Hearing During The Holidays

Like everything else in 2020, Thanksgiving festivities are going to be a challenge. Bringing people together during the COVID-19 pandemic will present a number of issues. And there’ll be the aftermath of the election. That’s a lot on the proverbial table this year.

But for anyone with hearing issues, these kinds of gatherings — which usually mean a generous amount of noise stuffed into a confined space — have always been an experiment in coping.

The fact is that “crowded” audio environments are the toughest, whether someone uses a hearing aid or not.

Here are some tips on dealing with the challenges at hand:

  • A good place to start, if you do have a hearing aid — especially if you got it recently — is to use it! Don’t let pride or embarrassment (or false confidence that your hearing isn’t that bad) get in the way of communicating. It’s not uncommon for people to not want to advertise their need for a hearing aid. But really, let that go.
  • Likewise, don’t be shy about telling people who may not know it that you’re hearing challenged — and that you need to see them clearly when they speak to better understand them.
  • Where you spend your time is important too. Try not to sit in the middle of the table, since that will mean dealing with sound from both sides simultaneously. Avoid being too close to the TV.
  • And taking a break — like sitting in a quiet room or taking a walk — can do wonders for your ability to process sound after concentrating in a noisy environment.

Everyone will be facing a uniquely challenging holiday season this year. Don’t let any hearing issues add to the list.

The Ways Hearing Can Go South

The annual National Audiology Awareness Month is recognized each October. One of the many things hearing health professionals do is examine people who have realized that their hearing is not functioning at the level they expect. At this preliminary stage, it is required to broadly diagnose what kind of hearing loss is being manifested.

The field uses four comprehensive classes of hearing loss when treating someone. These are sensorineural, auditory processing, conductive, and mixed hearing loss.

The first type, sensorineural, is due to damage to the inner ear or the nerve transmitters that send electrical signals to the brain. The performance of either the cochlea (which is the part of the ear that creates nerve impulses from the sound waves that have been processed by other parts of the ear) or the vestibulocochlear nerve (the communication conduit between the ears and the brain) — or both — have degraded in some way. Aging and long-term exposure to excessive sound are the most likely culprits in adults and hearing aids are the most common treatment.

When there is a breakdown between ears that are functioning correctly and the part of the brain that receives electrical inputs via the vestibulocochlear nerve, it is known as an auditory processing disorder. More common in children — about 5 percent of school-age kids suffer from it — it is not completely understood but has been linked to ear infections, head trauma, and premature birth. A wide range of treatments are combined to deal with individual situations.

The simplest type is conductive hearing loss; something’s just gotten in the way. It could be earwax, swelling of the ear’s walls or other organs, or an infection or allergies that have filled the ear canal with fluid. In rare circumstances, a benign tumor (fibrous dysplasia) or injured eardrum is the culprit. Depending on the issue, medical treatment usually solves the problem, but in some cases hearing aids are needed as a work-around.

Finally, the aptly-named mixed hearing loss is the category for some combination of the above three classifications.

Time to Stop Putting It Off

Obviously, COVID-19 has made visiting an audiologist challenging and, for a period of time in many places, pretty much impossible. Which has had the side effect of making ignoring your hearing issues more convenient.

Now is a good time to face up to facts if you’ve been noticing changes in your hearing.

Here are three good reasons to take care of issues now rather than later.

First, it’s good for your emotional health (something we’re all dealing with these days). Several studies have shown that people with untreated hearing loss are at higher risk for depression and anxiety—stemming from how easy it is to slide into isolation when having conversations is more difficult.

Another huge issue is how important good hearing is for overall brain function. There is now plentiful evidence that hearing loss leads directly to brain atrophy as neurons are reassigned due to the decrease of auditory input. This can lead to not just short-term issues; it is linked to higher rates of developing dementia and Alzheimer’s. According to the article “Hearing Loss and Dementia: Breakthrough Research Seeks Causal Link” published in The Hearing Journal last year: “The risk of developing dementia doubles for older adults with mild hearing loss, and triples for those with moderate hearing loss. And for those with severe hearing loss, the risk is five times that of someone who does not suffer hearing loss.”

And there can be more direct physical repercussions to untreated hearing loss. Issues with the inner ear’s vestibular system, which controls balance, makes the likelihood of suffering from a fall more likely. And for those over 65, falls are actually the leading cause of accidental death. A checkup with an audiologist will include testing this important aspect of hearing health.

Now’s the time to stop putting off dealing with any hearing issues you’re experiencing.

Keep Those Ears Dry

It’s summer and everyone is trying to get in some outdoor recreation after being cooped for the past few months. Even if pools are still closed due to COVID-19, swimming in the ocean, lakes, rivers, ponds, or backyard pools offers the opportunity for some socially-distant exercise.

But with summer swimming can come swimmer’s ear. (And truth be told, you don’t have to go swimming to come down with a case of it).

Swimmer’s ear is really just a fairly common type of bacterial infection of the skin lining the ear canal. It causes mild pain around the ear — especially when pressure is applied to the tragus, that lump of skin at the opening of the ear — and itchiness. If there’s clear fluid draining from your ear then you probably have swimmer’s ear.

What causes it is too much water in the ear canal — hence the name. Besides keeping water out in the first place with earplugs, it’s important to thoroughly dry out your ears after they’ve been immersed in water (this can include getting caught in a summer downpour). That means not popping hearing aids back in immediately. Give the ear canal some “air” so any moisture can evaporate.

Also, go easy on the ear cleaning if you know you’ll be swimming or engaging in any activity in which the ears can get very wet. Any abrasions in the skin of the ear will make it more likely that bacteria can — in an inelegant metaphor — get a foothold in your ear.

If you suspect you’ve got swimmer’s ear, then treat it. Ear drops that negate the bacteria and provide greater evaporation are the most common method. Swimmer’s ear can get worse — including the discharge of pus from the ears, infection of the lymph nodes, and fever — so don’t let it run wild.

Mask-Wearing, Whether You Like It or Not

 

With the rebound in COVID-19 cases hitting many parts of the country, the need — and in many places requirement — to wear masks isn’t going away anytime soon.

Other than bandits, no one likes wearing a mask. Someone with a hearing aid even less so.

Sure, the first few times you pull off your mask and your hearing aid flies out of your ear is fun, but the novelty wears off fast. The negative reinforcement of this scenario will probably make being careful when removing a mask second nature pretty quickly.

What else can you do?

Masks with fabric ties that require the basic shoelace knot — as opposed to elastic ear loops — are probably a better bet, since once untied the strings won’t lasso any part of the hearing aid on their way by your ear.

If you do like elastic ties better, there are also mask holders — simple loops with snaps — that will pull the loops together at the back of the head. No ears required. S-hooks from the hardware store can also serve the same purpose.

Also, contact your hearing health professional. There may be solutions already discovered that best suit the kind of hearing aid you have. Everyone is having to be creative these days; lots of ideas are circulating.

And clearly hearing people who are speaking while wearing a mask is no bargain either. If you have to communicate with someone, remember to let them know you’re wearing a hearing aid and that you may need them to speak slowly. And try to talk away from other noise.

Don’t forget to bring your patience. It looks like mask-wearing will be with us for the foreseeable future.

A Month For Men to Consider Their Health

Thanks to Congressional action in 1994, June is officially Men’s Health Month. Actually, the original legislation — first sponsored by then-Senator and later Republican presidential candidate Bob Dole — proclaimed June 12 to 19 National Men’s Health Week. Inflation ensued and now it’s a whole month.

The purpose is to encourage men to realize “… the value that preventive health can play in prolonging their lifespan and their role as a productive family member [and] be more likely to participate in health screenings.”

And in the specific realm of hearing health, men do have some areas of concern to keep in mind.

The fact is, according to the National Institute on Deafness and other Communication Disorders, men are twice as likely to have hearing loss issues than women. And less likely to seek treatment.

The disparity is not fully understood, though the greater percentage of men having industrial jobs in sectors like construction and the military is thought to play a role in this statistical reality. The fact that men hunt with firearms at a much higher rate is probably also a factor. The best solution to these realities is to embrace the use of hearing protection, since long-term exposure to high-decibel sound environments is one of the surest ways to develop hearing issues.

Unfortunately, there is also some evidence that the regular use of many analgesics — common pain relievers like aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) — can also be a risk factor for hearing loss in men (especially so in younger men). The cause is not clear, but just in cast try not to get in the habit of just taking pain relievers when not really needed.

Diabetes is also a risk factor, doubling one’s chances of developing hearing loss. And the rate of diabetes is slightly higher for men than women.

Finally, hearing loss is not an isolated condition. It is tied to an increased risk of depression and cognitive decline.

So, this June is the perfect time to think about making some lifestyle changes to protect your hearing or visiting a hearing health professional for a checkup.

Normal Isn’t the Operative Word These Days

In normal years, Better Hearing & Speech Month rolls around every May and a topic is embraced by the hearing health industry, led by the American Speech-Language-Hearing Association (ASHA).

But this is so not a normal year.

On the last day of April, ASHA released a statement making it clear that the already chosen theme “Communication at Work” had to be seriously altered. Instead, efforts would center on providing information and support in these unprecedented times of COVID-19.

“Our goal is to champion every person’s ability to communicate, including at this difficult time. Although circumstances are quite unprecedented for this year’s Better Hearing & Speech Month, the expertise and dedication of ASHA members are constant,” said ASHA President Theresa H. Rodgers. “The countless, innovative ways audiologists and speech-language pathologists have transformed their work during the pandemic — striving to help their patients, clients, and students to the fullest extent possible — testify to their unwavering commitment to ASHA’s vision of making effective communication, a human right, accessible and achievable for all.”

ASHA represents over 200,000 members, all of whom have been scrambling to change course. This has meant everything from instituting telemedicine and drop box services to suspending clinical trials and teaching college- and graduate-level courses remotely.

For individuals stuck at home, ASHA will be providing information on its website covering challenges that many are facing, including helping children with hearing issues deal with remote schooling and a lack of in-person therapy, managing virtual meetings when hearing impaired, and managing communication issues for the hard of hearing.

Updates can be found on the ASHA website.

When Your Job Makes You Hard of Hearing

Getting older is already a risk factor for hearing loss. Unfortunately, getting older after having a career in certain occupations raises that risk. And not surprisingly, jobs that are loud are jobs that can negatively affect hearing.

The economic sectors most detrimental to hearing are manufacturing (factory work), construction, aviation, mining, agriculture, and the military.

But others aren’t as obvious. The entertainment industry — including bartenders and waitstaff who work in nightclubs and concert venues — is high-risk. So too are dentists (those drills), ambulance drivers (sirens), and PE teachers (lose that whistle).

Basically, any job where high-decibel noise is an every day (or every night) occurrence.

One 2018 study, published in the American Journal of Industrial Medicine that tracked workers in the nuclear power industry, discovered that over half had hearing loss issues. The study was based on data collected from over 19,000 workers by the Building Trades Medical Screening Program. The Center for Construction Research and Training (CPWR) sponsored the research.

The study amplified a not surprising finding — the longer the career in a high-decibel setting the higher the hazard. Workers with careers over 30 years were 4 times more likely to having hearing issues than those who had worked for less than 10 years.

According to the Centers for Disease Control and Prevention (CDC), “occupational hearing loss is one of the most common work-related illnesses in the United States” with over 22 million workers exposed to dangerous noise levels while on the job.

And most alarming, the injury to one’s ears is usually cumulative, meaning it can be getting worse before becoming obvious later in life.

Using hearing protection now — each and every day (or night) on the job — is really the only way to keep occupational hearing loss at bay.

Hearing Loss and Genetics

For most people, hearing loss issues develop because something happens later in life. They get older or their ears are damaged because of accidents, infection, or exposure to loud noise.

But for some, it’s a matter of being born with issues. This falls under the rubric of genetic hearing disorders.

Genes are the basic building block of cell growth. They are the instruction manual. And unfortunately, problems can arise. These are known as mutations. These can then be passed down to successive generations as familial traits. Other factors, such as radiation exposure, can also introduce mutations.

Genetic hearing issues have been broken down into several broad categories.

When both parents have genetic traits and they are passed onto their child it is known as autosomal recessive hearing loss. Even if both parents have normal hearing, the dormant genetic predisposition can be active in their children.

If only one parent — or a new mutation — is the reason for hearing issues it’s known as autosomal dominant hearing loss.

X-linked hearing loss — when the X-chromosome mutates — is a far more common issue in men than women. Men only have one X-chromosome, while women have two (which makes the mutation less severe for women).

Genetic issues with the mitochondria don’t directly affect the ear but can do so indirectly. Mitochondria are the part of cells that generate energy and problems with them can negatively impact the workings of the inner ear.

Given the vast number of instructions in the human genome — it contains 3 billion base pairs of DNA — it’s a wonder things don’t go wrong more often. Only a few genetic wrong turns can introduce hearing loss.

The Brain Needs to Hear

One of the best reasons to stay on top of your hearing health and seek treatment for any issues with it is the link between hearing and cognitive performance. It has become increasingly clear in recent years that “losing” one’s hearing is often intertwined with weakening of one’s mind.
Several scientific studies have found that hearing loss, especially when untreated, can speed up changes to the brain that come with aging. This includes it literally shrinking—and untreated hearing loss can make this worse.


A 2019 study published in Alzheimer’s & Dementia, based on research by a team from Brigham and Women’s Hospital that spanned eight years, found that hearing loss was associated with a higher risk for cognitive deterioration.


“Our findings show that hearing loss is associated with new onset of subjective cognitive concerns which may be indicative of early stage changes in cognition. These findings may help identify individuals at greater risk of cognitive decline,” stated lead author Sharon Curhan, MD.
These most recent findings come after previous studies also pointed to changes in the brain that were driven, at least in part, by hearing loss.
One such study in 2014, carried out by Johns Hopkins Medicine and the National Institute on Aging, used MRI images of participants in the Baltimore Longitudinal Study of Aging — which has been active since 1958 — for analysis. It found that early intervention to limit hearing loss could be key to preventing permanent changes to the brain’s structure that, once occurring, cannot be reversed.


It seems clear that, in addition to just making life easier by enhancing one’s hearing, treating hearing issues will very likely have positive long-term effects on overall quality of life—and long-term health.