Professional Documents
Culture Documents
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The
Hearing-Loss Guide
Useful Information
and Advice for
Patients and Families
J ohn m. burkey
Foreword by Robert L. Daniels, M.D., F.A.C.S.
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Contents
Foreword ix
Preface xi
Acknowledgments xv
Introduction 1
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Resources 219
Appendix: Hearing-Loss Questionnaires 227
Notes 243
Bibliography 247
Index 255
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Foreword
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Foreword
on a near daily basis for more than twenty years as the lead audiologist
in a busy, community-based otology practice.
In this book, John comprehensively addresses the issues and impact of hearing loss, not only in educating the reader about the causes
of hearing loss in its different forms but describing the effects on the
person experiencing the loss and the consequences it has on those
around them. Particularly helpful are the coping strategies and explanation of resources for seeking and receiving assistance in proper diagnosis and treatment. He also systematically explains the myriad current
solutions, technologies, and treatments for hearing loss.
The main goal of the book, however, is to capture and utilize survey information gained from the lives and experiences of those dealing with hearing loss and its solutions on a daily basis. The result is
a comprehensive compilation of practical and helpful information
that readers can truly use, and perspectives that will help guide their
understanding.
Johns intent is to put at ease, console, and educate those whose
lives are so greatly affected by hearing loss, to give encouragement and
practical advice and dispel the myths and misinformation regarding
hearing loss and its solutions. This book will empower its readers to
seek and find the help that could really make a difference in their lives.
Robert L. Daniels, M.D., F.A.C.S.
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Preface
Hearing loss is an all too common problem that people dont talk much
about. Peoples natural response to other health issues or stressful
events is to seek information, advice, and support from others. Cancer
survivors gather to walk, share stories, and draw strength from others.
Expecting mothers commiserate in Lamaze classes. The overweight
exercise together at fitness centers or meet to weigh in and share lowcalorie recipes. Even if a persons support system is made up solely
of family and friends, their information, support, and advice remain
important. When faced with hearing loss, however, the first reaction
for many, if not most, people is to deny or hide the impairment, thereby
eliminating the chance for this kind of support.
Information and support are nevertheless needed. Hearing loss is
more limiting than people suspect. The ability to hear is interwoven in
nearly everything we do. Losing this ability consequently affects nearly
everything we do. Lives are turned upside downnot just the lives of
the people suffering hearing loss, but the lives of family and friends
as well.
Years as a clinical audiologist have repeatedly shown me how unprepared the majority of people are when faced with a hearing loss.
They werent taught anything about hearing loss in school, and it was
rarely or never the subject of any serious discussion in later years. They
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xii
Preface
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Preface
xiii
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Acknowledgments
I wish to thank the patients, spouses, and significant others who made
this book possible by generously sharing their time, experiences, and
advice so that others might benefit. I also thank executive editor Jean
Thomson Black, manuscript editor Phillip King, editorial assistant
Samantha Ostrowski, and the other professionals at Yale University
Press who helped to make this a more useful and readable book than it
otherwise would have been. Return postage for survey questionnaires
was paid by the Warren Hearing and Research Foundation, and I appreciate the foundations assistance. I wish to thank the physicians and
staff of the Lippy Group for Ear, Nose, and Throat for their support
throughout this project. Finally, I especially thank William H. Lippy,
M.D., for fostering a medical environment that encouraged projects
such as this book that might benefit more than just our own patients.
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Introduction
usan Tate loved to visit. She was active in her childrens parentteacher organization, her neighborhood association, and numerous church groups. When a new neighbor moved in down the
street, she delivered cookies and offered a warm welcome before the
moving truck was out of sight. Within a week she knew all the members
of the new family, what they did, where they had lived before, and why
they had moved. The information did not flow only one way, however,
as she also offered advice about local groceries, banks, city services,
and numerous other tidbits. Asking advice was always her first step
when making decisions or solving problems, so she was usually quick
to offer her thoughts when they might help others.
When Susan started having difficulty hearing in noisy situations
and groups, she wanted to approach this problem in her customary
way. The trouble was that she did not have any close friends with hearing loss whom she might ask for advice. Nor did she know anyone who
wore hearing aids. She supposed it was possible that one of her more
casual acquaintances might have some hearing loss or know someone
who did, but the subject seemed somehow taboo. Lacking good advice,
she decided perhaps she could let the hearing loss go for a while. This
went on for years before Susan sought professional help.
1
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Introduction
Susan is not alone. Many people find that useful first-hand advice
about hearing loss is in short supply, and they might reasonably conclude that this is because there are not many people who have experience with hearing loss. Yet this is rarely the situation. There are in
fact lots of people who struggle to hear. Conservative estimates place
10 percent, or over thirty million Americans, in this group.1 With increased longevity and the aging of the baby-boom generation, the number of people with hearing difficulties is increasing. The problem is
not limited to the United States, either. A large multi-country survey
in France, Germany, Italy, Japan, Norway, Switzerland, and the United
Kingdom reported a hearing-loss prevalence ranging from 8.8 percent
to 12.5 percent.2
Despite the prevalence, hearing loss largely goes unrecognized.
What attention it does garner is mostly expressed during commercials
with the basic message being that hearing aids are the solution. Because these are continually touting the smallest, least visible hearing
aids, a sometimes unintended secondary message is that hearing loss is
something that needs to be hidden. Many view the commercials as just
another sales pitch and dismiss the subject altogether. Few consider
the advertisements a source of good advice. Perhaps not surprisingly,
repeated watching of these ads hasnt resulted in multitudes of viewers
eager to discuss hearing loss.
Negative associations with aging, disability, and decline undoubtedly suppress discussion. Many dont want to admit a hearing loss
to themselves, let alone pointing it out to others. These bad associations may additionally delay or prevent people recognizing or getting
help for a hearing loss as well as at least partially explaining why only
25 percent of the people who could benefit from hearing aids actually
try them.3 Susan Tate likely knew several people with hearing loss and
possibly a couple with small hearing aids, but she was unaware of this
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Introduction
hearing instrument specialists, and anyone else that might have offered
some help.
Patients surveyed were those diagnosed with a hearing loss severe
enough to interfere with communication. These participants were well
aware of their hearing difficulties and many had lived with a hearing
problem for years. There were additional patients whose hearing was
bad enough for inclusion but they denied any hearing loss. They were
not surveyed. Obtaining helpful advice seemed unlikely if a persons only
reason for an evaluation was being forced into it by friends or family.
The survey was explained to patients meeting the above criteria,
and those expressing an interest in participating were given a copy of
the questionnaire to take home and complete. In order to foster candid
responses patients were instructed to not write their names on the survey or provide any identifying information on the survey or the return
envelope. While compiling the surveys for this book, every effort was
made to include all of the information volunteered. The few necessary
exclusions were for illegible responses, information that might in some
way identify an individual, and recommendations that might be seen as
promoting our office. One other practical exclusion involved instances
where pages of patient comments or advice on a particular topic were
in complete agreement. When this did occur, some comments were
omitted to minimize redundancy. At no point were responses edited
(other than for spelling) or censored to promote a particular view.
When possible, a different open-ended questionnaire was given
to the spouse or significant other of the hearing-loss sufferer (this is
also reproduced in the Appendix). They were queried about how they
themselves were affected as well as how their hearing-impaired loved
one was affected. In addition to noting observations, spouses were also
asked for advice.
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Introduction
The goal was to obtain information and advice from one hundred
adults having direct experience with hearing loss. Nearly four hundred
questionnaires were distributed before the target of one hundred were
completed and returned. Seventy-seven of these were from individuals with hearing loss. The other twenty-three were from a spouse or
significant other. The greater number of respondents with hearing loss
resulted from patients more often than not coming to their appointment alone. The survey return rate was a little better than 25 percent
for each group. This does not take into account the one in three people
who for a variety of reasons declined to participate after the survey was
explained. Counting everyone, the participation rate was about 17 percent. Even here, getting first-hand advice about hearing loss was hard
to accomplish.
Our patients come from the northeastern Ohio and western Pennsylvania region, including Youngstown, Cleveland, Akron, Canton,
Columbus, Pittsburgh, and their surroundings, and all of the patients
surveyed were seen in our office in Warren. People who live outside
this area or who have seen different professionals could have different experiences and opinions from the patients who were surveyed,
although most of the problems and opinions associated with hearing
loss are likely to transcend region.
Surveys were given to people twenty to eighty-five years old, but
most were approaching or a little past retirement age. Patients questioned ranged from the poor to the affluent. Their incomes were not
recorded, but the median Ohio income is fairly close to the national average. Similarly, the distribution of our patient base by race and ethnicity reflected national averages, except for people of Hispanic or Latino
descent, who are underrepresented in Ohio.6
The one potential bias worth noting is that of motivation. These
people sought out ENT advice because they wanted to hear better. They
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Introduction
were also the ones who considered hearing loss a big enough problem
that it was worth going out of their way to help others by participating
in this project. Readers can take all of this into account when deciding
which patient advice appears relevant for their own situation.
Throughout the book, survey responses are grouped by subject,
but not necessarily by the survey question asked. Much like what happens in political debates, respondents sometimes used the questions as
a starting point to speak to the issues they wanted to address. Consequently, focusing on subject provided a more logical approach and also
allowed for the inclusion of observations, impressions, and advice that
were volunteered but not specifically asked.
Separate from the patients surveyed are the few stories used to
explain or illustrate particular points. These stories, such as that of
Susan Tate, are based on actual patients or a composite of patients.
Their names and other identifying information have been changed in
the interests of confidentiality.
The book has two parts. Part 1 explains the basics of hearing loss
to provide a background understanding for considering the patient
observations and advice offered in Part 2. The first chapter describes
the anatomy and function of the human ear, explains the tests commonly used to diagnose hearing loss, and introduces the professionals
involved. Common reactions to hearing loss are also explored.
Next is a look at some of the gadgets (amplified telephones, wireless headphones, closed captioning) that can help in specific situations. An overview of hearing-aid technology, styles, and useful options
rounds out the second chapter.
Treatments for hearing loss are discussed in chapter 3. Although
they are not the majority of cases, some hearing losses can be corrected.
The simplest example would be a hearing loss resulting from earwax
obstruction. A more complex case might be a damaged eardrum
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pa rt o n e
Hearing-Loss Basics
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1
The ABCs of Hearing Loss
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hearing-loss basics
workings of the ear were a mystery. The variety of things that could go
wrong was a bigger mystery.
Confronted by hearing loss, even professionals such as bankers,
lawyers, managers, university professors, and engineers can find themselves unprepared. Their training is in areas unrelated to hearing, making it necessary for them to start at the beginning. Since the beginning
for many is to have their ears checked by a professional, the first thing
to do here is to provide an overview of this process.
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hearing-loss basics
might impede function. Fluid or infection behind the eardrum can also
usually be discerned even though the view through the eardrum is not
good. Problems with the ear bones arent likely to be visible.
Another structure important to the function of the ear is the Eustachian tube. This tube equalizes the pressure between the ear and
the outside world. Scuba divers, air travelers, and even people who
drive through the mountains may experience their ears popping as
the Eustachian tube does its job. A nonfunctional Eustachian tube can
result in pain, reduced hearing, an ear feeling plugged, and a variety of
chronic ear problems. Physicians cannot see a Eustachian tube problem directly, but they can infer it when unequal pressure visibly pulls
an eardrum back from its normal shape.
The small snail-shaped portion of the inner ear visible in figure 1
is called the cochlea, which houses thousands of sensory cells respon-
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hearing-loss basics
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rule out a hearing loss, to quantify the severity of a loss, or to differentiate the types of hearing loss just described. Not all hearing losses are
alike. A person may have a very slight problem that only prevents hearing the quietest sounds. Understanding normal speech may not be affected unless someone is speaking extremely softly or from a distance.
In contrast, another person may have a more significant hearing loss
that makes all but outrageously loud sounds inaudible. The majority
of people with hearing loss fall somewhere in between these extremes.
Hearing loss can occur across a wide range of frequencies or be focused in either the high or low pitches. High-pitched hearing losses
tend to be more common. The tests routinely used to sort this all out
are described next.
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hearing-loss basics
find the softest level where they can be understood. This speech reception threshold (SRT) should agree closely with the average threshold
for the beeps. If they do not agree then at least one of the thresholds
obtained is likely wrong and one or both of these tests are repeated
until the discrepancy can be explained.
Separate from how quiet a person can hear is how clearly something can be heard once it is loud enough. Some people with hearing
loss understand very well if the volume is raised. Others cannot hear
clearly regardless of the volume; sounds and voices may seem distorted,
like they are being played through a broken speaker. The third part of
the hearing test battery provides a measure of the extent to which this
might be an issue. Patients are asked to repeat single-syllable words
that are presented well above an individuals hearing threshold. The
percentage correct is then recorded. This measure of hearing clarity is
called speech discrimination or word recognition score (WRS) testing.
The final part of the hearing test battery is known as pure-tone
bone-conduction testing. The patient again listens for beeps, making it
clear when they are heard. The difference from the air-conduction testing is in the kind of headphone used and where it is placed. In boneconduction testing a small device called a bone oscillator is placed over
the bone behind the ear. The oscillator sends sound vibrations through
the skull to directly stimulate the inner ear. If a person hears poorly
during air-conduction testing but well in the bone-conduction test,
then the difference between the two (the air-bone gap) is the amount
of sound that is lost on the way to the inner ear. This is the amount of
conductive loss. If a person demonstrates the same amount of hearing
loss during both air- and bone-conduction testing, then no sound is
being lost as it passes through the ear canal, eardrum, and ear bones.
The hearing loss in this case is all sensorineural.
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The units of loudness employed to document the severity of a hearing loss are decibels hearing loss (dB HL). A person who can hear low
decibel levels (10 to 15 dB HL) is considered to have normal hearing.
Someone having a slight hearing loss would not hear sounds until they
reach 16 to 25 dB HL. Increasing in severity would be a mild loss (26 to
40 dB HL), a moderate loss (41 to 55 dB HL), a moderately severe loss
(56 to 70 dB HL), a severe loss (71 to 90 dB HL), and a profound loss
(91+ dB HL).1 All of the patients surveyed for this book had an average
hearing level worse than 30 decibels in at least the better ear.
As a reference, a whisper at five feet is about 20 dB when measured
using a slightly modified decibel scale (dBA) that ignores some lowfrequency reverberant noise. A quiet office or library is 40 dBA, normal
conversation is 60 dBA, and a flushed toilet 7585 dBA. Any sound of
85 dB or greater is considered potentially damaging to the ear. This
would include firearms, rock concerts, chainsaws, motorcycles, snowmobiles, and tractors.2
Related to the bone-conduction test just described is a screening
tool called the Rinne tuning-fork test. During this check the doctor
strikes a metal tuning fork so that it rings, and then alternates between
holding the tines of the tuning fork near the opening of the patients ear
and holding the base of the fork against the mastoid bone behind the
ear. The vibrating tuning fork is heard normally through air conduction when near the ear canal. When held against the mastoid, the tuning fork transmits the sound vibrations directly to the inner ear through
bone conduction. If the ear canal, eardrum, and ear bones work well in
transmitting sound to the inner ear, the tuning fork will appear louder
at the opening of the ear. If the tuning fork sounds louder when held
against the mastoid bone, then a conductive hearing loss is indicated.
This quick test from the physicians toolbox might seem archaic in the
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Tympanometry
Aside from the standard hearing test battery, tympanometry is the next
most likely test to have during an evaluation. As the name implies, tympanometry checks the tympanic membrane (eardrum). The patient sits
quietly while the tester holds a special earplug in the opening of the
ear canal. The person being tested hears a soft low-pitched hum and
feels a slight pressure change in the ear canal. The machine attached
to the earplug then measures how much sound is reflected back off the
eardrum as the pressure is changed. When the pressure in the ear canal matches the pressure on the opposite side of the eardrum then the
eardrum can move freely, transmitting sound farther into the ear. If, on
the other hand, the pressure on one side is greater or less than on the
other side, this stiffens the eardrum, reflecting sound back into the earplug. The result is a graph that should look much like a mountain peak.
Tympanometry can show if there is a pressure imbalance in the ear, or a
hole in the eardrum (even a pinpoint hole that is difficult to see), and it
can help to confirm an observation of fluid or infection, since these can
prevent the eardrum from moving. The test takes less than a minute for
each ear and is painless.
Testing Children
Evaluating the hearing of small children normally requires different
tests from those given to adults. A child who is four or five years of age
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can usually understand and follow the directions for the adult hearing
test battery. A two-year-old, however, is unlikely to raise a hand in response to beeps or repeat a list of words. An infant may do little more
than startle to loud sounds. Nevertheless, the hearing of these small
children can be tested.
Hospitals routinely screen newborns to rule out congenital hearing loss. The test used is called otoacoustic emissions (OAEs). In a
normal or near-normal hearing ear, the sensory cells in the cochlea vibrate in response to sound. This vibration results in the production of
a slight noise, which is the otoacoustic emission. During OAE testing
a small probe is placed in the infants ear. The probe presents a sound
and then it listens for the OAE response. If the response is present, the
infant is considered to have passed the screening. Otoacoustic emission testing can also be helpful for screening older children and even
noncompliant adults. The test is painless and usually takes only a few
minutes.
Auditory evoked potential (AEP) testing, in contrast, goes beyond
screening to provide a measure of the hearing level. During AEP testing a small electrode is taped behind the ear or on each earlobe. Another electrode is taped on the upper forehead or on top of the head.
Clicking sounds or tone pips are presented through an earphone, and
the brains electrical response to the sound is measured through the
electrodes. The hearing level is determined by presenting sounds at
different volumes and looking for the softest sounds that produce a response from the brain. Auditory evoked potential testing is often done
as a follow-up for infants who fail an OAE test. It can also be used with
children or adults who are developmentally delayed or in some other
way unable to respond. The test can take as little as twenty minutes or
last more than an hour.
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Beginning at about six months of age, visual reinforcement audiometry (VRA) becomes an option. During VRA a child sits on mom
or dads lap as sounds are presented through speakers or headphones
on the childs right and left side. A toy to the right or left is simultaneously lit or animated. After a few presentations the child associates the
sound with the toy and responds by looking in that direction. Once
this occurs, the toy is then turned on only if the child correctly turns in
response to a sound. Seeing the toy acts as a reward that keeps the child
turning whenever a sound is heard. Delaying the lighting or animation
of the toy prevents it acting as a cue for when to turn. The sound volume is reduced to find the quietest level at which the child correctly responds. This is then done at other pitches. The test is fun for the child,
takes only a few minutes, and provides a good estimation of the hearing.
By three or four years of age children begin to lose interest in VRA
testing too quickly for it to be effective. Fortunately, these children are
now ready for something else. While they still wont raise their hand
in response to sounds, they will usually respond if it is made into a
game. This is called play audiometry. The most common form is to
have the child throw a block into a box or bucket whenever a sound
is heard. Except for resulting in a mess of blocks everywhere, it works
surprisingly well. Similarly, children this age may not repeat words, but
they usually will point to pictures. A child who can correctly point to
a picture of a baseball or a hotdog when the word is presented much
softer than a whisper likely has good hearing. There may be a problem
if the words have to be louder. This combination of blocks and pictures
served as the games that Sam found enjoyable at the beginning of the
chapter.
Correctly identifying and quantifying a hearing loss is only one
part in the evaluation of a child with a hearing problem. Also of con-
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cern is how the loss might affect speech, language, and educational development. Because of this, referral to educational specialists as well
as speech and language pathologists is routine when an uncorrectable
hearing loss is found in a child.
Hearing Professionals
A variety of people may examine or in some way test the ear. A school
nurse or a parent volunteer may do a quick kindergarten hearing screening. A general practice physician may examine the ear for earwax or
signs of infection. There are professionals, however, that are specially
trained to work with ear problems. The first of these are ear, nose, and
throat (ENT) physicians. They are also known as otolaryngologists.
Physicians who focus strictly on the ear are called otologists. All of
these specialists can diagnose ear problems and medically or surgically
treat the ones that are correctable. The other professionals extensively
trained to evaluate and work with ear problems are audiologists. These
professionals evaluate hearing loss as well as provide a variety of rehabilitative measures, such as hearing aids and assistive devices. Audiologists are the mainstay for those who must cope with a hearing loss that
otologists and ENTs cannot fix. Ear, nose, and throat physicians and
otologists often work in close cooperation or partnership with audiologists to provide comprehensive hearing care.
A quick way to find an ENT physician in ones area would be
through the website for the American Academy of Otolaryngology
Head and Neck Surgery (www.entnet.org), where one can search for
a doctor by region. A local audiologist can also be found at the website for the American Academy of Audiology (www.audiology.org) or
the American Speech-Language-Hearing Association (www.asha.org).
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believe them. It can be much easier and more comforting to believe that
ones hearing remains fine and that others are mumbling. Concerns
about not hearing as well as friends and family can also be dismissed if
these people are viewed as having exceptionally good hearing. A person may instead acknowledge his or her hearing loss but dismiss it as
a normal part of aging. All of this can and often does delay or prevent
people seeking or getting help for a hearing loss.
Even full-time workers and the socially active that very much depend on their hearing have been shown to avoid acknowledging hearing difficulties. They felt stigmatized, were uneasy talking about the
problem, minimized the effects, tried to portray themselves as normal,
and had different perspectives than their spouses regarding hearing
deficits.4
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computers, cell phones, and a great many other electronic devices do.
Hearing loss or not, people adjust the volume to whats audible for
them. Since there are no standard volume settings from device to device or even from channel to channel on the radio or television, the setting on the dial may offer little feedback about a persons actual hearing
ability. What does it mean if a person turns the television up to number
17 on the loudness bar? Does this mean they hear well or poorly? More
often than not, the listener does not know and likely doesnt care. They
just want to use and enjoy these devices. For those with hearing loss
this often means doing so rather loudly.
People with hearing loss often get into the habit of watching the
person who is speaking. They do this for a couple of reasons. The first
is lip reading. Making use of lip reading may sound like some daunting
task akin to learning sign language, but this is not the case. Most people
have at least some lip-reading ability and use it without even trying. It
may not be possible to follow a conversation by lip reading alone, but it
can be a big help with filling in an occasional missed letter or word. As
long as a person can get into a position to watch the speaker, lip reading
can help. Related to this is that although sound radiates out in all directions from a source, spoken speech can be somewhat directional. Getting in front to better see a person speaking puts the listener directly in
the path of the sound.
One additional act people naturally employ to better hear and understand is to get closer. Sound volume drops off significantly the farther a person gets from a sound source. This can present a real problem
for someone who is already having hearing difficulties. Moving close
can help to bring speech and other sounds up to an audible level. It
also helps when there is background noise. From far away, a voice can
easily get lost in even a small amount of background noise. By moving
closer to a person speaking, the volume of speech increases relative to
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Social Withdrawal
Rather than intentionally or unintentionally taking steps that make it
easier to hear, some people with hearing loss react by avoiding situations that require good hearing. After repeatedly failing to hear, understand, or be certain that what was heard was heard correctly, or
constantly asking others to repeat, many people will begin to withdraw
from social activities. People with hearing loss are more likely to decline invitations to parties and avoid going to church, movies, lectures,
and various other events. The unintended result is social isolation.5
A study looking at triggers for withdrawal and isolation in industrial
workers found that the fundamental issue was worker perception of
the problem of hearing loss. Fear of being stigmatized caused workers
to conceal the hearing loss and its impact.6 Whether hearing-impaired
individuals become absent from groups due to difficulty hearing or fear
of being stigmatized, the end result is the same. Their self-imposed exclusion from groups and social situations also helps explain why Susan
Tate could find no one to ask for advice about her hearing loss. The
hearing-loss sufferers she might have asked had removed themselves
from her social circle.
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the process. Many other plans to improve hearing start small, such as
making a conscious decision to better utilize the tactics (moving closer,
watching the speaker) that come naturally. Seeking information is another small step that can serve as a starting point. Others try to solve
their hearing problem in one big step, through hearing aids or, when
possible, surgery.
Some might consider choosing to ignore hearing loss as a plan,
but this leaves a person merely reacting to the negative consequences
that ensue. Deciding to ignore a hearing problem is more an argument
that hearing is irrelevant than a strategy. This choice, made all too frequently, has more in common with denial.
Whether people start big or small, those who do decide to solve
a hearing problem need options. Some of these options may include
the few just mentioned, but there are many more. The next couple of
chapters will describe the variety available.
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2
Hearing Aids and Other Gadgets
olutions for hearing loss are rarely one size fits all. This is also
true for devices that might help a person compensate for a hearing loss. The severity of hearing loss, word understanding ability, pattern of loss (high pitched versus low pitched), and sensitivity to
loud sounds varies from person to person. Listening needs and listening environments can also be unique.
Scott Wilson, for instance, was a forty-two-year-old computer support specialist who came to our office because he was having difficulty
hearing at work. Scott was healthy, and his ears looked good, but he
had a long history of skeet shooting, which had caused a permanent
mild high-pitched hearing loss. Both he and his wife agreed that it did
not cause him any appreciable listening difficulties at home or in his social life. Scott could also hear well on his home phone and cell phone.
The problem was using the phone at work. His job entailed troubleshooting computer problems over the phone, and he was struggling to
hear the callers. He surmised that his difficulties were partially due to
the hearing loss but also to the call center where he worked, which had
lots of background noise. Scott needed a solution that would let him
effectively do his job.
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Giovanna Pizzati also reported hearing difficulties. She misunderstood her husband, which became a big problem once he retired and
was home with her all the time. She often failed to hear the doorbell
when it rang unless she was in the same room. The grocery cashier,
bank tellers, and even her priest seemed to mumble. When she misunderstood her grandchildrenwhich was oftenthey became upset
and felt she wasnt paying attention to them. Mrs. Pizzati clearly needed
help, but her hearing loss and listening needs called for a different answer than the one that would work for Scott Wilson.
Both of these people knew they had a hearing loss and were motivated to seek a workable solution. For Scott there was a simple answer
he had not considered. Giovanna, on the other hand, knew of something that should help, but she was hesitant. Like so many others, they
both lacked the information necessary to move forward. This chapter and the next will describe the range of choices that are available
to those with hearing loss. First are some options that can help with
specific listening problems.
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When surveyed about the use of alerting devices, one person responded simply, I have a dog. Even though this wasnt what we expected, it was an excellent answer, because a dog is actually a mobile,
multi-purpose alerting device. Just try to keep it from barking when
someone is at the door! On a more formal level, there are dogs specifically trained for this task. They are called hearing dogs, and they are
taught to alert a hearing-impaired person to a variety of sounds. More
information on hearing dogs can be found at International Hearing
Dog (www.ihdi.org) or Dogs for the Deaf (www.dogsforthedeaf.org).
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ties at work was one of these amplified headsets. The version he eventually got had extra large earphones that completely covered his ears
and blocked the outside sounds that often interfered with his hearing.
Whats more, his employer agreed to supply this special headset since
it would improve Scotts productivity.
A more general purpose listening device is a personal amplifier.
A personal amplifier looks a bit like an iPod or other personal music
device connected to a set of ear buds or a small headset, but instead of
playing music, it amplifies surrounding sound. It is an inexpensive option for a person who occasionally needs a boost in volume, but does
not want the expense of hearing aids.
A unique listening challenge is faced by physicians, physicians assistants, nurses, and other healthcare workers who use a stethoscope to
do their jobs. Even a little hearing loss can be a problem; a large hearing
loss can make it impossible. Switching to a stethoscope that is amplified can result in better care for the patient and a continued career for
the practitioner. An amplified stethoscope provides a good example
of the benefit that can result from finding and using the right assistive
listening device.
Captioned Devices
The ultimate goal when compensating for a hearing loss is not just to
hear, but to understandto communicate. If in spite of a persons best
efforts hearing remains impossible, the goal of communication may still
be within reach. The key is to read what cannot be heard. This may
work in only specific situations and require a little planning, but it can
be worth the effort.
The majority of people are aware that closed captioning is available on television programs. Even if they have never used it themselves,
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they have likely seen the words scrolling across the bottom of a television screen in a sports bar or waiting room. There is no charge for a
viewer to use closed captioning at home. It is just a matter of searching
through a televisions setup menus to find the closed-captioning option and switch it on.
In contrast, a standard telephone is clearly an audio-only device.
There is no built-in option for closed captioning. This is not to say
that captioned telephones dont exist. They do. Rather than being a
single device, however, this phone is part of a system. A special phone
displays the text of what is said, but a service is required to translate the
conversation from voice into the text that is shown. This may sound
expensive, but most states have programs that help to cover the cost.
Go to www.captel.com or www.captioncall.com for more information.
Those of us with children or grandchildren know that much of
their communication is done by texting. They could easily talk on the
phone with their friends but choose instead to use their thumbs. Having a hearing loss should not stop a person from following this crowd.
Similarly, much of what is said or texted on the phone could just as
easily be conveyed through e-mail.
One time-honored way to communicate without the need for hearing is to write notes. As long as ones handwriting is legible, this does
work. The downside is that it can be slow and cumbersome. An alternative for those with a little computer know-how might be to display
the text of spoken speech on a computer screen through the use of
speech recognition software. Most of these computer programs were
originally designed for business uses, but they have evolved to provide
the general public with an alternative to typing. A person speaks into
a microphone headset and the words appear on the computer screen.
As long as the speaker, listener, and computer are all in the same place,
it can act as a form of closed captioning. Given a laptop or other small
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Hearing Aids
Hearing aids are the best option for the majority of people with hearing loss, because they help in not only one or two listening situations
but over a variety of them. Hearing aids were the solution that Giovanna Pizzati needed, but she hesitated out of fear that they might be
too complicated for her to work. In the end she gave them a try. She
was surprised to find that they were not only easy to use but made it
possible for her to hear her husband at home, the cashier at the grocery,
the teller at the bank, and a variety of people who had seemed to be
mumbling. Mrs. Pizzati felt that had she known more about hearing
aids, she would not have hesitated so long. Other patients in our survey
have expressed similar sentiments.
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Digital Technology
Technological advances have made hearing aids better than they were
years ago. Todays digital signal processing has definite advantages
over older analog technology, but these advantages are not always what
people expect. The most common assumption is that digital sound will
be noticeably clearer. What many forget is that the high-fidelity analog
stereo systems that were enjoyed years ago had awesome sound. Clarity wasnt an issue. Similarly, many of the older analog hearing aids had
very little distortion. Going digital didnt necessarily change this.
The real advantage of having a digital processor is that it makes a
hearing aid highly adaptable. It can be variably programmed for different pitches to bring a wide range of speech into an audible range,
while also limiting loud sounds from becoming uncomfortable. It can
also be fine-tuned based on a persons listening preferences. Digital
technology additionally makes possible or improves the functionality
of a variety of helpful features, such as noise reduction and feedback
suppression.
The adjustability of a digital hearing aid depends largely on how
many channels, or bands, it has. A hearing aid with only two bands, for
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instance, would divide the entire frequency range into high and low
pitches. Either band could be emphasized, similar to using the bass
and treble controls on a car radio. A hearing aid with multiple bands is
more like a graphic equalizer that can better balance sound for an individuals needs or preferences. Most of todays hearing aids incorporate
ten to twenty frequency bands that can be programmed independently.
Having this flexibility is especially important for individuals who hear
better at some pitches than others. Being able to adjust a small portion
of the frequency range is also helpful for limiting specific sounds that
might otherwise be uncomfortable.
Another advantage of digital technology is that it can allow a hearing aid to have several different programs. The default program might
be intended for everyday listening. A second might have reduced amplification and an aggressive noise filter to help in a loud work environment. A third program could be adjusted to faithfully reproduce
music rather than emphasizing the speech frequencies, as is the norm
in hearing-aid design. Older hearing aids had only one program that
was often an uneasy compromise between an individuals many listening needs. Digital models that perform as several different hearing aids
in one result in fewer compromises.
The microphone traditionally used in hearing aids is omnidirectional, meaning it collects sound from all directions. This helps to ensure that speech and important sounds are not missed, but it has the
disadvantage of bringing in a panorama of unwanted sounds. A man
wanting to hear his wife who is sitting across the table in a restaurant
hears the people behind him as well. A woman trying to listen to her
children in a school play hears an infant shaking car keys at the end of
her row. One way to overcome these shortcomings is to also include a
directional microphone in the hearing-aid design. This microphone
focuses on sounds coming from the front and ignores sounds from the
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sides or from the back. A user can then switch back and forth between
the microphones (directional or omnidirectional) best suited to a situation. A more sophisticated style of directional microphone incorporated into many digital hearing aids looks for sounds that appear to be
human speech and focuses in that direction. These directional microphones are sometimes called adaptive or automatic. Two separate reviews examining directional microphone functionality both concluded
that this feature is a plus for hearing and understanding.2
Noise reduction is another feature incorporated into many hearing aids. The digital sound processing that allows for the amplification
of wanted sounds can also be used to minimize or eliminate sounds
that are unwanted. Hearing-aid manufacturers use a variety of different proprietary noise algorithms, but the general approach is to
minimize sounds that have a different acoustic signature than speech.
Reducing noise can improve listening comfort and in theory improve
understanding. The problem for understanding is that in a busy restaurant or at a church social, unwanted conversations may still crowd
out a particular person speaking. The noise-reduction algorithms
dont know which people to amplify and which to consider noise. This
issue may explain why the reviews that found directional microphones
helpful for improving speech understanding reported equivocal results
for noise reduction.3 Nevertheless, noise reduction remains important for reducing unwanted sounds and is often used in combination
with directional microphones as part of an overall strategy to improve
understanding.
A common complaint of older hearing aids was whistling. This occurred when sound from an aid escaped the ear and entered the hearing aids microphone. A feedback loop ensued in which sound would
be amplified again and again until an aid would screech at its maximum
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loudness. It was annoying for the user and for bystanders as well. Today, feedback suppression is included on all but the most basic digital
hearing aids. Some of the best employ noise cancellation technology,
which is highly effective. Feedback suppression might not completely
eliminate the chance for whistling, but it makes this unwanted noise
much less likely in everyday use.
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the Bluetooth signal sent from external sound sources and then sends
the sound to the hearing aids. Once the parts are synchronized or
paired with each other, everyday connection between the hearing aids
and Bluetooth devices is usually seamless.
A wax guard is another hearing-aid option to consider. Earwax is
the arch nemesis of hearing aids. It can block the devices opening, preventing sound from getting to the ear. Wax can also build up against the
receiver, causing corrosion and failure and necessitating costly repairs.
A large number of hearing aids returned to manufacturers for repair
have stopped functioning solely because of earwax. With a little planning, however, preventing interference and damage from earwax need
not be difficult. Hearing-aid manufacturers offer a variety of guards
that act as a barrier to the wax. Most are either incorporated in the
original design or offered as an option at the time of manufacture. A few
are sold as an aftermarket item, such as disposable stick-on wax guards.
Hearing-aid buyers are inclined to focus on cosmetic and technological
features. A wax guard may seem inconsequential in comparison, but it
is not something to overlook.
One final option worth noting is a hearing-aid drier. Hearing aids
are not generally designed to get wet. A good soaking can damage the
electronic components. Even high humidity or excessive perspiration
can cause internal corrosion. A few hearing aids claim to be water resistant. Fewer still profess to be waterproof. Even so, a hearing-aid owner
will be best served by keeping his or her devices as dry as possible. Real
life, however, sometimes does its best to prevent this from happening.
A person gets caught in the rain, becomes the target of a grandchild
with a squirt gun, drops the hearing aid in the sink, or soaks it with
sweat while gardening. Fortunately there is an inexpensive accessory
called a hearing-aid drier to help in these situations. It consists of a
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small jar or other container that is filled with a desiccant similar to that
shipped with new shoes or electronics to keep them dry. The hearing
aid is closed in the drier overnight and the desiccant absorbs any moisture. There is also an electronic version of this device. Some people use
a hearing-aid drier only in case of emergency; others who live in damp
climates or perspire easily use it routinely.
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be fixed are fixed and that people are not sold hearing aids unnecessarily. There is no similar safeguard for people compensating for a hearing
loss in other ways. Some needlessly struggle with a correctable problem. Being aware of the medical possibilities can help a person to minimize this risk. The next chapter explains these possibilities.
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Treatments for Hearing Loss
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Ear Infections
The other common treatable condition that can affect a persons hearing is an ear infection. Infections sometimes occur in the skin of the ear
canal or in the space behind the eardrum. The skin of the ear canal can
become infected through an abrasion from a fingernail, bobby pin, or
other object that would be better left out of the ear. Water remaining in
the ear after swimming can also contribute. Bacteria like dark, warm,
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moist places to grow such as a wet ear. This is why these infections are
often referred to as swimmers ear. Once infected, an ear canal can
itch, swell, seep, and hurt. Hearing is not usually affected unless the
ear canal swells shut, in which case sound is blocked from reaching the
eardrum. Swimmers ear is usually treated with medicated eardrops or
ear wash.
Another frequently seen problem is otitis media, in which the normally air-filled space behind the eardrum becomes filled with fluid.
This most often happens following an upper respiratory infection. The
infection prevents the Eustachian tube from adequately ventilating the
middle ear and results in the accumulation of fluid. Otitis media may
also occur as a result of sinus problems, allergies, and pollutants. Even
second-hand smoke increases the risk.3 The fluid usually resolves on
its ownbut if it does not, it provides an ideal environment for bacteria. Middle-ear fluid that becomes infected is then called acute otitis
media. It can cause the eardrum to bulge painfully or even burst. Acute
otitis media is treated with oral antibiotics.
Infected or not, otitis media usually impairs hearing. The fluid
presses against the eardrum, interferes with the motion of the ear bones,
and acts as a barrier to sound. A little fluid may have little impact, but a
lot of fluid or fluid that is thick creates a significant impairment. It may
be possible to wait to see if a slight hearing loss from otitis media might
go away on its own or following antibiotic treatment. Waiting in the
hope that a bigger loss will resolve can be more difficult.
Fluid in the middle ear that does not go away can be drained
through a procedure called a myringotomy. A physician first numbs the
eardrum with a drop of medicine, then puts a small nick in the drum.
Fluid is suctioned through this small hole. In most cases the eardrum
heals in a few days and the fluid does not reoccur. With the fluid gone,
there is no longer an impediment to sound transmission. If the fluid
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Prevention
Often overlooked in the search for possible treatments is the importance of prevention. The best treatment is one that avoids the development of a problem in the first place. Anything that stops a progressive
condition from becoming worse could also be considered an effective
treatment. Hearing-loss prevention meets both of these criteria.
Perhaps the most practical and well proven way to prevent hearing
loss is to avoid or protect oneself from loud noise. Keeping away from
loud noise can also avert additional damage for those who already have
some loss. More on this important and all too often neglected subject
will be presented in later chapters.
Medical conditions, medications, industrial solvents, and environmental hazards can also lead to or worsen hearing loss if left unchecked. Smokers and people who live with smokers have been found
to be twice as likely to develop hearing loss as non-smokers.4 People
with diabetes are at increased risk of hearing loss, and this is especially
true if the disease has been uncontrolled.5 High blood pressure is additionally a concern: better management of it might prevent many hearing losses that are now attributed to age.6
Ear, nose, and throat physicians routinely consider a patients
medical history, work environment, and personal habits when looking for factors such as those just mentioned that might have caused
or that might further contribute to a hearing loss. One way a patient
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can help in this process is to thoroughly complete any medical or history questionnaires that the doctor requests. Even seemingly unrelated
questions can be important and their answers may provide the clue
needed to head off a hearing problem or stop an existing problem from
worsening.
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Small traumatic perforations can often be repaired with the placement of a paper patch over the hole that serves as a template for healing. This simple procedure can be performed by an ENT physician
in-office and has been found to be effective in up to 92 percent of these
cases.8 Tympanoplasty surgery is required to repair larger or more
complicated perforations. During this surgery a tissue or vein graft is
placed over or under the remains of the eardrum, depending on the
size and location of the perforation and the preferred technique of the
surgeon. This is done on an outpatient basis at a hospital or surgery
center and can result in a dramatic hearing improvement. The success
rate has been reported at about 90 percent.9
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anesthesia. If there is also the need to repair a hole in the eardrum, the
combined procedure is called a tympano-ossiculoplasty.
Ossiculoplasty can result in a big hearing improvement. The larger
the conductive hearing loss prior to surgery, the greater is the potential
for hearing gain. Even a successful ossiculoplasty, however, may not completely restore the hearing to normal. This is especially true if all of the ear
bones have to be replaced, because the one replacement prosthesis cannot reproduce the natural amplifying lever action of all three ear bones.
Cholesteatoma
Hearing loss can also occur from cholesteatoma, which is an abnormal
skin growth in the middle ear. Cholesteatoma most often develops after
a history of Eustachian tube dysfunction and ear infections. Skin from
the ear canal enters the middle ear through a hole or retracted area in
the eardrum. The skin and dead cells that are shed from the skin then
accumulate in the middle ear and become infected. Left unchecked,
cholesteatoma can further erode the eardrum, dissolve the ear bones,
and damage the facial, balance, and hearing nerves. More serious complications are also possible but rare.
One of the first signs of cholesteatoma is often a foul-smelling drainage from the ear. The initial diagnosis is sometimes an ear infection,
because drainage and swelling obscure the cholesteatoma. An ENT
physician will usually try to clean the canal so that the eardrum can be
inspected, but the ear may be too swollen or painful. When this is the
case, a diagnosis of cholesteatoma may not be made until a follow-up
visit, after treatment with antibiotics or a medicated ear wash. Patients
may be tempted to forgo the follow-up if the ear seems better after the
treatment, but those who succumb to this temptation end up returning
to the doctor a little later when the ear starts to drain again.
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The standard treatment for cholesteatoma is surgical removal under general anesthesia. The eardrum then needs to be reconstructed, to
prevent the process from starting anew. An ossiculoplasty may also be
required if the ear bones have been damaged or destroyed. All of this
is ideally done during one surgery. If the cholesteatoma removed was
extensive, however, a surgeon might close the eardrum without reconstructing the middle ear. After six months or a year a second surgery is
performed. If the cholesteatoma has reoccurred, it is removed, the eardrum closed, and another follow-up surgery scheduled. If the cholesteatoma has not reoccurred then the middle ear is reconstructed. Yearly
ear examinations are routine for anyone treated for cholesteatoma,
because the disease can be tenacious. If all goes well, cholesteatoma
surgery with ossicular reconstruction can result in a significant hearing
improvement, although some conductive loss may still remain.
Otosclerosis
Otosclerosis is a hereditary ear disease that produces an overgrowth of
soft spongy bone that fuses the smallest of the middle-ear bones (the
stapes) in place. This prevents it from transferring sound to the inner
ear. The disease is fairly rare, affecting an estimated 1.4 out of every
1,000 adults.10 Onset is most common in young adulthood but can take
place at any age; women are more likely to develop the disease than
men. Otosclerosis can occur in one or both ears. Hearing loss is progressive and can result in a severe conductive deficit. The disease process may also produce some gradual sensorineural loss over time.
Next to wax buildups and ear infections, hearing losses from otosclerosis are some of the most treatable. A surgical procedure called a
stapedectomy (or stapedotomy) is performed in which all or part of
the stapes bone is removed and then replaced with a prosthesis that
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restores sound transmission to the inner ear. The normal lever action
of the ear bones is maintained, so there is no loss in efficiency with
this reconstruction. Patients with otosclerosis who are deemed candidates for stapedectomy surgery have up to a 95 percent likelihood
of significantly improved hearing with little or no remaining conductive loss.11 In addition to surgery, medication may also be prescribed to
try to minimize or prevent the development of sensorineural loss from
otosclerosis.12
The benefits of this surgery were exemplified by a young woman
I met years ago during her preoperative visit. Through her childhood
and teenage years she had enjoyed perfectly normal hearing. Starting in
her early twenties, however, her hearing quickly diminished to a moderately severe loss in each ear. She couldnt hear her children, work had
become impossible, and she did not feel safe going out by herself. One
month following her surgery, testing showed the hearing in her surgical
ear to have been restored to normal. Six months later she had surgery
in the other ear, with a similar result. Her hearing was still good when I
saw her twenty years later during a routine follow-up.
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ears. The portion of the inner ear responsible for balance can also be
affected. Autoimmune inner ear disease may occur in isolation or in
combination with other autoimmune diseases, such as lupus. Physicians sometimes order a variety of blood tests to look for signs of the
disease, but diagnosis can be difficult because there is no one specific
diagnostic test.16 For patients who are diagnosed, however, steroid
therapy offers the hope of improved hearing and balance.17 Because of
diagnostic difficulties and the desire to catch the problem early while it
is more easily treated, physicians may try steroid therapy if there is even
a suspicion of autoimmune inner ear disease.
Mnires Disease
Mnires disease is another treatable inner-ear disorder that can adversely affect hearing. The classic symptoms of this disease are an incapacitating vertigo, fluctuating hearing loss, a roaring sound, and a
sensation of fullness in the affected ear. The symptoms occur together
during Mnires attacks, which typically last from several hours to a
few days. Attacks can happen days, weeks, or even years apart. Usually
only one ear is affected. A persons hearing may recover completely
after the first few attacks, but repeated attacks can result in a severe
hearing loss that does not return to normal.
Mnires disease is thought to be caused by a buildup of fluid
pressure in the balance portion of the inner ear. There is no known
cure, but there are treatments to minimize the frequency and severity of attacks. One of the most basic is switching to a low-salt diet to
help prevent any fluid buildups in the inner ear. Diuretics may also be
employed to reduce fluids in the body. Excess fluid may additionally
be reduced by surgically placing a small silicon tube (a shunt) into the
inner ear. Beyond controlling the dizziness, the hope is that fewer or
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Congenital Loss
The overall incidence of congenital hearing lossmeaning it is present
from birthhas been estimated at 2 or 3 children out of every 1,000.18
One or both ears may be affected. The vast majority of congenital losses
are sensorineural and considered permanent. Some are hereditary, and
their likelihood is predictable based on family history. Genetic testing
can identify the cause for some others. Often the reason for the sensorineural hearing loss remains unknown. Hearing aids are the usual
recommendation when a congenital hearing loss is in the mild or moderate range. If the loss is severe or profound, the medical interventions
discussed in the next section become viable options.
A congenital hearing loss can also result if the outer portion of the
ear or ear canal fails to develop properly. This is called atresia or microtia. The inner ear may be unaffected, but there is no passageway
for sound to reach it. If the inner ear is good, it is sometimes possible
to surgically create a new ear canal to transmit sound into the ear. The
less invasive alternative to this surgery is the bone-anchored hearing
aid discussed next.
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conductive hearing losses that cannot otherwise be corrected. The system consists of several parts (figure 3). On the right is shown a small titanium implant that is surgically inserted into the bone behind the nonhearing ear. A bell- or tulip-shaped titanium abutment is connected to
the implant with a threaded connecting pin. The abutment extends
slightly through the skin, much like a tooth pushing up through the
gum but with far less protrusion. A sound processor (shown on the
left) snaps on to the abutment and can be worn as much or as little as a
person wishes. Figure 4 shows the complete system in place behind an
ear. A persons hair almost always blocks the abutment from view and
sometimes also the processor, depending on hair length. In addition to
traditional bone-anchored hearing aids, there are also abutment-free
designs that hold the processor in place with a magnet implanted un-
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der the skin. This works generally similar to directly attached models,
but there is nothing visible protruding through the skin.
A bone-anchored hearing aid works by taking outside sounds and
converting them into vibrations that travel through the skull to both
inner ears. If a person is deaf on one side, the sound vibrations travel to
the opposite side where they can be heard. If a hearing loss is instead
conductive, such as from atresia or other middle-ear pathology, sound
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vibrations travel through the bone to bypass the problem and reach the
inner ear directly. The sound is natural, and users require little or no
time to adjust to the improved hearing. It is also effective regardless of
whether the loss was from birth or acquired later in life.
Further information about traditional bone-anchored hearing aids
can be obtained from Cochlear Corporation (www.cochlear.com) and
Oticon Medical (www.oticonmedical.com). Information on the Cochlear Attract and MED-EL Bonebridge magnetic systems are available at www.cochlear.com and www.medel.com.
Cochlear Implant
A cochlear implant is a medical device specifically designed to help a
person overcome a severe or profound sensorineural hearing loss that
is beyond the range of hearing aids. It is todays bionic ear. Worldwide
there are more than 300,000 in use.19
A cochlear implant consists of at least two parts (figure 5). The
first part is the implant itself. The electrode portion of the implant is
inserted into the inner ear (cochlea) to replace the nonfunctioning sensory cells. The body of the implant sits under the skin a little behind
the ear. Surgery is performed on an outpatient basis under general anesthesia and usually takes two or three hours. Healing takes four to six
weeks, and then the second essential part of the implant systemthe
externally worn sound processoris programmed for the individual.
The traditional style of processor looks similar to a behind-the-ear
hearing aid, except that it also has a transmitting coil that talks to the
implant. Other parts of the implant system shown in figure 5 include an
alternate one-piece style of sound processor and a remote control. The
relative position of the implant and externally worn processor behind
the ear are shown in figure 6.
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Nothing is heard with a cochlear implant until the sound processor is programmed and turned on. When this first happens, sound
may have little meaning and seem like gibberish. The recipients brain
needs time to adjust to this new input. People who could hear and had
developed speech and language before becoming deaf adapt the most
quickly. Those with a congenital hearing loss have to learn everything
from the beginning. This takes longer and requires extensive speech,
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hearing-loss basics
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dow and hearing birds sing. Reactions such as hers are common with
a cochlear implant.
Additional information about cochlear implants is available from
Advanced Bionics (www.bionicear.com), Cochlear Corporation (www
.cochlear.com), and MED-EL Medical Electronics Corporation (www
.medel.com).
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P a rt T wo
First-Hand Experience
and Advice
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4
Real-Life Consequences of Hearing Loss
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first-hand experience
understand and sympathize with her viewpoint. I also began to recognize her view as prevalent among many other patients. They wanted at
least some of their hearing-loss information first-hand. This realization
was the impetus for the patient survey that provides the first-hand information and insights offered through the rest of this book.
What is the first-hand reality of hearing loss? What are the specific
ways individuals see their lives affected? The answers are personal, and
as the responses that follow attest, there is not just one answer. This
chapter begins with a few of the more obvious problems that patients
described. A variety of other issues resulted as secondary effects that
were every bit as real, but might not on the surface have seemed as apparent. The second part of the chapter focuses on these.
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Misunderstanding
Difficulty understanding speech was the most frequently reported
problem resulting from hearing loss. While only a few people lamented
not hearing the doorbell ring or the sound of raindrops, everyone who
responded mentioned problems with understanding what others are
saying. At times the problem appeared to be the hearing loss making
a speaker largely inaudible. More often, speech was heard or heard
poorly, but not well understood. This happened not only in person
but also with devices like the telephone and television. Especially
problematic was understanding in noisy settings. Some understanding
trouble was obvious to the listener. At other times the listener thought
he or she understood what was said, only to find that this was not the
case. The following comments illustrate some of these difficulties with
understanding.
I cant understand what people are saying particularly in
groups or with background noise.
I sometimes misunderstand when or where to do things.
Sometimes fail to hear all that others say resulting in misunderstandings. My interpretation of not clearly heard words may
be wrong.
I have difficulty understanding in large groups.
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This past week I bought a new ear plug for my amplifying
gadget I use in church. When we left the store my friend told me I
had bought a warranty for it. I didnt understand the clerk.
While in groups at restaurants, meetings, I have difficulty
hearing when many are conversing or many other noises are in the
background. At church, it is difficult when different microphones
are used in different places.
I dont hear clearly what people are saying.
My hearing loss is relatively minor, but I do have trouble hearing some voices (especially soft voices, people who do not speak
up, people who do not speak clearly, and sometimes I have trouble
with telephone calls).
Difficult to carry on conversation in large crowds.
Sometimes I dont get all of a conversation. I may agree with
someone without knowing what really has been said. I ask people
to repeat things a lot.
People have to repeat what they say to me.
The telephone was the biggest obstacle. Words sounded different than what the person was saying.
Miss parts of conversation when more than one or two people
are around me. Retired so its mostly friends and relatives. Background noise is the biggest problem.
Difficult to hear when people speak quietly.
Unable to understand children, hear on phone, TV, etc. Day
to day tasks such as banking cannot hear teller.
Its difficult to carry on a conversation with a group of people
at restaurants or gatherings. Others have to repeat themselves so
often when having a conversation. If everything is quiet its not as
difficult to hear.
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first-hand experience
I had to ask people to repeat.
I can perform most activities myself. I sometimes ask people to
repeat even though I am wearing hearing aids.
I always got to ask someone to repeat what they said.
People have to repeat what they said to me.
They often have to repeat what they said to me.
I still perform all my normal tasks. I often ask people to repeat
what was said.
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first-hand experience
any activity, and there is a good chance that hearing is involved. Even
something as seemingly unrelated to hearing as bird watching has a
hearing component. First, hearing helps a birdwatcher locate birds.
Then, being able to listen to any birdsong adds to the enjoyment. If
an activity includes other people, the chance of hearing being involved
increases significantly. With few exceptions, movies, music, lectures,
meetings, church, family gatherings, and everyday conversation are
dependent on good hearing. Difficulty hearing may reduce the enjoyment of any of these activities or cause a person to forgo them entirely.
The effort and fuss required to participate can reach a point that it just
doesnt outweigh the benefit. People begin to skip things.
I avoid crowds and parties.
I tend to stay out of groups. I have insulted people who spoke
to me and I ignored them. I have answered questions I wasnt
asked. Misunderstood what was said. I only watch TV shows
without background noise (music, clapping).
Not able to hear what people are saying. Background noises make
dining out and attending church and other functions hard to hear.
I dont go out as much. I cant do jury duty.
Hard to hear unless person is very close.
I avoid loud places, i.e. bars.
Theaters and concerts are not enjoyable anymore.
I really do not swim anymore because I cant wear hearing aid
and I feel helpless without it.
It is a problem not hearing well. I miss hearing my TV programs well. I read a lot and that helps.
Went on a trip with friends recentlyreduced enjoyment. Between cataracts and hearing problems our love of travel has been
very curtailed.
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loss, however, average annual earnings declined $14,100. The worst hearing losses resulted in as much as $30,000 less per year. Interestingly, this
same study found little evidence that those with hearing loss felt they had
been discriminated against in terms of promotions or earnings. The comments that follow illustrate several workplace-related hearing difficulties,
but as in the study, the issue of income was largely left unaddressed.
I was a teacher and often did not hear my students questions
and I did (and still do) answer questions wrong because I fill in
words that I didnt hear and what I did hear was wrong.
It affected me at my educational administrative position.
Sometimes dont hear directions or names correctly. At work I
may not relay messages accurately.
Had trouble at work because I would only hear bits and pieces
of conversation.
At work I had a difficult time hearing my students. I am a Spanish teacher and good hearing was essential to my job.
It also impacted me at work as sometimes I could not hear a
soft spoken person on the phone.
Employment is limited. Before I retired, I had to change my job
duties where I didnt have to talk to people except on the phone (I
can hear fine on the phone).
Cannot do most things that require you hear in order to do a
job or run machinery.
Work as a police officer, need to hear for public safety.
My work includes many meetings and telephone conversations. Without hearing aids I would not be able to function in
those environments.
At work I aim to stay out of meetings.
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first-hand experience
I have others repeat, but does not hinder anything else to the
best of my knowledge.
Yes. Others have to constantly repeat themselves and express
themselves.
My hearing affects others because of conversation and they
may need to repeat or speak louder in some situations.
Family thinks they have to raise their voices to talk to you. They
have to get up close and repeat themselves. It irritates them.
My long suffering wife needs to repeat herself.
I ask people to repeat words. Says they told me but I didnt
hear them.
My relatives get impatient with me because I always ask them
to repeat themselves.
Sometimes people get impatient when I ask them to repeat.
Having others repeat is annoying to them and myself.
Friends and family have to repeat what they say.
I think people get annoyed because they have to keep repeating what they say to you.
Others get disgusted because they have to repeat what they
said.
My friends, co-workers, family have to speak clearly, not whispering or mumbling.
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Wife gets very upset having to repeat.
Just my kidsall grown up and love to tease mom.
Im sure it does sometimes. I might ask them to repeat what
they said or give me an answer not related to what they said because I misunderstood the words they spoke.
At home Im affected because my husband refuses to talk directly to me. He talks while walking away from me or from another
room.
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I try to have someone with me when I have to go somewhere
that I have to follow directions.
At a busy restaurant I often look to family members to repeat what the servers say or to answer for me because I cant hear
them.
I have others make calls for me. Many times I have to give the
phone to my wife or someone else to help me make calls.
Even though I wear hearing aids all the time, I sometimes ask
others (especially my wife) to deal with telephone calls.
I let others talk on the phone for me when phone does not have
a speaker or in situations where a speakerphone is inappropriate.
I have my wife do most of my telephone chores.
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ily overheard and utilized by someone with normal hearing are inaccessible with hearing loss. All of this casual overhearing and perhaps
downright eavesdropping left undone can also be isolating. It may not
necessarily be clear to someone with hearing loss exactly what is being
missed, but they do feel left out.
A good example was recently described to me by a retired college
administrator. Many years ago he had suffered a sudden hearing loss
that left him essentially deaf in one ear. He had learned to cope fairly
well by turning toward the person talking or by positioning himself so
that family, friends, or others he wished to hear were on his good side.
This method, however, was not foolproof. He told of being seated at an
event with a pastor at his side. After the event he was surprised when
the pastor seemingly out of nowhere asked if he had a hearing loss. Apparently the pastor had been talking to him the whole time and he had
been unaware. How many other situations in which something like this
may have occurred, he could not say. His experience of being left out
was not unusual.
I feel like Im missing out on most conversations, only getting
partial stories. I sometimes embarrass my children when I respond
to what I think people are saying to me.
Im less likely to join in a group conversation because many
talk too fast, too softly, or not plainly for me to understand what
is said.
There are times when its a blessing, but in reality it isolates you.
You miss out on a lot of conversations in social settings.
I feel left out of many conversations because I cant hear all the
words. People must repeat things over and over.
You miss out on conversations.
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Friends obviously avoid conversation; others try not to be
obvious.
My close friends will not visit or watch TV with me because I
have to have the volume up!
Atmosphere of isolation if hearing loss continues.
It affects you in all aspects of life. You constantly feel left out
because of hearing loss.
I cannot participate in group discussions.
I feel I miss quite a bit.
Staying away from groups. Not wanting to socializebackground noise. Problem understanding conversation on TV. Especially on the phone.
I try not to go places where there is a crowd and so I know I
miss out on a lot.
Ive become a little more isolated, especially avoiding crowds.
I notice they talk low and I feel left out.
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Makes you sad. Sometimes they blame you, say you arent trying
to hear them.
Many questions/statements made to me need to be repeated.
Can get frustrating at times.
Mostly annoying. Makes me very aware of my age.
Its embarrassing when I dont hear what someone is trying
to tell me. I also feel badly when the person I dont understand
becomes impatient or disgusted.
I can get very irritable and edgy when trying to hear something.
It really doesnt bother me! Sometimes I get upset if I cant
hear people with soft voices.
I can be irritable with someone who talks when Im trying to
hear something like the news.
My hearing loss made it much more difficult to communicate with others. I was constantly asking people to repeat things.
This frustrated me, made me anxious and sometimes annoyed
others.
It is very discouraging.
There are many times that I do not know what is going on
around me. I feel that I miss out on important information and
facts. Family gets nervous and yell for me to hear and then I get
frustrated.
I cannot carry on a conversation in a large group or a noisy
place. People have to repeat much of what they say to me. So I get
embarrassed and just give up.
It makes you irritable not being able to hear people.
I have a spouse who is soft spoken and I must ask him to speak
up repeatedly and it becomes frustrating.
Sometimes makes me mad when I cant hear something.
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It is embarrassing when meeting people and when answering the telephonehaving to say please speak louder, I cant
hear you!
Makes me mad when unable to hear.
I get frustrated at not being able to hear what is being said.
Affects my mood and leisure. Am retired. Very depressing.
People get impatient with me.
It sometimes affects my mood because it is stressful when I
am around people whose voices I cannot hear. I am saddened
because I cannot go to movie theaters anymore. It does not affect relationships. My husband, family and most friends are very
understanding.
Im insecure and dont like to tell people I have a problem. The
guys at work joke about it. I get mad when people are insensitive.
I get very frustrated when I cant hear conversations. I then
usually give up on it. I feel embarrassed to keep saying pardon
me? When I taught elementary school it was difficult because the
children mumbled or turned their head away and could not hear
them at all.
I miss many words and conversations. Its frustrating.
A lot of embarrassment when I misunderstand what is being
said because I dont hear all of the questions or conversation. My
friends get tired of repeating themselves and I still dont know if I
heard them correctly.
It makes me feel stupid because I dont hear everything. People talk softly or mumble and have their back to me and I dont
hear them.
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5
Coping and Getting Help
xcept for his hearing loss, Gunnar Schmidt was a fairly typical seventeen-year-old. He was a senior in high school, played
on the basketball team, and looked forward to college. Whats
more, his grades and standardized test scores had earned him a full
scholarship to a respected university. None of this was an accident,
however, because many people had worked to make sure that hearing
loss did not stand in his way.
There had been concern about Gunnars hearing from the start,
because his mother and older brother both had hearing loss. When
Gunnars newborn hearing screening indicated a problem, his mother
saw to it that further testing and a medical evaluation quickly followed.
Gunnar was soon fitted with hearing aids, and she made sure he wore
them. The close interaction she maintained with his ENT doctor, audiologist, speech language pathologist, teachers, and school educational specialists meant that Gunnar had all the tools he needed to do
his best.
Gunnars mother had also taught him to move closer to the person
speaking, lip-read, and engage the help of others wherever practical. He
would often let others know they should get his attention before speak92
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ing, seek a copy of classroom notes from a friend, or ask his teachers
to present homework assignments on the blackboard as well as orally.
Hearing aids provided his primary assistance, but he did not overlook
the little things that might additionally help.
Mrs. Schmidt knew the ins and outs of living with a hearing loss.
She had also learned a lot about childhood hearing loss and made a
variety of medical and educational contacts when her oldest son was
diagnosed and cared for. Whether there was something Gunnar could
do to more easily hear or something others could do to help, she orchestrated it all. Gunnar was the beneficiary.
The story is very different for most people with hearing loss. They
dont have someone to round up a whole team of the right professionals or offer first-hand advice about how best to cope with the range
of difficulties hearing loss can impose. They may not even be aware
of the problem. Recognition can be slow in coming because hearing
loss often develops gradually over months and years. Without a sudden
change to create a light-bulb moment of recognition, the hearing may
be perceived as normal long after it is anything but.
Whether folks acknowledge a hearing loss or not, they almost
always take at least a few steps to cope with it. Lacking the advice of
Mrs. Schmidt, some of these steps turn out to be well planned while
others not so much. Still, little things can make the difference between hearing and not hearing or understanding and misunderstanding. Some of these things are free. Several require buying hardware.
Unfortunately, a few that work well, such as asking people to repeat
themselves, can also be annoying to others. They are easy to spot
when described.
Patients explain in this chapter how they went about getting information and help as well as what simple listening strategies and
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non-hearing-aid technologies they tried. The focus here and in the following chapter about hearing aids is on what patients actually did and
experienced. What patients recommend based on these experiences
comes later.
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I am a health educator, familiar with hearing loss. Most information I received about hearing aids came from other people who
had them.
Ear doctors and hearing-aid center. Very good quality.
After I was diagnosed I read a magazine (Hearing Loss Magazine) that explained many aspects of hearing loss, evaluation and
real-life case scenarios.
Experience observing how my wife managed her hearing loss,
books, computer searches (used with caution).
My relatives. The quality is OK but I need a professional for
exact information.
Hearing tests and information given by hearing-aid personnel.
Reading about products in paper and in ads.
Veterans Administration. I broke eardrum while serving in
Korea.
My doctor and his staff. He helped me see I needed my aids.
I see ads but they dont explain a lot.
Internet.
Doctors office, Internet, news stories. I dont really get a lot
of information.
Reputable hearing-aid agents and friends who are knowledgeable.
Family and friends I guess.
My ENT physician and hearing-aid supplier. I believe the information Ive received has been accurate and helpful.
People who conduct the hearing test, also most helpful the audiologist or person who fits your hearing aid and gives instructions.
Went to clinic sponsored by local hospital (very good) then
sought testing from audiologist and hospital and subsequently got
hearing aids.
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Doctors office. Good information.
Other people with hearing loss. Good information.
Mailings.
Doctors and hearing-aid people. I think they have done a
good job.
Primary source is my doctor. I rely on his opinion 100 percent.
I read articles and my doctors office is good at explaining
things.
Online, material from doctors office, talking to others who
were having trouble hearing or had hearing aids.
From friends that have the same problem.
Got a lot of info from my doctors. Some from general
advertisements.
Seeking Help
How often do people seek help once a hearing loss is suspected? Do
they do it on their own or get pushed into it? Few hurdles actually stand
in the way of finding out what can be done. A person can easily meet
with a physician or audiologist to determine whether a hearing loss can
be corrected or visit a hearing-aid center to see if one of their devices
would help. Weighed against this easy access are the denial and negative stereotypes that have already been mentioned, as well as possible
financial concerns and the general inertia of continuing to do nothing.
A study of more than two thousand older veterans showed how frequently inaction wins out.1 The study participants were checked with a
questionnaire, a hearing screening, or both to find individuals who had
some degree of hearing loss. Of those failing the screening, only 15 percent to 27 percent (depending on the screening method used) went
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No. The loss was so gradual that I became accustomed to it
until it became acute. I tried to find other reasons for the hearing
loss, made excuses.
My wife noticed the hearing loss. She insisted.
Yes, I did seek help. I wanted to hear clearly. To be truthful I
didnt realize my hearing loss was as bad as it was. It came to me
that I could not distinguish certain letters over the phone. Also, my
daughter-in-law said to me one day that she had been talking to me
and I did not respond.
No, I thought it was a temporary thing.
Yes. Because I was missing out on what people said.
Fairly soon. I felt it would not be as large an adjustment.
At first it didnt seem too bad. Once it started causing problems, I got help.
No because I was told by others that hearing aids were not the
answer.
No, because I was a truck driver and saw no reason to amplify
the noise of the truck and traffic. At that time I was either driving
or sleeping 6 days a week.
I did not seek help right away because I was thirty years old
and didnt want to admit that I was having trouble hearing
vanity!!
Yes. Realized I needed to have a device for certain situations;
otherwise it was not fair to others around me. I learned from my
dads reluctance to get hearing devices. Sooner versus later!
Yes, was teaching at the time and obviously had to hear.
Yes. I was young and had many ear infections and hearing loss
runs in family.
Yes, my father-in-law had hearing loss and surgery to help him
and encouraged me to follow up.
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Sometimes ask person to repeat or say what I believe I heard
to check if I got the whole message correctly.
If Im having trouble figuring out what someone is saying I
will ask another person who is with me to repeat what the speaker
is saying.
Sometimes I ask others to repeat even though it irritates them.
I tell them that I forgot my hearing aid.
Sometimes they have to repeat, and talk clearer.
I ask my husband to repeat what I cant hear. It helps but it can
be exhausting for him. Some people do not have the patience to
handle a disability!
Sometimes I ask someone to repeat what was said.
I say What did you say? Others repeat. I can do my normal
tasks.
I have my wife answer the phone most of the time or repeat
message again if I cant hear.
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Lip Reading
A few of the patients reported using lip reading to improve their understanding. Few is the key word here, in that only 13 percent said this.
This percentage is likely misleading, however, because even people
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who claim not to use lip reading can and usually do understand the
unheard words of a football coach when his player fumbles the ball.
The point is that enough patients reported a benefit to show that lip
reading can be helpful.
I have used lip reading.
Do a lot of lip reading.
Im not good at lip reading, but I tend to try.
In some situations, I hear and understand better when watching lip movements.
Lip reading does help.
If I cannot see their lips, have their heads down, sideways and
behind me, I need someone to repeat what they say or have another person tell me what was said.
Apparently I do some lip reading.
Seeing who is speaking as I am deaf on one side I often dont
know who is talking unless I see lips moving.
Lip reading, I can hear better.
I try to read lips but its hard. I hate to have people keep repeating themselves.
Moving Closer
Some of the patients also noted the value of moving closer to the
speaker. As their comments demonstrate, not everything that works
has to seem like rocket science.
Try to have person get closer to your ears
I do get closer and ask for people to repeat. This does help.
I move closer to the speaker.
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I try to be in smaller groups.
I sit in the middle of the table instead of at the end.
I find the proper seating at gatherings.
I try to avoid locations with a lot of background noise.
Right ear is better so I turn to the right side to converse. In
restaurant I sit in corner with back to wall. It reduces ambient
noise.
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Lip reading, leaning into the person talking, having the person
repeat.
Repeating and getting closer.
Lip-read, repeat, talk slower.
All of the above (lip reading, getting closer, having person repeat) at one time or another.
Use lip reading, getting closer, etc. when situation requires it.
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I have to have people face me when talking.
I just tell them I cant hear them in a normal way and they
respond.
Have wife listen for me or make calls etc. due to not being able
to hear.
If you ask in a nice way, people will respond.
Have person talk straight to me (not with head down in book,
looking away etc.) and repeat things.
Ask a person to speak louder, more clearly, or repeat.
I have found that if you politely ask the person you are talking
to to please speak up and or speak clearly, they will understand
and do what they can to help.
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course, that the phone was heard to ring in the first place. Several patients reported using an amplified telephone to overcome these difficulties. Also found helpful were speakerphones that allowed listeners
to use both ears and vibrating phones to make a person aware of calls.
Amplified phone helps a lot. You can control the volume and
the tone.
Use amplified telephone.
I use an amplified telephone. Yes it helps.
An amplified telephone is helpful in clarifying sound and minimizing feedback.
I use the vibrating function on my cell phone/pager when Im
in a crowd.
Vibrating phone.
I use the speaker phone.
I use speakerphone for phone conversation.
Wireless Headphones
Throughout the survey patients mentioned television watching as a valued activity, as well as the negative impact hearing loss has on it. If the
television is loud enough to overcome the hearing loss, it is often too
loud for others in the room. If it is comfortable for those with normal
hearing, then the person with hearing loss cant enjoy the show. Several
patients mentioned wireless headphones, with a separate volume control from the TVs regular speaker, as their solution for this dilemma.
Wireless headphones for the TV.
I use TV Ears [a brand name of wireless headset] for
viewing.
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Wireless earphones helped TV before hearing aids.
Wireless headphones.
I got wireless headphones attached to the TV so it doesnt
have to be so loud, but I cannot hear conversations when wearing them.
Headphones help because they block out background noise
and isolate what you want to hear. I tried them but not for long
because I moved closer to the TV.
Closed Captioning
Closed captioning is another option utilized by patients who struggle
with television listening. As they explained:
I use closed captioning for all programs that offer it. I had a
workable TV given to me but did not have closed captioning so I
gave it away.
Yes, closed captioning on TV. I can see words I dont hear
correctly.
Closed captioning, amplified telephone both helps.
Use closed captioning. It helps a little (usually cant read
that fast).
Closed captions help sometimes with complex dialog.
I use closed captions for some TV shows (i.e. British
comedies).
We use closed captioning so volume can be at a normal level.
I use closed caption on TV. Yes it is great. It sure does help.
I use closed captioning, also amplification. Headphones dont
usually work alone (cant hear as well) and using with the aids is
uncomfortable.
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Used closed captioning when watching movies. It is a distraction for rest of family members as well as myself.
Turn up the volume when by self, otherwise closed-captioning.
I use the closed captioning on TV. Yes, it does help. I would miss
a lot if I didnt have this functionbeen using it for thirteen years.
I always use closed captions when available.
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Never have used any of the aforementioned.
I havent used any.
I suppose there are special devices, but I have never tried any.
No I dont use any.
No.
Sign Language
The option of sign language deserves some discussion, since it provides a workable alternative to spoken language. It is the primary communication method of the deaf community. Yet wherever possible
spoken language usually remains the communication method of choice
for those who are hearing impaired but not deaf. Having to learn sign
language is the first problem, but not the most difficult one. The bigger issue is that family, friends, co-workers, and the majority of people
in the surrounding community are unlikely to know sign language. It
can be like trying to use only French in an English-speaking country.
An interpreter could help bridge the gap, but try to find one when you
just drop in at the bank or the grocery. Of those surveyed, few reported
knowing or having tried to learn sign language. No one reported using
it in place of spoken language.
Ive tried off and on.
Tried but failed.
Have tried a bit. Not seriously.
Im trying but not doing very well.
I already know sign language as I taught hearing-impaired
children in school.
I used some in my teaching at school, but do not use it for
myself.
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The Hearing-Aid Experience
oud noise was the downfall of Jackson Jones, and hearing aids
were his penance. At least that was how he described it. Jackson had the start of a high-frequency hearing loss by the time
he was done with his military service in Vietnam. After that, he worked
for years in a steel mill. When the mill closed, he found another noisy
but well-paying job at a stamping plant for an auto factory. He also had
a side job several summers cutting grass for a lawn service. When not at
work, he liked to hunt, target shoot, and do woodworking. When asked
if he had used hearing protection through all this noise, his answer was
sometimes. His hearing had gradually worsened over time until it
reached a point ten years ago that he felt little choice but to get hearing
aids. He was on his second set and trying to decide whether it was time
to retire these five-year-old hearing aids in favor of new ones.
Mr. Jones wore his hearing aids through most of his waking hours
every day. Even though he wore them, he wouldnt admit to liking the
aids so much as needing them. They brought peoples voices up to a
volume he could hear. He readily acknowledged that they made life
easier at home and at the quieter office job he now had at the auto company. But he also made some of the same complaints offered by other
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users of hearing aids. The complaints didnt stop him from purchasing
a new set of hearing aids, this time Bluetooth compatible, but within
several months he was describing these new ones as his penance.
No hearing-related subject generated as many comments from patients as did hearing aids. People surveyed may have said little about lip
reading, flashing doorbells, or penance, but they were not at all shy saying what they thought about hearing aids. Do hearing aids work? Do
people actually wear them? Are they a lot of fuss? Are two better than
just one? What are the pros and cons? These questions almost always
prompted a response. This was true for people who used hearing aids
and those who did not. Even questions such as How does your hearing loss affect you? or Does your hearing loss affect others? were
often answered in relation to hearing aids. A hearing loss may not have
been considered bad enough for hearing aids or considered poor
even with hearing aids. Hearing aids were seen as not only something
to be judged, but something to be judged against.
Despite all of the attention hearing aids received, there was not
always consensus about them. There were at times a wide range of experiences and beliefs. Some people felt hearing aids were very helpful
while others found fault. More often than not individuals had mixed
feelings much like Mr. Jones. For a reader whose mind is already made
up about hearing aids, the observations provided in the following pages
could easily be used to support an existing view of them as either a godsend or a curse. For those who are open minded, the following pages
should provide a more nuanced, interesting, and useful perspective.
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Most people Ive talked to dont want to wear them, like they
are embarrassed to admit they need them. I definitely do wear
them and I tell them.
I think hearing aids have improved so much that people have
a better view nowadays . . . but some young people do make fun of
hearing aids.
You are getting oldsenile.
As a negative. View it as something expected in the elderly, but
not with someone younger.
As being undesirable and a social handicap.
Expensive!! And troublesome and I can attest to both. When
they work right, theyre wonderful.
Most people I know feel uncomfortable with them.
A bit troublesome and cumbersome to use.
They probably think only old people need hearing aids.
Most people view hearing aids as a necessity for older
people.
Some view you as handicapped and dismiss me.
Just something to help you. Most people wouldnt want one.
I grew up around hearing aids as my mother wore one. Its OK
with me.
I used to think one aid you had trouble hearing; two aids and
you were deaf. Now I dont care. I wear hearing aids on both ears
and am grateful that I can hear. I do not care what others think. I
want to hear!!
Most ignore. Others who need them either do not want to pay
the price, some want to save money for their grandchildrens college, or they do not want to be bothered taking care of them.
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I dont know most of the time. If I dont care, they dont care.
Im extremely happy with mineimproved my quality of life.
I dont know anyone who has had a negative opinion of my using
a hearing aid.
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Fear and price. It had been recommended that I get two. But
insurance only covered one. I was afraid to only wear onefear of
not being able to get used to it.
Hearing loss did not seem to be serious.
Didnt think I needed it.
I just did not feel ready for them six years ago. I was in my
early forties and felt I was too young to become dependent on
hearing aids.
I could always ask people to repeat.
No. I had tinnitus and I figured hearing aids would only make
the constant ringing louder.
I was told by others that hearing aids are not the answer.
The cost. Hearing aids should not cost as much as they do.
First tried hearing aids in 1989 but they didnt help my sensorineural hearing losshavent worn them in twenty years. They
just made everything louderevery situation and noise was amplified. Actually, I have an appointment coming up to evaluate new
hearing aids.
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Yes. It seems as if every little noise is magnified. I heard every
choir member turn the pages at church. The little noises are too
distracting.
I did not have that much trouble adjusting to hearing aids.
Yes. Something in your eargetting used to different noise.
Yes. They pick up outside sounds louder than what you want
to hear in front of you.
Somewhat, but I was willing to allow time for my brain (or
whatever) to adjust to the change. I learned from audiologist
(1) it takes time to adjust, (2) devices can be adjusted and (3) some
have capability for self programming and adjustment based on
usage.
In-the-ear bothered me more and itched. Now outside the ears
more comfortable.
At the beginning it was difficult in crowded areas, such as restaurants, so many people talking at once. But, I did not give up, I
was determined to get used to it. It does not bother me at all.
Still bothers me.
Not really. I have in-the-ear aids and they from the beginning
have been very comfortable to wear. From time to time I forget to
take them out at night.
Not the open-fit ones. Easy to adjust to.
At first it was difficult, but you can tell the difference and pick
up sounds you were not able to hear.
Yes, until I got used to normal sounds.
No it was quite easy for me. Best thing ever happened after
hearing loss was the aids.
Minor adjustment to difference in sounds.
It took several months to get adjusted to them. Sort of tinny
sound of your own voice is hard to get used to. When fitted with
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aids, try to give them time to work for you, and you to get adjusted
to them.
I honestly dont remember having trouble. I really needed
them!
They have helped, but I never have gotten to the point where
I can hear clearly.
Background noise, tires on the road when driving, but it was a
pretty easy adjustment because I could hear so much better.
A few patients reported trying but then returning hearing aids. Interestingly, difficulty getting used to them wasnt the primary cause.
I tried them early on in my life and rejected them because of
my young age.
Almost twenty years ago I was not satisfied with the performance of a new pair of hearing aids. I returned them and purchased a pair from a different company.
I tried in-the-ear ones on trial. Didnt like the tunnel sound.
Yes. Was teaching schooldid not help much, could not handle putting in and out, cost. I am wearing hearing aids now. Hearing aids help a lot.
I did try them for a month. I found my hearing to be improvedbut was not ready to have them. Plus at the time, cost was
a factor.
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from far away, listening on the phone, hearing in background noise, understanding when in a group, making out foreign accents, and keeping
up when people speak fast are only a few of the listening challenges that
can be caused by hearing loss. Ideally, the goal in using hearing aids is
to negate these difficulties. But do hearing aids actually meet this need?
Are they a cure-all or do they solve only some of these problems? What
are the situations in which hearing aids were found to help?
Just in general everyday livingmeetings, company.
Watching a show or dining out with friends.
In a library, courtroom, etc. where only one person is talking.
I cant understand anything anybody says without them.
Church, TV watching, telephone, out to dinner (conversations). Any situation!
Before getting my hearing aids I had to turn up TV and radio.
TV level 21, I just got new aids, now TV is on level 12.
When I watch TV. When people speak to me on the phone.
Work, meetings, social relationships.
In a large group where people are talking from all sidessuch
as a restaurant.
Driving a car (traffic). Your TV doesnt have to be turned up
so loud that other people are bothered. You can hear without people shouting and its easier to listen on the phone.
Everyday activities, conversations, radio, TV. With hearing
aids I do not need to turn up the television or radio.
Listening to conversation in a crowd, being able to hear movies, etc. Hear sermon at church, just normal conversations.
They do amplify sound so that I can hear more.
I can hear the TV and hear what people are saying. You can
hear sounds now that you couldnt hear before.
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Performance Issues
Noise was not the only problem reported with hearing aids. Some of
the other complaints could be broadly grouped as performance issues,
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first-hand experience
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first-hand experience
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first-hand experience
Pro: I can hear better. Con: Ugly, people notice, have to have
your hair cut to cover ears, too loud, too soft, dont fit tight, sweating is a big problem.
Pro: I can hear. Con: They pick up too much background
noises. Bothersome to use wearing a hard hat. Sweating affected it.
Pro: Hearing is a major pro. I could not function in daily life
without my aids. Con: Squealing, wind noise, clicking when eating or chewing, cant lay your head on the side, cant get wet.
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Having two aids seems to produce a more balanced sound.
With one the location of a noise is distorted and hard to locate
and identify.
Yes. What one does not get the second one does.
Wearing the two together is always better than just one because
hearing clarity and balance is improved.
I own two. Wear one because two seem to interfere with my
hearing. I get an echo and hear my own voice louder.
Yes because sounds are more equal.
I need both of them.
Two are better, but if you could only afford one then one is
better than none.
I found just using one you dont hear as well.
Two are better than one because if you have loss in one ear you
probably have loss in both ears and the sound is better balanced.
Yes. My left ear is my best and I can understand with it. I cant
understand anything with my right ear alone but it helps me understand some words.
Yes, together. Strain to hear with only one.
Definitely, one broke on me and I had to revert to wearing one
and that was difficult, it seemed I was off balance.
If you have any loss, wearing two is better. I wore only one for
many years, but in hindsight realize I was not helping myself.
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Yes, but not every day.
I need to wear mine pretty much steady, otherwise I would
have a hard time hearing.
All the time. Could not function without. Carry old pair as
spare when out of town.
I wear my hearing aid every waking moment.
Just in a group.
I usually wear them in the evening.
Yes except in loud machinery areas.
I wear them when I am going out to church, social activities,
etc. With the need to wear a hair piece, glasses, and hearing aids it
causes discomfort over my ears (aids are behind the ear).
All the time except bedtime.
Yes. I own hearing aids and I wear them every day, all day until
bedtime.
Wear daily. Wear my hearing aids from morning to night except sleeping, shower, using hair spray.
In most situations hearing loss is not a problem. I do not always
wear hearing aids. In certain situations they are neededchurch or
very large room with multiple speakers spread out across the room.
Yes, sometimes just one. Not always my choosing. Ive had one
thats worked fine from day one and the other has been a SOB to
keep working properly.
I wear them when I know I am going to be around other people for conversation.
Yes I do wear them even though I dont like it.
I have worn mine (both ears) for thirty-five years.
Sometimes. Dont like to put phone next to hearing aid while
talking on the phone.
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A Wish List
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first-hand experience
Be more understanding. We didnt ask for hearing loss.
It doesnt bother me.
Less joking about it. More realistic expectations.
Be more considerate of this disability.
Other people have a tendency to not care about what they
themselves take for granted!
Maybe not to associate it with old age. Ads on TV/media often
portray the elderly with hearing aids.
I wish they would realize that no one wants to have hearing
loss and if the person has a hearing aid or aids and still has some
trouble. Be patient!
When younger people tend to pity you. As you age they think
it is all age related.
I think society responds to some extent.
I wish society would respond positively.
To be treated as a hard-of-hearing person instead of a mutant.
I think hearing loss is accepted more and more. Deaf education is improved and available for very young children.
I think they respond great. Society seems to have taken great
strides in making people with disabilities enjoy themselves.
You can only change yourself.
Need to respond to someone with hearing loss the same way
they respond to person with bad eyesight.
Hearing aids should be viewed the same as they do for
glasses.
Realize it is a medical condition and needs more accommodations.
It will go the way the stigma of wearing eyeglasses has disappeared.
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Treat me like I didnt wear hearing aids. I do the same for others who wear them.
I expect others to accommodate my hearing loss when I remind them.
Try and be more understanding.
Be more considerate and patient. People in our society today
have a tendency to care only about themselves!
For them to understand it is just as frustrating for me as it is for
them. They can walk into my room instead of me coming to them
or just face me when talking.
It is very irritating when people walk into another room and
try to carry on a conversation with you.
They treat me great and I can pretend I dont hear them when
I want.
More patience.
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There needs to be more practical direction from the audiologist when it comes to choosing aids. Forget the sale. Do the best
for the client.
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telecoil can also process the magnetic waves that come from a standard
telephone or from an induction loop system that plugs into a television,
radio, microphone, or other audio device. These options can provide a
very clear sound with little outside interference. Unfortunately, as some
people describe, not all hearing aids have these capabilities and not all
audio devices will work with the ones that do. People wished for better.
Affordable Bluetooth integration in hearing aids. Durable and
effective ear or neck loops.
I believe the wireless aids are the answer to my problem.
Telephone/cell phones that could actually be used with a hearing aid.
Hearing-aid compatibility with other sound-producing devices.
Headphones that can be used without the ringing when you
put them on. I have over the ear hearing aids.
A lot of items say they are hearing-aid compatible. They
are not.
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Smaller but efficient aidsespecially when background noise
is present.
Out of sight.
They have done a good job making them smaller and not
noticeable.
Make them more inconspicuous.
Smaller hearing aids.
Invisibility.
An advanced hearing aid that could be implanted in the ear
that is not visible.
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should cover partial expenses. I know I put it off for a while due
to cost.
Im thinking in my situation, living on Social Security, I had
to take a great chunk out of savings. No one will let you make payments. A person with no savings has to take out a loan. It can keep
a person from getting them.
I wish hearing care and hearing aids were less expensive.
Cost reduction by hearing-aid sellerstoo much markup in
price. Provide more insurance coverage at affordable rates.
A cheaper but good hearing aid.
The high cost is definitely a deterrent for the geriatric
crowd.
Make hearing aids more cost effective for people on fixed income. Just bring down the cost!
Cost and that they would last longer and insurance to pick up
the cost.
Hearing-aid companies should discount batteries so you buy
their aids.
Hearing aids are too expensive. I did not have insurance. It
was all on me. Some people cannot afford them so wont even go
to the doctor for their problem.
Make hearing aids less expensive. Most people who are elderly
start losing their hearing and are on fixed incomes. Im on a fixed
income and cant afford a hearing aid as they are too expensive.
Otherwise I just live with the problem.
Insurance should pay for hearing aids for young persons.
Cheaper prices for hearing aids and cochlear implants. I would
like to see hearing aids covered by insurance.
I think there are newer and better hearing aids on the market
but I am not able at this time to afford them.
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Have a free clinic that repairs hearing aids or have the cost
lower for hearing aids. Basically money is an issue and some people just dont have the money for hearing tests or doctors to check
the real loss of hearing.
I think insurance companies should help with the cost. If they
can pay for meds that are fun drugs they should pay for the hearing aids to help people in everyday living. I am not one that wants
something for nothing but the cost of hearing aids is not cheap.
With todays economy I cannot afford the second one.
Have insurance pick up some of the cost. Especially senior
citizens, as the hearing loss gets worse as we age.
Why insurance doesnt cover hearing aids, Ill never know.
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Perhaps get a hearing aid six years ago. I have missed so much.
You dont realize how much you miss until you are able to hear
what others do.
I would have worn ear protection when working in a lot of
noise.
I have otosclerosis so I dont think I could have done anything
different. I have had many surgeries, but I think the older I get my
hearing gets worse.
I wish I knew about my doctor sooner rather than being the
third surgeon. I should have got the hearing aids sooner when I
could not hear multiple people speaking in a group.
Early in army life and later in a noisy workplace where hearing
protection was not stressed, I believe now that this may have been
the beginning of my hearing loss.
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first-hand experience
Better quality microphones. People need to speak more
clearlymost mumble and dont look at you when they speak.
Yes. Have better acoustics so I can hear better.
Background noise is hard to eliminate!!
Church. The acoustics are terrible.
Less intrusive extra noise. Its hard enough to hear without
music blaring overhead for example.
Something to aid theater-movie goers.
Theaters might employ more closed captions.
High ceilings and plain walls are tough.
New schools are equipped for hearing loss, handicapped children. This is great!
Theaters could have earphones for the hearing impaired.
Background music on TV or movies could be stifled so things
would be clearer.
Church and theatersscrolling words/dialogs or audio enhancers.
Church. Some priests are very soft spoken.
Churches could tone down the organs etc. Theaters the same.
Makes me want to remove the hearing aid.
Meetings in very large, or high-ceilinged rooms need loud
speakers etc.
Additional advances in wireless and lower cost wireless
options.
Media could do away with the loud music which drowns out
the voices. Large areas/halls when speeches are being made could
be more tuned so voices carry.
Playing music everywhere is annoying. Theatersbackground
noise too loud.
The use of amplifiers in large groups.
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first-hand experience
TV shows need to have much more clarity. So hard to understand conversations and know whats going on.
Keep background noise away from newscasts.
People need to be more aware of devices to watch TV with
other people.
Have commercials on TV not get louder than the TV
program.
Radio and TV commentators should speak slower.
Media should not be permitted to raise and lower the volume
for certain things like advertisements.
Commercials are too loud.
Keep background music not so loud or just not have it at all.
In old times, one was able to hear a movie because there was no
background music.
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First-Hand Advice
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want or need advice about. Even if the adviser does hit on an applicable pointin this case hearing lossthere is often little knowledge
or relevant experience to back up the opinions given. These unhelpful
views instead derive from overheard comments, second-hand stories,
and marketing hype.
Whats needed is real advice, accurate and useful. The man in the
waiting room who shared his experience provided a real-life example
of the kind of advice that is needed. Unfortunately it was not possible
to stuff an interactive version of this guy into the book, but there are
many patients who generously offered information and helpful advice
based on their own first-hand experience. What should someone with
hearing loss do? What can a person expect from hearing aids? Are they
worth the fuss? How can family, friends, or others help? These are a
few of the questions addressed in the pages that follow.
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Get it checked. You may be able to do more for yourself and
your hearing problem.
Not to put off seeing a professional. Go as soon as you think
you have a problem.
Having your hearing tested is at least a start to find a solution
to your loss.
Have your hearing checked. Find out what is causing the loss.
Wax, loud noise, etc.
Get to an audiologist for a hearing test first to determine bone
or nerve deafness or just a build-up of wax.
Get ears tested. Get hearing aids. Do as doctor tells you.
Get tested. See if theres something to help you hear better.
I would suggest they get a hearing test. Do all you possibly can
to get the help that is much needed.
Dont delay getting help. Get hearing tested ASAP. Time is
essential.
Get help from a professional. Get a hearing test.
When you have to ask a person to repeat and others can hear
what is said, its time for a hearing test. Have the hearing test by a
reputable audiologist.
Dont ignore it because it only gets worse.
Seek care immediately. See an audiologist or ear specialist.
I have such a friend and Ive told her to get a hearing test.
Find out what is causing the loss and seek help.
Make sure they get their hearing checked and if needed a hearing aid.
Get the best advice you can for the problem you have.
Be proactive and go to specialists.
Seek medical attention ASAP. Things probably wont get any
better, so accept your situation and seek professional help.
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Sometimes knowing someone else with the same problem(s)
helps.
If it bothers them enough they will get help.
He should get more information because if let go too long it
could turn into a serious situation.
Some people in this situation cannot be helped, stubborn and
set in their ways.
Try to show them what they are missing in life: human contacts, relationships, needless frustration for themselves, imposition
and harassment experienced by others.
You are missing out on so much. Denial is just one of the stages
before admitting you have a problem.
The longer you wait to get it fixed the more loss youll have.
Its not a sin, its a medical condition.
You cant change people. Some just do not want to admit that
they have a problem.
Being that I had to get help I would tell them what I went
through. I would explain how important it is to hear and get
help.
Do not put it off because it will get worse! Trust me I did.
Wake up! Lets go! Be proactive! Think about how it affects
others.
Youre annoying because I have to repeat everything to you. It
is important. It ages you.
Ive tried to help neighbor who refuses to admit problem and
I have yet to have any success. His family (children) have medical
training and they dont seem to have any luck either. So I guess Im
not a good source for this advice!
Advice wouldnt help if they are in denial.
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Learn how to deal with it. Denying it does not help the
situation.
Your hearing is very important!! The loss of it means you have
lost a part of you, your freedom, the person you are! Take care of
you. Take care of your hearing.
Depends on your relationship to themyou might refuse to
repeat for themsee if they can be convinced.
Patiently test and encourage. Test them by speaking in low
sounds so they experience the loss.
Let them see by my example how you can help yourself. Recommend seeing a professional. Dont wait. Youre missing out on
things you may not have to.
Continuing denial only detracts from your quality of life.
Ask if it doesnt bother them to miss so much of the conversation and if it does then go get checked.
Try not to be so vain as I am.
Tell them to get hearing aids as its a lot better than not hearing
at all.
My husband is a perfect example as his hearing is much worse
than mine, but he refuses to get a hearing test no matter what I say.
Uses all kinds of excuses such as ringing of the ears or complains
about the way they talk.
I would tell them it is so important, it can change your life. You
will want to do more things because you are able to hear.
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Use a rifle or gun, use hair pins or other sharp objects to dig
out wax in ears.
Ignore it. Dont wait to check it out and act on it.
Do not deny yourself any of lifes pleasures.
Dont shower or swim with hearing aids in.
Take hearing aids out when you go to the beauty parlor. Cant
get them wet, wear them swimming.
Avoid thinking the problem will go away.
Dont turn up the sound unbearably loud.
Pretend you can hear what is going on.
A person with hearing loss should never let vanity play a part
in not wearing hearing aids. It is better to hear what someone says
to you than stare blankly or keep saying what?
Ignore the advice given to you as I did for many years.
Avoid wearing hearing aids in heavy rain unless protected.
Do not be in denial. Face up to their situation and know there
is help for thema new perspective on life.
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Use your hearing protection.
Definitely earplugsbut if they could change their situation to
get out of itI would suggest that.
If at all possible find a job or other situation that will not damage your hearing. Nothing is worth losing your hearing for.
Wear your hearing protection. I discussed this with many people that I work with in an industrial environment, but to no avail.
Wear protective earphones. Once you lose your hearing you
can never get it back to exactly the way it was.
Wear earplugs. Turn the volume down. Protect your hearing.
Its precious and not repairable.
Use devices to filter loud noises. See an ENT for any ear problems (i.e., serious infections, drainage, etc.).
Get help. Insist on protective devices. Report abuses to proper
authorities.
Think!
Protect their hearing at all cost. You miss out on so much by
not being able to hear.
Cut out exposure to loud sounds, wear ear plugs when operating power equipment (lawn mowers, power saws, etc.).
Do whatever you can to protect your ears.
Make someone aware of the consequences.
If you can change it, then do so.
Use earplugs if possible. Avoid noisy environments.
Take all necessary precautions. Wear protective head/hearing
gear. Protect your hearing at all costs.
Warn them, but most people wont take the advicejust human nature.
In the presence of noise wear ear protectors. Follow professional advice to avoid hearing loss from other causes.
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See a specialist, not a general doctor. Have hearing checked.
Go to a reputable hearing-aid centerone that will do more
than sell you hearing aids.
See the MD who knows what they are doing, not everyone
does! Listen to your MD for all options. Rule nothing out.
Talk with a doctor who is well versed on hearing loss.
Get help from the best available source.
Be certain the people you deal with for hearing problems are
professional and accredited.
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Family member, close friends, to be understanding, talk to person and see how loud they have to talk.
Ask for help from those you love and trust.
Family members could be helpful for support but they need
professional help also.
My relatives. The quality is OK but I need a professional for
exact information.
Church, family, and anyone else that they come into contact
with at work.
Church groups and support groups.
Seek out family members.
Other than professionals, I dont know of any support
groups.
Not sure. Maybe find others with hearing loss. Find out what
works best for them. Find out what hearing aid works from those
who already have them.
Family members, co-workers, church groups etc. Any one of
these.
Person should look for help where ever they can get it.
Seek support from family and co-workers. They will encourage you to get help and they will be patient and support you by
taking measures to help you hear them.
Family. Ask for advice.
Family, friends who are honest with you about your problems
caused by your hearing loss and from friends that have the same
problem.
Other people with hearing loss. Good information.
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I wear hearing aids. They help a lot but dont cure the situation 100 percent. One must be proactive. Pay attention and train
yourself to handle the situation.
You still arent going to hear everything and the background
noise is very distracting. But try them and try to get used to it. It
will improve your life.
Dont expect to hear whispering or low voices.
It is realistic to expect hearing aids, if recommended, to improve hearing. It is unrealistic to expect normal hearing with
hearing aids.
Living with hearing aids is much better than living without.
I have some friends who have serious hearing loss and they
live a normal life.
Hearing aids may not cure all your needs.
That they do helpsome. One can never be as good as they
were before hearing loss.
Unrealistic that hearing aids will return your hearing back to
normal.
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Get hearing aids and let people know you have them. People
talk louder when they see a hearing aid.
It seems unrealistic to live with hearing loss if it is recommended by professionals that hearing aids would help.
If you cant hear with your own ears well, hearing aids are the
next best thing.
Get hearing aids and wear them! They are no good in the
cupboard.
Just live with it. Lot worse things to deal with than hearing
loss. Could be worse things you could have and nothing to help
you with it.
You have to want them yourself.
Unrealistic to think hearing loss will get better or that you will
hear better without a hearing aid.
As long as you can get along fairly well dont buy a hearing aid.
Get hearing aids. Live again. Forget cosmetics.
Most likely your hearing will keep getting worse. Keep on top
of it.
The only advice I can give is: Im so glad they make hearing
aids. I put mine in as soon as I get up and take them out at bedtime.
I forget I have a hearing loss. I even forget I have them in. I wish
they would fit better (short hair) as you couldnt see them behind
your ears. But I deal with it.
Take care of them. Clean them each night, have them cleaned
professionally and they will last much longer. They are very
expensive.
Maintain a program of regular check-ups for both hearing and
hearing aids.
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extra for a higher level of coverage, former service members with veterans benefits, or those included under special programs for children
or the needy, most people are on their own and must pay for their own
hearing aids. Having lived with this reality, many patients offered financial advice about hearing aids.
Save your money. They are expensive and do help.
Look for a zero percent 12-month or 18-month loan to help
you spread (hearing aid) payments out.
It is expensive and an investment.
If you cant afford seek government aid.
Try to go the cheapest route because of the cost, but make sure
you get the correct help.
Thats a puzzle. Hearing aids are super expensive! Mine
are $2,000 each! Then on top of that are repairs at hundreds of
dollars.
Do not get a hearing aid from magazine ads, mail order ads,
etc. I encountered so many unhappy people with hearing aids.
Some had paid $$$$ for their hearing aids and cannot hear. One
man has eight different aids. They are buying them from magazine
ads. Save your money to buy a good hearing aid.
Buy the best no matter what the cost.
Sometimes your insurance can be helpful depending on who
you are covered with.
If insurance companies dont cover them, see about financing
them, getting a loan, etc. Dont put off getting them due to cost
alone.
Talk with your doctor if you cant afford hearing aids. They
should work with you.
Dont go the cheap route.
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Get the best hearing aid you can afford. Get one that you feel
comfortable with so you will wear it.
Determine if hearing aids and hearing tests are covered by
your health insurance programs; consider insuring your hearing aids.
Pay close attention to what you pay. Check around for price.
The cheapest may or may not work for you.
Be ready for a lot of expenseGetting hearing aids, maintaining hearing aids, and buying batteries.
Dont buy devices that promise the world yet cost very little
you get what you pay for. However, some folks I know have really
been duped by spending lots of money with little results.
Get best-quality hearing aids you can afford. Good hearing
should be a financial priority.
Watch for those hearing-aid batteries on sale.
Plan for hearing-aid replacement every three to five years.
See if medical coverage will help. Most do not. Would be a big
improvement if health programs would pay a portion.
If you cant afford hearing aids, put it on the credit card.
Small church groups are often looking for projects. Steering a
friend to seek a chairperson for a prospective money-raising project where doctors and costs are already analyzed and noted.
Save up money to get hearing aids. People dont have $3,000
to $4,000 around for hearing aids. Insurance does not cover this.
Maybe we should lobby the insurance companies to have this as
coverage.
People spend money for big TVs, expensive cell phones etc.
but what good are they if you dont spend the money for your hearing so you can enjoy the other things!
Check all options.
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Yes because they are very helpful and you dont have to keep
saying I beg your pardon or whats that you said.
Yes, it makes it easier to socialize.
Yes, definitely. It will open up a whole new world to you. You
really should hear what you are missing. I hate to take mine out. I
feel helpless without it.
Yes, I can now have TV volume lower and hear conversations
in groups.
Definitely yes. If you have hearing loss, hearing aids definitely
help.
Yesif they help! Dont know or realize what youre
missing.
Yes. You are missing out on too much of life.
If needed and can afford themdefinitely.
Yes. They are a tremendous help and are a wonderful piece of
technology.
Yes, if they need them. Why struggle to hear? Asking others to
repeat annoys them.
Yes, if testing supports their use. Quality of life can be greatly
improved.
Yes. Youll be a more compatible mate.
Yes. Even just giving them a try for a month until they are ready.
They really do make a difference. The longer you wear them the
better it is.
Yes, but only if the person gets tested by a professional.
Yes, yes, yes. If you need hearing aids get them. After I got over
the shock of my needing aids, it was the best thing that ever happened to me.
Yes. Hearing loss leads to other complications.
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Yes. I saw how they helped my mother. Im in the process of a
trial period for a hearing aid.
Yes, at any and all costs.
Yes, absolutely. Dont live with hearing loss, get hearing aids. Protect your hearing and swallow your pride if you need hearing aids.
Yes. Its so much better to hear someone clearly. If you dont
wear aids and need them you will gradually isolate yourself from
others. As long as I wear my hearing aids, keep them in good condition and wear them always my life is good and I am able to lead
a very normal life.
Yes, it is worth the money or seeking other help to get a hearing aid.
They are not worth the money.
Yes most definitely. Have hearing evaluated at a young age and
use aids as soon as necessary.
Yes, they help a lot. Having hearing aids is a lot better as you
can hear what is said a lot of the time and not have to ask for it to
be repeated so many times.
Yes, life is difficult with hearing loss.
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Deal with the facts, get professional help, and live life to the
fullest.
Let others know of your inability to hear. Ask if they would
speak clearly and loud enough and face toward you.
Look at people when talking.
Have someone with them who can repeat in a louder voice.
Make sure you heard what you thought you heard.
Watch, pay close attention while driving or walking outdoors.
Hang in there and dont go bonkers; bite the bullet and get
hearing aids.
Help is probably available. You will be more confident and your
friends will be relieved that you are not such a burden to them.
Your hearing is very important to you. You may not be aware
of what youre missing.
Take care of your hearing.
Let people know if you dont understand what they say.
Be patient.
Dont be afraid or embarrassed to let people know you have a
hearing problem. Remind them to speak to you face to face and not
scream at you. If at all possible get a hearing aid. You will love it.
It is not something you should be embarrassed about or prevent you from living life.
Get the best care you can.
Always sit in the front row or near the front at meetings,
church, etc.
Make the best of it with help of aids. It will work out.
Dont be ashamed to wear a hearing aid.
Have patience and wear hearing aids all the time. Not just on
special occasions.
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Do not deny the presence of hearing loss and be assertive in getting a correct diagnosis of the cause. If hearing aids are prescribed,
be persistent in learning how to use and care for them.
Do what is necessary to protect the hearing that you still
have.
I try to use common sense and manage certain undesirable environments, however, I try to live life to the fullest.
Just let people know you have difficulty hearing. Most people
will speak up a little louder. Dont be reluctant to say I have a hearing problem.
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Be patient, they did not ask for this to happen. Educate them
when you can, help by being their ears for sounds/noises they cannot hear.
Try to speak more slowly and better diction.
Learn to tolerate asking you to repeat sentences. Also tolerate
loud TV, radio, etc. Speak clearly to them.
Be understanding! Take your cues from the person.
Help them to avoid denial of the loss. Help others understand
what conditions are best for understanding conversations. Make
an effort to face them and speak distinctly when communicating.
Minimize background noise (radio, TV, running motors, etc.)
when talking.
Just be patient and find best way to overcome.
Dont talk to them or ask anything from another room or when
walking away from them.
Keep trying to have person seek treatment.
Speak louder to them.
Be patient. Try to be accommodating. Look at them when talking. Go into the same room when speaking as well. Dont become
angry or frustrated with them.
Be patient. Never make fun or joke about it. Encourage the
person to get help.
Be patient, talk slower, get closer, talk louder. Solicit patience
from them. Ask them to help.
I would appreciate patience and kindness.
I would like them to get my attention rather than just blurting
something out and to let me know what they are talking about so I
dont miss anything while trying to figure out what they are talking
about.
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Make sure the speakers work at church and at other social
programs.
Give support.
Be patient with their lack of hearing and frustration. Encourage them to do something about it.
Need to be as supportive as possible and most really are!
Be patient and speak slow and clearly. Most people dont understand hearing loss. They think all we need is more volume. In
my caseand I understand most peoplewith nerve damage, dont
need volume so much as clarity. People who speak slow, clearly, at
an even tone, are blessings to mealso few and far between.
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Advice from Spouses or Significant Others
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It seems that sometimes when I say something she hears something else than what I said.
Sometimes she cant hear what Im saying. I need to repeat
myself.
He does not hear what most people are saying in a room full of
people. I tell him what the TV is saying.
He asks for things to be repeated.
It is a problem in the workplace and at home.
He hears part of a conversation and makes up what he doesnt
hear!
When he does not wear his hearing aids, I cannot talk
to him.
He doesnt hear words correctly and has to turn the TV up
real loud.
I sometimes repeat what someone has said or point to what is
being talked about. I try not to answer for him, but sometimes I do.
We adjust the car speakers with more volume on his side.
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The television is very loud. Car radio is loud also. He must be
looking face to face to see that youre speaking. Hearing loss has
worsened and is worse in one ear. Im concerned about emergency
situations.
He feels he has to depend on me.
Not hearing ringing of a phone, doorbell, sleep machine going
off, smoke alarm.
The TV is very loud!
He sings and has some trouble with hearing pitch.
My spouse has been a choir director and band director since
his college days. Because of his hearing loss, he doesnt feel he can
hear all of the highs and lows to make sure a group is well balanced
in sound. With hearing aids his own instruments sound terrible
and sometimes his own voice sounds badly to him. He becomes
frustrated and sometimes anxious when not hearing well. He has
given up conducting and giving private lessons. It is hard to watch
music leave his life when he loves it so.
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went, the noise was overwhelming. His wife said her husband would
do nothing to help himself and that she was held responsible for whatever he could not hear. Everything misheard was her fault. She was
essentially a slave to his hearing loss. The man was an imposing figure.
He was tall and beginning to gray, and had a deep, commanding voice
and the build of a professional wrestler who had let himself go. His
demeanor was almost as good. All of the pleas for assistance from the
wife and daughter were made easily understandable by his response to
their concerns and to his test results. I dont have a hearing problem,
he boomed. I make it other peoples problem! He was serious.
Fortunately for everyone, the average person with hearing loss is
not likely to be so demanding, controlling, or obnoxious. Nevertheless,
a persons hearing loss can and does affect others. Even if produced
unintentionally, the effects are real. An examination of more than four
hundred older married couples drawn from a large well-known epidemiological study concluded that spouse hearing loss increases the
likelihood of subsequent poorer physical, psychological, and social
well-being in partners.2 While the experiences from spouses and significant others described below are not as alarming as the conclusions
from this cited study, it is possible to understand how these encounters
could result in stress and negative effects.
As a wife I have been trying to speak to him in a normal tone
and slowly. We no longer go to places where there are lots of people.
Birthday parties, weddings, things of that sort. I have to learn to be
more patient and pronounce each word more slowly. Sometimes I
forget and have some exciting news and I blast off. He does not get
what Im saying. I realize and start over and talk more slowly. We
have learned to live with it.
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I have to repeat to him what others have said. And I usually
have to repeat myself at least twice.
Sometimes I have to translate to explain what someone says.
I always sit to his right so he can hear me when I repeat what
he misses in conversation. Its just another long-term wifely duty.
I also do all of his telephone answering and direct his attention to
anyone wanting to talk to him.
I have to attend to more things so that things are understood
correctly. I get tired of repeating.
Im not heard and must repeat information to spouse.
She asks me to repeat things or turn the TV up or radio.
I make most of his phone calls and help with ordering in restaurants or I am a go-between in other situations.
Having to repeat over and over again.
It is hard to carry a conversation with him if there is noise
around. You cant talk softly and have him hear you.
I act as translator. Its hard to have a quiet conversation
when others are around. When eating out, he chews and cant
hear so we sit quietly. He gets impatient when he cannot understand me.
We all (family and friends) just repeat what we have said and
try to face him directly. Sometimes I forget he is behind me or has
one or both of his hearing aids removed.
I am often not heard and have to repeat what Ive said.
Sometimes I have to repeat what others say. I have to remember to be in the same room when we talk. I go into another room
when he watches TV and has it too loud.
I have to know if he hears what I say or understands what
others say.
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Yes. Yes. We get tired of repeating. I have to tell him what people say.
I have to speak louder and close to her. If she didnt answer
something I said or asked and she is thinking of the answer, Im not
sure she heard me unless I ask her if she did.
Sometimes for others. For me yes because I am his ears
constantly.
Yes. Because you constantly have to translate back to him on
what everyone is saying.
You always have to repeat what others are saying.
Sometimes I repeat something that someones said that I know
he didnt catch. I let subjects go when I realize hes not hearing
enough to understand me and that my explaining would just frustrate him.
Sometimes he will turn volume up on our phone. Big surprise
when I use it or big wait a minute if he uses it after I have had it
turned down.
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No, not really. I am annoyed at times, but try to be understanding.
Sometimes. Because I think he hears me but he doesnt.
It would if the aids didnt work, but so far they do. In fact, we
finally got the bad one fixed, so hes hearing better than ever.
I sometimes do not start conversations unless it is pertinent to
him. I miss the spontaneous conversations because it is easier.
Yes. It gets very trying to keep repeating or youre not sure he
even hears you in the first place.
Not really. After so many years we have adjusted and take care
of each others needs. Hearing loss is a great problem that my
spouse has learned to deal with and he copes quite well most of
the time.
After a while I dont even want to talk to him. It gets very frustrating having to repeat myself.
Not really. We have been married for almost fifty years and have
worked together to make the best of all complications or problems.
We have learned to adjust.
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It was not his idea. He had an ear infection and went to the
doctor.
She found her hearing loss out when her yearly checkups
were showing some more loss. Im surprised shes ready for
hearing aids.
Yes. He said you call and get an appointment.
My idea, as he knows he cant wear hearing aids in the workplace or where there is loud noise. Theyre used to the work routine
and ignore the noise because they cant hear above the noise.
I dont remember. Probably on his own after failing the hearing screening at the local fair.
Both of our ideas.
On her own after having a hearing test.
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Get help or at least talk with a doctor about it.
Wear ear protection when possible: on tractor, when working
with power equipment, shooting guns.
Get hearing test. Get hearing aids if they can help you.
Get a hearing aid.
Hearing aids are expensive, so buy those that can be changed
or adjusted if your hearing should become worse. Be patient while
aids are being fine-tuned.
Get a hearing test. Then see what can be done to help.
Look at someones face when talking and reading lips. Never
be embarrassed to let someone know you cant understand them.
Get hearing aids.
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ing aid. Make sure others talk right to him and he is paying attention to them.
Be patient and understanding and pray that hearing aids help.
Pray a lot!
Be patient.
Be gentle. Be loving. Learn to anticipate the hearing
problem.
Be patient with that person! Although it is very hard! Try to
insist and encourage them to get a hearing test.
Deal with it.
Be patient and understanding. Help any way you can without
making them feel dependent. Be willing to adjust.
Pay more attention to how you talk so you can carry on a
conversation.
Be patient. Sometimes you forget they cant hear and there can
be misunderstandings as a result.
Summing Up
Beyond simply answering the survey questions, a couple of spouses
provided their own overview of the problem. They summed up for all
of the spouses and significant others.
Its very hard to admit that we cant hear, and also we dont
want anyone to see hearing aids. We listen to all of the failures
that others have had, and this allows us to not want to seek professional help because of their problems. A person has to be
pushed to seek medical advice. No one wants to spend thousands
of dollars on a risk (hearing aids) that may not work, even with a
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thirty-day return policy. It makes one very cautious in these economic times. A person must realize this is extremely important just
like a prescription.
Hearing loss is no game. Its serious. Being someone elses
ears for a long time does affect your significant other. Its like having two lives wrapped into one because you have to be two people
at one time.
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Themes and Parting Advice
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and others like him should not hesitate with regard to hearing aids
were even more abundant. This was a theme that ran through patient
and spouse recommendations. There were others. These are examined
in the following pages, along with a few issues that might benefit from
further explanation.
Areas of Agreement
Getting a Hearing Evaluation Is Essential
Of all the subjects examined in the hearing-loss survey, the need for a
hearing evaluation was the recommendation made most often. Nearly
every respondent addressed this issue, and all of those who did stressed
its importance. This was true of both the people with hearing loss and
their spouses. While the wording varied from person to person, there
was no ambiguity of intent. Some people may think hearing professionals can be a little preachy about the importance of having ones
hearing checked, but those with hearing loss and their partners took
no backseat in this regard.
Survey contributors sometimes recommended having this evaluation performed by an audiologist or a physician, but more often they
did not specify whom to see. Because most people prefer to obtain their
medical and hearing care locally, finding someone good who is easily
accessible becomes a priority. No one recommended advertisements
from the newspaper, TV, radio, Internet, or elsewhere as the best way
to do this. Asking the advice of a primary care doctor, nurse, member
of the clergy, relative, or friend with hearing loss was most often the
suggested road to finding a good hearing professional.
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Used (hearing) protection at a young age.
Wore earplugs in the artillery and at work.
That so many people stressed the importance of hearing protection based on their own experiences should not be a surprise. Educational campaigns and occupational hearing protection programs have
tried for years to alert people to the damage caused by excessive noise.
A few statistics help to explain the urgency. Forty-two percent of employees in a typical Midwest automotive factory were found to have
hearing loss.2 When dairy farmers were compared to a matched group
of non-farmers, 25 to 28 percent more farmers suffered hearing loss.3 A
recreational firearm study of more than fifteen hundred men found that
the risk of hearing loss increased 7 percent for every five years the men
had hunted.4 Recreational woodworkers were found to be 30 percent
more likely to have hearing loss than non-woodworkers.5 Even onethird of classical musicians may be at risk of hearing loss depending on
the instrument they play.6
Survey participants made clear that the key to prevent hearing
loss from loud noise is to avoid loud noise or use hearing protection. For those who work in industry, the employer should alert employees if sound levels are potentially damaging and then provide
appropriate hearing protection. At home or recreationally, individuals should use earplugs or muffs during any very loud activity. This
includes using lawn tractors, snowblowers, gasoline-powered string
trimmers, chain saws, circular saws, shop vacuums, and firearms, to
name only a few examples, as well as attending rock concerts. Earplugs and earmuffs work well, are inexpensive, and are readily available at most home improvement centers. An alternative is to have
custom earplugs made that exactly match the contours of the users
ears. These are available from most hearing-aid centers. Regardless
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first-hand experience
me? When I taught elementary school it was difficult because the
children mumbled or turned their head away and I could not hear
them at all.
I dont hear a lot going on around me. People dont want to
repeat to you, get mad if they do, yell, talk really loud or ignore you.
Makes you sad. Sometimes they blame you, say you arent trying
to hear them.
I miss many words and conversations. Its frustrating.
Patience Is Recommended
Throughout the survey patients were queried on a variety of subjects.
Nowhere was there a question about anyone having patience. Yet this
was a matter that kept popping up. Over one-third of patients (36 percent) and spouses (35 percent) had something to say. Patients lamented
that people frequently do not have patience if they misunderstand
or ask others to repeat. They wished and recommended that family,
friends, and society as a whole be more patient with them and with
others who have hearing loss. Spouses also noted that patience was not
just a recommendation but a must. Anyone wanting to help a person
with hearing loss would do well to heed this advice.
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207
percent of the people who owned hearing aids said they would recommend them to others. Why? How could so many people recommend hearing aids and there also be so many disparaging remarks?
The problem here is in trying to view hearing-aid satisfaction as an
all-or-nothing proposition. People dont have to love everything about
their hearing aids for them to be of benefit. They can even hate certain
aspects but still find the devices to be of value overall. The portion of
chapter 6 that detailed the pros and cons of hearing aids showed that
patients had a mixed bag of perceptions. A few examples provided one
individual at a time illustrates this reality.
patie nt 1
I purchased hearing aids and it was some help, but did not
solve the problem.
I have them in both ears and use them.
It depended on the type of group you are with and whether
they were quiet or noisy as to how well you could hear. They do
me the most good when I have a quiet conversation with people.
Do not help in a noisy restaurant or in large group.
Having hearing aids is a lot better as you can hear what is said
a lot of the time and not have to ask for it to be repeated so many
times.
Would this person recommend hearing aids to others? Yes. They
help a lot.
patie nt 2
I cant understand anything anybody says without them.
They cant begin to compare with what God gave me.
Not helpful in loud rooms. When the wind is blowing.
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first-hand experience
They are better than nothing but in general they are a big
hemorrhoid!
patie nt 3
They do help some. One can never be as good as they were
before hearing loss.
Most helpful when talking with other people.
They pick up too much background noise.
Theaters and concerts too loud for hearing aid.
Not helpful when there are too many people talking and loud
background noise.
Would this person recommend hearing aids to others? Yes. Its
worth the money.
The preceding comments were representative of those seen
throughout the survey. Nearly everyone had positive and negative
views about hearing aids. There were few unqualified endorsements.
Nevertheless, survey participants recommended hearing aids, not because they were loved, but because they helped them hear better.
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209
Expectations Matter
By now it should be apparent that a hearing-aid user or prospective
user should not expect some hearing equivalent of brass bands and
fireworks. As a couple of survey participants explained:
It is realistic to expect hearing aids, if recommended, to improve hearing. It is unrealistic to expect normal hearing with
hearing aids.
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first-hand experience
Theyre not perfect because I dont hear and understand
everything. But Im thankful they really do help.
The majority of hearing-aid users surveyed had similar expectations. The most negative hearing-aid comments came from the few
people who expected not only to hear better, but to hear well. For them,
anything misunderstood was a sign that the hearing aids didnt work.
While their overall descriptions of how the hearing aids performed
were not very different from those of seemingly happier users, the difference was in how their expectations shaped their perception of the
experience. Those who viewed their cup as half full were happier with
the outcome.
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first-hand experience
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213
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first-hand experience
spouses were asked what aside from using hearing aids their partner
does to cope with the hearing loss, the answer was often nothing.
When hearing-aid users were asked if they used non-technological
tricks to help them hear, such as lip reading or getting closer, all too often the answer was no. One person said when questioned about using
these measures: No, I wear aids. It was as if hearing aids precluded
doing anything else that might help. The reality is that the combination
of hearing aids and a few listening strategies is better than hearing aids
alone. Use an all-of-the-above approach.
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first-hand experience
have been unaware of the options available or not known how to obtain one. Easy access through the Internet can solve both problems.
A few of the better known websites for hearing products are Adco
Hearing Products (www.adcohearing.com), Harris Communications
(www.harriscomm.com), Hear-More (www.hearmore.com), Independent Living Aids (www.independentliving.com), and LS&S (www
.lssproducts.com). Do a little window shopping.
Some people may have no interest in hearing loss beyond finding
a booming alarm clock or an amplified telephone. Others want a full
evaluation and find it through an otologist or audiologist. Books serve
as another source of information, but not one that was often mentioned
by patients. Perhaps most of their concerns were already addressed
through the healthcare system or they simply didnt know which hearing-loss books would be worth reading. A few suggestions are offered
with the resources at the end of this book.
Numerous organizations provide information, support, and resources to the hearing impaired. A few are definitely worth looking
up. As the preceding pages demonstrate, however, most people are
unaware of these organizations. As one person asked: Is there one?
Two good places to start would be the Hearing Loss Association of
America (www.hearingloss.org) and the Hearing Health Foundation
(www.hearinghealthfoundation.org). They also publish informative
magazines, Hearing Loss Magazine and Hearing Health Magazine,
respectively.
Parting Advice
A lot of information and advice has been offered. A quick reading is
likely sufficient for most people to gain a better understanding of the
problem and some of the solutions. To make the best use of this infor-
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217
mation and advice, however, may require a second look at the parts
most applicable to any particular reader. This revisit should include
exploring the suggested websites. Useful information and help really
are out there. Still, in line with the old adage that the best information
comes first-hand, some final parting advice is warranted.
Have a good doctor examine you and take his advice. The
sooner you get examined youll realize how important it is!! Also
how important it is for the people around you. You will find your
life a lot more pleasurable when you can hear better.
Dont expect miracles with hearing aids. They will help, but it
wont be like you have perfect hearing.
Always be up front about your hearing problem. Take good
care of your hearing aid. It is your best friend.
Having a hearing loss should not be a crutch or be something
that causes you to be afraid of interaction.
Be kind to your ears. Stay away from places with loud amplifiers. Cover your ears when you use loud machinery (lawn mowers,
saws, snow blowers, etc.).
Talk to a variety of people candidly; ask questions about hearing loss, then think seriously about opinions and suggestions you
get. Seek professional opinion. Get second opinion.
Youll be surprised by what you are not hearing in your everyday life. Dont be afraid, its a whole new world again.
Talk to your family member/friend. Offer to go with them to an
appointment. Dont make them feel bad for their hearing loss.
Anyone can have hearing loss. No one can understand what it
is like unless they live it. But with our sharing they can have a better understanding.
Have patience. They dont like it either.
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Resources
Here is a list of resources the reader may find helpful. Each has a website that
offers information on hearing-care professionals, organizations, ear and hearing problems, hearing aids, medical devices, or assistive products.
219
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220
Resources
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Resources
221
Books
Shouting Wont Help: Why Iand 50 Million Other AmericansCant Hear
You, by Katherine Bouton (Sarah Crichton Books).
Baby Boomers and Hearing Loss: A Guide to Prevention and Care, by
John M. Burkey (Rutgers University Press).
Overcoming Hearing Aid Fears: The Road to Better Hearing, by John M.
Burkey (Rutgers University Press).
The Consumer Handbook on Hearing Loss and Hearing Aids: A Bridge to
Healing, edited by Richard Carmen (Aural Ink Publishers).
Living with Hearing Loss, by Marcia B. Dugan (Gallaudet University
Press).
What Did You Say? An Unexpected Journey into the World of Hearing Loss,
by Monique E. Hammond (Two Harbors Press).
The Complete Idiots Guide to Hearing Loss, by House Clinic, William M.
Luxford, M.D., M. Jennifer Derebery, M.D., Karen I. Berliner, Ph.D.
(Alpha).
Hear Your Life: Inspiring Stories and Honest Advice for Overcoming Hearing
Loss, by Melissa Kay Rodriguez (Greenleaf Book Group).
Mayo Clinic on Hearing: Strategies for Managing Hearing Loss, Dizziness,
and Other Ear Problems, by Wayne Olsen (Kensington Publishing
Corporation).
Captioned Telephones
CaptionCall
4215 South Riverboat Rd.
Salt Lake City, Utah 84123
Website: www.captioncall.com
CapTel Customer Service
450 Science Dr.
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Resources
Cochlear Implants
Advanced Bionics
28515 Westinghouse Place
Valencia, California 91355
Website: www.bionicear.com
Cochlear Corporation
13059 East Peakview Ave.
Centennial, Colorado 80111
Website: www.cochlear.com
MED-EL Medical Electronics Corporation
2511 Old Cornwallis Rd.
Suite 100
Durham, North Carolina 27713
Website: www.medel.com
Hearing-Aid Manufacturers
Beltone
2601 Patriot Blvd.
Glenview, Illinois 60026
Website: www.beltone.com
GN ReSound
8001 East Bloomington Freeway
Bloomington, Minnesota 55420
Website: www.gnresound.com
Miracle Ear
5000 Cheshire Parkway North
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Resources
223
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224
Resources
Magazines
Hearing Loss Magazine
7910 Woodmont Ave., Suite 1200
Bethesda, Maryland 20814
Website: www.hearingloss.org/content/hearing-loss-magazine
Hearing Health Magazine
363 Seventh Ave., 10th Floor
New York, New York 10001
Website: www.hearinghealthfoundation.org/hearing-health-magazine
Tinnitus Today
P.O. Box 5
Portland, Oregon 97207
Website: www.ata.org/about-ata/news-pubs/tinnitus-today
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Resources
225
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Hearing-Loss Questionnaire
You are being given this questionnaire as research and possible source material for an article or book about hearing loss. Completing and returning this
questionnaire will be taken as permission to use the information provided.
While you are under no obligation to answer these questions, the information
you volunteer may help others with hearing loss. The more completely and
candidly you answer the questions, the more others are likely to benefit. The
results from this questionnaire are intended to be anonymous so please do not
sign your name or provide any identifying information.
he ar in g los s
How does your hearing loss affect you? How does it affect your relationships,
work, mood, leisure, safety, finances, etc.?
227
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228
Appendix
Once you began to suspect a hearing loss, did you seek help right away?
Why or why not?
What is your primary source of information about hearing loss, hearing care,
or hearing aids? What is the quality of this information?
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Questionnaires
229
he ar in g a i ds
Have you ever been advised that you need or would benefit from a hearing aid
or aids? Yes / No (please circle)
Do you own a hearing aid or aids? Yes / No (please circle)
How do you feel most people view hearing aids?
If a hearing aid or aids was recommended, but you did not follow through,
please share your reason(s).
Did you try, but then return a hearing aid or aids? If yes, please explain.
If you own a hearing aid or aids, do you wear it? If not, please explain.
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230
Appendix
Please describe the situations in which you have found a hearing aid or aids
to be helpful.
Please describe the situations in which you have not found a hearing aid or
aids to be helpful.
If you use or have tried a hearing aid or aids, was it difficult to adjust to?
Please explain.
If you use or have tried a pair of hearing aids, are wearing the two together
better than just one? Please explain.
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Questionnaires
231
What do you see as the major pros and cons of hearing aids?
other s o lutio n s f o r h e a r i n g l os s
Do you turn up the radio, television, or other devices? Does this help?
Do you use closed captioning on the TV, an amplified or captioned telephone, wireless headphones, or other electronic gadget to help you hear or
communicate? Does it help? Please describe:
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232
Appendix
Are there non-technological tricks that help you to hear (lip-reading, getting
closer, having person repeat, etc.)? Please explain.
Have you changed your activities in some way to increase your likelihood
of hearing or changed your activities to limit your need for hearing? Please
explain.
Is your solution to hearing loss to have others repeat or perform tasks that
you cannot hear well enough to perform yourself ? If yes, please describe.
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Questionnaires
233
Have you had surgery or taken medicine to treat your hearing loss? If yes,
please describe. Did it help?
Have you tried or do you know of any other solutions for hearing loss? If yes,
please describe. Did it help?
wis h list
What would you change about hearing care?
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234
Appendix
Would you like your family or others to treat you differently because of your
hearing loss? Please explain.
How do you wish society or the media would view or respond to hearing
loss?
Are there changes you would like at work, church, shopping malls, theaters,
or other settings that might lessen your hearing difficulties? If yes, please
describe.
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Questionnaires
235
adv ic e f ro m o n e he ari n g -i m pa i r e d
per s o n to an ot h e r
What advice would you give to someone with hearing loss?
What advice would you give to someone who suspects a hearing loss?
What advice would you give to someone at risk to develop hearing loss from
noise exposure or other preventable cause?
What advice would you give to someone who has a hearing loss but denies it
or feels it is unimportant?
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236
Appendix
Given a second chance, is there anything related to your hearing that you
would have done differently? If yes, please explain.
What advice would you give to family or friends of someone with hearing loss?
Was there a group, association, or publication you found helpful and would
recommend?
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Questionnaires
237
Aside from health care professionals, who should a person look to for support? Should a person seek help from family members, co-workers, church
groups, etc.? What kind of help?
What would you suggest as some realistic or unrealistic expectation for living
with hearing loss and/or hearing aids?
Do you have any financial advice related to hearing care, hearing aids, or living with a hearing loss?
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238
Appendix
What other advice or comments can you offer regarding hearing loss, hearing
aids, or hearing care?
Does your spouse or significant other recognize how the hearing loss affects
him or her? Describe their perspective.
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Questionnaires
239
Did your spouse or significant other seek help for the hearing loss on his or
her own, or was it your idea? Please explain.
Does your spouse or significant other wear a hearing aid or aids? Does this
help? Please explain.
What else does he or she do to cope with the loss? Does it work?
Is the hearing loss a problem for others? Is it a problem for you? Please
explain.
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240
Appendix
Does the hearing loss affect your relationship? If yes, please explain.
In what other ways does your spouse or significant others hearing loss affect
you or your family?
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Questionnaires
241
What advice would you give to the spouse or family of someone with hearing
loss?
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Notes
Introduction
1. Kochkin, MarkeTrak VII: Hearing Loss Population Tops, 1629; National Institute on Deafness and Other Communication Disorders, Report on the Task Force.
2. Hougaard, Ruf, and Egger, EuroTrak + JapanTrak 2012: Societal and Personal Benefits, 1626.
3. Kochkin, MarkeTrak VIII: 25-Year Trends, 1231.
4. National Council on Aging, Consequences of Untreated Hearing Loss,
1216; Kramer et al., Association of Hearing Impairment, 122137.
5. Uhlmann et al., Relationship of Hearing Impairment, 19161919; Lin
et al., Hearing Loss and Incident Dementia, 214220.
6. U.S. Census Bureau, State and County Quick Facts.
243
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245
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246
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253
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Index
255
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Index
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Index
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257
tion, 88; spouses and significant others on, 186; and work
situations, 81
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258
Index
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Index
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259
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260
Index
Hearing clarity: and digital technology, 40; testing of, 20, 142
Hearing Health Foundation, 216
Hearing-impaired patients: contradictory perceptions of, 9; fear
of being labeled, 3; first-hand
advice of, 8
Hearing loss: common reactions
to, 2630; concealment of,
29; denial of, 3, 5, 2627, 30,
97, 98, 99, 161163, 164, 203;
education about, 143; first-hand
advice on, 159169; ignoring
of, 2627, 30, 98; impact of, 3,
25, 71; natural compensation
for, 2729; negative stereotypes
of, 1, 23, 2627, 96, 137139;
plan for, 2930; prevalence,
population estimates of, 2, 71;
prevention of, 53, 143; types of,
1718; variety of solutions for,
3132, 50. See also First-hand
advice; First-hand experiences;
Treatments
Hearing Loss Association of
America, 216
Hearing-loss questionnaires: and
first-hand advice, 46, 72;
sample of, 227238; survey
methods, 5, 67
Hearing protection. See Noise
protection
Hearing tests: basic test battery,
1922; for children, 2225, 92,
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136; and cochlea, 17; and ear examinations, 1826; for suspected
hearing loss, 159160, 202
Hearing threshold, testing of, 1920
Hear-More, 216
Help from others, as coping strategy,
105106
Incus, 15
Independent Living Aids, 216
Induction loop systems, 3738, 44,
147, 173
Information sources: first-hand
experiences with, 9499; list of,
219225; overlooked resources,
215216, 217
Inner ear: autoimmune inner ear
disease, 5960; and ear examinations, 15, 17; and Mnires
disease, 6061; and vestibular
system, 17
Insurance coverage, 148149, 150,
157, 173, 174, 175
International Hearing Dog, 34
Internet, information sources on,
94, 216
Language, impact of hearing loss
on, 25
Language pathologists, 25, 66
Leisure, impact of hearing loss on, 8
Limitation of activities, as secondary
effect of hearing loss, 7779,
85, 88
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Index
Y6609.indb 261
261
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262
Index
Pagers, vibrating, 33
Patience: asking others to repeat
and, 100, 206; first-hand advice
on, 179, 206, 217; friends and
family reactions, 140, 181, 198,
206; and societal reaction to
hearing loss, 139, 157, 206
Personal amplifiers, 35
Pinna (outer ear), 15
Play audiometry, 24
Pollutants, 52
Protection. See Noise protection
Public venues: assistive listening
devices in, 38, 109110, 153, 154,
155, 157, 173; and background
noise, 120, 125, 154; and closed
captioning, 154; and effect
of hearing loss on mood, 90;
getting help from others and,
105, 106; hearing-aid use in,
42, 122, 123, 126, 134, 208; and
Y6609.indb 262
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Index
chlear implant, 6467; and congenital loss, 61; and otosclerosis, 58; sudden sensorineural
loss, 5859; testing of, 20
Sign language, 110
Single-syllable words, 20
Sinus problems, 52
Smoke detectors, 33
Smoking, 53
Social isolation: first-hand advice
on, 164; hearing loss associated
with, 3, 29, 85, 8688, 205;
spouses and significant others
on, 187, 189
Social networking services, as information sources, 94
Sounds, missing, 7273
Speech, impact of hearing loss on, 25
Speech discrimination, testing of, 20
Speech pathologists, 25, 6566
Speech reception threshold (SRT),
testing of, 20
Speech recognition software, 3637
Spouses and significant others: on
communication breakdowns,
185187; compensating for
hearing loss, 8182, 85, 99,
100, 106, 183, 186, 187, 188189,
190, 191, 192, 195196, 200; on
consequences of hearing loss,
184192; effect of hearing loss
on mood, 89, 187; effect of hearing loss on relationships, 8384,
188191; on family and friends,
Y6609.indb 263
263
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264
Index
Y6609.indb 264
prevention, 5354; and Mnires disease, 6061; and otosclerosis, 5758; and perforated
eardrum, 5455; and sudden
sensorineural loss, 5859; surgical treatments for severe or total
hearing loss, 6167, 111; types
of, 78, 50
Two-syllable words, and hearing
threshold, 1920
Tympanometry, 22
Tympano-ossiculoplasty, 56
Tympanoplasty surgery, 55
User-adjusted volume control, 4445
Vertigo, and Mnires disease, 60
Vestibular system, and inner ear, 17
Vibrating alarm clocks, 33
Video otoscopes, 14
Visual reinforcement audiometry
(VRA), 24
Volume settings: adjustment of devices, 8, 2728, 8485, 100101;
adjustment of hearing aids,
4445; and hearing clarity, 20.
See also Loudness
Websites, as information sources, 94,
215216, 217
Whistling, of hearing aids, 4243,
127, 129, 130
Windy conditions, and hearing-aid
use, 125, 126, 130
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Index
Y6609.indb 265
265
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