December 9, 2006 Issue

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


Volume 1, Number 11                December 9, 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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In this issue
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1. Understanding Hearing Loss

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

3. Answers to Your Questions

4. Tips for Successfully Coping with Balance Problems

5. Subscriber-only Special

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



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1. Understanding Hearing Loss
==================================================

Smoking and Hearing Loss

by Neil Bauman, Ph.D.

A man asked, "While it is common knowledge that smoking is
harmful to the lungs, I have been told that smoking may damage
hearing as well. Is this true? I could not find a reference to
this in your list of ototoxic drugs on your website."

The Hearing Loss Help website does not contain a complete list of
the many ototoxic drugs--only a small representative sample--thus
nicotine is not included there. The complete list (single-spaced)
would be 43 pages long! (The book "Ototoxic Drugs Exposed" is
the only source that contains a reasonably complete list as far
as I know.)

There are several aspects to consider when discussing smoking and
hearing loss:

1. When people think of smoking, they think of the side effects
of nicotine. Nicotine is indeed an ototoxic drug and has been
associated with such unwanted ototoxic side effects as hearing
disorders, tinnitus, dizziness and vertigo.

2. Most people know that smoking constricts the blood vessels.
This means it also constricts the tiny blood vessels in your
inner ears. This cuts down the blood flow (and life-giving oxygen)
to your inner ears. In turn, the lack of oxygen makes the hair
cells "sick" (to use a fancy medical term) and thus temporarily
reduces hearing.

3. Another aspect of smoking that few think about is that it
produces free radicals in our bodies. Anything that produces free
radicals in our bodies can damage our hearing if the free
radicals end up in our inner ears where they "zap" the hair cells
and sometimes damage or kill them. This results in permanent
hearing loss.

4. Finally, and this is also not well known, smoking makes your
ears even more sensitive to loud noise. Thus, if you smoke and
are around loud noise, the damage to your ears will be even more
severe than it would have been had you not smoked.

So no matter how you slice it, smoking is not good for your ears
(or the rest of your body either).


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

Are Epidurals Given During Childbirth Ototoxic?

by Neil Bauman, Ph.D.

A lady asked, "Have you ever heard of epidurals used during labor
and delivery being ototoxic? The reason I ask is because I met a
woman whose child was born deaf 6 months ago. She had received 4
different epidurals during her labor and delivery because none of
them seemed to be working effectively. She was wondering if the
drugs used in the epidurals could have caused the hearing loss in
her infant."

Good question, but I'd need to know exactly which drugs she was
given before I could give you/her a specific reply.

However, in general terms, yes, some of the drugs used for
epidurals can be ototoxic. When I looked them up, some of these
drugs are listed as causing hearing loss, tinnitus and/or various
balance problems.

In addition, doctors sometimes use a drug that is not
normally an epidural to help the effects of the basic epidural
drug. Unfortunately, some of these drugs are also ototoxic. There
are any number of these additional drugs that they use.

Then too, researchers are experimenting with a drug that I
consider highly-ototoxic as an epidural. I just hope they don't
use it because it could destroy a baby's hearing and balance.

Furthermore, some drugs are not necessarily ototoxic as such, but
cause problems that could result in ear problems in the infant.
For example, some epidurals cause the mother's heart to slow way
down. The result is that the baby doesn't get as much oxygen as
it should, and this could cause hearing loss in the child.

Other epidurals can cause what they euphemistically call CNS
(central nervous system) problems in the child--and since hearing
loss is technically a CNS problem, hearing loss may be included
(and thus hidden) under the generic term "CNS problems."

Finally, the epidural dose is calculated on the weight of the
mother, and since the mother is about 20 times the weight of the
baby, the baby is getting a gross overdose of these drugs--and
because the baby's liver is not working efficiently at this
point, it cannot metabolize these drugs well. As a result, these
drugs can float around in the baby's body doing all kinds of
mischief including damaging its ears.

So based on all the above, I wouldn't be surprised one bit if
some epidurals result in hearing loss and/or balance problems in
newborn babies. When it comes to drugs, you can't be too careful.

If you would like more information on the ototoxicity of the 763
drugs known to damage ears, click on Ototoxic Drugs Exposed.

**************************************************

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volume or interference?

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**************************************************


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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.
______________

Loud Noise and Hard of Hearing People

by Neil Bauman, Ph.D.

A hard of hearing person asked, "Is the noise damage threshold
the same for me as it is for a person with normal hearing? Do I
just add my decibel loss (by frequency) to the noise damage
threshold for normal ears? [approximately 80 to 85 dB] If
sustained noise at 90 dB is bad for a person with normal hearing,
does my noise damage threshold start at 150 dB because I have a
60 dB hearing loss?"

Excellent question. I used to wonder about this too. It sounds so
plausible on the surface--hard of hearing people can stand far
more noise than hearing people because of their underlying
hearing loss.

Although this is generally true for people with conductive
hearing losses, it certainly is not true for the vast majority of
us since we have sensorineural hearing losses.

Here is why. Think about this logically. The mechanism of damage
is the same whether we have normal hearing or are hard of
hearing. Excessively loud sounds damage our ears by destroying
both the minute hairs (cilia) on the hair cells, and the
underlying hair cells themselves too. When this happens, that
hair cell no longer sends a signal to our brains. As a result we
end up with a hearing loss at the frequency of sound that hair
cell was sensitive to.

At first, if we have normal hearing, the few destroyed hair cells
would not produce noticeable hearing loss. But when enough hair
cells are destroyed, the message being sent to our brains is
riddled with "gaps" which we notice as hearing loss. The actual
damage to our inner ears is the same whether we have near normal
hearing or have a profound hearing loss.

However, if we have a severe or profound loss, we may not seem to
lose much more hearing from being exposed to loud sounds. This is
not because we have a higher tolerance for loud sounds, but
because there are not many hair cells left to be destroyed! (I've
seen pictures where whole banks of hair cells are completely
missing. This is quite striking when compared to pictures with
all the hair cells present.)

Therefore, in answer to your question, "No, you cannot add the
amount of your hearing loss to the noise damage threshold to find
the amount of noise you can stand without further damaging your
hearing." For example, it is absolutely wrong for me to think
that since I have an 80 dB loss, I can stand noise at 90 dB plus
the 80 dB I am missing for a total of 170 dB before I do any
further damage to my ears. This loud a sound will definitely
instantly destroy more of my remaining hearing.

Not only that, in actual fact, I will be writhing in pain long
before I hear a sound that loud. Why? Most of us with severe or
worse hearing losses usually have severe recruitment as well. As
a result, our tolerance for loud sounds is actually much LESS
than for those with normal hearing. A sound of 110 dB, while very
loud to a person with normal hearing will actually cause us pain
because we perceive it an too loud to stand!


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==================================================
4. Tips for Successfully Coping with Balance Problems
==================================================

Weird Hearing and Balance Problem

by Neil Bauman, Ph.D.

A concerned mother explained: "Our daughter is 8, and has a
bilateral vestibular disorder. She has trouble reading and if she
reads too much she will get horrible vertigo spells. Even her
gait is affected. When she comes home from school on Friday, her
stance is wider than normal and she tends to plop her feet down.
This abnormal gait disappears by Saturday.

Other than balance and hearing difficulties that come and go, she
appears fairly normal. I liken my daughter's brain to 'RAM' on a
computer. It seems her brain does not have enough 'RAM' to hold
several 'programs' open at once, unlike a computer (and most
people's brains) which can hold open, and use, several 'programs'
at a time.

For example, if she's using her vision program, her hearing and
motor programs may shut down. If she's using her hearing, her
vision and motor programs may shut down. If both her vision and
hearing programs are taxed beyond their limits, her vestibular
program can't operate either.

If she's in a busy place such as a grocery store, or even at
school, her vision goes first, then her hearing, then her muscle
control and finally her balance. She literally slithers out of
her chair to lie prone on the floor for which she gets into great
trouble at school for 'refusing to listen' and get back up in her
chair, going to her room to get some quiet, etc.

Her inability to keep more than one program open at a time also
leads to very high distractibility. For example, if she's
looking, she can't hear. If she's listening, she's not looking.
If she's walking and hears a noise, she drops whatever is in her
hand.

Do you know of anyone that has a child who even remotely behaves
like this?"

Your daughter's behavior seems so strange so as to be almost
unbelievable--but similar things happen to other people too.

Although your daughter has several health problems, if she had
just lost her balance system, she could have similar experiences.

You see, normally our balance (vestibular) systems work
automatically and subconsciously behind the scenes. However, is
something destroys our vestibular system, then the conscious
parts of our brain have to take over for the subconscious parts
(in this case, the vestibular parts) and try to keep us upright.
This requires a lot of RAM (to use your analogy) and when too
much is used for balance, then the other systems suffer (and may
fail). Symptoms of a damaged/destroyed vestibular system may
include memory loss, fatigue, nausea, blurred vision and other
visual problems, and in extreme cases, sensory shut-down.

A lady recently told me about her sister, an RN, who had
something similar happen to her. This sister had taken Gentamicin
drops in her ear on her doctor's orders--but she had a hole in
her eardrum and the Gentamicin got into her middle ear, and from
there totally destroyed the balance in her inner ears. She wrote:

"My sister has been diagnosed with vestibular damage [balance
problems], nystagmus [eyes jerking horizontally], and oscillopsia
[bouncing vision]; she experiences all the gamut of symptoms you
mention--the vertigo, dizziness, nausea, vomiting, and ataxia
[staggering gait]. She even experiences motor function shut-
down, and a LOSS OF CONSCIOUSNESS when in an environment that
becomes too challenging for her brain--too much visual stimuli."

Particularly notice that last sentence. This is somewhat similar
to what your daughter is going through. Notice that this nurse
experiences too much sensory overload, she too, "slithers to the
floor" so to speak--totally out of it.

Thus, if a person has vestibular system problems such as both
your daughter and this lady have, the answer is twofold. First,
try to cut down on the amount of sensory stimulation that you
receive at any given time. This may mean simplifying your
environment so as not to overload your brain and cause it to shut
some systems down in order to cope. Second, schedule a number of
"quiet time" breaks in a less challenging atmosphere throughout
the day in order to give your brain time to recover before it
shuts some things down.



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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.

This issue's special is for the wonderful T-Links--either the
single or dual versions which let you hear on your cell phone via
the t-coils in your hearing aids.

The T-Links normally sell for $59.00 (dual) and $49.00 (single).
If you always wanted the T-Links, get one now and save $10.00 in
the process!

Until the end of 2006, you can get the T-Links (dual) for just
$49.00 + P&H, or the T-Link (single) for just $39.00 + P&H.

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

To learn more about the T-links, or to purchase them at this
special price, here is your special link.



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

Getting More Volume Out of Your T-Coils and Telephones

by Neil Bauman, Ph.D.

A man wrote: "I received the T-Links and hooked them up to my
ClearSounds amplified telephone model CSC50. They function as
advertised however in my particular case the sound that I get is
just not quite loud enough. This is true even though the
telephone amplification is turned to its high limit and my BTE
hearing aid volume controls are set at the highest level. What do
you suggest? Is there some way of amplifying the signal? The
other party has no problem hearing my voice. The sound is useable
but I miss a lot of the words. If I could just amplify the T-
Links a bit I would be satisfied."

I hear you. Sometimes I'm in the same boat, just need a bit more
volume and not able to get it. Here are two things for you to
consider.

1. Not all phones are created equal. Some don't have as loud a
signal on to the t-coil jack as others do. Thus you need more
volume to run them. You can try plugging the T-Links into other
phones and see which one gives you the most volume.

2. Not all t-coils are created equal. The t-coils in your
hearing aids may not be strong enough in the first place, or are
not set up to provide full volume. This is an internal adjustment
done by your audiologist.

For example, using my new hearing aids with their t-coils on my
Walker Clarity amplified phone is a waste of time. There is just
not enough volume to hear with, but my old hearing aids have
wonderful t-coils and I have lots of volume when using this same
phone.

Obviously, I need to get different t-coils in my new hearing aids
to bring them up to "snuff." You might need to do the same. Also
note that many dispensers never set the t-coils up properly in
the first place.

In addition, orientation is important. If your t-coils are
oriented in the wrong plane, you won't hear well if the T-Links
require a different orientation. (This is true for all devices
that use t-coils such as phones and room loops as well.) Some t-
coils are oriented to pick up better from vertical loops and
others from horizontal loops. With my new hearing aids, I have to
have the ear hooks raised off my ears about half an inch before
the sound comes in loud and clear. But when they are sitting down
on my ears, I don't hear much at all. With my old hearing aids, I
hear wonderfully well with the T-Links seated properly.

_____________

Getting More Volume out of Audio Devices Other Than Telephones

If you need a bit more volume when listening to audio devices
such as FM receivers, iPods, MP3 Players, etc (but not
telephones) when using neckloops, Music-Links or earbuds, you can
get the boost you need with a neat little amplifier I just
discovered at Radio Shack.

I had trouble hearing women's voices on my new iPod--even at full
volume when using earbuds. I just needed a bit more volume to
make their voices understandable. The Radio Shack "3-Way
Headphone Volume Booster" (Part No. 33-1109; $24.99) did the
trick. You just plug this amplifier into wherever you'd plug in
your Music Links or earbuds and plug the Music Links or earbuds
into the amplifier, switch it on and you're in business.

Note: since this amplifier has no volume control, turn down the
volume on your audio device before you switch it on so you don't
inadvertently blast your ears with the increased volume. This is
especially important if you are just wearing earbuds like I
mostly do.

My iPod has lots of power to drive a neckloop or Music Links if I
am wearing my hearing aids and using their t-coils. Its just when
wearing earbuds that I can have problems. Mind you, I have an 80
dB loss so I need lots of amplification in order to hear in the
first place. If you have normal hearing this kind of volume will
damage your hearing. For us, it is the only way we can hear.


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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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