Love Your Heart, Test Your Hearing for World Heart Day, the Better Hearing Institute Urges

Washington, DC, September 16, 2014—Your heart and hearing may have more in common than you realize says the Better Hearing Institute (BHI), ( www.BetterHearing.org) which is raising awareness of the link between hearing loss and cardiovascular disease for World Heart Day, September 29. A growing body of research shows that a person’s hearing health and cardiovascular health frequently correspond. So BHI is encouraging people to take a free, confidential, online hearing check at www.BetterHearing.org to help determine if they need a comprehensive hearing test by a hearing healthcare professional.

Studies show that a healthy cardiovascular system—a person’s heart, arteries, and veins—has a positive effect on hearing. Conversely, inadequate blood flow and trauma to the blood vessels of the inner ear can contribute to hearing loss.

David R. Friedland, MD, PhD, Professor and Vice-Chair of Otolaryngology and Communication Sciences at the Medical College of Wisconsin in Milwaukee, has been studying the relationship between cardiovascular and hearing health for years.

He says, “The inner ear is so sensitive to blood flow that it is possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body.”

Dr. Friedland and fellow researchers found that audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease and may represent a screening test for those at risk. In their study, they concluded that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered. ( http://ow.ly/Bp7f8)

Five Heart-Healthy Reasons to Get a Hearing Test

1.     Six decades of research points to heart-hearing health link. A comparative review of more than 60 years of research found a correlation between cardiovascular and hearing health. Specifically, the study authors concluded that the negative influence of impaired cardiovascular health on both the peripheral and central auditory system—and the potential positive influence of improved cardiovascular health on these same systems—have been found through a sizable body of research. ( http://ow.ly/BqqPy)

2.     The ear may be a window to the heart. Some experts find the evidence showing a link between cardiovascular and hearing health so compelling that they say the ear may be a window to the heart. They encourage collaboration between hearing care providers, cardiologists, and other healthcare professionals. Some even call on hearing care professionals to include cardiovascular health in patient case history and to measure their patients’ blood pressure. ( http://ow.ly/Bp7oV; http://ow.ly/BqYsK; http://ow.ly/BqZdt)

3.     The same lifestyle behaviors that affect the heart impact hearing. More evidence of the interconnectedness between cardiovascular and hearing health is found in three studies on modifiable behaviors: One found that a higher level of physical activity is associated with lower risk of hearing loss in women. Another revealed that smokers and passive smokers are more likely to suffer hearing loss. And a third found that regular fish consumption and higher intake of long-chain omega-3 polyunsaturated fatty acids are associated with lower risk of hearing loss in women. Coincidence? Or does it all come back to blood flow to the inner ear? Research is ongoing. ( http://ow.ly/BqrlJ; http://ow.ly/Bqsz0; http://ow.ly/BqtO3)

4.     Addressing hearing loss improves quality of life, helps reduce stress.  Eight out of 10 hearing aid users say they’re satisfied with the changes that have occurred in their lives due to their hearing aids. Many say they see improvements in their life overall, in interpersonal relationships, and that they experience reduced anger and frustration, and enhanced emotional stability. (http://ow.ly/AZ2D7)

5.     Today’s hearing aids are better than ever and virtually invisible. State-of-the-art, sleek, sophisticated, and virtually invisible, today’s hearing aids combine high-performance technology and style with durability and ease-of-use. They’re a high-tech tool to help people stay socially, physically, and cognitively active. The options are so varied there’s an attractive solution for just about anyone. 

For more information on hearing loss and to take the BHI Hearing Check, visit www.BetterHearing.org. Follow BHI on Twitter@better_hearing, and on Facebook at http://www.facebook.com/betterhearinginstitute.

Celebrate the Sounds of Summer for a Lifetime: Protect Your Hearing, the Better Hearing Institute Urges

Washington, DC, June 30, 2014—As summertime kicks into full swing, the Better Hearing Institute(BHI) is urging children, teens, and adults of all ages to protect their hearing, reminding them that permanent noise-induced hearing loss cannot be reversed.

The sounds of summer are among the most cherished and offer wonderful lifetime memories. But summertime also brings loud noises that can permanently harm our hearing. Prolonged exposure to the roar of lawn mowers, power tools, motorized recreational vehicles, target shooting, concerts, loud sporting events, and fireworks all can wreak havoc on our hearing. In fact, the single bang of a firecracker at close range can permanently damage hearing in an instant, making it forever more difficult to hear the subtler sounds of summer.

While many noisy recreational activities are part of summer fun, it is extremely important to take precautions to ensure that these activities do not damage our hearing.

“Hearing is the sense that connects us to each other,” says William Hal Martin, Ph.D., Professor of Otolaryngology, National University of Singapore, Program Director MSc of Audiology, Center for Hearing, Speech & Balance, and Co-Director of Dangerous Decibels . “Exposure to loud sounds cannot only destroy our ability to hear, it can cause tinnitus—ringing in the ears.”

“People of all ages are at risk to hearing loss from loud sounds, but it easily can be prevented by simple steps,” Martin continues. “It is important to recognize when your ears are in danger and to safeguard them so you can enjoy listening to friends, music, and sounds you love for the rest of your life.”

Nearly 40 million people in the United States today have hearing loss. Hearing loss affects Gen Xers, baby boomers, and people of all ages. In fact, results from a 2008 study suggested that the prevalence of hearing loss among younger adults, specifically those in their 20s and 30s, is increasing ( http://ow.ly/yyMI0 ). Other research indicates that hearing loss from noise affects nearly 17 percent of 12-to-19 year olds in the United States, and if they continue to be exposed to hazardous sounds, they will have significant hearing problems much earlier in life than one would normally expect. 

( http://ow.ly/yydHP ) ( http://ow.ly/yyewp ) ( http://ow.ly/yyLHV ) (http://www.dangerousdecibels.org/ )

BHI offers some simple tips to follow:

• Walk Away and Plug Your Ears: If a loud noise takes you by surprise, quickly plug your ears with your fingers and walk away. Increasing the distance between you and the source of the sound will help reduce the intensity (or decibels) at which the sound is reaching your ears.
• Use earplugs: When you know you will be exposed to loud sounds, use earplugs. Disposable earplugs, made of foam or silicone, are typically available at local pharmacies. They are practical because you still can hear music and the conversation of those around you when you have them in your ears. But when they fit snuggly, they are effective in adequately blocking out dangerously loud sounds. Custom ear protection crafted to fit each unique ear also is available from your local hearing healthcare professional. Custom protection ensures a proper fitting mold each time, further reducing the risk of unwanted noise exposure.
• Leave the fireworks to the professionals: Make sure your family and friends fully enjoy the summer and 4th of July festivities by celebrating smart. Leave the fireworks to the professionals. When watching the show, stay a safe distance away—where you can enjoy the colors and lights, but not expose yourself and your family to loud noises. To protect your hearing, make sure you are wearing earplugs and that they are securely in place before the show begins. And be sure to keep them in for the entire show.
• Turn it down: When listening to smartphones and MP3 players, keep them at a low volume. Importantly, limit your use of headphones and ear buds. Remember, it’s not just the volume that matters; it’s also the duration of time spent listening.
• Limit your time in noisy environments: Do all you can to limit the length of time you spend in a noisy environment. And when you do participate in noisy activities, alternate them with periods of quiet. Plus, remember to use ear protection.
• Take measures to protect against swimmer's ear: Be sure to dry your ears completely after swimming. And do your best to drain any residual water from your ear canal by tilting your head to the side. Also, monitor the bacterial count when swimming at the beach. Many beaches post signs. Stay out of the water on the days that the bacterial counts are high.
• Visit your local hearing healthcare professional: A hearing healthcare professional can provide a hearing test to determine your baseline hearing level and determine if you have any hearing loss that should be addressed. Hearing healthcare professionals also can provide custom-fitted ear protection to help you preserve your hearing.

How Noise Affects Our Hearing

We hear sound when delicate hair cells in our inner ear vibrate, creating nerve signals that the brain understands as sound. But just as we can overload an electrical circuit, we also can overload these vibrating hair cells. Loud noise damages these delicate hair cells, resulting in sensorineural hearing loss and often tinnitus (ringing in the ears). The cells that are the first to be damaged or die are those that vibrate most quickly—those that allow us to hear higher-frequency sounds clearly, like the sounds of birds singing and children speaking.

Sound volume is measured in decibels, with the softest sound a normal hearing human can hear measuring at 0 dBA. Any sounds above 85 dBA for 8 or more hours are considered unsafe. Most firecrackers produce sounds starting at 125 dB peak SPL, presenting the risk of irreversible ear damage. Repeated exposure to loud noise, over an extended period of time, presents serious risks to hearing health as well. If you have to shout over the noise to be heard by someone within arm's length, the noise is probably in the dangerous range. Here are other warning signs:

• You have pain in your ears after leaving a noisy area.
• You hear ringing or buzzing (tinnitus) in your ears immediately after exposure to noise.
• You suddenly have difficulty understanding speech after exposure to noise; you can hear people talking but can't understand them.

For more information on hearing loss and to take the free, quick, and confidential online BHI Hearing Check, go to www.BetterHearing.org.

Are You a Little Dizzy in the Head?

Do you get dizzy or lightheaded when you turn your head, or roll over in bed? You may have Benign Paroxysmal Positional Vertigo, or BPPV. BPPV often occurs if you have bumped your head pretty hard. Inside our inner ear, we have two distinct sections, our cochlea, for hearing, and our semicircular canals, for balance. We have three semicircular canals, each one positioned to represent the three planes of space. These canals are fluid-filled, and at the base of these canals are little "crystals". When you bump your head, these crystals can become dislodged and then float around in their respective canal. A quick movement of your head moves these dislodged crystals causing you to feel dizzy. There are ways to treat this condition,

the easiest is to be aware of your condition, and avoid moving your head quickly. When you are getting out of bed, move slowly. This helps a lot of people avoid the situation completely. However if your condition is more severe, you should see an Ear Nose and Throat doctor. He or she can diagnose your condition, and if it is truly BPPV, there is a "maneuver" that they can perform to help you get those crystals back where they belong. This maneuver is either called an "Epley" maneuver or a "repositioning" maneuver. It only takes a few minutes in the ENT's office, and provides a great deal of relief for many with this condition. Dizziness should never be treated lightly. It could result in a fall which could lead to injury. Consult an ENT if you have any issues with dizziness, especially if it is also associated with any noises in your ears/head, and or a feeling of fullness or pressure in the ears. Be proactive; be safe.

TWO EARS ARE BETTER THAN ONE! EXCEPT WHEN ONE IS REALLY BAD......

According to Sergei Kochkin, Ph.D. of the Better Hearing Institute, there is an advantage to wearing two hearing aids. If you have hearing loss in both ears, then you are most likely a candidate for two hearing aids. While a hearing healthcare professional can best determine if you are a candidate for two hearing aids (a binaural fitting), the ultimate decision-maker concerning binaural instruments is the person who will wear them.

But what do you do if there is a significant difference between your ears. A good ear and a bad ear; a good ear and a "dead" ear; a "not perfect ear" and a bad ear. There is a solution for these situations. Instead of putting a hearing aid in that "bad" ear, wear a CROS system. A CROS system is a combination of a regular hearing aid for the better ear and a "transmitter" on the bad ear. The transmitter looks just like a regular hearing aid, but its job is to send the sound waves that it receives on the bad ear, around the head and into the hearing aid on the better ear. Typically the devices look the same on each ear, but they can be different if need be.



The benefit of the CROS system, is that your bad ear will "hear" as well as your better ear. For example, a person sitting on your "bad side" will sound just as good as the person sitting on your "good side". We are not really using the bad ear to process the sound, we are using it to gather sound from that side and send it to the other ear.

Now if you've tried CROS aids in the past, and had a negative experience, you should try them again. Talk about "new and improved!" In the past, they were huge behind-the-ear devices and originally were connected with a wire. But today's CROS systems are much smaller and communicate wirelessly.

Another good use for a CROS system is if you have one ear that is "clear" sounding, and the other ear is extremely "unclear", a CROS system can also help. Sometimes patients who have hearing loss due to Meniere's Disease will find themselves in this situation. It's not so much that there's a big difference in hearing, but there is a huge difference in the "clarity" of the ears. Louder, does not make the bad ear "clearer".

Another benefit of CROS systems is that they don't cost as much as two hearing devices because the transmitter is not an actual hearing aid. That makes the "CROS" device significantly less expensive. The hearing aid for the better ear can be any technology level; whatever that ear needs. So is there a disadvantage to CROS systems? There are a couple. CROS systems, because they are now wireless, tend to run the battery down faster. You can expect almost half the life that you would get with a regular hearing device. And the smaller the device, the smaller the battery.......the smaller the battery, the shorter the battery life. I prefer to only fit CROS devices with a size 13 battery, but if the patient wants discretion, there are CROS systems out there using the smaller 312 battery.

The other disadvantage of CROS systems is that by using a CROS device in the bad ear, you do not stimulate the hearing hair cells, as you were doing by wearing a regular hearing aid before. Sometimes, this needs to be considered, especially if the hearing loss has progressed quickly, and a cochlear implant may be in a patient's future. However, if the ear has been "unaided" for quite a while, or is a "dead" ear, then stimulating those hearing hair cells is no longer an issue, and the CROS system could make a difference.

COCHLEAR IMPLANTS: WILL I HEAR BETTER THAN WITH MY HEARING AIDS?

 

Patients often ask me if they will ever end up in a cochlear implant.  Generally, most people with hearing loss do not reach that point.  Your hearing has to reach the bottom of the audiogram (hearing test graph) before a cochlear implant will help you hear better than with your hearing aids.  Sometimes a patient may qualify for an implant even though their "graph" portion of the audiogram is not in the profound range.  That may occur if your ability to "understand" speech becomes very poor, even when wearing your hearing aids.  The portion of the cochlear implant that is visible to others is the "speech processor", which looks like a large behind-the-ear hearing aid.  The speech processor has a wire coming out of the bottom of it which leads to a round disk which attaches magnetically to the patient's skin, above their ear.  The rest of the device is the "implanted" part and is not visible to others.  Speech processors have all decreased in size, and have greatly improved over the years.  A more in-depth discussion of cochlear implants follows:

 

What is a Cochlear Implant?

 

A cochlear implant (CI) is a surgically implanted electronic device that can help provide a sense of sound to a severely hard of hearing or deaf person.  Cochlear implants may help provide hearing in patients who are deaf due to damage to the sensory hair cells in the cochlea.  An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of environmental sounds and assist them in understanding speech.  The surgery is performed by a Neurotologist (ear specialist), and the pre-operative testing, and post-operative programming of the device are performed by an audiologist.  There is typically a four to six week delay between surgery and device hook-up to allow the surgical incision to heal.

A cochlear implant consists of two main parts:

• An external portion that sits behind the patient's ear and consists of:
• A microphone which picks up sounds from the environment.
• A speech processor which selects, filters, and arranges sounds from the environment to be sent to electrodes in the cochlea.
• A transmitter which transmits power and the processed signal across the skin to the internal portion of the device.

• An internal portion that is surgically implanted under the skin and in the cochlea:
• A receiver/stimulator which receives the signal from the transmitter and converts it into electrical impulses.
• An electrode array which collects the electrical impulses and sends them to different regions of the auditory nerve. 

 

How does a Cochlear Implant work?

 

Cochlear implants are very different from hearing aids.  Hearing aids amplify sound and sends the signal from the outer ear through the middle ear into the cochlea.  The cochlea contains hair cells which have frequency (or "pitch") representation from high pitch to low pitch (think about a piano keyboard).  A cochlear implant bypasses the damaged hearing hair cells and directly simulates the auditory nerve in a frequency appropriate manner.  These electrical impulses on the auditory nerve are then sent directly to the brain for processing.  It takes time for patients to learn or re-learn how to process sound.  Some individuals may only learn to use the sounds for environmental awareness and safety, while others are able to use these sounds to have full conversations in person or on the phone.

What is the candidacy criteria for a Cochlear Implant?

The candidacy criteria for children and adults differ:  Current cochlear implant candidacy criteria for adults:  (Boys Town Research Hospital Website)

• Bilateral (both ears) moderate to profound sensorineural hearing loss (thresholds of 40 dB HL or greater)
• Limited benefit with appropriately fit hearing aids, defined as pre-operative test scores of:  ≤50% understanding of sentences in the ear that is to be implanted or ≤60% understanding of sentences when tested bilaterally (best aided condition)
• No physical contraindications for placement of the implant (i.e., CT scan results)
• Medically cleared to undergo surgery
• Realistic expectations
• Commitment to follow-up appointments

What are some Contraindications to receiving a Cochlear Implant?

• Deafness due to lesions of the acoustic nerve or central auditory pathway
• Active middle ear infection
• Absence of cochlear development
• Tympanic membrane (ear drum) perforations in the presence of active middle ear disease
• Medically unstable to undergo surgery
• Unrealistic expectations
• Not committed to follow-up appointments

Information from the NIH: National Institute of Deafness and Other Communication Disorders (NIDCD)

The Zombies May Be On To Something! Need Brains!

Healthy ones, that is.  Never before has there been more interest in "brain training".  My mother-in-law turned me on to "Lumosity" a year ago.  I have to admit, I was skeptical.  But I was also intrigued....could I preserve my brain function?  Could I stave off dementia?  We all know that we need to exercise our bodies for better health, but exercise our brain?

And what's the difference between Alzheimer's Disease and Dementia?  Both terms seem to be used interchangeably.  Dementia is defined by the Alzheimer's Organization as a term used to describe a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities.  According to Alzheimer's Disease International, Alzheimer's disease is a FORM of dementia that destroys brain cells and nerves disrupting the transmitters, which carry messages in the brain.

Recent studies are suggesting a connection between hearing loss and dementia.  The relationship is being studied by Johns Hopkins University as well as other institutions.  Research which was published in the Archives of Neurology, found that seniors with hearing loss are significantly more likely to develop dementia over time than those who retain their hearing.  The study also found that the greater the hearing loss, the higher their likelihood of developing dementia.

At my national Audiology convention in April I attended multiple classes which presented research on the association of untreated hearing loss and dementia.  Although they are still studying the relationship, the underlying connection seems to be ISOLATION.  According to a Johns Hopkins study on hearing loss and cognitive function, isolation is a known risk factor for dementia.  When people have hearing loss, they become uncomfortable in social situations because they often can't hear and/or understand what people are saying.  Their hearing difficulties cause them to respond incorrectly or miss the punch-line of a joke.  Social situations often involve large groups of people and poor acoustics which makes hearing more difficult than usual.  Sadly their solution is to withdraw from situations where they have trouble hearing.  No more parties, dinner with friends, bridge club or church.

The same Johns Hopkins study, stated that the reason for the link between the two conditions is unknown, but investigators suggest that a common pathology may underlie both or that the strain of decoding sounds over the years may overwhelm the brains of people with hearing loss, leaving them more vulnerable to dementia.

In fact, the symptoms of untreated hearing loss and Alzheimer's Disease are extremely similar.  As we learn more about how the brain works, we may be able to prevent all forms of dementia, but for now we need to do whatever it takes to reduce the isolation which seems to be a factor.  So get your hearing tested!  Wear your hearing aids faithfully!  And stay with the group!  Preserve your brain and who knows, maybe a zombie may be interested in it.  You too could be zombie bait..... 

"WHY ISN'T MY BATTERY LASTING AS LONG AS IT USED TO?" OR "WHERE HAS ALL THE MERCURY GONE?"

 "WHY ISN'T MY BATTERY LASTING AS LONG AS IT USED TO?"

OR "WHERE HAS ALL THE MERCURY GONE?"

History of Mercury in Hearing Aid Batteries:

In the late 1970s, zinc air batteries were introduced and quickly replaced their predecessor, the mercuric oxide battery.  Zinc air batteries contained significantly less mercury, were superior in performance and were immediately more reliable.

Although, the development of zinc air batteries was an improvement they still contained added mercury.  In zinc air batteries, the mercury is fused with the zinc powder which prevents the battery cell from leakage or swelling, while activating the battery quickly.

Mercury is extremely harmful to the environment.  It can seep into the ground, via landfills, contaminating drinking water and food.  Exposure to mercury can result in contamination, deformities in offspring, permanent damage to the brain, and even death.  In 1996, legislation banned mercury from household alkaline batteries, but zinc air batteries were exempt until manufacturers could come up with an alternative.   

In June 2011, a number of states banned the selling or distribution of mercury containing batteries, including zinc air batteries.  Manufacturers have now removed mercury from hearing aid batteries to comply with the law.

Zinc Air Mercury-Free Batteries:

Without the added mercury, today's zinc air batteries need a longer time to fully activate, once the tab is removed.  They use oxygen as a source of power.  The battery ingredients begin to activate only when the tab is removed and air begins to enter the pinholes on the positive side of the battery.  As a result, it is recommended that you wait at least 2 minutes before using the battery, following the removal of the tab.  By waiting 2 minutes, the battery gets a big gulp of air which allows it to get a full charge, and can result in an extra day's worth of life.

Hearing aid batteries should be stored at room temperature, as heat can shorten their life.  There is no need to refrigerate them.  When carrying extra batteries be sure to place them in a "battery caddy" or case.  Batteries that are loose in a pocket or purse, near metal objects (such as coins) may short out when used.  

HEAT, HUMIDITY, AND HEARING AIDS

Protect your hearing aids from heat.  Never leave your hearing aids in a hot car or in direct sunlight.

Protect your hearing aids from moisture caused by high humidity.  Crackling or static sounds in your aid are symptoms of moisture.  This may be due to the aid getting wet, or even just from humidity in the air.  High humidity can cause moisture to collect in the hearing aid and/or ear mold tubing.  Even small amounts of moisture can have an effect on the sound quality of your hearing aid.  This moisture can cause corrosion to build up on the battery, the battery contacts, and  internal components.  To remove moisture from your aid, use dehumidifiers such as a Dri-Jar or a Dry and Store kit daily.  Both of these types of dehumidifiers are available at Hear Here.  Dri-Jars cost $12, and meet most moisture needs.  If your moisture problem is more severe, an electronic Dry and Store kit may be more appropriate.  Dry and Store kits cost $75, but can last a lifetime with proper care.