1. During an appointment with your audiologist, expect a thorough assessment to determine the severity of your hearing loss and a detailed discussion about your lifestyle, hearing priorities, and budget to help determine what hearing aids are best for you.
2. Expect an adjustment period when you first begin to wear hearing aids. Hearing loss typically occurs over time, and it can take time for your brain to become accustomed to all the sounds you are now hearing again. The world is a very noisy place and you may notice sounds you didn’t realize you were missing such as your footsteps when walking, running water from the faucet & the quiet hum of the refrigerator. After wearing the hearing aids for a week or two, all of those ambient sounds will become less prominent to you. The more you wear hearing aids, the quicker you will adjust!
3. Expect them to “whistle” as you put them in your ears. Once they are in your ears, the whistling should stop.
4. Expect to take care of your hearing aids! The better care that is taken of them, the longer they will last. It is as simple as routine nightly cleaning. Wiping them down with a tissue every night will go a long way!
5. Expect a new technology to be developed every couple of years. You can speak with your audiologist to determine if new technology would be beneficial for you. Just as any other electronic device, they do not last forever and will eventually wear out.
Purchasing hearing aids is a big adjustment to your life but with these few pointers to get you started, you are on your way to better hearing!
Hearing loss can be a problem for the whole family, not just the individual. Below are a few strategies that can help with effective communication at home:
- Maintain eye contact : Face the speaker and maintain eye contact. Facial expressions and body language add vital information to communication
- Gain attention: Gain the listener’s attention before you begin talking. If the person with hearing loss hears better from one ear, move to that side of the person.
- Keep hands away from face: When talking, try to keep your hands a way from your face. You will produce clearer speech and allow the listener to make use of those visual cues.
- Speak naturally: Speak distinctly, but without exaggeration. You do not need to shout. Shouting may actually distort the words. Try not to mumble. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process what you are saying.
- Rephrase rather than repeat: If the listener has difficulty understanding something you said, find a different way of saying it. If he or she did not understand the words the first time, it’s likely he or she will not understand the words the second time.
- Converse away from background noise: Try to reduce background noise if possible. Turn off radio or television. Move to a quiet space away from the noise source. When going to a restaurant, ask for a table away from the kitchen, server stations, or large parties.
- Move to an area with good lighting: Sit where there is good lighting so that your face can be more easily seen. Avoid strong lighting coming from behind you, such as through a window.
Learning About Cochlear Implants
If you or a loved one has a severe hearing loss and have tried hearing aids without success you may be a candidate for a cochlear implant. A cochlear implant is an implantable device that works together with an externally worn processor to bypass the damaged portion of the inner ear to deliver sound to the brain. Due to damage to the organ of hearing, many people find that hearing aids simply amplify sound and do not provide clarity or understanding.
To learn more about cochlear implants and other implantable devices please join Jacksonville Hearing and Balance Institute as we partner with Cochlear Americas to host an Open House event on Wednesday, March 7th, 2018. Representatives from Cochlear Americas will be available from 8am-3pm to answer questions, discuss candidacy and show models of cochlear implants and other implantable devices. A cochlear implant audiologist from Jacksonville Hearing and Balance Institute will be available from 10-12pm and from 1-3pm to discuss the evaluation and follow up process.
Mark your calendars for this wonderful and informational event. Feel free to drop by at your convenience any time between 8am and 3pm.
Wednesday March, 7th 2018
Sheraton Jacksonville Hotel
10605 Deerwood Park Blvd
Jacksonville, Florida 32256
To register, or for more information, contact Ralyn Jelus at firstname.lastname@example.org or by telephone/text at (404)695-8612. We hope to see you there!
Hear for the Holidays
As the holidays draw near you may find yourself concerned with your ability to hear family and friends at holiday parties and gatherings. Many people often report that they can hear the conversation around them but can’t understand what people are saying or they state that people often mumble. This may be especially true in a crowded restaurant or room.
If this situation sounds familiar you may have a hearing loss in one or both ears. A type of hearing loss often seen in older adults is known as ‘presbycusis’. Presbycusis describes a pattern of hearing loss that manifests in the high pitch range. This means low pitched sounds (men’s voices etc) are easy to hear but high pitched sounds (women and childrens’ voices, birds, etc) are much more difficult to hear.
Speech is comprised of many different sounds and they all need to be heard well in order to understand conversation clearly. Low pitched speech sounds, such as vowels, bring the volume or the “power” to speech. High pitched sounds, such as consonants, provide the clarity to speech. In the case of presbycusis, an individual can hear the low pitched vowels but are unable to distinguish the high pitch consonants which results in being able to hear that someone is talking but not being able to understand what they are saying. In addition, listening in a noisy environment such as a party or crowded restaurant can be difficult, stressful and exhausting. The volume of the background noise often “washes over” the soft high pitched consonants making them even more difficult to hear. Also, when a hearing loss is present the brain has a harder time teasing out a speech signal from the unwanted background noise.
If you find yourself struggling to hear loves ones this holiday season call 904-399-0350 to schedule an appointment for a comprehensive hearing evaluation with an audiologist. You will be able to learn more about your hearing and the steps you can take to communicate more easily with friends and family.
WJCT Speaker Series
Jacksonville Hearing and Balance Institute (JHBI) is excited to partner with WJCT to host a speaker series this Friday, November 3rd, on hearing loss, cognition, and navigating the complicated world of hearing aids.
The event starts at 10:30am with an hour of free hearing screenings provided by two members of JHBI’s audiology staff. Hearing screenings are provided on a first come, first served basis so arrive early if you’re interested! Registration is open from 11:30am-12:00pm. The main speaking event, including a presentation and a question and answer session, will run from noon until 1:00pm. Complimentary lunch is provided.
Dr. Douglas Green Jr., the founder of JHBI and the practice’s neurotologist, will be speaking on the connection between hearing loss and cognitive decline. Dr. Kristen Edenfield, a clinical audiologist that has been with JHBI for over three years, will be discussing hearing aids as a treatment for hearing loss and how to navigate the world of amplification.
If you are interested in attending, please RSVP by November 1st at 5pm by calling 904-358-6322 or visiting wjct.org/jhbi.
A Brief History
The introduction of the jet engine aircraft in the late 1940s and early 1950s raised concerns about hazardous noise and was one of the most important occurrences to the subsequent development of hearing conservation programs (Nixon, 1998). No sound of the jet engine’s magnitude had ever been routinely experienced in the military or by civilians. In 1952, the Navy conducted a study to evaluate the effects of the jet engine noise on personnel aboard the aircraft carrier USS Coral Sea. The study verified the seriousness of the high-intensity noise problem. In response to the problem, the NAS-NRC Armed Services Committee on Hearing and Bioacoustics (CHABA) was established in 1952 (Nixon, 1998). It was their job to examine the areas of (a) effects and control of noise, (b) auditory discrimination, (c) speech communications, (d) fundamental mechanisms of hearing, and (e) auditory standards. CHABA members were at the forefront of hearing conservation program (HCP) development. They began sponsoring and publishing reports related to noise in the military. They went on to publish a Memorandum No. 2 on “Hearing Conservation Data and Procedures” in 1956. The Memorandum described components of a hearing conservation program and provided recommendations for their implementation.
In 1956, the Air Force was the first to establish a comprehensive hearing conservation program. The Regulation was revised in 1973. Both were model programs after which many organizations within and outside the government were created (Nixon, 1998). In 1978, the Department of Defense Instruction (DODI) 6055.3 was published and contained requirements that attempted to make all hearing conservation programs uniform across services. By 1980, the three branches (Air Force, Army, and Navy) had established hearing conservation programs in compliance with DODI (Nixon, 1998). In 1987, the DODI was revised. The most current DODI is 6055.12, and ensures that all services have a hearing conservation program implemented and these programs should include: a) sound measurements, b) engineering control measures, 3) noise labels in hazardous areas/on equipment, d) issuance of hearing protective devices, e) appropriate education to all personnel working around hazardous noises, f) routine audiometric testing which is to be stored in the Defense Occupational and Environmental Health Readiness System (DOEHRS), g) access to materials, h) record keeping through DOEHRS, and i) program performance evaluations (DOD, 2010).
NIHL in the Military
Northeast Florida is home to many military installations, including Naval Air Station Jacksonville, Naval Station Mayport, Kings Bay Naval Base, Camp Blanding Joint Training Center, Naval Aviation Depot Jacksonville, and Marine Corps Blount Island Command, which together provide employment to more than 50,000 active duty, reserve, and civilian men and women. As of 2011, there were 2,226,883 military members in the United States serving (including active duty, National Guard, Air National Guard, and reserves). Within the military population, an estimated 60% of veterans returning home from war have a hearing loss (CDC, 2013). Disabilities of the auditory system, including hearing loss and tinnitus, are the third most common injury experienced by veterans (Helfer, Canham-Chervak, Canada, & Mitchener, 2010). As far back as World War II, handguns, rifles, artillery rockets, ships, aircraft carriers, vehicles, communications devices, and many more, have been sources of potentially damaging noise levels (Humes et al., 2006, p. 201). Hearing is critical to the performance of military personnel, and noise-induced hearing loss (NIHL) is a severe impairment that can potentially reduce military effectiveness.
Several studies have been conducted to document reports of military hearing loss and tinnitus and effects due to noise. Results from a study conducted in 2010 using data between 2003-2005, found that a total number of 88,285 hearing impairment and noise-induced hearing related injuries (NIHI) were documented—unspecified hearing loss, tinnitus, perforations of tympanic membrane, acoustic trauma, impairment of auditory discrimination, etc. (Helfer et al., 2010). Overall, NIHI visits were reported for 9.6 per 1000 personnel.
How Does NIHL Occur? How Can It Be Prevented?
Loud noises destroy the ear’s special cells, called “hair cells.” They lie within the sensory organ of the ear, called “the cochlea”. The cochlea cannot regrow new hair cells. Once they have become permanently damaged, they are no longer a useful part of the cochlea. Hair cells are important because they help translate sound into a signal the brain interprets, or “hears.” The hair cells can be damaged significantly by a single impulse sound — gunfire, for example, or by prolonged noise exposure at levels that are harmful to healthy hair cells (greater than 85 dB).
Prevention is key in helping to reduce the number of military members and veterans with NIHL. Hearing conservation programs are a step in the right direction. Hearing protection devices, such as passive and active earplugs and earmuffs will also aid in prevention when used properly. Engineering controls to help reduce excessive noise levels should also be implemented. Most importantly, education about the dangers of hazardous noise levels is paramount to further reducing the incidence of NIHL in military members and veterans. Over the past several years, all branches of the military have been making strides towards better education about hearing loss and taking steps towards providing the best hearing protection for soldiers.
For the general population, three strategies you can use for prevention are: 1) walk away- at further distances, dangerous noise levels are not as harmful to your ears, 2) turn it down- if you have the ability, make sure you are listening to things at safe levels, reference the dB level above, and 3) protect your ears- always have a pair of earplugs or muffs on hand when you go to concerts, loud sporting events, hit the shooting range, etc. And just remember, currently, there is no cure for hearing loss, so try to protect the healthy hair cells you have!
DoD. 2010. Department of Defense Instruction 6055.12: DoD Hearing Conservation Program. Washington, DC: Department of Defense
Helfer, T. M., Canham-Chervak, M., Canada, S., & Mitchener, T. A. (2010). Epidemiology of hearing impairment and noise-induced hearing injury among U.S. military personnel, 2003-2005. American Journal of Preventative Medicines, 38(1S), S71-S77. doi: 10.1016/j.amepre.2009.10.025
Humes, L. E., Joellenbeck, L. M., & Durch, J. S. (2006) Noise and military service: Implications for hearing loss and tinnitus. Washington, DC: National Academies Press
Nixon, C.W. (1998). A glimpse of history: The origin of hearing conservation was in the military? Wright-Patterson Air Force Base, OH: U.S. Air Force Research Laboratory
The Benefits of Binaural Listening
The question regarding whether to purchase one or two hearing aids is an important topic to address with your audiologist during a hearing aid consultation. Hearing aids are an investment in your hearing health that can contribute to improved communication with family and friends and lead to better quality of life. Hearing aids are also a financial investment and it makes sense that many people want to weigh the benefits versus the cost.
In some cases one hearing aid truly is the best option. For example, a person may have a hearing loss in only one ear and normal hearing in the other ear. Another example is a person who has very little useful hearing in one ear; in this case a hearing aid may not provide any benefit at all and a cochlear implant may be the better option. In most other cases if both ears have a hearing loss then two hearing aids are better than one.
Binaural hearing is the term used to refer to hearing with two ears (whether with two normal hearing ears or with two hearing aids). Bimodal hearing applies to people who wear a hearing aid on one side and a cochlear implant on the other ear. Studies have shown that binaural/ bimodal hearing have many benefits and leads to improved communication ability.
Detecting Location of Sound
The ability to detect where sounds are coming from is called “localization” and is a function of the brain that is dependent upon sound being heard well by both ears. The brain uses timing and loudness cues to determine which ear received the sound first and at which ear the sound was louder in order to determine where the sound is located. The brain is unable to detect the location of sound accurately with only one (amplified) ear.
Understanding in Noise
When sound reaches the ears, the signal travels to the inner ear and is then transferred to the hearing never. It then travels up the brainstem to the hearing centers of the brain. The brain analyzes and combines the sound heard from both ears to help “tease out” the speech signal from the unwanted background noise. If the brain only receives sound from one amplified ear it has much more difficulty separating speech from noise.
When sounds are received by both ears the signal travels through multiple pathways in the brainstem. This double input of information to the brain creates a boost in the volume of the speech signal making it easier to hear. This boost or summation of volume does not occur with one ear.
Studies have shown that when the brain listens with two ears, less effort is needed to hear and understand speech which helps to reduce fatigue.
For more information about the benefits of listening with two ears or about bimodal benefit for cochlear implant users call Jacksonville Hearing and Balance Institute at 904-399-0350 to set up a hearing aid consultation.
The Phonak Belong Platform: An Overview
Last week Phonak launched their ‘Made for All’ direct connect hearing aid, the Audeo B-Direct. Using a new proprietary 2.4 GHz radio chip these devices allow users to stream phone calls directly to any cell phone with Bluetooth without an intermediary device. Current technology from other hearing aid manufacturers allows only users of an Apple phone the ability to stream phone calls. The Made for All technology will allow Android, iOS or other Bluetooth cell phone users access to hands-free phone use. By utilizing built-in microphones as a voice pick-up feature, the Audeo B-Direct is able to function like a wireless Bluetooth headset. Once a phone call is received by the user, they are able to answer calls with a push of a button on the hearing aid. At this time, streaming of the phone call is only heard on the user’s preferred side, not to both devices. Patients will also have the ability to balance environment noise when background noise is present by either using the volume control on their phone or directly on their hearing aids. Using a streaming protocol called AirstreamTM Technology, the new TV Connecter from Phonak offers a “plug and play” solution that turns Audeo B-Direct hearing aids into wireless TV headphones. This device allows users to stream content from their TV without having to wear a body-worn streamer and is capable of streaming to multiple hearing aid wearers at the same time.
Virto B Biometric Calibration:
Another recent launch from Phonak is the use of Biometric Calibration in Virto B custom hearing aids. Using 3-D modeling software 1,600 biometric data points are identified from an earmold impression and are used to calculate calibration settings that are unique to each user. This technology allows individual ear anatomy and its effects on the acoustics of the incoming sound to be accounted for which provides a 2dB improvement in directionality. Another available option is the Virto B- Titanium invisible in the ear (IIC) option, which is made from medical grade titanium. Titanium is stronger and thinner than acrylic, allowing for significantly reduced device size.
Audeo B-R and Bolero-PR Rechargeable Options:
Phonak continues to offer a built-in rechargeable device option (Audeo B-R and Bolero B-PR). With a single charge, the device is powered for up to 24 hours. Smart charging options are also available, which allow on the go users to charge from anywhere, without having to worry about running out of power.
If you or someone you love is noticing hearing difficulties and would like to discuss hearing aid options, contact The Hearing Center at JHBI at (904) 399-0350 ext 246 to schedule an appointment to speak with an Audiologist about your options!
Hearing Loss and Communicating with Family
If you have hearing loss, you have probably noticed that your difficulty hearing is not just a problem for you, but for your whole family. When families have trouble communicating, they often report a decrease in perceived intimacy and an increase in conflict. This is because for most people, verbal communication is how we connect. When you cannot hear your friends and family, it becomes difficult to participate in a lot of things, from milestone events to nightly dinners. As the person with hearing loss, you are certain to feel this isolation and usually your family feels the disconnect as well. Even if you use hearing aids, there may still be some situations you cannot communicate well in depending on the severity of your hearing loss.
The first step to bridging the gap created by a hearing loss is simply to start the conversation on why you might not be participating the way you used to. Many times, people with hearing loss are assumed to be rude or dismissive because they are not responding in the expected way. Explain to your family that you are having trouble hearing them and go into detail about what situations make it worse. If you have extra difficulty understanding your spouse when he or she talks from another room, be very clear that this is not a situation you can succeed it. Explain to your children or grandchildren that they need to turn the television off when you are having a conversation so that you can hear them. Pinpoint situations that you really struggle in and work to tackle one at a time. Be patient with yourself and your family though – it may take a few reminders for them to break long standing habits.
Another good step is bringing your family or close friends to your audiologist appointments with you. Your hearing healthcare provider can explain your hearing loss and the limitations you might continue to have, even with hearing aids. Sometimes, it’s helpful for a third party to remind your family of the things they can do to help you succeed in hearing with as little frustration as possible. Your audiologist is there to help you as well as those closest to you in every aspect of your hearing loss journey so be sure to utilize them as a resource.
The Link Between Hearing Loss and Cognitive Decline
Recently, the Hearing Center at Jacksonville Hearing and Balance Institute partnered with Phonak (a major hearing aid company) to give a presentation to the community regarding the connection between hearing loss and cognitive decline in older adults. Unfortunately, it filled up too quickly for us to accommodate everyone who wanted to attend. Just in case you missed it, here are some of the highlights from the presentation:
The study in question was conducted by Frank Lin, Ph.D. and his colleagues at Johns Hopkins University using information gathered from older adults over a period of decades. The researchers found that those individuals with untreated hearing loss (whether it was mild, moderate, severe, or profound) were significantly more likely to experience cognitive impairments than their normal hearing peers.
But just how are hearing loss and cognitive impairment connected? As Dr. Lin reports, “Your inner ear has to take in a complex sound and convert it into a signal that goes into the brain. When we say that people have hearing loss, it means the inner ear is no longer as good at encoding those signals with accuracy and fidelity. So the brain gets a very garbled message — you can hear what’s being said but you can’t quite make it out. It takes a little more effort to hear what that person said. As a result, the brain has to re-dedicate sources to help with hearing and sound processing. That comes at the loss of something else.” Dr. Lin also notes that, “As we develop hearing loss, we withdraw socially. You’re less likely to go out and you may be less likely to be engaged in conversation.”
While more research needs to be completed regarding the link between hearing loss, social isolation, and cognitive decline, these early results certainly emphasize the importance of hearing heath on one’s overall health. Unfortunately, up to two-thirds of adults with hearing loss remain untreated. Here at JHBI, we hope that by increasing awareness about this topic, we can identify hearing impairments and possible intervention strategies earlier rather than later.
Lin, F. R., et al. (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine(4), 173, 293-293. doi:10.1001/jamainternmed.2013.1868