The Link Between Your Kidneys and Your Hearing

By Judy Huch, AuD and Laura Friedman

March is National Kidney Month and today, March 12th, is World Kidney Day. Why is this important? For years we have been aware of rare syndromes involving renal disorder and hearing loss, such as Alport, MYHIIA, Muckle-Wells, Brescheck, and Bartter syndromes.1 But in October 2010, a study done in Australia showed a link between chronic kidney disease (CKD) and hearing loss, which was published in the American Journal of Kidney Diseases.

This study examined the “medical records of 2,564 people aged 50 and over, 513 of whom had moderate chronic kidney disease. Some 54.4% of all the patients with chronic kidney disease had some degree of hearing loss, as compared to only 28.3% of those who had no kidney problems.” Even more interesting, 30% of the CKD patients had a severe hearing loss compared to just 10% in those patients without CKD.

So what is the correlation between the CKD and hearing loss? According to researchers, "The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear." Also, some treatments for kidney ailments are ototoxic, meaning they cause hearing loss. 

In the U.S., there are 31 million adults living with kidney disease, 7.5 million of whom have moderate forms of CKD.  Based on the recent findings it is important that these patients be aware that their hearing is also at risk. If you have patients or know anyone with chronic kidney disorder, please urge them to have their hearing tested annually to monitor any changes to their hearing status.

______

1Toriello, H. V., Reardon, W., & Gorlin, R. J. (2004). Hereditary hearing loss and its syndromes. (Second ed., pp. 267-289). New York, NY: Oxford University Press.

A portion of this post originally written by Judy Huch, AuD, Editor of Hearing Health @ Hearing Health & Technology Matters.Other content was contributed by Healthy Hearing, The American Speech-Language-Hearing Association, and Oregon's Deaf and Hard of Hearing Services.

An Ice Storm or a Nice Storm?

By Kathi Mestayer

When we get fuzzy speech data to work with, such as in music lyrics, noisy settings or, if you have a hearing loss, everywhere, our brains can come up with some pretty silly interpretations, like “I led the pigeons to the Flag…” instead of “I pledge allegiance to the Flag …”

But even when we hear correctly, that same brain can play it back to us more than one way, with more than one meaning.  Kind of like an optical illusion…but with sound.

A string of words that has multiple interpretations is called an oronym.  Like “I scream, you scream, we all scream for ice cream.” You can interpret it either way, depending on the context, the way it is said, or the phase of the moon.  

Why?

In his book, “The Language Instinct,” the Harvard psychologist and linguist Steven Pinker tells us: “In the speech sound wave, one word runs into the next seamlessly; there are no little silences between spoken words the way there are white spaces between written words. We simply hallucinate word boundaries when we reach the edge of a stretch of sound that matches some entry in our mental dictionary.”

So, if our mental dictionary contains more than one match for what we hear, well, we can hear it both ways. In fact, the sound input doesn’t even have to be speech for our brains to have a crack at it. Pinker explains: “The brain can hear speech content in sounds that have only the remotest resemblance to speech.”

So, we will superimpose meaning onto just about anything, and if it doesn’t make sense, we just keep trying until something fits. Kind of like when my brain heard baroque music coming from the vacuum cleaner, or the countless phrases I swear my parrot says (everything from “ashram” to “wiki” with “kabuki” and “Nietzsche” and many more in between). 

While our brains are busy riffing on what we hear, programmers and engineers are working hard trying to create devices that can interpret speech, even passably, well. One application is online captioning, or what I call “robo-captions.”

The results are not particularly impressive so far, but our brains are a tough act to follow. According to Pinker, “No human-made system can match a human in decoding speech.” That fact was brought home to me when my friend complained about the speech-activated calling system in her car. “It can only interpret the numbers if I read them without any pauses. If I pause, for just a second, the computer inserts the number eight,” she says.  

Online captions created by speech-interpretation software are particularly bad at it (the real-time captions on TV are much better). You can go here to get a quick chuckle.

Staff writer Kathi Mestayer serves on advisory boards for the Virginia Department for the Deaf and Hard of Hearing and the Greater Richmond, Virginia, chapter of the Hearing Loss Association of America. This is adapted from her reader-sponsored work, “Be Hear Now.”

Make Listening Safe

By Sloan Blanton

Our ears are one of our most precious commodities. With our ears we are able to communicate with our peers, enjoy the beauty of music, tune into the natural world around us and become aware of safety hazards, such as sirens. Some people are born without the ability to hear, and for thousands of years those individuals lived without any legitimate hearing solutions. In the past 150 years, numerous technological advancements have emerged, providing hearing assistance through the use of hearing aids, assistive listening devices, cochlear implants, and more.

However, today's increasingly industrialized society poses a new risk. A growing number of people are prone to noise-induced hearing loss. Our smartphones and personal audio devices increase our vulnerability, especially when we are tuned in for extended periods of time. Concerts, nightclubs, and sporting events make us prone to hearing loss as well.

For all of these reasons and more, the First International Conference on Prevention and Rehabilitation of Hearing Impairment established the annual International Ear Care Day in 2007. The event is held on March 3 each year to build advocacy and promote hearing care in countries all around the world. This year's theme is: "Make Listening Safe."

The World Health Organization (WHO) works closely with this event, releasing an annual assessment of each country's status in providing quality ear care services. This year, the WHO found startling numbers to be true about the state of hearing loss in the world; over 1.1 billion young adults ages 12 to 35 are at risk for "recreational hearing loss." In this age group, 43 million people currently deal with the unfortunate effects of hearing loss, whether it is noise-induced or through birth defects or illnesses. Recreational hearing loss leads to many harmful effects. Physical and mental health can be affected, as well as employment and education opportunities. Hearing loss may also lead to attention-seeking behaviors and learning disabilities.

“As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss,” says Dr. Etienne Krug, the director of the WHO’s Department for Management of Noncommunicable Diseases, Disability, Violence, and Injury Prevention. “They should be aware that once you lose your hearing, it won’t come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk.”

Both intensity and duration affect safe listening levels. The safe level at 85 decibels (dB) is eight hours of continual exposure. The number drops drastically at 100 dB to just 15 minutes. Exposure to these loud sounds usually leads to temporary hearing loss and a ringing sensation in the ear (tinnitus). When the exposure is particularly loud, regular, or prolonged, it can lead to permanent hearing loss and a lack of speech comprehension, and is damaging the ear's sensory cells. High-frequency sounds are typically the first to be impacted.

To reduce the risk of noise-induced hearing loss, set the volume on your personal audio device to no greater than 60 percent of the maximum volume. Wear earplugs in bars, at sporting events, and in other loud places. Even using headphones allows sound to be customized for individual listeners. Take short breaks while in loud environments to reduce the harmful effects of noise exposure, such as avoiding loudspeakers.

By having one’s ears checked regularly, individuals are able to monitor the onset of hearing loss before it becomes a serious concern. There are also many smartphone apps that provide useful information regarding volume levels to inform users of whether they are exposing their precious ears to risky sound levels.

Hearing Health Foundation is a proud supporter and partner of International Ear Care Day. It is worth marking on your calendar in an effort to curb the trend of noise-induced hearing loss while encouraging mankind to develop lasting solutions to lifelong problems.

Source: World Health Organization

Hearing Restoration Project (HRP) Special Research Update

By Peter G. Barr-Gillespie, PhD

We always seek ways to deepen the research collaboration between the consortium members. Since its creation more than three years ago, the HRP consortium has gathered twice each year for scientific meetings; these interactions have proven to produce meaningful research outcomes. The following is a recent example:

At the meeting held in Seattle last fall, 15 researchers convened to compare and discuss data from the past year, as well as to plan for the coming year’s projects. During the discussions, five of the investigators were surprised to find that they independently had the same observation, one that was so surprising that they each initially dismissed it as an experimental artifact. They had each separately found this result: in an adult mouse cochlea that had previously lost its hair cells due to damage from sound or drugs, weeks later, a few cells remaining in the cochlea began to display molecular markers related to hair cells.

These results may suggest that the supporting cells in the cochlea are more responsive to damage than we thought, and that they were trying to convert into new hair cells. The five different groups had the same observation using very different methods added considerable weight to the findings, and emphasize the value of the collaborative, data-sharing approach to science utilized by the HRP.

These observations were talked about among the 15 HRP investigators, and a new project was born to further investigate what were provisionally labeled “X-cells.” Given the flexibility of the HRP’s funding process, we were able to fast-track the proposal. The investigators wrote the proposal in a few weeks and vetted it with the rest of their HRP colleagues; the proposal was then evaluated and approved by the Scientific Advisory Board of the HRP and the project is now moving forward.

We hope to see exciting results from this project, which should establish whether these “X-cells” are real. If so, the HRP will determine how to push these cells further along their molecular differentiation pathway to become full-fledged hair cells, which might restore hearing in damaged ears. 

HHF understands the value of the consortium and has enabled the group to meet regularly for these important discussions. When the consortium members agree that an area of research deserves further exploration, a proposal is written and put forth for review and approval. Once approved, the fact that HHF can release the funds quickly helps to accelerate the pace of research.  

This helps us get closer to our goal of a cure!

Peter G. Barr-Gillespie, PhD

Director, Hearing Restoration Project

Turning Tables for Hearing Health

By Chill Kechil

Chill Kechil is our latest Les Paul Ambassador, helping to educate musicians and others about the risks of noise-induced hearing loss and tinnitus. Here, the New Jersey-based DJ and composer describes how he has managed his hearing loss while building a career in the music industry.

I found out in high school through hearing tests that I had some high frequency hearing loss. This caused me to be very aware of protection at a relatively early age. I fortunately did not go to a lot of concerts and wore earplugs way before they became commonly used. 

As I began DJing and producing music, I became aware of many technology tools that help both protect and aid me in producing music. The most common technology app is the dB (Decibel) Meter that I have on my iPhone. I also had custom earplugs made that I use when the sound in a venue is loud. When DJing, I use headphones that are best at “isolating” the sound in the headphones and reducing the outside sounds. This not only protects my hearing but also allows me to mix the next song in my headphones before playing them over the sound system to the audience. When DJs wear headphones, this is what they are usually doing—mixing the next song into the current one that is playing. 

When composing and producing music, there are several applications that I’ve found helpful. The first is a volume limiter that I use on the output channel of the mix. This prevents the signal/sound from going too loud and becoming distorted, which could damage your hearing as well as the sound equipment. 

The second is the use of a visual EQ (equalizer) monitor which allows you to “see” the frequencies of the sound being played. This indicates whether there is too much or too little sound in low to high frequencies, allowing me to mix the music better for a better listening experience. In particular, since my focus is on the high frequency areas, I use the visual EQ to monitor too much signal in that range. (There are many types of EQ tools available but I think many producers use visual monitors in one way or another.)

I also learned that, although human hearing technically ranges from 20 to 20,000 hertz (Hz), most people don’t fully hear the entire range, and in the higher and lower frequencies they may only be able to sense that there is a sound being made. A common practice in producing is to use filters to cancel and smooth out sounds below the lower and higher ends of the frequency spectrum. This prevents signals in the lower frequencies from causing unnecessary vibrations or rumbles as well as preventing artificial, “fizzy” sounds at the high frequencies. The ear is most sensitive to sound from about 2,000 to 5,000 Hz, so this is where I try to focus on minimizing peaks in the sound levels. 

Chill Kechil is donating a portion of his music and apparel proceeds to Hearing Health Foundation. Support HHF and enjoy his music at chillkechil.com. Read more about Chill Kechil in the upcoming Spring issue of Hearing Health magazine, out in April.

'My Daddy Sleeps Loud!'

By Cory MacIver and Holly F. Pedersen, Ed.D.

My daughter Kaylyn enjoys weekend “campouts” in the living room. After one such event, my wife asked our daughter, “How was the campout with Daddy?” Kaylyn replied, “Good, but my daddy sure sleeps loud!”

When your child with a hearing loss can hear you snoring even without her amplification, there is no denying it. Kaylyn Rae entered the world 16 weeks ahead of schedule weighing 1 lb 9 oz. Our home-based early intervention services began when Kaylyn was released from the NICU at 6 months old. In addition to our audiological and medical appointments, specialists from the North Dakota Vision Services, North Dakota School for the Deaf, and Minot Infant Development made regular home visits. 

As a first-time father, the barrage of female providers into our home was intimidating to say the least. I found myself making excuses to be away during these visits, having my wife fill me in later. This was a frustrating time for everyone—I was not yet comfortable participating in the intervention visits and worried I was giving the impression I didn’t care enough to be involved. 

Our deaf education specialist, Holly Pedersen, and I began to communicate about this situation. We both realized that, while more and more fathers want and expect to be involved in their children’s lives, information about exactly how to do that when one’s child has a disability was lacking. This led to an ongoing partnership to investigate the experiences of fathers of children with hearing loss and how to engage them in the team when providing services.

One of our first projects involved a method called Photovoice, which involves using photographs to express one’s point of view. Dr. Pedersen identified relevant quotes from the available research on fathers and I selected personal family photographs that illustrated these concepts, and together we created a PowerPoint presentation using them.

Kaylyn is now 10 years old and attends fourth grade in her neighborhood school with an excellent support team. Kaylyn loves dance class, American Girl dolls, and being a big sister to our youngest daughter, Cady (age 2). My wife Kara and I enjoy the ups and downs of life with our family—it’s a wild ride, but we wouldn’t want it any other way.

Cory MacIver is an educator with Minot Public Schools. He and his wife, Kara, are parents to two beautiful daughters who both happen to have disabilities. Holly F. Pedersen, Ed.D., has worked with children and youths with hearing loss in early intervention, public, and residential settings for more than 20 years. Pedersen is an assistant professor of special education at Minot State University in Minot, North Dakota.

Read more about children and hearing loss in our Winter 2015 issue. 

How to Have a Better Conversation with Someone with Hearing Loss

All of us with hearing loss know how hard it can sometimes be to converse comfortably with our friends and family. We get tired, frustrated and sometimes just tune out. But it is hard on those that love us as well. They don’t like to see us struggle or be unhappy; and they can get annoyed that we don’t understand what they are saying. Today’s post is for them. Please share these tips with your friends and family and enjoy better conversations!

HOW THOSE WITH HEARING LOSS HEAR

The first step in having better conversations is for our friends and family to understand how those of us with hearing loss actually hear. The best way I know to explain it, is as a game board from Wheel of Fortune. Some of the letters are filled in, others are blank. The contestant (or listener in this case) is trying to make sense of the assorted and incomplete sounds he or she is hearing and turn these sounds into a word or phrase that makes sense in the context of the conversation.

It is also useful to point out that hearing aids don’t work like glasses. Glasses, by bending light through a curved lens, can transform an image that is blurry and distorted into something crisp and clear. So if you wear glasses, in most cases, you can see just like someone with typical vision, or pretty darn close. With hearing aids, this is not the case. Hearing aids are helpful in amplifying sounds, but this just makes them louder, not necessarily crisper or clearer. Most people with hearing loss can hear that someone is talking to them; they just can’t understand what words are being said. The clarity is not there.

Hearing aids also have a tough time differentiating among sounds so that the background noise (i.e., the hum of the refrigerator or the air conditioner) is amplified in addition to the more important sounds of the conversation. This can actually make it harder to hear in certain situations!

HOW TO HAVE A BETTER CONVERSATION WITH SOMEONE WITH HEARING LOSS

So, with that as background, here are our tips for having more satisfying conversations with someone who has hearing loss. Please share your tips and ideas in the comments.

1.  Provide Context Before and When Speaking: Context makes it easier to fill in the blank spaces of the words on the Wheel of Fortune game board. If all you hear is “__oot,” knowing if the conversation is about owls (hoot) or a robbery (loot) or musical instruments (flute) is a big help!

2.  Get Their Attention Before Speaking: Hearing takes concentration for those with hearing loss, so make sure they are ready and are paying attention. Talking to them before they are ready will have them playing catch-up and make it harder for them to understand the context of the conversation.

3.  Make Sure They Can See Your Lips: Lip-reading is helpful in filling in the blanks of what is not heard. I always tell people I can’t hear you if I can’t see you. See Shari's post, I Can’t Hear in the Dark, for more on this. Don’t cover your mouth with your hands and make sure that you are well-lit.

4.  Enunciate Clearly and Speak at a Steady Rate: Remember that volume is only part of the problem. Clarity of the sounds is really key. Speak your words clearly, and try to maintain a regular pace of speech. Rapid speech is very difficult to follow since all that brain processing time is condensed, while slower than typical speech will look weird on the lips and make lip-reading less useful.

5.  Be Aware of The Surroundings: Background noise is a problem, so try to avoid it if you can. Turn off the A/C or at least turn the fan down to low. Don’t play music in the background. Pick a quieter restaurant or request a corner booth. A quiet and well-lit spot always works best.

6.  Take Turns Speaking: If there are multiple people in the conversation, it is important that only one person speaks at a time and that each speaker makes the effort to face the person who has trouble hearing.

7.  Be Prepared to Repeat or Rephrase: Get ready for hearing, “What?,” at least a couple of times during the conversation. Try not to get frustrated, but simply repeat what you have said. If the person does not get it the second time, try rephrasing your thought using different words that might be easier for him or her to hear. Or spell a word that is giving a particularly hard time. Often knowing the first few letters of a word can help to connect the dots.

8.  Keep Your Sense of Humor:  Hey, it can be frustrating, I know. But remember the goal is to connect with one another, so why not laugh at the misunderstandings. It is better than the alternative.

Readers, what tips do you have for improving conversations with someone with hearing loss?

Shari is the Chairman of  HHF's Board of Directors and founder of the blog, Living With Hearing Loss. 

Thank you Greg F. for these great ideas. Greg is a member of Hearing Health Foundation‘s National Junior Board and is working on a mobile phone app to help those of us with hearing loss find quiet spots in NYC.  

Good Acoustics for Green Buildings

By Kathi Mestayer

LEED, or Leadership in Energy and Environmental Design, is a green building certification program run by the U.S. Green Building Council. Its objective is for buildings to save money and resources and have a positive impact on the health of occupants, and promote renewable, clean energy.  

This includes good acoustics. “Our 2009 ratings systems for schools and healthcare institutions cover sound because of the overwhelming evidence that it critically affects learning and healing environments,” says Larissa Oaks, the LEED Indoor Environmental Quality Specialist with the U.S. Green Building Council (USGBC).

Surveys by the Center for the Built Environment and other groups have shown that occupants of office buildings and other work environments rated “acoustic comfort” low, even when the air quality and temperature were deemed acceptable. Acoustic comfort is defined as conducive to speech intelligibility, speech privacy, and concentration where appropriate, with few distractions and annoyances.

Optimizing green design and good acoustics can be a balancing act. "The imperatives of green design—such as lower-energy consumption mechanical equipment and designs, harder-surfaced materials, reduction in use of full-height partitions, and more glass—resulted in spaces that achieved high marks for efficiency, and high LEED certification levels, while simultaneously not meeting the needs of the occupants acoustically," says Ethan Salter, a principal at Charles M. Salter Associates in San Francisco and a lead technical adviser for the LEED acoustics credits.

These credits specify measures to create (and ways to measure) sound isolation and speech privacy, and reduce background noise and external noise. For example, for school acoustics, limits apply for noise from HVAC (heating and cooling) systems and noise from adjacent spaces.  

Limits are also set to minimize the effect of reverberation from hard surfaces, which makes speech harder to understand. Reverberant environments can degrade speech intelligibility and increase the “noisiness” of a space, with greater potential for distraction. To mitigate reverberation, designers can incorporate absorptive materials where possible; there are a number of new, sustainable material options that fit within the “green” framework.

As of this writing, LEED credits are in place for acoustical performance for healthcare facilities, classrooms, offices, and other workplaces. There is also a pilot credit for exterior noise control.

Take a closer look at an example of LEED acoustical credits here.

I’ve written about the dangers of workplace noise; the perils of an open office plan, especially for anyone with a hearing loss; and one company’s efforts to protect their employees’ hearing.

Bumping Into People With Hearing Loss

By Kathi Mestayer

Recently I was backing out of my parking spot in the Barnes & Noble parking lot. I noticed another car in my rear-view mirror, backing up right behind me, approaching my bumper with apparent disregard, and so I finally beeped my horn. A couple of times. Loud. Well, that bumper kept coming, and then hit mine, not hard, but a definite impact. The car pulled out and drove away.

So, I do what anyone would do in that situation—I make a note of the licence plate, and followed it. After a couple of blocks, the car turns into another parking lot. I park behind it, knock on the window, and when it rolls down, said, "Did you know you just hit me in the Barnes & Noble parking lot?"

"No! Oh! I'm so sorry!" said the driver. She lifts up the back door of her SUV, showing me the cute little toys (including a tiny toy stroller) she had bought for her grandchildren. She thought the impact was one of them hitting the back window, or just falling over.

"Didn't you hear me blow my horn?"

"No! You blew your horn?"

"Are you hard of hearing?"

"Yes! I had my hearing tested and they told me I have a hearing loss, but to come back when I can't hear anymore."

"What?!"

What ensued was a few minutes of conversation in which I shared this information:

1) Go back now to get your hearing loss treated. If you didn't hear my horn when our cars were 12 inches to zero inches apart, that's not a good sign.

2) You can't locate sounds because you have a much worse loss in one ear. The driver acknowledged she was almost completely deaf in one ear.

3) Go to a good audiologist, not a testing closet in the back corner of your pharmacy (really!).

At the end, she said, "I just know there's a reason we were brought together! Give me a hug?"

We had a big, warm hug and went our separate ways.

How to Handle the Holidays When You Have a Hearing Loss

By Shari Eberts

My post How to Tackle Thanksgiving Dinner When You Have a Hearing Loss received so many helpful tips in the comments, I decided to incorporate them into a new post that focuses on the holidays more generally. Thank you to everyone who shared their ideas! There were so many great ones. I wish you all a very happy and healthy holiday season!

The holidays are a great time of year, filled with family dinners and celebrations, gatherings with friends, holiday parties, and lots of socializing. I love getting dressed up, enjoying the decorations and participating in the general feeling of happiness that comes along with the season. But if I’m not careful, all the socializing and holiday hubbub can become exhausting and overwhelming. I want to be a part of the fun, but the concentration required to hear can be taxing, particularly at holiday parties held in noisy restaurants or similar venues.

But, let’s NOT let that put a damper on the holiday season! I hope these tips will help you approach the holiday season with more joy and less fear. Please let me know your suggestions in the comments.

Living With Hearing Loss’s Tips to Survive and Thrive at Holiday Gatherings

1. Position yourself in a good spot: For me, it is very helpful if I have a wall behind me to block the background noise. If it is a seated meal, I try to sit near the middle of the table, which gives me a better shot at hearing more conversation. If it is a cocktail party, I scope out a quieter area of the room away from the music and high traffic areas like the buffet or bar area and try to spend time there. If the party is in multiple rooms, I head to the quieter room. You can invite some friends to come with you. I bet they will enjoy the lower volume too.
   

2. Avoid background noise when possible: If I am hosting, I always keep background music to a minimum. Other hosts may like to play music more loudly. Try asking your host to lower the volume a bit or to adjust the volume in different parts of the room or venue. I always ask restaurants to turn down the volume of the music too!
   

3. Converse with those next to you: At a seated dinner, don’t try to participate in conversations across large distances. If you would like to talk with someone, move closer to him, or ask that you continue the conversation when you have a chance to be closer together. If it is a party with multiple rooms, you can ask someone to join you in a quieter spot.
   

4. Wear your hearing aids: Many of us hate to wear our hearing aids, but they really can help. Experiment with a couple of different settings to find what is optimal. You can even practice at home if you don’t want to spend time experimenting at the event. It may take some time getting used to the new setting, but the investment of that time will be worth it.
   

5. Try other technologies: There are many new technologies now available that can help you hear in a group setting including personal FM systems or other one to one communication devices. Some of my friends swear by these.
   

6. Have reasonable expectations: You probably won’t hear everything that everyone says, but that is ok. Enjoy talking to the people near you, then seek out others to talk with during other parts of the party.
   

7. Take a break: Don’t be shy about taking a break from the action for a few minutes to give your ears and brain a rest. Head to the restroom, or find a quiet spot in another room. Or go stand outside for a few minutes. It really helps me to clear my head and build up some energy for another round of socializing.
   

8. Don’t fake it: It is very tempting to just nod along and pretend that you hear what others are saying or laugh just because others are laughing. But it can be dangerous, particularly if someone is asking you a question. Be brave and be honest with others if you are having trouble hearing. It will make your interactions more memorable on both sides.
   

9. Give visual clues to indicate if you are having trouble hearing: If you are having trouble hearing, you can cup your ear with your hand to indicate to the speaker to speak louder without interrupting the flow of the conversation. I have seen this in action and it is very effective.
   

10. Bring your sense of humor: It can be hard to keep it all in perspective during the holidays when you feel like you are missing out on the fun, but try to laugh a little and be grateful for the wonderful friends and family around you. You may not hear every word they say, but you can partake in all of the good feelings nonetheless. Try to enjoy the moment.

Readers, what tips do you have for enjoying the holidays when you have a hearing loss?

To read more posts by Shari Eberts, please visit her blog, Living With Hearing Loss