August 28, 2007 Issue
HEARING
LOSS HELP E-zine
"The premier e-zine for people with hearing loss"
Volume 2, Number 7
August 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 anyone you know that is interested in successfully living with their hearing loss. We just ask that you keep this e-zine intact and only forward it in its entirety.
================================================== In this issue ==================================================
1. News Items
2. Beware of (Ototoxic) Drugs That Can Damage Your Ears
3. Answers to Your Questions
4. Subscriber-only Special
5. Coping Strategies
6. Information on Hearing Aids, Cochlear Implants and/or Assistive Devices
================================================== 1. News Items ==================================================
Smoking and Noise Team Up to Destroy Your Hearing
by Neil Bauman, Ph.D.
In December of 2006 I wrote about
smoking and hearing loss and pointed out that smoking in the presence of loud noise makes your ears even more susceptible to hearing loss than either smoking or loud noise alone.
Now, researchers have published the results of a study on workers in one manufacturing plant showing just how severely noise combined with smoking can affect hearing loss. Here are the shocking results. Workers who were exposed to noise above 85 dB
and who smoked had an incidence of significant hearing loss 442% greater than those who worked in the same noisy environment but didn't smoke.
The researchers next compared the incidence of workers who had hearing loss greater than 30 dB between 4000 Hz and 10,000 Hz in both ears. The incidence of hearing loss was only 11.2% in non-smokers, but was a whopping 49.5% in smokers.
When looking at these same workers, but just considering hearing loss greater than 25 dB at 4,000 Hz in their better ear, the results were even more pronounced. Non-smokers had an incidence of hearing loss of 18.4%, but that figure sky-rocketed to 63.6% in smokers.1
Therefore, if you value your hearing, you need to do two things. First, if you smoke, stop smoking. Second, wear ear protectors when around noise louder than about 80 dB for extended periods.
Note: smoking isn't the only agent that has this synergistic effect when combined with loud noise. A number of drugs, chemicals (particularly the organic solvents) and heavy metals also have this property. "Ototoxic Drugs Exposed"
(chapters 8 and 14) explains this in much more detail and lists the specific
drugs, chemicals and heavy metals that have this nasty property.
1 Extracted from "Interaction of smoking and occupational noise exposure on hearing loss: a cross-sectional study" Gholamreza Pouryaghoub, et. al. Dept of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran published in BMC Public Health 2007, 7:137. http://www.biomedcentral.com/1471-2458/7/137.
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Autoimmune Inner Ear Disease (AIED) and Allergies
by Neil Bauman, Ph.D.
Autoimmune Inner Ear Disease (AIED) is a baffling condition to treat. Sometimes it occurs as the result of untreated allergies. One man explained,
"After undergoing steroids and all sorts of medical treatment with no results, I finally heard about allergies being a cause of AIED. After being tested, I found I have terrible environmental and food allergies. Allergy shots have really helped and I am improving now. I also found that in my case, MSG (monosodium glutamate) and various food additives cause attacks of hearing loss and tinnitus. These substances can cause immune system dysfunction. The more you stay away from such things, the better you feel. Your body doesn't turn on itself for no good reason--it has a little help! Please pass this information along to other people who suffer this horrible agony."
If you have been diagnosed with AIED, make such you see a good allergist and have yourself checked out for allergies that might be the underlying cause. If so, treating your allergies may bring your AIED under control without any other treatment needed.
To learn more about AIED, read my article "Autoimmune Inner Ear Disease (AIED)".
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Having trouble hearing your iPod (or MP3 player) in true stereo?
If you wear hearing aids that have t-coils in them, the dual Music-Links will let you hear beautiful, clear, true-stereo sounds in both ears!
Click here to learn more.
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================================================== 2. Beware of (Ototoxic) Drugs That Can Damage Your Ears ==================================================
Ototoxic Side Effects—What's the Risk?
by Neil Bauman, Ph.D.
A lady asked, "Just curious. When the doctor prescribes
prescriptions, should I ask if this is an ototoxic medication
and whether there is a substitute that works just as well? I want to be more prepared in the future."
It's a great idea to be prepared beforehand. If there is another medication that does the same job and is not ototoxic, I'd go for it. (Of course, you want to check out
all the side effects of any drug you are considering taking, not just the side effects that affect your ears. After all, you have to live with your whole body. Thus, you need to choose a drug whose side effects are minimal on your ears
and the rest of your body.)
However, I sincerely doubt many doctors will even know if the drugs they prescribe are ototoxic. Actually, since 83% of the commonly prescribed drugs are ototoxic one way or another, your chances of not having an ototoxic drug prescribed are quite slim.
You really need to know ahead of time what the specific ototoxic properties of any drug are, and what the risk likely will be—then decide if you want to accept that risk given the circumstances you find yourself in at that time.
The easy way to be prepared is to refer to "Ototoxic Drugs Exposed". This book lists all the known ototoxic drugs at the time of printing, the ototoxic properties of each drug, the likelihood of an ototoxic event occurring (if known), how serious it could be if it does occur and a general risk assessment factor for that drug.
Based on this information, you can then make a more informed decision as to whether to take a given drug or not.
Then, if you choose to take a drug, you'll already know what ototoxic side effects to watch for. If any of these side effects begin to occur, you can immediately stop taking the drug (and contact your doctor) while you reassess your position. If you don't detect any ototoxic side effects, then you can probably safely take that drug and not damage your ears.
Remember that just because a drug is listed as being ototoxic doesn't mean you WILL get those ototoxic side effects when you take it. In fact, many people won't get any side effects. However, a number will. Since you don't know which group you'll end up in, you want to be as prepared as you can be ahead of time.
--o--o--o--o--o--o--o--o--o--o--o--
Tapering off Psychotropic Drugs
by Neil Bauman, Ph.D.
Drugs that affect our minds such as anti-anxiety drugs, anti- depressant drugs and anti-psychotic drugs can cause a host of unwanted side effects,
and build up a kind of dependence that makes it very hard to get off them without even more side effects occurring, including unrelenting tinnitus.
The secret to getting off these drugs is to do it very slowly. A lady that is on Paxil [Paroxetine] (among other drugs) explained:
"You may or may not know but the medical community is in the dark ages about tapering off anti-psychotic medications. There is a significant minority, including me, who have trouble big time, if we were to taper by their protocol which is very fast. (Actually, I suspect we are far more than a minority.)
The psychiatrist of one of the posters on the "Paxil Progress" board said that anti-psychotic medicine should not be tapered any faster than 10% of the current dose every 4 weeks. Yes, it is a slow process, but here is the proof. I have had minimal side effects and can hold down a full time job. The people who taper off too quickly have a totally different experience which is not pleasant.
Check out the "Paxil Progress" board as it is very informative. I have learned a lot there."
If you are on any of the psychotropic drugs such as Paxil (Paroxetine), Zoloft (Sertraline), etc, and also any drugs in the Benzodiazepine class, I'd suggest you check out this website for help in slowly tapering off these drugs.
Another tip from this lady is that you slowly taper off only one drug at a time. Since she is on several drugs, at her safe taper rate it is going to still take her another
six years to be drug free. This is the way to do it if you don't want unpleasant side effects cropping up because of tapering off too fast. It also gives your brain a chance to get its brain chemistry working properly again without the help of drugs.
The goal is to become healthy again and drug free. Then you won't have to worry about ototoxic (or other) adverse side effects.
--o--o--o--o--o--o--o--o--o--o--o--
Gabapentin, Migraines and Ototoxicity
by Neil Bauman, Ph.D.
In the preceding issue of this e-zine I had written an article called "Gabapentin Does Not Work for Tinnitus".
In response to this article a lady wrote: "I had to respond to the article about Gabapentin. I had to see a new doctor for my migraines. Whereas my previous one, who moved away, had been quite understanding about drugs (his mother had an almost identical experience to mine with hearing loss), this new one was like a drill sergeant.
He said, "You will take these drugs no matter what the side effects. It's the only way to help your migraines." This attitude was really scary, as he listed off a number of drugs, some of which I had already tried with poor results. I'd already had allergic reactions in the past, and was not sure of the new ones he listed. But I wrote them down and tried looking them up on your online list. Even though not all of them were on those lists, I was too afraid of being forced to take something that could be dangerous. After he threw up his hands (literally) and said, "What can I do with you—you can't take anything," I left this doctor and went to a pain clinic instead. Thankfully, these people will work with me.
After I got your book [Ototoxic Drugs Exposed], I took out this list and looked up every one of the drugs this doctor had mentioned. All were at least a Class 3 [moderately ototoxic] or worse. Of course, one of those was Gabapentin, the first drug he had prescribed. I had actually taken some of it before I'd left his practice, and it did
not help the migraines. I'm just glad I didn't continue taking any more of those, because they are so dangerous.
I know too many people who have been prescribed this drug without much reason. It is being prescribed for many conditions it is not even meant to treat, just because there isn't much else, and the doctors think it "might" work. This is especially true for migraine patients who get treated like guinea pigs for any new drug that just "might" help. That is because there are so few drugs that were created for, or actually work, for migraines.
I am horrified to learn that this is now being prescribed for tinnitus. I guarantee it will
not work for that—mine was worse even after the few pills I took. It is really a scary drug and it's good that you are warning people. By the way, I use my book all the time. Just recently, I had to ask for a different prescription for a minor illness because the first one was a Class 3. My internist had no problem giving me a new prescription for a different drug.
Most doctors, other than otologists, just do not know about ototoxic drugs.
I'd like to use my experiences to help other people avoid the same pitfalls I experienced, I cringe to hear of other people who have been damaged by all this ignorance, when it could be avoided. When it comes to drugs, it is just appalling how much ignorance there is out there. The only sources I have found that are trustworthy are these: (1) your
HearingLossHelp.com website, (2) your book "Ototoxic Drugs Exposed," (3) some pharmacists and (4) my psychiatrist. I'm not sure about others, but mine was especially careful about drugs.Another experience I had right after my hearing loss was that my (good) neurologist had wanted me to try Effexor [Venlafaxine] for migraine, but did not want to write the prescription until I had talked to my psychiatrist, as he knew I was going in for a consultation. What my psychiatrist told me was that there was no documentation that he had ever read, but that he had prescribed it for two of his patients. They both had reported minor hearing loss after long- term use.He had them tested by an audiologist, decided to never prescribe it again. He didn't ever want to risk anyone's hearing again. He felt that in my case having both a significant loss already and endolymphatic hydrops that was the last drug I needed to be taking. I'm not sure there is any documentation yet on Effexor except in your book. It's not on any of my other lists.Of course, I am grateful to my old neurologist and my psychiatrist, for being so careful. Most doctors are not."If you want to protect your hearing, you need to be proactive-- just as the above lady is. You can do what she is doing, and check out the ototoxic side effects of any drugs before you take them in "Ototoxic Drugs Exposed".
This book contains information on the ototoxicity of 763 drugs known to damage
ears.
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Having trouble hearing on your cell phone because of lack of volume or interference?
If you wear hearing aids that have t-coils in them, try the dual T-Links and hear beautiful, clear, interference-free sounds in both ears!
Click here to learn more.
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================================================== 3. Answers to Your Questions ==================================================
If you have a question, or if something has been puzzling you
concerning your ears, email it to
mailto:neil@hearinglosshelp.com
and put "e-zine question" as the subject. Suitable questions will
be answered here.
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Musical Ear Syndrome Caused by Constant Background Noiseby Neil Bauman, Ph.D.
A young lady wrote: "I was very interested in your article on
Musical Ear Syndrome (MES). The description seems to accurately describe what I have been experiencing throughout my life, and I must say it is relieving to find out that I am not insane. However, I am still a little concerned because I don't seem to match the description of someone typically suffering from MES.First, I am only 21 years old. I began hearing phantom music when I was very young (quite possibly before I reached ten years of age). I vividly remember hearing a distinct pianist serenading me to sleep on many occasions. I would sit up in my bed, listening intently, but as soon as I sat up the sound would disappear. Once I returned to my previous position in bed, the music would continue.I forgot about this strange phenomenon for quite some time, and as far as I can recall the music stopped as I entered adolescence. I have never had any hearing problems what-so-ever, so I didn't bother with it. Recently, however, the single pianist seems to have decided to get fancy. Earlier this week I was settling down to bed in my new apartment and I could have sworn that a full orchestra was being carried to my ears over the air conditioning vent. It was very soothing and playing one of my favorite tunes ("Carol of the Bells" by Trans-Siberian Orchestra), so I didn't bother trying to make the sound go away. I did notice that when I sat up the sound ceased, just like in my childhood. Similarly, as soon as the air conditioner turned off the music went with it.I know that for the most part this sounds typical of MES, except I am not elderly, not hard of hearing, don't lack auditory stimulation, am not on medication, or under any particular stress. The only symptom I may possibly share is tinnitus, but of that I am not positive. Occasionally I hear a high pitched single drawn out beep, but I had always assumed that I was hearing an alarm system or something.I was just wondering as to your opinion on the whole thing. I figured I may as well make sure I am not crazy."Don't worry. You are not crazy. Nor are you alone in your experiences. What you are hearing is a rather interesting phenomenon. Furthermore, there is a perfectly rational explanation for your phantom music.Since you are hearing a special variety of Musical Ear Syndrome phantom music, you do not have to fit into the typical mold of being elderly, hard of hearing, having tinnitus, etc. Younger hearing people experience such things too.Here's what is happening.Sometimes, when you are relaxing, or laying down trying to go to sleep, your brain decides it's time to have some fun. Somehow it modulates certain constant external background sounds so they sound musical. Examples of sounds your brain uses includes jet plane noise, road/wind noise when riding in vehicles, fans and other motors and even running water. In your case, as you discovered, your source was the constant background sound of the air conditioner.You heard the phantom music when you were trying to go to sleep—but when you sat up, it went away because now you were focused on something else—discovering the source of this music, so your brain stopped the phantom music to do some real work for you. Then, when you laid down and relaxed again, your brain went back to its old tricks—and there's that music again. This continued as long as there was a background sound on which to piggyback the music. Thus, when your air conditioner stopped, so did your phantom orchestra.You are not alone in hearing such things. Here are some examples of similar experiences other people (some hearing and some hard of hearing) have had. The first example is very similar to your experience.A lady wrote: "For years I've been hearing phantom music of various sorts when I lay in bed waiting to go to sleep--a wide variety, from band and orchestral, to Irish folk music, symphony, opera and so on. My only explanation for it was that my inner ear was making sense of faint but rhythmic sounds in the room, for example, the fan of the air cleaner."Another lady, elderly in this case, came to the same conclusion about fan motors and phantom music. Her cousin explains: "The music she hears can be initiated by her proximity to various electrical appliances! Not only initiated, but even terminated when the appliance is switched off. It appears that the source of the trigger is the noise produced by the fan in each of the appliances, viz. a fan heater, an exhaust fan above hot plates, and a fan in a microwave oven. The phantom music can be started, then stopped, by switching the fan on, and then off."This kind of phantom music can also be derived from airplane engine sounds. One lady wrote: "My mom is hard of hearing. Recently on a flight to Arizona with my dad she commented to dad when they arrived at their hotel that she really enjoyed the music on the plane. Dad said there was no music on the plane. On the return trip, mom started hearing the music again and told dad to listen. He said, nope, no music. But mom continued to enjoy it until the plane landed."I sometimes have the same experience when I am flying. To me the noise of the jets eventually modulates and becomes "vague" orchestral music.This phenomenon is not new at all. One man recalls: "During WW II, I was a passenger in C-47 (DC-3) military aircraft given mostly to hauling freight and the like in the southwest Pacific area. Flights were long and very noisy. I discovered I could hear music in the noise and used it as a form of entertainment. I heard a lot of choral music and popular orchestras. If one were lucky, one might have a lot of mail sacks to bed down on, and the music made a very nice sendoff to dreamland. I just thought it was a normal response to a very much overdriven sensory system trying to deal with the auditory bombardment."The same thing can happen when you are riding in a vehicle. When I used to drive my old jalopy with the windows open. I'd have the radio turned up so I could hear the beautiful classical music I like. When I'd turn the radio off, often I would still hear the music for miles and miles. The wind and road noise combined in my brain and took on a musical quality. I knew what was happening, but it was very pleasant, just the same.Others have had similar experiences in their cars. For example, a man perceptively explained, "The [phantom] tunes I hear appear to feed upon the noise of the expressway." This is also Martha's experience. She explains: "I have been hearing humming music when I was traveling 70 miles each way to work on the Interstate. I associated it with the noise of the tires on the road."As you can see, a lot of people experience phantom music when the conditions are right--constant background sounds, they are relaxing and their brains are on autopilot. So relax and enjoy your music. At least it is better than listening to the air conditioner!To learn more about
Musical Ear Syndrome
and the many strange experiences people have with their phantom sounds, click on
the above link.
================================================== 4. Subscriber-only Special ================================================== As is our custom, with each issue of Hearing Loss Help e-zine we bring you a subscriber-only special that is only available to you, our loyal subscribers.This issue's special is for the dual Music Links (your choice of either black or white). The Music Links let you hear beautiful clear stereo sound when you listen to stereo audio devices via the t-coils in your hearing aids.The dual Music Links normally sells for $49.00. If you always wanted a pair of Music Links, now is your chance to save 20% off the regular price. For a limited time you can get them for just $39.00.Order your Music Links now while you are still thinking about this offer because this special will only be available until September 3rd 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 the dual Music Links at this special subscriber price of just $39.00,
click
here now.
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================================================== 5. Coping Strategies ==================================================
Hospital Communication Kits—Boon for Hard of Hearing Patientsby Neil Bauman, Ph.D.
People tell me: "I am going to the hospital shortly and I am worried that I won't be able to hear, or will misunderstand, the instructions and questions of the doctors and nurses since I have quite a bad hearing loss. What can I do to make my stay in the hospital more communication friendly?"The good news is that I have just written an article on this very subject. This article explains what you should do, and gives links where you can get low-cost ($3.00 to $5.00) "Hospital Kits" to help make your communication encounters in the hospital much less stressful.
Click here to read this article and access these hospital kit links.
--o--o--o--o--o--o--o--o--o--o--o-- When You Hear Music
in the Wrong Keyby Neil Bauman, Ph.D.
In the last e-zine, I wrote about a man that was having trouble hearing his piano on key, and how my wife hears two different pitches--one in each ear. They are not the only ones with this problem. The day the e-zine came out, Joyce wrote:"I was most interested in your article "When Your Piano Sounds Bad," especially your wife's experience with different pitches in each ear. Despite my being born with a moderate-to-severe bilateral sensorineural hearing loss, I was also born with perfect pitch—the ability to identify musical notes without a reference.I have been involved in numerous music-related jobs (playing the piano, directing choirs, directing or playing handbells, etc.) up until a very bizarre change took place almost overnight. My perception of pitches has changed. When this first happened, I would hear the song being transposed up a half or whole step even in the middle of the song (as I turned the page). It was maddening. Then it seemed to "settle" to the point that it only seems "off" when I'm a certain distance from the source of the sound. When I am in the congregation looking at the hymnal, the hymns sound as if they are in a different key than they are written. But when I go up to the piano, organ, or whatever instrument, it is in the correct key.I can still play the piano, but always fear one day that even the piano will be in a different key as I'm playing it. I don't sing anymore, as I never know if I'm hearing the correct key as they're playing.I truly wish I understood this difference in perception of pitch. If you know of any research in this area, please pass it on."If anyone else has problems with pitch because of their hearing loss, I'd love to hear from you. I'm curious as to how common this problem really is, and if you've found ways to overcome it, Also, if you know of any research on this subject, please let me know.
================================================== 6. Information on Hearing Aids, Cochlear Implants and/or Assistive Devices ==================================================
Automatic T-coils, Music Links and Neckloopsby Neil Bauman, Ph.D.
A mother wrote: "I have some questions about your Music Links. My daughter wears binaural hearing aids that switch to t-coil mode automatically when needed. She would like to listen to her MP3 player with increased ease and clarity. What is the difference between the Music Links and a Neckloop? Which is better? Also, do they both work with MP3 players the same way? Do they both have stereo sound? In your experience, which device works better with digital hearing aids?"That's a lot of questions to answer. Before I answer them, however, I need to address the automatic t-coils your daughter's hearing aids sport.Automatic technology can be wonderful, but it can also be a real pain. Therefore, I don't recommend that you buy
any hearing aids with automatic features unless they also have manual overrides so you can force them to do what you want when it is necessary. This warning particularly applies to automatic volume controls and to automatic t-coils.In your daughter's case, if her hearing aids don't have manual overrides on her t-coils, although they will switch to t-coil mode automatically when she uses a telephone, they won't switch automatically when she wants to use them with loop systems such as room loops, neckloops, and the Music Links.All is not lost. Oftentimes there is a workaround. For example, you can put small magnets on the hearing aids to force them to switch to t- coil mode. However, it is much better to take the hearing aids back and ask that manual overrides be installed on each aid. This will make them so much more useful. Typically, digital hearing aids won't have manual override switches, but the automatic t- coil feature may be able to be turned off, or one of the memories may be able to be programmed for the t-coils to be permanently turned on when using that memory.Once this is done, she should be able to hear her MP3 player or iPod wonderfully well via her t-coils. etc.Now to answer your questions. Which is better, the Music Links or a Neckloop?For starters, the Music Links give true stereo sound. Neckloops by definition are mono devices. With a stereo to mono adapter from Radio Shack you can use a neckloop—but it will give mono sound (same sounds in both ears), not true stereo like the Music Links. Therefore, if you want to listen to true stereo sound, you have to go with the Music Links. If you don't care about stereo, then a neckloop will work fine too.Now, as to how well they will work, I'd go with the Music Links for a couple of reasons.1. T-coils are very directional. Thus if you wear a neckloop and tip your head, the signal strength may vary and can almost fade out. The same thing can happen when using a room loop. The Music Links--since they are on your ears—never change their orientation to the t-coils in your hearing aids, so the sound stays constant no matter what your body position.2. Since the Music Links are closer to your hearing aids as compared to neckloops, they typically receive a better/stronger signal—especially if the device (MP3 player for example) doesn't put out a strong signal (because the manufacturer is trying to increase battery life) I've seen people wearing their neckloops hooked on their ears in order to increase the signal strength. It looks sort of funny, but it works. Much better to use the Music Links that sit on your ears in the first place if the device doesn't produce a strong signal.With devices that put out a good signal, neckloops and Music Links give comparable sound—but remember neckloops give mono sound, Music Links can give stereo sound.Finally, which device works better with digital hearing aids? In truth, I don't think there is any difference between the devices on how well they work with digital hearing aids. They both use the same technology. Of more importance is the quality of the t- coils. Not all t-coils are made equal. Some work wonderfully well, and others give just so-so performance. Therefore, it is wise to check out how well the t-coils work before you purchase any given hearing aids.If you are interested in getting a set of Music Links for yourself, see this issue's special in Section 4 above.
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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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