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Considering Daily Practice During COVID-19

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What a crazy time it is! Some days, I feel emotionally stable, and other days, I feel a little panicked. I also realized the more I watch TV or read the news, the more stressed I become. I am now limiting the amount of TV/news exposure I get and have much less physical tension and emotional stress.

We are all trying to navigate staying healthy with staying sane as we take care of our basic needs. It seems that day to day, things ebb and flow, but try to remember this has happened to society in decades past. It isn’t new to have a virus wreaking havoc on different populations of people. In America, it has been a few generations since experiencing a significant virus; thus, we are not accustomed to the constraints and new behaviors a pandemic imposes on us.

That being said, we are a strong people, we are intelligent people and I think now after the initial shock of learning about this virus and how to “live” with it is over, we are in a position to take back some control of our lives. By following a few logical steps, we are able to reduce our chances of being exposed to any virus or bacteria.

Limit Physical Exposure

At this point, we don’t have to stay in the house all the time but it is prudent to apply logic to our activities. Which activities give you the most benefit: grocery store vs. clothes shopping; going on a walk and meeting friends outdoors or setting up a meeting indoors?

 

Wash Your Hands

Wash your hands after being out in public or touching surfaces you did not personally clean. This should already be second nature to most of us. Don’t touch a doorknob out in public. Either use a tissue or the bottom of your shirt to grab the door. Hold the pen to sign the credit card charge with a tissue, then immediately toss the tissue into the trash. Consider all surfaces suspicious. I keep hand sanitizer in my car so when I sit down, I use the sanitizer before closing the door or touching the steering wheel. When I enter the house, the first thing I do is wash my hands and declare I am in my safe zone! I think once this becomes the new normal, we will be healthier from all sorts of colds and flu bugs!

 

Wear a Mask in Public

Please wear a mask when you go out and are around other people. You don’t want to spread any germ accidently. If all of us wear masks when we are around people, then this virus would have to work much harder to invade our bodies. The mask is paramount! But, it must be worn over the nose and mouth. Try it on at home and make certain it stays put while you talk. If it slides down, maybe you have it on upside down. Do you have it tied properly? Does it need a wire to help it sit snugly around your nose? If it does not have one, it is easy to sew one on. You can use a pipe cleaner that is folded over a few times to make it stiffer. There are many ideas for the mask nose, look online. Type in “how to make a mask” and you will see thousands of ideas.

Wash your cloth mask in hot soapy water when you get back to the house. I walk in the door and put my mask in a designated bowl, then put hot water and soap in it. I let it soak (until I remember to take it out) and then rinse it and hang it up to dry. Usually it is dry by morning, so I have a few masks to use while the first is drying. I wear a mask at work all day! Actually, I wear two masks. One is a medical grade mask and then I put a cloth mask on top of that. I find it extremely difficult to breathe and must take deep breaths to compensate, but it is worth it.  Masks are annoying, but I know I am keeping my patients safe from me and when they wear a properly fitted mask, they are taking care of me, too! Win, win. When I see someone wearing a mask out in public, I know that person is being thoughtful of me! QCBN

By Karon Lynn, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit TrinityHearing.net.

 

Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.

 

Hearing Mythbusters

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With the internet being ubiquitous, information is easier to access than ever. However, that does not mean that the information is necessarily correct. This sentiment is especially relevant when it comes to health advice. One might read that carrots help improve eyesight; in actuality, this was wartime propaganda to disguise radar technology.

Given the daily onslaught of information, it can be difficult to determine what is factual.

Cleaning Your Ears

Earwax is not innately bad. In fact, it offers multiple benefits! It can serve to keep bugs out of your ear canal and studies have shown it possesses antibacterial and antifungal properties. Of course, too much of a good thing can begin to cause issues. Impacted earwax (i.e. filling the entire canal) can cause hearing difficulty and discomfort. Realistically, though, the majority of people are not at risk of impacted earwax. The skin in the ear canal grows outward, carrying excess wax with it. However, people with stiff or curvy canals, or those who naturally produce a lot of wax, may find that it starts to build up. What are the options for someone in the latter category?

Odds are Q-tips spring to mind. After all, who doesn’t love scrubbing their ear canals after a nice shower? But Q-tips do pose some risk. First, the wax may be inadvertently pushed further down the canal. More concerning, the Q-tip may be inserted too deeply and cause pain or harm. If use cannot be resisted, hold the Q-tip near the end and clean only the outer portion of the canal.

Another common home remedy is an ear candle. In theory, a hollow candle is placed into the ear canal and the opposite end is lit, creating a pressure which removes debris. However, no scientific evidence supports the efficacy of ear candling. Quite the opposite is true. The literature states that ear candling has at best a neutral effect, and can actually pose some risks. There have been reports of burns, infections and even candle wax and ash deposits in the canal.

The best way to prevent buildup is to keep the earwax moist. If the wax is dry and hard, it cannot flow out of the canal as easily. Debrox is the name of popular and safe over-the-counter drops designed to clean the ears. Mineral oil is another reliable, natural preventative measure. Olive oil should be avoided, as it is too thick.

Of course, medical professionals can remove the wax as well. Audiologists regularly have standing appointments every few months to clean out patients’ ears.

Treating Tinnitus

Tinnitus is a condition in which a person hears a sound despite there being no external stimulus to produce said sound. It may sound like ringing or cicadas, although it differs for everyone. At the time of writing, there is no known cure for tinnitus. Unfortunately, there are many medications hawked as treatments. The majority tend to contain a supplement called ginkgo balboa. No studies to date have shown that ginkgo balboa or any other supplements have any effect on tinnitus. There is no inherent danger from these medications, but any perceived benefit is likely a placebo effect.

While tinnitus cannot yet be cured, there are daily strategies that can help manage the severity. First, stress should be minimized as much as possible. Studies show that when people are under more stress, tinnitus tends to be rated as more severe or bothersome. Diet has also been shown to play a role. Caffeine, salt, sugar, alcohol and nicotine play the biggest role in causing tinnitus to flare, but different individuals can be affected by certain foods. Reducing intake of any of the above may offer some relief. Another strategy, although not always simple, is to not focus on the tinnitus. Focusing on the noise will cause stress, which can exacerbate the noise.

Many people find that having background noise, such as television or a white noise machine, can help to mask the noise they hear in their ears. If someone needs consistent noise, hearing aids have the capacity to play customized masking sounds. Additionally, the literature shows that simply wearing hearing aids can offer significant relief for many people. Please note that counseling options are also available for more severe cases.

If you are unsure if a piece of information is accurate, ask your hearing care provider. Extensive schooling and continuing education ensure their knowledge remains current. Accurate information is the greatest tool in remaining healthy. QCBN

By Jeff Lane, Au. D.

Dr. Jeff Lane is an audiologist at Trinity Hearing Center, located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Dr. Lane has a passion for improving the lives of others and may be reached at 928-522-0500 or at audio@trinityhearing.net.

 

Which Hearing Aids Are Right for Me?

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The world of hearing aids can be intimidating. With multiple manufacturers and models, it can feel akin to purchasing a vehicle. A minority of adults with hearing loss are actually fit with hearing aids, while the average length of time between noticing an issue and seeking treatment is seven years. Fortunately, licensed providers are available to act as guides, with “guides” being the keyword. While providers are very knowledgeable and reliable sources, the question of which type of hearing aid is best suited for an individual is highly dependent on lifestyle and desires. Selecting amplification should be a collaborative experience.

Inside the Ear or Behind?

At the most basic level, one must choose between hearing aids which are contained entirely within the ear or sit on top of the ear. One style is not superior to the other in terms of sound quality or processing power, but each does have its own advantages and disadvantages. An in-the-ear (ITE) style is customized to fit the patient’s ears specifically. Thus, an ITE aid can be quite comfortable and easy to insert for those with dexterity or vision issues. They can also be more discrete, depending on the size of the shell, if cosmetics are a concern. However, as they completely fill the ear canal, patients with better hearing in the low frequencies can feel “plugged up,” and experience difficulty adjusting to their own voice. ITEs can also be more fragile and are not a viable option for those with chronic middle ear issues.

The other style is one that has the hearing aid resting on top of the ear between the skull and pinna. Sound is delivered to the ear canal via either a thin wire, a receiver in the canal (RIC), or tubing and an earmold behind the ear (BTE). The degree of hearing loss may act as the determining factor on occasion, as those with a profound hearing loss would need the power a BTE aid provides. However, most patients should be able to use a RIC aid. A RIC aid is advantageous in that it does not fill the entire canal, providing for a more natural sound quality. They are also highly durable and easy to maintain. One feature exclusive to non-ITE aids is the option of a rechargeable battery. Disadvantages of this style are that it can be more difficult to put on and it can be more visible. The cost difference is usually negligible between ITE and non-ITE aids.

How Fancy Should They Be?

Once the style is chosen, the next decision is level of technology. As with any electronics, there is a range of how advanced hearing aids can be. Noise is going to be the most important factor in choosing a level. All levels of hearing aids produced by a given manufacturer will provide the same sound quality and amplify 360 degrees when in quiet. Thus, if the patient is elderly and spends the majority of waking hours watching TV, entry-level hearing aids will suffice.

Those who are younger and are in more challenging listening environments will derive more satisfaction from a fancier aid. First, there are going to be more programs and algorithms available for reducing background and wind noise. For example, a standard-level aid may have three programs designed to improve listening ability in noise and nothing to filter out wind. The advanced level may have five programs and an algorithm for wind, and premium even more. Second, the fancier a hearing aid becomes, the more automatic its function. All levels possess an automatic program that allows the hearing to analyze your environment and self-adjust. A fancier hearing aid will have more modes from which it can automatically choose. In essence, the artificial intelligence becomes more precise. Finally, higher-level hearing aids have more directionality. An entry-level aid will either amplify all around the patient or directly in front of them. But, what if the room is noisy and the talker is off to the right? More advanced hearing aids are able to focus on specific points around the body, with the number of points correlated with the level.

A hearing health provider can offer tailored guidance and answer questions about the minutiae. But the above can function as a primer for the start of the research process. Possessing a firm grasp of amplification needs and desires will help ensure the best possible outcome. QCBN

By Jeff Lane, Au. D.

Jeff Lane, Au.D., is doctor of audiology with a passion for improving the lives of others. He practices at Trinity Hearing Center, 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

 

Understanding the Effects of Noise Pollution

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Noise, or unwanted sound, is one of the most common environmental exposures in the United States. In 1981, the U.S. Environmental Protection Agency (EPA) estimated that nearly 100 million people in the United States (about 50% of the population) had annual exposures to traffic noise that were high enough to be harmful to health.

How Does the Body Respond to Noise?

Despite the widespread prevalence of noise exposure, noise has historically been treated differently from pollutants of a chemical or radiological nature, or even air pollution. In industrial studies and community studies, noise exposure is related to raised catecholamine secretion. Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction and stroke. Noise is a nonspecific stressor that activates the autonomous nervous system and endocrine signaling. Noise has been shown to increase anxiety and depression.

According to the National Institutes of Health, annoyance is the most prevalent community response in a population exposed to environmental noise. Noise annoyance to second hand noise can result in interference with daily activities, feelings, thoughts, sleep or rest, and may be accompanied by negative emotional responses, such as irritability, distress, exhaustion, fear and other stress-related symptoms. Severe annoyance has been associated with reduced well-being and health, and because of the high number of people affected, annoyance contributes substantially to the burden of disease from environmental noise. It is estimated that DALYs (disability adjusted life years) from environmental noise in the Western European countries are 61,000 years for ischemic heart disease, 45,000 years for cognitive impairment for children, 903,000 for sleep disturbance, 22,000 years for tinnitus and 587,000 for annoyance solely. As you can see, noise is not benign. It has become a growing concern for city administrators and government officials.

Average Noise Level that Causes Stress

Sound is measured in decibels (dB). According to the Centers for Disease Control and Prevention, a whisper is about 30 dB, normal conversation is about 60 dB, and a motorcycle engine running is about 95 dB. Noise above 70 dB over a prolonged period of time may start to damage your hearing. Loud noise above 120 dB can cause immediate harm to your ears. Some children’s toys produce enough sound to cause hearing loss. Vehicles with modified muffler systems will be above the 95dB volume, especially when revving the engine.

PDSD and Noise Exposure

Post-traumatic stress disorder (PTSD) is a disorder that results from the experience or witnessing of traumatic or life-threatening events. Anyone can get PTSD at any age. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters and many other traumatic events. Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also cause PTSD. According to the National Institute of Mental Health, about eight people out of every 100 people will experience PTSD at some point in their lives. Many of these people suffer from exaggerated startle syndrome, causing anxiety, fear or actions that appear to be extreme or irrational in response to hearing a loud sound.

Thoughts from a Neighbor

Recently, I had a discussion with a patient who was concerned with loud vehicles driving in the city limits. She wanted to know if it would cause her a hearing loss in addition to the stress it causes her. She has a dog that soils the carpet because it is afraid of the sound. She complained that the inconsiderate drivers go past countless people who are unable to cope with the sound. She worried about how the noise affects people who are ill in their home or in a nursing home or even someone suffering from a migraine headache. She postulated that loud vehicles bother people who are attempting to sleep during the day because they work the night shift. She said her entire community is exposed to excessive sound from one vehicle with a modified muffler.

My recommendation is a friendly discussion with the owner asking that person not to rev the engine while driving in the neighborhood. If the problem persists, contact the city and make a complaint about the excessive noise. Without input from community members, the city will not be aware of the extent of the problem.

Together we can work to reduce unwanted sound in our communities. Our joint focus can help educate and encourage people to be aware of and reduce the amount of noise they generate. QCBN

 

By Karon Lynn, Au.D.

 

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit TrinityHearing.net.

 

Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.

Understanding the Value of Baseline Hearing Tests

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People getting a hearing test are often asked if there has been a change in their hearing. Some want to know how much their hearing has diminished through the years. Others ask to have a comparison made from the test and ask if their hearing is likely to change significantly. These are important concerns; however, let’s look at a missing component.

Why Baseline Tests are Important

Hearing, as with any function of our body, will change or fluctuate through time. The bloodwork you had to monitor your insulin or thyroid function last year will not be suitable to use this year. The same goes with vision testing. You need a current vision examination to correctly order glasses. Hearing is no different. Hearing loss can gradually creep up on people and without proper, testing it may go untreated. A baseline hearing test gives the patient and audiologist a starting point or reference. This helps with short-term and long-term planning. The baseline hearing test is recommended before you start experiencing hearing difficulty so the audiologist can have a good grasp of how you functioned before noticing a decline in hearing.

 

Follow Up Testing

Once you have a through baseline hearing test, it is time to decide how often you want to have monitoring tests completed. Your audiologist will be able to make a recommendation. My recommendation is different depending on what the individual is experiencing. If someone has normal hearing and is not currently having difficulty hearing, I might recommend a hearing test every two to three years. If an individual is struggling to hear in some situations, I would recommend a hearing test once a year. Most insurance policies will pay for testing at least once a year. If someone has bouts of significant changes in hearing, I recommend they call and schedule a test while the hearing is acting up! We need to document what is going on while it occurs to better diagnose what or where the problem is.

Who Needs a Baseline Test?

Hearing testing can be completed on all age groups. A one-year-old or even a newborn can have a hearing test. We normally recommend a hearing test on children who are not speaking at the level expected for their age. Another time to request a hearing test would be if a child has chronic middle ear infections. Hearing is important to learn to speak and function within a family. Once a child enters school, the school will usually offer hearing screenings when children are in their elementary years. If a child does not pass a school screening, it is important that the parents follow the school’s recommendations for attention to the hearing. Once a child reaches high school, it is recommended that they have one test prior to leaving school. This would be the hearing test as the individual goes out into the world and will serve as the baseline for future testing. Adults can ask their primary care doctor to order a hearing test to safely store in their medical records should it be needed at a later time.

Why Would Hearing Change?

Traditionally, when a person gets a hearing test, he or she usually wants counsel on management strategies and hearing health. If the individual has not had a test in three or more years, it is difficult to offer a comparison of change in hearing and recommend long-term solutions. Hearing changes at different rates for every individual and the best person to compare your hearing against is you!

If you become ill and need strong medications, you may suffer a change in hearing. If you have whiplash or a head injury, you may notice a change in hearing. Head injuries may occur after falling off a horse, getting hit with a bat, slipping on ice or a motor vehicle accident, to name a few causes. Perhaps you fly somewhere and when you land your hearing is not as sharp and clear and it just doesn’t seem to recover. Hearing change may come after being exposed to a loud noise. It can happen as the result of attending a concert, going on a hunting trip or being near a child who is playfully blowing a horn. I have seen people who woke up one day and one of their ears was completely stopped up. The availability of a baseline hearing test will help your audiologist and physician determine the type and degree of change you suffered and offer the best management options. QCBN

 

By Karon Lynn, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit TrinityHearing.net.

 

Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.

Understanding Your Audiology Results

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The first step on any hearing health journey is undergoing an examination. This exam provides you and the audiologist an understanding of your current state of hearing and allows for proper recommendations to be made. The findings are presented in a report called an audiogram. An audiogram contains both a written section and a graph. While the audiologist does review the audiogram during the appointment, it can sometimes be difficult to remember or fully grasp how to interpret your results. Proper interpretation is imperative, as it empowers you to be an equal part in treatment.

Hearing Thresholds

Hearing thresholds are presented graphically on the audiogram. The x-axis of the graph (left to right) represents frequency. Frequency is interpreted by humans as pitch, with increasing frequency corresponding with increasing pitch. Pitch increases from left to right along the x-axis. Thus, the left half of the audiogram would represent bass, while the right half would be treble. An average exam will test frequencies between 250 and 8,000 Hz. While human hearing can detect frequencies above and below this range, these are the most important for daily communication.

The y-axis (top to bottom) represents intensity as measured in decibels hearing level (dB HL). On this scale, 0 dB HL does not represent the absence of sound, but rather the quietest sound that the average adult can hear. Intensity is interpreted by humans as loudness. A higher decibel level corresponds to a louder sound. Quiet sounds are at the top of the graph, while very loud sounds are at the bottom of the graph.

Your ears function both as combined and independent systems. As such, the audiologist will want to test the respective performance of each ear. The hearing thresholds for the right ear are represented by circles or triangles, while the left ear thresholds are Xs or squares. Hearing thresholds are the quietest sound you can hear at a given frequency. For example, the right ear threshold at 1k Hz may be 20 dB HL. This would mean that at that specific frequency, the right ear can hear the sound when it is 20 dB HL or louder, but not below that level. This will hold true for the threshold of each respective frequency. For normal hearing, 20 dB HL is considered to be the cut-off, with 21 dB HL and higher representing increasing degrees of hearing loss.

Speech Understanding

Another main component of a hearing exam is speech testing. Speech test results may be found in numerical form in a box typically located at the bottom of the page. Two main speech tests are typically performed. The first is the speech recognition threshold (SRT). It represents the quietest level at which you can understand speech 50% of the time. The SRT mainly functions as a way to verify accuracy within the test battery. A measurement which is more relevant to daily communication performance is the word recognition score (WRS). Your WRS represents how well your brain can interpret speech sounds and is reported as the percentage of words repeated correctly. When measuring the WRS, the words are presented at a loudness level that is easy for the patient to hear. A high WRS means you can understand words well, while a lower WRS means that the brain has difficulty interpreting the speech sound because of distortion in the auditory system.

Relationship Between Thresholds and Speech Understanding

One important concept to understand is that your hearing thresholds and ability to understand speech are not necessarily correlated. Better hearing thresholds do not always mean a better WRS, nor do worse thresholds always mean a worse WRS. Indeed, two individuals may have the exact same hearing thresholds, yet drastically different abilities to understand what is being said. What then, influences your WRS? It all has to do with the frequency filters in your ears. Each speech sound has a different fundamental frequency. Sounds like “shh” have a higher frequency than “oo” would. When sound is picked up by your ears, it is sent through specially designed filters to help separate out all the speech sounds. As more damage occurs to the auditory system, those filters become less precise and overlap with each other. Thus, “shh” and “oo” may appear to your brain to be coming from the same filter and it has difficulty distinguishing them.

While many factors are taken into account when deciding treatment, test results are a main one. By possessing a greater understanding of your results, you can feel confident in the decisions being made. QCBN

By Jeff Lane, Au. D.

Dr. Jeff Lane is an audiologist at Trinity Hearing Center, located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Strategies to Improve Communication

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One inevitable side effect of hearing loss is increased difficulty communicating with others. Specifically, the person with hearing loss will often not hear, or will misunderstand, what someone has said. Sometimes, the misunderstanding can be humorous. More often, though, it is frustrating and embarrassing. Some people with hearing loss will eventually began to retreat from social interactions, reducing quality of life. Hearing aids can be of great benefit in restoring these communication abilities. However, hearing aids alone are not a total solution. While astounding advancements have been made in the world of hearing aids in the past few years, they still have their limits, as with any technology. Use of effective communication strategies can greatly improve the benefit received from hearing aids. All of these strategies are simple to implement in daily life (although adjusting habits make take time).

Assertive vs. Passive or Aggressive

People with hearing loss often change their communication style over time. It is not done purposefully, but as a subconscious adjustment to the progressing loss. Many will become passive, allowing others to do the majority of the talking. On the other side of the coin, a smaller group will become aggressive, dominating the conversation (talking more means they have to rely less on their ears to lis-ten). Again, no blame should be dealt or guilt felt for adopting either of these styles, but neither is effective or sustainable. The goal should be an assertive approach to communication. Allow for a natural flow to occur, but do not be afraid to stick up for yourself. Ask someone to speak louder or slower if not understood, or to repeat if necessary. Choose the seat in a restaurant that will be most conducive to listening (more on this later). Although people with hearing loss often fear that they will annoy or inconvenience others, the literature states that others are very receptive when those with a hearing loss own it and are upfront about the topic.

Effective Communication Strategies

Distance: One of the best ways to improve understanding is simply to get closer. The Inverse Square Law states that for each doubling of distance the auditory signal is reduced by six decibels (dB). Thus, if a person’s voice is at 60 dB when standing three feet away, it will decrease to 53 dB at six feet and so on. The take away here is that talking to a person with hearing loss from across the room is ineffective as the signal will be much quieter by the time it actually reaches their ears (or hearing aids). This also means that there is more interference (other noise) between the listener and the talker, and that the interference may be louder to the person with hearing loss than the speech signal. If you want to talk, get close.

Vision: A person with hearing loss will often say that they are expert lip readers. While they may not be able to spy on your conversation from across the room, it is true that people with hearing loss rely heavily on visual cues. It allows their brain to expend less energy trying to understand. The talker should be in the same room and facing the listener, with good lighting and nothing obstructing their mouths (e.g. a hand or hands).

Noise: Understanding speech in noise is a difficult task for anybody. As noise cannot be erased from the world, minimizing its impact is the best outcome. At a party or restaurant, try to sit as far away from the source of the noise as possible. Do not choose a table at a restaurant that is in a corner or in the middle of the room, as these locations increase the echo. The person with hearing difficulty should choose a seat that places the majority of the noise behind them. This is especially important for those with hearing aids, as the aids will detect the extraneous noise and turnoff the rear microphone, only amplifying signals coming from the front.

Rephrasing: Everyone’s natural response to missed speech is to say, “What?” However, a more effective response would be to ask the person to rephrase or fill in missing information, like asking, “What time are we going to dinner on Tuesday?” This allows the listener to receive the needed information and acknowledges to the talker that they were heard.

While communication may never be perfect, implementing these strategies, along with hearing aid use, will greatly improve understanding and enjoyment. QCBN

By Jeff Lane, Au. D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Becoming Hearing Aid Savvy

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Hearing is something we often take for granted, until we have concerns. The following are some of the commonly asked questions that come up when individuals are considering hearing aids.
I think I need hearing aids, but how do I know what I should buy?
Your lifestyle determines the technology that would be the best for you. Those who are in group settings for church, meetings or family gatherings will need to purchase aids with more advanced technology than someone who is usually in quiet environments and only occasionally attends small meetings or gatherings. The ability of the hearing aid to switch from surround sound to directional sound is what helps you understand better in the presence of noise.
What technology is available?
There are a variety of bells and whistles available inside hearing aids: omni-directional microphones, directional microphones, automated feedback squelch, multiple tuning channels, sound recover of high frequencies, controls that allow the sound from one ear to transfer to the other, to name a few. You may want wireless connectivity for your cell phone, PDA or wireless laptop and the TV. There are even waterproof and water-resistant hearing aids for the active individual.
What features should I look for in a hearing aid?
Directional microphones will greatly reduce (not eliminate) background noise. Car noise, fan noise and other steady state noises are reduced. Unwanted speech noise from other people in the room is more difficult to eliminate because that sound is the same pitch you are trying to hear. Because of size restraints, you can’t zoom into speech like the huge directional microphones used to eavesdrop on the pro golfers talking to their caddies!
Wind block technology focuses on the sound wind makes flowing over a microphone and suppresses it.
Automatic feedback squelch is one of the most wonderful technologies. It is now uncommon to have hearing aids that whistle!
Multiple tuning channels will help the audiologist fine tune the aids to sound more comfortable.
Sound recover is a feature designed to take the energy from the high frequencies that you cannot hear and push them to frequencies you do hear. This helps with clarity of speech. There are microphones that will transfer wanted sound on one side to both ears so that you can hear better while walking with your friends or driving a car.
Bluetooth connection allows you to hear speech on the telephone in both ears while the phone is in the room rather than holding it up to your ear! This helps with clarity on the phone.
How are hearing aids priced?
Hearing aid features require enormous engineering to create a technology that is small, physically stable/dependable and able to reduce noise and expand and compress the desired sound before it enters the ear canal. The base price of the hearing aid is increased to cover the audiologist’s time for fitting and adjusting the device five or six times, educating the patient on the use and the ongoing care of the hearing aid. The audiologist can teach you how to pair the hearing aids to a phone and TV and help with troubleshooting if a problem arises. Fitting and caring for the hearing aid wearer is labor intensive. The price includes years of care of the devices. The warranty covers loss and damage, so the price of replacement and repair shipping fees are a factor. Appointments are made to keep the hearing aids clean and functioning, despite being housed in a warm, moist and wax-producing ear canal. Additional office visits may focus on counseling the family on the emotional and stress-related issues that arise when living with a hearing-impaired individual. The hearing aid is just part of the package that comes with the purchase price. The audiologist becomes part of your family’s hearing team.
What do I take with me to the appointment with my audiologist?
Write a list of the situations in which you have difficulty hearing. Ask the people you are most often around to do the same. When you compare the lists, you may see a significant difference in perception. The audiologist will be able to point out more situations to you so that you will have a good picture of when you have difficulty hearing. Many times, the family and friends of the hearing-impaired person will have as much relief from a hearing aid being used as the person wearing the hearing aid! Take a copy of any previous hearing tests with you to the appointment. Ask to have a trial with the hearing aids. As you use the devices and go back for adjustments, you will be able to make an educated decision about how much hearing aids are able to improve the quality of your life. QCBN

By Karon Lynn, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit TrinityHearing.net.

Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.

Exploring New Hearing Aid Technology

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A new technology in the hearing aid industry is remote adjustment to the hearing aid. This reduces the number of trips back to the office to have fine tuning completed. An appointment is made with your audiologist to be seen remotely at your house or office. It has been an interesting option to implement during the last few months. Most of the people I have contacted remotely are happy about the process, as they can stay in the comfort of their home or go to the environment causing difficulty and have the hearing aids adjusted by their audiologist while they listen.

Technologies Inside a Hearing Aid

We now have reliable rechargeable hearing aids. The battery life is designed to last a full day, between 18 and 30 hours. The difference in the length of battery life is based on the type of technology used in that hearing aid. A person using the Bluetooth circuit while streaming the phone or other Bluetooth enabled devices will drain the battery more quickly than someone who rarely talks on the phone. The battery is charged every night and is designed to last about six years.

Hearing aids are doing a better job of adjusting sound to make it more natural and realistic. The ability to change the way the hearing aid automatically modifies and enhances the sound in a place that has significant noise competition is now more successful. The two hearing aids are able to communicate with each other to focus on what you are looking at and diminish the input from other places in the room. This uses near-field magnetic induction (NFMI) and requires little power drain. Battery life is an important consideration for anyone wearing hearing aids. The two aids will change volume and programs together automatically or with the touch of a button. This near-field signal is a safe and effective means of changing the settings and using the specialized features that require two hearing aids.

Another circuit available in hearing aids is Bluetooth, which uses a band of radio frequencies around 2.4 GHz. Bluetooth technology works well to reduce the distance restriction of near-field technology but classic Bluetooth requires more energy than the NFMI. There are a few types of Bluetooth technologies on the market with different abilities. The type of Bluetooth in your car that streams your phone to the speakers requires significant power, which hearing aids are not able to accommodate (at this time). The Bluetooth circuit in a hearing aid is called Bluetooth low energy (BLE). The earlier versions of Bluetooth used in hearing aids needed a gateway device worn near or around the neck to send the signal to the hearing aids. Today, the gateway device is not needed!

After pairing the hearing aids to the device that you want to hear, e.g. phone, computer, car phone system or TV, you are able to hear the sound in both ears. As you listen to the signal through the hearing aids, you hear the sound with the proper frequency enhancement for your particular hearing loss. To talk on a Bluetooth phone, you do not need to hold the phone in your hand, you simply touch a button on the hearing aid and magically, you hear the voice in both ears! The other person hears your voice through a microphone inside your hearing aid. The phone can be sitting up to 30 feet away from you before the signal becomes weak.

The TV will need a transmitter to send the sound to your hearing aids. The device can be programmed to automatically connect to the TV sound when you walk into the room or you push a button on the hearing aid to hear the sound. This technology is nice because the other people in the room are able to set the volume where they want and the hearing aid user can listen at the volume he or she prefers.

Remote Microphone Use

Some environments are so noisy that even normal hearing people have difficulty understanding speech. If a hearing aid wearer is in this type of environment, often a remote microphone helps increase understanding of speech. The tiny hearing aid with its two microphone openings is just not able to make a voice louder that is six or more feet away from you. The remote microphone can be placed near the person you want to hear and it streams the sound back to the hearing aids.

As with any electronic device, change/improvement is a given. Don’t give up on hearing better, try out the new technology and decide if it improves your quality of life. QCBN

By Karon Lynn, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.

Understanding the Connection Between Sleep Apnea and Hearing Loss

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Sleep apnea is a common disorder and, according to the National Sleep Foundation, it affects about 18 million Americans. Most of us think of sleep apnea as snoring with periodic gasping or “snorting” noises. This seemingly innocent annoyance interrupts sleep and can cause excessive daytime fatigue and other symptoms such as generalized inflammation, cardiovascular and endocrine problems. It can also affect the way a person thinks and even hears.

More than half of individuals with sleep apnea are overweight and most snore heavily. Untreated sleep apnea can lead to a variety of other health issues, including high blood pressure, heart attack, stroke, diabetes and obesity. In addition to snoring and daytime sleepiness, symptoms of sleep apnea may include morning headaches, irritability, learning or memory problems, mood swings, dry throat upon waking in the morning and frequent urination at night.

Types of Apnea

There are two types of sleep apnea; obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea occurs when the airway collapses or becomes obstructed. This is the most common type of apnea. Central sleep apnea occurs when your brain doesn’t send the right signals to your breathing muscles. Central sleep apnea is more common in individuals with certain medical conditions, such as congestive heart failure and stroke or sleeping at high altitude.

How Does Sleep Apnea Affect the Hearing Organ?

The organs in the inner ear are dependent on a healthy supply of blood flow. Good circulation nourishes delicate hair cells in the hearing organ or cochlea. These hair cells do not regenerate or re-grow so any damage to this part of the inner ear results in sensorineural hearing loss, the most common type of permanent hearing loss.

Hearing health professionals know that circulatory issues can cause hearing loss. Research indicates that people with heart disease are 50% more likely to have hearing impairment. According to the American Diabetes Association, patients with diabetes are twice as likely to have hearing loss as those individuals who do not. Smokers are more likely to develop hearing loss because of the depleted oxygen levels in the inner ear. Untreated high blood pressure can also contribute to hearing loss and tinnitus, also known as ringing in the ears.

Why the connection with sleep apnea? Researchers think inflammation in blood vessels could be to blame, since the ear would be prone to that kind of damage. Sleep apnea causes major inflammation in the bloodstream and brain, which promotes vascular complications. People with sleep apnea have thicker blood and their blood clots more readily.

Sleep Apnea and Sudden Hearing Loss

The results published in Archives of Otolaryngology-Head & Neck Surgery showed that men who experienced sudden deafness were 48% more likely to have previously been diagnosed with sleep apnea. According to the researchers, this shows a clear link between the two disorders. The sudden hearing loss or deafness is typically in one ear and, if treated promptly, is regained in a period of two to three weeks.

Scientists do not yet understand the link between hearing loss and sleep problems. They have discovered that sleeping less – just over two nights – can harm blood vessel function. Your ears depend upon the blood that circulates in your body. The slowing of blood flow means fewer nutrients to the ear and this can lead to atrophy and destruction of the auditory hair cells. But this is a theory that has yet to be proven conclusively.

Treating Sleep Apnea

If you suspect you have sleep apnea, schedule an appointment with your physician. Before you go to the appointment, write down notes to help you remember when you think the sleeping issues started and how often you have difficulty sleeping. Mention any over-the-counter or prescription medications you may have tried to help your sleep quality. Discuss any lifestyle changes you may have already implemented that do not appear to help with sleep.

Your physician may recommend changes such as weight loss, smoking cessation, use of a continuous positive airway pressure (CPAP) machine or oral breathing devices to wear at night, medicine to help you stay awake during the day, and/or surgery to correct a blockage. This treatment will become a partnership of management between you and your physician. Ask to have your hearing tested even if you are not currently experiencing hearing difficulty. A baseline audiogram is important to help your physician monitor any changes in your hearing sensitivity over time. QCBN

By Karon Lynn

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Karon Lynn is a doctor of audiology with 30 years of experience working with hearing impaired individuals. Dr. Lynn may be reached at 928-522-0500 or at audio@trinityhearing.net.