Do Airplanes Trigger Tinnitus?

By Shari Eberts

I am lucky enough to have mostly mild tinnitus. Sometimes I have flare-ups and lately I have been experiencing a day of tinnitus after any air travel. This is a problem for me since I love to travel, and most of the places I like to travel to require an airplane ride. So what’s a weary hard-of-hearing traveler to do? It became clear to me that proper ear protection on the airplane is key.

My post-airplane tinnitus flare-ups have been occurring for the last several months and are usually accompanied by a reduced ability to hear. Even for someone with typical-hearing, it can be a challenge getting off the plane at a new destination, navigating the baggage claim, the rental car agency, and perhaps customs, all with two children in tow. But with a tinnitus flare-up and reduced hearing, it is even more challenging.

For me, I believe the issue is the sustained level of noise on the airplane; according to my iPhone decibel reader app, the interior of a plane is very loud—anywhere from 80 to 95 decibels, depending on the flight. Once in the air, the sound is like white noise and is easy to forget about or ignore, but it is constant, and can be damaging to our hearing. The rule of thumb is that prolonged exposure to any noise at or above 85 decibels can cause gradual hearing loss—and that damage can be permanent.

Here are some workarounds that I have found; I hope they work for you as they do for me:

1. When I get on the plane I shut my hearing aids off, so they act as earplugs. This can be a challenge if I need to communicate during the flight because almost all sound is blocked, preventing me from hearing. While sometimes I must turn them on, I try to keep my aids off for the entire flight, from prior to takeoff until we have reached the gate.
   

2. I try to reserve a seat on the aisle and as far away from the engines as possible. Sometimes this is not possible without paying extra for a special seat, but when possible, I do so.
   

3. I wear a hooded sweatshirt or jacket on the plane for an additional barrier to the noise. It helps prevent the tinnitus and the effect of reduced hearing.

These activities have helped a little bit, but have not fully eliminated the issue. I am still searching for solutions until there is a cure. Please share your tips with us in the comment box below.

This post originally appeared on the blog Living With Hearing Loss on March 25, 2015. The author, Shari Eberts, is the chair of HHF's Board of Directors.

A Neurological Emergency

By Jane Madell, Au.D.

Hearing loss is the most common disability in children worldwide. Annually in America approximately 3 in 1,000 babies are born with permanent hearing loss, making hearing loss one of the most common birth defects in the U.S. Hearing loss cannot be viewed in isolation; it can cause problems for auditory brain development. When a child with hearing loss is born, the child has already had 20 weeks of auditory deprivation.

Typical*-hearing babies
When babies with typical-hearing are born, they have been listening to their mother’s voice and the voices of others near their mother. They can tell the difference between their mother’s voice and their father’s voice. They recognize inflection; they can tell which words are important and separate them from words that are used to connect the important words. They recognize emotion in voices, and music they heard during pregnancy. Although the sounds they hear are softer and a little muffled compared with those heard outside the womb, they provide significant input to the auditory brain.

Babies with hearing loss
Babies with hearing loss are born with brain deprivation, which is why it is important to act quickly to reduce the effect of this delay. The critical thing to remember is that there is a short window for developing the auditory brain. If children do not get the opportunity to hear during the first 3 to 3 ½ years, they will lose that opportunity. We are not just talking about developing language (which is certainly critical), but also about literacy. Reading is in the same part of the brain as hearing, so if we want children to succeed, we need to build the auditory brain early.

Typical-hearing babies who are not exposed to language
Lack of exposure to auditory stimulation affects everyone’s brain. Typical-hearing children who live in homes where their parents do not talk with them will also show a lack of auditory brain development. Hart and Risley (1995) have demonstrated that the number of words heard directly affects both the number of words in a child’s vocabulary and the child’s IQ at age 3 years. Children who heard ~30,100 words in a 14-hour day had a vocabulary of ~1,100 words and an IQ of 117 at age three years, while children who heard ~8,600 words in a day had a vocabulary of 525 words and an IQ of 79.

So what should we be doing?

Every child needs good exposure to language. While professionals have a role, the most important people in providing language stimulation to children are their parents. Everyone who works with children needs to help parents understand that EVERY child needs a lot of auditory input. Parents need to be encouraged to talk, read, and sing to their children. Ten books a day should be the goal. We need to help parents learn how to talk to their children, and, most importantly, how to enjoy talking to their children. All children with limited language — not just those with hearing loss — have reduced economic possibilities.

Empowering parents
Ears are the pathway to the brain; the brain is the organ of hearing. Just as parents are the people who need to feed their children and keep them warm, parents are also the people who have to give children power to use their brain. It is essential that parents are properly educated about their child's hearing loss and the role they play in their child's auditory development. If children can learn to listen and talk, they will be able to:

• Talk to people around them and learn from them

• Hear and learn great ideas

• Read well and learn about the world

• Receive a good education

• Have life choices

The ability to get a good education and to increase life choices has the added advantage of reducing poverty, as well as the possibility of making major changes in a child’s life.

Take action today to protect your children's ears against the dangers of noise and consider donating today to help us find a cure for hearing loss and tinnitus.

This post originally appeared on Hearing Health @ Hearing Health & Technology Matters’ blog on February 10, 2015. The author, Jane Madell, Au.D., is an audiologist, speech-language pathologist, and auditory verbal therapist with 40-plus years of experience in the greater New York City area.  

*Typical Hearing was use in place of Normal Hearing. 

Make Sure You Hear That

By Kathi Mestayer

With another holiday season right around the corner, participating in conversations around the dinner table and social gatherings can be a real challenge for those with hearing loss. It can lead to feelings of frustration, especially if there is a family member who has an unacknowledged—and untreated—hearing loss.

Undiagnosed, untreated hearing loss has been shown to detrimentally affect personal relationships, as the Better Hearing Institute reports: “Research demonstrates the considerable negative social, psychological, cognitive, and health effects of untreated hearing loss with far-reaching implications that go well beyond hearing alone. In fact, those who have difficulty hearing can experience such distorted and incomplete communication that it seriously impacts their professional and personal lives, at times leading to isolation and withdrawal.”

Here are some tips to help you hear your best:

• Sit at the end of the dinner table so you can see everyone’s faces. The ambient noise from a crowded table can be a tough listening situation, so seeing people when they are speaking will help.

• Try to avoid sitting or standing next to fans, vents, or anything else that may be adding an extra layer of background noise.

• Adjust the programming on your hearing aid or other listening device to accommodate a noisy environment.

• Consider using an FM system or other assistive listening device to help you hear.

Before she became a staff writer for Hearing Health, Kathi Mestayer’s first article for the magazine in Summer 2011 spoke about the challenges of communicating well with family members. Her “tacit norms” include this list of informal rules in her family:

• Outdoors is better. A screened porch or the back yard is a much quieter and easier place to converse than a noisy house.
  

• One speaker at a time. Really.
  

• Be patient. We’re all trying our best, even the kids.
  

• Take a break. Struggling to make sense out of the incomplete sound data we get is exhausting. A nap or some quiet time is the best way to recharge your brain.

We hope that these tips are helpful to you in hearing that “thank you” from your loved ones.  

Show your thanks by making a gift to honor or in memory of a loved one and help HHF find a cure for hearing loss and tinnitus through our Hearing Restoration Project. We are ever thankful for your support!

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.”

Playground Lessons

By Scott Swanson

It's 1982. I'm 4 years old, and the proud new owner of two behind-the-ear hearing aids. These things are monsters. Huge. A result of life-saving surgery I had two years earlier. My mother had to put them in for me every morning. At age 4, I had no clue that this stinks. 

In 1983 I started kindergarten. In the Pacific Northwest, where I live, rain is a way of life. You don't duck for cover just because there's precipitation in the air. This especially goes for recess. At my school, there was this woman we called "Grandma" whose job it was to oversee the playground. She was old, and she laid down the law. She also rewarded kids who picked up toys with sugar-free candies. Those things were the worst! But some of us enjoyed the nice gesture.  

One fine September day it was raining and as usual, we got sent to the playground. I was getting pretty deep into a game of Foursquare, or maybe it was Red Rover. Either way, I find myself being sent inside by Grandma. Back to my classroom I went. I'm pretty sure I thought I was in trouble. Was I hogging the ball? Being mean? I couldn't figure it out.

School ended later that day, and I walked home in the rain. I remember when I walked through the front door my mom and dad were chuckling. They asked me how my day was. I gave them a generic response: "Fine.” "How was recess?" "Dumb." "Why?" "Grandma sent me back to my classroom for no reason." More chuckles, and then my mom told me to have a seat.

She told me that the school called to say they very concerned for my safety. She explained to me that Grandma noticed my hearing aids. She also noticed the rain. She put two and two together. When water and electronics mix, people get electrocuted. Grandma must have thought she saved my life. My parents told the school that although they appreciated them erring on the side of caution, I was not in danger of being electrocuted. A little rain would at worst damage my hearing aids but definitely not cause me to lose my life. 

I still see Grandma from time to time in the grocery store. I think back to that day and I doubt she remembers. She was old to us then, let alone 25 years later. Most importantly, I know she had my safety on her mind, and for that I'm thankful. I'll always remember her as much as any teacher I had at that school. Gross sugar-free candies, and all!

Scott has moderate to severe hearing loss. At age two, while undergoing life-saving surgery, Scott was administered ototoxic antibiotics, which have a side effect of hearing loss. By the age of four Scott had enough hearing loss to require hearing aids. He initially wore behind-the-ear (BTE) hearing aids, but currently wears completely-in-canal (CIC) hearing aids. Scott is the only one in his family that lives with hearing loss.

Your Brain Is a Muscle: Use It or Lose It

By Sloan Blanton

Brain Awareness Week (March 16-22, 2015) celebrates one of the most important organs in the human body and current progress and breakthroughs in brain research. While the brain literally affects every organ and bodily function, did you know hearing loss, especially when it goes untreated, can affect brain function and size? It can also affect quality of life. Depression rates are higher for those with hearing loss, as is the likelihood of emotional issues, such as anger and withdrawal, which can lead to poor mental health.

I was born with a sensorineural hearing loss in both ears so it is all that I have ever known. While I sometimes feel socially isolated because I am not always able to follow the conversations around me, and I also know my speech development has been directly affected by my hearing loss, my cogitative ability has been in no way impaired. However, several studies have found a correlation between aging, cognitive function, and hearing loss. For a long time, many researchers believed the two to be unrelated, but recent findings have proven otherwise.

From 2001 to 2007, the Health, Aging, and Body Composition study tested the hearing and cognitive abilities of nearly 2,000 adults between ages 75-84. In the study, those with hearing impairment lost cognitive abilities up to 40% more quickly than typical-hearing participants. Additionally, participants with hearing loss developed cognitive issues on average three years sooner than those with typical hearing.

Numerous theories dive into the relation between the brain and hearing loss, such as that the brain must work harder to process sounds when there is an inability to hear, which then takes the brain’s attention away from other cognitive functions. "We take for granted that processing sound is simple, but for the brain it's very energy intensive," Dr. Frank Lin, the assistant professor conducting the study, reported. "The most powerful computers in the world are no match for the sound-processing capabilities of the brain of a 3-year-old child."

The decline of cognitive ability impairs other brain functions, such as thinking and memory retention. Social isolation resulting from hearing loss can put the elderly at greater risk for dementia and other cognitive impairments. "It's early days yet, but we have seen that if you take an adult with typical hearing and put her in an MRI scanner while listening to garbled speech, the scans reveal that the brain has to spend extra energy to decode it," says researcher Jonathan Peelle.

In 2014, Neurolmage published Lin’s study on hearing loss possibly causing the brain to atrophy, like an unused muscle. Those who have had hearing loss for at least seven years or longer tended to have brains with small temporal lobes, making short- and long-term memory and processing meaning from sensory input difficult.

According to Healthy Hearing, a deeper understanding of hearing loss, both its causes and its effects, is crucial. The hope is that individuals with age-related hearing loss could benefit from cognitive and perceptual training exercises, and thus can have an improved quality of life. That includes better physical health, better mental health, improved relationships, and the ability to continue to engage in society. To make sure you're receiving the best care and are living the highest quality life possible, make an appointment with your hearing healthcare professional for your annual checkup; more than just your hearing will benefit.

Watch out for the “Break the Stigma” issue of Hearing Health Magazine this spring, which will include research on how addressing, and then treating, hearing loss leads to happier, healthier outcomes. If you're not already a subscriber to the FREE magazine, subscribe here.

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.

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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.