Take care of your ears: Facts about hearing loss

Illustration by Megan Rojas

The chirping of birds, the joyous laughter of loved ones and the rustling of leaves are all sounds that help shape our world.

"Our sense of hearing is extremely important," says Debbie Abel, an audiologist with the American Academy of Audiology. "It allows us to maintain communication with family and friends, keeps us safe in our environment and on top of our game at work."

But life's noises are either muffled or silenced for an estimated 36 million people in the U.S.

“There’s no shame in hearing loss,” Abel says. “The shame is doing nothing about it.”

To find a specialist, talk to your primary care provider or search the audiology, ear/nose/throat care or otolaryngology categories on AngiesList.com.

Types of hearing loss

CONDUCTIVE HEARING LOSS occurs when sound waves aren't transmitted properly from the outer to the middle ear. Common causes are inflammation caused by colds, allergies and ear infections; the presence of a foreign body or built-up earwax in the ear canal; a perforated eardrum; or fluid in the ear.

"To hear, the three little bones in your middle ear must move freely," Abel says. "If there's fluid, it affects your ability to interpret sound." If you suffer from this kind of loss, Abel adds, you can most likely regain your hearing through treatments with medicine or surgery.

SENSORINEURAL HEARING LOSS occurs when the cochlea of the inner ear, or the nerve pathways to the brain, are damaged. Diseases and viruses — such as Lyme disease and herpes — as well as certain drugs can cause this hearing loss.

"Some medications, like antibiotics with the suffix -mycin or -micin, can damage the hair cells in the cochlea," Abel says. "Unfortunately, this kind of damage is permanent."

Humans are born with 30,000 hair cells per ear. They convert the sound vibrations that travel from the middle ear into electrical impulses that are carried to the auditory nerve.

Abel adds that other possible culprits of sensorineural hearing loss are noise exposure, head trauma and aging.

MIXED HEARING LOSS is a combination of both conductive and sensorineural — is the third kind of hearing loss.

Don’t play it by ear

Follow these tips to prevent noise-induced hearing loss:

  • If you’re exposed to loud noise like a lawnmower or hair dryer on a daily basis, wear protective earplugs or muffs for protection.
  • Turn down the iTunes. Abel says you know the volume on your MP3 player is too high if someone next to you can hear your music. “Follow the 60/60 rule for headphones,” she says. “Don’t listen at more than 60 percent of the maximum volume longer than 60 minutes.”
  • Silence is golden. Give your ears a break by alternating quiet activities with louder ones.
  • Rock on responsibly. Abel says at 110 decibels or more, music concerts of any genre can be damaging. “Wear comfortable earplugs to avoid doing harm.”

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My dad is also a WWII vet. He is also from the generation that doesn't want help unless he earned it. But he does take help from the VA now that he's in his 90's. They treat him very well and with respect, which is something his other coverages don't always do. So I am grateful to the VA for that. My question is, he is fitted with hearing aids that go behind his ear. Those are extremely uncomfortable as he has glasses and oxygen tank tubes that go behind his ear so he foregoes the hearing aids. Does anyone know of another style that he could use, that doesn't use the space behind the ear? That would be comfortable for him?

I was involved in this topic re: Hearing Aide service from the VA, as above but had heard nothing further, I am now getting bits and pieces again so would like to broaden the scope to include tinnitus or noises in the ear. I have seen Audiologists and ENT doctors about this for some 25 years. Was advised to join the American Tinnitus Association and was a member for many years and received their rather non-professional Journal for many years. In the past I had rather minor noise in my left ear, static like sounds, that after some testing were attributed to to much fluid in my inner ear. Nine months ago I had 3-way By-pass surgery and a valve replacement and shortly thereafter began to hear major pulsating noises. It was as if a truck was about to drive through the wall of my house. Terrible. Two audiologists said that it was due to my heart. However, I was advised to see an ENT doctor rather than my cardiologist, which I did.I had ssomekind of "plunger" and am scheduled for an MRI tests of my Inner Ear and am scheduled for an MRI.In the past the ENT doctor would evaluate the tinnitus by X-raying my head. The current ENT doctor says that shows nothing and was a waste. Can anyone else shed some light on noise in the ear, as above and efforts to help moderate it? I have taken Ginkgo Biloba for many years for the moderate noise and feel it has been of some help but this new noise drives me up the wall. Many thanks....

The person who is visiting an audiologist should be aware of what is available. So many times people are fitted with those tiny CIC (completely in the canal) hearing aids that end up in the draw because they cannot hear on the phone with them or in a noisy restaurant or airplane. Some, not all hearing aid health providers fit these unsuspecting individuals with these tiny, most expensive hearing aids and because most people who are losing their hearing are led to believe these with help them. I am not an audiologist and I do not fit people with hearing aids. I am a retired microbiologist and know people who have the worst fittings imaginable by so call people who tell them these hearing aids will work. Many people do not ask for a trial period of at least 30 days and when it comes time to return them it does not happen. Instead the hearing health provider cops an attitude. One out of three seniors over the age of 65 has a hearing loss. Hearing loss is an invisible disability and there are 36 million in the USA with a hearing loss. Some seniors are diagnosed with dementia and Alzheimer because they cannot hear well. Many people stay home away from social activities and family gatherings because they were not fitted properly with the correct hearing aid. One size hearing aid does not fit all. Are you a hearing aid dealer? I know Florida has put some these shysters out of business.

Hermine- To quote you "The best hearing aid for you is the one that you hear conversations with. A hearing aid should be behind-the-ear, directional microphones, manual volume control, and telecoils to help you hear on the phone and using assistive listening devices. It should also have WDRC (wide dynamic range compression) program that makes loud sounds softer and soft sounds louder." Those are your words. You cannot make a statement like that. You will lose credibility and the other statements that you make which are good will lose credibility.

Please do not put words in my mouth. Of course a person who realizes they have a hearing loss should see a doctor but not a family physician because some treat hearing loss as not a serious matter because it is not a life threatening illness. First see an otolaryngologist or otologist and then be sure you see a university trained audiologist for an accurate audiogram. A good place to start is a university with a audiology dept or hospital if you do not know where to go. Another excellent organization is Hearing Loss Association of America www.hearingloss.org. If you are experiencing sudden hearing loss see an ear doctor within 72 hours.

Great info and great questions, but no unbiased person to answer, so here are some short answers, if you want more info, email me personally. Lynn- No hearing stimulus package. Scam to get you in the office. VA- Great place to get help if you qualify! Rebecca Y- You can't treat your hearing like you do your toilet paper purchase. My grandmother always told me you get what you pay for. Saving a few dollars today doesn't amount to much if it doesn't do what you want. Go to a doctor of audiology, you won't have to compare test results. Stanley- See an ENT. If there is a problem, they will tell you your options. Fred- Great idea, not many people want to admit the have a hearing loss, but really great idea. Roger- Not sure what information you are trying to give. Hearing loss is not that simple. Distortion can happen in the cochlea (inner ear) and most often the brain (lack of proper practice) The auditory nerve is a conductor, damage happens from atrophy mainly. See a doctor of audiology. It took us 4 years post graduate work to figure out what you are improperly explaining. Stretched ligament? Really? Hermine-One size does not fit all, your information is not for everyone. How can you make those recommendations without a hearing test and knowing a person's listening needs. Anyone who recommends specific solutions for unknown needs and problems scares me. TB- RIGHT ON! DRR- most insurances do not cover hearing aids. If reimbursement continues to decrease at this rate, nobody with any education will test your hearing and the payment for these services are horrible and getting worse. Beverley- A dysfunctional eustachian tube is when the "pressure valve" that equalizes pressure behind your ear drum is not working properly (clogged) and can create hearing loss, pressure behind the ears, fluid and infections. Can be caused by many things such as a cold or congestion and may occur naturally as we age. See your ENT. Hope this answers some of your unanswered questions and misinformation. This is a great representation why people don't get the help they need. So much misinformation and uninformed experts giving advice. See an Academy Certified audiologist. Its a new certification to help consumers/patients find a true expert. I'll answer any questions you may have drlocker@hearflorida.com.

Has anyone had experience with Audibel Hearing in Seminole, FL and the 2.8 Million dollar hearing stimulus package announced for Florida? ($1,000 voucher)

Thanks Walter. My father is one of "the greatest generation", and his focus has always been on what he can do for his country, not what his country can do for him. So I will tell him that he has already "paid" for the hearing aid with his service in the South Pacific in WWII. Happy Veterans Day to you and the veterans of all our wars.

As long as your father served in the US Military, he is entitled to services of the VA. He paid for these services by his service to his country and shouldn't have any qualms about seeking assistance there. He must go to a local VA Center with proof of his military service, such as his Service #, Discharge papers, etc. He will be issued a membership card with his picture on it and he can use any VA center in the USA with it. He will fill out a means form when he applies and once a year, thereafter. As I indicated certain things like Hearing Aides and audiological testing and fitting of aides and batteries for them are FREE. Other things to assist with mobility like canes, lazy-susan like seats for cars, etc. are also provided at no cost. I have no idea how such things are provided free and not others, but only know, through personal experience that they are. Wish your father a "Happy Veteran's Day"

Thanks Walter for the information about the VA. I will do some more checking for my father. He has not used the medical services of the VA and does not want anything that he has not earned. However, since the hearing aids are so expensive, it would be great if he is eligible.

Re: the question by Laurie about the VA's coverage of paying for aides. I am a Vet. and also have to many assets so must make some payments for being seen at the VA. I am on my second set of aides provided at no cost by the VA. They also provide free batteries. Tests by Audiologists are also at no cost as are adjustments to aides.

The best hearing aid for you is the one that you hear conversations with. A hearing aid should be behind-the-ear, directional microphones, manual volume control, and telecoils to help you hear on the phone and using assistive listening devices. It should also have WDRC (wide dynamic range compression) program that makes loud sounds softer and soft sounds louder. When some tells you it is digital ask they to tell you what programs you have. For the first tie I would get a good audiogram in either a university with an audiology dept. or a hospital with an audiology dept. Too many hearing aid deals promise you excellent hearing but when you get home you are disappointed. Be sure to get a 39 day trial basis and during that time go to the noisy restaurant and then go back to have it adjusted while you are on the trial basis. Join www.hearingloss.org for more information and join a local chapter. Hearing loss is an invisible disability.

What is a dysfunctional eustacian tube?

Great to know about Costco - need one as I recently had a sudden total hearing loss in one ear. ENT said to wait for 3 months to see if any would come back - so now need hearing aid.

My ears feel constantly like they are plugged with water. It gets so bad it sounds like a blackbird squawking. I have post nasal drip 24-7 in which I think is the root of my problem, and I mentioned it to my doctor and he said that there isn't much that they can do for me. what is your opinion?

Good article & pics. But first advice is to have your primary Doc check out the problem-you may be referred to an ENT specialist. Then, if the Dr says there's no Medical issue which may be causing the problem, take advantage of all the different companies which provide free tests-but don't buy until you have at least 2 test results to compare the accuracy of the tests. Their equipment or the technician who does the testing(the licensed audiologist doesn't usually do the test itself,(usually just reads the results and then recommends the type aid needed and fits it. After you have at least 2 comparative test results that are either the same or very close, you can shop for the aid. I went through this process and actually the last test perdormed was at Costco Hearing Center.Itw as the most detailed, complete and the audiologist performed the test and we talked about my needs before she recommended I come back when I had thought about it more. Costco sells different brands and Consumer reports rates them as better than most of the big Name brands. Costco prices are usually 50% of the price you'd pay elsewhere. They also have all the follow up services, batteries,cleaning if needed, etc. after you buy, and a guarantee that is terrific.

I would like to see someone develop a small lapel pin, with a logo that would let people know that I am hearing impaired. Many handicapping conditions are immediately evident, but hearing loss isn't one of them! Thanks! :-)

Get evaluated by an audiologist. You can't make decisions about getting hearing aids or about adjusting them until you know whether you have a hearing loss; and if you do, the type, degree, configuration, and symmetry must be determined. If something can be treated medically or surgically, the audiologist will refer you appropriately. If medical treatment is not indicated, the audiologist can advise you regarding the hearing aid options available, costs and so forth. Don't first seek help from a commercial hearing aid dealer or fitter first, because they're in business to sell hearing aids. Get an objective audiologic opinion first.

My father is a WWII vet with a hearing loss. The local VA told him that although he is retired, he had too much income to be eligible for them to pay for the hearing aid. Where can I check out the VA policies on this?

My hearing aids were covered by my insurance. Look around for another company. I believe the new Affordable Insurance Act says you cannot be refused coverage.

If hearing comes difficult, get a hearing test from an audiologist. A good article for people to be aware what to do if there is sign of hearing loss

Does anyone have a recommendation for the best hearing aids?

Good information. I've had hearing loss for 40 years and have used hearing aids successfully to allow me to live a normal life. It is too bad insurance does not cover them as being hearing impaired leads to isolation, to which elders are particularly exposed.

The article left out three things that may be important. First, the auditory nerve may be damaged. This limits the ability to understand speech. There is no known remedy and the hearing loss is permanent. If you hear a constant hissing noise, a damaged auditory nerve may be the reason. Second, the ligament between the inner-ear bones may be stretched. This problem may progressively attenuate higher-frequency sound. Third, people with hearing aids should know that hearing damage occurs with the sum of the decibel input of the source and whatever is amplified by the hearing aid. Some hearing aids are better than others.

THANK YOU ! very informative.

I liked everything about this story. The text and picture were informative.

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