Articles on conductive hearing loss

Hearing Loss: Do You Care???

Mr. Bibin Georgie Thomas, Audiologist
5.3% of the world's population is affected by the disablingeffects of hearing loss. It is an invisiblehandicap. Some have congenital hearing loss, while others acquire it later inlife.Fortunately,there are medical/surgical and/or assistive devices (hearing aids) to aid them. As per World Health Organization (WHO) estimates, one-third of those above the age of 65 years acquire hearing loss known as Sensorineural hearing loss. This occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, sensorineural hearing loss cannot be medically or surgically corrected. This is the most common type of permanent hearing loss.  Hearing loss will reduce a person's ability to comprehend speech. Greater the loss,larger is its impact upon speech comprehension. Hearing loss can be conductive or sensorineural based on which part of the ear is affected. In conductive hearing loss, the outer or middle ear does not conduct sounds well as it should, causing a loss of sensitivity for hearing soft sounds. Conductive hearing loss could be caused by impacted wax in the ear canal, perforated eardrum due to an injury or middle ear infection.The fragile inner ear is subject to infection by a variety of viruses including mumps, measles or any illness accompanied by very high fever resulting in sensorineural hearing loss. Certain drugs that areototoxic also cause sensorineural hearing loss. It is nothing but reduced sensitivity to soft sounds as well as difficulty in distinguishing one sound from another. The causes mentioned here are only a few, but the list is exhaustive. The degree of hearing loss can range from mild to severe/profound hearing loss. Even mild hearing loss can isolate hard of hearing people from the mainstream culture and severely restrict their social lives.Symptoms of hearing loss: Avoiding Communicative SituationsSaying you understood something when you did not Refusing to admit you have a hearing loss Expressing anger through outburstsContinually talking so that you do not have to listen Saying "Never mind, it's not important" Simply nodding your head for everything spoken infront of you People who mumble and speak too softExperience of a ringing sound in the earsOften asking people to repeat what they sayComplaints that you play the TV too loudDifficulty in understanding a conversation in a largegroupStruggling with localization of the soundsHaving been told that you speak too loudly Denial is an initial reaction, Projection is the second reaction i.e., blame someone else. The next step is anger, misdirected,at the person in closest proximity. Depression may follow resulting in self-imposed aloofness.  Treatment Treatment measures for hearing loss are: medication, in cases of infection causing conductive hearing loss; surgery to correct the outer ear, middle ear bones and eardrum problems, and hearing aids; makes some sounds louder so that a person with hearing loss can listen and communicate.Hearing aids are the effective therapeutic device for 90% of the hard of hearing people. Only 10% of hearing loss can be corrected medically or surgically.Properly fitted and used, hearing aids are able to enhance the quality of life of hard of hearing people. Hearing aids are highly sophisticated devices, reflecting a blend of advances in computers, communication and electronic technology, with added features and development appearing at a rapidly increasing rate. A number of programmable and digital hearing aids are currently in the market, arriving every year.The first step the hearing-impaired person should take is to ensure that he or she has the proper hearing aids and that they are properly adjusted to one'shearing loss. This requires consultation with an audiologist. The hearing-impaired person should not hesitate to ask questions regarding the relative effectiveness of different aids and adjustments. The manipulation of conversational situations is also necessary. People with a hearing loss have a lot of difficulty in understanding speech in noisy situations. The right kind of thing to do in this situation is to ask that the background sounds be reduced e.g. the radio does not have to be on when one is talking to another person in the car. At public performances, they can ask for seats up front / directly in line and close to the loudspeaker. In other types of public performances, they should arrive early and select the most appropriate seats, which would ordinarily be up front. In these situations,changing seats to determine whether another location is better is perfectly appropriate.   It is always good for the speaker to ensure that the hearing-impaired listener can see his / her face during a conversation. People with hearing loss may not even realize it, but they are speech reading to some extent as long as they can seethe other person's lips move. The person who communicates should make sure that they do not inadvertently cover their lips. Conversations can be moved to quieter sections. In any type of situation, the closer the speaker and listener are, the easier it will be to hear. Ways to Prevent Hearing LossDeafness and being deaf may not be in our hands, but if we take care and see to the issues of the ears before it is too late, it can be prevented or reversed in a number of cases. The health of the mother during pregnancy should be given adequate consideration so as to have a healthy and fit baby. Similarly in any case of ear problem or pain, the doctor should be consulted very soon to make sure that is not something serious.Taking care and consulting an Otolaryngologist or Audiologist while having medicines that are proven bad for the ear can help to reduce medicine related deafness. In the same way staying away from too much sound or wearing ear defenders when in noisy environment can also help in preventing the problem.Hearing loss imposes some adjustments in life; some easier to cope with than others. Try to recognize it, admit your problem and seek medical help at the first indication of hardness of hearing. There’s help available...all you have to do is ask for it. 

Tips for Better Hearing - How to Avoid Hearing Loss?

Dr. Sivaprasad Reddy, Audiologist
Who should and how to prevent hearing loss?Hearing loss of permanent type is called Sensorineural hearing loss. It is irreversible and is believed to be the direct consequence of damaged inner/ outer hair cells or the nerve fibres attached to these hair cells deep in the inner ear. While a very small percentage of individuals are born with a Sensorineural hearing loss, a majority of them acquire it over the age, and the onset NOT necessarily limited to old age.It is apparent that a majority of parents of pre-teen kids are concerned about their kids’ music listening habits. The concerns are even more with a majority of teens using earphones as a regular accessory and ‘unsafe’ volume as a style statement. In post-teen years, the youth is increasingly being exposed to smoking and disco music (sound intensity is often more than 95 dB). In the adulthood, exposure to some unhealthy living habits and unsafe levels of work-related noise lead to Sensorineural hearing loss. After the middle age, a cumulative of health conditions and increased genetic manifestations make it tough for your ears. Generally acquired a type of Sensorineural hearing loss often starts at high-frequency zones of the inner ear and spreads to other parts as well, often at a gradual pace year after year. Hence, it is important to take care of inner ear and prevent Sensorineural hearing loss by individuals of all age groups. Pick and choose one or more from the following tips according to the cause of hearing loss suspected by your audiologist or ENT doctor.Regular (once in 6 months) hearing check-up is mandatory for everyone diagnosed with the Sensorineural hearing loss. While it is helpful to follow these tips, it is important to start using a hearing aid when the Sensorineural hearing loss is more than 35 dB in one or both ears. Ignoring hearing loss beyond 1-2 years is shown to have several influences on brain functioning and those even more challenging to deal with.1. Use earplugsThe louder the noise and the longer you're exposed to it, the greater the chance of damaging your hearing. Protect your ears with ear protectors – earplugs or earmuffs – and get away from the noise as quickly or as often as you can. If you can't leave the venue, take regular breaks. A 10-minute rest break will give your ears some time to recover.2.  Turn down the musicDon't listen to your personal music player at very high volumes and never to drown out background noise. If the music is uncomfortable for you to listen to, or you can’t hear external sounds when you’ve got your headphones on, then it's too loud. It's also too loud if the person next to you can hear the music from your headphones.3. Use the 60:60 ruleTo enjoy music from your MP3 player safely, listen to your music at 60% of the maximum volume for no more than 60 minutes a day. All MP3 players bought within the EU have a 'smart volume' feature, so use it if you have one. It will help you regulate the volume.4. Wear headphonesWhen listening to your personal music player, choose noise-cancelling headphones, or go retro with older muff-type headphones. These block out background noise and allow you to have the volume lower. Earbud style headphones and in-the-ear headphones are less effective at drowning out background noise. Try to take regular breaks from your headphones, though, to give your ears a rest.5. Turn down the dialTurn down the volume on your TV, radio or hi-fi a notch. Even a small reduction in volume can make a big difference to the risk of damage to your hearing. If you need to raise your voice to be heard above the sound, turn it down.6. Good DietYou can increase your inner ear’s resistance to the boon of age-related hearing loss by keeping a healthy dose of:Zinc - found in dark chocolate, oysters, eggs, nuts, pumpkin seedsResveratrol – found in red wine and grapesN-Acetyl Cysteine (NAC) – found in poultry foods and yogurtOmega-3 Fatty Acids – found in salmon fish, flax seeds, krill oilVitamin A – found in carrot, sweet potato and green y leaf vegetables7. Don't put up with work noiseIf you’re experiencing noise at work, talk to your human resources (HR) department or your manager and ask for advice on reducing the noise and getting hearing protection.8. Do not Honk          Your vehicle horns can damage the hearing of the others. Restrain from honking and help others live peacefully.9. Be careful in the carListening to music in a confined space increases the risk of hearing damage. Don’t listen to music too loud for too long.10. Have a hearing detoxGive your ears time to recover after they’ve been exposed to loud noise. You need at least 16 hours of rest for your ears to recover after spending around two hours in 100dB sound, for example in a club. Reducing this recovery time increases the risk of permanent deafness.

Know All About Hearing Aids

SLP Sanjay Kumar, Audiologist
What is a hearing aid?A hearing aid is an electronic device that we can wear in or behind our ear. It helps a person with hearing loss to listen, communicate effectively. A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.How hearing aids help?Hearing aids are useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.How can I find out if I need a hearing aid?If you think you might have hearing loss and could benefit from a hearing aid, visit an Audiologist. An Audiologist is a hearing health professional who identifies and measures hearing loss and will perform a hearing test to assess the type and degree of loss and dispenses the hearing aids if needed.What are the different styles of hearing aids?Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic ear mold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the ear mold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss.Behind-the-Ear Aid: Open FittingA small plastic case rests behind the ear, and a very fine clear tube runs into the ear canal. Inside the ear canal, a small, soft silicone dome or a molded, highly vented acrylic tip holds the tube in place. These aids offer cosmetic and listening advantages and are used typically for adults.Receiver-in-Canal AidsThese aids look very similar to the behind-the-ear hearing aid with a unique difference: the speaker of the hearing aid is placed inside the ear canal, and thin electrical wires replace the acoustic tube of the BTE aid. These aids also offer cosmetic and listening advantages and are typically used for adults.The in-the-canal (ITC) hearing aid is made to fit the size and shape of a person’s ear canal. A completely-in-canal (CIC) hearing aid is nearly hidden in the ear canal. They usually are not recommended for young children .They are the smallest aids available and offer some cosmetic and listening advantages.Do all hearing aids work the same way?Hearing aids work differently depending on the electronics used. The two main types of electronics are analog and digital.Analog aids convert sound waves into electrical signals, which are amplified. Analog/adjustable hearing aids are custom built to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by your audiologist. Analog/programmable hearing aids have more than one program or setting. An audiologist can program the aid using a computer, and you can change the program for different listening environments—from a small, quiet room to a crowded restaurant to large, open areas, such as a theater or stadium. Analog/programmable circuitry can be used in all types of hearing aids. Analog aids usually are less expensive than digital aids.Digital aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code also includes information about a sound’s pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others.Digital circuitry gives an audiologist more flexibility in adjusting the aid to a user’s needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.Which hearing aid will work best for me?The hearing aid that will work best for you depends on the kind and severity of your hearing loss. If you have a hearing loss in both of your ears, two hearing aids are generally recommended because two aids provide a more natural signal to the brain. Hearing in both ears also will help you understand speech and locate where the sound is coming from.You and your audiologist should select a hearing aid that best suits your needs and lifestyle. Price is also a key consideration because hearing aids range from few thousand to lakhs. Similar to other equipment purchases, style and features affect cost. However, don’t use price alone to determine the best hearing aid for you. Just because one hearing aid is more expensive than another does not necessarily mean that it will better suit your needs.A hearing aid will not restore your normal hearing. With practice, however, a hearing aid will increase your awareness of sounds and their sources. You will want to wear your hearing aid regularly, so select one that is convenient and easy for you to use. Other features to consider include parts or services covered by the warranty, estimated schedule and costs for maintenance and repair, and the hearing aid company’s reputation for quality and customer service.

How to Manage Hearing Loss?

Mr. Bibin Georgie Thomas, Audiologist
5.3% of the world's population is affected by the disabling effects of hearing loss. It is an invisible handicap. Some have congenital hearing loss, while others acquire it later in life.Fortunately,there are medical/surgical and/or assistive devices (hearing aids) to aid them. As per World Health Organization (WHO) estimates, one-third of those above the age of 65 years acquire hearing loss known as Sensorineural hearing loss. This occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, sensorineural hearing loss cannot be medically or surgically corrected. This is the most common type of permanent hearing loss. Hearing loss will reduce a person's ability to comprehend speech. Greater the loss,larger is its impact upon speech comprehension. Hearing loss can be conductive or sensorineural based on which part of the ear is affected.In conductive hearing loss, the outer or middle ear does not conduct sounds well as it should, causing a loss of sensitivity for hearing soft sounds. Conductive hearing loss could be caused by impacted wax in the ear canal, perforated eardrum due to an injury or middle ear infection.The fragile inner ear is subject to infection by a variety of viruses including mumps, measles or any illness accompanied by very high fever resulting in sensorineural hearing loss. Certain drugs that areototoxic also cause sensorineural hearing loss. It is nothing but reduced sensitivity to soft sounds as well as difficulty in distinguishing one sound from another.The causes mentioned here are only a few, but the list is exhaustive.The degree of hearing loss can range from mild to severe/profound hearing loss. Even mild hearing loss can isolate hard of hearing people from the mainstream culture and severely restrict their social lives.Symptoms of hearing loss:Avoiding communicative situationsSaying you understood something when you did notRefusing to admit you have a hearing lossExpressing anger through outburstsContinually talking so that you do not have to listenSaying "Never mind, it's not important"Simply nodding your head for everything spoken infront of youPeople who mumble and speak too softExperience of a ringing sound in the earsOften asking people to repeat what they sayComplaints that you play the TV too loudDifficulty in understanding a conversation in a large groupStruggling with localization of the soundsHaving been told that you speak too loudly Denial is an initial reaction, Projection is the second reaction i.e., blame someone else. The next step is anger, misdirected,at the person in closest proximity. Depression may follow resulting in self-imposed aloofness.TreatmentTreatment measures for hearing loss are: medication, in cases of infection causing conductive hearing loss; surgery to correct the outer ear, middle ear bones and eardrum problems, and hearing aids; makes some sounds louder so that a person with hearing loss can listen and communicate.Hearing aids are the effective therapeutic device for 90% of the hard of hearing people. Only 10% of hearing loss can be corrected medically or surgically. Properly fitted and used, hearing aids are able to enhance the quality of life of hard of hearing people.Hearing aids are highly sophisticated devices, reflecting a blend of advances in computers, communication and electronic technology, with added features and development appearing at a rapidly increasing rate. A number of programmable and digital hearing aids are currently in the market, arriving every year.The first step the hearing-impaired person should take is to ensure that he or she has the proper hearing aids and that they are properly adjusted to one's hearing loss. This requires consultation with an audiologist. The hearing-impaired person should not hesitate to ask questions regarding the relative effectiveness of different aids and adjustments. The manipulation of conversational situations is also necessary.People with a hearing loss have a lot of difficulty in understanding speech in noisy situations. The right kind of thing to do in this situation is to ask that the background sounds be reduced e.g. the radio does not have to be on when one is talking to another person in the car. At public performances, they can ask for seats up front / directly in line and close to the loudspeaker. In other types of public performances, they should arrive early and select the most appropriate seats, which would ordinarily be up front. In these situations,changing seats to determine whether another location is better is perfectly appropriate. It is always good for the speaker to ensure that the hearing-impaired listener can see his / her face during a conversation. People with hearing loss may not even realize it, but they are speech reading to some extent as long as they can seethe other person's lips move. The person who communicates should make sure that they do not inadvertently cover their lips. Conversations can be moved to quieter sections. In any type of situation, the closer the speaker and listener are, the easier it will be to hear.Ways to Prevent Hearing LossDeafness and being deaf may not be in our hands, but if we take care and see to the issues of the ears before it is too late, it can be prevented or reversed in a number of cases. The health of the mother during pregnancy should be given adequate consideration so as to have a healthy and fit baby. Similarly in any case of ear problem or pain, the doctor should be consulted very soon to make sure that is not something serious.Taking care and consulting an Otolaryngologist or Audiologist while having medicines that are proven bad for the ear can help to reduce medicine related deafness. In the same way staying away from too much sound or wearing ear defenders when in noisy environment can also help in preventing the problem. Hearing loss imposes some adjustments in life; some easier to cope with than others. Try to recognize it, admit your problem and seek medical help at the first indication of hardness of hearing.There’s help available...all you have to do is ask for it!

6 Tips for Communication With the Hearing Impaired

Dr. Rajesh Kr. Bhardwaj
As per WHO's 2005 report, 63 million persons (6.3 percent of the population) have a significant hearing impairment. That means roughly one person out of a dozen has a significant hearing loss.Some concepts need to be understood before we can proceed - 1. Difference between speech and language - speech is the spoken word, whereas language is an overall communication which includes reception and expression. Speech requires proper motor skills of articulation, vocal cord function etc whereas language is more related to comprehension and making sense of it all.2. Communication - Effective social interaction is communication. For instance a person who is hearing impaired and has no speech can still communicate. She can articulate simple demands like I need water by gesturing towards a glass of water. A person can communicate her sorrow, anger, frustration etc without having to resort to speech.Hearing impairment does not necessarily mean that the person is totally deaf - there is usually some hearing available.While speaking with a hearing Impaired person, kindly keep the following in mind :1. Speak up a little- Do not whisper or speak softly and do not shout - speak just  a little above your normal volume2. Speak clearly - do not mumble - articulate your sounds well3. Reduce background noise - speak in as quiet a room as possible because background noise distorts your sound signal to the patient.4. Keep your lips and face clearly in front of the hearing impaired person- hearing impaired persons are very good lip readers and can judge what you are saying by reading your lips5. Use gestures liberally so as to illustrate what you are saying - this helps them to get the context of what you are saying. 6. Learn Sign Language - if you are the primary care giver of a hearing aid person and the person is completely deaf, sign language will help the both of you communicate effectively with each other. Remember that it takes a while to master sign language.If you think it is frustrating for you to communicate with a hearing impaired person, imagine the frustration the person suffers from her inability to hear and communicate effectively. Kindly be patient, polite, and do not get frustrated if your message is not going through- try again.

Can Diabetes Lead to Hearing Loss?

Mr. T. Kannan, Audiologist
Hearing loss is common in people with diabetes. As diabetes becomes more common, the disease may become a significant contributor to hearing loss.A recent study found that hearing loss is twice as common in people with diabetes as it is in those who don't have the disease.Also, of the 86 million adults in the U.S . who have pre-diabetes, the rate of hearing loss is 30% higher than in those with normal blood glucose. Research shows that people with uncontrolled type I or type 2 diabetes are twice as likely as others to experience hearing loss.In a large study of people ages 20-69, researchers from the National Institute of Diabetes and Digestive and Kidney diseases found a strong association between diabetes and hearing problems,emerging as early as age 30.It,s possible that the high blood glucose levels associated with diabetes cause damage to the small blood vessels in the inner ear,similar to the way in which it damages the eye and the kidneys.Diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear.Since it happens slowly, the symptoms of hearing loss can often be hard to notice. In fact, family members and friends sometimes notice the hearing loss before the person experiencing it.Signs of Hearing loss :Frequently asking others to repeat themselvesTrouble following conversation that involve more than two peopleA hearing problem frustrates you or triggers arguments when talking to family membersA hearing problem causes you to attend public events or services less often than you would likeThinking that others are mumblingProblems hearing in noisy places such as busy restaurantsTrouble hearing the voices of women and small childrenTurning up the TV or radio volume too loud for others who are nearbyHearing loss makes you feel depressed

Preventing Hearing Loss In 8 Easy Ways

Dr. Imad khan Ruman, Audiologist
At some point, many adults realize they’re pressing the “volume up” button on the TV remote more often, or that a lot of people around them need to speak up. There are two common reasons that lead to hearing loss in people, which are:Age. As you get older, the tiny hair cells in your inner ears slowly break down and can’t pick up sound vibrations as well as they used to.Noise. A lot of loud sound over time can damage the hair cells in your ears.The good news? There are things you can do to prevent noise-induced hearing loss and keep age-related hearing loss from getting worse. Here are eight tips to help keep your ears as sharp as possible.Recommended Related to Healthy Seniors: 6 Low-Impact Exercises as You AgeAs you age, it's a good idea to downshift from high-impact exercises. All that pounding needs to give way to something that's more in line with what your body needs now. Add these six low-impact moves to your exercise routine. They come from Jacque Ratliff, exercise physiologist and education specialist with the American Council on Exercise.1. Avoid Too Much NoiseHow loud is too loud? If you have to shout over the noise around you, it's loud enough to damage your hearing. For example, the sounds from motorcycles, concert speakers, power tools like saws and drills, and even earphones are all loud enough to hurt your hearing over time.2. Be a Quiet EnforcerTurn down the background noise level in your life by buying appliances and devices that have low noise ratings. If the noise is too loud in the gym, movie theatre, restaurant, or any other place you go often, ask the manager to turn it down.3. Limit Loud Sounds in Your LifeSometimes you can't avoid the blare of an ambulance siren or the jackhammer on your street corner. But it's best to limit the amount of time you're around them. Noise-induced hearing loss is a result of the loudness of sounds and how long you hear them.4. Wear Hearing ProtectionIf you know you're going to be hearing loud sounds for more than a few minutes, think about wearing protection, such as:Earplugs. Usually made of foam or rubber, earplugs go in your ear canal and can reduce noise by 15 to 30 decibels. You can buy them off-the-shelf or have them custom-made to fit you.Some ear plugs are designed to reduce noise levels evenly across all frequencies. They’re useful for people who need to make sound quieter but undistorted, such as musicians.Earmuffs. These fit completely over your ears and reduce sounds by about 15 to 30 decibels. Remember that your earmuffs must fit tightly over both ears to block sound.You can also wear earplugs and earmuffs together for even greater protection.5. Don't SmokeAlong with age and noise, research has shown that tobacco can increase a person's risk for hearing loss. If you smoke, preserving your hearing is one more good reason to quit. If you aren’t a smoker, avoid breathing secondhand smoke.6. Remove Earwax ProperlyA buildup of wax in your ears can muffle sound. But don't use a cotton swab to clean them out -- they can push wax even deeper into your ear canal. Instead, use an at-home irrigation kit to soften wax and gently wash it out. If wax gets compacted in your ear, your doctor may need to remove it.7. Check Medications for Hearing RisksAbout 200 medications can damage hearing, including some antibiotics and cancer-fighting drugs. Even high doses of aspirin can harm your ears. If you take a prescription medication, check with your doctor to make sure it won’t hurt your hearing. If you must take a medication that may harm your ears, make sure your doctor checks your hearing and balance before and during your treatment.8. Have Your Hearing TestedMake an appointment to get a hearing test if you:Have close relatives with hearing lossHave trouble hearing conversationsAre around loud noises on a regular basisOften hear ringing in your earsIf you have some hearing loss, you can prevent more damage by steering clear of loud noises. If your problem is severe enough, you might think about getting a hearing aid or other treatment. Be sure to see your doctor if you have a sudden change in your hearing that you can’t explain. It could be a symptom of other serious medical problems.

This Diwali Celebrate With Hearing Aids On!

Dr. Sivaprasad Reddy, Audiologist
Diwali is a busy festival celebrated with family members, friends and fire crackers. No other festival is celebrated with so much happiness and participation from all family members. Friends meet up their friends and distribute gifts and sweets. Fire crackers are lit up and the entire family jointly celebrates this fete.Many hearing aid users are apprehensive to wear them for the fear of loud crackers. Fire crackers emanate a variety of sounds not all of them are loud bursts/ blasts. This article shall provide solutions and options to this problem so that you can continue to wear hearing aids even on a Diwali day. In general, as recommended by the Environment Protection act (1999), it is safe to maintain 3 meter distance from loud crackers. Apart from that use the following options and participate in the Diwali celebrations.Lower the volume when bursting crackers. Many wireless hearing aids today come with a volume changing option in android/ apple App. While non-wireless hearing aids may still have a toggle/ wheel to lower the volume. Make sure the volume is restored (switch off and then on) as soon as you get back to conversing with someone.Visit your audiologist and ask them to create a special program only for Diwali week. He can help you program your aids with a new program that maximizes noise reduction and reduces overall output. Use the program button or smartphone App to select this program. This will help you enjoy all types of sounds without a sign of discomfort.There are some users bothered a lot by all types of brief (impulse) noises –knock at the door, chopping vegetables, vessels and crockery noise while washing, blast noises etc. Hearing aid technology is now advanced to provide a solution to this small set of users too. This special feature called, impulse noise management/ control, is available with several manufacturers. Many users find it very comfortable with this feature on. This feature acts turbo fast on these impulse noises and puts them within the comfortable hearing range. In some cases it marginally improves speech understanding also, after all, speech sounds such as /k/, /t/, /p/, /t/ have a soft impulse noise in them. This feature doesn’t need a special program to be created and is on as long as the hearing aid is on.Figure shows how short impulse sounds are controlled by a hearing aidNow that we have learned of the ways to get rid of uncomfortable sounds, hearing aids are very important while conversations are on and family/ friends gather on the occasion. Those wearing two hearing aids will find it extremely convenient to follow conversations and won’t miss a bit. This Diwali, there is no celebration without hearing aids on.

How to Find Which Hearing Aid Suits Me the Best?

Dr. Sivaprasad Reddy, Audiologist
Hearing aid is a digital electronic device that amplifies sounds to meet the reduced hearing power. Hence it has a bundle of amplifiers (channels) and they can be adjusted (bands) using a software by trained audiologists. Hearing aids come with a variety of special features and the price varies with the number of features. The best hearing aid may not be expensive at all, or cheaper, as predicted by some. Though there are different ways in which the best hearing aid is selected, the method described here is accepted and followed in best audiology clinics across the world.You can select the best hearing aid for you in 3 stages – Thorough hearing test, Detailed counselling basis your listening requirements and Experience the sound and features. Also, try and keep a room for knowing what special accessories are available with the hearing aids. Sometimes, you may need an accessory that connects hearing aids with your TV or mobile phone or even the class teacher.Role of a trained AudiologistAudiologist has an eye to see the detail in your audiogram. The audiogram values help us selecting the sound power, channels, vents in hearing aids, special features that can bend high pitch sounds. Some audiograms are so challenging that it needs discussion among 2-3 experienced audiologists.Audiologist is also trained to identify the listening needs and match them with correct features in hearing aids. Even the Identification of communication situations that cause you the most difficulty is a critical first step in solving your problems. Audiologist’s knowledge, expertise and access to multiple brands will make this easier and better for you.After successfully completing these 2 stages, it is the time test the proof of the pudding by wearing the hearing aids. The hearing aids are programmed and the required features are activated. Most of the times the demonstration and experience can be completed within the clinic premises. In some cases, because of special listening needs, the experience is given in the real-life situation.Special features in Hearing AidsIt is now proven that the hearing aid users are more satisfied with new programmable technology. Advanced programmable technology allows the audiologist to adjust the hearing aid to your specific hearing loss with more precision. The following description helps in knowing some new features in programmable hearing aids.Multiple ChannelsThe majority of today’s hearing aids have multiple channels. Each channel represents a portion of the frequency range important for understanding speech. One advantage of multiple channels is that features such as gain and compression can be programmed differently to reflect changes in the patient’s hearing across frequencies.Directional MicrophonesUsing two microphones it is possible to configure a hearing aid so that sounds from the side, and especially the back of the hearing aid user are amplified less than sounds originating from the front. The user can easily hear conversations coming from front and ignore the rest. Directional technology is available on all hearing aid styles except CICs (because of size constraints). Importantly, directional technology does not improve localization of sounds.Noise ControlWith digital hearing aids, it is possible for the hearing aid to analyze an incoming signal and differentiate speech from a noise signal. This can be accomplished simultaneously in several channels, hence, works better in hearing aids with more channels.Stop Whistling Acoustic feedback (whistling from the hearing aid) can be annoying, embarrassing, and in some cases, prevent the hearing aid wearer from using the correct amount of gain. Many of today’s hearing aids have an automatic feature that quickly detects acoustic feedback and cancels it.Wireless Hearing Aids (with Bluetooth)They have a special Bluetooth in them which can amplify the ‘streamed’ sound also. Sounds picked up directly from TV, mobile phone, music system etc (with the help of an accessory) and amplified by hearing aids with little distortion or interference from noise.Hearing Aid could be your Style StatementHearing aids are available in at least 4 different styles. The most popular ones are worn behind the ear – BTE (behind the ear) and RIE (receiver in the ear). They are available in a variety of colour options and can help you surely make a style statement.The less popular ones are worn inside the ear – ITC (in the canal) and CIC (completely in canal). They are tucked inside the ear and have few options to express your style. They also have several limitations in terms of feature availability.All said it is good to be realistic in having expectations even from these miniature and most sophisticated computerised devices. Hearing aids will not permit you to hear the flapping of hummingbird wings near a jet engine. Remember that it takes time to get used to hearing aids, especially if you're a new wearer. Keep in mind that background noise is almost always part of your environment, and adjustment to it is required. In time, you will tune out many of these everyday sounds. It's important not to become disappointed or frustrated while your brain begins to adjust to a whole new world of sound.

Important Info for Parents of Young Babies With Hearing Loss!

Dr. Chander Mohan Mittal, Cardiologist
FROM US TO YOU :THE PROCESS OF GETTING THE RIGHT HEARING INSTRUMENTSThe process of getting the right hearing instruments is important and ongoing. It requires strong motivation and active participation from you as a parent. Even the most advanced instruments will not help if your child does not wear them, or if they are not properly maintained.Your child's willingness to wear hearing instruments will most likely depend on how much you can teach and motivate them. The more knowledge they have, and the more involved they feel, the easier things will be. The earlier the child learns to handle their hearing loss and hearing instruments, the more ownership they will take and the more confident they will feel. One way to achieve this is to make sure that their first experiences with hearing instruments are positive. For instance, make sure that the first sounds your child hears with the new hearing instruments are gentle, comfortable sounds such as music or friendly talk.Also, be aware of the importance of being motivated as a parent. If you are unmotivated and cannot accept what is going on, your child will immediately react and reject the hearing instruments. Remember to be happy and positive when they first start wearing them.However, no matter how well your child seems to be adapting to the hearing instruments, there will always be times when he or she takes them off - sometimes much to your frustration. Be aware that there can be many reasons for this, not all of which are related to the hearing instruments or the hearing loss.We asked parents what message they would like to send to parents whose baby had recently been diagnosed with hearing loss. And this is their message for you:Your baby is the sameprecious little person they were before you found out about their hearing loss.It is fine to be sad.Some days will be hard but most days will be wonderful.Soon you really will be able to say,"It's only hearing loss" and realize that it is nowhere near as bad as you imagined it might be.Over the years you will experience joy,surprise, laughter and pride as you see what your child achieves.Don't be scared - you are not alone.Reach out to other parents in the same position and ask them lots of questions.Have coffee with a deaf mum or dad - they can be a great resource.Take time out to enjoy your family and friends - and ask for help when you need it. Kiss your beautiful baby and hang on for the ride of your life. It is going to be different to what you imagined but it will surprise and delight you over and over again.Hearing aids are vital in developing your baby’s ability to listen and speak. Ideally, your baby should wear hearing aids all the time when they are awake. Unfortunately, that’s not always possible during the early months of life.For practical reasons, your baby might only use the hearing aids for certain times of the day when they are very small. It’s important to increase the use of hearing aids as your baby develops.The aim is for your baby to wear the hearing aids for all their waking hours, as soon as possible.In these very early stages,it may be difficult to tell whether your baby is hearing with the aids. Don’t be discouraged. Young babies can’t do much to show you they are hearing. Find out more about how to tell if your baby is hearing in ‘Signs of hearing in babies.'It’s important to check your baby’s hearing aids daily. Your baby can’t tell or show you much about what they hear, so you can only know if the hearing aids are working by checking them. This is a routine you need to continue until your child is old enough to tell you if something is wrong with the aids.Your audiologist will show you how to check the hearing aids. Most people need to be shown a few times before they feel confident. Your audiologist will be happy to review the procedure with you as often you like.The hearing aid may produce a whistling sound when your baby is lying down or leaning. This is called acoustic feedback and is a common problem for newborns. It happens because the ears are small and soft and your baby spends a lot of time with their ear pressed against a surface, such as when sleeping or feeding.You can reduce feedback by using a lubricant. Your audiologist can recommend a lubricant suitable for hearing aids. Young babies may need new ear moulds every few weeks to reduce the feedback.Try to use the hearing aids as much as you can, in ways that still allow you to enjoy spending time with your baby. It helps if you can make wearing the hearing aids part of your baby’s routine.If you can only use the hearing aids for certain times of the day:A bouncinette can be helpful. Your baby’s head and neck are supported and you can face your baby directly with a clear view of your face. If you use a bouncinette, a netting fabric cover is a good idea because the netting reduces the risk of whistling from the hearing aids.Alternatively, you could sit upright on a chair or the floor with your baby lying in your lap. Place your baby’s head on your knees and legs on your chest. You can get good eye contact and it is a good position for playing ‘Peek-a-boo’ or ‘This little piggy went to market’!Hearing aids are usually removed for sleeping, mainly for comfort. It will not harm your baby to wear the hearing aids while sleeping, although it might be a bit uncomfortable.The bedding behind your baby’s head may cause the hearing aid to whistle. This may be annoying for you. Your baby may or may not hear the whistle, depending on the degree of hearing loss. In any case, the sounds heard will be affected by the feedback.Feeding is a special time with your baby. Most babies are cuddled close while they feed so whistling from one or both hearing aids can be a problem.Cuddling is important, both for you and your baby. You may be able to find a way to cuddle your baby that does not cause the aids to whistle. Otherwise, turn off one or both hearing aids at this time. If you can only leave one hearing aid turned on, this is still helpful.Remember to turn the aids back on after feeding if your baby is still awake.The hearing aids should not get wet so you need to take them out when your baby has a bath.At times, it’s impractical for your baby to wear hearing aids. Your baby may not want to wear them when tired, for example. There are a few ways you can help make it easier for your baby to hear.At about six months of age,babies start gaining more control of their hands and begin to explore the world around them. Just as many babies find it interesting to pull off their shoes and socks, some babies love to pull off their hearing aids. Some babies also put them in their mouths.Replace the hearing aid if your baby pulls it off. Try to stay calm. If your baby keeps pulling the aid off, or if replacing it develops into a struggle, put the hearing aid away for15 minutes and try again later. This will help avoid a situation where your baby gets your attention by pulling the hearing aids off.Here are a few ideas for preventing your baby from pulling the hearing aids off.  Aviator caps:Some parents use little cotton ‘aviator caps’ which come down over the baby’s ears and tie under the chin. Providing the cap is made of thin fabric (like at-shirt) the single layer of cotton over the hearing aid microphones makes very little difference to the sound reaching the hearing aid microphones. Soft baby headbands are an alternative, but be careful not to cover the hearing aid microphone with thick fabric.Huggies: Some parents use ‘Huggies’ which are available with us. A ‘Huggy’ is a clear rubber ring with two bands to hold the hearing aid. The ring is fitted over your baby’s ear to hold the hearing aid behind the ear. Double-sided tape: You can get tape made for use on skin that will hold the hearing aid firmly against your baby’s head. Clips: We can give you a clip with cords that attach to the hearing aids. This stop the hearing aids from being lost and can make it harder for your baby to get the hearing aids into their mouth.Your baby’s aids have (or can be fitted) with a tamper resistant battery compartment so your baby cannot accidentally swallow a battery. Make sure you use this feature while your baby is young.Try to avoid your baby chewing on the ear mould, in case it is accidentally swallowed.Feel free to discuss any questions or concerns you have with our audiologists.They will be happy to help you.Hearing aids are vital in developing your baby’s ability to listen and speak. It takes a while for some babies to get used to their hearing aids, but with encouragement and perseverance they will become a normal part of your baby’s life.The aim is for your baby to wear the hearing aids for all their waking hours,as soon as possible.Signs of hearing become more obvious as your baby get older. At about six months of age, babies usually have some head control and will be learning to sit up. At this age, you might notice your baby’s head turn towards some sounds. Over the next few months your baby will start to show increased interest in a wider range of sounds than when they were younger.The types of sounds your baby can hear with the hearing aids.Your baby can’t tell you if the hearing aids are working so you will need to check them every day. This is a routine you need to continue until your child is old enough to tell you immediately if something is wrong with the aids.We will show you how to do a daily check of the hearing aids. Most people need to be shown a few times before they feel confident. Your audiologist will be happy to review the procedure with you as often as you need.As your baby spends more of the day awake, try to increase use of the hearing aids until they are worn for all waking hours.You may need to spend five minutes playing games with your baby after you first put on the hearing aids. There will be less need for this distraction as your baby becomes familiar with the aids. The hearing aids will become a normal part of life just like clothes,shoes, hats and all the other things that babies get used to.When babies gain more control of their head and neck, the problem of acoustic feedback (whistling)usually lessens. But, your baby’s ears will still be soft and grow quickly, so you may need to continue getting new ear moulds frequently. Using a lubricant can help reduce feedback. Your audiologist will be able to recommend a lubricant that is suitable for use with hearing aids.You will have more opportunities to help your baby learn about speech and other sounds as the hearing aids are worn more often. Here are some tips for helping the development of your baby’s listening skills.Talk and sing: Spend time every day verbally interacting. Position yourself about one metre from your baby’s hearing aids.Describe your actions: As you go about your daily activities, talk to your baby about what you are doing.Exaggerate your voice: Try to over stress the normal variations of pitch as you speak. Many people do this naturally when they talk to babies.Use music: If you are listening to music, let your baby see you sing along. You might like to pick your baby up and dance together every now and then.Play games: Try to play games that involve sound.Pair sounds withactions: Join interesting sounds with fun activities. For example, make aeroplane sounds while you fly your baby around the room or say ‘hop-hop-hop’ as you step your fingers up your baby’s leg and tickle their tummy. And, don’t forget the traditional baby games like ‘peek-a-boo’Copy your baby: Repeat any sound your baby makes. See if you can have a conversation, making sounds to each other in turnUse rewards: When your baby responds to a sound, give a reward such as a smile, clap or cuddle. At this age, babies can learn very quickly how to get your attention.If your baby finds your reaction fun, they are more likely to respond to the sounds againDon’t rely on external stimulation: Noisy toys can be lots of fun, but babies are generally more interested in human voices. Don’t rely on toys, TV or radio to provide lots of stimulation for your baby. Some TV, radio and music is fine, but interaction with you is much more interesting.Reduce background noise: When you spend special time with your baby (talking, singing or playing games), try to reduce background noise so your baby can hear you as clearly as possible. Turn off the TV or radio.Let your baby explore your mouth: Many babies at this age start to put their hands into your mouth as they explore your face. This can be a good chance for your baby to feel your mouth and tongue moving as you speak.Hearing aids are usually removed for sleeping, mainly for comfort. It will not harm your baby to wear them while asleep, but it might be uncomfortable.Bedding behind your baby’s head will probably cause the hearing aids to feed back.This may be annoying for you. Depending on the degree of hearing loss, your baby may or may not hear the whistle, but the sound heard will be affected by the feedback.Feeding is a special time between you and your baby. At this age, many babies sit in high chairs for meals. Feeding your baby is an ideal opportunity to talk about what you’re doing and introduce your baby to important phrases and words. Describe your baby’s food. Ask your baby if they want ‘More?’ and of course, talk to your baby about the food being ‘All gone!’The hearing aids should not get wet. Take them off before bathing your baby.At times, it’s impractical for your baby to wear hearing aids. Your baby may not want to wear them when tired, for example. There are a few ways you can help make it easier for your baby to hear.Amplify your voice: Speak in a raised voice, but don’t shout. Shouting makes your speech less clear. Instead, speak up as though you are talking to someone on the other side of the room.Keep your baby nearby: Your voice will be louder and it will be easier to hear and see you if you are close. Even if your baby cannot hear you, being able to see you will make your baby feel secure.Cuddle your baby: This is a good time to hold and cuddle your baby as you talk, because feedback won’t be a problem. Some people suggest holding your baby snuggled up under your chin or cheek, enabling the vibrations from your voice to be felt.At this age, babies start gaining more control of their hands and begin to explore the world around them. Just as many babies find it interesting to pull off their shoes and socks, some babies love to pull off their hearing aids. Some babies also put them in their mouths.Replace the hearing aid if your baby pulls it off. Try to stay calm. If your baby keeps pulling the aid off, or if replacing it develops into a struggle, put the hearing aid away for15 minutes and try again later. This will help avoid a situation where your baby gets your attention by pulling the hearing aids off.It can be difficult to tell whether hearing aids are working in a young baby with a hearing loss. In the first six months, the signs that your baby can hear are subtle.Asa parent, you no doubt feel concerned about your baby's development. This information will help you recognise your baby's responses to sound.A baby's response to sound is affected by their age, stage of development and degree of hearing loss.Alack of response doesn't necessarily mean your baby cannot hear.Babies with normal hearing don't respond to the softest sounds that they can hear in the first two months of life. At this stage the baby's responses to sound are hard to detect - babies might widen their eyes when they hear a sound, or stiring their sleepDifferent levels of sound arouse various responses in babies, depending on how active they are. Babies react to softer sounds when they are just dozing off to sleep as opposed to when awake and active.Some sounds will be more interesting to your baby than others. In early life, babies are intrigued by voices, so they will respond to voice at softer levels than they would respond to other noises around the home.Babies are also more interested in complex sounds like rattles or music than in simple sounds like beeps or simple whistles. If a sound is repeated too often, young babies lose interest and may stop responding altogether. This is called habituation.Babies with significant hearing impairments may be unfamiliar with many sounds around them. It might take some time after the hearing aid has been fitted to see clear signs of hearing.The vocalisations of babies give clues about what they can hear. Some babies quieten down and concentrate when their hearing aids are first turned on each day; others become noisier as they test their aids. Older children may make a wider variety of sounds when wearing their hearing aids.Although it's challenge trying to tell how much your baby can hear, you can get a lot of information when you know what to look for.1. Talk to us about the ways your baby might respond to sound.Your baby's ability to respond to sound will depend on the degree of the hearing loss and the effectiveness of the hearing aids. Ask us to explain the types of sounds they think your baby might hear.We assess your baby's hearing with a Behavioural Observation Audiometry, which uses a range of different noisemakers. You will be able to observe some of the ways that your baby responds.This guide will help you identify the behaviours that show your baby is hearing sounds.2. Take note of what your baby does at homeDon't try to do your own hearing tests. If your baby is overly active or tired they may not respond to the sounds you expect. This can be disheartening. If you've made the same sound several times your baby might have habituated and won't respond at all. It's better to just keep alert so that you are ready to observe those responses to sound that your baby naturally displays.You will see the best hearing responses when it's quiet and your baby is not fast asleep or upset. You will probably see more obvious responses when your baby is very calm or drifting off to sleep, or when there are sudden loud noises. If the house is noisy it may be more difficult to see responses to certain sounds.It's important to watch whether your baby's response may have been to visual cues as rather than auditory ones. If you clap your hands in front of your baby's face causing a blinking response, you can't really tell whether the blink is due to the loud sound or the motion of your hands. Some babies may also be tuned in to the smell of a parent's perfume or aftershave and use that as a clue to whenMum or Dad is close by.The following questions are a guide to help you with your observations:Also consider keeping a "listening diary" to record your observations.This will show you your baby's progress and can be useful in discussions with your audiologist and your child's early intervention teacher.3. Discuss your observations with us, including any concerns and questions. Your observations are invaluable in helping us make decisions about fine-tuning your baby's hearing aid.