Featured Columns

Written by Steven Burns
From his column To Your Health

It was a Saturday morning, time for our meeting of friends at a Starbucks to talk about our week and our walk with God. That morning, I noticed that my left ear was ringing, and I could not hear well. Ringing was not new for me, but it always went away—until that Saturday.

Since then, ringing varies, and I’ve gotten used to it. But last year the hearing loss finally required action. My little sound processing unit (hearing aid) enables understanding of people on my left, which I had lost. I don’t wear it at night, so if I don’t want to hear the alarm, I sleep with my good ear on the pillow.

How’s your hearing? If you are over 60, you have a 1 in 3 chance of hearing loss, whether you realize it or not. By 75, half of us have hearing loss, and after age 85, 8 in 10 are affected. How can you know if your hearing is worsening? Take the following quiz.

  1. Do you ask others to repeat themselves frequently? (At this point, I see many of you poking your spouses in the ribs.)
  2. Do you avoid talking on the phone because you can’t hear well?
  3. Is it hard to follow conversations with more than one person?
  4. Do you think other people mumble?
  5. Are children and women with high-pitched voices hard to understand?
  6. Have you skipped church because you can’t hear the preacher?
  7. Does the music at church hurt your ears or just sound like noise? (This is not a discussion of praise music vs hymns; even good old Praise and Worship songs can cause a threshold effect—suddenly becoming too loud.)

The most common type of hearing loss is sensorineural hearing loss (SNHL). This is due to injuries such as shooting guns or other loud sounds. A subset called presbycusis, or age-related hearing loss, makes up the largest portion. With SNHL, nerve fibers stop working, like an antenna with a frayed wire. Eventually, not enough nerves transmit sounds to the brain effectively.

A second common type is conductive hearing loss. When the eardrum or middle ear bones are damaged, sound vibrations can’t reach the cochlea (hearing organ). In that case, nerves are okay but sounds can’t reach them. By the way, conductive hearing loss can also be due to excessive wax in the ear canals—a curable hearing loss. 

My form of hearing impairment, Meniere’s disease, is much less common. If you want to know about it, visit this link

If you are over 60, you have a 1 in 3 chance of hearing loss.

So, when you understand that you have hearing loss, what should you do about it? The first step is diagnosis. Start with your family physician or internist. He or she can diagnose the type of loss, and send you to a specialist if needed.

Otolaryngologists (ear-nose-throat doctors or ENTs) are usually not needed unless there is a surgical reason for hearing loss. However, they can treat conductive hearing loss most of the time, with good results. If hearing loss is severe, a cochlear implant may be needed. That is a very technical surgery that can restore hearing in the worst cases.

An audiologist can test your hearing and suggest whether hearing aids will help. Most audiologists work in ENT offices, although some have private practices. For the cost-conscious, some warehouse stores have audiologists. One even has its own hearing aid brand. Costs in those stores can be a third of that with an audiologist. Some universities have audiology training departments. Our city has a huge university (Arizona State, my undergrad alma mater), with an excellent audiology department. Charges for testing and hearing aids is just a fraction more than that of warehouse stores, and you’ll have the pleasure of helping to educate an aspiring audiologist.

Hearing aid cost is a real barrier for many. A pair of the best devices starts at about $6,000 or more. Through our university program, the cost is about $2,300 for similar devices. Warehouse stores have dropped the cost to about $1,800 for their best aids.

So how can you justify spending that much just to hear better? Let’s look at the cost of not hearing well:

  1. Decreased interactions with other people, including conversations;
  2. Missing important details when others are speaking;
  3. Frustration and embarrassment that impair interpersonal relationships, including those with spouses; and
  4. Memory problems.

Memory problems? How could that be? Have you heard of the computing term “garbage in, garbage out?” When you only hear partial words, your brain tries to figure out what was said. You see, we were made for speech. Broca’s area, in the left frontal lobe, interprets speech for humans, and then the words are analyzed elsewhere. But what if the sounds that reach Broca’s area are not complete words? Then the analysis centers must go into action, figuring out context and possible word choices, instead of keeping up with the conversation. Poor hearing gums up the works, and affects our memory of conversations. There may be other ways hearing causes memory loss, as well.

Last, those who serve in ministry must work on the skill of speaking to people with hearing loss. Visit this link to find help  in this area. Come to think of it, spouses should read this too.

Dr. Steven Burns is board-certified in family medicine and has been in practice for more than 30 years.

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