A large of number of people who have invested in hearing aids and identify themselves as someone with a hearing loss, do not seek treatment, drop out of treatment programs, fail to use their hearing aids or chose not to return to the provider to assist them in improving their hearing aid results. Research has noted that 1/3 of adults do not use their hearing aids thus resolving themselves to living with the hearing loss and communication difficulties. This perpetuates the disabling impact of communication barriers and other health related factors, quality of life and economic independence. As an Audiologist, I deal with hearing aids daily. I always try to remember what it is like being one of my patients, from the hearing aid novice to the experienced user. Here are some things to keep in mind as the patient who wears hearing aids. 1. Not all hearing aids are created equal or by the same manufacturer. When comparing hearing aid companies, one company’s top of the line model may be the next companies mid-level model. While researching a manufacturer, there are many areas to take into consideration … such as how many levels of technology do provide? What is their country of origin? If warranties and extended warranties/repairs are provided, and for how many years? Will they provide extended warranties, and for how long? Compare apples to apples, not apples to oranges. There are some differences even between apples (red vs green). 2. You get what you pay for. This includes the time and the supplies provided by the business where you purchased your hearing aids. If you purchase over-the-counter (OTC) hearing aids form a big box company, TV, or internet place – they are not customized to your hearing loss and your needs. There is no one for you to see for adjustments, or you may have to fight to see someone every time you go in, even with an appointment. SERVICE means a lot! 3. Level of education – A hearing aid dealer/dispenser/ hearing instrument specialist – all have a license to practice but are trained more on the SELL of the hearing aids versus an Audiologist who is trained on the ear, hearing and health as well as the hearing aids. (You don’t go to your plumber to fix your bladder-you go to a Urologist/ DO/MD- both deal with forms of pipes but only one understands YOUR bladder). 4. Aural education! What is aural rehabilitation (AR) and do I need it? Audiologists and speech language pathologists are trained to provide aural rehabilitation techniques. AR provides techniques and skills to implement better understanding and communication skills for both the listener and the speaker. When working with an Audiologist, an aural rehabilitation program is set up and reviewed as the hearing aids are selected, set and tweaked - It is individualized for each patient. The importance of good hearing aid management skills and the individual care and time taken with the patient are our highest concern because when we succeed with your program -you succeed with better hearing! Patricia Larson Shields, AuD
Otoacoustic emissions (OAE) hearing screening, used widely in hospital-based newborn hearing screening programs, represents a significant advance for screening young children. An objective method that screens hearing in a range of sound frequencies critical for normal speech and language development, portable OAE screening is the most practical method for screening infants and toddlers because it does not require a behavioral response from the child. It can help detect sensorineural hearing loss and call attention to hearing disorders affecting the pathway to the inner ear is quick and painless. The procedure is performed with a portable handheld screening unit. A small probe is placed in the child's ear canal. This probe delivers a low-volume sound stimulus into the ear. The cochlea responds by producing an otoacoustic emission, sometimes described as an “echo,” that travels back through the middle ear to the ear canal and is analyzed by the screening unit. In approximately 30 seconds, the result is displayed on the screening unit as a "pass" or a "refer." Otoacoustic emissions (OAE) screening can help to detect sensorineural hearing loss occurring in the cochlea. It can also call attention to hearing disorders affecting the pathway to the inner ear.
Dr. Patricia Larson Shields AuD SLP
In the United States, there are nearly 29 million people with hearing loss who could benefit from treatment with hearing aids. Unfortunately, only 16% of those individuals actually seek treatment. Untreated hearing loss will have obvious effects, including difficulties in communication and participating in social interaction. Additionally, untreated hearing loss can have negative impacts on overall health and lead to increased health care costs in the long run.
A recent study conducted at Johns Hopkins Bloomberg School of Public Health compared health care costs for older adults with untreated hearing loss and older adults without hearing loss over a period of ten years. The results showed as much as 46% higher health care costs for individuals with untreated hearing loss. The group with untreated hearing loss also had 50% more hospital stays, with about 44% of those at risk for hospital readmission within 30 days. They were also 17% more likely to have an emergency room visit and had on average 52 more outpatient visits than the group without hearing loss. The average cost of healthcare for people with untreated hearing loss was $22,434 higher than those with no hearing loss over a 10-year period, with only about $600 directly related to having hearing loss.
Another study at Johns Hopkins looked at the relationship of untreated hearing loss with other health problems. This study found that people with untreated hearing loss also had a 50% greater risk of developing dementia, a 30% greater risk of falls and a 40% greater risk of depression as compared to those with normal hearing.
Researchers did not determine why untreated hearing loss increases health care costs or health care utilization, however, they speculate that difficulties in communication may play a significant role. People who cannot hear their physicians may have difficulty communicating their symptoms, following instructions or understanding recommendations made by the physician, or participating in conversations to develop a treatment plan.
Audiologists work with patients to develop individual treatment plans which address their specific needs. If you or a loved one is living with hearing loss, please don’t let it go untreated. When a loved one needs help, “I didn’t hear you” is not the answer they should get. It is not cost or health effective.
If you or a loved one is struggling to hear every day, even with powerful hearing aids, Cochlear Implants may be a solution. Cochlear implants work differently than hearing aids. Hearing aids make sounds louder and rely on the healthy sensory cells in the inner ear to transmit sounds to the hearing nerve. As hearing loss progresses, there may not be enough healthy sensory cells left in the inner ear to transmit sounds. So even if hearing aids are loud enough, some sounds are distorted and unclear. It’s almost like turning up a badly tuned radio. Cochlear implants bypass the damaged cells in the inner ear and transmit sounds directly to the hearing nerve using electrical impulses. Stimulating the hearing nerve directly gives a clearer, more precise signal, but not necessarily louder. Having a cochlear implant is more like improving the signal of a badly tuned radio instead of turning it up. Sound heard with the implant is different than acoustical sound, however, and my take some time at first to adjust. Cochlear implants are approved for adults with moderate to profound sensorineural hearing loss in both ears who understand less than 40% of what they hear with their current hearing aids. In order to qualify for cochlear implants, a cochlear implant evaluation must be performed. This is often conducted by a team of specially trained health professionals. A medical workup is necessary to ensure there are no medical contraindications to surgery. An audiological evaluation is required to ensure the candidate meets the FDA candidacy criteria. Candidates must have realistic expectations, a strong support system and be motivated to learn to hear with the new device. Children as young as 12 months may qualify for cochlear implants if they have profound sensorineural hearing loss in both ears and receive limited benefit from hearing aids. Children age 2-17 years are approved for cochlear implants if they have severe to profound sensorineural hearing loss in both ears and receive limited benefit from hearing aids. In any case, a trial with hearing aids is always a necessary step in the cochlear implant candidacy process.
If you have questions about the cochlear implant candidacy process or think you may qualify for cochlear implants, please contact Hearing Plus, LLC.
1. Research hearing aid types – Learn about hearing aid types and hearing technology to gain a basic understanding of the many choices available.
2. Undergo a hearing test and complete hearing evaluation – A comprehensive hearing test and evaluation is the first step toward identifying hearing loss and finding the right hearing aid for a specific hearing problem. We will work with you to provide recommendations for appropriate hearing aid solutions, if necessary, based upon your hearing evaluation and lifestyle needs.
3. Honestly identify hearing needs – Some hearing aids are well suited for noisy situations; others are not. Some hearing aids types are perfect for an active lifestyle, while others are better suited for quiet activities such as watching television or listening to music. Features, controls - even color - may be important factors to consider when choosing the right hearing aid for your needs.
4. Understand hearing aid costs – Hearing aids may be a larger purchase and as such, the buyer should receive a written contract which includes the cost of the hearing aids, as well as any services provided by the hearing professional. These services may include fitting, training and follow up appointments. Insurance coverage and financing may also be available to help make certain hearing aids more affordable.
5. Get a comfortable fit – Custom earmolds ensure the best fit when purchasing new hearing aids. New hearing aids require a period of adjustment, and any level of discomfort could make the transition difficult.
6. Follow up – Adjusting to new hearing aids takes time as the brain learns to hear again in a new way. Follow up appointments are imperative to get the most out of new hearing aids.
7. Ask about the return policy – Most hearing professionals will offer a trial period for new hearing aids. Some may charge a fee if the hearing aids are returned; others may offer the opportunity to try a different hearing aid style.
8. Understand the warranty – As with any major purchase, hearing aids come with a warranty to cover repairs or replacement during a 3-year period. We remain committed to making sure you are taken care of throughout the life of your hearing aid and even have extended warranty plans available.
9. Consider using hearing aids with other assistive listening devices – Today's hearing aids are designed to work seamlessly with phones and audio equipment. Imagine having the sound from your radio or TV come through your hearing aid so others in the room can hear at comfortable levels. New wireless hearing aids may be the ultimate in convenience for the hard of hearing. We can answer questions about the compatibility of hearing aids with assistive listening devices.
10. Help a friend- with the prevalence of untreated hearing loss it is likely you know or may encounter someone who could benefit from better hearing as well. At Hearing Plus LLC, we are committed to helping all in our community that suffer with hearing loss and appreciate any referral you can share with those in need.
Memorial Day is coming up this month. I see many service men and women in my practice. I would like to thank them and their families for their service, dedication and sacrifice. Many of America’s heroes return from their deployment and/or service time with a hearing loss and PTSD (Post Traumatic Stress Symptoms Disorder). To understand PTSD, we need to define it. It is a traumatic event such as death, threatened death, serious injury or actual or threatened violence. There are simple PTSD and complex PTSD. Simple refers to a single discrete traumatic event which results in feelings of fear, terror or helplessness. Complex PTSD refers to those exposed to repeated trauma over time with some or all the symptoms of simple. The may also include but not be limited to excessive dependence, anxiety, self-hatred, distrust, shame, fatigue, sleep and eating disorders, depression, difficulty planning and difficulties with making decisions, sometimes to the point of paralysis or in need of a service animal.
To compound this disorder many are left with a hearing loss. Individuals with a hearing loss also experience isolation, depression, anxiety and many other communications impairing frustrating hurdles. Tinnitus (pronounced tin- eye-tus or tin-e-tus... either way it is annoying) is a humming, ringing, buzzing, swooshing or any other of a description of sounds in people’s head or ears not heard by others. This often accompanies both PTSD and hearing loss. Hearing loss and tinnitus have been known to be one of the most prevalent in service-connected disabilities. These two conditions together are often referred to as auditory dysfunction. One study noted more that 1.45 and 1 million Veterans receiving disability compensation for hearing loss and /or tinnitus. (Office of Public Heath, 2015 Veteran Benefits Administration 2016). In another study which looked at the prevalence of hearing loss and tinnitus cohort of Iraq and Afghanistan (IVA) with post deployment conditions including traumatic brain injury (TBI), PTSD, and other typical post concussive conditions such as headaches and vertigo/dizziness, the Veterans Administration (VA) data years 2001-2014, concluded that TBI, PTSD, and depression were significantly associated with increased hearing loss, tinnitus, or both.
That was just from the IVA deployment in those years. I want to say a big THANK YOU to all who have, are and will be serving in the military, firefighters, EMS, first responders, police, those who defend protect and serve this country and communities they live in as well as their families for the sacrifice they have endured not just in the battles but in the loss of their lives, hearing and overall communication abilities. They are our heroes in the real world. They are worth remembering, hearing and listening to.
Let's go to the movies and enjoy the sound! I recently sat down with Jeff Logan of Logan Luxury Theatres in Mitchell, Huron, and Dell Rapids to discuss individuals who would enjoy going to the movies but due to the acoustics, both for hearing and hearing impaired, don't benefit from this entertainment experience. Logan and I reviewed not only the assistance one may take advantage of at the movies but also church, restaurants and schools. We are fortunate in the cities of Mitchell, Huron, and Dell Rapids because Logan cares about his patrons having the best experience at the movies. He has purchased closed caption devices that set in the cup holders for individuals who prefer to read due to speech understanding or comprehension difficulties.
He also has new amplification headphones. The devices have a sound reduction effect, that limits the background noise thus amplifying speech. It also has a fabulous aspect for the visually impaired as it can be programmed to tell what is happening (i.e. Joan enter the room and looks at the letter.) The movies are just one area that assistive listening devices are and can be utilized. One of the areas whit the greatest difficulty hearing is while attending worship services. Many churches have installed amplification systems to assist hearing impaired parishioners in hearing the sermons, teachings, or homilies. And some restaurants have remodeled their space to improve acoustics and make a more enjoyable dining experience.
The hearing aid manufactures have also created new hearing aids that are connected to your phone. most are available for the iPhone or iPad, but few are streamable with Android. Manufacturers have also developed devices beyond the hearing aids to assist with various aspects of a better listening environments. The schools provide a FM system - or loop system - for students with hearing impairments. These work with the wearer's hearing aids or cochlear implant as the signal is transmitted directly from the educator to the hearing device. They may be a neck loop, body worn or at ear level.
The most important part is the student is receiving the best learning environment in spite of their hearing impairment. People with hearing loss struggle with understanding speech, even though the hearing aids are working overtime to pick up signals. Give your hearing aids a reprieve and reduce your listening fatigue by considering utilizing the facility's system, such as those used at Logan Luxury Theatres, churches, or schools. Don't be afraid to ask for assistance and let's enjoy going to the movies, places of worship, and school.
Don't dismiss the ringing in your ears. "The ringing in my ears is driving me crazy." "What is it and how do I get rid of it?" "I have heard many claims but I want the truth." These are the questions and phrases I hear often. The claims are real and it is called tinnitus. Tinnitus is, for most people, phantom perception or sound occurring in the brain's pathway due to a loud sound or background activity under stress related situations. The individual with the tinnitus is the only one who can hear it, which is called subjective tinnitus. On occasion, a rare condition occurs in which the tinnitus may be heard and measured by a train professional. Such tinnitus is related to blood flow or contractions of small muscles in the head and it may be caused by the inner hair cells being damaged. This is the objective of tinnitus.
In the general population, tinnitus may be caused from repeated exposure to loud sound, an episode of explosive sound, head or neck injury, stress, certain medications, ear disease, or dysfunction. The truth is millions of people suffer from tinnitus and there are many conflicting reports and causes as there are individuals. No two people listen the same way, share the same medical and environmental backgrounds, or go to the same places at the exact same time. No treatment - whether it is a medication or hearing aid - is going to be the right answer for everyone. If you are utilizing a hearing aid to mask out the ringing, one way or the other, you will need to have a good tinnitus matching procedure provided by a trained audiologist.
As an audiologist, I need to know the exact frequency and intensity as well as if it is maskable and by what type of noise, tone, or response pattern. I need to know if it is intermittent or continuous noise, if it is pulsed or sounds similar to a bee buzz, locust, ocean waves, hissing, highline wire hum, tea kettle whistle, or a telephone ring. There are a numerous amount of variables to just say it is related or probably related to a certain cause, and to treat everyone the same is not answering the questions or providing all the correct avenues of treatment.
So, for now, most will use the Band-Aid approach, but if you would like more information, call an audiologist
We as humans are so blessed to have bodies which perform so many functions without us having to think about them. An example would be breathing. Most of us don't have to tell our body inhale and exhale -it is an automatic function. Hearing and speaking are an important part of the whole-body health. This is a truth that has been proven by years of studies demonstrating the connections of the heart, mind and lifestyles.
Recent studies suggest mediation is not only good for your overall well-being, but it can improve your hearing abilities. It is true there are genetic and environmental factors (such as excessive loud noises) associated with the cause of hearing loss, however most of us have far more ability to prevent hearing loss, or improve it, than we realize. The use of hearing protection when exposed to loud sounds is the first thought. Turning down the volume is the second. Have you thought or inquired from you physician or pharmacist which medication maybe ototoxic and if it changes to those for others may be used? How about getting plenty of exercise?
Exercise improves blood flow. Research has shown at least two hours per week of waling decreased the risk of hearing loss. Exercise also helps the balance system and the cognitive functioning, such as memory, executive functioning skills and motor planning skills. Avoid smoking. Yes, you have heard this related to your lungs about a thousand times. But, your ears? Absolutely. It decreases oxygen to the blood thus increasing the likelihood of a hearing loss.
Meditation and positive thinking also are associated with better hearing. The 2016 Hearing Review found that, "those who meditated have an increased thickness of gray matter in the parts of the brain responsible for attention compared to those who do not meditate." The review suggests that by taking time to calm your mind and focus, your overall health, including your hearing skills, improves. That is pretty impressive. Mediation also improves the blood flow to the ears and increases the oxygen level in the body. The chattering voice that does not seem to quiet can be difficult to not focus on at first but with time, it fades into the background.
Thanks for paying attention. Happy health, hearing and mediating!
Then communicating with someone with a hearing loss, with or without hearing aids or cochlear implants, we need to be cognizant of both the listener and the speaker. The individual who has the untreated hearing loss will often be aware at some level that their hearing is not "what it used to be." They will tend to blame or question all around until they are ready to take ownership of their hearing loss. they will say others "mumble or don't speak clear" or "if they would only speak up and use clear English."
Although these things may be true, they are not true with all speakers. If you are the one hearing yourself say these things, it may be time to get your hearing checked. Checking will determine if it is your hearing, memory, auditory processing or if it is everybody else. When speaking with others who wear hearing aids or cochlear implants, remember as a speaker you have a duty to perform the following:
These are just a few suggestions to help reduce miscommunication. We all want to be heard and understood so remember your manners.
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Patricia Larson Shields, AuD FAAA MA CCC-SP/L is a doctor of audiology with her degree from The School of Audiology of the Pennsylvania College of Optometry in February, 2003. She has been in business in Mitchell, SD since September, 1991.