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Occupational and Routine Life Hearing Loss

Posted on July 10, 2013 at 10:15 PM Comments comments (106)
Occupational and Routine Life Hearing Loss (Pt 1 of 4)
PREVENTING NOISE-INDUCED HEARING LOSS

If you’re exposed to hazardous noise on the job, your employer may already be providing annual hearing tests to identify any change in hearing that might indicate under-protection from the noise. Occupations particularly at risk for hearing loss due to exposure to noise are as follows:

Firefighters
Police officers
Factory workers
Miners
Farmers
Construction workers
Military personnel
Heavy industry workers
Musicians
Entertainment industry professionals
Office staff in crowded buildings
Lumberjacks
Landscapers
Heavy equipment operators 
Hunters
Motorcycle or car enthusiasts 

If you are aware of some of the symptoms of Noise Induced Hearing Loss (NIHL) (like ringing ears or muffled speech), seek a hearing test from a qualified hearing health professional. Although noise exposures are hazardous, other medical causes for hearing loss should be ruled out by a qualified health care provider, using data from your hearing test and your history.

Be alert to hazardous noise. Since prevention is so critical, make sure that your family (especially children), friends, and colleagues are aware of the hazards of noise. Although animal research with drug therapies and the physiology of the hearing system may eventually lead to the development of treatment strategies to reduce NIHL, the most fundamental recommendation is to utilize hearing protection while in noisy environments.

Various media articles tell us about teenagers losing their hearing at ear-splitting rock concerts, soldiers developing hearing loss from artillery fire, and people going deaf after an explosion. It also happens on the job when workers are exposed to less intense but sustained noise over time. Construction workers seem especially affected because they often work around noisy vehicles and power equipment.

This modern world of ours has certainly turned into a noisy place. Namely, today, we have noise everywhere. From car alarms and cars themselves filling the streets with different sounds, over leaf blowers and other household machinery humming, buzzing, clapping and working loudly day after day, to traffic, construction works and other sources of noise, we are surrounded by a cacophony of countless mechanical instruments. 


Some people would think that this is solely the case with big cities. However, nowadays, noise has taken over farms too, due to the presence of loud machinery and many other such devices.







Our ears are amazing! We can hear a wide range of pitches from the squeak of a mouse to the low roar of a waterfall. We can hear over a loudness range from a pin dropping to the same roaring waterfall or a jet engine. But our ears do have their limits. Excessive noise can cause damage to the nerves in the inner ear. Our ears can recover from a short exposure to loud noise, but being around too much noise over an extended period of time will eventually cause nerve damage and hearing loss. The louder the noise and longer the exposure, the greater chance permanent damage will occur. A really loud noise, such as a gunshot, can cause immediate hearing loss, but that does not happen too often on the job.  Continued exposure to workplace noise over a number of years often lead to loss of hearing and damage.
 
Of the roughly 40 million Americans suffering from hearing loss, 10 million can be attributed to NIHL. NIHL can be caused by a one-time exposure to loud sound as well as by repeated exposure to sounds at various loudness levels over an extended period of time. Damage happens to the microscopic hair cells found inside the cochlea. These cells respond to mechanical sound vibrations by sending an electrical signal to the auditory nerve. Different groups of hair cells are responsible for different frequencies (rate of vibrations). The healthy human ear can hear frequencies ranging from 20Hz to 20,000 Hz. Over time, the hair cell’s hair-like stereocilia may get damaged or broken. If enough of them are damaged, hearing loss results. The high frequency area of the cochlea is often damaged by loud sound.
 
Sound pressure is measured in decibels (dB). Like a temperature scale, the decibel scale goes below zero. The average person can hear sounds down to about 0 dB, the level of rustling leaves. Some people with very good hearing can hear sounds down to -15 dB. If a sound reaches 85 dB or stronger, it can cause permanent damage to your hearing. The amount of time you listen to a sound affects how much damage it will cause. The quieter the sound, the longer you can listen to it safely. If the sound is very quiet, it will not cause damage even if you listen to it for a very long time; however, exposure to some common sounds can cause permanent damage. With extended exposure, noises that reach a decibel level of 85 can cause permanent damage to the hair cells in the inner ear, leading to hearing loss. Many common sounds may be louder than you think…
 
A typical conversation occurs at 60 dB – not loud enough to cause damage.
A bulldozer that is idling (note that this is idling, not actively bulldozing) is loud enough at 85 dB that it can cause permanent damage after only 1 work day (8 hours).

When listening to a personal music system with stock earphones at a maximum volume, the sound generated can reach a level of over 100 dBA, loud enough to begin causing permanent damage after just 15 minutes per day!

A clap of thunder from a nearby storm (120 dB) or a gunshot (140-190 dB, depending on weapon), can both cause immediate damage.

In fact, noise is probably the most common occupational hazard facing people today. It is estimated that as many as 30 million Americans are exposed to potentially harmful sounds at work. Even outside of work, many people participate in recreational activities that can produce harmful noise (musical concerts, use of power tools, etc.). 

Sixty million Americans own firearms, and many people do not use appropriate hearing protection devices.

TINNITUS and NOISE EXPOSURE

Another condition that is often part of NIHL is tinnitus (pronounced “TIN-i-tus” or “tin-EYE-tus”). This is a condition described as the perception of sound (often buzzing, ringing, or hissing) in the absence of any external stimulus (that is, there is no sound others hear but the tinnitus sufferer does). This essentially takes away the opportunity for the person to experience quiet, and can be very distressing.
 
Some 30 million adults suffer from persistent tinnitus (it can also affect children). For some people the problem is severe enough that it impacts their everyday life. Tinnitus affects people differently. The most common areas in which tinnitus has a direct influence are:
 
Thoughts and emotions. Some are annoyed, bothered, depressed, anxious or angry about their tinnitus. They think and focus on their tinnitus often.

Hearing. In some, the sound of the tinnitus competes with or masks speech or environmental sound perception.

Sleep. Many tinnitus sufferers report that their tinnitus interferes with them getting to sleep. It can also make it more difficult to get back to sleep when they wake up in the middle of the night.

Concentration.Some tinnitus sufferers report that they have difficulty focusing on a task because of their tinnitus. This might include reading a book or the newspaper.

Blog to be continued in a 4 part series 

 

Protect Your Ears This 4th of July

Posted on July 1, 2013 at 7:53 PM Comments comments (223)
Protect Your Ears This 4th of July, 
Stone’s Hearing Aid Service Urges Community

The Stone’s Hearing Aid Service Family is urging people to use sound judgment and ear plugs in celebrating the 4th of July, America’s noisiest day of the year. The single bang of a firecracker at close range can permanently damage hearing in an instant. Loudness is measured in decibels, with silence measuring at approximately 20 dB sound pressure level (SPL). Any noise above 85 dB SPL is considered unsafe. Most firecrackers produce sounds starting at 125 dB SPL–presenting the risk of irreversible ear damage.
 
We are asking that people pack earplugs when heading out to this year’s 4th of July celebrations and is advising them to exercise safety whenever around fireworks. The single bang of a firecracker at close range can permanently damage hearing in an instant. But by following some simple precautions, people can enjoy the 4th of July festivities and still protect their hearing.
 
The best advice we can offer is to leave the fireworks to the professionals and sit at a comfortable distance from the display, where you can enjoy the colors and lights, but not expose yourself and your family to loud noises. To protect your hearing, make sure you are wearing ear plugs and that they are securely in place before the show begins. And be sure to keep them in for the entire show.
 
Disposable ear plugs, made of foam or silicone, are typically available at local pharmacies. They are practical because you still can hear music and the conversation of those around you when you have them in your ears. But when they fit snugly, they are effective in adequately blocking out dangerously loud sounds.
 
Noise is one of the most common causes of hearing loss. Ten million Americans have already suffered irreversible hearing damage from noise; and 30 million are exposed to dangerous noise levels each day.
 

According to the American Pyrotechnics Association, consumption of fireworks in the United States has risen dramatically over the past decade, from 152.2 million pounds in 2000 to 213.9 million pounds in 2009. As more and more Americans come into contact with fireworks, it becomes increasingly important that people follow sound safety measures, including the use of ear protection.
 
The Dangers and Signs of Loud Noise
 
Loudness is measured in decibels, with silence measuring at 0 dB. Any noise above 85 dB is considered unsafe. Most firecrackers produce sounds starting at 125 dB–presenting the risk of irreversible ear damage. Repeated exposure to loud noise, over an extended period of time, presents serious risks to hearing health as well. If you have to shout over the noise to be heard by someone within arm's length, the noise is probably in the dangerous range. Here are other warning signs:
 
·         You have pain in your ears after leaving a noisy area.
 
·         You hear ringing or buzzing (tinnitus) in your ears immediately after exposure to noise.
 
·         You suddenly have difficulty understanding speech after exposure to noise; you can hear people talking but can't understand them.
 
Anyone can take the first step to addressing hearing loss by taking a simple, interactive screening test in the privacy of their own home by going to www.hearingcheck.orgif there is a hearing concern, please visit Stone’s Hearing Aid Service for a more comprehensive hearing evaluation for free .
 
Prevention is so critical to preserving our hearing, especially for children who are at highest risk for noise-induced hearing loss.  Make sure your family and friends fully enjoy the holiday festivities and celebrate smart. Leave the fireworks to the professionals. Stay a safe distance away. And pack the earplugs. Remember: close to 40 percent of hearing loss is preventable with proper protection.
 
Protecting Our Hearing
 
We hear sound when delicate hair cells in our inner ear vibrate, creating nerve signals that the brain understands as sound. But just as we can overload an electrical circuit, we also can overload these vibrating hair cells. Loud noise damages these delicate hair cells, resulting in sensorineural hearing loss and often tinnitus (ringing of the ears). The cells that are the first to be damaged or die are those that vibrate most quickly–those that allow us to hear higher-frequency sounds clearly, like the sounds of birds singing and children speaking.
 
The best way to protect hearing is to avoid excessively loud noise. When you know you'll be exposed to loud noises, like fireworks, wear ear protection. Every day you can protect your hearing by keeping down the volume on ear-buds  stereos, and televisions. And you can teach children to quickly plug their ears with their fingers when they're suddenly and unexpectedly bombarded by loud sirens, jack hammers, and other loud sounds.
 
Stone’s Hearing Aid Service recommends that people should not personally use firecrackers to celebrate the 4th of July, since one explosion in close proximity could cause permanent hearing loss, not to mention bodily harm. There is a reason why fireworks are illegal in many states, and that is because of their inherent danger.
 
Noise is one of the most common causes of hearing loss. Ten million Americans have already suffered irreversible hearing damage from noise; and 30 million are exposed to dangerous noise levels each day. Children are most vulnerable.
 
Adverse Health Effects
 
Noise can pose a serious threat to a child’s physical and psychological health, including learning and behavior. For example, noise can:
 
INTERFERE WITH SPEECH AND LANGUAGE. Repeated exposure to noise during critical periods of development may affect a child’s acquisition of speech, language, and language-related skills, such as reading and listening.
 
IMPAIR LEARNING. The inability to concentrate in a noisy environment can affect a child’s capacity to learn.
 
IMPAIR HEARING. Tinnitus, often described as a ringing or buzzing sound in the ear, is a symptom associated with many forms of hearing loss.
 
NIHL is a permanent hearing impairment resulting from prolonged exposure to high levels of noise or by sudden high level (impulse) noise.
 
DISTURB THE CARDIOVASCULAR SYSTEM. Elevated blood pressure and other cardiovascular ailments can be found in children who are chronically exposed to loud noise.
 
DISRUPT SLEEP. Noise can awaken a child or disrupt his or her sleep patterns.
 
Minimizing the Risks
 
Take the following steps to protect your child from the physical and psychological effects of noise:
 
•           Instruct him or her to walk away from sources of loud noises.
 
•           Limit the amount of time spent on noisy activities.
 
•           Lower the volume.
 
•           Have your child’s hearing tested if he/she routinely participates in noisy activities, such as playing an instrument or attending concerts or sporting events.
 
•           Ensure that he or she wears child-sized hearing protection, such as earplugs or earmuffs, during noisy activities and events.
 
•           Create a quiet learning and sleeping environment.
 
When to Seek Help
 
Consult a hearing specialist (a person who tests and measures hearing) or an otolaryngologist (a doctor who treats diseases and problems of the ear, nose, and throat) if you or your child experiences any of the following symptoms:
 
•           Asks people to repeat themselves.
 
•           Regularly hears ringing, roaring, or hissing sounds.
 
•           Speaks loudly or raises voice to be understood by someone standing nearby.
 
•           Does not react to unexpected loud noises
 


The noise levels (in decibels) on the thermometer are approximate as measured at a typical listener’s distance.
Use this sound thermometer to judge your or your child’s noise exposure. Noise levels at 85 dB or above can be harmful to your hearing and require protection.

As you can see, firecrackers alone range at 125DB, that is louder than a rock concert...
 











Stone’s Hearing Aid Service is reminding the community that regular hearing checks are critically important for detecting hearing loss early and for getting appropriate treatment in order to minimize the negative impact that unaddressed hearing loss can have on quality-of- life. Stone’s Hearing Aid Service offers FREE hearing evaluations.
 
 The Stone’s Hearing Aid Service Family wishes you, your family and friends a happy and safe 4 of July.

Stone’s Hearing Aid Service, Your Hearing is OUR Concern

The Impact of Treated Hearing Loss on Quality of Life (Pt 3 of 3)

Posted on June 27, 2013 at 7:09 AM Comments comments (211)
The Impact of Treated Hearing Loss on Quality of Life 
(Pt 3 of 3)

PERSONALITY ASSESSMENT
 
Seventy-nine items were devoted to miscellaneous personality scales in addition to the personality measures under emotional and social effects. All of the personality scales used in this study are published scales. Family members indicated that the respondents' cognitive/mental state (e.g., they appear confused, disoriented or unable to concentrate) was affected by their hearing loss, primarily if the hearing loss was "severe" to "profound" (groups 4 and 5). In this study, impressive improvements in family perceptions of the persons' mental and intellectual state were observed if the individual had a severe to profound hearing loss (groups 4 and 5 only). Non-wearers were more likely to be viewed as being confused, disoriented, non-caring, arrogant, inattentive, and virtually "living in a world of their own."
 
Previously we indicated that there were no significant differences in measures of "withdrawal" between aided and unaided subjects. This finding is contrary to the literature. However, family members did report that non-wearers in three of five groups (1,4, 5) were more introverted as evidenced by greater likelihood of being private, passive, shy, quiet, easily embarrassed, etc. Moderate to severe hearing loss non-wearers (quintiles 3-5) were shown to score higher on a personality variable called "external locus of control." This means they were more likely to believe that events external to them control their lives. In other words, they felt less in control of their own lives. On the other hand, hearing aid wearers felt they were more in control of their lives and less a victim of fate.
 
HEALTH IMPACT
 
The survey asked six generic questions on self-perceptions of health, prevalence of pain and the extent to which the respondent believed that hearing loss impacted their general health. In addition, from a list of 28 health problems, respondents indicated whether they experienced that health problem and the extent to which the problem interfered with their activities.
 
Overall assessment of health (including absence of pain) appeared to decline as a function of hearing loss with further deterioration of heath associated with non-usage of hearing aids for the three most serious hearing loss groups (quintiles 3-5). Three of the five hearing aid wearer groups (quintiles 1, 3, 5) reported significantly better health compared to their non-wearer counterparts. The lowest self-rating of overall health was the non-wearer group in quintile 5 (profound hearing loss). Nonetheless, our research determined there was no consistent evidence that hearing aid usage is associated with reductions in arthritis, high blood pressure, heart problems or other serious disease states.
 
PERCEIVED BENEFIT OF HEARING AIDS
 
As a validation check on comparisons of hearing aid wearers and non-wearers, both respondents and their family members were asked to rate changes they observed in 16 areas of their life that they believed were due to the respondent using hearing aids. Total findings are shown in Figure 2. In general, for nearly all quality of life areas assessed, the observed improvements were positively related to degree of hearing loss. Family members in nearly every comparison observed greater improvements in the respondent.
 
The top three areas of observed improvement for both respondents and family members were "relationships at home," "feelings about self," and "life overall." The most impressive improvements were observed in quintile 5 (profound hearing loss) in that 11 of 16 lifestyle areas were rated as improved by at least 50 percent of the respondents or family members.
 
CONCLUSIONS AND DISCUSSION
 
The results for this study are impressive. Hearing aids clearly are associated with impressive improvements in the social, emotional, psychological, and physical well-being of people with hearing loss in all hearing loss categories from mild to severe. As such, these findings clearly provide strong evidence for the value of hearing aids in improving the quality of life of people with hearing loss. Specifically, hearing aid usage is positively related to the following quality of life issues:
 
Greater earning power (especially the top 60% of hearing losses)
 
Improved interpersonal relationships (especially for mild-moderate losses) including greater intimacy and lessening of negative dysfunctional communication

Reduction in discrimination toward the person with the hearing loss

Reduction in difficulty associated with communication (primarily severe to profound hearing losses)

Reduction in hearing loss compensation behaviors

Reduction in anger and frustration

Reduction in the incidence of depression and depressive symptoms

Enhanced emotional stability

Reduction in paranoid feelings

Reduced anxiety symptoms

Reduced social phobias (primarily severely impaired subjects)

Improved belief that the subject is in control of their lives

Reduced self-criticism

Improved cognitive functioning (primarily severe to profound hearing loss)

Improved health status and less incidence of pain

Enhanced group social activity

In this study, both respondents and their family members were asked to independently rate the extent to which they believed their life was specifically improved due to hearing aids. All hearing loss groups from mild to profound reported significant improvements in nearly every area measured:
 
Relationships at home and with family

Feelings about self

Life overall

Mental health

Social life

Emotional health

Physical health

Short of stating definite causality, the evidence is quite compelling and perhaps suggestive of causality for the following reasons:
 
The sample, the largest of its kind, is nationally representative of hearing loss subjects ages 50 and over. Thus, we need not be concerned with spurious findings due to sampling methodology.

Many of the findings held up across all hearing loss quintiles from mild to profound.

The specific findings were corroborated within the study. That is, significant differences between wearers and non-wearers were noted. Also, at the end of the survey respondents and their family members were asked to specifically indicate if their life was improved as a result of wearing hearing aids in 16 quality of life areas. Both respondents and their family members indicated significant benefit due to hearing aids in most areas measured.

The differential efficacy between the 16 quality of life parameters noted by respondents and their family members (from a low of 4 percent to high of 74 percent improvements) indicates that a positive halo or acquiescence did not exist in this sample of respondents.

The survey findings are consistent with other correlational and especially the randomized control studies and pre-post hearing aid fitting studies among smaller, more narrowly defined samples.

The findings are consistent with the literature on factors impacting hearing loss; that is, the theoretical improvements that should occur if hearing loss is alleviated.

The findings are consistent with the observations of clinicians and dispensers of hearing aids.

A CALL TO ACTION
 
Dr. Firman of the National Council on the Aging stated in his speech to the media in the summer of 1999, "This study debunks the myth that untreated hearing loss.is a harmless condition."
 
In focus groups conducted with physicians, the prevalent view is that hearing loss is "only" a quality of life issue. If, quality of life is defined as "greater enjoyment of music," then one might agree. But the literature and this study clearly demonstrate that hearing loss is associated with physical, emotional, mental, and social well-being. Depression, anxiety, emotional instability, phobias, withdrawal, isolation, lessened health status, lower self-esteem, and so forth, are not "just quality of life issues." For some people, uncorrected hearing loss is a "life and death issue."
 
This study challenges every segment of society to comprehend the devastating impact of hearing loss on individuals and their families, as well as the positive possibilities associated with hearing aid usage. We need to help physicians recognize hearing loss for the important health issue that it is. We need to help those with hearing loss who are currently in denial about their impairment, to understand the impact their hearing has on their life as well as that of their loved ones. We need to assure that hearing aids are recognized in society not just for their treatment of hearing loss, but also as a potential contributing factor to the successful resolution of other medical, emotional, social and psychological conditions.
 
This study also demonstrates for the first time that individuals with even a mild hearing loss can experience dramatic improvements in their quality of life. This finding is significant because the challenge is to demonstrate to "baby-boomers" (ages 45-59) with emerging hearing losses that hearing aids offer something to them of value early-on in their lives, and that they do not need to wait until retirement to receive the benefits of enhanced hearing.
 
If you are one of those people with a mild, moderate or severe hearing loss, who is sitting on the fence, consider all the benefits of hearing aids described above. Hearing aids hold such great potential to positively change so many lives.
 
COMMON MYTHS
 
The consequences of hiding hearing loss are better than wearing hearing aids.
 
What price are you paying for vanity? Untreated hearing loss is far more noticeable than hearing aids. If you miss a punch line to a joke, or respond inappropriately in conversation, people may have concerns about your mental acuity, your attention span or your ability to communicate effectively. The personal consequences of vanity can be life altering. At a simplistic level, untreated hearing loss means giving up some of the pleasant sounds you used to enjoy. At a deeper level, vanity could severely reduce the quality of your life.
 
Only people with serious hearing loss need hearing aids.

The need for hearing amplification is dependent on your lifestyle, your need for refined hearing, and the degree of your hearing loss. If you are a lawyer, teacher or a group psychotherapist, where very refined hearing is necessary to discern the nuances of human communication, then even a mild hearing loss can be intolerable. If you live in a rural area by yourself and seldom socialize, then perhaps you are someone who is tolerant of even moderate hearing losses.

For more information about hearing loss, the importance of hearing aids and the quality of life and a FREE hearing evaluation, please contact Stone's Hearing Aid Service.

The Impact of Treated Hearing Loss on Quality of Life (Pt 2 of 3)

Posted on June 20, 2013 at 7:30 AM Comments comments (196)
The Impact of Treated Hearing Loss on Quality of Life
(Pt 2 of 3)

RESEARCH ON THE POSITIVE IMPACT OF HEARING AIDS ON QUALITY OF LIFE
 
Following are the results of the largest study in the world conducted on the impact of hearing aids on quality of life. After reading this, we hope you agree that hearing aids when successfully fit to your unique audiological needs, have the potential to literally transform your life.
 
Utilizing the famous National Family Opinion Panel (NFO) in 1997, a short screening survey was mailed to 80,000 panel members to find a representative sample of people with hearing loss in the United States. This short survey helped identify nearly 15,000 people with self-admitted hearing loss. The response rate to the screening survey was 65 percent. Since 1989, research has been conducted in this manner on more than 25,000 people with hearing loss and the findings have been under the generic name "MarkeTrak." Working with the National Council on the Aging, a sample of 3,000 individuals with hearing loss ages 50 and over were randomly drawn from the MarkeTrak hearing loss panel. Equal samples of 1,500 hearing aid owners and non-owners were drawn from the panel. What is unique about this study is that people with hearing loss, as well as their significant other (usually the spouse), were studied.
 
Extensive questionnaires were sent to both the person with the hearing loss and the spouse or family member. The number of questions was 300 and 150 respectively. The comprehensive survey covered a myriad of topics including: self and family assessment of hearing loss, psychological well-being, social impact of hearing loss, quality of relationships, life satisfaction, general health, self and family perceptions of benefit of hearing aids (wearers only) , reasons for purchasing hearing aids (wearers only), reasons for not purchasing hearing aids (non-wearers only) , and attitudes toward hearing health and hearing aids. In addition, a number of personality scales, which were deemed relevant to this study, were included in the survey.
 
After analyzing the returned surveys for usability (e.g. minimal missing information, hearing aid owners who wear their hearing aids) the final sample sizes for respondents with hearing loss and family members were reduced to 2,069 and 1,710 respectively. Thus, this study involved nearly 4,000 people.
 
The goal of the study was to determine if hearing aids had an impact on hearing loss independent of hearing loss. In other words, do people with mild hearing loss derive as much benefit as individuals with more serious hearing losses? As part of the research design, in addition to quality of life items, a paper and pencil assessment of hearing loss was administered with the anticipation that the results of this assessment would be used to control for hearing loss when comparing the quality of life of hearing aid wearers and non-wearers.
 
The key hearing assessment tool used was the Five Minute Hearing Test (FMHT) by the American Academy of Otolaryngology-Head and Neck Surgery. The FMHT is a fifteen-question test measuring self-perceived hearing difficulty in a number of listening situations (e.g. telephone, multiple speakers, television, noisy situations, reverberant rooms), as well as self-assessments of some signs of hearing loss (e.g. people mumble, inappropriate responses, strain to hear, avoid social situations). Previous research has determined that the FMHT is significantly correlated with objective audiological hearing loss measures.
 
Based on hearing difficulty scores, all subjects in this study were grouped into five equal size groups (20 percent each-called quintiles). These ranged from quintile 1 (the 20 percent of respondents with the mildest hearing loss as measured by the FMHT) to quintile 5 (the 20 percent with the greatest hearing loss). The quintile system was utilized for all analysis as a means of controlling for differences in hearing loss between the hearing aid wearer and non-wearer samples. The use of these quintiles allowed the researchers to achieve more valid comparisons between samples of hearing aid wearer and non-wearers.
 
If the responses of all hearing aid wearers with those of all non-wearers were compared without regard to degree of hearing loss, the findings would have been misleading, and even erroneous. For example, it is widely known that incidence and degree of depression have been found to increase with severity of hearing loss. Thus, even if people with severely hearing loss experience reduced depression after getting hearing aids, they might still report more depression than non-wearers overall, since hearing aid wearers tend to have more severe hearing loss. However, when hearing aid wearers are matched with non-wearers in the same quintile (non-wearers having a fairly similar degree of hearing loss), the differences between them better reflect the potential impact of the hearing aids rather than the effect of their degree of hearing loss.
 
While there is no audiological basis for labeling hearing loss associated with each quintile group, the researchers did find an excellent correlation between self-perceived loss (e.g. mild to profound hearing loss) and the FMHT test. As we discuss the findings of this study with respect to the five hearing loss groups, it's appropriate to consider people in quintile hearing loss groups 1, 3 and 5 as having respectively a "mild," "moderate," and "severe /profound" hearing loss; group 2 is between mild and moderate hearing loss while group 4 should be viewed as between moderate and severe hearing loss.
 
RESEARCH FINDINGS
 
Following is a systematic evaluation of the impact that hearing aids have on quality of life. This will be done by comparing the responses of hearing aid wearers and non-wearers while controlling for hearing loss. As you evaluate the impressive findings below keep in mind the following:
 
The devastating impact of hearing loss on quality of life is well-documented;

Quality of life is primarily impacted by the fact that uncorrected hearing loss results in reduced speech intelligibility;

Hearing aids when fitted correctly improve speech intelligibility and therefore can restore your ability to function more effectively in life.
 
DEMOGRAPHICS & HOUSEHOLD INCOME.
 
It should be recognized that in most respects the five hearing loss groups were well matched on key demographics: gender, marital status, employment status, and age. A striking trend was discovered when evaluating household income by level of hearing loss. Income is significantly related to both hearing loss and hearing aid usage. Figure 1 shows there was close to an $8,000 difference between those with mild hearing loss (quintile 1) and those with profound hearing loss (quintile 5). Note that income drops significantly only for severe to profound hearing loss groups
(4 and 5-the top 40 percent of individuals with hearing loss).
 
Compared to non-wearers, there was a $13,000 a year difference between the mild and profound hearing loss groups. The differential for hearing aid wearers was much less severe ($7,000). Hearing aids appeared to have a positive impact on household income, but only for individuals whose hearing loss was in the higher 60 percent (moderate-profound). People with a moderate to profound hearing loss, who did not use hearing aids, on average, experienced household incomes $5000-$6000 less than their counterparts who did use hearing aids. This is despite the fact that the higher hearing loss non-wearer groups tended to be employed slightly more often.
 
Hearing aid wearers also reported that they have plenty of discretionary income more often than non-wearers. For example, 22 percent of group 5 (profound hearing loss) hearing aid wearers reported they had plenty of discretionary income compared to only 8 percent of non-wearers. The discretionary income differential for samples with more severe hearing loss was a likely cause of the lower earning power. Because of higher hearing disability levels, communication is probably impacted, resulting in lower income and therefore less earning power. Finding a solution to their hearing loss is exacerbated for these groups, in that lower earning power means that the respondent was less likely to be able to afford a hearing aid to correct the hearing loss.
 
ACTIVITY LEVEL
 
Respondents were asked to indicate the extent (times per month) to which they engaged in thirteen activities in a typical month. Six of the activities were solitary in nature while seven involved other people. Total solitary and social activity scores were calculated. Hearing aid wearers were shown to have the same level of solitary activity as non-wearers. However, hearing aid wearers were more likely to engage in activities involving other people. They were shown to have significantly higher participation in three to four of the seven activities measured. Four out of five quintile hearing aid wearer groups indicated they participated more in organized social activities while three out of five of the hearing loss groups reported they were more likely to attend senior centers if they were hearing aid wearers. The most serious hearing loss group (quintile 5) reported greater participation in four out of the seven activities if they were hearing aid wearers.
 
INTERPERSONAL RELATIONS
 
The survey asked 12 questions concerning the respondents' quality of interpersonal relationships with their family using a four-point scale. Twelve questions concerned negativity (e.g. arguments, tenseness, criticism) in the relationship. We found that interpersonal warmth in relationships significantly declined as hearing loss worsened. Hearing aid wearers in quintiles 1-3 (mild to moderate) were shown to have significantly greater interpersonal warmth in their relationships than their non-wearer counterparts. Also, significant reductions in negativity in family relationships appeared to be associated with hearing aid usage in quintiles 1 and 2-the hearing loss groups with the mildest hearing disability.
 
SOCIAL EFFECTS
 
Forty-seven items in the survey assessed the social impact of hearing loss and hearing aid usage. The majority of the items were scored on a five-point scale taking the values "strongly agree" to "strongly disagree." Average monthly contact with family and friends by phone and in person was also assessed.
 
The stigma of hearing loss was shown to increase as hearing loss increased. All five non-wearer groups reported they would be embarrassed or self-conscious if they wore hearing aids, while all five wearer groups reported lower stigmatization with hearing aids. The conclusion is not, of course, that usage of hearing aids would lead to reduced stigma; most likely hearing aid wearers have resolved their concerns about the stigma associated with hearing aid usage more so than their non-wearer counterparts.
 
As hearing loss increased, respondents were more likely to overcompensate for hearing loss by pretending that they heard what people said, by avoiding telling people to repeat themselves, by avoiding asking other people to help them with their hearing problem, by engaging in compensatory activities such as speech reading, or by defensively talking too much to cover up the fact that they could not hear well.
 
All five hearing aid wearer groups reported significantly lower overcompensation scores. The greater the hearing loss, the greater was the likelihood that respondents reported they were the target of discrimination. The greater the hearing loss, the greater the likelihood that respondents with more serious hearing losses were accused of hearing only what they wanted to hear, found themselves the subject of conversation behind their backs, were told to "forget it" when frustrated family members were not heard the first time, and so on. All hearing loss groups except quintile 1 (the mildest hearing loss) reported significant reductions in discriminatory behaviors, if they were hearing aid wearers.
 
A strong relationship between hearing loss and family member concerns of safety (e.g. cannot hear warning signs, instructions from doctor, made a serious mistake, not safe to be alone) was found, as well as significant differences between hearing aid wearers and non-wearers. Respondents also agreed that safety concerns increased as hearing loss increased.
 
The data however, indicated that safety concerns were significantly higher among hearing aid wearers than non-wearers in quintiles 1-3. Perhaps the realization that mistakes were being made or that unaided hearing loss could result in possible injury, motivated the current hearing aid owner to purchase hearing aids. This explanation is consistent with the findings from previous MarkeTrak research, which indicated that the number one motivation to purchase hearing aids was "the realization that their hearing loss was getting worse."
 
There were a number of social effects that were correlated with hearing loss but were not impacted by hearing aid usage. These were negative effects on the family (e.g., "I find it exhausting to cope with their needs"), family accommodations to the individual with hearing loss (e.g., "I have to use signs and gestures a lot of the time"), rejection of the person with hearing loss (e.g., "They tend to get left out of social activities because of their hearing loss"), and withdrawal (e.g., "They tend to withdraw from social activities where communication is difficult"). In addition, hearing aid usage was not associated with increased phone or in-person contact with family or friends.
 
THE EMOTIONAL EFFECTS
 
Eighty items in the survey dealt with the emotional aspects of hearing loss. All five hearing aid wearer groups scored significantly lower in their self-ratings of emotional instability. In agreement with their family members, they were less likely to be tense, insecure, unstable, nervous, discontent, temperamental, and less likely to display negative emotions or traits. Four of the five hearing aid wearer groups reported significantly reduced tendencies to exhibit anger (e.g., "I sometimes get angry when I think about my hearing") and frustration (e.g., "I get discouraged because of my hearing loss"). In agreement, family members observed significantly less anger and frustration in all five hearing aid wearer groups.
 
The average reduction in depression associated with hearing aid usage across all five groups was 36 percent. All five hearing aid wearer groups reported significantly lower depressive symptoms (e.g., tired, insomniac, thinking of death) while four of the five hearing aid wearer groups (quintiles 1-4) reported a significantly lower incidence of depression within the last 12 months compared to their non-wearer counterparts.
 
Hearing aid wearers in quintiles 2-4 reported significantly lower paranoid feelings (e.g., "I am often blamed for things that are just not my fault"). Not surprisingly, in agreement with family members, all five non-wearer groups scored higher on denial when compared to hearing aid wearers (e.g., "I don't think my hearing loss is as bad as people have told me").
 
Family members and respondents were asked to indicate if the person with the hearing loss exhibited anxiety, tenseness or if they worried for a continuous period of four weeks in the previous year. In addition, they were asked to indicate if they experienced anxiety symptoms (e.g., keyed up or on edge, heart pounding or racing, easily tired, trouble falling asleep). Three of the five non-wearer groups (1, 3, 5) exhibited higher anxiety symptoms. In addition, three of the five non-wearer groups (1, 2, 5) exhibited more social phobias than non-wearers of hearing aids. Reduction in phobia and anxiety associated with hearing aid usage would appear to be more pronounced in individuals with serious to profound hearing losses (Quintile 5).
 
Factors not appreciably impacted by hearing aid usage in this study were: sense of independence (e.g., burden on family, answering for the person with hearing loss) and overall satisfaction with life. Although not as conclusive as some of the previous factors, non-wearers reported that they were more self-critical (e.g., "I dwell on my mistakes more than I should") and had lower self-esteem (e.g., "All in all, I'm inclined to feel that I am a failure"). Hearing loss was found to be highly correlated with self-criticism. There is also some evidence, though not as strong as other correlates of hearing aid use, that non-wearers were more critical of themselves (Quintiles 1, 3, 5).

To be continued in a following blog posting

The Impact of Treated Hearing Loss on Quality of Life

Posted on June 11, 2013 at 8:37 PM Comments comments (106)
The Impact of Treated Hearing Loss on Quality of Life 
(Pt 1 of 3)

The number one reason why people purchase their first hearing aids is they recognize their hearing has worsened. The second reason is pressure from family members who are negatively impacted by the individuals hearing loss. As you know by now, hearing loss occurs gradually. 
By the time you recognize a need for hearing aids, your quality of life may have deteriorated unnecessarily. 

The average age of first-time hearing aid wearers is close to 70 years of age, despite the fact that the majority (65 percent) of people with hearing loss are below the age of 65; and nearly half of all people with hearing loss are below the age of 55. 
 
For the vast majority of individuals who have decided to wait to purchase hearing aids (78 percent of all people who admit to hearing loss), although they may be aware their hearing loss has deteriorated, they delay hearing aid purchases under the excuses: "My hearing loss is not bad enough yet; I can get by without them; my hearing loss is mild." A large number of people wait 15 years or more from the point when they first recognize they have a hearing loss to when they purchase their first hearing aids. This is a tragedy since they might not be aware of the impact this delayed decision has had on their life, and the lives of their family and associates. 
 
The literature presents a compelling story for the social, psychological, cognitive and health effects of hearing loss. Impaired hearing results in distorted or incomplete communication leading to greater isolation and withdrawal and therefore lower sensory input. In turn the individual's life space and social life becomes restricted. One could logically think that a constricted lifestyle would negatively impact the psychosocial well-being of people with hearing loss. 
 
Research indicates that hearing loss is associated with: embarrassment, fatigue, irritability, tension and stress, anger, avoidance of social activities, withdrawal from social situations, depression, negativism, danger to personal safety, rejection by others, reduced general health, loneliness, social isolation, less alertness to the environment, impaired memory, less adaptability to learning new tasks, paranoia, reduced coping skills, and reduced overall psychological health. For those who are still in the workforce, uncorrected hearing loss has a negative impact on overall job effectiveness, opportunity for promotion and perhaps lifelong earning power. Few would disagree that uncorrected hearing loss is a serious issue. 

PRIOR EXPERIMENTAL EVIDENCE THAT HEARING AIDS IMPROVE QUALITY OF LIFE 
 
An effective human being is an effective communicator; optimized hearing is critical to effective communication. Modern hearing aids improve speech intelligibility and therefore communication. The benefits of hearing aids (audiologically defined as improved speech intelligibility) have been demonstrated in rigorous scientific research. It would seem that if one could improve speech intelligibility by correcting for impaired hearing, that one should observe improvements in the social, emotional, psychological and physical functioning of the person with the hearing loss. There have only been a few studies to date comparing hearing aid owners and non-owners with known hearing loss. The majority of studies had small sample sizes and in general tended to confine themselves to U.S. male veterans. The results of these studies, as well as the exciting findings of a very large U.S. study conducted in collaboration with the National Council on the Aging in 1999 (with publication in January 2000), are described below. 
 
Harless and McConnell demonstrated that 68 hearing aid wearers had significantly higher self-concepts compared to a matched group of individuals who did not wear hearing aids. Dye and Peak studied 58 male veterans pre- and post-hearing aid fitting and found significant improvement on memory tests.
In the most rigorous controlled study to date, Mulrow, Aguilar and Endicott studied 122 male veterans and 72 patients from primary care clinics. Half were randomly chosen and fit with hearing aids while the other half were not. After four months compared to the control group, the researchers found significant improvements in the hearing aid wearers on emotional and social effects of hearing handicap, perceived communication difficulties, cognitive functioning, and depression. 
 
In addition, the same researchers in a follow-up study published in 1992 demonstrated that the quality of life changes were sustainable over at least a year. Bridges and Bentler determined in a study of 251 subjects comprised of normal hearing elderly individuals with hearing aids, and individuals with unaided hearing loss that hearing aid wearers had less depression and higher quality of life scores compared to their unaided counterparts. 
 
Finally, in a pre-post study (that is the person was studied before and after a hearing aid fitting) with 20 subjects, Crandall demonstrated after three months of hearing aid use that functional health status improved significantly for hearing aid wearers. 

To be continued in a following blog posting

Nutrition and Age-Related Hearing Loss

Posted on June 3, 2013 at 9:37 PM Comments comments (197)
Nutrition and Age-Related Hearing Loss 

Most of us fear getting old. Pain, loss of mobility and the failing of functions like sight and hearing are just some of the reasons. Hearing loss is especially tragic. Imagine not being able to listen to the radio or the stereo, go to concerts or lectures or hear your little grand-daughter sing? 




Age-related hearing loss, particularly affecting the cochlea of the inner ear, is the leading cause of deafness in the world, with 40% of 75 year-olds affected. 

But is the loss of functions an inevitable part of the ageing process? Especially when there is increasing scientific evidence that diet has a big part to play? 

There has long been a known association between good nutrition and good hearing. The basic vitamins A, B, C, D, and E, in addition to iron, copper, magnesium, iodine, and folate have all been identified as particularly beneficial for good ear development and hearing health. Moreover, recent studies indicate that certain forms of hearing loss (especially noise-induced losses) can be reversed or improved through specific nutrient therapy. As research continues, new nutrients are being added to the list. 

Everyone knows that consuming too many chips, crisps, sweets, burgers, biscuits, cakes, sugary drinks and so on encourages nutritional deficiencies and all their associated health problems. This is because they provide a lot of calories in the form of saturated fat and sugar but very few vitamins and minerals. Now we are seeing evidence that these foods can even affect our hearing, and it's not just elderly people who are affected. As we shall see, even children's hearing appears to suffer from a faulty diet. 

How Does Nutrition Work to Improve Hearing? 
Each of the identified nutrients acts in a different way, and is therefore recommended for different reasons (see below). Some work to heal ear tissue, and some improve blood flow and oxygen to the inner ear. Still others fight free radicals, thought to be a specific factor in noise-induced hearing loss. 
Importantly, many symptoms of hearing loss are the direct result of vitamin and mineral deficiencies, and improvement may be as simple as supplementing one’s diet with the necessary nutrients. 

Prophylactic Protection from Hearing Loss with Nutrition 
In 2007, University of Michigan researchers reported supporting the emerging evidence that nutrients can effectively block inner ear damage caused by free radical activity following noise-induced trauma. A high combined dose of Vitamins A, C, E, and magnesium, taken one hour before noise exposure and then continued for five days following exposure, was reportedly highly effective in preventing permanent noise-induced hearing loss. If these findings are sustained in clinical trials over the next few years, a hearing-protection tablet or snack bar may be available in the very near future. 

Definitions of deafness are based on the degree of hearing loss in terms of decibels (dB) ranging from mild to profound hearing loss. A loss of 35 to 70 dB is generally considered hard of hearing, while a loss of 90 dB or greater is considered profoundly deaf. There are two main types of hearing loss. 

Conductive Hearing Loss 
This is a temporary hearing loss affecting the middle and outer ear, due to an ear infection, wax build-up or other blockage, ruptured ear drum, colds and otosclerosis - abnormalities in the bony labyrinth of the middle ear. 

Sensorineural Hearing Loss 
This is caused by nerve damage affecting the inner ear and is a permanent hearing loss in about 99.9% of cases. Much of this hearing loss is believed to occur in the cochlea of the ear, which is nourished by many small blood vessels.

The damage can be due to:
Meningitis; Maternal rubella; Cytomegalovirus; Chronic exposure to loud noises; Premature birth; Head trauma; Drug exposure; As well as many other factors.

Heredity/genetics and unknown causes 
As we shall see, both types of hearing loss can also have nutritional causes. 

The Homocysteine Connection 
In a research study carried out at the University of Georgia in 1998, elderly people with impaired hearing were found to have vitamin B12 levels 38% lower and folic acid levels 31% lower than people with normal hearing. These deficiencies inevitably lead to high levels of the toxin homocysteine, which encourages cholesterol deposits to form on artery walls. As we know, such deposits reduce the blood flow and so can also reduce the supply of nutrients and oxygen to the heart and other organs. Parts of the heart muscle or the brain can be destroyed if a small artery becomes completely blocked (occluded), and the ears may suffer from similar harmful effects. B vitamin deficiencies also damage the auditory nerves (those related to hearing). 

Saturated Fat and the Microcirculation 
A healthy microcirculation - the network of capillaries which supplies every inch of your body tissues - does not just depend on an unrestricted blood flow from your arteries. The red blood cells themselves can also affect your circulation. It is essential that red cells should be 'deformable' - flexible and able to squeeze in single file through tiny narrow capillaries, carrying life-giving oxygen to your brain, inner ear and other tissues. The deformability of red cells depends on their outer membrane, which should incorporate a rich supply of essential (polyunsaturated) fatty acids (EFAs) into its structure. An excess of saturated fat in your diet, especially in the presence of a relative deficiency of EFAs, can interfere with this. Saturated fat is hard fat and when too much is present, it increases blood viscosity and is also incorporated into red cell membranes, making them abnormally hard and inflexible. If these red cells then become stuck in narrow capillaries, 'log-jams' can develop, cutting off parts of the microcirculation. Sensitive cells will be deprived of nourishment and oxygen just as if there was a cholesterol blockage. 

In a research study carried out in 1988 on children with hearing difficulties, fluctuations in their hearing were found to vary according to their fat intake. Dietary changes and a drop in cholesterol levels led to a return to near-normal hearing. In another study it was found that hearing impairment at high frequencies was directly related to blood viscosity, red cell rigidity also being an important factor. 

Not only deafness but also tinnitus - a continuous ringing in the ears - seems to be linked with a defective microcirculation, and has been treated with the herb Ginkgo biloba. Professor Edzard Ernst of Exeter University says: "if one views tinnitus as being caused partly by impaired microcirculation in the inner ear, the mechanism becomes understandable. Gingko has been shown to improve microcirculatory blood flow by acting on both the vasculature and the blood in a complex fashion. The end result is an improvement of the circulation. This explanation would tie in with its positive effects in other circulatory disorders, e.g. peripheral vascular disease." 

A remarkable 82% decrease in blood platelet adhesiveness (which contributes to blood viscosity) has been found after the administration of 400 iu vitamin E to normal volunteers for two weeks. 

Nutritional Deficiencies 
Nutritional deficiencies may have a profound effect on the hearing ability. Nutrients which have been researched include vitamins A, B12 and D, folic acid, iodine, iron, magnesium and zinc. 

Vitamin A 
Research is scanty, but vitamin A deficiency appears to cause abnormalities of the otic capsule of the ear, and may also cause atrophy of the cochlea. A number of papers have reported a 5-15 decibel improvement in the pure-tone threshold in patients with hearing loss who are supplemented with a combination of vitamins A and E. 

Vitamin B12 and Folic Acid 
The University of Georgia study already mentioned found low levels of these B vitamins in elderly people with hearing loss. Cochlear function, say the researchers, is dependent on an adequate vascular supply and normal function of nerve tissue. Homocysteine is elevated during deficiencies of vitamin B12, folate or both, and is believed to be a vascular toxin and a neurotoxin. Poor vitamin B12 and folate status might also adversely affect the central nervous system because of the numerous roles that these nutrients play in cellular metabolism, vascular function and myelin synthesis. 

Researchers Shemesh et al at the Institute of Noise Hazards Research in Israel have found that people with chronic tinnitus and noise-induced hearing loss are 2.6 times more likely to be vitamin B12 deficient than those with normal hearing. They suggest that a lack of B12 may cause damage to the protective myelin sheath around nerves in persons subjected to repeated noise exposure. They have managed to obtain some improvement in tinnitus and associated complaints in 12 patients with low vitamin B12 levels following vitamin B12 replacement therapy. 

Vitamin D 
Otosclerosis, on the other hand, seems to have a strong connection with vitamin D. In one study, abnormally low vitamin D levels were found in 21% of 47 patients with this problem. Supplementation with calcium and vitamin D resulted in significant hearing improvement in three out of 16 cases. The same researchers found that treatment of vitamin D deficiency could prevent progressive hearing loss, and occasionally may partially reverse it. 

In some individuals, hearing loss may be a manifestation of vitamin D resistance due to magnesium deficiency - one of the most common nutritional deficiencies found in individuals consuming a western diet. Researchers in Japan have found that 23 out of 28 patients with hearing loss showed a normal value of vitamin D but a significantly decreased level of its biologically active form 1,25 dihydroxyvitamin D3, which is synthesized by means of a magnesium-dependent enzyme. 

Iodine 
There is both clinical and laboratory evidence that hearing loss can result from congenital and acquired hypothyroidism. Both iodine and iron play major roles in thyroid hormone metabolism, and deficiencies of both minerals have been investigated for their role in hearing loss. French research suggests that iodine deficiency is a major public health problem in several European countries. It has found that hearing impairment at speech frequencies is more severe among children at risk of mild to moderate iodine deficiency, defined as those who excrete less than 10 mg of iodine per 100 ml urine. Iodine is no longer added to table salt in the UK, and those who do not regularly consume seafood or sea salt may be at risk of iodine deficiency. 

Iron
Red cell basic ferritin is a measure of iron sufficiency, and was found to be significantly lower in 224 patients with hearing loss compared with normal controls. 

In another study, 426 patients with idiopathic sudden hearing loss were found to have low haemoglobin and serum iron levels. They were administered either iron or vitamin supplements or medications. Hearing improvement was achieved in 53% of those administered iron supplements, a result significantly better than the other groups. 

Magnesium 
Three hundred young healthy individuals with normal hearing, undergoing military training with exposure to high noise levels, were given either magnesium aspartate or placebo. Thresholds for noise-induced permanent hearing loss were significantly higher in the magnesium group. Magnesium supplementation was therefore found to be protective against damage to hearing caused by exposure to noise. 

The reasons for the protection afforded by magnesium are not clear. Researchers hypothesize that a low concentration of magnesium in the perilymph fluid of the inner ear may cause energy depletion and irreversible damage to the hair cells found in the cochlea. 

Zinc 
Zinc supplements may help tinnitus. In one study they were given to tinnitus sufferers with low blood zinc levels, resulting in a significant improvement in symptoms in 52% of cases, especially in cases of continuous tinnitus. -
Nutritional Therapy for Hearing Problems 

Oily fish (herrings, salmon, mackerel, sardines) and essential polyunsaturated oils Help to reduce platelet adhesiveness, lower cholesterol and maintain red cell deformability. 

lue and purple berries and Ginkgo biloba supplements Rich in flavonoids, these have long been known to support the microcirculation. 

Low-fat diet rich in fresh fruit and vegetables to help lower cholesterol. -
Copper (found in nuts, pulses, shellfish, whole-grains) Copper is also needed for a healthy microcirculation - possibly the reason why it is considered in Rudolph Steiner's anthroposophical medicine system to be a warming element. 

Warming spices such as ginger and chillies Act as circulatory stimulants. 

Nuts Very rich in arginine, needed to make nitric oxide which helps to keep blood vessels dilated. Also rich in vitamin E and essential fatty acids. 




Correct food allergies  
Glue ear is a common cause of hearing loss in children and is frequently caused by intolerances to foods such as wheat or dairy products. 

Correct nutritional deficiencies 
If hearing problems or low nutritional status persists despite an improved diet, consider supplementation with appropriate nutrients. 

Stone’s Hearing Aid Service does not based this article as a nutritional specialists, but on research conducted on the subject matter. The Stone’s Hearing Aid family recommends that anyone changing a diet or supplements seek the advice of a medical specialist or nutritionist. 

At Stone’s Hearing Aid Service, Your Hearing is Our Concern. Call or stop in any time for a FREE hearing evaluation or hearing health advice, our door is always open. 

Allergies and Your Ears

Posted on May 9, 2013 at 8:34 AM Comments comments (159)
Allergies and Your Ears


Allergy Season is here and can cause a lot of ear pain due to sinus drainage into the ear canal caused by Immunoglobin E (IgE) antibodies that attack certain substances known as allergens when entering the body, causing inflammation and increased mucus production throughout the nasal passages and airways. Parts of the ear become affected by excess mucus in the nose and throat, resulting in an array of complications that result in ear pain and ear infection. 


Can Allergies Affect Your Ears? 

Ear allergies are common in children and adults who are prone to sinus infections. Ear allergy symptoms include itchy ears, congestion and aching pain. These symptoms are caused by fluid trapped in the eustachian tubes, and usually lead to an ear infection. The tubes connect the ear to the nose, and when you are sick the tubes become narrow due to inflammation. Ear infections can be treated with over-the-counter medication and saline sprays, home remedies and in severe cases prescription medication. If symptoms do not subside within three to four days, contact your physician. 

Allergies 

Allergic rhinitis and allergic sinusitis are commonly triggered by seasonal and environmental allergens, such as pollen, mold, dust, animal dander and chemicals. Inhalant allergens causing rhinitis and sinusitis symptoms are breathed in through the eyes, nose and mouth, causing inflammation of the nasal and lung passages due to excess mucus production resulting from the chemical histamine releases throughout the body. Congestion, runny nose, sneezing, coughing and wheezing lead to ear pressure and ear infections in allergic individuals. 

Symptoms 

People suffering from chronic allergies exhibit year-round ear flare-ups, associated with allergic congestion and sinus pressure. Pain manifests as a dull aching sensation, throbbing pain, chronic burning and itchy discomfort in the outer or middle ear, and may be accompanied by nausea, headaches and fatigue. Foul-smelling, yellowish-green drainage from the ear signifies a definite ear infection. Increased crying in babies, frequent touching of the ear, scratching of the outer ear and lobe, and muffled hearing are ear infection indicators.

Temporary Symptoms 

Short-term hearing loss is a symptom of allergic ear infections. As fluid builds up behind the eardrum in the middle ear, sound vibrations take longer to travel, muffling hearing. 

Outer Ear Infections 

Outer ear infections are caused by bacteria entering the ear canal due to allergy- induced excess fluid in the middle ear, which makes the outer ear more prone to moisture-loving bacteria. Allergy congestion causes fluid build-ups and itching of the outer ear, allowing bacteria to infiltrate the ear canal, causing sharp or dull, burning pain deep within the ear that may worsen with movement. Chronic outer and inner ear infections and pain signify potential allergies in children.

Middle Ear Infections 

Upper respiratory allergic reactions cause mucus to line the nasal and lung passages connecting to the Eustachian tubes that lead to the middle ear. The Eustachian tube typically drains substances from the middle ear, however can become blocked due to excess fluid caused by allergy and sinus congestion. As fluid, mucus and wax get impacted in the middle ear due to clogged Eustachian tubes that are unable to drain, painful and throbbing pressure occurs behind the eardrum, leading to middle ear infections. Middle ear infections may cause nerve damage resulting in permanent, sensorineural hearing loss 

Ruptured Eardrums 

Eardrums can rupture due to pressure caused by fluid and pus build-ups resulting from ear infections. Frequent rupturing injures the ear structure, potentially necessitating surgical repair and causing severe hearing loss.

Treatment

Allergic reactions that cause congestion and ear pain can be treated with oral antihistamines, suppressants and decongestants, available in pill form, chewable tablets or liquid syrups. Ear infections caused by allergies benefit from prescription antibiotic treatments, fluid draining procedures and pain relievers. Doctor consultation is advised, as ear pain can signify severe ear infections that cause malignant otitis externa, leading to nerve and bone damage in the skull, hearing loss, ruptured eardrums and permanent ear damage.

Over-the-Counter Medication and Saline Sprays Antihistamines are over-the-counter medications that block histamines from aggravating receptor sites in your body and prevent and reduce allergy symptoms. If you are already suffering from allergies, the medication will take effect within 12 hours after your first dose. For maximum results it is necessary to take the medication daily during allergy seasons. Saline nasal sprays can also reduce inflammation in your eustachian tubes when used twice daily. Always follow the medication instructions, as possible side effects of the medication include itching, rashes and difficulty breathing. 

Home Remedies 

If there is fluid trapped in your ear, a mixture of vinegar and water can absorb the fluid and kill bacteria. Mix 1 teaspoon of vinegar with 1 teaspoon of water, followed by using an ear dropper to place two to three drops in the affected ear. Allow it to sit for 15 to 20 minutes, and tilt your head to the side of the affected ear to allow it to drain. Repeat this treatment every three to four hours, or until your ear allergies subside. Do not use this mixture if your ear drum is ruptured, as it can cause discomfort. 

Prescription Medication

If your ear allergies worsen, your doctor may prescribe antibiotics, which will clear up the fluid in your ear and any possible bacteria. Some of the common medications prescribed include amoxicillin and corticosteroids. Follow your doctor's orders on dosage, as missing a dose can result in the infection becoming resistant to the medication. Prescription medication's side effects include nausea, vomiting, diarrhea and headaches. Notify your doctor immediately if you begin experiencing these adverse reactions.

 Ear pressure is usually caused by pressure building up behind the ear drum or wax pushing up against the ear drum. Learn about treating ear pressure that is caused by allergies, inner ear conditions or the use of Q-tips with help from a neurologist and otologist in this free video on ear problems and hearing.

How to Overcome Allergy Sinus Video Click Here
 http://www.ehow.com/video_7828520_overcome-allergy-sinus-trouble.html
Allergy sinus troubles cause multiple symptoms including headaches, fatigue and congestion. Relieve your allergy sinus troubles with the help of a board certified allergist in this free video.  

May is Better Hearing Month

Posted on May 3, 2013 at 12:48 PM Comments comments (235)
May is Better Hearing Month
 
Just like any other routine visit, (Annual Physical, Dentist, Vision et)  your hearing should be evaluated as well, and at Stone’s Hearing Aid Service, this evaluation is FREE.
 
If you are experiencing hearing loss symptoms, it may be time to visit Stone’s Hearing Aid Service. Prior to receiving your hearing evaluation, you may want to think about a few questions and comments to bring up during your visit that will help you ease into the lifestyle changes that may accompany a hearing device, including how you can alleviate the hurdles hearing loss may prompt in your daily routine. For some, writing a few things down may be the best option so nothing is forgotten while in our office. And remember, do not be shy during your visit; we welcome and expect many questions and are here to assist you.
 
What to do before going to Stone’s Hearing Aid Service
No appointment is required at Stone’s whether you have a scheduled appointment or are a walk-in, come in with a little bit of background knowledge about your issue. Go to the library or look at reputable sources online to determine what your problem may mean. Then, write down any questions that come to mind while you're looking up information.

If you are taking any medications, make sure to write down the name of each prescription before seeing us so we are aware of your medication as sometimes these may be affecting your hearing. It may be helpful to write down anything you may be allergic to as well to ensure a hearing aid won't cause an allergic reaction.
 
Lifestyle changes
Watching television, listening to music or even working may change after you've gotten a hearing aid. When you're speaking with your hearing health professional, consider telling them a little bit about your daily lifestyle so they are aware of the most dramatic changes that you may experience.
 
Accessories
After purchasing, you will want to investigate hearing aid accessories, including ones to maintain the cleanliness of the device. Make sure to go over the uses of each tool with us so you do not accidentally damage the hearing aid, and you are able to maintain a properly working functioning aid for as long as possible. This is a great time to take notes during your visit.
 
Hearing aid settings
There are many different technological advances and special settings available on your hearing aid that you should ask us about. Anti-shock settings that react appropriately to sudden loud noises are a great option for many individuals, especially those around young children or individuals who live in an urban setting. Data logging or memory settings may also be helpful because they log how you use hearing aids in different environments that you're regularly exposed to. Other settings may include a remote control, power-on delay, telecoil, noise reduction, wind noise management, digital, Bluetooth and feedback cancelation.
 
Bring along a friend
Coming to see us with a friend or family member may help ease any office jitters or communication issues between you and us, they might end up considering an evaluation while with you and your friend or family member may also have questions that you have not considered. Bringing someone along to Stone’s is also helpful because they can have a pen and paper on hand to take down notes while you are speaking with us.
 
Stone’s Hearing Aid Service,
Your Hearing is Our Concern
.

Why Do Hearing Aids Cost What They Do?

Posted on April 18, 2013 at 7:32 PM Comments comments (19)
Why Do Hearing Aids Cost What They Do? 




We at Stone’s Hearing Aid Service have created an explanatory  breakdown of what you get for the cost of your hearing device as this is a valid question and concern by many. 





Due to personal patient questions, as well as reading through comments on a blog by the Better Hearing Institute a majority of the comments seem to indicate that hearing aid costs where high because the people who sell them are dishonorable and take advantage of the need of quality hearing health. 

Well.... We at Stone’s Hearing Aid Service cannot speak for other businesses, however, we can tell you that we have been a family owned and operated business for 128 years in the same community with the same reputational name and no Department of Health complaints by being truthful and ethical —our patients are like our family members and we value them and appreciate their loyalty to us. 

A cost breakdown: 

Hearing aids represent a significant investment due to many factors that go into the over-all price. Medicare and most insurance companies usually do not cover the costs of hearing aids. Hearing aids represent a significant financial investment for your hearing health and quality of living. The price of a hearing aid covers a number of costs including: 

1) Testing Equipment--We at Stone’s Hearing Aid Service are proud of keeping our evaluation technology state of the art, in office and transportable equipment. 

2) Research and Development--This is a significantly important process in the hearing industry and part of the cost of your hearing aids, however, it is also a very important one that you directly benefit from. 

3) Follow-up Care--We at Stone’s Hearing Aid Service never charge you for follow up visits, cleanings, evaluations, in home appointments or even “By Appointment” Saturday or Sunday care. 

4) Quality Construction and Parts--You get what you pay for-- We purchase our devices only from the highest quality manufacturers and we stay on top of the industry so that we are aware of trends and changes in design and quality. Do not take this commitment for granted. There is *significant* variation out there in regards to this matter. We could purchase less expensive devices and charge less (and will do so if there is a financial need for less technological devices). However, we chose to stick with quality products and keep our patients happy. We are not going to sacrifice quality for price.

5) Professional Treatment--We treat our patients like we would treat our treasured family members. We set aside enough time for each of you to receive the quality treatment you deserve and we do not run you through our office like cars in an automated car wash or a production line. Some patients end up trying several sets of devices before we settle on just the right one, and we do this because it is the right thing to do for you, the patient. We even have patients who just come in to talk and keep up with current community events, because we care.

6) Normal Overhead-  Business vehicle, fuel and maintenance to do home visits at no additional charge-There is a cost to having a physical building, Historic District Fees, with the grass trimmed and the snow shoveled, with comfortable heating and cooling, a clean bathroom for you, phone service and a friendly voice on the other end when you call us.

7) Taxes and Insurance--Yes, we have to pay those too....

8) Professional Continued Education--Hearing aid technology changes as fast or faster than cell phone and computer technology does. We at Stone’s Hearing Aid Service have to keep up on the latest technology so that we can be competent and professional and bring the most up-to-date technology to you, our patient. 

We could sell you older technology and charge less, but you would not have the advantage of the latest advances in sound processing and state-of-the-art research. 

We are committed to providing our patients the best technology that is available on the market and we will not accept less than that for you, our patient.

Hopefully this blog breaks down and explains the questions you have lingering, that there is more to the price tag than just the device. It is not "just a hearing aid", it is an advanced piece of hearing technology that makes decisions about your listening environment every 8 milliseconds. 

Please feel free to visit or call us with questions or concerns as “Your Hearing is Our Concern” 

Mark, Matt and the Stone’s Hearing Aid Family  

Glue Ear Can Mimic Dyslexia

Posted on April 9, 2013 at 4:42 PM Comments comments (191)
Glue Ear Can Mimic Dyslexia 

Glue Ear:   

What is 'glue ear'? This is a common condition in childhood. The tube can become obstructed by adenoids at the back of the nose, the air cannot enter the middle ear, and the cavity fills with fluid. The eardrum becomes dark looking. As time goes on the fluid becomes thicker until it has the consistency of thick glue. 
Often the only sign is deafness and children's schooling may suffer and behavior may deteriorate.   

Dyslexia:    

Dyslexia is typically characterized by ‘an unusual balance of skills’. Dyslexia is a syndrome: a collection of associated characteristics that vary in degree and from person to person.



These characteristics encompass not only distinctive clusters of problems but sometimes also distinctive talents. The syndrome of dyslexia is now widely recognized as being a specific learning disability of neurological origin that does not imply low intelligence or poor educational potential, and which is independent of race and social background. Dyslexia may overlap with related conditions such as dyspraxia, attention deficit disorder (with or without hyperactivity) and dysphasia. In childhood, its effects can be mis-attributed to emotional or behavioral disorder. By adulthood, many dyslexics will have developed sophisticated compensating strategies that may mask their difficulties.   

Although dyslexia seems to be more prevalent amongst males than females, the exact ratio is unknown: the most commonly quoted figures are between 3:1 and 5:1. The evidence suggests that in at least two-thirds of cases, dyslexia has a genetic cause, but in some cases birth difficulties may play a related role. The majority of experts concur that about 4% of the population are affected to a significant extent. This figure is based on the incidence of pupils who have received normal schooling and who do not have significant emotional, social or medical implications, but whose literacy development by the end of the primary school is more than 2 years behind levels which would be expected on the basis of chronological age and intelligence. However, perhaps as many as a further 6% of the population may be more mildly affected (e.g. in spelling).  

Dysphoneidetic Dyslexia:
There are many types of dyslexia. One such type is known as dysphoneidetic dyslexia is the one we chose to discus in topic due to the relation of hearing.  

Dysphoneidetic dyslexia is also known as auditory dyslexia as it related to how people hear sounds and mentally process them. This type of dyslexia refers to people who find it difficult to connect sounds and symbols. It becomes difficult for them to break words into individual sound parts. It is often associated with sequential difficulties in auditory processing. Individuals suffering from this disability find it difficult to sequence two individual words together. Sufferers of dysphoneidetic dyslexia find it difficult:  

To sequence sounds into words 
To remember individual sounds or sequence of sounds 
To process fast auditory inputs Apply phonetic rules 
To follow phonetic patterns
To identify strange spellings  

The symptoms of this disability are common to many other disabilities. The symptoms include poor reading, reading aloud, poor attention span, poor pronunciation, easy distraction, tiredness, and bad spelling.   

In a lot of cases it will clear up by itself but in severe cases treatment will involve making a small hole in the drum, usually under anesthesia. A tube (grommet) may be inserted; then the adenoids may be removed. Adenoids usually disappear at puberty and most children with glue ear do not need treatment after this time. The hearing is usually restored to normal.   

Important Facts:   

Thousands of children are being misdiagnosed as having special needs while suffering from glue ear, according to a study, writes Dorothy Lepkowska. It found that the symptoms of the illness, which causes dulled hearing, are often mistaken for dyslexia or other learning difficulties. An estimated seven out of 10 children have had the condition by the time they reach the age of four, but it can continue to affect them sporadically until adulthood.   

Psychologist Dr Lindsay Peer said symptoms such as poor communication and literacy skills, particularly in spelling, a lack of concentration and behavior problems due to frustration at not being able to hear properly were often thought 
to be due to a special educational need. 

Of the 1,000 people who had already been diagnosed as dyslexic, studied by Dr Peer, 703 were also found to have suffered from glue ear at some point in their lives. "Some children get it just once, but for others it is a recurring problem," she said. "Specialists in ear, nose and throat problems say that it can appear from as young as nine months, so it can affect speech development and the processing of sounds as the child develops.   

"The condition can carry with it a specific inability to hear soft sounds. For example, in a word such as 'sometimes', where the 'm' is soft, the pupil does not hear it and so will have problems spelling it correctly.”   

"Glue ear can create a series of problems which mimic dyslexia. There needs to be more communication between GPs and health visitors, parents and teachers so that everyone is aware that this can seriously affect the way a child learns."   

Children may experience school phobia and behavior problems, as well as feelings of stress and anxiety, because they are unable to follow lessons or don't know what is expected of them in the classroom.  

If glue ear is not treated, children may continue to have problems with talking, reading and writing. 

There are several different ear tests available some work on high frequency notes. Therefore, it is important to go back to your doctor or health visitor and ask for another checkup if you feel there may still be a problem.