Everybody has trouble hearing at one time or another.  Whether you have “normal” hearing or some degree of hearing loss, spoken language isn’t always clear.  When we’re listening to someone and we can’t quite make out what they’re saying, the auditory and language systems of our brains must make an educated guess or admit defeat.  This process happens continually and constantly every waking minute of every day.  Sometimes the speech sounds are clear and we can easily interpret the speaker’s message but other times our brain needs to put a lot of extra effort into filling in the missing information.  The human brain is exceptionally good at filling in the blanks.  In fact, researchers have found that you can insert rather large chunks of random noise into spoken words and not lose the message.  In many cases test subjects are completely unaware of the manipulation.  That’s how good we are at coping.

But, this “filling in” comes with one major problem:  We can’t tell when it’s happening and we are often utterly convinced that we are 100% correct (like the favorite song lyrics) even though we may be very wrong.  In addition, this constant extra processing by the auditory system takes effort and resources.  Hearing loss causes us to miss certain key speech sounds more often, which then puts a greater demand on the brain to “fill in”.  As an Audiologist, I’m always amazed at how clients often struggle for years with a hearing loss before seeking help.  Part of that reluctance to act comes from the amazing “filling in” ability of the brain.  They can’t hear what they’re missing because their auditory system is working overtime to create something out of next to nothing.  They believe the lie created by their own perception and are convinced that they are doing o.k.  On the positive side, I’m equally amazed at how clients with very dramatic hearing losses can cope so well after being fit with hearing instruments.  Just a few extra consonants here and there can make such a difference.  It’s amazing how resilient we can be when we look after ourselves and give our ears the sounds they are craving.  Our brain’s natural listening abilities (skills that we’ve practiced our entire life) can continue to do the job, with a little help.

So how do we get our yearly dose of music without eventually losing the ability to enjoy it?  Use hearing protection.  I know that it’s unpopular and inconvenient and maybe even un-cool, but it’s the only way that really works.  You can stay all day, be as close to the stage as you like and still be able to hear the grass grow the next day.  If you’ve made the mistake of overdoing it, give your ears lots of rest afterward to minimize the damage, at least 48hrs with no loud noise exposure.  If you’re bringing your children to the event be sure to protect their hearing as well and in the process, develop a lifelong habit that they’ll thank you for when they hit middle-age.

For true music lovers though, the muffled or plugged sound of standard foam earplugs may rob them of any enjoyment so I suggest “musician’s earplugs.”  They’re just as effective, are reusable, are reasonably cheap (<$50/pair) and can be found at most music supply shops.  They have a special filter that doesn’t muffle the high frequencies which in turn preserves the clarity of the instruments and vocals while still protecting your hearing.  Professional and amateur musicians will often have me make custom fit plugs for better comfort but the sound quality is the same.  I wear them to every concert and forget that they’re in, they sound that good.  Don’t sacrifice a lifetime of good hearing for one ear splitting concert but instead enjoy every concert for the rest of your life.

As an Audiologist, I can’t tell you how many clients come into my office and say the following:

“I had a hearing test once and it showed my hearing was down but the doctor told me that it was normal for my age.”

One recent client expressed how insulted she was that the doctor assumed, because she was a senior, good hearing wasn’t important to her (she was 89 by the way!).  I would have to strongly agree with her feelings and my blood boils every time I hear another account of how a health professional, however well-meaning, mis-informs their patient.

If their patient had a broken leg would they say, “That’s normal after a fall like you’ve had.” Or if they had cataracts would they say, “Oh your vision is going but that’s normal for your age.”  Certainly not!  They would recommend the appropriate course of action to restore the patient to as close to full health as possible.  While hearing loss amongst seniors is indeed common, it is also common for non-seniors as well but you don’t hear them being told “Hearing loss is normal for a 22 year old like you.”

So many people live with hearing loss and taking action is a big step which takes no small amount of courage and humility.  They’re looking for reassurance from their doctor that they are not ‘going crazy’ and indeed need some help and good advice.  That there’s some hope for improvement if they go see an Audiologist.  When they’re told “It’s normal for your age.” the real message is, “You should just live with it, it’s who you are now, a person who doesn’t need to hear because you’re old.”

Un-addressed hearing loss causes communication problems that are anything but ‘normal’ and the negative impact on a person’s general health and medical status is very real and well documented.

But the tide is changing.  Slowly, physicians are taking a more proactive approach to hearing care and recommending that patients get tested even before problems arise.   Today’s seniors are re-defining what it is to be a senior.  They’re active, involved, and engaged in shaping the economy, society and the entire world.  What will be considered ‘normal’ in 8 years when two thirds of North America is over the age of 60!

So if someone tells you hearing loss is ‘normal for your age’ politely, but firmly let them know that your hearing is important to you at any age.  Everyone is entitled to enjoy easy, natural communication with their loved-ones and friends.  To deny someone the opportunity to stay connected is in effect saying they don’t matter.  And you matter!

Here are just a few amazing ear facts:

- The ear senses pressure changes as small as 1 billionth of 1 atmosphere

- The ear accurately senses between 20 and 20,000 vibrations per second

- The ear detects loudness changes from 0 decibels to 130 decibels

- Hearing is active well before birth and stays active while we’re asleep or unconscious

- Unlike a microphone, the ear actively tunes sound and has cells which contract and expand in rhythm to sound

Unfortunately, there are a few more facts that aren’t so amazing:

- The cochlea does not heal so damage done when you’re 18 can affect you when you’re 80

- The cochlea does not feel pain when it’s being damaged by loud noise

- The cochlea can be damaged by immune reactions, disease, drugs, blasts, chemicals, toxins, loud sounds, physical impact and aging

- The cochlea requires a richer supply of oxygen and nutrients than other tissues and so it is particularly sensitive to changes in cardiovascular health

- Cochlear damage cannot be fixed by transplant or surgery (although in the case of severe deafness, cochlear implants can help)

- Hearing loss not only affects your ability to hear soft sounds it can make loud sounds too loud, disrupts your ability to hear in noise, throws off your enjoyment of music, reduces your distance hearing and disconnects you from people and from your general environment.

It’s amazing how one little cochlea, barely the size of a pea, can do so much but can also be so vulnerable.  That’s why protecting your hearing, even if you already have hearing loss, is so important.  Avoid loud noise or wear hearing protection if you can’t avoid it.  Get your hearing checked regularly, especially if you experience a change.  If you have hearing loss, make sure you’ve seen an ear-nose-and-throat specialist at least once.  Let your doctor know if any medications seem to affect your hearing.  If you wear hearing instruments, using them as much as possible will help your brain stay in tip top shape and minimize or eliminate the isolation that hearing loss can cause.  Give your hard working cochleas all the help
they deserve!

So what happens if we can’t hear?  Well, one peculiar trait of the human brain is that it doesn’t like unused real estate.  When parts of your brain are no longer used because they’re not being stimulated those parts get re-assigned to do other things.  So as the expression goes, if you don’t use it, you lose it.  When you don’t use the hearing parts of the brain, the brain begins to start losing its ability to hear.  The longer you wait to do something about a hearing loss, the harder it will be to regain your former abilities.  When a hearing instrument is
employed after a long period of untreated hearing loss a physical change in the brain starts to reclaim those areas important for hearing but it can be a slow and frustrating process.

The good news is that you can make that change back to a healthy, happy, hearing brain if you are persistent and regular in your hearing instrument use.  Using your hearing instrument only occasionally does nothing.  In fact, it just sets up a negative cycle of failure:  the hearing instrument sounds different, your brain is out of practice, you don’t hear well, you experience frustration, you toss the hearing instruments in the drawer, you don’t get to practice listening, your brain is out of practice, etc etc.

So use it!  Give your brain a workout every day by keeping those hearing instruments on and engaging in a rich sound and speech filled life.  Your brain will thank you for it!

So why would hearing loss be linked to dementia?  Well, hearing loss has already been shown to contribute to social and physical isolation and to cognitive decline.  The researchers further speculate that hearing loss puts stress on the “cognitive reserve”.  Think of the cognitive reserve as the computing power of your brain.  The authors speculate that the brain has to devote more resources to handle the poor quality information coming from the ears which reduces its ability to function well.  Because you need to use more to hear, less is available for things like working memory.

So what can be done?
Firstly, have your hearing checked by a certified Audiologist.  It’s painless, takes no time at all and will be a permanent starting point against which to measure any future changes in your
hearing.  Secondly, if you do have a hearing loss, consider hearing instruments to improve the quality of what you’re hearing and to allow you to stay active and alert.  Thirdly, if you already have hearing aids, have them checked regularly to ensure they’re working well, that they’re programmed for your hearing (which will change over time) and that the best
technology available is working daily to keep you independent and enjoying life.

If you would like to read the study itself or the Globe and Mail article, please click on the links below:

http://www.theglobeandmail.com/life/health/new-health/conditions/alzheimers/hearing-loss-linked-to-risk-of-dementia/article1906747/

http://www.metroatlantaotolaryngology.org/journal/mar11/hearing%20loss%20and%20dementia.pdf

For a toy to be sold in Canada, the maximum allowable noise level is 100dB and yet industrial workers are required to be protected at levels at or above 85dB.  In addition to toys, portable entertainment devices are often the gift of choice for young children.  These are potentially hazardous for several reasons: their output can well exceed 100dB, they can be worn for extended periods of time, and they are often turned up to hazardous levels to be heard over background noises such as in noisy cars, buses, airplanes or crowded areas.  Standards also do not take into account that toys are often held directly to the ear by children or that very young children may not have the capacity to move away from loud toys laid next to them.

While, the long-term effects of hazardous noise on a young ear are not well documented, permanent hearing loss rates among teenagers are clearly sky rocketing.  A 2006 study in the Journal of the American Medical Association reported incidents of hearing loss in teens at 19.5%, almost 30% higher than was reported just 10 years earlier.  Another recent study by the University of Florida found 25% of freshmen tested had hearing loss.  These are tragic numbers given that noise induced hearing loss is irreversible and 100% preventable!

So what can parents do?  First of all, simply keep safe sound levels in mind.  Just because a toy is marketed to children, doesn’t mean it’s sounds are safe.  Find a quiet corner of the store and listen to the toy.  Toys are made louder than necessary so they can be heard over the noise of a crowded department store and attract the attention of children and their parents.  If a toy sounds loud, don’t buy it.  Remember not only will you be saving your child’s hearing but you’ll save yourself the headache of listing to it over and over again as it wails away in your living room.  If a toy you already own is too loud, some duct tape placed over the speaker will muffle the sound so it can still be enjoyed.

For headphones a good rule of thumb is you must be able to carry on a normal conversation with someone 4 feet away.  If you can’t, it’s too loud.  To be certain, put a set of safe headphones under the tree, they’re inexpensive and have built-in limits which ensure safe enjoyment of iPods and MP3 players.  If your child reports any difficulty hearing or reports ringing, buzzing or funny sounds in their ears have their hearing tested by an Audiologist to see if they’ve done any damage.  By avoiding hearing loss this year you’ll be helping them enjoy the sounds of Christmas for a lifetime.

This scenario illustrates what can happen when you have difficulty hearing.  Listening is normally an effortless and often pleasurable experience.  Understanding human speech is one of the most difficult things the human brain does however we normally do it quite easily as long as conditions are right.  But when conditions change, such as the intrusion of background noise or more than one talker at once, the brain has to work much harder to cope.  Throw in hearing difficulties and suddenly you’re using even more mental energy to try and listen and fill in the gaps.  Just as the driver retreats exhausted to the safety of home and vows never go out again, you may find yourself not enjoying more and more situations and retreating further and further to a quiet corner.  Listening ‘through’ a hearing loss is like looking through a windshield covered in snow or rain; it takes extra effort and can be exhausting.

Fortunately a hearing system can help clear up the view and give you back that energy you’ve been missing.  By providing the clear, crisp sound your brain needs to do its job, listening can be pleasurable again.  Just as the skilled driver enjoys the road again when the sun comes out, you can use your natural listening skills again giving more energy and more positive listening experiences at the end of the day.