understand sounds, especially speech sounds. The use of hearings aids and cochlear implants help us to detect sounds easier but it is important to help re-train the brain to better understand sounds and make sense of the information sent through the devices.
For us to optimally understand conversation, our working memory is used to recall words and their context. Also, when a hearing loss is present, our brains have a hard time understanding the conversation because they cannot accurately interpret the information fast enough. Both of these characteristics have also been shown to decrease as we age.
Those with even a mild hearing loss and good speech understanding have experienced difficulty hearing conversations in noise. The hearing loss is causing ours brain to work harder to filter out the pertinent speech information from the background noise.
Auditory training is also referred to as “aural rehabilitation” and “hearing exercises”. The goal of auditory training is to help improve working memory and increase auditory processing speed. Hearing aid users who practiced auditory training, specifically hearing speech against background noise, for 3 hours a week were able to correctly identify 25% more words in sentences than when they started. It may be time to consider auditory training if any of the following applies when also wearing devices:
You are still avoiding noisy restaurants
You are asking family members to repeat themselves more often
Feeling fatigued after a conversation or being in a noisy listening environment
Auditory training can be done at home with a program set up by your audiologist or completed through apps available on smartphones, tablets, and computers. These programs are designed to act like a game so it is interactive and fun to do. Examples of some apps are:
If downloading an app isn’t the user’s preference, other ideas for auditory training include listening to audiobooks and having practice conversations with family members.
In addition to hearing aids, cochlear implants, and osseointegrated implants, there are other devices on the market to help those who are hearing impaired. Devices such as amplified phones, lighted door bells, and amplified alarm clocks are just a few of these options.
For anyone with hearing loss, the telephone can be quite a difficult task. Two options that can help ease this stress are 1. Amplified telephones and 2. Captioned Telephones. There are many national companies that provide captioned telephones to patients with hearing loss. Captioned telephones go through a transcription service to write out what is being said on a screen. Patients can then read what the other person is saying. Any audiologist or medical provider can certify a patient’s hearing loss.
*Check out CaptionCall.com for more information.
Devices such as amplified alarm clocks also have features such as a “bed shaker” that sends a small vibration at the alarm time. Patients have also utilized smart watches with a vibration feature for alarms.
*Check out Diglo.com for more assistive technology for patients with hearing loss
As audiologists, we often get asked “How do I clean my ears?” by patients. Many people do not know that your ear typically cleans itself! Earwax, or cerumen, is a self-cleaning agent meant to protect and lubricate your ear canal. Glands in your ear canal produce this substance to trap dirt and dust particles so they do not make their way to your eardrum. The earwax naturally migrates out of your ear with jaw movements, such as chewing or talking. Different factors can impact how much earwax a person produces (e.g. genetics, medications).
When a cerumen impaction occurs, it is typically due to the patient using Q-tips or other objects to clean their ears. But, in reality this typically just inhibits the natural migration of the earwax and pushes it down deeper into the ear canal! Symptoms of a cerumen impaction include decreased hearing, tinnitus (ringing in the ears), itchiness, or a plugged feeling in the ears.
There are safe methods to help remove the earwax from your ears, if there is a buildup. Patients can place a few drops of mineral oil, a mixture of hydrogen peroxide and water, or commercial wax softeners into the ear over the course of a few days. If a deep impaction has occurred, softening the wax alone will most likely not remove all of the wax and the individual will need to have the cerumen extracted. Licensed medical providers have the ability to manually remove earwax. Different methods of extraction include suction, water irrigation, or curette removal. The method used varies depending on the condition of their ear and the amount of wax. Consult a physician if you believe that you have a cerumen impaction.
It’s finally the holiday season and everyone is excited for good food, (socially distant) gatherings, and presents, unless that is, you have young children with noisy toys constantly playing throughout your house. Although most parents can attest to how loud their children’s toys are, you may not know just EXACTLY how loud.
The Arizona Commission for Deaf and Hard of Hearing (ACDHH) and the Sight and Hearing Association are two of many organizations that put out an annual list of noisy toys for the holiday season. There are toys on their list that have been tested and shown to have an output of 103 dB! Measurements were taken as if a child had their ear next to the speaker, which is very realistic as anyone with young children would know. According to the American Speech Language Hearing Association and the American Academy of Audiology, 85 dB is the loudest that a child should be exposure to. For reference, the Occupational Safety and Health Administration (OSHA) notes that exposure to 90 dB for 8 hours a day is considered a “permissible noise exposure”. The permissible time of exposure for a 100 dB sound is only 2 hours. Many of theses toys are actually labeled as educational toys.
Here are some tips for testing to see if toys are too loud:
Test the toys prior to buying. Many toys have a “TRY ME” button
Hold the toy relatively close to your own ear and see if you think it is too loud
Ways to Reduce Volume
If there is a volume control, make sure it is set at the lowest volume
Put waterproof tape or glue over the speaker to dampen the sound
Put tape over the volume control to prevent your child from changing the volume.
The below list was organized by The Arizona Commission for Deaf and Hard of Hearing (ACDHH):
With everything going on during the holiday season, it’s easy to forget that some people struggle during holiday get-togethers for various reasons. One recent online study shows that 50% of families will host at least one person with hearing loss at their holiday table. For these loved ones, the holidays can be isolating and frustrating, because they don’t feel included in the celebration.
Here are some suggestions to help you have a hearing-friendly holiday:
Minimize background noise. Skip the holiday music or television in the background. Background noise can make it difficult to hear. Consider having rowdy football fans enjoy the game in a different room.
Pay attention to seating. Seat the individual with hearing loss at the head of the dinner table or middle of the table, making it easier for them to see all the guests’ faces. Round tables enable easy viewing for everyone. When setting your table, try decorating with shorter centerpieces to avoid blocking sightlines.
Rephrase, don’t repeat. Instead of repeating the same words, try rephrasing. It’s very likely when someone with hearing loss mentions they can’t hear you; they may be having trouble understanding a specific word or phrase. This approach draws less attention to the individual with hearing loss by keeping the conversation more natural. For those uneasy or self-conscious about hearing loss, this will be appreciated.
Skip the mood lighting. A well-lit room helps those with hearing loss see the mouths and facial expressions of those speaking.
Capture attention. Look directly at the person with hearing loss when speaking to them, so they can see your mouth and facial expressions. To get their attention, gently touch them on the hand, arm or shoulder, or say their name before starting to speak.
Speak clearly. Be deliberate while speaking clearly. Be careful to project, but don’t shout. Keep your hands away from your face when speaking. Avoid disturbances which make following a conversation more difficult.
Ask how you can help. Be respectful and discrete by taking aside the individual with hearing loss and asking if there’s anything you can do to make their visit easier. Demonstrate understanding and compassion, and you’ll be an example of the true meaning of holiday spirit.
If you’re concerned about possible hearing loss for you or a loved one, consider scheduling a consultation with one of our audiologists.
At Jacksonville Hearing and Balance Institute, we are pleased to offer the newest technology in regards to hearing healthcare. Hearing technology has vastly improved over the years with advancements including rechargeability and Bluetooth compatibility.
In response to the COVID-19 pandemic, the audiologists at JHBI have started offering remote programming for our hearing aid patients to alleviate the need to come into the office for appointments. The newest hearing aids offer remote programming through the use of a smartphone application. An appointment time is then set for you to meet with your audiologist via a video call through the applications. During your virtual appointment, your audiologist can make real time changes to your hearing aid settings. You are able provide feedback on sound quality and volume, just as if you were in our office. Remote programming is a great option if you travel often, have transportation issues, or have difficulty leaving home.
Here’s what Gail D., one of our new hearing aid patients, has to say about remote programming:
“Being an older patient, I am not technologically savvy. My Audiologist thoroughly explained how to access the appointment. I was able to voice all my concerns and questions,which were answered, as well, as if I had been in the office. She was able to make an adjustment in my hearing aid and evaluate the change. I clearly was able to notice a difference right away…. It’s nice to know some things can be resolved this way.”
New hybrid hearing device helps those who find hearing aids to be ineffective
By Charlie Patton Tue, Aug 19, 2014 @ 4:51 pm
Traditionally there have been two approaches to hearing loss: hearing aids to amplify sound for those who retained some hearing; and cochlear implants to restore some hearing to those who are totally deaf.
A new device, a Cochlear Nucleus Hybrid Implant System, has been approved by the FDA for use in people who have some hearing but have found hearing aids ineffective.
J. Douglas Green Jr., a neurotologist and founder of the Jacksonville Hearing & Balance Institute/The Hearing Center, calls the device “an extraordinary melding of technologies.”
The hybrid includes three elements: an implant that Green puts in place during a 90-minute outpatient procedure; a sound processor that converts high-frequency sounds to electric signals and sends them to the implant; and an acoustic component that functions like a hearing aid, amplifying low-frequency sounds.
The cochlear implant component restores the ability of people to hear high-pitched sound.
The hybrid “gives patients a more natural sound quality,” Green said. “People really like that. There is more clarity to the sounds.”
Green will offer free seminars about the implants: a dinner presentation from 6:30-8:30 p.m. Tuesday and a lunch presentation from noon-1:30 p.m. Wednesday at Hotel Indigo, 9840 Tapestry Park Circle.
While seminars are free, seating is limited and a reservation is required. Go to HearingHealthSeminar.com or call (877) 432-7844.
Tinnitus, or ringing (also commonly described as buzzing/chirping sounds) in the ears, can be a very debilitating problem. Unfortunately, tinnitus treatments are often complex and costly. One of the best, most cost-effective tinnitus treatments involves the use of hearing aids. In many cases, hearing aids are a “kill two birds with one stone” approach, and are helpful in both the correction of hearing loss and the reduction of tinnitus.
Below is a summary of a retrospective review of 70 patients with hearing loss and chronic tinnitus, courtesy of the American Academy of Audiology. The authors found that hearing aids can be a very effective treatment for tinnitus, and we agree. In fact, some of our most successful hearing aid patients initially began using hearing aids as a tool to help their tinnitus, only to later discover the added advantage of better hearing.
Hearing Aids as Tinnitus Therapy
McNeill et al (2012) report that “hearing aids have become common therapeutic tools in the audiological management of tinnitus.” They note that hearing aids are used in tandem with counseling and hearing aids serve as an important part of treatments, such as Tinnitus Retraining Therapy (Jastreboff and Jastreboff, 2000).
McNeill and colleagues performed a retrospective study of 70 patients (48 males, 22 female, mean age 55 years). Each patient had hearing loss and a primary or secondary complaint of “bothersome chronic tinnitus.” Of note, while wearing hearing aids (Oticon, Phonak or Widex) 26 patients reported their tinnitus was totally masked, 28 reported partial masking (i.e., 77 percent, or 54 of 70 reported partial or total masking) and 16 reported no masking. Tinnitus pitch masking revealed (on average) a perceived pitch of 6900 Hz. Of note, for the group that did not achieve masking (n=16, see above)they reported a mean tinnitus pitch perceived at 8000 Hz (the average perceived tinnitus pitch for the partial masking group was 7,600 Hz and for the total masking group was 5,400 Hz). The authors note the patients who had the most tinnitus relief via their hearing aid fittings had tinnitus matching results within the frequency range of the hearing aids.
McNeill et al report that their results indicate hearing aid fittings may be useful in the management of tinnitus because hearing aids reduce the audibility of tinnitus and hearing aids improve the patient’s reaction to tinnitus. The authors recommend hearing aid fittings to treat tinnitus in patients with hearing loss. Further, they note the best results are obtained when the patient has good low-frequency hearing, a strong reaction to their tinnitus and when the tinnitus pitch is perceived to be (i.e., matched) within the fitting range of the hearing aid.
What is it like to not hear splashing of water when swimming or not be able to participate fully in Marco Polo with your friends at a pool party? Imagine hearing only silence. For Rachel, a 12 year old bilateral cochlear implant recipient and JHBI patient, situations such as these could not be experienced or fully enjoyed.
Rachel lost her hearing completely at age 5 years and quickly received a cochlear implant to each ear. Since her surgeries, Rachel uses her cochlear implant external sound processors to hear again. She has excelled in school and has even learned to play the violin. Rachel’s original sound processors were water resistant but not waterproof, and she could not use them while swimming or bathing and could not hear to communicate in these situations.
In March 2012, Rachel’s cochlear implant manufacturer, Advanced Bionics, released the first completely waterproof sound processor, the Neptune. When Rachel and her family learned of this new processor option, she immediately “had to have it”. After the Neptune was fit to her right ear, she immediately raced home and went swimming in her back yard.
Share with Rachel and her parents as she uses her new external cochlear implant Neptuneprocessor to enjoy swimming and hearing underwater for the first time.
The Bionic Ear Association is sponsoring an event in our area on December 8, 2012. Click here if you’re interested in trying or learning more about the Neptune processor while enjoying a guided boat tour of the St. Johns River!
A small study by the House Research Institute revealed that 72% of teens reported reduced hearing after attending a three-hour show. This type of hearing loss typically disappears within 48 hours, but if it occurs repeatedly, permanent hearing loss can develop, the study authors noted.