People Make Spaces Quieter

By Kathi Mestayer

I used to think that crowded spaces were noisier. But I was wrong. More people can make a space quieter, especially if it's an echoey, reverberant room. That's right—people make spaces quieter.

I noticed this the other day when I was leaving a large gathering that I attend often. The crowd was much smaller than usual, but the echoes were way worse than usual. I asked a couple of friends, who echoed (really!) my observation. Way noisier than usual.

So I got home and emailed an acoustician, Richard Peppin, of Engineers for Change. My question: "Is it possible that the space was really noisier with fewer people in it?"

His terse, but (as always) helpful, reply: "Yes. Because people absorb sound and hence reduce reflections."

Who knew?

Kathi Mestayer writes articles on a wide variety of aspects of hearing loss: office acoustics, building acoustics, ADHD and hearing loss, hyperacusis and recruitment, nonverbal communication, and language and culture.

ERG 2015 Announcement

By Pallavi Bharadwaj

We are excited to inform you of the opening of the application period for Hearing Health Foundation's 2015 Emerging Research Grants program. 

This program is designed only for the first year applicants, who are dedicated to explore new avenues for hearing and balance science. Please note that the current Hearing Health Foundation awardees, applying for a second year of funding, are no longer eligible. 

We encourage you to review our announcement and Policy on Emerging Research Grants, as several eligibility changes have gone into effect for this funding cycle. If you are eligible to apply for this program, please make note of the deadlines given below. 

For 1st year Applicants:

LOI deadline: October 25, 2014 by 5pm ET

Full Application opens: Early November, 2014

Full Application deadline: December 6, 2014 by 5pm ET
Then please review the instructions for submitting a LOI.

With any questions about this opportunity, please feel free to reach out to us at grants@hearinghealthfoundation.org . 

Thank you for your interest in this program and please do share this information with your interested colleagues as well. 

The Danger From Noise When It Is Actually Music

By Yishane Lee

Les Paul Ambassador

John Colianni

Noise-induced hearing loss affects anyone exposed to very loud or chronic noise. It doesn’t matter if the “noise” is actually music. It has been estimated that up to half of classical orchestral musicians have hearing loss because of their work in music, practicing or performing up to eight hours a day. Sound levels onstage, no matter the music genre, can reach up to 110 decibels (dB), although it is not usually continuous. That is equivalent to a jackhammer—even if there’s a melody behind it.

Researchers at the Nofer Institute of Occupational Medicine in Poland measured the exposure for classical musicians as 81 to 90 dBA (A-weighted decibels, a unit of measure for how humans perceive sound) for 20 to 45 hours a week. In their study published in the International Journal of Occupational Safety and Ergonomics, they estimated that this exposure over the course of a career increases the risk of a hearing loss of 35 dB by 26 percent. At the greatest risk for hearing loss are those in the brass section—horn, trumpet, tuba—as well as those playing percussion, the study found.

Prolonged exposure at 85 dB (the sound of heavy traffic) will permanently damage the delicate hair cells of the inner ear, leading to hearing loss. Tinnitus, or ringing in the ears, is another potential problem. Roughly 90 percent of tinnitus cases occur with an underlying hearing loss.

Not surprisingly, rock and jazz musicians are not immune. Indeed, there are a number of well-known rock and pop musicians who have publicly discussed their hearing loss and/or tinnitus, among them Sting, Eric Clapton, Neil Young, Phil Collins, and Will.i.am.

But hearing loss due to noise (or music) is completely preventable. A related study by the Polish scientists determined that brass players benefitted the most from the use of custom-molded, silicone earplugs with acoustic filters that reduced sound levels. Woodwind, percussion, and string players also benefited.

In 2013, the Les Paul Foundation and HHF teamed up to launch the Les Paul Ambassadors program. Guitar great Les Paul was determined to find a cure for hearing loss and tinnitus, and through his foundation’s support of HHF’s Hearing Restoration Project, an international research consortium of top hearing scientists, we have the opportunity to find a cure. Learn about the program and the first Ambassador, Lou Pallo, as well as our other Ambassadors saxophonist Chris Potter and jazz pianist John Colianni.

Learn more about NIHL and its risk factors, treatment, and prevention in our new Summer issue of Hearing Health magazine.

Emerging Research Grants for 2014 Announced

By Tara Guastella

HHF is proud to announce that 10 leading hearing scientists have been an awarded an Emerging Research Grant. It was an incredibly competitive funding cycle and it is a true honor for these investigators to have risen to the top and received this award.

Six grantees are first-year grant recipients and are studying areas such as noise-induced hearing loss, tinnitus, ototoxicity (hearing loss caused by certain drugs and medications), age-related hearing loss, and hearing aids.

Four previous grantees are receiving a second year of funding for their work. This group is researching such areas as central auditory processing disorder (CAPD), auditory physiology, cochlear implants, genetic hearing loss, and Usher syndrome.

One first-year grant recipient, whose work is funded by the continuing support of the General Grand Chapter Royal Arch Masons International, is aimed at developing better ways to assess auditory processing disorders. Here is an excerpt on his work:

Srikanta Mishra, Ph.D.

New Mexico State University

Medial Efferent Mechanisms in Auditory Processing Disorders

Many individuals experience listening difficulty in background noise despite clinically normal hearing and no obvious auditory pathology. This condition has often received a clinical label called auditory processing disorder (APD). However, the mechanisms and pathophysiology of APD are poorly understood. One mechanism thought to aid in listening-in-noise is the medial olivocochlear (MOC) inhibition— a part of the descending auditory system. The purpose of this translational project is to evaluate whether the functioning of the MOC system is altered in individuals with APD. The benefits of measuring MOC inhibition in individuals with APD are twofold: 1) it could be useful to better define APD and identify its potential mechanisms, and 2) it may elucidate the functional significance of MOC efferents in listening in complex environments. The potential role of the MOC system in APD pathophysiology, should it be confirmed, would be of significant clinical interest because current APD clinical test batteries lack mechanism-based physiologic tools.

Read more about the research all of the 2014 grant recipients are conducting.

A Musician Tunes Into Positive Thoughts

By Tara Guastella

Lynn Crisci and her boyfriend, Doug Julian, attended the Boston Marathon on April 15, 2013, sitting on the edge of a sidewalk café, about 30 feet from the first bombing that occurred that fateful day.

When the explosions occurred, Lynn watched the smoke, debris, and shrapnel travel upward. But what she later learned is that pressure cooker bombs are designed to explode horizontally, rather than vertically. This fact appears to be part of the reason why Lynn incurred a frontal lobe brain injury, hearing loss in her right ear (which was facing the explosion), and constant tinnitus. Other people she knew who were closer to the explosion—but standing up instead of sitting down—did not suffer the same type of injuries.

Though Lynn had her hearing tested after the explosion, and has documented hearing loss, the doctors did not recommend a hearing aid. This makes it very challenging for Lynn in situations where background noise is present, such as in a busy restaurant or bar.  The hearing loss plus her brain injury makes it often impossible for Lynn to hear, and then mentally process, what someone in a noisy setting is saying to her. Lynn feels her hearing problems put a strain on her relationships, embarrassing herself and others and drawing negative attention.

Tinnitus impacts Lynn to the point where she has much difficulty falling asleep and usually gets three hours of sleep nightly. Her tinnitus is further aggravated by stress and loud noises, which makes the tinnitus worse.

Lynn also suffers from severe post-traumatic stress disorder (PTSD), putting another strain on her long-term relationship with Doug. “I feel that he often ends up taking care of me, more like a dependent than an equal partner,” says Lynn. “I feel like a burden to him which leaves us both frustrated, stressed, and unable to focus on my strengths.”

One positive is that Lynn knows she has survived a traumatic event before. A professional musician who started performing at age 5, Lynn had a workplace accident in 2006 that left her in a wheelchair for several years and needing a cane to walk for several years after that.

Not only is Lynn walking today, but she also completed the 2014 Boston Marathon. “I did it to take back my neighborhood,” she says. Living blocks from the marathon finish line, she was sick and tired of feeling afraid every time she went outside. With the goal of facing her fears in mind, she trained for five months—often daily and often in pain—in order to finish the Boston Marathon. She had never been a runner before, much less race a marathon.

Lynn’s hearing loss affects her everyday life as well as her career. Music does not sound the same to her anymore. She’s far from giving up, however. “You don’t know what you can do until you want it badly enough,” she says. Lynn is hopeful that our Hearing Restoration Project (HRP) will restore her hearing one day so she can reclaim her artistic calling.

"Hearing Loss Is a Non-Healing Injury"

By Tara Guastella

Shannon Silvestri and her two teenage children attended the 2013 Boston Marathon to cheer on dad Kevin. It was the third time they’d be watching him run the marathon.

The family was invited to watch the race by Ashworth Awards, the company that creates the marathon medals and which is based in the same town where the family lives. They were at the Lenox Hotel, located at Exeter and Boylston streets in Boston. After Kevin ran by (finishing what would be his personal best race time), and Shannon received an automated text message that he had finished the race, they gathered their things, snapped a few photos, and began exiting out a side door of the Lenox on Exeter Street. Shannon was walking between her son in front of her, her daughter with a friend behind her, and two of her husband’s friends behind them.

As they were passing through the barricades set up to keep the thousands of spectators organized, the first explosion occurred. It was the first of two homemade pressure cooker bombs that exploded that day. The blast occurred to the left side of Shannon and her family, but the sound bounced off the building and hit Shannon in her right ear. “I could feel the air and the sound waves hit me,” she says. “I could really feel it.”

She immediately covered her ears, fell to the ground, and then looked front and back to check on her children. "Everything seemed like it was in slow motion," she says. Her daughter immediately let out a big scream, knowing her father was out there. Her son ran and Shannon finally found him a couple of streets away. Shannon says, "This was his fight-or-flight response."

Seconds later, the second blast occurred and again it hit Shannon in her right ear as she was turned to comfort her daughter. “It was such a strong feeling of pressure, or a blockage, in both my ears. It felt like I really needed to pop them,” she says. “All I could hear was a muffled chaotic mess and when I looked back all I saw was smoke, debris, and metal barricades flying through the air as people were trying to escape the horror that just occurred.”

Shannon thought terrorists were attacking the city by plane. Her cousin’s husband was killed in the 9/11 attacks so this was the first thing that came to mind. Needing to find Kevin, they headed toward the family meeting area even though law enforcement was trying to keep people from entering this area. Shannon remembers thinking, “I don’t care how many pieces he is in, I am taking him home.” She felt selfish, hurt, empty, alone, and every other emotion she could think of. She didn’t care what scenario she was bringing her kids into, she had to bring the four of them home together.

What the family didn’t realize at the time was that they were closer to the blasts than Kevin was. At the time of the explosions, Kevin was farther down the road, past the finish line, picking up his finisher medal.

Since cell phone service wasn’t working properly, one of Kevin’s friends who was with the family ran ahead to find him. "He was like my superman, whipping off his jacket and saying, ‘I will find him,’” Shannon says. Suddenly, she saw Kevin emerge with the friend. Kevin was uninjured.

Shannon hugged him and remembers saying, “These are the times I appreciate your stubbornness.” Kevin had earlier said he wanted to beat his first marathon time.

Next the family attempted to get out of Boston but everything was on lockdown, including Shannon’s car. They decided to walk the nearly three miles to the Boston Athletic Club. Her son was very upset that Shannon had scraped her knee and wanted to get her something for it. The family stayed there for almost four hours. It was very emotional with people hugging, crying, and reuniting with family and friends.

Shannon went into a restroom because she felt like she needed a good cry but didn’t want to do so in front of her kids. Inside, she met a young teenage girl who worked at the club. The girl couldn’t get in touch with her mother and was frightened by the stories she was hearing. “I told her that I’m a mother and asked if she wanted a hug,” Shannon says. The girl hugged her tightly and the two cried together for a few minutes and then felt better.

Later that week after the bombings, Shannon’s left ear “popped” as did her son’s ears. As for Shannon's right ear, that never popped. Luckily, her daughter’s ears were unaffected.

To help survivors cope with the events of last year’s bombing, Shannon started a website called Boston Strong: Strength, Courage, & Healing and she began making Boston Strong pins/charms. All of the proceeds go to help survivors.

Over a year later, Shannon’s hearing in her right ear has worsened, as has her tinnitus, and her left ear also has a degree of hearing loss. Certain noises and sensations cause pain, a condition known as hyperacusis, so she decided not to get hearing aids. Her audiologist told her that at some point she may lose most if not all hearing in her right ear.

Recently, Shannon accepted a position at the Massachusetts Office of Victim Assistance, which has been instrumental in helping marathon survivors. She will be leading a peer-to-peer support network for people who sustained hearing loss as a result of the blasts. Shannon says she wants to help others cope. “People don’t recognize hearing loss as something that is life-changing. It’s a non-healing injury,” she says.

How My Sudden Hearing Loss Paved the Way to a New Life's Mission

By Monique Hammond, Guest Blogger

Like everyone else does, I took my clean, crisp hearing for granted. But over a four-hour period in September 2005, I lost my hearing in my left ear. That same day, an intense vertigo attack made the world spin out of control. I became violently ill and spent the next two days in the hospital. My whole inner ear and nerves had come under attack.

The final verdict was that I had suffered a sudden sensorineural hearing loss (SSHL), which is considered a medical emergency. The doctors suspected the cause to be a viral infection complicated by an excessively loud noise exposure from a church fundraiser the day before. I largely credit the treatment of oral steroids and antiviral medication that I received at the very start for being able to regain limited hearing.

The “ear event,” as I like to call it, has left me with a severe one-sided hearing loss, never-ending, high-pitched tinnitus, and annoying sound sensitivities, which make the adjustment of hearing aids quite tricky. Although hearing aids have helped many people beyond their wildest dreams, they have not been tremendously effective for me. Strangely enough, I feel that my hearing aid helps me more with stability—as I am still plagued by pesky balance issues—than with hearing acuity.  

Going back to work only reinforced the realization that my job was eroding right from under me: I simply could not function safely and effectively anymore in the noise-confused environment of the hospital pharmacy that was my place of work. I had enjoyed my work and coworkers and I also appreciated my paycheck. Losing all of that has been emotionally a most difficult adjustment.

I am quite open about my challenges as I have found that to be the best policy for me. I am lucky because my friends and family have been very supportive. Over time, they have come to appreciate the varied challenges that hearing loss bestows on those affected. Yes, I must remind them now and then not to talk to me through walls. But sometimes people forget.  

Of all the hearing-related issues that I have come across, I have chosen noise-induced hearing loss (NIHL) as the focus for any of my training, education, and advocacy efforts. Why? Because this is a preventable disability that is on a steep rise. The damage is irreversible but completely avoidable. As yet there is no cure for any kind of hearing loss, and organized public education on this timely topic as well as on hearing loss in general is greatly lacking. (Learn about research toward a cure by HHF’s Hearing Restoration Project.)

All my life I have been a big believer in prevention and education and from that aspect nothing has changed. This why I wrote my book, “What Did You Say?,” and why I bring my new life mission—to help people hear better longer—into a gaping public education void.

These days I am kept busy working with support groups, leading training sessions, doing public speaking, and writing articles and a blog. Although I do use Facebook connected to my website, my favorite social medium is Twitter. It is an ideal tool to keep up with news and research and to communicate information about a myriad of hearing loss topics to my followers.

Yes, the journey into the world of hearing loss has been a long and often thorny road paved with fears and tears but also with plenty of revelations and amazement. Life is different now, but as Senator Hubert H. Humphrey once said: “It is not what they take away from you that counts. It's what you do with what you have left.”

Monique Hammond is a registered pharmacist and the author of “What Did You Say? An Unexpected Journey Into the World of Hearing Loss.” Learn more at moniquehammond.com.

Protect Your Ears This July 4!

By Tara Guastella

The Fourth of July is a great time for barbecues, trips to the beach, and spending time with friends and family. But fireworks and firecrackers, ubiquitous to many Independence Day celebrations, not only are a potential fire hazard, they also can do permanent damage to one's ears.

These beautiful spectacles measure between 140 and 165 decibels. This means that even one minute of exposure to them can cause immediate, permanent hearing loss.  

When exposed to sounds that are too loud or loud sounds that last a long time, such as a fireworks display, delicate cells in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensory hair cells in the inner ear convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back.

While you're enjoying summertime get-togethers, remember to pack ear protection, such as earplugs or earmuffs, and don't forget a pair for the kids! Also remember to Walk, Block, and Turn:

Walk away from loud sounds.

Block loud sounds with ear protection.

Turn the volume down (when you can control it).

Learn more about how loud is too loud today.

We wish you and your family a happy, healthy, and safe Fourth of July holiday!

Stay tuned for more about NIHL—its symptoms, prevention, treatment, and related conditions such as tinnitus—in the upcoming Summer issue of Hearing Health magazine. Get a free subscription by signing up here. We also wish to salute and thank our military service members, who are disproportionately affected by hearing loss and tinnitus as a result of their service, on this American holiday.

The HRP's Andy Groves, Ph.D. and HHF Board member Nancy M. Williams to Speak at HLAA Convention

By Tara Guastella

If you are headed to Austin for the Annual Hearing Loss Association of America (HLAA) Convention at the end of June, make sure to stop by Andy Groves, Ph.D.’s workshop on Friday, June 27, at 1:30pm.

Andy Groves, Ph.D.

Baylor College of Medicine

Dr. Groves will be giving a presentation on the Hearing Restoration Project (HRP) and how the power of collaboration is expediting the road to a cure for hearing loss and tinnitus. Chickens, fish, and most non-mammals have a remarkable ability to naturally restore damaged inner ear hair cells (damage or death of these cells is what causes hearing loss). The HRP is working to identify how we can translate this process, known as hair cell regeneration, to humans to develop a biologic cure for hearing loss and tinnitus.

The HRP scientists are working collaboratively sharing ideas, data, and resources to shorten the timeline to a cure. During our last monthly conference call with the consortium, an HRP scientist was presenting initial data on a series of experiments he is conducting. After feedback from other consortium members, he will now approach the experiment in a more beneficial way with greater impact to the research process. This experience highlighted the power of many minds over one.

Hear more about the HRP and the exciting research advancements at Dr. Groves’s workshop on Friday. Materials and information on the HRP will be available for attendees so don’t forget to pick up more information while you’re there.

HHF Board member, Nancy M. Williams, pianist and hearing loss advocate, will also be presenting at the HLAA Convention. She will share her story of reclaiming the piano to help participants tap into their passions.

When Williams reclaimed her passion for the piano after a 25-year hiatus, she came to terms with her hearing loss—and pursuing her passion radiated out to other aspects of her life. Ms. Williams will share her story in the “Finding Your Calling... Despite a Hearing Loss" workshop on Saturday, June 28 at 8:45am.

Be sure to stop by both exciting sessions!

Boston Bombings Leave Doctors Using Wartime Surgeries to Fix Social Work Student's Ruptured Ear Cavity

By Tara Guastella

On April 15, 2013, Lauren Vulcano, then a 24-year-old school counseling graduate student, and her boyfriend Mark Snickenberger, also then 24, were watching Mark’s brother run in the 2013 Boston Marathon. The events that unfolded that day changed the way Lauren will hear forever.

The day was as pleasant as any until the first backpack containing a homemade pressure cooker bomb exploded. Lauren was standing just four feet away. “I first felt a very calming feeling, almost euphoric,” she says. “I could really feel the heat and it felt nice, like being on beach—but I was completely unaware of what was happening. It felt like five minutes but in reality it was only a matter of seconds.”

Mark panicked and grabbed Lauren to try and move her away from the scene. She stood still with both of her hands covering her ears standing perfectly straight—like a “telephone pole,” she says. Lauren tried to plug her ears as hard as she could since the extreme loudness and subsequent ringing in her ears (tinnitus) physically hurt.

Suddenly Lauren’s right ear started to bleed just as the second bomb exploded; she learned later that her eardrum had ruptured. “Mark put his arm around me and guided or dragged me down the street, pressing my injured right ear against his left shoulder to apply pressure,” Lauren says.  “Finally I snapped out of the state of shock and began to understand what was going on.” Once Lauren and Mark made it to a safe location in an AT&T store, Lauren noticed the eight-inch gash on the side of Mark’s leg with blood pouring out of it.

Lauren and Mark are circled in the above photo as they escaped from the Boston Marathon bombing.

Lauren began taking off her coat in an attempt to take care of her boyfriend’s leg. She then realized her own shoulder was bleeding. “Since we didn’t know what was in the air, I was instructed to put my coat back on,” says Lauren. “I felt so helpless because I wanted to do something to help Mark since he saved my life by dragging me out of the bomb scene.”

As she made attempts to scream and call for help, Lauren realized she couldn’t hear herself screaming, and she thought no one else could hear her screaming either. “In the AT&T store, someone brought a wheelchair in for me and then they ran Mark into the medical tent,” Lauren says.

Lauren and Mark are circled in the above photo as they escaped from the Boston Marathon bombing.

While they were tending to Mark’s leg, Lauren left to find Mark’s mom. “After a quick discussion of who should go with him to the hospital, Mark’s mom said ‘no, you go. He needs you.’ I grabbed his stretcher and helped the first responders run it to an ambulance. When no one instructed us which ambulance to go to, I just picked one and started pulling his stretcher into its back entrance.”

Lauren was so worried about Mark’s leg that it wasn’t until they arrived at the hospital that she realized she also had a black eye and her forehead was bleeding. Once at the hospital, Lauren says she finally felt safe and laid down beside Mark to let the doctors care for them both.

“I was examined by the on-call ear surgeon who had an impeccable bedside manner, given the situation,” Lauren says. “I then learned that a BB from the bomb had gone straight into my ear, hit the cochlea, and bounced out, rupturing my eardrum and shattering the malleus bone [a small middle ear bone].”

Lauren was later released from the hospital and arrived home around 9 or 10pm that evening; Mark had to stay overnight. A piece of nylon from the backpack that contained the bomb had melted into Lauren’s hair and a portion of skin on the right side of her head was burned so badly from the explosive heat that her hair fell out. “Not wanting to be alone that night I made my mom give me a sponge bath and then stayed on the phone with Mark for the remainder of the night.”

The following day Lauren went to visit the ear surgeon at the surgeon’s office. Since the loud blast Lauren experienced is considered a military injury, not a civilian injury, her doctors continually consulted with military physicians.

Lauren’s doctor used an updated version of an old wartime surgery technique. In the past working out on the field, wartime doctors would place a piece of cigarette paper between the pieces of the eardrum in hopes some of the skin cells would "crawl" across the paper to make a skin graft. Today this surgery is more complex with better material used, but it didn’t work for Lauren’s ear. “For several months, my ear was just still too damaged for the skin graft to take,” Lauren says. “I had a real surgery in June and when that didn’t work, my doctor referred me to Massachusetts Eye and Ear Infirmary.”

Lauren had another surgery in August and when that didn't work, they tried a number of those "quick fixes" again. In each of these surgeries another piece of Lauren’s ear injury puzzle is revealed. “My next surgery will be where I receive a prosthetic malleus. It's frustrating that after a year of the best medical care, my ear hasn't gotten much better. It's just too damaged from the blast,” she says.

Even after undergoing three surgeries and still not being able to hear out of her right ear, Lauren graduated on time (taking extra classes) from her master’s program earning a dual license in school guidance counseling as well as school social work/adjustment counseling and will be a school guidance counselor this fall.

“As I was sitting in classes learning about things like post-traumatic stress disorder and depression, I began to become very aware of my own symptoms,” Lauren says. “I knew how to identify the signs and I knew what these conditions looked like.”

Living through the blasts, though taxing on health and personal life, has greatly benefited her career, she says. “This past year I had a full-time internship at an elementary school. Feeling things firsthand really helped me to become aware of children’s symptoms much more accurately since I knew exactly what to look for,” she says.

Another aspect that helped Lauren overcome the experience of the explosions and her hearing loss is being able to talk about it. “I am naturally a ‘chatty Cathy,’ so when I went back to classes after the bombing I didn’t want people to ignore the elephant in the room—that I was in a bombing. I wanted to lay it all out there and give them an opportunity to ask me questions so it was all out in the open,” she says. “So I asked my professors if I could give a presentation of how I escaped after the bombing and talk about it with classmates.” All of Lauren’s professors were incredibly understanding, she says.

As she first began sharing her experience, Lauren would sob through the entire narration of the day’s events. Now after being completely open about it for over a year, Lauren can recount that day without a tear in her eye. Lauren, Mark, and Mark’s brother ran the 2014 Boston Marathon with other marathon blast survivors, including the Campbell family, Dave Fortier, Lynn Crisci, Shannon Silvestri, and many others.