Hearing Loss Help  

by Neil Bauman, Ph.D.

A man wrote:

Dr. Neil: I have question. Are there cell phones that have the t-coil built in so you just hold the cell phone close and sound jumps to hearing aids t-coil? Thus, use of T-Links or neckloops are not necessary?

I’ve got good news for you. Yes—most cell phones are that way now. Therefore, all you need to do is hold your cell phone up to your hearing aid (in t-coil mode) and listen. If you hear well without any interference, that is all you need.

However, some phones and hearing aids still have too much interference (typically a loud buzzing) and by using the T-Links, you keep the phone far enough away from your hearing aids that you do not get this interference. (The interference drops off rapidly with increasing distance.) That is one reason to use the T-links.

Another reason you might want to use the T-Links is to have hands-free use—for when you are driving, or walking around. That way, you can have the phone in your pocket and hear it just fine. If you have a Bluetooth enabled phone, using a Bluetooth neckloop would have these same two advantages.

You can learn more about the T-Links here, and learn more about a Bluetooth neckloop here.

by Neil Bauman, Ph.D.

A lady wrote:

My mother has been losing her hearing for quite some time now. We have to speak very loud in order for her to hear us. She has tried various hearing aids and sound magnifiers (for church), but she is very frustrated because they don’t quite do the job. At 89 I don’t think she is a candidate for surgery. I told her that maybe she is at the point that nothing is going to help her because the hearing mechanics in her ear are gone. Of course she feels left out of things and is beginning to withdraw a little.

The first question I have is what are her discrimination (word recognition) scores? I’m thinking that the reason amplification isn’t giving the level of success you would expect is that she can’t understand what she hears, even when speech is amplified to her most comfortable level. In other words she has poor discrimination.

If this is so, then amplification alone isn’t the answer. Real time captioning (CART) at church and meetings would help her far more than amplification in this case.

As you already know, trying to hear in groups and family gatherings is largely a waste of time for her. However, all is not lost. She does not have to be left out. The secret is to converse with her one-to-one in a quiet location. Conversation under these conditions can still be quite effective if she is close to the speaker (nose-to-nose so to speak) so she can both speechread a bit and hear a bit).
 

by Neil Bauman, Ph.D.

A mother wrote:

I read your article on the Internet concerning sudden sensorineural hearing loss (SSHL). My daughter lost her hearing in her right ear when she was 12 years old. We believe it was due to a virus. The Doctor told us at the time, that she could have an implant but to wait because in about 10 years a new treatment would be available. He said a shot was being developed that would stimulate the nerve endings to “grow” and she would get her hearing back. I have yet to find any information about this treatment on line. Have you ever heard of it? My daughter is just finishing her first year of college now. She has learned to live with the deafness of her right ear, but still remembers the new treatment the Doctor told her about, and if possible, would like to have it done.

Your doctor was being pie-in-the-sky optimistic. What he was talking about back then is basically hair cell regeneration, and now 7 or 8 years later it is still 20 or 25 years away if it ever happens, according to the researchers I have talked with. There are no guarantees that all the research they are doing will ultimately prove successful, or even successful enough to begin human trials. At this time, they are moving ahead in the belief that their research will ultimately prove successful. Maybe when your daughter is 40 or 50 it will be available. But it certainly isn’t here yet.

Because your daughter has normal hearing in one ear, she isn’t eligible for a cochlear implant in her deaf ear. However, there are three special kinds of hearing aids that can help her overcome her single-sided deafness.

First, there are CROS aids. These special hearing aids basically take the sound from the deaf side of the head and route it to the good ear. That is why they are called CROS aids—which stands for “Contralateral Routing Of Sound”. You can learn more about CROS aids in my short article called “What are CROS and Bi-CROS Hearing Aids?“.

Second, there is the BAHA (Bone Anchored Hearing Aid). In this case, a titanium post is screwed into the mastoid bone behind the ear, and when it heals, a “hearing aid” is snapped on to this post. The amplified sounds vibrate this post which passes these sounds to the good ear via bone conduction. You can learn more about the BAHA here.

Third, the newest kid on the block is the TransEar hearing aid. This is a BTE (behind-the-ear) hearing aid with a difference. You wear it on your deaf side. The TransEar has a special ear mold with a miniature oscillator embedded in it. The ear mold fits tightly in the ear canal and vibrates the skull bone, thus passing these sounds to the good ear via bone conduction, much like the BAHA does. You can learn more about the TransEar here.

In addition to these three devices, there are a number of “tricks” a person with single-sided deafness can use to help them hear better. For example, in meetings and classes, the person should sit to the side of the room so that their deaf ear is towards the wall. That way their good ear hears into the whole room. No one can then talk from their deaf side. In like manner, if possible, they should arrange their office so that people have to approach and speak to them from their hearing side.
 

by Neil Bauman, Ph.D.

A man wrote:

For the last 10 or so years I have noticed a decline in my hearing. This year when I went to get tested, it was 55 dB in each ear.

A question I have is when I talk everyone says that I’m yelling at them, but to me I’m just talking. I stop and think there is no way I’m yelling. They tell me I cannot hear myself talk so I say things a lot louder, is that possible?

Very much so. You don’t hear your own voice as loud as you used to, so you speak up so you hear your voice at its accustomed volume. “Yelling” is a bit of an overstatement—but since you are definitely talking louder than normal, many people call it “yelling”. However, we know that we are not truly yelling because we know the effort it takes to really yell, and we are not doing that!

By the same token, when you get hearing aids, just the opposite can happen. Your amplified voice now seems so loud in your ears that you drop your voice and talk much softer than normal. People now have trouble hearing you. Fortunately, in time, you get used to how loud your voice should sound, and all will be well.

by Neil Bauman, Ph.D.

A man wrote:

Several years ago at a hearing clinic, I told the young lady that I had ringing in my ears. She asked me if I had ever taken Niacin, and I hadn’t. She said it helps some people. I took Niacin pills for a good while, and it seemed to rid me of the ringing in the ears. I did get a flushing from taking Niacin. She suggested Niacinamide, and that seemed to help the flushing.

For one reason or another, I have not had ringing in my ears for a lot of years, so I no longer take Niacin or Niacinamide.

I would like your thoughts about taking Niacin or Niacinamide for ringing in the ears. Do you know of a connection here, or was it helping me a fluke?

Niacin (Niacinamide) or Vitamin B3 helps some people with tinnitus because it increases blood flow to the peripherals which includes the inner ears (hence the flushing—it shows it is doing its job).

If your tinnitus was caused by a lack of blood to your inner ears, then taking Niacin really can work—its not a fluke. However, Niacin does not work for everyone—only for those with circulation problems to their inner ears. For example, nothing I’ve tried has helped my tinnitus because mine is probably the result of my severe hearing loss, not lack of blood flow to my inner ears.

 by Neil Bauman, Ph.D.

A mother asked:

Do you or don’t you restrict your child’s activities due to their LVAS (Large Vestibular Aqueduct Syndrome)?

When my daughter (almost 12) was diagnosed with unilateral LVAS at age 8, the ENT said to avoid loud music (to protect her normal ear), scuba diving, and head trauma.

I have found information saying kids should avoid diving (which my daughter does and enjoys), roller coasters (which my daughter has ridden and loves), doing “headers” in soccer (which she practiced at a recent soccer clinic), contact sports like basketball (which she played for the past 3 years), and playing the trumpet (which she is supposed to start next fall). She is very active.

I am questioning whether I should try to convince her to change the instrument she has selected to play in band next fall. We had a band night where they could try all the instruments, which she did, and she loved the trumpet. The teacher said she was a natural and had done better than any incoming 6th graders he’d heard that night. So naturally we signed her up to play trumpet. But I don’t want to put her hearing at risk either.

Also I’m wanting to know if I should stop her from diving off the diving board this summer, not sign her up to play soccer next fall, and limit her at Six Flags to only non-roller coaster rides. On the other hand, she’s done these activities in the past, and her hearing in her LVAS ear has remained pretty stable. I would hate to limit activities she really enjoys.

You are not alone in trying to determine which activities your LVAS child should or should not do. Many parents of children with Large (or Enlarged) Vestibular Aqueduct Syndrome (LVAS/EVAS) often agonize over this very question.

Fortunately, if a child has a history of LVAS for a few years such as your daughter has, the question is relatively easy to answer—no matter what the doctor gives as guidelines. Let me explain.

All of the above activities have the potential to cause hearing loss in people with LVAS. But just because there is the potential doesn’t mean it will happen. You have to consider each child on a case by case basis.

Since your daughter has been doing a number of these activities for some time, all you have to do is ask yourself, “In the past few years, have any of these activities caused more hearing loss or balance problems in my daughter?” If the answer is “no”, then let her continue to do these (and related kinds of activities), because obviously her ears are not sensitive to these kinds of activities.

However, if your daughter lost more hearing or had balance problems each time she did one of the above, then obviously these activities are not the right ones for her, and you should restrict her to those activities that have not caused hearing loss/balance problems in the past.

In your daughter’s case, you’ve answered your own question. These activities haven’t bothered her in the past, so let her do them in the future—unless you subsequently find that they really are damaging her ears.

 by Neil Bauman, Ph.D.

A man wrote:

I love my T-Links. One thing I find is the sound is too loud with the T-Links, Oticon hearing aids, and many phones—even when set to their minimum volume. Any suggestions?

One of the reasons your T-Links sound so loud is that they are very close to you t-coils. The solution should be simple.

Have you audiologist reduce the amplification on the t-coils (in t-coil mode) to something that is just right when using the T-Links. It can be that simple to fix.

by Neil Bauman, Ph.D.

Hearing loss in a spouse adversely affects marriages. This should be no surprise. In fact, according to a recent survey of baby boomers with hard of hearing spouses, 48% “of the respondents feel that their marriage has suffered because of their spouse’s hearing loss.” (1)

This does not have to be. Hearing loss can bring about changes in a marriage, but these changes do not have to adversely affect the marriage itself. Let’s look at this a little closer.

One of the findings was that 65% “feel annoyed when their spouse can not hear them.” Instead of being annoyed and letting that affect the marriage, why don’t these spouses practice good hearing loss coping strategies so that their spouses do hear them the very first time? When they do this, the annoyance factor fades away.

A second finding was that “another 16% feel ignored”. I think this applies much more to family gatherings rather than just spouse to spouse communication. In groups its so easy to ignore the person that misses what is said. Because they miss things, they often don’t respond—and thus become “invisible” to the group. The hard of hearing person is not intentionally ignored—it just happens. This is why practicing good coping strategies, including being assertive, is so important. So too are using hearing aids and any assistive listening devices (ALDs) that will help the hard of hearing person hear better.

A third finding was that “8% feel sad or hurt.” I’m surprised this figure is so low. Hearing is important to us. We value it, so when we lose it, we feel the loss—and therefore must grieve this loss. Some of the emotions we experience during the grieving process include sadness and feeling hurt. These feelings should go away as we work through the grieving process and learn to become well-adjusted hard of hearing people. In addition, the hearing spouse must also grieve—not for the hearing loss since they don’t have any—but for the loss of the free and easy communication they once had with their now hard of hearing spouse.

To learn more about the grieving process in relation to hard of hearing people read our short book, “Grieving For Your Hearing Loss—The Rocky Road From Denial To Acceptance.”

A fourth finding was that 60% “find themselves in recent years talking louder daily so their spouse can hear them.” I don’t see that talking louder as such, is a problem, but a sign of using an effective coping strategy. Speaking louder so a spouse can hear you the first time has got to be far less annoying than endlessly repeating yourself in your regular voice, and in the end your spouse still doesn’t get it. Of course, the hard of hearing spouse should do what he/she can to help this situation—and that means getting hearing aids if they will help, and/or using assistive listening devices.

A fifth finding was that denial often rears ins ugly head. In fact, 57% “feel their spouse is reluctant to get his or her hearing checked.” Why? Well, “46% feel that denial is the number one reason” their spouse refuses to have a hearing test. I have heard the shocking statistic that 6 out of 7 hard of hearing people either deny they have a hearing loss, or do nothing about it. that is what causes problems in marriages. If the hard of hearing spouse would acknowledge that he/she has a hearing problem (and a hearing test will confirm that), then together the marriage partners can work on finding effective solutions so that hearing loss will not harm their marriage.

There are ever so many effective coping strategies that spouses can employ to make communicating with each other easier. Some of them involve using assistive devices and hearing aids, while others don’t cost a cent. There are a good number of these freebie effective coping strategies in our very readable book, “Talking With Hard of Hearing People—Here’s How To Do It Right!”

(1) “Being Hard of Hearing Can Cause Hard Feelings Between Spouses” in: Advance for Audiologists, April 11, 2008.

by Neil Bauman, Ph.D.

A lady wrote:

My biggest wish right now is to be able to hear better in a noisy place like a restaurant, or at a social gathering where I am moving around. I know the PockeTalker works, but that means carrying it, and I like to have my hands free. I was wondering if I should trade my current hearing aids in for ones that have t-coils and directional microphones.

I am looking for that magic device that I can carry with me and set down and be able to have the person’s voice come right up to my ears. It does not have to have a very large range.

That is some magic device alright. Trouble is, it doesn’t exist. There are good assistive listening devices (ALDs)—some work well in some situations, while others work well in different situations. However, there is no single device that works well in all situations.

The secret to better hearing is just this—the noisier the place, the closer you need the microphone to be to the speaker’s mouth. It’s that simple. This is why placing a microphone in the center of a table doesn’t work well. It picks up too much of the noise in the room.

When it comes right down to it, you have two basic choices. One is to get new hearing aids that cut out most background sounds while zeroing in on the voice of the person to whom you are speaking. The second is to use an ALD, either alone, or in conjunction with your hearing aids.

Hearing aids with directional microphones can be wonderful. About 5 years ago, Siemens came out with their BTE Triano. It had three microphones on each aid—and when set in full directional mode—boy was it great! I tried it in a crowded exhibit hall, and it cut out all the racket except the voice of the guy I was talking to. I was totally impressed!

However, most hearing aids do not have wonderful directional microphones. For example, my current hearing aids have directional microphones (2 mics on each aid), and in directional mode they do cut down noise from the sides and back by about one third, but that is not enough so that I can have an easy conversation in noisy situations. I still have to try to hear through the remaining racket.

The problem with full directional mics (as opposed to semi-directional mics) is that you have to be facing the person to hear them. For example, a person could be yelling a warning to you from behind and you’d not hear a thing; or in a group, if you are looking at the person who is talking and another person chimes in, you won’t hear them—so you won’t be able to follow group conversations; nor will you be able to hear questions at meetings because you never know which direction to turn to before the question is half over, not to mention getting whiplash from all that head spinning!

However, if you are only talking to one person, having full directional microphones makes it possible to hear the person with whom you are chatting without all the background racket.

Many modern hearing aids combine both noise cancellation and directional microphones to help you hear better in noisy situations. Naturally, some work better than others, so you have to try them out to see which works the best for you.

Your second basic option is to use an assistive device. In noisy situations, my choice, because it is relatively cheap, yet works with any hearing aids with t-coils (or without hearing aids when wearing earbuds) is the PockeTalker with a super-directional microphone or lapel microphone—depending on the situation.

For example, in noisy restaurants, I just put the PockeTalker on the table and clip the lapel mic on the person I want to hear—and wear either my hearing aids and neckloop or no hearing aids and earbuds. This decimates the background noise.

Just to give you one example. One time I was with my wife in a steakhouse restaurant. We were seated near one end—but at the other end was the bar and large-screen TV. As it happened, a ball game was on. Every time the game got exciting, there were loud yahoos from the bar patrons. This made it most difficult for me to hear my wife. However, with the PockeTalker and lapel mic, the background level dropped dramatically. I could hear my wife’s voice with ease.

I like using this combination when in restaurants or, in the car—places where you are seated and remain seated for a time.

If I am standing up and walking around—such as at receptions, or wandering around in noisy exhibit halls, my choice is a PockeTalker and handheld super-directional microphone.

Let me show you the difference. A few months ago I was in an exhibit hall talking to the various salesmen at their booths. When I started, I had my hearing aids on, but the racket was not only making it very hard for me to understand much, it was also giving me a headache. So I hauled out my trusty PockeTalker, super-directional microphone and neckloop.

I just aimed the microphone at the salesperson’s mouth and wow! It was just like he was talking right into both of my ears at the same time. The background roar almost became a whisper. That is what a properly used assistive device can do for you!

If you are interested in the PockeTalker and/or the specific microphones I use, here are the links to those wonderful devices. (They are all on the same web page—so you can just scroll down if you like.)

PockeTalker

Neckloop (NKL 001)

Lapel Microphone (MIC 054)

Super-directional microphone (MM400-S)

 by Neil Bauman, Ph.D.New research reveals that for some people with hearing loss, the tinnitus associated with hearing loss stems from over-active sensory nerves in the face and neck.(1) After hearing loss occurs, for some reason, touch-sensing nerves in the face and neck step up their activity in the brain. The result is that some neurons in the cochlear nucleus become hyperactive. This increased activity has been linked to tinnitus.

For these people, treatment for their tinnitus may be as simple as acupuncture targeted at the nerves in the head and neck.

These findings may also reveal why many people with temporomandibular joint syndrome (TMJ) also suffer from tinnitus.

(1) The Hearing Review, Vol 15, No. 2, February 2008. p. 60.