August 29, 2006 Issue

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


Volume 1, Number 8                       August 29, 2006
Publisher: Neil Bauman      neil@hearinglosshelp.com
            http://www.hearinglosshelp.com
    Copyright Center for Hearing Loss Help 2006

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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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and only forward it in its entirety.

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In this issue
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1. What's in a Name?

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

3. Answers to Your Questions

4. Tips for Successfully Coping with Hearing Loss

5. Subscriber-only Special



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1. What's in a Name?
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"Hard of Hearing," "Hearing Impaired" or "Deaf"--Which Is
Correct?

As hard of hearing people, we have the right to choose what we
want people to call us. Overwhelmingly, we prefer to be called
"hard of hearing people." Yet many well-meaning, but misinformed,
people persist in referring to us as "hearing impaired."

The term "hearing impaired" was supposed to be the politically
correct term to be used when referring to all deaf and hard of
hearing people in a collective sense. However, this term is
almost universally resented by both deaf people and hard of
hearing people and, as a result, is most definitely not
politically correct.

So don’t be afraid to use our preferred terms. If we say we are
hard of hearing, refer to us as hard of hearing people. If we say
we are deaf--use the word deaf. These are the terms we want you
to use. Don’t ever say we are hearing impaired. Most of us hate
that term.

If you want to talk about all people with hearing losses, either
say "people with hearing loss" or "deaf and hard of hearing
people." If you want to be more specific and single out one group
or the other, either say "deaf people," or "hard of hearing
people."

Actually, "people with hearing loss" is the best term since it
puts the word "people" first, not our disability. After all, we
are people first and foremost, but people who just happen to have
ears that don’t work very well.

And while I am at it, we hard of hearing people should always
say, "I have a hearing loss" not "I am hard of hearing." Why?
Because when I say "I am hard of hearing" the inference is that I
am nothing but one big broken ear. However, when I say, "I have a
hearing loss" I am saying that I am a person who just happens to
have a hearing loss--but the hearing loss doesn't define me, any
more than my tall height defines me. It is just one of the many
characteristics that goes into making me me.



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2. Beware of (Ototoxic) Drugs That Can Damage Your Ears
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Keflex (Cephalexin) Hearing Loss and Other Ear Problems


A lady wrote: "I have been searching the internet for an answer
to my rather severe hearing loss. About 15 years ago, I began
seeing a local doctor who was 'fresh out of medical school.' He
told me that a facial infection I had was due to an infection
that had been caused by dental work I'd had done five years
prior. I also had been given my 'own home supply' of Keflex to
treat that infection which I proceeded to take over and over
again throughout that five year period.

I had 'motion sickness' that began almost immediately while
taking Keflex. I definitely remember that I had no problem at all
with motion sickness before taking Keflex. During and after
treatment, I couldn't even (and still cannot) ride in the back
seat of a car due to terrible motion sickness.

I also noticed a ringing in my ears within a year following the
dentistry work and a year into my Keflex therapy.

I had periodic severe pain in my right ear that began a couple of
years before I stopped taking the Keflex.

In addition, I also noticed my eyes jerking horizontally. I
probably was taking Keflex on and off for about three years
before the symptoms began.

Furthermore, I began to notice the hearing loss about a year
after I quit taking the Keflex.

I took no other medications during that time--absolutely none.

My current doctor told me he would not give me Keflex again for
the infection, and that "if taken for longer than ten days,
Keflex can cause deafness." He had just finished medical school
and said that a memo had passed his desk in medical school
stating the problem with Keflex.

Can you tell me if that is true since I cannot find anything that
lists Keflex as an ototoxic medication?"

Shocking, isn't it? Here you have suffered hearing loss,
tinnitus, ear pain, nystagmus, and motion sickness from taking
Keflex over the years, and yet you can't readily find information
as to whether this drug is ototoxic or not?

Keflex is the brand name of the generic drug Cephalexin, one of
the drugs in the Cephalosporin family.

One of the reasons you are having trouble finding out whether
Keflex is ototoxic or not is that it is not listed in the
Physicians' Desk Reference (PDR) as being ototoxic. However,
Keflex is indeed ototoxic.

According to The Compendium of Pharmaceuticals and Specialties
(CPS), the Canadian drug bible, Keflex can cause hearing loss,
tinnitus, dizziness and vertigo.

In case you didn't know this, drugs in the same family often have
much the same ototoxic side effects. For example, the PDR lists
Cefuroxime as causing dizziness and hearing loss. Another
Cephalosporin (Cefaclor) can cause dizziness, ear pain and
vertigo. Cefpodoxime can dizziness, tinnitus and vertigo. So you
see that this class of drugs is indeed ototoxic to some degree.

As your current doctor pointed out, most antibiotics are only
safe for your ears if taken for a maximum of 7 to 14 days. After
that, all bets are off.

Unfortunately, in your case, you took this drug many, many times
over a 5-year period and thus you unwittingly damaged your own
ears.

The motion sickness should have been your first clue--indicating
this drug was damaging your vestibular (balance) system. As time
went on you got tinnitus. For many people tinnitus is often the
first indicator that they are damaging their ears.

Then you noticed the ear pain, another ototoxic symptom.

Still later, your eyes began jerking sideways (horizontal
nystagmus). This indicates that your balance system was being
damaged on one side worse than the other. Again, unfortunately,
neither you nor your eye doctor connected this with the ototoxic
effects of the Cephalexin.

Finally, you began to notice your hearing dropping. In actual
fact, your hearing very likely had been dropping all along--most
of it in the very high frequencies--so you didn't notice it right
away. By the time your hearing loss became noticeable, it was
already too late to do anything about it.

This goes to show that although Cephalexin isn't the most
ototoxic of drugs, you still have to be careful because it can
cause severe and permanent hearing loss and other ear problems as
you have discovered.

In the future, you should avoid this drug and all drugs in the
same class, and also be VERY cautious with any other known
ototoxic drugs as your ears are obviously sensitive to the
effects of such drugs. What happened in the past is a good
indicator of what can (and likely will) happen in the future if
you take more ototoxic drugs.

For information on the ototoxicity of Cephalexin, the rest of the
Cephalosporins and the 763 other drugs known to damage ears, click on Ototoxic Drugs Exposed.


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Having trouble hearing on your cell phone?

If you wear hearing aids that have t-coils in them, try the dual
T-Links and hear beautiful clear sounds in both ears!

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3. Answers to Your Questions
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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.
______________

Transcranial Magnetic Stimulation: Treatment for Tinnitus and
Musical Ear Syndrome?


A man asked: "I was wondering if you could comment on
Transcranial Magnetic Stimulation? I read in an article that this
treatment has helped people with tinnitus."

A lady with Musical Ear Syndrome asked: "I have read that
something called Transcranial Magnetic Stimulation reduces
auditory hallucinations. Is this safe?"

Good questions. People suffering with severe tinnitus or from
hearing other phantom sounds (Musical Ear Syndrome (MES)) are
always on the lookout for any new therapy that might alleviate
their tinnitus or MES symptoms.

The new kid on the block (only developed in 1995) goes by the
fancy name of repetitive Transcranial Magnetic Stimulation (rTMS
for short).

Transcranial Magnetic Stimulation works on the principle that a
varying magnetic field will induce an electrical current in
nearby "structures." In this case, the nearby "structures" are
the cortical areas of your brain.

A doctor typically holds a powerful electromagnet (basically a
coil of wire encased in plastic) over the frontal regions of your
skull and delivers magnetic pulses for about 20 minutes a day for
5 days. The treatment alters the biochemistry and firing patters
of neurons in the cortex—that is, the part of your brain nearest
the surface.

The frequency of the stimulation determines whether it speeds up
or slows down the cortical activity in your brain. Numerous
studies have revealed that chronic tinnitus is associated with
increased activity in the primary auditory cortex. Therefore, in
the case of tinnitus and auditory hallucinations, you want to
slow down this activity.

Studies show that using a low-frequency (1 Hz) rTMS actually does
reduce the "excitability" of the cerebral cortex, and can cause
long-lasting inhibitory effects in tinnitus perception—up to 6
months or more.

In one study, after 5 days of rTMS treatments, there was a highly
significant reduction in tinnitus perception, whereas people who
received the sham treatment did not show any significant changes.
This is good news.

However, rTMS certainly isn’t the whole answer for tinnitus and
other phantom sounds. For example, in one study it had good
effects in 25% of the people studied, partial effects in 28% of
the people, and no effect in 47%. If this holds true for all
people with tinnitus, then rTMS won’t help half the tinnitus
sufferers. However, if you are one of the lucky ones, you may
receive partial or complete reduction in your tinnitus—so you
may want to pursue rTMS therapy if nothing else is working for
you.

So far, rTMS therapy shows promise, but there are still many
unanswered questions such as: how safe is it? How long will the
suppression ultimately last? Does it work for all kinds of
tinnitus?

Although it is used in other countries, here in the USA, the FDA
has yet to approve rTMS for regular use, so it is only being used
in clinical trials at the present.

My personal opinion is that rTMS indeed shows promise in reducing
or eliminating tinnitus and auditory hallucinations. However, I’d
wait until further research determines that it is totally safe.
For example, I’d want to be very sure that rTMS treatments don’t
slow down other parts of my brain. My brain is already running
slow enough as it is!


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==================================================
4. Tips for Successfully Coping with Hearing Loss
==================================================

The Single Most Effective Hearing Loss Coping Strategy

© 2006 by Neil Bauman

If you only had one coping strategy you could employ, and it
mustn't cost a cent, what would this single most effective
hearing loss coping strategy be? Do you know?

That's right. Get close—get as close as you can to the speaker's
mouth.

There are four very good reasons to get close.

1. Sounds Drops Off with Increasing Distance

You all know this, but do you realize just how dramatic this drop
off is? If I am talking and you have your ear right at my mouth,
you will hear me 100%. However, if you move just 2 feet away from
my mouth, the sound will rapidly drop off according to the
inverse squares law, and will only be one quarter as loud. To
calculate this, you put a 1 over the distance squared. In this
case, it is 1 over 2 x 2 which is 1 over 4 or ¼.

So just 2 feet away you will only hear me ¼ as loud. If you
increase that distance to 8 feet, then you will only hear me
1/64th as loud (1 over 8 x 8). At the back of a room at say 20
feet, you will only hear me 1/400th as loud (1 over 20 x 20).
Couple this with your hearing loss, and this makes a dramatic
difference in what you hear.

Therefore, if you want to hear better, get close!

2. Background Noise Becomes a Problem with Increasing Distance

With increasing distance, more sounds come between you and the
speaker--and because they are closer to you than you are from the
speaker, you hear them better. As a result, they drown out the
speaker. This means any extraneous sounds from the audience such
as coughing, papers crinkling, shifting in your seat, people
talking, or any external sounds coming in through the windows or
doors all make it more and more difficult for you to understand
the speaker the farther you are from him.

Wearing hearing aids doesn't really help in these cases because
with increasing distance you need to turn up your hearing aids
more--and when you do that, your hearing aids pick up more and
more background noise which interferes more and more with your
ability to understand speech.

However, if you have your ear right up at the speaker's mouth,
you won't hear any of this background noise.

Therefore, to eliminate all this background noise, get close!

3. Speech Becomes Distorted with Increasing Distance

As speech sounds travel through the air, they are subject to
distortion. For example, reverberation and reflections off hard
surfaces in a room can distort speech. The closer you are to the
speaker, the less you will hear this. If you have your ear close
to the speaker's mouth, you won't hear any distortion at all.

Therefore, to eliminate distortion, get close!

4. Speech Intelligence Drops with Increasing Distance

Did you know that the further you are from a speaker, the less
intelligence there is in the speech sounds you hear. This means
that with increasing distance it becomes harder and harder to
understand what the speaker is saying. Let me explain.

Most hard of hearing people have a high frequency hearing loss.
Thus, their audiogram shows reasonable low frequency hearing,
significant mid-frequency hearing loss, and hearing that drops
off dramatically in the high frequencies.

Now follow this carefully.

Most of the volume in speech is in the low frequencies which you
already hear not too badly—so you hear these low frequency
sounds quite well.

However, most of the intelligence in speech is in the softer high
frequency sounds which you don't hear much of at all.

Therefore, because you can still hear the low frequencies
reasonably well, you can hear people talking, but because you
can't hear the softer high frequencies well, if at all, you have
great difficulty understanding what people are saying. You
desperately need to hear those high frequency sounds better in
order to understand speech.

Now here’s where it gets interesting.

Low frequency sounds travel quite well through air so you can
hear them at a greater distance. For example, the low frequency
component of my voice easily travels to the back of a typical
room.

However, high frequency sounds attenuate quite fast in air so you
can't hear them well from very far away. They rapidly drop out of
the air with increasing distance. Picture the high-frequency
sounds coming out of my mouth and falling in a pile on the floor
close to my feet. The mid-frequency sounds travel farther and
fall in a pile in the middle of the room, while the low frequency
sounds from my mouth zoom right to the back of the room.

What this all means is that the farther your ears are from my
mouth, the fewer high-frequency sounds you hear and consequently,
the less you understand of what I am saying because the sounds
you need to understand speech are all laying here in a pile near
my feet. They never reach your ears! So, if you want to hear the
intelligence in speech, you need to be close to my mouth.

Therefore, to understand speech better, GET CLOSE!

There are two ways to get close.

1. Get physically close

You do this by coming up and putting your ear close to my mouth.
This may work well in one-to-one situations, but won't work in
groups. Therefore,

2. Get electronically close

You do this by using an assistive listening device (ALD) that has
the microphone close to my mouth.

This is the beauty of assistive listening devices. The speaker
wears a microphone that is very close to his mouth--maybe 5
inches away. The result is that all the high frequency sounds
reach the microphone and are captured before they have a chance
to fall on the floor just beyond him.

Once these sounds have been captured by the microphone, they
never have to travel through the air again except for a half inch
or so in your ear canal. As a result, you don't lose the
intelligence contained in the high frequency sounds.

For example, if you are using an FM system, the sounds reach your
ears via radio waves—including the high frequency sounds. If you
are using an infrared system, the sounds reach your ears via
light waves—including the high frequency sounds. And if you are
using a loop system, the sounds reach your ears via a varying
magnetic field—including the high frequency sounds.

The result is that when listening to an ALD that is being used
properly, you hear wonderfully clear sound (at least as clear as
your damaged ears permit). This is because you have effectively
covered all bases—you have gotten close (because the microphone
is close to the speaker's mouth), you have cut out most or all
background sounds (because the microphone is close to the
speaker's mouth), you have eliminated distortion (because the
microphone is close to the speaker's mouth) and you have captured
the intelligence of the high-frequency sounds (because the
microphone is close to the speaker's mouth).

Here is something that is important for you to understand.
Hearing aids by themselves cannot do this because the microphone
is at your ears, not at the speaker's mouth—thus the high
frequency sounds from his voice still land in a pile near his
feet. They never reach your hearing aids’ microphones! This is
why if you are at any distance from a speaker, you need to
supplement your hearing aids with effective ALDs.

Let me illustrate this with a story that shows just how effective
ALDs can be. In my Hearing Loss Association of America chapter,
we use a room loop. At one meeting, I was sitting in the first
row right in front of the speaker—about 10 feet away.

With my hearing aids in their microphone settings and by
speechreading, I could understand the speaker, but I had to pay
close attention. When I switched my hearing aids to their t-
coils, suddenly the speaker’s voice was wonderfully clear—just
as if he was talking into both of my ears at the same time. It
was so clear that I could look away and still easily understand
him.

Then I got up and walked to the back of the room. With my hearing
aids back in their microphone settings I had to strain to
understand the speaker. All the crispness had gone out of his
voice. His voice sounded very bassy and muffled. However, when I
switched the t-coils back on, wow! The sound was beautiful and
clear again—just like he was talking right into both of my ears.

This is how dramatic the difference is when you get
electronically close via your hearing aids and ALDs.

So whether you are using your bare ears, wearing hearing aids or
using ALDs, always remember that the single most effective
hearing loss coping strategy is simply this—get close!

________________

(Note: The above article is extracted from one of Dr Neil's
recent presentations. If you want a dynamic speaker that
understands hearing loss from the inside out, consider booking
Dr. Neil to speak to your group or at your next conference. You
can contact him via the contact information at the bottom of this
eZine.)


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5. Subscriber-only Special
==================================================

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.

Since we have been talking about tips for coping with hearing
loss, here is a special offer on the book "Help! I'm Losing My
Hearing--What Do I Do Now?" In addition to the above important
tip, this 118 page book contains 26 other hearing loss coping
strategies that will help you effectively live with your hearing
loss. And that is just ONE of the 13 chapters in this book!

To take advantage of this special, you have two choices.

1. You can get the printed edition of this book for only $16.95,
a savings of 10% off the regular price of $18.95.

2. If you'd rather have the eBook version (identical content to
the printed version), but instantly downloadable to your computer
as soon as you place your order, you can get it now for only
$9.42 and save 35% off the regular eBook price. Just think, you
can be reading this eBook a mere 5 minutes after you complete
your order--even if it's 3 AM!

Take advantage of this special offer now while you are thinking
about it. This special offer is only good until September 19th.

To take advantage of this special offer, you MUST click on the
below link. Do NOT order from the regular links on the web site
or you will be charged the regular prices.

Here is your special link.
 

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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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