HEARING LOSS: DON’T SUFFER IN SILENCE
A patient of mine brought her 75-year-old father to see me. He’d become increasingly withdrawn and seemed depressed.
He seldom spoke and often seemed to ignore people. His daughter thought he might have Alzheimer’s disease. She questioned whether he should still be living on his own and wanted my opinion about hiring someone to care for him at home or placing him in a nursing home.
He did seem listless and a bit peculiar. He would answer some of my questions and then not respond at all to others. I soon realized that he was hard-of-hearing. He apparently tried to mask the problem by ignoring what he couldn’t hear.
He said he’d realized his hearing was poor but had been ashamed to admit it, fearing that people might treat him like “an old man.” Besides, he didn’t want a hearing aid. He recalled friends saying that it made things worse by exaggerating noises and producing static.
After a long discussion, I convinced him to try a hearing aid. An otolaryngologist (ear, nose, and throat doctor) ruled out any reversible hearing disorder, and an audiologist (nonmedical hearing professional) fitted him with an aid. Several weeks later, his daughter told me he’d “rejoined the human race.”
A SILENT EPIDEMIC
Such stories are all too familiar. Close to 30 million Americans —about one in three by age 65—have at least a mild hearing impairment. But people with hearing loss often fail to seek help. Some think that being unable to hear is just another unavoidable burden of aging, or that hearing aids might only compound the problem. Still others are deterred by the cost of the aids, which range from several hundred dollars to $2,500 or more. Only some health insurance plans pay for hearing aids; Medicare doesn’t.
Because hearing loss develops gradually, a few people may not notice even a significant impairment. They may attribute their problem to people’s mumbling, or dismiss family members’ complaints about excessive radio or TV volume as just another form of nagging.
People who can’t hear well tend to become isolated. Frustrated by their inability to follow conversations, they may stop trying and simply withdraw. Or they may make puzzling remarks that are unrelated to the conversation. It’s easy to mistake such behavior for signs of depression or mental decline.
A DEAFENING DIN
Hearing loss commonly develops as people get older, in part because of the physical deterioration that accompanies aging. Very loud sounds, such as an explosion, immediately damage the delicate sensory cells of the inner ear. Chronic exposure to any sound that makes conversation difficult, such as the 85 decibels of a food processor, may eventually cause permanent hearing loss.
But noise isn’t a threat only to older people. Loud music may be gradually deafening many younger people as well. A numbing 115 decibels—about eight times as loud as the food processor—can pour from the earpieces of a personal stereo. (On the decibel scale, loudness doubles approximately every 10 units.) And rock concerts can be even louder than the headphones—loud enough to do permanent damage in less than half an hour. Indeed, one study found that nearly a third of college freshmen already had detectable signs of hearing loss. Here are some ways to minimize noise damage:
• Whenever possible, avoid situations in which you have to raise your voice to carry on a conversation.
• If someone else can hear the music coming from the headset of your personal stereo, it’s too loud.
• Carry earplugs that you can use when you’re exposed to blaring music, roaring motors, or other loud sounds. Inexpensive, compressible foam plugs that expand to fit the ear canal work fairly well. More expensive plastic plugs that an audiologist molds to fit your ear work better. If you’re going to be around particularly loud noise, such as the whine of a chain saw, consider wearing an earmuff-style protector.
DETECTION AND TREATMENT
When hearing deteriorates because of aging or noise, the first sensory cells to go are those that pick up high-frequency sounds. Voices may sound as loud as ever, but certain words become harder to pick up. Since some consonants have a higher frequency than vowels, certain words, such as “shin” and “thin,” become difficult to distinguish. Background noise, such as the voices and rattling silverware in a restaurant, can make it particularly difficult to catch what someone is saying. Another early sign that may accompany hearing loss is ringing in the ears.
If you suspect hearing loss, don’t just blame it on getting older. See your physician to rule out correctable causes. Earwax, for example, commonly builds up in the ear canal and can significantly reduce hearing. Over-the-counter kits for dissolving earwax may be worth trying, although there’s a small chance that the loosened wax will settle deeper in the ear canal. Don’t use cotton-tipped applicators, which can tear the ear canal or injure the eardrum. Any hardened wax should be removed by a doctor.
Hearing problems can also be caused by aspirin, nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin-IB), the heart drug quinidine (Cardioquin, Quinaglute), and other common medications. Reducing the dosage or switching to equivalent drugs can help. Some treatable conditions that affect hearing include circulatory disorders, inner-ear infection, hypothyroidism, otosclerosis (immobilization of the tiny bones that transmit sound vibrations), Paget’s disease of the bones, and rheumatoid arthritis.
If there’s no correctable cause and the problem affects your daily life—making you strain to catch what people are saying around you, over the phone, or at the movies, for example— a hearing aid can help. While today’s devices still have drawbacks, they’re a big improvement over the clunky, noisy contraptions that people used to wear.
Health handbook introducing you to read the article: EAR PROBLEMS: RINGING EARS
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