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TBI and Hearing Loss

Brain Injury Symptoms

The past couple of years have seen a rise in the number of Traumatic Brain Injury (TBI) news reports. Driven by their prevalence in both professional and junior-league sports, TBI and CTE (a degenerative brain disease in those with a history of repetitive brain trauma) have become almost commonplace.

TBI symptoms can be moderate or severe, and include everything from problems with attention, concentration, and vision to “difficulties with interpretation of touch, temperature, [and] movement.” Brain injuries can also affect hearing.

Though hearing difficulties after a head injury are not a given (and can’t be relied on to definitively diagnose TBI), any occurrence or increase in hearing loss should be noted and treated. TBI hearing loss can affect the outer, middle, or inner ears, and range in length (short vs. long term) and severity. Tinnitus sometimes results, as does hyperacusis (sensitivity to sound), or Meniere’s syndrome (an incurable and “excessive pressure in the chambers of the inner ear”).

Hearing Loss Treatment

Treatment of hearing loss concurrent with that of brain injuries can be tough, as symptoms can overlap. According to the Hearing Review, these symptoms can be “mistaken for PTSD, mental health issues, and cognitive deficits.” If serious enough, long-term management may include hearing aids or auditory processing therapy.

If you notice any instance of hearing loss, you should always check with your primary care physician, who will refer you to an audiologist. With their help, you can come up with a plan to help manage your loss.

If you suffer any blow to the head, or play regular contact sports, its always a good idea to talk with your doctor, as well — even if you don’t have any symptoms.

REM has written about TBI before. Don’t hesitate to check out our past blogs, such as TBI and tinnitus and Going Back to School with TBI.

National Audiology Awareness Month

October is National Audiology Awareness Month. What does that mean? What can you do? How can you help spread awareness?

Do a Google search, and you’ll find half a dozen calls to action from a variety of different hearing education resources. The American Academy of Audiology, for example, asks hearing professionals to take charge locally and dedicate time during October 1-5 (“Public Awareness Week”) to “rally with your colleagues,” while Cochlear Americas seeks stories from the experts, hoping to inspire and teach.

Healthy Hearing, on the other hand, lays out the facts for the non-professional. They highlight the importance of not only hearing tests, but the importance of audiology assessments:

“Audiologists have a valuable and varied role in treating the hearing health of people of all ages, from the very young to the very old. They not only perform hearing evaluations and fit hearing aids, but also treat noise induced hearing loss, ear infections, trauma and damage to inner ear and eardrum due to illness or ototoxic medications.”

In line with Healthy Hearing, the NIDCD has a dedicated website to help inform the consumer, especially concerning adolescent hearing loss. This is a great resource for parents and teachers.

Finally, REM has some tips for how you can help with National Audiology Awareness Month:

  1. Spread the news about hearing loss prevention, which is a big part of any audiologist’s job.
  2. Find your favorite resources. In addition to the websites listed above, REM’s own blog — covering a variety of topics over the course of several years — might prove helpful.
  3. Encourage ear protection when exposed to loud noises.
  4. Get an app that monitors noise levels in the world around you.
  5. Realize that everyone over 55 deserves a hearing assessment*.

There’s lots you can do to help this coming October!

*The purpose of this hearing assessment and/or demonstration is for hearing wellness to determine if the patient(s) may benefit from using hearing aids. Products demonstrated may differ from products sold. Test conclusion may not be a medical diagnosis. The use of any hearing aid may not fully restore normal hearing and does not prevent future hearing loss. Testing is to evaluate your hearing wellness, which may include selling and fitting hearing aids. Hearing instruments may not meet the needs of all hearing-impaired individuals.

Portable Music Device Hearing Loss

Hearing loss is on the rise! For children, exposure to loud, constant noise is more prevalent than ever. A recent study, undertaken by researchers from Erasmus University, links portable music devices to future hearing problems in children. According to the ASHA Leader article that breaks down the study:

“Even using the portable music players just one or two days per week (regardless of how long they wore headphones or how high the volume setting), these children were more than twice as likely to have hearing loss when compared to children who did not use these devices at all.”

That’s a bold, frightening claim, but parents should realize there are still ways to help protect their children’s hearing. Volume level and length of exposure — despite the prevalence conclusions of the study — are still major determining factors in later-life hearing loss. Limiting time and sound level is strongly advocated. It will help!

When asking your children to turn down their music or take out their earbuds for a while, REM recommends explaining why you’re telling them to do so. Teach them good hearing etiquette early in life, lessons they can apply years down the road. Teach your children (and other adults you may know) to take care of their hearing now.

For more information about how long it takes (and how loud it needs to get) before sound causes hearing loss, you can check out one of our past blogs.

Back to School with Hearing Loss

Summer is winding down and school is peeking out over the horizon. If you have hearing loss or communication difficulties, what can you do to prepare? Who can you talk to?

1. Talk to your child. Be transparent. If your child has hearing or language issues, reassure any anxieties they may have. Share as much info as you can about any assistive listening devices or speech therapy classes currently in place to help them learn and stay on course with their fellow students.

2. Get informed! See what services your school offers, and see what else could be offered. Talk to local audiologists and speech pathologists, maybe do some research online. Possibly, you can even give your local school board some ideas.

3. Be aware of your school’s IEPs (Individualized Education Programs) and 504 plans. These can offer “formal help for K-12 students with learning and attention issues.”

4. If your child has hearing loss, allow them to try unfamiliar things. Allow them to achieve and stumble. Ellie Parfitt, who is deaf, writes on the Hearing Like Me blog: “One thing that my parents have learned from having a deaf child, is that you should encourage them to make their own decisions, choose subjects they would like to study and make sure you encourage them to try new things.” This is good advice for anyone.

For more information, check out one of our blogs from last summer. Here, you’ll be able to find info about specific devices and ideas concerning your child’s educational development.

The Genetics of Hearing Loss

Can you inherit hearing loss? As you might expect, the answer is complicated.

Because of genetic mutations that can be passed from parent to child, certain individuals may be more pre-disposed to hearing difficulty than others. Hereditary hearing loss can be seen in everything from genetic abnormalities in inner ear sensory cells to specific disorders such as Usher syndrome, Pendred syndrome, and Otosclerosis.

In some cases, genetic hearing loss can appear in newborns. About 50% of all children’s hearing loss can be due to genetic influences. According to BabyHearing.org:

“In approximately 70% of cases of genetic hearing loss, the cause is autosomal recessive. About 12 babies per 10,000 have a recessive cause of their hearing loss. Congenital hearing loss (hearing loss present at birth) that is due to one of the many recessive genes is twice as common as Cystic Fibrosis, another recessive genetic condition.”

Hereditary hearing difficulty can also manifest later in life. Anyone can experience the symptoms and effects of hearing loss at any time.

The causes and permutations of hearing disorders are very complex, and not everyone will be able to — or feel the need to — have their genes sequenced to see what could potentially be passed down to their children. That said, it’s important to know that sometimes hearing loss simply can be explained by genetics, to the fault of no one involved. So, if you notice any hearing issues in you or your child, it’s important to get them checked out right away, even if you don’t fit into any high-risk groups.

Balance and Hearing Loss

Hearing and balance are two peas in a pod. Balance is intricately connected to the inner ear, and if you have balance issues, you might have hearing loss (and vice versa). If you notice symptoms of either, it’s always a good idea to talk to your primary care physician or audiologist.

Noticing Symptoms

Why go see an audiologist if you experience dizziness or loss of coordination with hearing loss? “Hearing and balance disorders are complex with medical, psychological, physical, social, educational, and employment implications.” It often takes an audiologist — well versed in the diagnosis and treatment of not only hearing loss, but also its associated physical manifestations — to figure out the best way forward.

It’s important to not waste any time if you notice any differences in your balance. A fall due to uneven equilibrium is never ideal, especially if you’re older. It can be frustrating, costly, and even permanently debilitating. A Johns Hopkins study showed that falls are increasing among senior citizens in the US. Researcher Elizabeth Burns, at the National Center for Injury Prevention and Control, says that “Falls are the leading cause of both fatal and nonfatal injuries among adults aged 65 and older.”

How to Help Yourself

1. If you have a hearing loss and balance problems, hearing aids can usually help compensate for your balance issues.. The more you can hear your environment, the better you’re able to interact with the world around you.

2. Though it may seem to go without saying, keep your floor clear of any refuse or piles, don’t walk around in the dark, and don’t feel ashamed to walk with a cane or walker if you need one.

Regular Hearing Assessments

It is REM’s belief — one we share with patients in a readily available handout — that regular hearing assessments** could be just what you need to decrease the risk of falls, increase your longevity, and enjoy a better overall quality of life. Please reach out and call us or your doctor for more information.

**The purpose of this hearing assessment and/or demonstration is for hearing wellness to determine if the patient(s) may benefit from using hearing aids. Products demonstrated may differ from products sold. Test conclusion may not be a medical diagnosis. The use of any hearing aid may not fully restore normal hearing and does not prevent future hearing loss. Testing is to evaluate your hearing wellness, which may include selling and fitting hearing aids. Hearing instruments may not meet the needs of all hearing-impaired individuals.

Diet and Hearing Health

A healthy diet is an important part of hearing health. It’s easy to understand why – a healthy diet equals a healthy body, and when you eat all the right foods and get plenty of exercise, you age better, more naturally, and maybe even slower.

So, how does hearing specifically fit into all this?

Let’s start with minerals. Minerals in food are necessary nutrients the body needs, and there are a few that are crucial to help preserve good hearing. Potassium, folic acid, magnesium, and zinc are all important to help your hearing remain its best. Check out the linked article for more information, and start paying attention to what vitamins you’re regularly consuming. You might need to add some supplements if you’re lacking in any essentials (though talk to your doctor first).

As for overall health, a recent article on the CaptionCall website cites a study: “Over the last 26 years researchers at Brigham and Women’s Hospital, part of Harvard Medical School in Boston, have been studying women’s diets and how it relates to hearing loss.” Results showed that those with better dietary habits had a 47 percent less likely chance to experience hearing loss later in life. “Researchers note that the main relation between healthy diet and hearing loss prevention is increased cardiovascular health. Healthy diets lead to an increase in blood flow and reducing inflammation.”

So, looking beyond diet, it might be safe to conclude that a healthier heart equals hardier hearing. “The connection between hearing health and cardiovascular health has led many professionals to believe the ear may be a window into the heart,” writes Beth McCormick, Au.D., in a Starkey blog.

The body works together in ways that the medical community is still figuring out, and different studies on diet and hearing will naturally have different conclusions. That said, a healthy body is always a good thing to strive for, right?

Healthy body, healthy heart, healthy mind, healthy hearing.

Summertime Hearing Tips

Every summer, we write about how to protect your hearing and your hearing aids while outdoors, in the heat, or on vacation. This year we decided to do something a little different. After a couple protection tips, we get into the benefits of summer, and how the season can help improve your hearing health.

How to Protect Your Hearing

1. Swimmer’s ear can often lead to ear infections, caused by trapped water in the ear canal. If you notice water in your ear that’s not going away on its own, use over-the-counter ear drops to reduce moisture. If you’re already experiencing pain or discharge, a visit to the doctor is recommended.

2. Summer months often mean vacation, air travel, and unfortunately, airplane ear. Also called barotitis media, airplane ear is ear pain and a stuffed-up feeling due to the change in air pressure during the plane’s ascent and descent. Yawning, blowing your nose, swallowing, or chewing gum can help.

3. Be aware of how loud summer activities are, and how little it can take to damage your hearing. Do yourself a favor and get a phone app that monitors the sound levels around you. Many are free. You can find more info on our previous blog, Surprising Levels of Everyday Sounds.

How to Protect Your Hearing Aids

1. Do not keep your hearing aids in direct heat or sunlight (e.g., dashboard in your car).

2. Use hearing aid dehumidifiers to reduce moisture damage.

3. If going to the beach, protect your aid by putting it in a ziplock bag with a desiccant. If applying suntan lotion, be sure any doesn’t get on your device.

4. Always open the battery door at night, especially when it’s hot and humid. Humidity can have a devastating effect on your hearing device.

How the Summer Can Help You Hear

Summer is a great time to socialize with others, and if you’re a regular reader of these blogs, you know what we’re about to say — socialization is brain training and a crucial part of maintaining hearing health and wellness.

Check out some hard of hearing community events. The Hearing Loss Association of America, for example, promotes accessible theater groups that use assistive listening devices — such as captioned performances — for the hard of hearing.

Most importantly, have fun! Use the time to learn about all the hearing aids and technology you might not know about. Take advantage of the nice weather to experiment with ideal sound environments. Enjoy the improved communication skills offered by today’s devices. All of this is in the best interest of your cognitive and emotional well-being.

What Services Do Audiologists Offer?

Deciding to get your hearing tested is a big move for a lot of people. Whether it’s at the urging of a primary care physician or something you decide to pursue yourself, choosing an audiologist often comes with a whole list of unknowns. You may find yourself asking what an audiologist does and what services they’ll provide during the course of your visits. Maybe you’re wondering if you even need to see one in the first place (if you’re having difficulty hearing then probably, yes).

After the decision to meet, you’ll first be given a medical history form. You may also be asked to fill out questionnaires regarding balance and tinnitus. Medication and its potential implications on balance and hearing problems will also be discussed.

After the history? The hearing test. For more information about what to expect from a hearing evaluation, please check out our recent blog.

Once the test is complete, you’ll sit down with the audiologist for the consultation, often based on your COSI (client oriented scale of improvement) — your personal improvement benchmarks. Discussing your results, you and your audiologist will go over personalized communication problems, word recognition tests (comparing hearing speech in noise with hearing aids vs. no aids), and customized treatment recommendations.

If the audiologist decides you’ll need a hearing aid, this is when you’ll begin to talk about specific models. You’ll discuss what you want out of your hearing aid experience, whether you’d like to interface with Bluetooth® technology, and how often you plan to use your aids out in social settings.

After you choose your aid, the audiologist will then monitor the device’s results using real ear measurements. He or she will want to be sure the aid is working to its specifications and your needs. You’ll often meet for follow-up appointments at regular intervals, usually every 6 to 12 months, for maintenance and cleanings.

Other services audiologists often provide are:

  1. Earwax removal
  2. Auditory processing testing (if you have problems comprehending speech even though there is no indication of peripheral hearing loss)
  3. Balance testing or referral for balance consultation

Audiologists are also there to help with your tinnitus needs and can offer advice for any hearing-related questions you may have.

Noisy Restaurants and Hearing Loss

If you have hearing loss, you know how difficult noisy restaurants can be. Conversations you might have no problem comprehending one-on-one suddenly become a huge challenge. Maybe you find yourself nodding along, hoping to grab a few words here and there.

Online, there is no shortage of advice on how to deal with hearing difficulties in restaurants. An article on Starkey’s website has tips ranging from seat position (if possible, sit with your back to the noise) to seat selection (if possible, choose a booth). Oticon.com, on the other hand, stresses that the atmosphere of the restaurant matters just as much as where you choose to sit: “In trendy ‘industrial chic’ restaurants, the steel, granite, tile and other hard surfaces amplified sound, raising readings to nearly 85 decibels and creating uncomfortably high sound reverberation.”

The American Academy of Audiology takes a different approach and recommends anyone concerned about restaurant noise install a noise meter on their phone. “These are sound level meters that run on your phone and in one case incorporates a reporting function so you can inform the world about the acoustics of a restaurant.”

Perhaps most important in the hearing loss/restaurant issue is the stigma you may feel comes attached to your hearing difficulty. This should not be the case. There is nothing wrong with suggesting a different restaurant or — if you’re already there — asking if they wouldn’t mind moving to a less noisy area. Simply letting people know up front about your concerns is rarely a bad idea.

For more tips or ideas, or if you want to know which hearing devices best work to help you comprehend speech in noise (such as the the Oticon Opn™ hearing aid), reach on out! We’ll be happy to tell you all we know.