How do you recognize you've got a hearing problem and what do you do about it? That's today's topic on Ask The Hearing Doctors.
Hi, I'm Jim Cuddy, and this is Ask The Hearing Doctors. And I'm joined by Dr. Ana Anzola, Dr. Wendy Thorne, doctors of audiology at Hearing Doctors, the Washington DC area's highest-rated audiology practice with over 1,500 five-star reviews. Ana, Wendy, let's jump right into it. Hearing loss. It seems to be one of those things that kind of slowly creeps up on you. What are some of the early warning signs that, that people may experience that they don't realize they even have a problem?
Oh yeah. Sure. So, um, people tend to mumble or that's what they think that everybody else is doing. Um, asking for repetition. Things don't sound very clear. You may hear parts of the word, but not everything. And some other things are, you can experience tinnitus, which is any sort of ringing or buzzing in your ears. Um, you're having to turn the TV up louder and louder, or even, you know, relying on captions when you're watching a TV or movie.
Sounds like I might need a checkup because I do tend to turn the TV up a little on the loud side. Um, I imagine there are, are a lot of reasons why someone may lose their hearing, but what are some of the common causes for folks?
So I think the, the most commonly... uh, cause would be aging process. It's called presbycusis and it's a slow, insidious process that happens. We tend to lose our hearing. We don't even know what's going on. We just, all of a sudden don't understand as well as we used to.
Is that just a natural process in most people anyway, is that just, you're getting older and that's, that's kind of the way it,
Yeah. And it starts, the process can start around the, the, your thirties and forties. Wow. So it's sooner than what most people think. They think 70, 80, but it is getting sooner and sooner in life.
But it's, uh, it tends to be a gradual thing unless you have some other underlying condition, I would assume.
Exactly. So it doesn't come with pain. Um, and you're not hurting. It's just, you're slowly not hearing as well as you used to, you feel like you're not hearing, um, the conversation. You're not part of the conversation anymore because you tend to miss. And if you do miss it's, it's very disconcerting because you don't stop to say, "what did I miss?" You just ask for the repetition and life goes on.
You know, the other thing that comes to mind are people that work particular jobs, where there's a lot of noise and, or even on a social level where you're going to a concert maybe, or, or things like that. What sort of problems do you run into and what are, what are the safety measures that one takes, especially if you're working at a job, let's say you're working at an airport?
Oh yeah. Um, throughout my travels, I've noticed I look outside the window from my airplane and I see so many crew members not even wearing hearing protection. What's really recommended is a double protection. Um, but it's very concerning not to have them even wear anything. Yeah. And by a double protection, what she means is, you know, in the ear ones and the big muffs over, that's always the safest way. You could have recreational, occupational noise exposure, which puts you at risk really fast. What about screaming children at home? But I would imagine, but I would imagine that, that after a while, I mean, especially if you have a lot of kids... Maybe a nursery or preschool teacher, things like that, but no, not your kids saying "Dad."
That's not so much. But in an environment where perhaps a teacher, somebody like that, they could actually suffer hearing loss because of, of just every day being subjected to that kind of noise. Music teachers, band directors...
Yeah, yeah, right. So if you're going to band camp. Yes. On stage, or people who are in an orchestra...
Now this kind of surprises me because I've read that medications can actually cause hearing problems, damage. What types of medications are we talking about and how does that happen?
Yeah. So there's, um, a lot of medications that are considered ototoxic. Um, they're usually, you know, pretty strong medications, usually anything in the mycin family. So meaning they end in "omycin". Um, there's also high doses of aspirin, chemotherapy drugs, um, usually ones that are not like everyday, typical ones that people take, but typically things that are used to treat more complicated illnesses and diseases.
Now these, so are these more, if you're on medications longer term that it, that it inflicts this damage, or could somebody say, you said the myecin families, and I know I have been given erythromycin as an antibiotic or whatever. And that's just a couple of weeks or whatever it is. Is that going to cause damage or is it more longer term? It's long-term. It's not something, you know, short, short-lived. It's something that's really long-term.
What about infections and viruses and other diseases and things like that? I mean, so here we're talking about the medications, but what about the other, you know, the other side of it, if you will, and, and, and the effect on hearing?
Oh yeah, so absolutely. So we have things that could happen to the middle ear. So there are three parts to every year. So now we're talking about maybe the outer ear or the middle ear, and that could also affect somebody's ability to hear or even understand speech.
And obviously birth defects, congenital hearing problems. I would imagine you're probably see a fair amount of that as well?
Oh, absolutely. Yeah. We've seen a few. Yeah, and there's, you know, a lot of illnesses that even the mother can get when she's pregnant that can be passed on to the child that can cause some hearing loss, um, like CMV, um, a lot of the MMR, you know, illnesses that thankfully are decreased from vaccines, but meningitis, lots of different things that you can get even as a child that can cause hearing loss long-term.
You know, there's the, the, the childhood song where the leg bone is connected to the hip bone and all that kind of thing, but it sounds like the systemic effects of different diseases go can go right to your ears and have a negative effect.
Absolutely. And there's has been some recent, uh, research, um, even with COVID, um, affecting the tinnitus or the hearing in itself. Um, so it's, the information is out there and we just need to bring it out to life.
You mentioned tinnitus and, and that is not necessarily hearing loss though, correct? It's just a condition of ringing in the ear? Correct. Okay. And is that, is that easily taken care of? How do you deal with that?
So tinnitus doesn't, kind of along with what you first said, it doesn't typically occur with hearing loss. We have a lot of people with tinnitus and no hearing loss, people with hearing loss and no tinnitus, and then both. But a lot of times they do kind of co-exist together. Um, there are different masking treatments that we can do. Um, no matter what you do, if you look at research that always says, there's no cure for it. Um, but we always want to remind patients just because there's no cure meaning, there's no medication you can take to completely get rid of it, that doesn't mean it can't be managed. So we do a lot of management strategies with people that have mild all the way to very severe tinnitus. Yeah. I personally suffer from tinnitus. So I have tinnitus in the absence of hearing loss, so that could also happen. Um, and so you can, it ranges between very mild, all the way to very significant. Uh, it affects you in, in, in different stages. Um, so mine is very mild and I'm able to sort of cope with it, but my world, it needs to be loud because I, I expect my world to kind of mask and I use my world to kind of mass my own tinnitus. Um, but I do have a tinnitus device that I use at home.
Ah, so it's a type of therapy then?
It is. It's sound therapy and it works really well.
That's great. Now the other thing, because of hearing loss, you, you've got a lot of problems with say relationships or, or family fighting and things like that because somebody doesn't hear, well, they're turning up the TV, "turn the TV down!" or, or maybe you take a different tone with them. You're speaking loudly to them and they maybe perceive it as "why are you yelling at me?" and that kind of thing. That's gotta be a big problem for not just for families, but I would think in the workplace too.
Absolutely. That's probably the most, um, common, um, complaint that we get. You know, "my family is really upset with me. I'm really trying, but they don't understand, um, what I'm going through" perhaps, or they don't even know themselves. And so, or at work it's very serious because they could be missing important information that would, you know, um, take him up to the next level. Um, you know, if they miss, they could have missed that promotion. That's really important, you know? So...
The other issue, or a one of many issues, of course, when it comes to hearing loss - denial. "No, I..." as, as you mentioned, when we were getting started, "no, I hear just fine. You're mumbling" and that kind of thing. I don't know if there's maybe a stigma that comes with, with people thinking, "Oh yeah, I'm, I'm losing my hearing. I don't want to go and have those big hearing aids" and that kind of thing. How do you deal with that? How does, how do you all deal with that? But also how would I deal with that of a family member? I know they're losing their hearing. They need to have their hearing checked and taken care of and whatever needs to be done. How do I convince that person that it's okay, it's not that bad, this is actually going to make life better?
See, but they don't know that, and that's the most interesting thing. Um, but I think that if you present it in a way where, you know, "we care about you, know your scores, get it checked out." Um, it's not a test, it's a baseline. So it's sometimes it's how you present it to the family members, uh, because it's important. Um, anybody over the age of 50 should be getting their hearing checked. Um, if you perhaps, um, have issues or concerns, then you can, of course, you know, get it checked out as soon as possible. My youngest patient is five years old and my oldest is 103. So it really tends to affect you in different ways.
Wow. Yeah. That's quite a range in age. Yeah. Yeah. So anybody could have hearing loss. I mean, anybody, it doesn't matter. And any signs of it, you should probably do something. Um, how often should you have your hearing checked? I mean, we go to the doctor, you know, to have a physical, once a year, you go to the dentist twice a year, you get your eyes checked with some regularity or you're supposed to, what about hearing? Cause that's never one that seems to be on the forefront of people's minds.
Should be at least every year. Once a year. And is that for any age?
Especially if you're 50 and older, um, some of our younger patients, we kind of leave it to every two to three years, but definitely every year, if you're 50 and older or if you have a known hearing loss or if you're noticing some concerns. Yeah, for sure. Um, if we follow them because of ototoxic medication, chemotherapy, and then we tend to do a more, um, serious follow up, like every three months. Um, if they wear, um, amplification systems or corrective devices, we tend to see them every six months. So it really varies. It's very personalized.
If I feel like I have a hearing problem, do I immediately come to contact Hearing Doctors? Do I go to an ENT? Do I see my primary care physician? How do I, what's the, what are the best steps for me to take?
Well, you can certainly come to us any at any point in time. Um, I think it's to be, you know, something that you should discuss with your primary physician. Um, if it's, um, ENT-related, medically-related issue, like there was no eardrum, you have a perforation, you're bleeding, you know, certain things then definitely go to an ENT. Okay, great. Yeah, but if it's just general hearing concerns or you want to get a good baseline or ringing in the ears, definitely come see an audiologist. That's what we're specialist in. Yep. Or a hearing hearing health care provider.
So my turning up the TV really loud every night would just suggest I need to come see you guys. Fantastic. Ana, Wendy, thank you so much. Great information and look forward to doing it again soon.
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