Category Archives: Hearing Loss

Hearing Loss and Travel

For individuals with hearing loss, traveling by plane can be a particularly stressful experience. As the summer months approach and we begin to make travel plans to see friends and family, keep the following tips in mind for a stress-free and enjoyable traveling experience.

-Sign up for e-mails from your airline in order to receive written communication regarding any travel changes leading up to your flight.

– Arrive to the airport early so you have plenty of time to communicate with the agents at the check-in desk. Let them know you have difficulty hearing and request that they speak slowly and, if possible, maintain eye contact for the added benefit of lip reading.  Or better yet, check-in online.

– When going through security you are allowed to keep your hearing aids, cochlear implant or BAHA processor on. Notify the TSA agent if you have an implantable hearing device such as a cochlear implant or a BAHA. You will likely be scanned with the security “wand” rather than go through the full body scanner. This will not cause any problems with your implant.

– Once through security make sure to find a TV monitor to visually confirm your gate number and boarding time. Wait at your gate within view of the boarding door so you don’t miss your boarding time. Often there will be a monitor to display the boarding group as they are called.

– You can safely use your hearing aids, cochlear implant or BAHA on an airplane. Notify the flight attendant that you have difficulty hearing and where your seat is located in case they need to provide important safety information during the flight.

– Be sure to pack extra disposable batteries if applicable or if your device is rechargeable be sure to pack your charger in your carry-on in the event your battery unexpectedly dies.

Overall, use visual and written confirmation of information when available and don’t be afraid to advocate for yourself. Happy travels!

Sudden Hearing Loss

Many types of hearing loss happen gradually over a period of months or years. Sometimes, hearing loss can occur suddenly without any warning. Sudden hearing loss often affects one ear and may be accompanied by tinnitus and/or vertigo. When hearing loss occurs suddenly, it is critical to receive treatment ASAP. Sudden hearing loss is considered a medical emergency due to the time sensitive nature of receiving treatment to restore hearing sensitivity.

According to the Clinical Practice Guideline for Otolaryngology Head & Neck Surgery, sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually (about 66,000 each year in the United States). Sudden sensorineural hearing losses are often idiopathic, meaning the cause is unknown. Only 10-15% of individuals who experience a sudden hearing loss have had the cause diagnosed. Some risk factors or causes have been identified as:
-Infection (bacterial or viral)
-Head trauma
-Autoimmune diseases 
-Inner ear disorders

Although the cause of a sudden sensorineural hearing loss may not be known, treatment of the loss is still possible. The Clinical Practice Guideline for Otolaryngology Head & Neck Surgery recommends the following:
-Audiometric evaluation within 14 days of symptom onset to confirm the diagnosis
-Oral and/or intratrympanic steroid therapy within 14 days of symptom onset
-MRI to rule out retrocochlear pathologies

Patients may recover some hearing within the first two weeks–the degree of recovery varies greatly patient to patient. Although there is limited evidence-based data, early intervention and treatment often results in greater recovery of hearing sensitivity. 

If you or someone you know experiences a sudden hearing loss, please call our office at 904-399-0350 as soon as possible. 

Hearing Loss in One Ear; What Are My Options?

Profound hearing loss in one ear with normal or near normal hearing in the other ear is referred to as Single Sided Deafness (SSD). This type of hearing loss can occur suddenly from a viral infection or it may occur gradually over time as a result of various ear disorders such as Menieres Disease. Whatever the cause, hearing with only one ear presents unique struggles and can often lead to a decreased quality of life.

Our bodies are designed with two ears for important reasons:

  • Improved ability to understand speech amongst competing noise such as talking with a family member while the television is on in the next room
  • Localization, or knowing where sound is coming from
  • Improved access to sound; the volume naturally increases when the brain hears with two ears so decreased volume makes it more difficult to detect sound around you
  • Easier listening: when one ear is doing all the listening this places a higher workload on the brain, leading to increased fatigue and can lead to less enjoyment in conversation and willingness to participate in social activities

Often, a hearing aid does little to improve the clarity of speech for those with SSD creating frustration for hearing aid users and their families. A CROS hearing aid may be a good option for those looking for awareness of sound on their deafened side but it will not address the difficulties listed above.

A cochlear implant is a device that bypasses the damaged portion of the inner ear responsible for stimulating the hearing nerve to deliver sound to the brain in a much more effective way. With time, the brain uses this information to understand speech.

The biggest barrier for those with SSD has historically been insurance coverage. Unfortunately, despite years of clinical and anecdotal research proving the benefits of a cochlear implant for those with SSD, many insurance companies still view a cochlear implant as an option only for people with profound hearing loss in both ears. Luckily, the cochlear implant manufactures are making strides in working towards more consistent coverage of cochlear implants for people with SSD. They are doing so by applying for and obtaining FDA approval.

Med El and most recently Cochlear Americas both have FDA approval for the use of cochlear implants as treatment for adults with profound hearing loss in one ear and normal to near normal hearing in the other ear. This is exciting progress as we work towards providing greater access to better hearing for those with SSD.

If you have profound hearing loss in one ear and would like to learn more about your options please give our office a call at 904-399-0350 to schedule an appointment.

Back to Basics: Understanding Your Hearing Test

After your initial appointment with Jacksonville Hearing and Balance Institute, you will leave with a graph depicting the results of your hearing test. There are a lot of symbols and colors, but what do they all mean?

The graph you received is called an Audiogram. The audiogram shows two things: Pitch and Volume.

  • Across the top of the graph is pitch. The left side is low pitch, the right side it high pitch, kind of like a piano keyboard.
  • Down the side of the graph is volume.  The top is very soft, the bottom is very loud.
  • You will also see the degrees of hearing loss as shaded sections ranging from NORMAL hearing to a PROFOUND hearing loss. The further down the graph, the more hearing loss is present.

On your print out of the audiogram, there will be O symbols for the right ear and X symbols for the left ear.  You may also see these color coded as red for right and blue for left.

  • These symbols correspond to the softest sound you can hear at each of the pitches when we had you in the sound booth.  You hear everything BELOW the symbols.
  • The graph example below shows that the patient hears in the NORMAL in the low pitches and SEVERE in the highest pitches.
  • The lower pitch sounds generally correspond with the Vowels of speech, which give volume
  • The higher pitch sounds generally correspond with the consonants of speech, which give clarity.
  • For patients with more hearing loss in the higher pitches, they will generally HEAR that someone is talking but may not UNDERSTAND exactly what is being said.

Below this graph will test your speech understanding. We test two aspects of speech.

  • The first is your Speech Reception Threshold or SRT, which measures the softest level of speech in which you can repeat words
  • The second is your Word Recognition Score. This is a percentage of how many words you repeated correctly at a comfortable volume. We use this to test optimal performance understanding speech WITHOUT the presence of noise.

All of these components are reviewed during your appointments with us at JHBI.  We use the combination of how soft you are hearing tones, combined with your speech understanding, to determine if you would benefit from hearing aids or implantable devices.

We like to repeat your hearing test once per year, sooner if you feel necessary, to monitor any changes in hearing and word understanding. If you think your hearing has changed, or think you would benefit from hearing aids, please give our office a call to schedule an appointment.

Age-Related Hearing Loss

Do you ever think that everyone around you is mumbling? Most people in their advanced years don’t consider this truly “hearing loss” because it often occurs very gradually. If you are noticing changes to your hearing, the best thing that you can do is to get your hearing tested. However, while you may not notice it right away, it could surprise you to know that age-related hearing loss often goes untreated.

By the time you retire, there is a good chance that you will be dealing with some level of hearing loss, and if this is the case, you need to decide whether or not your hearing loss is affecting your quality of life. Age-related hearing loss is the type of hearing loss that often goes untreated, and understanding why can make a difference in your overall health.

What is Age-Related Hearing Loss?

Some forms of hearing loss are preventable, but age-related hearing loss is a little different. The medical term for age-related hearing loss is presbycusis, and it affects at least 60% of adults over the age of 75. This is because, as we age, the structure of our ears change, and the tiny hair cells that help conduct sound in the ear no longer work effectively. If your brain isn’t getting all of the information that you are hearing, you are going to lose sound in your environment. The problem is that most people don’t get help for their hearing loss and it then goes undiagnosed for several years, gradually decreasing quality of life and creating unnecessary hardships.

Top 3 Signs and Symptoms of Age-related Hearing Loss

  • Difficulty understanding speech and mixing up speech sounds
  • Difficulty hearing in the presence of background noise
  • Turning up the TV, phone, or radio to levels too loud for other listeners

Contact Us!

If you are ready to treat your age-related hearing loss, contact the clinic today to start your journey to better hearing!

Keep your Loved Ones with Hearing Loss Engaged in Conversations over Thanksgiving!

It’s not uncommon to see family members and friends with hearing loss limit their participation in loud, large social gatherings. Multiple speakers, clanking of silverware, and lots of background noise can make it difficult to understand the conservation we are trying to participate in. Here are some tips and reminders that may be helpful this Thanksgiving:

  • Seat the person with hearing loss at the head of the table or somewhere they are able to see others seated at the table
  • Provide adequate lighting 
  • Take turns speaking to prevent multiple, overlapping conversations
  • Speak clearly, but not overly loud or over-enunciated
  • Indicate topic shifts and reiterate key information 
  • Don’t be afraid to ask for repetition or clarity

Why is Hearing in Noise So Difficult?

One of the most commonly reported challenges people face with their hearing is understanding speech in background noise. Noise can vary depending on the environment. Sometimes it might be multiple people talking at once, like at a party. It may also be ambient noise such as music from a speaker or dishes clanking at a restaurant. Regardless of the type of sound, extra background noise makes it more difficult to understand conversations with others.

Many people don’t realize that a lot of our hearing ability comes not just from what the ears pick up, but how our brain processes the sound information from our ears. Hearing in noisy places is more challenging for a couple of reasons:

  • Audibility – we have to be able to hear all the sounds of speech in order to easily understand it. Extra noise can overpower soft speech sounds.
  • Focus – noisy environments tend to be busier. If there are distractions present, it decreases our ability to concentrate as effectively as we can in quiet.
  • Memory – in order to understand speech, our brain has to process sound and remember the information. Busier environments compete for the brain’s attention in focusing and remembering speech.

The good news is that hearing devices can address the concerns listed above and make it easier to understand in noisy places. Although in most cases it is not possible to completely eliminate all background noise, hearing devices such as hearing aids or cochlear implants can make a big improvement in speech understanding, both in quiet and in noise.

If you are interested in learning more about how you can optimize your hearing in noisy environments, contact our office at 904-399-0350 to schedule a hearing evaluation.

Hearing with Two Ears

Our bodies are designed with two ears for many important reasons. Listening with two ears:

  • Leads to better understanding in background noise
  • Allows for improved ability to detect where sound is coming from and
  • Gives speech a “boost” in volume

In addition, listening with two ears lessens the amount of work it takes the brain to understand speech and can lead to an improved quality of life. 

For people whose hearing loss is severe, two hearing aids may not be very helpful. However, research, anecdotal evidence and experience tells us that using a hearing aid in one ear and a cochlear implant in the other ear can improve clarity of speech, even more so than using just one cochlear implant. 

This has been demonstrated over and over to the point where two cochlear implant companies have partnered with hearing aid companies to create compatibility between the cochlear implant and hearing aid. This not only leads to the great benefits discussed above but also allows streaming of phone calls and other media to both ears at the same and easier access to program or volume changes.

To learn more about your hearing aid and/or cochlear implant options, give our office a call at 904-399-0350 for a hearing evaluation.

Why Does My Tinnitus Get Worse When I’m Stressed?

Although tinnitus (or ringing / buzzing / whooshing / roaring in the ears) is often an underlying symptom of hearing loss, it can be exacerbated or even triggered by stress. A person’s reaction to tinnitus depends on how the autonomic nervous system responds to the sound itself. While many patients are able to ignore their tinnitus, for others it can cause significant stress, anxiety, and irritability when the brain subconsciously decides that the tinnitus is an “alarm”. Just like your body enters “fight or flight” mode when you encounter a genuine threat, tinnitus can trigger the same physical and emotional reaction. This makes it very difficult to concentrate or relax when you are stressed and have tinnitus.

One of the ways we attempt to combat this stress response is through relaxation exercises. Some patients report a reduction in the intrusiveness of their tinnitus with the use of these methods over time; including progressive muscle relaxation, deep breathing, mediation, and yoga. In addition, you may try a simple form of sound therapy: add calming sounds or white noise to your calming routines to help aid in relaxation. And of course, limiting the amount of caffeine consumed during the day and getting an adequate amount of sleep at night will also help in the long term.

For more information on tinnitus and tinnitus treatment options, contact our office to set up an individualized consultation to discuss what methods might be best for you!

Assistive Technology For Patients with Hearing Loss

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.

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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.

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