April 28, 2007 Issue

             HEARING LOSS HELP E-zine
"The premier e-zine for people with hearing loss"


Volume 2, Number 4                April 28, 2007
Publisher: Neil Bauman      neil@hearinglosshelp.com
            http://www.hearinglosshelp.com
    Copyright Center for Hearing Loss Help 2007

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                      "Hearing loss may change your life,
                        but your life need not be any less
                                rewarding and fulfilling
                        because you have a hearing loss."

                                                               — Neil Bauman, Ph.D.

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Please recommend and/or forward this issue of Hearing Loss Help
e-zine to at least one of your hard of hearing friends, or to
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In this issue
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1. Balance Issues

2. Beware of (Ototoxic) Drugs That Can Damage Your Ears

3. Answers to Your Questions

4. Coping Strategies

5. Subscriber-only Special

6. Information on Hearing Aids, Cochlear Implants and/or
Assistive Devices

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1. Balance Issues
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Numbness Not Part of Ear-related Balance Problems

by Neil Bauman, Ph.D.

A man wrote: "I hope you can help me It all started on March 11. I got to work and started walking to the job and got dizzy and light headed. During the next 3 hours, I felt worse and worse. I got sick to my stomach. I called my wife to come and take me to the hospital. As we were going to hospital my chest, hands and feet felt numb. At the hospital I told them my chest hurts, my hands and feet feel numb, and I'm spinning. I was in the hospital 10 days.

After I got out, they sent me to an ENT doctor because I had lost the hearing in one ear. He put me on Prednisone and some other drugs. My hearing came back quite fast. However, since this happened, I need to use a walker because I am dizzy. My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy.

I am just 54. They have done an MRI and found nothing. They say only my left ear was involved. The neurologist said today that a small blood vessel going to my ear could have caused a small stroke. Of all of the stories that I've read on the Internet, no one talks about numbness. Furthermore, I can't believe that hearing plays that much of a role in having to use a walker."

That's quite an experience you have gone through. I agree with you that numbness is not a part of "ear problems." Typically, numbness is the result of a lack of blood flow to the affected parts of your body. Hence the sensor nerves there (pain, heat/cold, pressure, etc) temporarily cannot send their messages to your brain. Thus you have the numb feeling (or rather lack of feeling).

Whatever you had obviously affected your whole body, including one of your ears. When the blood flow was cut off to this ear, it immediately affected the two things your ears give you—your hearing and your balance.

Since the vestibular parts of your inner ears are the main balance organs in your body, when one or both of them are damaged, you typically get violently sick and the room spins— just as you experienced.

Thankfully, your hearing came back, but you are now left with what appears to be some permanent balance problems. Let me explain what happens in your ears that causes you to have these balance problems.

Your inner ears consist of two parts, the cochlea and the vestibular system. When something damages the cochlea, you lose hearing. Apparently the same thing that affected your cochlea also affected your vestibular system causing your dizziness and vertigo. Often both are damaged together since both structures lie side by side and share the same fluids.

Perhaps you don't know this, but you actually have 3 separate balance systems in your body. First, and the most important, is the vestibular system in your ears. Second is your eyes. Trailing a distant third is your proprioceptive system (pressure sensors in your legs and feet).

Since there are two of each of these subsystems, you really have 6 separate parts of your balance system—all sending balance information to your brain. If all 6 send the same consistent information, you have normal balance.

However, if one (or more) of these parts is damaged and begins to send different (false) balance information, then instantly your brain is confused. The result is the dizziness and vertigo (spinning) you experienced.

Fortunately, over time, your brain generally learns how to ignore the bad signals. When this happens, the vertigo and much of the dizziness goes away. It can take a few months or more for your brain to adjust.

One thing that helps is to do balance exercises that teach your brain to ignore the bad balance signals, and only use the good ones.

One more point. You mention, "My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy." This is often the result of damage to your vestibulo-ocular reflex. This is just a fancy way of saying that the vestibular system in your inner ears and your eyes are tied together in intricate and wonderful ways so that when you are moving around your eyes have a stable horizon or reference point.

When this vestibulo-ocular reflex is damaged or broken, then your eyes move independently, rather than being coordinated by your brain to move in unison with your body movements. One of the results is the dizziness you feel when you, or something around you, is moving.

When you wrote, "I can't believe that hearing plays that much of a role in having to use a walker," you were only thinking of your ears as hearing organs. By now you realize they are so much more—they are critical to proper balance. When you don't have good balance as you have unfortunately discovered, you cannot always function independently.

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If you wear hearing aids that have t-coils in them, the dual
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in both ears! Click here to learn more.

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2. Beware of (Ototoxic) Drugs That Can Damage Your Ears
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Fluoxetine, Tinnitus and Hearing Loss

by Neil Bauman, Ph.D.

A lady wrote: "I was prescribed Fluoxetine (Prozac) for fibromyalgia. I took it for 7 days before contacting my Rheumatologist about the tinnitus and other disturbing side- effects. He seemed surprised that this medication would cause tinnitus, but said to stop taking it. Forty-eight hours later the tinnitus stopped and I was elated.

Then I made a really bad decision. I thought that perhaps I could take the medication every other day to help with the fibromyalgia and not get the side effects. I took one more capsule and within about 8 hours the tinnitus was back.

I still have the tinnitus even though I have been off the medication for 11 days. It is a loud, high-pitched whistling sound that is constant 24 hours a day every day.

What is the likelihood that this is permanent? And are there any steps I can take to increase the chance that it will go away?"

What you have experienced illustrates the "fickleness" of many of the ototoxic drugs. You don't know what is going to happen next.

Fluoxetine (Prozac, Sarafem) is quite ototoxic. Your doctor should have known this. It is listed in the PDR (and the CPS for those of you living in Canada) as causing tinnitus (as well as hearing loss, hyperacusis, ataxia, dizziness, nystagmus, vertigo and ear pain), so your doctor could have looked it up if he had wanted to. This shows how little doctors really care about the ototoxic side effects of the drugs they prescribe. Ear problems seem typically to fly under most doctors' radar.

When you stopped taking the Fluoxetine the first time, how were you to know that, if you took it again, the tinnitus would be much more persistent?

Instead of taking the full dose every second day, a better choice might have been to take half the dose every day. Sometimes tinnitus is dose related, so a reduced dose might not trigger it whereas a full dose could, but there are no guarantees of course.

Whether it is now permanent is anyone's guess. I'd like to say that it will go away in time—but I have no guarantee that it will.

Obviously, you are very sensitive to this drug—so it would seem wise to stay away from Fluoxetine permanently. If I were you, I'd stay away from any drug that is known to cause tinnitus until you get a handle on how you can control your tinnitus.

In order to give yourself the best chance of having your tinnitus fade away, besides not taking any drugs that are known to cause tinnitus, you need to learn to ignore your tinnitus. If you focus on your tinnitus, and get upset with it, your limbic system will flag the tinnitus sound as "important" and consequently it will seem even louder and more intrusive. Therefore, treat your tinnitus as meaningless sound, and let it fade into the background if you can. This is called becoming habituated to your tinnitus.

Incidentally, I've had several people tell me they lost hearing after taking Fluoxetine for several months or years, so it is not a good drug for our ears—no matter how you slice it.

To be safe, you need to check out the ototoxic side effects of any drugs before you take them. One way to do this is to check out any drugs you take in Ototoxic Drugs Exposed. This book contains information on the ototoxicity of 763 drugs known to damage ears.

A man asked: "How important is sodium in controlling tinnitus? Seems like if I eat out and ingest some larger amounts, my tinnitus goes off the rails."

Sodium is indeed a known trigger of tinnitus—so maybe that is what causes it in your case as you already suspect. "Hidden" sodium could also be the source of your tinnitus. For example, MSG added to food by the chef also makes tinnitus worse. (MSG contains sodium—the "S" in the acronym MSG.)

On the other hand, how do you know it is sodium, and not some other "stuff" in the restaurant food? Some people find that wine, vinegar, cheese, caffeine, or certain spices also affect their tinnitus.
 

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4. Coping Strategies
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The "Dear Family" Letter Works

by Neil Bauman, Ph.D.

A hard of hearing wife wrote: "I loved your 'Dear Family' letter on dealing with my hearing loss. I cried after I read it because it hit the nail right on the head! My husband is terrible (regarding my hearing loss) and I'm hoping this will help! I'm getting up the courage to give it to him this week."

Note: anyone can access this "Dear Family" letter through the short article Effective Communication in the Family. It explains some easy communication tips so that you can more easily converse with your loved ones.

I encouraged this lady to give this letter to her husband. A few days later she wrote: "I just wanted to tell you that I gave the 'Dear Family' letter to my husband last night. (It was easier than I thought.) He even apologized and told me that hearing is just something he's taken for granted and always forgets that I can't hear. Let's hope things will improve now."

I hope things will improve for you too. However, I must caution you it won't come all at once. You will have to keep on reminding him again and again that you can't hear, and refer him to the "Dear Family" letter and the specific points he is breaking.

This is because even if he really wants to meet your needs, he often will forget because communication habits are so deeply ingrained. It will take a lot of effort on his part to form new communication habits. However, with your help he can learn the proper ways of effectively talking with you.

This same lady also lamented: "My hearing loss began about ten years ago. I can't imagine what I'm going to go through if I go completely deaf. I think when a person is diagnosed with a hearing loss, they should also prescribe counseling for them and their families, besides just fitting them with hearing aids! It would save us from a lot of torment and depression. I've been laughed at, made fun of, ignored at gatherings, and yelled at because I couldn't understand what someone was saying."

What you are saying is absolutely true. Hard of hearing people, and their families, do indeed need counseling—but they seldom get it. Part of the blame lies with the audiologists for not taking the time to do the necessary counseling, but part of the blame lies with hard of hearing people and their families who do not think they need such training, so won't come to sessions put on by their audiologists. I've talked to some audiologists who are discouraged because they prepare information for these sessions, and then their clients don't show up.

This lady concluded with the observation, "As your hearing ability continues to drop, people assume your IQ drops with it."

Unfortunately, what you say is too often true. Therefore, we have to show people that it is not true—that we have just lost our hearing, not our brains. The way we do this is to be proactive and TELL people we have a hearing loss, then explain what we need them to do so we can hear and understand them.

This way they will know it is our ears and not our IQ that has gone south. However, if we bluff (pretend to hear and understand when we don't), can you blame people for thinking the elevator stopped one floor short of the penthouse?

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5. Subscriber-only Special
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As is our custom, with each issue of Hearing Loss Help eZine we bring you a subscriber-only special that is only available to you, our loyal subscribers.

This issue's special is for the eBook version of our book "Talking With Hard of Hearing People—Here's How to Do It Right." It ties in with the above article on how to effectively communicate with a hard of hearing family member.

This book is short (only 30 pages), easy to read, yet is packed with simple, effective tips for talking with hard of hearing people in various situations—one-to-one, in small groups, in larger meeting, during emergencies and in hospitals and nursing homes.

"Talking With Hard of Hearing People" is normally $5.99. Now is your chance to save 33% off the already low eBook price. For a limited time, you can have it for just $4.00. Furthermore, for our overseas friends, because it is an eBook, there is no shipping charge and you can download it immediately—no waiting time. (Note: the eBook version is identical in content to the printed edition.)

Order it now while you are thinking about it because this special will only be available until May 23rd at midnight.

To get this special price, you must click on the below link. Do not order from the regular links on the web site or elsewhere, or you will be charged the regular price.

To purchase this eBook edition of Talking With Hard of Hearing People—Here's How to Do It Right at this special subscriber price of just $4.00, click on the above link now.
 

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6. Information on Hearing Aids, Cochlear Implants and/or
Assistive Devices
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Using Neckloops, T-Links and Music Links with Cell Phones and
Other Devices

by Neil Bauman, Ph.D.

A man explained: "I have a high-frequency hearing loss. I use two hearing aids with telecoils. I have heard about a neckloop, but I am unclear if I just need a neckloop, or something additional to make the neckloop work."

Yes, you need something additional. Think of a neckloop as equivalent to a pair of ear buds. You have to plug the ear buds into an audio device in order to hear anything. The same is true with a neckloop. You can plug a neckloop into any device that you can plug ear buds into.

This man continues: "I sometimes have trouble hearing when I use (or try to use) my cell phone if there is even just one person nearby talking. Will a neckloop help me?"

When you switch your hearing aids to t-coil mode, you will instantly eliminate all the voices and noise around you. That is one of the advantages of using your t-coils in noisy situations.

However, regular neckloops won't work in cell phones. They have the wrong size of plug. Special neckloops are available that have the correct plug and the integrated microphone that you need in order for them to work with cell phones.

However, in my experience, neckloops—unless they are amplified—don't have enough power to effectively work with cell phones. (Incidentally, amplified neckloops cost a lot more and require batteries. If the batteries die on you, so does the conversation.)

Since the above are not problems with the T-links, when using a cell phone, I'd recommend using the T-Links instead of a neckloop. Then you could listen to your cell phone with both ears via your t-coils and not hear the outside interference. You can see the T-links here.

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A lady explained: "A problem I have with cell phones is that I have no privacy. I have to have the volume up so loud that people around me (even two offices away) can hear my conversations even with the speaker off. Is there something that can help me?"

I have good news for you. Switch your hearing aids to t-coil mode and use the T-Links. Then you'll have totally private conversations. No one will be able to hear the other person on your phone—even if they put their ear right up to it! How's that for privacy? Since the T-Links plugs into the headset jack, it cuts out sound from going to either the receiver or speaker, thus no one will be able to hear you, and you'll hear beautiful clear sound in both ears via your t-coils.

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When she set her hearing aids to t-coil mode, a lady had trouble with interference when using her phone around florescent lights. She wrote: "The florescent light is in my kitchen is an old fixture, but I also tried the new florescent bulbs that screw into a regular light socket in the ceiling fan I have in the kitchen, and I would have to leave the kitchen to talk at all on the phone. As soon as I switched the light bulbs back to the regular ones, the noise quit (except when I stand near the sink where the old fixture is located above the sink.) The old kitchen fixture still causes a buzzing noise in my hearing aids."

What you have discovered is one of the few problems when using t- coils—they are subject to interference from stray magnetic fields. This stray magnetic field is typically caused by the alternating current in your house wiring. You hear this 60 cycle A/C as a loud humming or buzzing sound.

Certain electrical fixtures and appliances cause a lot of interference. Florescent lights, particularly older fixtures, are one of the culprits. Sometimes just changing the old ballast for a new one largely eliminates the problem. Other than that, just moving a few feet away often reduces the interference to a low level.

Another source of interference are TVs and computer monitors that use CRT tubes. Again, just moving back 3 feet or so generally reduces the interference to a very low level. (Note: flat screen LCD TVs and computer monitors do not cause this kind of interference.)

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A lady wrote: "I am wondering if the dual Music Links and my hearing aids set to t-coil mode will work with a computer. Can I plug the Music Links into the earphone jack on a computer?"

You bet. The Music Links work great in any stereo earphone jack—including the one on your computer

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Another lady wrote: "I have just purchased a Williams Sound PockeTalker and neckloop. I was wondering if your dual Music Links can be used with the PockeTalker instead of the neckloop? They would appear to be somewhat lighter and easier to use."

For sure! They work just fine. Since the PockeTalker has a mono jack and the Music Links has a stereo plug, get a stereo to mono adapter from Radio Shack (Part #274-882, $3.99), then just plug the adapter into the PockeTalker, and the Music Links into the adapter, and you're all set. (If you don't use an adapter, you'll only hear sound in one ear. The other channel will be shorted to ground.)

The Music Links are definitely lighter than a neckloop. However, I don't think there is really any difference in their ease of use. You wear the neckloop around your neck. You wear the Music Links hooked over your ears. You can check out the Music Links here.

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                       HEARING LOSS HELP E-zine

Neil Bauman, Publisher               Center for Hearing Loss Help
49 Piston Court                       Stewartstown, PA 17363 USA
Phone: (717) 993-8555                       Fax (717) 993-6661
http://www.hearinglosshelp.com     neil@hearinglosshelp.com

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