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Hearing Loss Help e-Zine Archives

May 31, 2012 Issue

            

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

Volume 7, Number 2              May 31, 2012
Publisher: Neil Bauman      neil@hearinglosshelp.com
            http://www.hearinglosshelp.com
    Copyright Center for Hearing Loss Help 2012

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You are receiving Hearing Loss Help e-Zine because you valued your ears enough to specifically ask for this subscription, or you are a customer of the Center for Hearing Loss Help. If you no longer wish to receive Hearing Loss Help e-Zine, just scroll to the bottom where you can delete yourself from this e-Zine mailing list quickly, easily and automatically.

If you are missing any previous issues, you can read them in our archives.

 

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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.
 

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In this issue ==================================================
 

1. News Items

— More Hearing Aid "Alphabet Soup"
— CaptionCall Phone Reminder
— Marvel Comics Creates "Blue Ear", a Hard of Hearing Superhero

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

— Propranolol and Hearing Loss
— The Ambulance Down in the Valley—A Drug Allegory for Our Time

3. Answers to Your Questions 

— Ear Candling—Does It Really Get the Wax Out of Your Ears?
— Do I Have to Wear My Hearing Aids All the Time?

4. Tinnitus & Other Phantom Sounds

— This Is Not Recruitment

5. Effective Coping Strategies

— Are Serious Vestibular Problems a Wheelchair Sentence?
— Just Wear Your @#$%& Hearing Aids!
— Coping Strategies When You Can't Hear Your Spouse

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

— What Is the Difference Between a Passive and an Amplified Neckloop?
— Seven Cell Phone Strategies to Use When Driving
— Where Can I Get the Best Buy on Hearing Aid Batteries?

 

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1. News Items
===============================================


More Hearing Aid "Alphabet Soup"

by Neil Bauman, Ph.D.


It never ends—the continuing additions to the ear-level hearing aid "alphabet soup" I mean. There are so many acronyms for hearing aids, its hard to know what they all mean.

First came the Behind-the-Ear (BTE) hearing aids. Currently there are a couple of variations of BTE aids such as the Over-the-Ear (OTE) hearing aid and the Receiver-in-the-Canal (RIC) aid. (Sometimes the later are referred to as RITE aids—Receiver-in-the-Ear aids).

Current BTE and OTE aids are tiny in comparison to the huge BTE aids that first came out around 1956 such as the Zenith Diplomat.

After the BTE aids had been out a few years, manufacturers miniaturized the electronics and packed them into a hearing aid that fit into the ear. These were appropriately called In-the-Ear (ITE) hearing aids. There were a number of variations of these such as the very-noticeable full shell and the half shell ITE aids.

Then came the In-the-Canal (ITC) aids. These were followed by the ever-smaller Completely-in-the-Canal (CIC) aids.

Now they have just added to the confusion even smaller deeply-fitted CIC aids such as the Invisible-in-the-Canal (IIC) and the Micro-in-the-Canal (MIC) aids such as the Phonak Nano (and its variations).

Then there are special Bone Conduction (BC) hearing aids such as Cochlear's Bone-Anchored Hearing Aid (BAHA), and SoundBite's In-the-Mouth (ITM) hearing aid.

And if that weren't enough, don't forget the Contralateral Routing of Sound (CROS and Bi-CROS) aids also for single-sided deafness.

By now, if you are fed up with choking down this big bowl of alphabet soup, just remember, in spite of all these different kinds of aids and no matter what names and acronyms they go by, the best hearing aid for you is the one that lets you hear the best. Secondary considerations include how the hearing aid connects with other assistive devices. For example, make sure you get a hearing aid with a t-coil in it. Don't let style and size dictate how well you hear. Those should be tertiary considerations at best.

 

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CaptionCall Phone Reminder

by Neil Bauman, Ph.D.


Here is a reminder for those of you who fully intended to get the new CaptionCall phone I mentioned in the last eZine but put it off, and a heads up for those of you who are new subscribers to the Hearing Loss Help eZine—CaptionCall's special promotion is still on. This means you can still get their new amplified and captioned CaptionCall phone absolutely free. They will even come to your house and set it up for you—all at no cost to you.

In order to take advantage of this offer, go to the CaptionCall website . Near the top right corner of your screen, you’ll see three green boxes. Click on the middle one labeled “Request Info” or the right “Order Now” button if you want to take advantage of this free offer. In the promotion code box, type in the special promotion code “HS1283”. Fill in the rest of the form and click submit.

If you would rather phone in your order, simply call the toll–free CaptionCall customer support number at 877–557–2227. Be sure to mention promotion code “HS1283” in order to get your free phone.

You can learn more about this phone and the requirements in order to use it here.

 

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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 about the Music Links.

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Marvel Comics Creates "Blue Ear", a Hard of Hearing Superhero

by Neil Bauman, Ph.D.


One thing I hear from parents of hard of hearing children is the lack of successful hard of hearing role models for their children to emulate.

Below is the story of one mother who decided to try to do something about this.

"Hearing-Impaired Superhero for Child Who Refuses to Wear Hearing Aid"

"After her four-year-old son Anthony told her he didn't want to wear his hearing aid to school anymore because 'superheroes don't wear hearing aids,' Christina D'Allessandro wrote Marvel asking if there was a hearing-impaired superhero she could use to prove Anthony wrong.

She received a response back from Marvel Entertainment editor Bill Rosemann, who pointed to Hawkeye as an example of a superhero whose hearing was destroyed, requiring him to wear a hearing aid. (His hearing was later restored.)

Realizing this was insufficient, Rosemann and others at Marvel set out to create a brand-new superhero who draws his power from a 'listening device.' They named the character 'Blue Ear' after Anthony's hearing aid.

'When danger makes a sound, the Blue Ear answers the call. Anthony Smith is Blue Ear,' reads the cover of Blue Ear's inaugural 'comic book.'

'From here, anything is possible,' D'Allessandro told WHDH-TV. 'And that's the way he's looking at it.'"

The above story was written by Neetzan Zimmerman and posted on Gawker.com on May 24, 2012.

 

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


Propranolol and Hearing Loss

by Neil Bauman, Ph.D.


A man wrote, "I am a musician and have occasionally taken Beta Blockers to deal with particularly stressful concerts etc. I gave up taking them as I found that I had some form of hearing loss and the frequency with which I heard the pitches was also affected. I was using Propranolol. My doctor had no idea that this could be a possible side effect and was somewhat bemused by my account of it’s effects.

It has been several years since I have used any form of Beta Blocker, but because of the high-stress field I work in I was wondering if you could recommend a type of Beta Blocker that would not affect my hearing as obviously this is vital to my performance."

It's good that you noticed a connection between Propranolol and your hearing loss even though your doctor said otherwise. The truth is that Propranolol is one of the Beta Blockers that is listed as causing hearing loss. Your doctor might not have seen this as hearing loss is not listed in the Physicians' Desk Reference (PDR) that many doctors use, although it is listed in a couple of other drug reference books that I consult.

My question to you is why are you using Beta Blockers to control the results of your stress? There are other ways to control stress that are not ototoxic. Why don't you investigate them rather than jumping on the drug bandwagon and then worrying about all the resulting side effects—which just further increases your stress level.

Find out which stress reduction techniques work best for you. It may be vigorous workouts, or meditation or prayer, or changing your diet to a low sugar diet, or getting more sleep, etc. Doing these kinds of things will help you bring your stress under control and improve your health at the same time. It's a win-win solution as opposed to the win-lose results when taking drugs.

If you want to look up any drugs for yourself and see what their ototoxic side effects are, as far as I know, the only reasonably complete source of such information that is readily available in one place and is in an easy-to-read format is contained in my book "Ototoxic Drugs Exposed".

 

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The Ambulance Down in the Valley—A Drug Allegory for Our Time

by Neil Bauman, Ph.D.


A lady wrote, "I have recently developed tinnitus. What should I take for headaches since I have read that taking Aspirin and Ibuprofen can cause tinnitus. I do not want mine to be more severe."

Not knowing your situation, my first reaction is to suggest you work at finding and eliminating the cause of your headaches, then you won't have to worry about the side effects of drugs because you won't need to take any!

Unfortunately, drugs are aimed at merely relieving symptoms (such as pain from headaches) rather than working to correct the underlying cause (which could be your neck out of whack, eyestrain, poor diet, lack of sleep, noisy surroundings, etc.)

To me, the much better and wiser approach is to root out and eliminate the cause, then the symptoms will go away on their own.

In the following poem, just substitute the word "drugs" every place the word "ambulance" occurs. At the same time, think of the "fence" as an allegory to rooting out the cause of any health condition, and you'll see just how mixed up and backwards our drug model of health care really is.

Joseph Malens wrote this poem back in 1895, but its message is just as powerful and relevant today as it was back then.
 

The Ambulance Down In the Valley

'Twas a dangerous cliff as they frankly confessed,
Tho' to walk to its crest was so pleasant.
But over its terrible edge there had slipped
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally.
Some said, "Put a fence 'round the edge of the cliff."
Some said, "An ambulance down in the valley."

Well, the cry for the ambulance carried the day,
For it spread through the neighboring city.
"A fence may be useful or not," so they say,
But each heart became brimful of pity—
For those who had slipped o'er the dangerous cliff.
And dwellers on highway and alley
Gave pounds and pence—not to put up a fence—
But for an ambulance down in the valley.

"For the cliff is all right if you're careful," they said.
"And even if folks slip and are dropping,
It isn't the slip that hurts them so much,
As the shock down below when they're stopping!"
So day after day as those mishaps occurred
Quick forth would the rescuers sally,
To pick up the victims who fell off the cliff
With their ambulance down in the valley.

Then an old sage remarked, "Its a marvel to me
That people give far more attention,
To repairing the results, than in stopping the cause,
When they'd much better aim at prevention."
"Let us stop at the source of this mischief," cried he.
"Come neighbors and friends, let us rally,
If the cliff we would fence, we could almost dispense,
With the ambulance down in the valley."

"Oh, he's a fanatic!" the others rejoined.
"Dispense with the ambulance? Never!
He'd dispense with all charity too, if he could,
No. We'll support the ambulance forever.
Aren't we picking up people as fast as they fall?
Shall this man dictate to us? Shall he?
Why should people with sense stop to put up a fence
When an ambulance waits down in the valley?"

After I wrote the above article, I discovered that Herbert Nehrlich wrote a sequel to this poem—talking about drugs as the "ambulance" just as I have done. You can read his sequel below the "Ambulance Down In the Valley" poem here, and then take to heart the surprise ending.

 

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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.


Ear Candling—Does It Really Get the Wax Out of Your Ears?

by Neil Bauman, Ph.D.


A lady asked, "Have you ever looked into 'ear candling'? It removes a lot of wax and is safe (if done properly)."

Ear candling is one of those "quack cures" that unfortunately became popular a number of years ago. It was supposed to "deep clean" your ear canals and remove wax and other "gunk".

Note: ear candles are not like regular candles. They are basically a coarse cloth mesh coated in wax (often bee's wax) and rolled up into a funnel shape. The mesh acts like a wick.

To candle an ear, you lay your head on one side with your ear pointing straight up. Then you have another person stick the bottom (small) end of the ear candle into your ear canal. The person then lights the mesh at the top of the funnel and lets it burn down to a stub.

I first heard of ear candling maybe 25 years ago. The people in the town where I lived at that time believed it worked. They'd candle an ear—then unroll the stub of the candle and show you all the "junk" the candle sucked out of your ear. It was quite impressive!

To prove or disprove whether all this "gunk" came from the ear canal or not, a friend and I decided to do a double test. First, my friend candled one of my ears. Then we put another candle in a clean glass jar to simulate the ear canal and lit it. After it burned down to the stub (just like the candle did in my ear), we unrolled it and guess what—it contained the same amount of "junk" as the one done in my ear.

The truth is, this "junk" is not ear wax sucked up from your ears. Rather, it is part of the candle that melted and ran down into the stub.

Thus, don't waste your time and dollars on ear candling. It just doesn't work—and if not done carefully, you can burn your eardrum if melted wax runs down into your ear canal.

Another lady asked, "An audiologist told me never to use ear candles as they cause a suction on the eardrum and can make it burst. Have you ever heard of this?"

No, and I don't believe it either. The theory behind candling is that it is supposed to create gentle suction as the hot air rises, thus creating a partial vacuum at the base of the (hollow) candle that "sucks" the wax and gunk from your ear canal up into the candle. In actual fact, the suction created is so gentle that the only thing it can move is air—if it even does that.

Assuming the candle is not sealed to the ear canal, as the hot air rises, it sucks in cold air from the bottom around the ear canal, and thus could never create enough suction to displace the ear drum. If the candle was sealed at the ear canal, then the candle would have to act as a two-way chimney—bringing cold air down at the same time hot air rises—and that just doesn't happen in nature. Thus, there isn't any significant air movement to create any suction.

In order to get any significant air movement—like in a real chimney—the "fire" would have to be at the bottom, not at the top like is done in ear candling and there would have to be a source of fresh air at the bottom to keep the fire burning—so the candle couldn't seal off the ear canal. And if you did this, there wouldn't be any suction on the ear drum anyway.

Therefore, at best, ear candling is a bunch of pseudo-science. It does not remove anything from your ear canals—only money from your wallet! If you have wax in your ears, learn how to remove it safely yourself, or have a health-care professional take it out for you.

 

—o—o—o—o—o—o—o—o—o—o—o—


Do I Have to Wear My Hearing Aids All the Time?

by Neil Bauman, Ph.D.


A lady asked, "Why must we wear our hearing aids all the time? I mean, lots of times they are not needed—when cleaning house, reading a book, at the gym, etc."

This is an excellent question. There are two schools of thought regarding the "right" answer. One school of thought—promoted by doctors, audiologists and people who have normal hearing—is that they have listen to everything all the time. That's the way God made us. Therefore, why should hard of hearing people be any different?

Thus, they tell us (hard of hearing people) to wear our hearing aids all our waking moments. In addition, they drag out the argument—"use it or lose it"—meaning that if we don't actively use the hearing we have, our auditory systems will atrophy and thus we will lose the little hearing we now have.

The second school of thought comes from those of us who have to live with our hearing losses every moment of every day. We know that hearing aids do not give us normal hearing. Furthermore, we know that neither our ears/brains nor our hearing aids can filter out background sounds so that we can hear in noise like people with normal hearing can.

Compounding this problem, is the fact that we also typically have to put up with conditions such as recruitment, hyperacusis, dead spots in our cochleae and "fuzzy" hearing that people with normal hearing don't have. All this can cause auditory overload resulting in extreme fatigue, headaches and other problems. Therefore, we feel we should be able to choose the times when we wear our hearing aids and the times when we choose "deafness" in those situations where the toll on our bodies is greater than the benefit we derive from the additional limited hearing we gain.

Let's look at both of these arguments, because both have some merit.

First, let's look at the argument that you should wear your hearing aids all the time you are awake. Yes, God did make our ears to hear, so when we lose hearing, it seems right that we should wear hearing aids to restore hearing to as near as normal as possible.

This argument would be valid if hearing aids gave us normal or near normal hearing. If you have a mild hearing loss, this may be close to possible. However, for those of us with severe hearing losses, what we hear via our hearing aids is a far cry from what people with normal hearing hear.

Because of the various factors mentioned above, we need relief from the barrage of sounds that so often assaults our ears. Simply put, we need "down time" in order to recharge. If that means taking off our hearing aids and living in a world of silence for a time, so be it.

For those of us that choose to be proactive, we may choose in advance not to wear our hearing aids when we know we will be in an environment that will cause undue wear and tear—not only on our bodies—but also on our emotional health. That way we can work longer and not require so much "down time". I wish more hearing people could experience what we hear (and the way we hear it), so they would understand why wearing hearing aids all the time is not necessarily good for us.

The argument that we must "use it or lose it" is basically a scare tactic in my opinion. Yes, to some (small) degree it is true, but in reality, it is largely a bogus argument. You see, we all hear some sounds (after all, we are hard of hearing, not deaf)—and those sounds, as small as they are, are enough to keep our auditory circuits running quite well. Besides, we do wear our hearing aids (or assistive listening devices) some or much of the time and again this keeps our auditory circuits in good working condition. We do not have to be exposed to amplified sounds from dawn to dusk in order to keep our auditory systems in good shape.

When I was a boy, I was fitted with a body-style hearing aid. I was given two ear molds and told that I had to switch ears or I'd lose the hearing in the unamplified ear.

What was the reality? For some reason, maybe because I was left-handed and thus could more easily put the ear mold in my left ear, I chose to only wear a hearing aid in my left ear for the next 20 or more years. (Now I wear hearing aids in both ears.)

If the "use it or lose it" rule was correct, then you would expect that now I hear better in my left ear than in my right ear, right? Guess what? Instead of losing more hearing, my right ear is now my better ear! In my case, I lost more hearing in my left ear from wearing a hearing aid and using amplified devices in that ear!

Nevertheless, there is a valid reason for wearing hearing aids as much as possible. You see, it takes our brains several weeks, and up to three months, to learn how to process the new sounds we now hear when wearing our hearing aids. Our brains actually grow new neuronal connections in order to process the sounds coming through our hearing aids. Therefore, the more we wear our hearing aids, the better our brains adapt to the sounds we hear.

In the process, we learn how to tolerate louder sounds so that they do not bother us the same as they'd did when we first began wearing hearing aids. This is a strong argument in favor of wearing hearing aids more rather than less.

I notice this phenomenon each time I put my hearing aids on. For the first few minutes, everything sounds too loud, but soon my brain adapts and things become more normal. Therefore, unless you're in the noisy environment that's causing undue wear and tear on your system, side with your audiologist and wear your hearing aids as much as possible.

At the same time, remember that you are in control. When wearing your hearing aids begins to wear you out, there is nothing wrong with taking your hearing aids off and giving your ears a break, thus giving you a chance to unwind and recover. By the same token, if you want to relax and read a book, there's nothing wrong with taking your hearing aids out and letting your ears relax at the same time. This way you can have the best of both worlds.

 

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4. Tinnitus & Other Phantom Sounds
===============================================


This Is Not Recruitment

by Neil Bauman, Ph.D.


A lady wrote, "I came across your website while researching the term 'recruitment' which the audiologist mentioned to me this week. She tested me and I have mild/moderate hearing loss. The reason I had hearing tested is because I have sensitivity to noise and also tinnitus (low drum/bass sound). I live in a condo and I hear snoring below and lot of movement above from neighbors. I have developed a really huge intolerance of noise especially motor sounds and a sleep disturbance.

I started using Bose noise-cancelling headphones and thought I had discovered Paradise—for a few months—until I started having post-nasal drip and my left ear started with tinnitus. Now there is no getting away from noise.

I expect the tinnitus will resolve when the post-nasal drip clears and I can resume my 'Paradise world' with the Bose headset. I was shocked when my audiologist strongly advised against using the headset and mentioned something about recruitment. She told me my problem will get worse if I wear the head set. Now what do I do? I paid $299 for these and thought they were the best thing ever. Do you have any thoughts on this situation. I am perplexed."

Personally, I don't think your problem is recruitment like your audiologist says. Recruitment is when certain sounds become too loud abnormally fast. Recruitment is not a supersensitivity to sound in general. Furthermore, recruitment is always a byproduct of a sensorineural hearing loss. The worse the hearing loss, generally the worse the recruitment.

Rather, I think your problem is that you have two other conditions. The first one is somewhat similar to recruitment and people often confuse them—namely hyperacusis. Hyperacusis is a supersensitivity to all sounds, not just certain ones that recruit. (Incidentally, you can have hyperacusis whether you have a hearing loss or not.)

The second condition I believe you are experiencing is Musical Ear Syndrome or MES for short. MES is where you hear phantom non-tinnitus sounds. Often the sounds are musical, but as in your case it can sound like snoring or people moving around upstairs.

My question is why are you hearing these sounds now? You didn't hear them in the past, so why are you hearing them now? Also, why are you only apparently sensitive to these sounds, and not all other sounds? This is why I believe you have Musical Ear Syndrome in addition to hyperacusis.

Assuming your tinnitus is caused by your post nasal drip, I agree that when your sinuses clear up, your tinnitus may also go away.

However, I'm with your audiologist on your not wearing the noise-canceling headphones. Noise-canceling headphones have their place to be sure—and that is when you are in noisy surroundings where you need to protect your ears or go deaf. That is where you should wear them—not in your bedroom where it is relatively quiet. Here's why.

God made our ears to hear sounds. When you wear your noise-canceling headphones, that cuts out all the faint sounds your ears normally hear—and you need to hear these sounds to keep your brain happy. When you wear the noise-canceling earphones, they starve your brain for sounds.

In addition, you have a mild to moderate hearing loss that is also starving your brain for sounds. As a result, your brain does two things. First, it cranks up your internal volume control to try to hear more sounds. When it does that, you now can hear fainter sounds—and regular sounds are now louder. In other words, you are more sensitive to sound. This is hyperacusis.

The more you starve your brain for sounds by wearing the headphones, the more your brain turns up its internal volume, and the more sensitive you become to sound. This becomes a vicious cycle. If you keep on doing this, you will likely drive yourself "buggy", and you'll have difficulty tolerating any sounds.

At the same time, because your brain is not hearing real sounds, it begins to manufacture phantom sounds. I think this is what is happening when you say you hear people snoring below you and moving around upstairs. I doubt that those are truly real sounds. Yes, they may sound like real sounds, and that is why you are being fooled, but they are phantom sounds generated in your brain.

To separate real sounds from the phantom, you have to ask yourself if it is even possible for a person with normal hearing to hear those 'upstairs' sounds from your apartment? Many apartments are built with carpeted, concrete floors. Sounds like snoring and people walking around just do not penetrate those floors.

For example, I know of people who are mad at their neighbors for making a lot of racket, when in actual fact, the neighbors are very quiet people and walk around in slippers on a carpeted floor. There is no way anyone can hear the upstairs neighbors walking around, yet the person below swears they hear them. One of the interesting things is they hear them even when the people above them are not home! That is another proof that these sounds are phantom.

I really think this is what is happening in your case. Continuing to wear the noise-canceling headphones will only make matters worse and Worse and WORSE.

I think you have another problem. You haven't said so specifically, but I suspect that you are either particularly stressed, anxious, worried, or depressed. Any of these emotional conditions can trigger what you are experiencing. For example, anxiety can easily cause hyperacusis, while stress, worry and depression can result in Musical Ear Syndrome.

So what can you do? First, you need to give your ears real sounds to listen to. Rather than wearing noise-canceling headphones to block out all sounds, you should listen to some soft sounds—sounds that you enjoy—while you fall asleep. As an example, this may be a CD of calming music, or one of environmental sounds such as rainfall, waterfalls, waves lapping on the beach, etc.—whatever you like.

Doing this will give your brain real sounds to listen to. As a result, your brain will slowly begin to turn down its internal volume so you won't be so sensitive to sound. In addition, the real sounds will also keep the auditory neurons in your brain busy so they won't have so much time to generate the phantom sounds you are now hearing.

You may find it most helpful to read my articles, "Here's Why Chronic Anxiety Can Result in Tinnitus and Hyperacusis", and "Musical Ear Syndrome". In addition, there are a number of other tips for dealing with Musical Ear Syndrome in my book, "Phantom Voices, Ethereal Music & Other Spooky Sounds".

 

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Having trouble hearing your television? Wouldn't you like to hear beautiful clear sound piped directly to your hearing aids?

If so, and you wear hearing aids that have t-coils in them, treat yourself to the Cadillac of room loop systems. Click on the above link to learn more.

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5.  Effective Coping Strategies
===============================================


Are Serious Vestibular Problems a Wheelchair Sentence?

by Neil Bauman, Ph.D.


A man wrote, "I am very interested in hearing and balance and was looking for your thoughts—I know you are not an MD, but would appreciate your views.

If someone is having vertigo from a serious disease such as bilateral Meniere's disease, is such a person better off without a vestibular system in the long run as his eyes and proprioceptive system will eventually take over for the loss of his ears?

Also, I know falls are a leading cause of death due to bad balance. As a result, are people who have vestibular loss/damage better off using wheelchairs outside where fast moving objects and other stimuli could cause them to fall over and seriously injure themselves?

Does someone without any vestibular function in either ear require a wheelchair for safety, independence and to compensate for poor balance?"

I congratulate you on your wanting to know more about ears and balance and how people with poor balance can effectively cope with their balance problems.

As you know, your body contains not just one, but three separate balance systems—the vestibular system in your inner ears, your eyes, and the proprioceptive system in your lower legs and feet. You need two of these three systems working in order to maintain your balance.

There is no cut and dried answer to whether a person with Meniere's disease is better off without a faulty vestibular system or not. Much of it boils down to personal choice. Some people choose to kill off all their remaining vestibular function in an attempt to end intractable vertigo. Other people choose not to. I think much depends on just how bad their vertigo is.

However, of all the people I know with bad balance (and I know a good number), I can't think of any that use a wheelchair solely for reasons of bad balance.

Perhaps this is because typically Meniere's disease occurs in mid-life while a person still has a reasonably active lifestyle, rather than in elderly, frail people.

Furthermore, sitting in a wheelchair is actually counterproductive. You see, the truth is, the more you exercise your remaining balance organs, the better your brain can maintain your balance. Let me give you some examples.

I'm thinking of three men—one plays golf every day to keep his balance working. The second one goes hiking all over the world—but he typically takes two walking sticks with him on rough or dangerous trails. I've been out hiking with the third man. He lurches and staggers around like the proverbial "drunken sailor", but doesn't fall down. He typically uses a hiking stick. He also has a big service dog which is trained as both a hearing ear and a balance dog.

So does a person without any vestibular function require a wheelchair? Generally I'd say "no". Walking sticks—yes, but wheelchairs—no. Of course there are exceptions depending on the person's age, frailty, health, etc.

Typically, people need to maintain an active lifestyle for optimal health and balance. Thus, those still vigorous enough need to walk and to do other exercise in order to keep their balance systems working as well as possible.

However, at night, it is prudent to have another person with you to lean on as necessary as your eyes don't help much with balance in dim light and do nothing to help you in the dark.

If you have no useable vestibular function, you should follow these guidelines.

1. Walk on firm surfaces when you are "working". When you walk on uneven or soft surfaces you negate your proprioceptive system. Save walking on soft or uneven surfaces for times when you are actively working on strengthening your balance systems and it is safe to do so.

2. Move around in the light. In the dark you lose the balance assistance your eyes provide.

3. Especially avoid walking on soft or uneven surfaces at night as you basically have no functioning balance systems left to help you.

4. Avoid visually "busy" scenes. For some people walking down aisles in the supermarket is too much. They need to focus on the floor to maintain their balance. And if the floor has a busy pattern, even that won't work.

5. When riding in a vehicle, sit on the driver's side in the back seat, or half way back on a bus. That way you can't see the visually busy road out the windshield and can't see the fence posts, poles, etc. whizzing by on the side of the road that can make you dizzy and upset your balance.

As you can see, there are a number of effective coping strategies people can employ to help themselves get around even though their vestibular systems are shot. How much better to employ these strategies and remain independent rather than give up and live in wheelchairs.

 

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Just Wear Your @#$%& Hearing Aids!

by Neil Bauman, Ph.D.


A young man explained, "I am having trouble getting started wearing my hearing aid. I have tried to convince myself to wear it, but so far, I am not able to do so. As I result, I am depressed about my future.

I am 17 years old and wish to become a CA. I sometimes think that wearing my hearing aid (a BTE) may be a hurdle in achieving my aim. Everyday I think that tomorrow I will start wearing my hearing aid, but my tomorrow never comes. As a result, each day passes stressfully. I'm afraid that people may not like to contact me or talk to me because of my hearing loss.

Please help me overcome my problem. Can you give me examples of some people who have managed to achieve a lot by overcoming their hearing problems?"

I understand your problem. I was that way myself way back when. The solution is simple—put your hearing aid in your ear and turn it on. That's it.

The thing that is holding you back is you are afraid of what other people will think of you. This is common—but you have to get past this.

Since you are self-conscious about wearing your hearing aid, put it on in a private place so people don't see you doing that. Then just walk out into the world and act normally. Don't call attention to your hearing aid (but don't hide it either). If someone mentions it, just say that it is a wonderful invention—that it lets you hear better again and let it go.

When you worry about your future, you are wasting your time worrying over something that, in this case, you can change by simply wearing your hearing aid. Since a hearing aid will help you hear better, wear it and quit your worrying.

In fact, far from being a hurdle, wearing your hearing aid will actually help you achieve your goals because with your improved hearing will come increased confidence.

Unfortunately, with every passing day that you say to yourself, "Tomorrow I shall start wearing my hearing aid", and then you don't do it just builds a higher and higher wall between you and your ultimate success. The only way to succeed and break down that wall is to just decide that today (right now) you will put your hearing aid on—so do it! Don't wait for tomorrow.

You are correct in thinking that people may not like to talk to you because you are hard of hearing. There is a simple reason—they don't like repeating themselves or shouting. They find that embarrassing. Solving this problem is easy. put your hearing aids on so they don't have to shout and they will be happy to talk to you.

You ask, "Can you give me examples of people [in your country] who have managed to achieve a lot by overcoming their hearing problem?"

It doesn't matter where you live. People the world over have the same problem. At first it was hard for me to wear my hearing aids in public—but I had to do it in order to hear. And when I did that, guess what? I was able to maintain good grades in school and college. In fact, when I graduated from the British Columbia Institute of Technology the silver medal for academic excellence in my technology went—not to a hearing person—but to the deaf guy in the class—me. You do not have to let your hearing loss hold you back. It it is up to you. You need to be proactive and take the initiative to do the things that help you hear better. Wearing hearing aids is one such step.

I also use all sorts of assistive technology. For example, I use powerful amplified phones—and one amplifier is not enough, I add a second external amplifier on the phone so I have enough volume. This works for me.

In noisy situations where my hearing aids don't help me (or make things worse), I use my PockeTalker and special directional microphone. Then I hear wonderfully well. (When I do this, it is very obvious I am using an assistive device, but I don't care. This way I can hear. And when I am not embarrassed to use the devices that help me, the people talking to me aren't bothered by them either.)

If you want to look for an example of someone who has accomplished a lot in his life, just look at me. I was born with a severe hearing loss—and it is getting worse by the year now—but I am living a happy, fulfilled and rewarding life in spite of my hearing loss. You can do the same. All you have to do is start helping yourself—and that means wearing your hearing aid, so put your @#$%& hearing aid on now! It's the first step on your road to success.

(If you are interested in the PockeTalker and super-directional hand-held microphone I use to converse easily in noisy places, click here.)

 

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Coping Strategies When You Can't Hear Your Spouse

by Neil Bauman, Ph.D.


A lady explained, "I am hearing impaired and also have tinnitus. I wear bilateral hearing aids. I work at home. My husband, when he gets home from work, tends to forget I am hearing impaired and will talk to me from various locations in the house. I have no idea what he is saying. In fact it sounds like a foreign language. At this point I get up and try to figure out what room he is in, find him and see what he wants. (I can’t tell the direction sound is coming from.)

Last week we were on vacation. We were walking down a street and he stopped to look in a shop window. I did not know he was not next to me anymore and kept walking. He yelled at me over and over until people were staring. I did not hear him and kept going. He then believed I had heard but was just not interested in coming back. Finally when I noticed he was not next to me I looked back and saw him standing there ½ a block back.

Another issue is when I am in a store and I can’t understand the clerk. I tell him/her I am hearing impaired at which point they laugh. They must think I am just using self-deprecating humor. They don’t seem to believe me.

We need some coping strategies for communicating. Can you point us in the right direction?"

You betcha! I've been there and done that too. And the good news is that I've learned how to cope effectively.

There are a number of coping strategies that you, as a couple, need to implement so communication becomes easier and is less frustrating. Your husband doesn't realize just how hard of hearing you are so continues to act like you are a hearing person.

Here are some communications rules you both need to follow.

Only talk face to face. This rule is easy to say, but hard to do in practice. This means if your husband wants to say something to you, he has to come to where you are, get your attention and face you. then he can talk—even if it is only to say "Come here, honey."

Now, fair is fair. Thus, whenever you want to say something to him— even to just call him to come to supper, you must go to wherever he is—not because he can't hear you, but so you can hear his reply, and see whether he even heard your message.

I'm warning you in advance. To start with, this is going to be hard. You'll not want to go to him because you know he can hear you. On his part, he'll keep calling you and expect you to go trotting to wherever he is, because it's always seemed to work in the past.

You have to sit down together and calmly talk over this rule . In the process you need to tell him that starting from now on you will never respond to him (whether you hear him or not) unless he comes to you. Then do it. He will get mad at you at first, but you need to persevere. And on your part, you need to go to him before you talk to him no matter how you feel about it. As I said, it's going to be hard changing longstanding habits, but persevere and soon you'll both notice how much easier communication has become.

There are only two exceptions to this rule of coming to the person, getting his attention and facing him before either one of you starts talking.

The first exception is if it is an emergency. For example, if you've fallen and broken a leg, you aren't going to be able to go to him, but you can scream. If it was the other way around, he can scream and you'll go to investigate this sound.

The second exception is if you are behind him and you want to ask him a question that can be answered by a yes or no, go ahead and ask it. On your part, you must be looking at him so you can see his reply. On his part, he just nods or shakes his head. It's that easy.

My wife and I do this quite often. She knows if I am behind her to just nod or shake her head if I ask a yes or no question. I respond verbally so she knows I got the answer correctly. It works for us.

If you can't determine direction, he has to learn to say, I'm in the back bedroom or the living room or wherever. That way you know where to go. This works well for a person that only has hearing in one ear and thus do not have directionality of sound. However, since you can't hear well in either ear, this won't work in your case.

One of the difficult situations is when you are walking away from your husband and he calls after you. When he yells after you and you don't hear him, he is just embarrassing himself and not solving the problem. Since you can't hear him, the "face to face" rule applies. This means he has to run after you and catch up before he says anything. I've been in situations where I've walked away and someone has had to run after me because I couldn't hear them.

Incidentally, as a hard of hearing person you need to learn to be more aware of what is going on around you. When you do this it will be the rare occurrence when you walk off without him.

I'm curious why clerks laugh at you when you tell them you are hard of hearing. I think your problem is that the clerk doesn't know exactly what he should do in order to make the communication successful. Perhaps he is laughing to cover up his embarrassment over this.

To prevent this and make the communication successful from the start, you need to tell the clerk exactly what you need him to do so you can understand him. It may be that you need him to look at you, or speak up or write something down. Analyze what the one thing is that will make the communication most successful and tell him to do that. Naturally, it will vary depending on the situation.

Typically all I do is say, "I'm hard of hearing and need you to look at me so I can understand you"—this is because I speechread. As I said, it could be speak up, speak clearly (but if they have an accent they may not be able to do this so you may want them to write it down so you can read it), face you when talking, etc.

I've given you some specific coping strategies to the situations you described. There are many other simple but effective hearing loss coping strategies. If you'd like to learn more of them, I suggest you get my  short, but invaluable book, "Talking with Hard of Hearing People—Here's How to Do It Right!".

 

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

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What Is the Difference Between a Passive and an Amplified Neckloop?

by Neil Bauman, Ph.D.


A lady asked, "Can you explain the difference between a passive neckloop and an amplified neckloop?"

Sure, I'd be glad to. A neckloop is just a loop of wire that goes around your neck and plugs into the audio output jack (typically the earphone jack) of any audio device such as an assistive listening device (ALD), radio, computer, iPod, MP3 player, etc. You hear the sound via the t-coils in your hearing aids.

A passive neckloop just consists of a loop of wire around your neck and a "tail" ending in a male plug. It works well where the audio output signal has lots of power. Typically assistive devices such as the PockeTalker have lots of power. So do most radios, computers, etc.

A passive neckloop has two basic advantages. First, it is cheaper than an amplified neckloop. Second, it has no electronics in it—so it doesn't need batteries (that can die at a most inopportune time).

Amplified neckloops work exactly the same way as passive neckloops with one big difference. They have a small amplifier built into them to make the signal louder so they have adequate power to "drive" the neckloop. Devices such as cell phones typically put out little power (to conserve the cell phone's batteries). Thus if you plug a passive neckloop into a cell phone, or other device with low power output, the signal may be so weak you won't hear it well or at all when listening via the t-coils in your hearing aids.

To get around this, you can use an amplified neckloop to boost the signal. This means you can use an amplified neckloop with any audio device. If you can't hear the signal well, you simply turn up the volume on the amplified neckloop. That is its big advantage.

At the same time, there are two disadvantages to amplified neckloops. First, they cost about twice as much as passive neckloops. Second, they use batteries—and those batteries can go dead at the most inopportune times (as I mentioned above) leaving you not being able to hear your device via your t-coils. (Of course you can get around this disadvantage by always carrying a spare set of batteries with you.)

You can see a passive neckloop and below it an amplified neckloop here.

If you want the low power advantage of an amplified neckloop combined with the passive nature of a passive neckloop, you can use the Music Links or T-Links. Because they hang on your ears instead of around your neck, they are so close to the t-coils in your hearing aids that the signal does not need to be amplified. Thus, these devices are good to use with cell phones and other tiny audio devices.

The Music Links and T-Links cost about the same as a passive neckloop. Their main disadvantage is that they are more fragile—the wires are very thin so they break much more easily than the wires in the robust neckloops. Also, some people don't like them hanging from their ears, but that is a personal preference.

If you are interested, you can see the Music Links and T-Links here.

 

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Seven Cell Phone Strategies to Use When Driving

by Neil Bauman, Ph.D.


A lady asked: "What is the best way to use a cell phone when driving?

1. The absolute best way is to leave your cell phone turned off when you are driving. That way you are never distracted at the wrong moment and you will never break any cell phone driving laws. You can get all your missed calls on voice mail once you have finished driving.

If you don't do this, then as appropriate, use the following cell phone strategies.

2. Only turn your cell phone on when you nood to make a call and you can choose a time when either there is no traffic around for you to worry about (such as driving in central Wyoming) or you are stuck in traffic and are not going anywhere anyway.

3. If you leave your cell phone on all the time, when it rings, pull over and then answer it. However, if there is traffic around you, you may have trouble getting over to the shoulder or there may be no shoulder or no place to park. Thus you may be tempted to answer your phone when you definitely shouldn't be distracted from all the traffic around you. Better to let the call go to voice mail and get it later when it is safe to do so.

When you asked your question, I know you didn't mean what I have just said above. However, these are very important safety considerations, and you would do well to heed them.

Now, to get to what I think you really asked, "What are the best hands-free cell phone options I can use when driving in those states that allow hands-free cell phone use?"

Talking on a cell phone (whether hands-free or not) is still never a good idea when you are in traffic because your mind can be more focused on your phone call than on your driving. This said, here are some hands-free solutions you can try. Which ones you can use will depend on your cell phone's capabilities and which hearing aids you have.

4. Some cars have bluetooth cell-phone capability built in. If you have a bluetooth cell phone, all you have to do initially is pair your phone with your car's bluetooth system. After you have done this once, you hear your phone through the car's speakers and a built-in microphone in your car will pick up your voice.

Thus, when your cell phone rings, the car's bluetooth system automatically plays the phone conversation though your car's speakers, and you hear it via your hearing aids. You just set the volume on the car radio to the best level for you to hear. A down side of this is that your conversations are never private unless you are alone in the car.

5. If you have a bluetooth cell phone and have hearing aids that use a remote that has bluetooth capability, you can use this option. You wear the remote around your neck and when your cell phone rings, you just press the button on the remote and it answers your phone. The microphone is built into the top of your remote. Thus, you have hands-free operation and you hear in both ears via your hearing aids. To hang up, you just press the button again. Phonak, Oticon and others have such features on some of their hearing aids. A nice feature of this option is that you never have to touch your hearing aids to change modes.

6. If you don't have a bluetooth remote on your hearing aids, but have a bluetooth cell phone, you can simulate the above option by wearing a special bluetooth neckloop. Note: your hearing aids must have t-coils. You pair the neckloop with your phone. Then, when the phone rings, you press the button on the bluetooth "dongle" (much like in 5 above). But you also have to switch your hearing aids into t-coil mode. Again, the microphone is on the top of the dongle so you have hand-free operation. You hear in both ears via your hearing aids and t-coils. To hang up you just press the button on the dongle again. Also, you have to switch your hearing aids back into microphone mode so you can hear things around you again. A good bluetooth neckloop for this purpose is the Clearsounds "Quattro".

7. If you don't have a bluetooth cell phone, or if you don't want to use bluetooth for whatever reason, if your cell phone has the standard 2.5 mm headset jack, you can plug in devices such as the T-Links or the Clearsounds CLA7 amplified neckloop. Before you start out you need to hang the T-Links on your ears and plug them into your cell phone. (With the CLA7, you need to put it around your neck and plug it into your cell phone.) To use your cell phone, you answer it the normal way. At the same time, you need to switch your hearing aids to t-coil mode, and in the case of the CLA7, turn it on and set the volume, then you are ready to talk. When finished, you hang up your cell phone the normal way, then switch back to microphone mode on your hearing aids.

You can see the T-Links here and the CLA7v2 Clearsounds Amplified Neckloop here. A downside of the CLA7 is that it uses batteries. Thus, if the batteries die, you're out of luck. The T-Links don't use batteries so you won't have that problem with them.

If you have one of the newer smart phones that uses a 4 pole 3.5 mm (1/8") jack (instead of the 3 pole 2.5 mm [3/32"] jack), and if you are using the T-Links you will need to get a 4-pole to 3-pole adapter (the link to a good place to get these adapters is given on the T-Links webpage referenced above). The CLA7v2 comes with the appropriate adapter.

One of the downsides of options 6 and 7 is that if your car produces significant interference when your hearing aids are in t-coil mode, you either have to try to hear above the interference, get a radio technician to eliminate the source(s) of interference, or not use t-coil solutions when you have the car running.

So there you have it—seven solutions for using cell phones when driving your car. Note, there are other devices available, but they are basically similar to what I have outlined above.

 

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Where Can I Get the Best Buy on Hearing Aid Batteries?

by Neil Bauman, Ph.D.


A lady asked, "Now that I have to buy my own hearing aid batteries, I'm getting confused by what's available. One brand claims to be the 'Longest Lasting' on their package. Are any of them really any better than the others? Where should I go to get the best deal? How much should I pay? I have never ordered batteries online. Are the expiration dates comparable to the ones purchased in stores?"

Good questions. When added up over the course of a year, the cost of hearing aid batteries can be significant. If you shop around, you'll find that the price of hearing aid batteries varies greatly depending on where you purchase them. For example, a quick look on the Internet revealed that some hearing aid batteries sell for as much as $1.12 EACH. I'm sure they cost even more in some stores. However, you should never have to pay that much. You can get them for significantly less.

Hearing aid batteries are basically all zinc-air batteries. One of the characteristics of zinc-air batteries is that they begin to lose their capacity the moment you remove the plastic tab in order to activate them. At that point, whether you use them or not, they rapidly lose their charge over a period of a couple of weeks or so.

Therefore, your best bet is to buy based on price, not on capacity or longevity. I've found that the ZeniPower zinc-air batteries combine good batteries with a great price—namely 18 cents each. I buy a box of 60 batteries at a time for just
$10.95 plus shipping.

There are a number of places that give you good prices on hearing aid batteries. As of this writing, the best price that I've found is at Premium Batteries. You can buy from them online via Amazon.com here.

You can get whichever size of batteries you need—675, 13, 312 or 10—all at the same great price.

What kind of shelf life can you expect? The last package of batteries I ordered was back in December, 2008 and the expiry date is still in the future—January, 2013. That's 5 years in the future from the date of purchase. You probably can't beat that in any physical store.

When you buy your batteries from a firm that just sells batteries, you can expect the freshest batteries because they sell so many and consequently have to continually renew their stock. In addition, you often get the best prices as well as the freshest batteries, so you can't beat that.

One Internet list I am on has recommended the ZeniPower HP batteries for years as being the the best batteries for the best price. I can't argue with that. That has been my experience too.

 

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                       HEARING LOSS HELP E-zine

Neil Bauman, Publisher               Center for Hearing Loss Helpp
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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