Anne Taylor is a bilateral cochlear implant user, a Gallaudet Certified Peer Mentor for the Hard of Hearing. She is President of the Hearing Loss Association of America – Sarasota/Manatee Chapter and writes a monthly column. Here is last month’s column
January and February 2019
Causes of Hearing Loss
Do you ever think about how much hearing enhances your life in so many ways?
- How about listening to music, going to the movies and plays?
- How about relationships with family?
- How about your job?
- How about safety? Smoke alarms warn you about a possible fire. Emergency vehicles switch on the sirens to warn you of their approach.
Difficulty hearing affects all aspects of life. According to Hearing Loss Association of America, approximately 48 million Americans have some level of hearing loss, with only 20% doing anything about it. In Sarasota/Manatee counties alone, there are approximately 160,000 people with hearing loss.
Hearing loss in not always age-related. Some of our soldiers are coming home from the wars with many life-changing injuries. Many of them say that the most challenging injury is hearing loss (most often caused by excess noise). About 2 to 3 out of every 1,000 babies in the United States are born with a detectable level of hearing loss in one or both ears. More than 90% of deaf or hard of hearing children are born with hearing loss in one or both ears.
Personally, I lost most of my hearing at five years old. I contracted mumps and had a tonsillectomy a few months later. My ears became infected and medication was used. Very likely, my inner ear was damaged, causing hearing loss.
It may be helpful to understand the causes of hearing loss by knowing how you hear.
How You Hear
According to Hearinglink, there are three parts to the ear – the outer ear, the middle ear and the inner ear–
- Outer ear consists of the pinna, ear canal and eardrum
- Middle ear consists of the ossicles (malleus, incus, stapes) and eardrum
- Inner ear consists of the cochlea, the auditory (hearing) nerve and the brain. The inner ear is also called the cochlea. ‘Cochlea’ means snail in Latin and gets its name from its distinctive coiled up shape.
Sound waves enter the ear canal and make the eardrum vibrate. This action moves the small chain of bones (the ossicles – malleus, inca, stapes) in the middle ear. The last bone in this chain knocks on the membrane window of the cochlea and makes the fluid in the cochlea move. The fluid movement then triggers a response in the hearing nerve. Thousands of tiny hairs (cilia) are attached to the nerve cells in the cochlea. These hairs help translate sound vibrations into electrical signals that are transmitted to your brain. This is how you distinguish different sounds.
Causes of Hearing Loss
- Damage to the Inner Ear – disease, aging (presbycusis), exposure to loud noise, head trauma, otosclerosis (a hereditary disorder in which a bony growth forms around a small bone in the middle ear),fluid in the middle ear, allergies and malformation of outer ear, ear canal or middle ear structures may damage the hair cells in the cochlea. The hearing mechanism is sensitive, delicate and easily damaged. When these hair cells are damaged, the electrical signals are not transmitted properly – resulting in hearing loss. It becomes more difficult for you to hear high-pitched sounds (ie. bird whistles, children’s voices). It may become more challenging to hear in noisy atmospheres. This is called sensorineural hearing loss and is permanent. It cannot be cured but may be helped by hearing aids, cochlear implants and/or assistive listening devices.
- Build-up of wax, or a foreign object in the ear can cause hearing loss. This hearing loss is called conductive hearing loss and hearing can very often be restored by having an ear, nose and throat doctor remove the blockage. It is not a good idea to try to remove blockages yourself with a q-tip. Q-tips can push the wax further down and/or cause the ear drum to rupture (tympanic membrane perforation). Infection, loud blasts of noise and sudden changes in pressure can also cause your ear drum to rupture.
- Infection and abnormal bone growths or tumors in the outer or middle ear can also contribute to hearing loss.
- Untreated diabetes can cause hearing loss due to the inner ear depending on healthy blood flow. A study performed in 2008 by the National Institute of Health reported people with diabetes are twice as likely to experience hearing loss as non-diabetics.
- Some drugs come with severe side effects. According to Healthy Hearing, ototoxic drugs can damage the hearing mechanism (oto is the prefix for hearing sound and toxic means harmful). Some of the heavy-duty antibiotics are ototoxic. Be sure to check with your doctor if multiple drug combinations taken together cause hearing loss. You may be surprised to know that excessive amounts of aspirin can cause hearing loss.
- Smoking restricts blood flow. The cochlea requires a good oxygenated blood flow and over time damage occurs. Your cigarettes may be contributing to hearing loss.
- Sickle Cell Anemia patients experience fatigue, joint pain, hearing loss because the red blood cells are misshapen – curved like a sickle. This restricts the blood flow to the ears as well as other parts of the body. Again, the cochlea needs a good oxygenated blood flow.
Ways to Prevent Hearing Loss
In some cases (such as infection, abnormal bone growth, tumors, aging, or sickle cell anemia), it is challenging to prevent hearing loss. You follow the doctor’s advice and take care of your health issues as best you can.
However, in many other cases, it is possible to protect your hearing.
Reduce excess noise
Workplaces can be excessively noisy. Most manufacturers producing excessive noise are monitored by the Occupational Safety and Health Administration (OSHA) and will require you to wear ear protection. Wear those ear plugs or noise cancellation devices. They will help you to hold on to your hearing a bit longer.
MP3 Players and iPods can pour excessive amounts of noise into the ear. Hearing loss can be caused by long-term exposure to loud noise. When you put on your music, think about turning it down a bit and you can listen longer.
Driving open-top cars with the windows down and listening to music is great now, but it can lead to hearing loss down the road. The decibel level can exceed 90 and can damage the ears (60 decibels is about the range for conversation. 110 decibels for a rock concert and up to 180 for a rocket launch)
Take care of your general health
- If you smoke, think about how cigarettes may affect your hearing in the long run, as well as your lungs.
- If you need to take medications, talk to your doctor about possible combinations which may put your hearing at risk.
- Follow your doctor’s advice for optimal health.
By making a few changes now, you may help yourself hear longer, and continue to enjoy a good quality of life well into old age.
Here’s to Healthy Happy Hearing!
Hearing Loss Association of America
November and December 2019
Local Cinema Hopes to Obtain Captions for the Deaf/Hard of Hearing
I stopped by the B & B Cinema in Venice the other day to check on its promise to provide Closed Captioning (CC) or Open Captioning (OC) for the deaf/hard of hearing. I spoke to a couple of employees who said captions will be available soon – possibly within the next three months.
A few years ago, it was such a thrill for me to be able to take my grandchildren to the movies for the first time. We went to see “Planes” (an animated movie about a crop-dusting plane with a fear of heights live its dream of competing in a famous around-the-world aerial race). As you know, it is very challenging trying to read lips on animated characters – err, in this case, the lips of planes! What was usually just noise for me became actual words by wearing the closed caption glasses.
As far as I understand, all Regal movie theaters in the country carry them. After purchasing your ticket, go to the service desk and ask for the closed caption glasses. They are FREE with your ticket and are programmed to the movie you wish to see. Bright green captioning appears to float on the screen when your chosen movie begins. So, no need to be concerned they are not working during the previews.
Occasionally, movie theaters show a movie with OC – meaning that the text is there for everyone to see. Open captions are an inexpensive easy way to provide captioning for persons with hearing loss. I am told that OC is already there on most movies. Pressing a button is all it takes to activate it.
Many Regal and AMC theaters offer an alternative captioning device called the Captiview (CV), as well as the Sony captioned glasses. The CV system consists of an OLED (organic light-emitting diode display) on a bendable support arm which fits into the cup holder. The captioning displays on a mini screen attached to the arm of the device.
Rear Window Captioning (RWC) is another option. The movie goer picks up a reflective plastic panel mounted on a flexible stalk which sits in the cup holder. A large LED display is mounted on a rear wall that displays the captions in mirror image.
While captioning is a savior for persons with hearing loss, there are some downsides.
The glasses are heavy and after a two-hour movie, they leave dents in the nose. Personally, I do not mind the dents – a small price to pay to understand the movie.
The CaptiView does not always stay upright for the length of the movie. The bendable arm falls over. CaptiView sometimes has a missing third line causing the viewer to miss some dialogue.
The RWC captions need readjusting each time someone walks by the reflector.
The glasses, CaptiView and the RWC are for one person use at a time and are expensive. The movie goer really cannot move too much as the captions on the glasses tilt. Also, captions may disappear on CaptiView and RWC if the bendable arm is moved when reaching for a drink or eating popcorn. Not very relaxing to say the least. There is sometimes a problem with batteries and the wrong movie being programmed into the device. The movie goer must go back to the lobby, explain the problem and get it fixed – all the while missing the movie.
The OC is definitely the favorite for people with hearing loss – it is already available on the movie file, efficient and less expensive than the captioning devices. So, why do movie theaters choose to not use OC frequently? The answer – because some folks are distracted by the captions.
After many years of not being able to enjoy movies on the big screen, I and many friends work around the problems of the captioning devices and are happy to “hear”. Also, we make a point of letting the staff know how much we appreciate their support of persons with hearing loss in the community.
I’ll be first in line when the B & B Theater in Venice gets the CC or OC. Won’t you join me?
September and October 2019
Hearing Loss Can Be Frustrating, says HLAA Board Member
I recently talked with Lakewood Ranch Attorney Richard Williams, a member of the Board of the Hearing Loss Association of America – Sarasota/Manatee Chapter, the Florida Bar, and the Deaf and Hard of Hearing Bar Association, regarding his experience living with hearing loss.
Anne: Richard, tell me about the frustrations of hearing loss.
Richard: Frustrations are part of daily life. Those of us with hearing loss can add a few more than folks who hear. There are three annoyances that affect me and other people with hearing loss.
I have the most common hearing loss, sensorineural, which cannot be fixed. There are many devices which help folks with hearing problems continue to live an active lifestyle and remain involved. We must understand that hearing aids are not like eyeglasses. We do not put them on and get 20/20 hearing. There is no magic correction – it is difficult to process sound even when made louder.
Anne: So, sometimes loud makes our problem worse?
Richard: Yes, indeed. The hearing loss has affected the brain’s ability to process sound, which affects a person’s ability to understand speech.
Anne: Tell me about your frustrations with hearing loss.
Richard: One annoyance is the phrase, “Oh, Never Mind”. As a person with hearing loss who needs near perfect listening conditions, my conversations with others are punctuated with “what”, “huh”, “please repeat”, “pardon me” and my stare of failure to understand.
Having to ask for the question to be repeated is something I do not enjoy doing. Generally, if I ask for a repetition once, it is given courteously. Ask twice and it’s repeated with concern. Ask three times and I sometimes get the eye roll and “Never mind, it’s not important.” Unfortunately, I and others with hearing loss just start doing the bluff, nod-and-smile.
Anne: Yes, all of us with hearing loss are guilty of bluffing. It is embarrassing to ask three times. What should we do?
Richard: I should say, “Please, do not say that to me. If you made the comment once, it was worth repeating”. I rarely push that response, unfortunately.
Anne: That is understandable, but we need to say if it was important for you to say it, then it’s important for me to hear it. What else bothers you?
Richard: The second peeve is restaurant or sports bar music blasting from the overhead speakers. There must be a study that is presented at restaurant seminars that music creates ambiance and turns over the tables quicker. When we go out, my better half and I make it a point to request a booth in a far corner.
I often ask the manager to turn down the overhead music with a variance of results. I was embarrassed one time after making the request – there was a live band in the next room, not overhead music. Sometimes after asking for captions on the TV, I’m branded as trouble from the get-go.
Anne: Oh, sometimes it is challenging to figure out if the music is live or canned.
Richard: A recent newspaper article from the Washington Post stated, “Hard-of-hearing diners report a vast range of responses when they seek softer music or quieter seating. Sometimes the music is turned down or off, and sometimes it isn’t. Sometimes it is even turned up. Maybe the volume is declared unchangeable, set by corporate overseers. Or there’s no available seating far from the clattering kitchen, the droning ventilation, or the hearty partyers.” (Fn1)
My “hearing” friends commiserate as they also find it difficult to converse in a restaurant with overhead noise. I know that my friends with hearing loss just avoid them. It would be wonderful if some establishments would install more noise baffling and advertise quiet dining.
Anne: I am often the only one who understands the waiter as I am an expert lipreader. I became deaf when I was five years old and lipreading was automatic. For folks who are late-deafened, it is usually challenging, if impossible, to read lips.
What else frustrates you?
Richard: My third annoyance in the hearing loss category is the failure of the medical community to effectively recognize and deal with patients who have hearing loss. One-third of people over 60 have hearing loss. There are 150,000 people with hearing loss in our two-county area. One shortcoming of the medical profession is the failure to address that fact. It is likely in some practices that a majority of their patients are over 60. I must announce to the nurse, who leads the way down the hall while talking, that I have hearing loss and cannot hear or understand. I get weary of asking the doctor to repeat, speak slowly or to write down specific instructions.
Anne: During my hospital stay recently, I decided to confess to having hearing loss. I was promptly ignored as the staff asked my husband questions about me and my health. They seemed to think I had lost my IQ, not my hearing.
Richard: My family physician group was in the process of building a new medical office for their six doctors and staff. I brought in “hearing loop” brochures and discussed the advantages and economics of making a least one patient room a looped facility. The hearing loop installation did not happen. They installed a beautiful fish tank in the lobby but could not spend the $800 or $900 to install a hearing loop system.
Anne: That is very disappointing.
Richard: I recently had a bronchial thing that would not go away and went to the local hospital 24-hour outpatient office to get some antibiotics. Both the receptionist and the intake nurse had surgical masks on. I rely on lipreading more than I think and just could not have a conversation with either one. The nurse was extremely frustrated and treated me with an attitude. I always explain my hearing difficulties to medical personnel and find a variety of reactions, including speaking loudly (just more distortion) or just not talking. I don’t think addressing an older person with hearing difficulties is novel. They all need some training on speaking to hard of hearing folks.
Anne: Certainly, there is a need for training to deal with people with hearing loss. As you say, one third of folks over 60 have hearing loss. Most of us folks with hearing problems do hate those surgical masks. There is a mask out now which has a transparent window over the mouth. Hopefully, hospital employees and dentists will realize how helpful these are to folks who have trouble hearing.
Richard: Another medical visit annoyance is the waiting room.
Anne: Oh, I know. You sit on the edge of your seat and hope you will hear your name.
I have often got up only to be told to sit and wait my turn. Sigh.
Richard: I must choose a seat near the door in order to maybe hear my name called. Sometimes there are two doors. I keep my eye on the door to attempt to hear the name. Flashed numbers or electronic signage would really help.
Anne: My mother’s doctor’s office does have monitors which flash the patient’s name and the number of the doctor’s room.
Richard: One more. My wife has been accompanying me to medical visits as I have gone through some more serious health issues lately, including tests and treatments that require anesthesia or other limiting procedures. When speaking to the doctor or nurse, they address the hearing person, my spouse, rather than me. Sorry, I may have hearing limitations, but I am not stupid. I have specifically answered questions directed to her, as I am the patient and want to make that clear. The inquiry must be directed to me. I can go easy on self-advocating in many situations, but when my health is on the line, I do not compromise.
Anne: I hear you, Richard.
Fn1 – Cohen, Joyce, (2019, June 17) Restaurants-Discrimination, Washington Post
You do not need to face hearing loss alone. Please contact your local chapter of Hearing Loss Association of America where you will find education, information, support and advocacy from members and peer mentors. For more information regarding the HLAA Sarasota/Manatee chapter, please go to hlas.org or call 941 244 0452.