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The Consequences of Untreated Hearing Loss: Why You Shouldn’t Wait to Seek Help for a Hearing Difficulty

April 18th, 2012

By: Crystal L. Chalmers, Au.D.
Doctor of Audiology
North State Audiological Services
15 Jan Court
Chico, CA 95928
(888) 844-7024
Follow North State Audiological Services | Facebook | Twitter | Youtube
www.nsaudiology.com

After over 30 years as an audiologist, I have heard a lot of reasons from a lot of patients as to why they had not addressed their hearing difficulties sooner.

And of course, I always explain to them that ignoring a hearing difficulty won’t make it go away, and that there are consequences for not treating a hearing loss.

Audiologist & Ear Doctor, Dr. Crystal Chalmers, Chico, CaliforniaNow there is even more evidence – gleaned from scientific studies by some of the top researchers in the world –  to support what audiologists like myself and many of my colleagues with Audigy Group have been saying all along: don’t wait to get tested and – if the tests do indeed show a hearing loss – discuss treatment options with your hearing care professional.

These studies clearly show that hearing loss doesn’t just affect one’s ability to hear the TV or communicate with a spouse, friends, or co-workers.  There can be serious implications for brain atrophy and cognitive function.

Study Results Released at Audiology Conference

A number of these studies were presented and discussed at the American Academy of Audiology’s “Audiology NOW! 2012” annual international conference which was held March 28 thru March 31 in Boston, Massachusetts.   I attended this conference and took in several of these workshops, notably one titled “Issues in Cognition, Audition, and Amplification: A Panel Discussion”.

This extremely informative workshop was presented by a panel comprised of six highly respected researchers from the USA, Canada, and northern Europe.

The presenters and their topics were:

● Larry E. Hulmes, Ph.D., Indiana University “Higher Level Processing Abilities”

● Ulrike Lemke, Ph.D., Senior Researcher, Phonak International, Zurich, Switzerland “The Cognitive Part of Successful Speech Recognition”

●  Brent Edwards, Ph.D., Starkey Research Laboratories, Eden Prairie, MN “How Hearing Aid Technology Can Affect Cognitive Function”

● Kathy Pichora-Fuller, Ph.D., University of Toronto, Canada “Can Hearing Aids Accelerate Listening and Speech Understanding?”

● Thomas Lunner, Ph.D., Eriksholm Research Center, Oticon International, Denmark, and Department of Behavioral Sciences and Learning, Linkoping, Sweden “Memory Systems in Relation to Hearing Aid Use”

● Frank Lin, M.D., Ph.D., Johns Hopkins Medical Institutions, Baltimore, MD “Hearing Loss and Dementia”

Collectively these presenters showed how brain function and hearing loss are intertwined and that when left untreated hearing loss clearly affects cognitive function.  Of special interest were findings on how the use of hearing aid technology could produce marked improvements in those who had had cognitive decline caused by untreated hearing loss, much the same as physical therapy can be used to restore deteriorated muscle mass.

University Study Links Brain Atrophy with Hearing Loss

A recent study by researchers at the Perelman School of Medicine at the University of Pennsylvania – the results of which were released in August of last year – show that declines in hearing ability may accelerate gray matter atrophy in auditory areas of the brain.  This shrinkage of the brain in areas important for hearing comprehension can cause an increase in the effort needed by the affected person to successfully comprehend speech.  This need for increased effort can be particularly troublesome for older adults as the amount of energy used for “hearing” can impact other areas in the affected person’s daily life.

The study found that people with hearing loss showed less brain activity on functional MRI scans when listening to complex sentences.  Poorer hearers also had less gray matter in the auditory cortex, suggesting that areas of the brain related to auditory processing may show accelerated atrophy when hearing ability declines.  In general, the study showed that loss of hearing sensitivity “has cascading consequences for the neural processes supporting both perception and cognition.”

“As hearing ability declines with age, interventions such as hearing aids should be considered not only to improve hearing but to preserve the brain,” said lead author Jonathan Peelle, Ph. D., research associate in the Department of Neurology.   The research for this study can be found in The Journal of Neuroscience and was funded by the National Institutes of Health.

May is National Better Hearing Month!

Learn More About These Studies and other Topics at My Upcoming Seminar

The Month of May is “National Better Hearing Month”, and once again I will be offering my free annual Educational Luncheon Seminar.  This seminar is a comprehensive presentation covering a variety of hearing health care topics such as understanding how our hearing system works, enhancing communication and listening skills, advancements in hearing aid technology, and what to look for in a hearing care professional.

The seminar will be on May 2, 2012 at the Chico Women’s Club, from 11:30 am til 1:00 pm.  A complementary catered lunch will be served.  There is no cost or obligation for attending, but due to limited seating reservations are required.  To reserve your space, call my office toll free at 1 (888) 844-7024 … because hearing is a wonderful gift!

About the writer:  Crystal Chalmers, Au.D., is an AudigyCertified™ Doctor of Audiology, the owner of North State Audiological Services in Chico, and a member of Audigy Group, the nation’s largest member-owned association of independent hearing care professionals.

Since 2006, Audigy Group has interviewed over 5,000 of the 18,000 audiologists in the United States, yet has selected only 250 to be members in this elite association.   Dr. Chalmers is the only Audigy Group professional in the entire northeastern part of California.  AudigyCertified™ is a trade-mark of Audigy Group, LLC.

To learn more about Dr. Chalmers, her practice, and Audigy Group visit online at our website or call toll free at 1 (888) 844-7024.

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Posted in American Academy of Audiology, Amplification, Audigy Group, AudigyCertified, Audiologist, Audiologists, Auditory, Crystal Chalmers, Doctor of Audiology, Hearing Aid, Hearing Aids, Hearing Care Professional, Hearing Comprehension, Hearing Difficulties, Hearing Difficulty, Hearing Loss, Hearing Test, North State Audiological Serivces, Uncategorized, Untreated Hearing Loss

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Seeking Hearing Help? The Cost of Quality and Other Secrets of Success

April 11th, 2012

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

So, you finally made and KEPT that appointment for a hearing evaluation. Congratulations! You took that all-important first step to a better quality of life.

First and foremost, be sure your hearing evaluation was done by an audiologist who holds Board Certification from the American Board of Audiology. A hearing evaluation is a test which allows this professional to determine the type and degree of hearing loss. Hearing evaluations are simple, quick, and painless, providing the information needed to make recommendations to improve the quality of life – YOUR life.

Ah, but the results of that evaluation were not… what you were hoping? No ear wax or infection…instead you’ve been told you are a hearing aid candidate. Finding the best hearing aids is a process that is unique to each person with hearing loss. It is important to work closely with your audiologist to determine which hearing aids best fit your hearing loss, lifestyle, listening needs and budget. Take heart…You’re going to love what you hear.  You may not, however, love the price tag, but please keep reading. Hearing aids are a worthy investment for you and those you love.

As with most things in life, you get what you pay for.  Most hearing aids range in price from around $1000-$3000 per instrument. And remember that in most cases you will be buying a pair. Whether we’re talking about cars, clothes or hearing aids, quality costs more. We’re not talking about those ear amps they sell on TV so “you can watch TV without disturbing your partner. ONLY $14.95!!!!” Such personal sound amplifiers (PSA) are devices that are intended for people with no hearing loss to aid in various recreational activities, not to amplify sound for those with documented hearing loss. The FDA recently felt it necessary to clarify for consumers the difference between a PSA and a hearing aid in order to protect consumers. Unlike hearing aids, PSA devices are “one size fits all”, and a recent study at Michigan State University determined that PSA devices were directly correlated to low consumer satisfaction and are potentially harmful to hearing.

AGX Hearing Lifestyle

A common question among consumers is “which hearing aids are best?” The best hearing aids are those chosen based on your unique hearing loss, hearing needs and lifestyle issues. Work with your audiologist to prioritize your needs, wants and budget and let them help guide you in selecting the best hearing aids for you.

So, what things should you consider when shopping for your first set of hearing aids, or looking to replace the pair that you’ve enjoyed all these years? Which features are important to you? Live in a hot and humid climate and enjoy being outdoors? Hitting the tennis courts each morning? Or maybe you walk or run with friends.  In general, the more active lifestyle you lead, the more sophisticated hearing aid you will need. If you lead an active life – playing golf, jogging in the morning or just out and about, buy hearing aids that reduce wind noise and protect against moisture build-up are worth the extra money. If you lead a quiet, sedate life, you may not need extra technology to get you through the day.

Call it self-image or self-confidence, there’s a stigma in some people’s minds about hearing aids. Concerned about cosmetics? With today’s technology, no problem! Hearing aids come in a variety of styles and sizes for those looking for a discreet fit.

Completely-in-the-canal (CIC) hearing aids slip into the ear canal and are nearly invisible. Custom made hearing aids block natural sound, and often create a “stuffy ear” feeling, but the latest “open ear” devices are light and powerful. These units are remarkably cosmetically appealing, utilizing a thin transparent tube to deliver sound into the ear.  So, if you’re concerned about how others will see you with hearing aids, the cosmetic appeal of an open fit is ideal.

Are you glued to a cell phone a couple of hours a day on the road? Does your PDA ring every 10 minutes? Do you have a music device like an iPod you enjoy listening to? Today’s hearing aids offer wireless connectivity to a range of Bluetooth compatible devices so you can stay in touch with family, friends and the folks back in the office using your hearing devices. You can now use your cell phone hands free, routed directly through your hearing instruments! Not exactly your grandmother’s hearing aid! On the other hand, if you still think a Blackberry is simply a tasty fruit, why spend extra for wireless connectivity?

So forget the PSA gizmos if you have a diagnosed hearing loss. They can make a bad situation worse. If you can afford the top of the line, there are some fantastic technologies available. But if you are on a budget, know there are still many options for you and your decision should be made based on exactly what you need and will use.

You need and want to enjoy the sounds around you everyday, and that’s something on which you just can’t put a price. You’re going to love what you hear.

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Posted in Audiologist, Best Hearing Aids, Bettie Borton, CIC Hearing Aids, Completely in the Canal Hearing Aids, Doctors Hearing Clinic, Ear wax, Hearing Aid Candidate, Hearing Aid Technology, Hearing Evaluation, Hearing Lifestyles, Hearing Loss, Hearing Test, Hearing Tested, Personal Sound Amplifiers, Uncategorized

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Why Should I Pay for a Hearing Test?

February 29th, 2012

By: Kumiko T. B. Dunn, Ph.D., CCC-A
East Valley Hearing Center, Inc.
6262 E. Broadway Rd., Ste. 103
Mesa, AZ 85206
(480) 830-0994
Connect with East Valley Hearing Center | Facebook | Twitter | YouTube
www.eastvalleyhearing.com

This question has been asked of us on a number of occasions in our private audiology practice. Audiologists are extensively trained healthcare providers similar to primary care physicians (PCPs), nurses, optometrists, and dentists. So it is a bit of a puzzle when we consider the reason some would ask why they have to pay for our medical services; few are likely to ask if they have to pay for a visit to their PCP when they have a cold, or for a visit to their optometrist for an eye test in order to get new glasses or contacts.

“I can get one just down the road for free.”

Audiologist, Kumiko T. B. Dunn, Ph.D., CCC-AThis statement often follows the first and brings to light the reason the first question got asked. By “down the road”, the questioners are often referring to locations where hearing aids are sold, often by people licensed as “hearing aid dispensers” and not audiologists. Hearing aid dispensers have primarily been trained to test their patients’ hearing for the purpose of deciding if a patient might be able to wear hearing aids successfully. Audiologists have, of course, also been trained to do this but the bulk of their education (8+ years beyond high school) is in the science of determining the possible source of a person’s hearing problems. In addition, audiologists are trained to determine the most effective treatment options for a patient’s unique needs, including hearing aids, cochlear implants, bone anchored hearing aids, middle ear implants, aural rehabilitation and assistive listening devices [ALDs]. Hearing aids can be an effective tool in improving one’s ability to understand conversation and communicate with others but the audiologist’s role is to use all tools available to improve these important aspects of life. Finally, there is also a difference between the hearing aid dispenser and the audiologist in the eyes of the insurance company. If a person’s insurance coverage will pay for a hearing test, a hearing test done by an audiologist will generally be paid for by insurance; a hearing test done by a hearing aid dispenser, however, typically will not.

We provide a complete and comprehensive hearing evaluation that will be used to provide you with the best hearing care possible. The team of audiologists and staff at East Valley Hearing Center hope that this provides a better understanding of why we ask for payment for our services. We are here for far more than to simply sell hearing aids. Our objectives are to determine the possible reason(s) for our patients’ hearing difficulties and to provide recommendations for the most effective ways to help relieve or reduce them.

East Valley Hearing Center is composed of providers, who are Doctors of Audiology (Au.D.) and Ph.D. Audiologists, Audiology Assistants, and support staff. We would be happy to serve you and your hearing needs.

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Posted in Assistive Listening Device, Audiologist, Audiology, Hearing Aids, Hearing Care, Hearing Evaluation, Hearing Problem, Hearing Test, Hearing Tested, Private Audiology Practice, Uncategorized

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Hearing is Big Business!

January 25th, 2012

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

Are you Assisting Employees with Hearing Loss? If not, listen up.

In a 2009 survey of 46,000 U.S. households, the Better Hearing Institute (BHI) determined that over the past generation hearing loss grew at an alarming 160 percent of the U.S. population growth— largely attributable to the aging of the American population. Yet the study found that 60 percent of people with hearing loss are below retirement age, indicating that 16.3 million people with hearing loss were in the U.S. workforce in 2010. In other words, untreated hearing loss has serious consequences for both employers and employees. Untreated hearing loss is costing society and those with the loss millions of dollars annually in lost revenue, productivity, and manpower.

Good hearing is good business.  Given the incidence and prevalence of hearing loss, most businesses will confront this challenge in the context of management’s responsibility and oversight of human resources. So, what can companies do to plan for and address the impact of employee hearing loss?  There are a number of simple steps employers can take to educate employees about hearing loss and to facilitate the use of hearing aids, where needed, that are simple to implement and very cost effective.

Previous research at BHI has shown that 50 percent of people with untreated hearing loss have never had their hearing checked by an audiologist and lack sufficient information to know whether they need to take action to correct it. Company owners and human resource professionals can help employees understand if they need treatment by:

 

  • Educating employees regarding the impact of untreated hearing loss on quality of life.
  • Encouraging employees to have their hearing screened on an annual basis, and providing opportunities for them to do so.

Employers can create a corporate climate where hearing loss is recognized so those with hidden hearing loss feel more comfortable. Here are some suggestions:

  • Avoid noisy restaurants as meeting locations.
  • Summarize meeting minutes in writing to be sure that those with hearing issues are clear on the outcome of the meeting.
  • Provide easy accommodations, such as moving an employee’s desk away from noisy hallways, machines, or air conditioning and heating vents, or installing a phone that amplifies high frequencies.
  • Build work environments that facilitate better hearing by choosing cubicles with noise-absorbent materials and equipping meeting rooms with an inductive loop that creates a wireless zone for hearing aids with telecoils, headsets or microphones.

In many cases, hearing aids can help protect employees from being at a competitive disadvantage with peers. Organizations can encourage the use of hearing devices, when needed, by participating with a private practice in Audiology to contract for the provision of services, group discounts, hearing devices, and more! Audiologists can design and implement screening programs (on and off site), as well as effective follow up scenarios to assist employees with managing hearing loss if it is identified.

Companies can also encourage employees to purchase hearing aids using pretax medical flexible spending account funds. In Montgomery, Doctors Hearing Clinic offers just such an option through their BHP program , and the good news is that it is FREE to employers, as well as employees and their families. This Better Hearing Program (BHP) offers free screenings, group discounts on hearing devices, in-service educational presentations, and a host of other hearing related employment benefits.

If you’re currently employed, encourage your employer to seek offerings for the provision of hearing healthcare services, and remember, these services can often be contracted with local audiology practices. If you’re an employer in the Tri County region and don’t currently offer a hearing healthcare package, the program at Doctors Hearing Clinic is an example of what is available to your company. This FREE array of benefits for your staff and their families, offers great value in hearing healthcare at no cost to you or your employees!

So start the 2012  business year out right. By encouraging employees to treat hidden hearing loss rather than hide it, an employer creates a win-win situation by ensuring that the loss of hearing does not interfere with job performance, productivity, safety, or the employee’s career or quality of life on or off the job.

References:

Sergei Kochkin, Ph.D., executive director of the Better Hearing Institute, a not-for-profit that educates the public about hearing loss, prevention and treatment.

Better Hearing Institute (BHI)

The Society for Human Resource Management

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Posted in Audiologist, Better Hearing Institute, Bettie Borton, Doctors Hearing Clinic, Employee Hearing Loss, Good Hearing, Hearing Checked, Hearing Evaluation, Hearing Health, Hearing Healthcare, Hearing Issues, Hearing Loss, Hearing Screening, Hearing Test, Hearing Tested, Treatable Hearing Loss, Uncategorized, Untreated Hearing Loss

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What Should You Expect from Your Hearing Evaluation?

January 12th, 2012

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

More than 32 million Americans have significant hearing loss, yet only a fraction of that number have ever had their hearing tested by a Board Certified Audiologist. Everyone over 25 should have a baseline audiogram! Consider this fact- 17% of all those involved in motor vehicle accidents will have resultant permanent sensorineural hearing loss. However, if you’ve never had a valid hearing evaluation, you’d be hard pressed to show that your hearing was normal prior to such an accident.

A thorough hearing test is the first step in determining if you do, in fact, have hearing loss. The hearing test results also allow your audiologist to recommend the best treatment options if you do in fact have hearing loss. A hearing test is a quick, painless and non-invasive test, and should always be performed by a licensed, Board Certified audiologist. Ask to see the credentials of those who will be doing your testing! As with most health care  professionals, credentialed individuals have the greatest amount of educational training in diagnosis and treatment of hearing impairment, and will offer you or your loved ones solutions that reflect their knowledge base.

Hearing Test Audiogram

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The test begins with a thorough case history, which reviews specific health information that may provide insight into hearing loss causes and will assist in determining which tests should be performed. Following the case history, the audiologist will examine your ear canals and eardrums with a special light called an otoscope. Your middle ear function will also be assessed by a test called tympanometry, which offers insight regarding the status of the area behind your eardrum. This area cannot be easily seen, and so the tympangram offers valuable information to the examiner. The test involves a pressure change, and may replicate the feeling you experience while going up in an elevator, but is not painful in any way.

Next, the levels of hearing in each of your ears should be measured in a sound-treated test booth. Some hearing aid technicians don’t use this type of equipment~ but be wary of any hearing test that is not conducted in such a booth, as reliability may be seriously compromised. During this test, a series of tones of different pitches, as well as speech signals, are presented to each ear through headphones. You will be asked to respond to the signals by either pushing a button, raising your hand or in the case of speech signals, repeating what you heard. You will be asked to respond to the lowest level that you can hear which determines your hearing thresholds. Thresholds for each pitch and ear are plotted on a graph called an audiogram. These thresholds indicate the level at which you are just barely able to detect sound. The speech testing yields a word recognition score, which is important in determining in part how well you will perform with hearing aids, which listening situations will be most challenging, etc.

Further tests may be conducted during the hearing test. Your ability to understand words or sentences at different volume levels or in the presence of noise may be assessed to determine how clearly you hear speech in various conditions. Following the tests, the hearing professional will discuss the results with you and may provide further recommendations, including treatment options, like hearing aids.

If you suspect you have hearing loss it is important to have your hearing tested as soon as possible. The use-it or lose-it principle does apply to our hearing; the sooner you treat hearing loss, the better the outcome of treatment. Most people wait an average of seven years from the time they suspect they have hearing loss until they purchase hearing devices. During that time period, the auditory system is at extreme risk for auditory deprivation, or lack of stimulation due to insufficient volume. This can make a difficult situation worse than it really needs to be. So why wait? Have a Board Certified Audiologist evaluate your hearing as soon as you (or others!) suspect there might be a hearing loss.

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Posted in Audiogram, Audiologist, Bettie Borton, Board Certified Audiologist, Doctors Hearing Clinic, Ear Canal, Eardrum, Ears, Hearing, Hearing Aid, Hearing Aid Technician, Hearing Care, Hearing Evaluation, Hearing Impaired, Hearing Loss, Hearing Test, Hearing Tested, Hearing Threshold, Listening Situations, Otoscope, Sensorineural Hearing Loss, Uncategorized

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Can I Prevent My Hearing Loss From Getting Worse?

November 10th, 2011

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

Bettie Borton, Au.D. Doctor of Audiology AudiologistWhen I diagnose patients with a loss of hearing, they usually want to know if there is any way they can stop the progression of the loss. Common sense (and a large body of research) tells us that hearing loss tends to get worse as we get older, but each case is unique. In many cases, hearing is stable for many years. In others, the hearing loss progresses relatively rapidly.

One of the most important things that all adults over the age of 50 need to do is to have an audiological evaluation that will establish their baseline hearing, and keep that on file with their primary care physician and with their health records kept at home. Getting a comprehensive audiometric  by a Board Certified Audiologist ensures that you have been evaluated by a professional who has the most training for this purpose, and ascribes to the highest ethical, practice,  and continuing education requirements available. Why is it so important to have this baseline? Well, if your hearing changes, it will be much easier to gauge the rate of progression of the loss if you have clearly established a “starting point”, and have annual re-evaluations to document any shift in thresholds. And remember, documenting that starting point could be very important –No one wants to borrow trouble, but  don’t forget that  17% of all of those involved in motor vehicle accidents with air bag deployment have permanent sensorineural hearing loss as a result! That could be difficult to prove in a court of law if you haven’t had a recent hearing test.

Noise is a leading cause of hearing loss, and hearing loss from noise exposure is usually preventable. Both the level of the noise and the length of time you’re exposed to it determine if a noise will cause damage to your hearing. A good rule of thumb is: if you have to raise your voice to be heard by someone standing three feet away, the noise around you could be damaging.  Everyday sounds, such as music, power tools, or a lawn mower, have been shown to cause hearing damage.

Visit a local hearing center for advice regarding the best options for ear plugs or other noise protection to wear during these activities and get your hearing checked on a a regular basis.  Your hearing professional can compare your exams over time to determine if your hearing loss is worsening. If a significant change is noted, your hearing professional may refer to you to an ear doctor for further evaluation.

 

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Posted in Audiological Evaluation, Audiometric, Baseline Hearing, Bettie Borton, Board Certified Audiologist, Doctors Hearing Clinic, Hearing Center, Hearing Damage, Hearing Loss, Hearing Professional, Hearing Test, Loss of Hearing, Noise Exposure, Sensorineural Hearing Loss, Uncategorized

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It Doesn’t Really Matter If I Wear My Hearing Aids, RIGHT?

October 28th, 2011

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
www.doctorshearingclinic.com

WRONG! According to ScienceDaily (Sep. 20, 2011), mild hearing loss has now been linked to brain atrophy in older adults. Anecdotally, over the course of my 30+ years in private practice as a Board Certified Audiologist, I’ve observed this to be true. But now, more and more research is indicating strong correlation between failure to obtain or use hearing devices and increased problems with understanding speech and cognition.

Bettie Borton, Au.D. Doctor of Audiology AudiologistWe have all heard (or perhaps experienced) the complaint that despite the fact that speech is audible, it’s not understandable. “I hear but I can’t understand” is probably the most commonly voiced concern in my office. So, if someone has hearing loss, if your hearing aids make sounds louder, why doesn’t that solve all hearing related issues? Well, like lots of things in life, it’s just not that simple.

A person’s audiogram (or those little blue X’s and red O’s on the graph of your responses to the “beeps”) tells us a lot, but it does not yield the whole story. Hearing thresholds (or the point at which someone is just barely able to detect sound across the frequency range) are certainly important, but don’t give much information regarding how well someone will understand when speech sounds are made sufficiently loud. Word recognition testing, with and without noise, provides additional information regarding this capability, and as a by-product, an indirect measure of the distortional component inherent to sensorineural hearing loss.

We now have mounting evidence that those who have hearing loss, but fail to get and/or use hearing devices run the risk of depriving their auditory system of sufficient loudness, which in turn results in degradation of the mechanisms responsible for understanding speech. A new study by researchers from the Perelman School of Medicine at the University of Pennsylvania shows that declines in hearing ability may accelerate gray mater atrophy in auditory areas of the brain and increase the listening effort necessary for older adults to successfully comprehend speech. When any one of our senses (smell, taste, sight, hearing, or touch) is changed in some way, the brain reorganizes and adjusts. In the case of those with hearing loss, researchers found that the gray matter density of brain in areas specific to hearing was lower in people with decreased hearing ability, suggesting a link between hearing ability and brain volume.

So, use it or lose it may be the prevailing philosophy. Take heart (and USE those instruments that you have!) According to this study,  early intervention for hearing loss with the consistent use of amplification can slow the progression of speech comprehension difficulty. “As hearing ability declines with age, interventions such as hearing aids should be considered not only to improve hearing but to preserve the brain,” said lead author Jonathan Peelle, PhD, research associate in the Department of Neurology. “People hear differently, and those with even moderate hearing loss may have to work harder to understand complex sentences.”

In two recent research studies, researchers measured the relationship of hearing acuity to the brain, first measuring the brain’s response to increasingly complex sentences and then measuring cortical brain volume in auditory cortex.  Results indicate that older adults (60-77 years of age) with normal hearing for their age were evaluated to determine whether normal variations in hearing ability impacted the structure or function of the network of areas in the brain supporting speech comprehension.

The studies found that people with hearing loss showed less brain activity on functional MRI scans when listening to complex sentences. Poorer hearers also had less gray matter in the auditory cortex, suggesting that areas of the brain related to auditory processing may show accelerated atrophy when hearing ability declines.

In general, research suggests that hearing sensitivity has important consequences for neural processes supporting both speech perception and cognition. Although most the research has been conducted in older adults, the findings also have implications for younger adults, including those concerned about listening to music at loud volumes. “Your hearing ability directly affects how the brain processes sounds, including speech,” says Dr. Peelle. “Preserving your hearing doesn’t only protect your ears, but also helps your brain perform at its best.”

Physicians should monitor hearing in patients as they age, and everyone should have a baseline audiogram performed by a Board Certified Audiologist, looking specifically at speech recognition abilities even in the presence of normal hearing. Patients should talk to their physician or audiologist if they are experiencing any difficulty hearing or understanding speech. If your physician has not referred you for hearing evaluation, take action!

The research cited above in this article appears in the latest edition of The Journal of Neuroscience and was funded by the National Institutes of Health.

 

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Posted in Advanced Hearing Technology, Au.D., Bettie Borton, Board Certified Audiologist, Communication, Diagnostic Testing, Digital Hearing Aids, Doctor of Audiology, Ear Protection, Hearing, Hearing Aid, Hearing Aids, Hearing Assessment, Hearing Care, Hearing Test, Hearing Tested, Hearing Threshold, Signs of Hearing Loss

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Medicare and Hearing Health Care

July 6th, 2011

By Crystal L. Chalmers, Au.D.
Doctor of Audiology
North State Audiological Services
15 Jan Court
Chico, CA 95928
(888) 844-7024
Follow North State Audiological Services | Facebook | Twitter | Youtube
www.nsaudiology.com

Two questions my staff and I get on a regular basis are: #1.)“Does Medicare pay for hearing tests?  Also: #2.) “If the tests show that I need hearing aids, will Medicare pay for the devices?”

The answer to question #1 is that Medicare does not cover routine hearing exams.  When I say “routine” I am referring to regular hearing testing done at the request of the patient for the purpose of determining the extent of hearing difficulties, much the same as any other health care check up.

Diagnostic audiological services are paid for, by Medicare, when a physician orders testing to obtain information to determine the appropriate medical or surgical treatment of a hearing deficit or related medical problem.

Audiologist & Ear Doctor, Dr. Crystal Chalmers, Chico, CaliforniaHowever, services are excluded when the diagnostic information required to determine the appropriate medical or surgical treatment is already known to the physician or the diagnostic services are performed only to determine the need for hearing aids or hearing aid reprogramming.

If the need for testing and hearing technology does not come under the specific guidelines outlined above, then the patient is responsible for 100% of the professional fees.

As for question #2.), the same is true for hearing aids, which under Federal law are considered “cosmetic” items.  Whether or not you agree with this, the law has stood this way for decades and it would take an act of Congress to change the national coverage policy.

That said, as a consumer you should be aware of any audiologist or hearing aid dispenser who tells you “yes” they will bill Medicare for your non-referred hearing tests and/or hearing aids.  This practice is illegal and as a consultant and special witness for the FBI, I can tell you that the Federal Government is not taking these fraudulent acts lightly.  In fact, they are cracking down on this activity and have recently prosecuted cases here in California.

To find out more about Medicare coverage for hearing care services and technology, visit the official U.S. Government site at www.medicare.gov.

If you have more questions about hearing care such as diagnostic testing and hearing technology, you can visit my website, or call my office toll free at 1 (888) 893-1352 …. Because hearing is a wonderful gift!”

About the writer: Crystal Chalmers, Au.D., is an AudigyCertified™ Doctor of Audiology, the owner of North State Audiological Services in Chico, and a member of Audigy Group, the nation’s largest member-owned association of independent hearing care professionals.

Since 2006, Audigy Group has interviewed over 5,000 of the 18,000 audiologists in the United States, yet has selected only 190 to be members in this elite association. AudigyCertified™ is a trade-mark of AudigyGroup, LLC.

To learn more about Dr. Chalmers, her practice, and Audigy Group visit online at www.nsaudiology.com

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May is Better Hearing Month!

May 4th, 2011

By: Peter J. Marincovich, Ph.D., CCC-A
Audiology Associates
1111 Sonoma Ave., Suite 308
Santa Rosa, CA 95405
(707) 827-1630
www.audiologyassociates-sr.com

May is Better Hearing month—but despite the fact that more than 34 million Americans report some type of hearing problem, relatively few are screened annually. With about 1 in 10 Americans reporting some type of hearing difficulty, hearing loss is the third most common health problem in the United States. Although hearing problems are commonly associated with the aging process, hearing loss affects all age groups. More than half of hearing impaired persons in the United States are under age 65, including 6 million people between the ages of 18 and 44—and more than 14 million are school-age children. Here are some things to be aware of concerning hearing.

Better Hearing & Speech MonthSound voids. Do you hear “ool” but not sure if someone said “pool,” “tool” or “cool”? Do you find yourself saying “I hear OK, but I have trouble understanding,” or “Soft sounds are too soft but loud sounds are too loud.” Hearing clearly when there’s background noise can be especially difficult for someone with hearing loss and trying to explain your hearing situation can often be difficult.

It’s common for people to be unaware of their hearing loss due to the gradual nature of its progression. As hearing slowly declines, an individual develops compensation strategies without even realizing it. Often it’s others, who are trying to communicate with the hearing-impaired individual, who are more aware of the situation. Hearing problems often go unrecognized, sometimes taking years before sufferers seek professional help.

Causes. There are many causes of hearing loss. Sometimes it’s readily apparent, such as wax build-up in the external ear canal, a condition that’s easily treated but unfortunately goes unrecognized in many individuals. Other causes can include hereditary factors, trauma, ear disease and certain medications. The cause of hearing loss is sometimes presumed. For instance, noise-induced hearing loss attributed to the use of stereo systems or portable music players is a growing phenomenon. Avoiding loud noise may help prevent premature hearing loss and the perception of sound voids.

There are easy ways to tell if a particular sound is potentially harmful. Do you have difficulty talking or hearing others talk over the sound? Does the sound make your ears “ring” (tinnitus), “hurt” or seem “muffled” after exposure? If you answered “yes” to any of these questions, the noise may be damaging your hearing. Most people don’t realize how loud everyday sounds actually are. Nearly 30 million Americans are exposed to dangerous noise levels each day, and 10 million Americans suffer from irreversible hearing damage due to noise.

The diagnostic hearing tests. The purpose of a complete evaluation is to determine the true nature of any hearing loss. The diagnostic process may include a variety of tests, depending on the assessment of your needs: audiometric tests to measure hearing at different pitches; speech evaluation to measure how well you hear and recognize ordinary conversation at different volumes; immittance tests of the middle ear; and complete medical evaluations.

Tinnitus is a medical condition characterized by persistent ringing in one or both ears, which can only be heard by the affected individual. These sounds can come and go; however, most suffers experience symptoms 24 hours a day, 7 days a week. The American Tinnitus Association estimates more than 50 million Americans suffer from tinnitus. It’s also the number one complaint from United States veterans. In some cases, tinnitus retraining therapy (TRT) and tinnitus retraining instruments (TRI) may provide individual solutions.

The balance system, due to its close proximity to the hearing mechanism, is also part of a comprehensive hearing evaluation. Fear of falling is a major health concern of individuals in their latter years. Nearly 300,000 hip fractures result from balance-related falls every year. The natural aging process may affect any one or all of the senses, as well as the central nervous system’s ability to interpret and react quickly to them. It’s very common to hear from someone who has fallen that they saw the curb or step, but just were not able to react fast enough or to keep their balance. With proper diagnosis and therapeutic exercise called balance retraining, many older adults are able to return to a more active lifestyle.

The Communication Needs Assessment in addition to the diagnostic hearing evaluation and after medical evaluation, if an individual still suffers from difficulty communicating; a complete communication needs evaluation is now the gold standard of hearing care. The fist step is identifying the individual’s need: What are the listening situations where the individual would like to hear well? The second step is identifying the individual’s lifestyle. For example, not just if they have trouble hearing in restaurants, but how often they do, or would they like to, go to restaurants.

May is Better Hearing & Speech MonthTechnology alone doesn’t help people hear better. Instead, it’s how well the practitioner works with the individual and applies the technology. If an individual doesn’t see well through a pair of glasses, it’s not due to the “glass,” per se. It has to do with either the measurement of the individual’s vision, the prescription or fit, or some combination. Hearing Aids are similar in application. What helps someone hear better is the correct amount of sound at the appropriate pitches for that individual’s hearing loss, environment and communication needs. Individuals with similar hearing loss may require completely different amplification strategies based on all of the factors mentioned here.

The all-important aftercare completes a comprehensive communication needs assessment for an exceptional sound experience. This includes assessment of need for assistive listening devices for telephone, Bluetooth, TV, loops or music systems. In addition to assistive solutions, aftercare will include lip reading and listening skills counseling.

It’s important that a hearing-impaired individual take an active role in listening and participate in the recommended auditory retraining and rehabilitation program to ensure he or she hears and understands as much as possible. The auditory system may not have heard certain voices and sounds for many years, and the reintroduction of new sounds and voices needs to be presented gradually. In other words, just as the hearing loss may have occurred gradually, the reintroduction of new sound needs to occur gradually. Through this process, each individual will adapt and develop necessary listening skills.

A hearing screening can quickly and accurately evaluate an individual’s hearing, determine the degree of hearing loss and put them on the path toward treatment. After treatment, it’s important to monitor the hearing loss to ensure the technology is meeting an individuals needs.

 

Peter J. Marincovich, Ph.D, CCC-A, is clinical director and owner of Audiology Associates, a full-service audiology practice since 1984, with offices in Santa Rosa, Mendocino, Novato and Mill Valley.

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Sound Advice: Noise-Induced Hearing Loss Prevention

April 22nd, 2011

By: Peter J. Marincovich, Ph.D., CCC-A
Audiology Associates
1111 Sonoma Ave., Suite 308
Santa Rosa, CA 95405
(707) 827-1630
www.audiologyassociates-sr.com

Have you noticed that daily life in our society gets louder every year? The change is subtle and is a problem that most of us take for granted and even ignore. According to many leading Audiology professionals, casually ignoring the sounds around us can lead to serious hearing problems, including noise-induced hearing loss (NIHL).

One of those professionals is David Coffin, Audiology clinic coordinator at Indiana’s Ball State University. “We are exposed to all sorts of sounds that can lead to permanent hearing loss,” Coffin says. “The average person will wear a helmet when riding a bike, or a seat belt in a vehicle, but doesn’t even think about ear protection when going to watch a rock band, a fireworks display, or even an auto race.”

According to the Better Hearing Institute, 30 million Americans are exposed to dangerous noise levels each day and 10 million Americans have already suffered irreversible hearing damage from noise.

The problem of noise induced hearing loss has been around for decades. It occurs at home, in the yard, at the office, at the factory, on the farm and in the military. But today, because of technology, virtually everyone is effected and at younger and younger ages. It is not uncommon for audiologists to see 20-year-olds with the hearing of 60-year-olds.

However, there is good news as well: NIHL is easily identifiable and completely preventable. Today, audiologists can assist with the prevention, diagnosis and rehabilitation of hearing loss.

Hazardous Noises

Normal conversations occur at approximately 60 decibels. Raising your voice over a noise in order to be heard by someone an arm’s length away is a good indication that the noise could be within risky range. Knowing which noises can cause damage, such as jet engines, lawn mowers, motorcycles, chainsaws, powerboats, and personal media players is the best arsenal against NIHL.

“Risky noise,” says Coffin, “can come in the form of the pop of fireworks, the snarls of traffic, the buzz of lawn mowers, or the percussive tones of marching bands.”

According to Coffin, such sounds are typically within the range of 90 to 140 decibels, but any noise above 80 can cause long-term hearing damage. The maximum exposure time per day for the exposed ear is 8 hours at 90 decibels. The risk of noise-induced hearing loss depends on both the intensity and duration of the exposure. As intensity increases, the length of time for which the exposure is “safe” decreases. For example, exposure to 85 decibels (often produced by gas-engine lawn mowers) for 8 hours can be as equally damaging as exposure to 110 decibels (often produced by a chain saw) for only a few minutes. For every 5 decibel increase in volume, the maximum exposure time is reduced by 50 percent. Therefore, according to Sight and Sound Associates, the maximum daily exposure time at 95 decibels is four hours; at 120 decibels, seven minutes, 30 seconds.

Warning signs that exposure to hazardous noise has occurred or is occurring include: the inability to hear someone a few feet away, ear pain after leaving a noisy area, ringing or buzzing (tinnitus) in the ears immediately after exposure to noise, or hearing people talking but being unable to understand them.

Loud explosions that peak for a few milliseconds at levels greater than 130 to140 decibels may cause hearing loss. More often, however, hearing loss is caused by repeated exposure to noise above 85 decibels over long periods. Some sources of common noises and associated decibels are: lawn mower, 90 decibels; stereo headphones, 105-110 decibels; automobile horn, 110 dB; baby’s cry, 115 decibels; rock concert, 115-120 decibels; and firearms, 125-140 decibels.

The commercial popularity of portable media players with earphones, such as the iPod and similar devices, and their long-term use by consumers, increase the risk of NIHL in those users. According to the National Center for Health Statistics, almost 15% of Americans below the age of 19 suffer from some measure of hearing loss. And according to Sight and Hearing Association, the incidents of teenage hearing loss has increased 400 percent over a ten-year period, as found in a recent study of eighth graders.

Symptoms of NIHL

NIHL usually develops gradually. People may lose a significant amount of hearing before becoming aware of its presence. The first sign of NIHL is not being able to hear high-pitched sounds, such as the singing of birds, or not understanding speech when in a crowd or an area with a lot of background noise. If damage continues, hearing declines further, and lower pitched sounds become hard to understand.

Signs of hearing loss from unsafe sound exposure include the inability to comprehend somebody talking from two feet away, hearing muffled speech, experiencing pain or ringing in the ears following exposure, and needing others to speak louder in conversation.

People often fail to notice the impacts of unsafe exposure to noise because it causes few symptoms. Hearing loss is rarely painful. Symptoms may go away minutes, hours or days after the exposure to noise ends. Many people naturally assume that if the symptoms abate, their ears have recovered to normal. However, even in the absence of more symptoms, some cells in the inner ear may have been destroyed by the noise. Hearing returns to normal only if enough healthy cells are left in the inner ear. But if the noise exposure is repeated and more cells are destroyed a lasting hearing loss will develop.

Sensorineural Hearing Loss

When the hearing system is exposed to noise at a risky or hazardous level, mechanical and metabolic changes can occur. Scientific research, based on studies of industrial workers, as well as lab studies of humans and animals, have investigated the effects of noise on hearing.

In these studies, excessive noise stimulated cells in the inner ear, resulting in chemical processes that can exceed the cells’ tolerance. This damages cell function and structure and results in sensorineural hearing loss (as opposed to a conductive hearing loss, where the outer or middle ear have been affected) and tinnitus (ringing of the ears).

The sensory cells in the cochlea may recover from their damage (as you have possibly experienced after a loud concert or work with a loud machine). Usually, recovery from temporary threshold shift (or TTS) occurs quickly, largely disappearing in 16 to 48 hours after exposure to loud noise. However, if the hearing sensitivity does not recover within a few days, an irreversible and permanent threshold shift has taken place.

Prevention

Hearing loss is not reversible, but NIHL is preventable. Individuals vary in their susceptibility to hearing loss and hearing typically declines with age, but a healthy person who is not exposed to hazardous noises can enjoy normal hearing into his senior years.

Noise is probably the most common occupational hazard facing workers today. Employers at noise-hazardous workplaces, and physicians, are in a position to advise those at risk for developing NIHL that there are three simple keys to prevention:

1)      Understand what noises put them at risk – those above 85 decibels, commonly portable media players, lawn mowers, motorcycles, chain saws, jet engines, etc. A general rule of measurement is that if one has to shout to be heard an arm’s length away, assume the noise is above a hazardous threshold.

2)      If possible, decrease noise at the source – for example, keep the volume low on portable media players, purchase motorized equipment with an effective muffler, etc.

3)      Buffer loud noises with earplugs or other forms of hearing protection. These are known as hearing protective devices (HPDs) and are required by law to be labeled with a Noise Reduction Rating (NRR) based on performance obtained under ideal laboratory conditions. HPDs are powerful tools for preventing NIHL if worn correctly and throughout the duration of the hazardous noise. Also sound absorbing materials, such as floor mats, can help reduce noise.

Early identification is important in order to recognize the presence of NIHL and take steps to prevent further hearing loss. Those regularly exposed to hazardous noise in the workplace or elsewhere should have an annual hearing test. If hearing loss is developing, it might indicate under-protection and could suggest preventative measures, such as better HPDs or turning down the volume on the iPod

Dr. Peter J. Marincovich, Ph.D., CCC-A

Clinical Audiologist

Dr. Peter Marincovich earned his graduate degree in communicative disorders from Louisiana State University, and his Ph.D., in Audiology from the University of Memphis. A Santa Rosa native, Dr. Marincovich has practiced in his hometown since 1984. Dr. Marincovich works with patients of all ages and levels of hearing loss. He is also a frequent presenter at seminars and academic conferences. He holds specialized credentials in teaching the handicapped, and conducts courses at Santa Rosa Junior College. Dr. Marincovich is owner of Audiology Associates with offices in Marin, Santa Rosa and Mendocino.

References

ANSI (1996). American National Standard: Determination of occupational noise exposure and estimation of noise-induced hearing impairment. New York: American National Standards Institute, Inc., ANSI S3.44-1996.

National Institutes of Health (1990). Noise and Hearing Loss. NIH Consensus Development Conference Consensus Statement 1990, Jan 22-24; 8 (1).

National Institute for Occupational Safety and Health (1998). Revised Criteria for a recommended standard – Occupational noise exposure, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 98-126.

National Institute on Deafness and Other Communication Disorders (1999). Noise-Induced Hearing Loss. NIH Pub. No. 97-4233.

Occupational Safety and Health Administration (1983). Occupational Noise Exposure Standard. 29 CFR Chapter XVII, Part 1910.95.

Yattaw, M. (1999, July 21). Audiology doctorate among nation’s first. Ball State University News. Retrieved October 19, 2010, from http://www.bsu.edu/news/article/0,1370,-1019-1169,00.html

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