An Animal Behavioral Model of Loudness Hyperacusis

By Kelly Radziwon, Ph.D., and Richard Salvi, Ph.D.

One of the defining features of hyperacusis is reduced sound level tolerance; individuals with “loudness hyperacusis” experience everyday sound volumes as uncomfortably loud and potentially painful. Given that loudness perception is a key behavioral correlate of hyperacusis, our lab at the University at Buffalo has developed a rat behavioral model of loudness estimation utilizing a reaction time paradigm. In this model, the rats were trained to remove their noses from a hole whenever a sound was heard. This task is similar to asking a human listener to raise his/her hand when a sound is played (the rats receive food rewards upon correctly detecting the sound).
 

FIGURE: Reaction time-Intensity functions for broadband noise bursts for 7 rats.

The rats are significantly faster following high-dose (300 mg/kg) salicylate administration (left panel; red squares) for moderate and high level sounds, indicative of temporary loudness hyperacusis. The rats showed no behavioral effect following low-dose (50 mg/kg) salicylate.

By establishing this trained behavioral response, we measured reaction time, or how fast the animal responds to a variety of sounds of varying intensities. Previous studies have established that the more intense a sound is, the faster a listener will respond to it. As a result, we thought having hyperacusis would influence reaction time due to an enhanced sensitivity to sound.

In our recent paper published in Hearing Research, we tested the hypothesis that high-dose sodium salicylate, the active ingredient in aspirin, can induce hyperacusis-like changes in rats trained in our behavioral paradigm. High-dose aspirin has long been known to induce temporary hearing loss and acute tinnitus in both humans and animals, and it has served as an extremely useful model to investigate the neural and biological mechanisms underlying tinnitus and hearing loss. Therefore, if the rats’ responses to sound are faster than they typically were following salicylate administration, then we will have developed a relevant animal model of loudness hyperacusis.

Although prior hyperacusis research utilizing salicylate has demonstrated that high-dose sodium salicylate induced hyperacusis-like behavior, the effect of dosage and the stimulus frequency were not considered. We wanted to determine how the dosage of salicylate as well as the frequency of the tone bursts affected reaction time.

We found that salicylate caused a reduction in behavioral reaction time in a dose-dependent manner and across a range of stimulus frequencies, suggesting that both our behavioral paradigm and the salicylate model are useful tools in the broader study of hyperacusis. In addition, our behavioral results appear highly correlated with the physiological changes in the auditory system shown in earlier studies following both salicylate treatment and noise exposure, which points to a common neural mechanism in the generation of hyperacusis.

Although people with hyperacusis rarely attribute their hyperacusis to aspirin, the use of the salicylate model of hyperacusis in animals provides the necessary groundwork for future studies of noise-induced hyperacusis and loudness intolerance.


Kelly Radziwon, Ph.D., is a 2015 Emerging Research Grants recipient. Her grant was generously funded by Hyperacusis Research Ltd. Learn more about Radziwon and her work in “Meet the Researcher.”

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Turning Fourth of July Into a Science Lesson

By Kelly N. Barahona

In most cities if not towns of a certain size in the U.S., a grand display of fireworks for the Fourth of July is part of the celebration of America’s birthday. But just how loud are the fireworks people have come to expect every summer? Unfortunately fireworks can measure from 140 to as high as 165 decibels, easily a hearing-damaging event if you are sitting too close.

This doesn’t mean you can’t enjoy the festivities. With the abundance of decibel-reading apps for smartphones it’s easier than ever before to learn how much noise is in the world around us. Most apps use the smartphone’s microphone to give a reading of the decibel level. As with a professional-grade meter, most apps can also show how the noise fluctuates over time, in real time, and provide numerical reference points that users can compare to their own sound levels. Some apps even let you geo-tag the decibel level to a specific location, like your local coffee shop or favorite restaurant.

Parents, camp counselors, and teachers can turn the Fourth of July into a science lesson. On the night of the fireworks show, Hearing Health Foundation recommends staying at least one block away from where the fireworks are being displayed and using a smartphone app to measure the decibel level.

If you want to be closer to the action, protect your hearing by using foam earplugs or over-the-ear earmuffs for the youngest children. A fun but loud activity like this can be a good segue for conversations about how listening to music at too loud a volume and participating in noisy recreational activities may be harmful, as well as how to incorporate better hearing health practices in your daily life.

Fourth of July should be a time of fun and enjoyment, but as with anything, it is necessary to take precautions to make the holiday safe as well. Teach your loved ones about the noises and sounds around them to hopefully encourage everyone to take active measures to protect their hearing on a regular basis. Remember, noise is the most preventable cause of hearing loss.

Some 1 Like You

By Makayla Allison

Our 6-year-old daughter, Lily, was recently diagnosed with Ehlers Danlos Hypermobility (EDS-HT). We received this diagnosis only after she acquired more than three dozen symptoms and diagnoses of uncertain significance, ranging from global joint pain and muscle weakness to tinnitus, and over the course of nearly five years.

It was a long and isolating time for our family as we tried to figure out what was going on. We so badly wanted to connect with someone who understood what our little one was going through, and when I asked Lily’s specialists if they could connect us with anyone, the answer was never yes due to privacy laws. Without a diagnosis it is nearly impossible to find groups of people in the same situation to talk to. And it can be even more frightening when the uniqueness of your symptoms isolates you even more.

The discovery of how Lily’s condition affected her hearing was both transparent and innocent. When Lily was 4 years old she asked me if the invisible bumblebees were going to sting her. She was so confused why she couldn’t see the bees that buzzed around her ears. It was shortly after she was referred to an ENT that we learned about tinnitus and that the sounds she hears come from inside her head.

Our daughter had a big desire to find a friend like her, but looking for someone else experiencing the same health challenges online, without posting them in great detail, was proving to be an impossible task. Her dreams inspired us to create Some 1 Like You (S1LY), an organization that connects people privately based on whatever health conditions they are experiencing, regardless of whether or not they’ve received a diagnosis.

According to the documentary film Undiagnosed: Medical Refugees, “The total number of undiagnosed patients is unknown but considered to be vast.... It takes an average of 7.6 years in the U.S. to uncover a rare disease diagnosis. Worldwide there are an estimated 350 million people living with a rare disease; add to [that number] patients still waiting for a diagnosis, patients who have been misdiagnosed, and adults and children who have diseases not yet named or recognized. Being ‘undiagnosed’ is not commonly considered to be an identity, but it should be. Helping people who are ill to feel that others are supporting and advocating for them, and know that they exist, can make all the difference in the world.”

Our mission for S1LY is to privately connect people across symptoms and diagnoses to empower the individuals facing these complex challenges. S1LY is unique because we can perform that search for people, while also keeping their health information private: To make these matches we take only their email address, as well as the health qualities, or groups of qualities they possess and are looking for in someone else.

Once a match is made, the email addresses of those members are shared with each other, and communication is then done only between members. It is our hope that this vast sharing of knowledge and resources among patients will make its way back to physicians and impact treatments as a whole across diseases.

S1LY has developed a Gifted Membership program to cover the lifetime membership fee to Some 1 Like You for constituents of qualifying organizations. 100 gifted memberships have been donated to the Hearing Health Foundation community. The first 100 people to submit their Connect Contact Forms to S1LY with the code “HHF100” will receive lifetime memberships to privately connect with Some 1 Like You members.

If you would like to explore gifted memberships for your patients or members at no cost, please email Makayla at gifted@some1likeyou.com. A portion of the proceeds of every S1LY membership goes to funding research on Ehlers Danlos Syndromes.

NIH Researchers Show Protein in Inner Ear Is Key to How Cells That Help With Hearing and Balance Are Positioned

By the National Institute on Deafness and Other Communication Disorders (NIDCD)

Line of polarity reversal (LPR) and location of Emx2 within two inner ear structures. Arrows indicate hair bundle orientation. Source: eLife

Using animal models, scientists have demonstrated that a protein called Emx2 is critical to how specialized cells that are important for maintaining hearing and balance are positioned in the inner ear. Emx2 is a transcription factor, a type of protein that plays a role in how genes are regulated. Conducted by scientists at the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health (NIH), the research offers new insight into how specialized sensory hair cells develop and function, providing opportunities for scientists to explore novel ways to treat hearing loss, balance disorders, and deafness. The results are published March 7, 2017, in eLife.

Our ability to hear and maintain balance relies on thousands of sensory hair cells in various parts of the inner ear. On top of these hair cells are clusters of tiny hair-like extensions called hair bundles. When triggered by sound, head movements, or other input, the hair bundles bend, opening channels that turn on the hair cells and create electrical signals to send information to the brain. These signals carry, for example, sound vibrations so the brain can tell us what we’ve heard or information about how our head is positioned or how it is moving, which the brain uses to help us maintain balance.

NIDCD researchers Doris Wu, Ph.D., chief of the Section on Sensory Cell Regeneration and Development and member of HHF’s Scientific Advisory Board, which provides oversight and guidance to our Hearing Restoration Project (HRP) consortium; Katie Kindt, Ph.D., acting chief of the Section on Sensory Cell Development and Function; and Tao Jiang, a doctoral student at the University of Maryland College Park, sought to describe how the hair cells and hair bundles in the inner ear are formed by exploring the role of Emx2, a protein known to be essential for the development of inner ear structures. They turned first to mice, which have been critical to helping scientists understand how intricate parts of the inner ear function in people.

Each hair bundle in the inner ear bends in only one direction to turn on the hair cell; when the bundle bends in the opposite direction, it is deactivated, or turned off, and the channels that sense vibrations close. Hair bundles in various sensory organs of the inner ear are oriented in a precise pattern. Scientists are just beginning to understand how the hair cells determine in which direction to point their hair bundles so that they perform their jobs.

In the parts of the inner ear where hair cells and their hair bundles convert sound vibrations into signals to the brain, the hair bundles are oriented in the same direction. The same is true for hair bundles involved in some aspects of balance, known as angular acceleration. But for hair cells involved in linear acceleration—or how the head senses the direction of forward and backward movement—the hair bundles divide into two regions that are oriented in opposite directions, which scientists call reversed polarity. The hair bundles face either toward or away from each other, depending on whether they are in the utricle or the saccule, two of the inner ear structures involved in balance. In mammals, the dividing line at which the hair bundles are oriented in opposite directions is called the line of polarity reversal (LPR).

Using gene expression analysis and loss- and gain-of-function analyses in mice that either lacked Emx2 or possessed extra amounts of the protein, the scientists found that Emx2 is expressed on only one side of the LPR. In addition, they discovered that Emx2 reversed hair bundle polarity by 180 degrees, thereby orienting hair bundles in the Emx2 region in opposite directions from hair bundles on the other side of the LPR. When the Emx2 was missing, the hair bundles in the same location were positioned to face the same direction.

Looking to other animals to see if Emx2 played the same role, they found that Emx2 reversed hair bundle orientation in the zebrafish neuromast, the organ where hair cells with reversed polarity that are sensitive to water movement reside.

These results suggest that Emx2 plays a key role in establishing the structural basis of hair bundle polarity and establishing the LPR. If Emx2 is found to function similarly in humans, as expected, the findings could help advance therapies for hearing loss and balance disorders. They could also advance research into understanding the mechanisms underlying sensory hair cell development within organs other than the inner ear.

This work was supported within the intramural laboratories of the NIDCD (ZIA DC000021 and ZIA DC000085).

Doris Wu Ph.D. is member of HHF’s Scientific Advisory Board, which provides oversight and guidance to our Hearing Restoration Project (HRP) consortium This article was repurpsed with permission from the National Institute on Deafness and Other Communication Disorders. 

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The Connection Between Hearing Loss and Dementia

By Alycia Gordan

June is Alzheimer's & Brain Awareness Month and Hearing Health Foundation would like to shine light on the effects untreated hearing loss can have on our brains and memory. Hearing loss is often linked with dementia, and research is being conducted to establish the exact link between the two. Evidence suggests that by treating hearing loss, the risk of dementia can be mitigated.

Dementia is a medical term that is used to describe a host of symptoms, characterized by a deterioration in a patient’s cognitive abilities. The degeneration of brain cells causes neurons to stop functioning, leading to a series of dysfunctions.

A person may have dementia if at least two of his mental faculties are affected: the loss of memory and focus; difficulty communicating; short or interrupted attention spans; impaired judgment; or an inability to perform everyday tasks.

Frank Lin, M.D., Ph.D., an associate professor of otolaryngology and epidemiology at Johns Hopkins University, conducted a study in 2011 in which the mental abilities of 639 cognitively stable individuals were supervised regularly for 12 to 18 years. The results indicated that volunteers with normal hearing were much less susceptible to acquiring dementia while those with mild, moderate, and severe hearing loss were two, three, and five times more susceptible to the disorder, respectively.

Another study conducted by Lin in 2013 involved observing the cognitive abilities of 1,984 older adults over six years. The research concluded that older adults with hearing loss tended to experience 30 to 40 percent accelerated cognitive dysfunction and were at a higher risk of developing dementia.

What Is the Cause?

Since the exact link between hearing loss and dementia is still a mystery, there are theories about how the former may aggravate the latter.

One of the theories suggests that if the brain struggles to cope with degraded sounds, its resources are allocated to processing these sounds and this “cognitive load” causes a decrease in overall cognitive functioning. Moreover, hearing loss accelerates atrophy in the cerebrum which is not exclusive to processing sound as it also plays a role in memory. In addition, it is speculated that social isolation that results from hearing loss causes stress and depression and exacerbates cognitive deterioration.

What Is the Solution?

Not many studies have been conducted to check the influence of treating hearing loss for treating dementia. However, the studies that have been conducted so far do provide considerable hope.

One way to improve profound hearing loss is receiving cochlear implants. French researcher Isabelle Mosnier, M.D., of the Assistance Publique-Hôpitaux de Paris, evaluated the effect of cochlear implants on cognitive functioning in 94 elderly people who had profound deafness (in at least one ear).

Mosnier found that hearing rehabilitation improved not only cognitive functioning of the elderly, but their speech perception as well.

The most direct link between auditory impairment and memory loss is the brain. Thus, any stimulus that helps the brain remain alert will keep the person active too. Hence, researchers are considering the use of music therapy to restore cognitive functions in people who suffer from memory loss.           

Concetta Tomaino, a cofounder of the Institute for Music and Neurological Function, found that music stimulates parts of the brain made inactive by dementia. In a pilot study, music therapy sessions were conducted with 45 individuals with chronic dementia and the results showed that neurological and cognitive abilities improved significantly for those in the music group.

This research shows there are techniques that can aid individuals with dementia and hearing loss. If you or a loved one has hearing problems, please see a hearing health professional to get a hearing test in order to potentially prevent future cognitive issues. 

Alycia Gordan writes for Brain Blog.

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Meet HHF's Small But Mighty Team

By Nadine Dehgan

Hearing Health Foundation (HHF) is working around the clock to help find cures and treatments and also to better the lives of those with hearing loss. And we are doing it with a small and incredible team.

Recently I attended a bowling outing with HHF's full-time staff and our mighty army of interns. (Please see the photo.) Missing are Yishane Lee and Robin Wisser Kidder whose wonderful talent is used to edit and design Hearing Health magazine; Caroline Oberweger who aids with foundation grants; and Frankie Huang who helped as a marketing intern.

From left to right: Stephanie Jacovina, Breana King, Shawaza Majeed, Laura Friedman, Nadine Dehgan, Hai Zhou and Kelly Barahona

Thanks to these talented people, HHF has been able to: 

• Increase awareness of preventable noise-induced hearing loss by developing. partnerships with peer organizations and corporations.

• Register to fundraise in every state—a necessary and time-consuming process.

• Write blog posts and magazine articles on various hearing loss topics as well as hearing research.

• Secure media placement in the following outlets: The New Yorker, The Guardian, Men’s Journal, and others.

• Rewrite our internal policies and procedures to streamline activities and reduce costs.

• Send supporters and constituents countless communications including magazines, letters, and appeals to raise funds so we can continue our important work.

• Communicate with the Federal Drug Administration, Federal Trade Commission, and various elected officials regarding the critical need for affordable hearing health care (e.g.,. over-the-counter hearing aids) and significance of funding hearing research.

• Advocate for the reversal of the 2018 federal budget’s proposed elimination of all federalUniversal Newborn Hearing Screening funding, $18 million in total.

• Announce our newly formed partnership with Hearing Charity of America’s Hearing Aid Donation Project to collect used hearing aids to give to those who need.

• Increase Hearing Health magazine ad sales revenue enabling HHF to invest in growing its readership.

• Continue to receive top ratings from charity watchdogs with HHF named twice in two categories in Consumer Reports’ top five best charities.

• And most importantly increase funding to our critical hearing and balance research programs promoting innovative approaches by both early-stage scientists and established experts in their fields!

At HHF we all live and breathe our mission. I would like to recognize and express my gratitude to those the who give of their time and talent to our cause.

There is much to do and many unmet research needs—but together we will get there.

From the bottom of my heart I am grateful and hope you wil join me in thanking these folks. They help make it all possible.

Nadine Dehgan is the chief executive officer of Hearing Health Foundation.

Finding a Community of Musicians with Hearing Loss

By Joanna M. Eng

At eight years old, Jennifer Castellano learned that she had perfect pitch—and found out that she needed hearing aids for a mild to moderate hearing loss in the middle frequencies, known as a “cookie-bite” loss. Now as a performing pianist and composer with two original solo albums, she has been featured on classical radio programs and has written music for an orchestra and a music teachers’ association.

Jennifer wrote about her unique experiences as a musician who has hearing loss, as well as a lifelong visual impairment caused by endothelial corneal dystrophy, in Making Music with a Hearing Loss: Strategies and Stories. She also serves as secretary of the Association of Adult Musicians with Hearing Loss (AAMHL), a nonprofit organization led by Wendy Cheng.

Leading up to AAMHL’s 2017 conference for musicians with hearing loss (July 13–16 in New Jersey), we talked to Jennifer about her music and how AAMHL has been a part of the journey.

How have the challenges differed between having a hearing loss and having a visual impairment?

My vision is much like my hearing.  Even with corrective lenses, my visual acuity is 20/300.  I cannot see things far away, but if I am up close I can see fairly well.  Without my hearing aids I can't hear too much, but if the sounds are really close to my ear, I can make them out.

But I can tell you that I have gotten two completely different reactions.  Since I was small, there were always resources made available to help me overcome my visual impairment. However, I was given no resources to help with my hearing loss. 

I didn't begin to talk until I was three-and-a-half years old. When my parents took me to a speech therapist, she advised that I would begin speaking when ready. My parents thought I was a late bloomer. They didn't consider hearing loss at that point because they were so focused on my vision problem. 

My mother spoke much louder than the average person (she claims it is because she is from the Bronx) so that is probably one reason why I was able to fool people for so long.  When you have a cookie-bite loss, it is easy to fool people because it’s like “oh, but you’re hearing these high and low frequencies fine.”  I never understood too much in the classroom though, especially when classmates spoke.  My teachers thought I was spacing out and not paying attention.

I did not have an FM system in school and did not become aware of what an FM system was until I was a second-year grad student.  When professors would comment on my piano tone sounding too percussive, I had no clue what they were talking about because I couldn't hear and tell the difference between tone qualities.

I currently wear Phonak Certena hearing aids in both ears.  I don't use any other listening devices when playing solo piano, but if I am playing with other instruments, I may have one of the performers wear my FM transmitter.  For example, when  guitarist Charles Mokotoff and I played a duet together, he wore my transmitter around his neck and it picked up the sounds of the guitar quite nicely.

What has been your involvement in AAMHL? How long have you been a member?

In 2007, I found the organization by doing a Google search.  At the time, I was a second-year grad student who was struggling to hear one of my professors in class and was looking for some resources. My hearing loss was now moderate to severe. It had changed in my early 20s, which is when the tinnitus started to kick in.  I wanted to know if there were other living musicians with hearing loss like myself.  I contacted Wendy, and the rest is history. 

It wasn't until 2015 that I began serving on the board as secretary, so I helped in planning the 2015 conference.  We met online at least once a month and discussed how the convention was going to work.  We would talk about the equipment we needed to make the event accessible for people with hearing loss.  I got to witness all of the hard work Wendy puts into this organization.  It is truly amazing what she does.

You played in ensembles with other musicians with hearing loss through AAMHL. What was the experience like?

I played mostly in duos.  I played with guitarist Charles Mokotoff, soprano Dawn Mollenkopf, violist Wendy Cheng, jazz singer Mandy Harvey, and violinist Stephen Shey.  AAMHL brought us all together for the conference in 2015 and the open mic event at HLAA's 2016 conference.  We all live in different areas so there was no way that we would normally play together.  AAMHL provided a common platform from which we all could perform together.

I don't consider these experiences to be different from the experiences I have had playing with musicians with normal hearing.  The experiences vary from person to person.  I have worked with some very fine musicians, some of whom have normal hearing and some who don't.  I would say that my more unfortunate experiences came from working with musicians who had normal hearing.  It seems that when one is faced with an obstacle such as hearing loss, it not only forces him or her to work even harder, but it also humbles them.

Another thing that people need to realize is that the level of musicianship is not determined by how well a person hears but rather how well a person listens.   Just because a person has normal hearing doesn't automatically make them a good listener.  When it comes to listening, one must be able to pay close attention and recognize what is happening around them.  Having a good musical ear means you have a good memory.  I was the strongest student in my ear training classes, not because I had the best hearing but because I have a very good memory.

Lastly, being a good musician requires discipline.  I have worked with six different musicians who have hearing loss and all of them are very disciplined.  They all were prepared and knew what they were doing, and we had only a matter of hours to prepare for a performance because we all were coming from different areas.  We all had to make sure our individual parts were rock solid. 

What were some of the highlights of the first AAMHL conference in 2015? What did you gain from it?

I really enjoyed the 2015 conference because I got to meet so many fine musicians and I got to learn about the available resources for people with hearing loss.

It was nice to finally meet others who had experienced similar things and who understood all too well the preconceived notions associated with hearing loss.  In my past experiences, everyone thought that because I wore hearing aids, my hearing was normal when I had them on.  Not true.  I got to learn how people compensate for their hearing loss and are able to successfully make music.

Probably one of the most memorable experiences, though, was when I met the singer Dawn Mollenkopf, who has a severe to profound hearing loss. And like me, she has synesthesia, a phenomenon in which perception in one sense triggers perception in another. We both perceived music in color and for us, this was a great tool for us in listening to music. Certain colors went with certain musical notes.  In my own personal experience, "seeing colors" in response to hearing sound helps me recognize and understand what I am listening to.  It is my synesthetic experiences that enabled me to develop a good musical ear because colors served as memory aids. This was my first time meeting a person with hearing loss who experienced synesthesia.

How long have you been composing music? What do you love about composing and what do you hope to express in your work?

I began composing music seriously when I was a sophomore in college. I have gone through different periods of writing.  In my early years, my focus was on incorporating visual imagery in my music, thus proving the commonalities between sound and color.  My work was influenced by my synesthesia.  Then shortly after graduating from college, I adopted two small parrots and soon my music took an avian spin.  It was my intention to pay homage to our finest music makers, birds.  As of now, I find myself seeking the divine or perhaps something that cannot be understood by the spoken word.  My music has always been a bit abstract but now I find that my music simply is what it is, a kind of story of a soul, my soul, striving towards happiness, striving toward heaven.

I can't say I enjoy composing music.  Actually the process is quite painful and is a lot like pulling hair.  It doesn't come all that easily but once the music is written and gets a performance, it is well worth the aggravation.  Writing music is a way to leave something behind for the generations after me.

What was the inspiration for your latest album, Images?

Early in 2015, I made a pilgrimage to the Holy Land with members of my church where we visited various historic and holy places. This wonderful trip was the inspiration behind Images, a collection of seven piano pieces, each inspired by either a specific place, moment, or feeling during my visit.  There are other original piano pieces on the CD, three of which were commissioned by the New Jersey Music Teachers Association.

What's next for you? What are you excited about in the coming year

Well, at the beginning of March I had my first organ lesson.  Yup, I am learning the organ.  I had played piano for a few masses at my church and enjoyed it.  There was no organist available at the time and I didn't know how to play so I played the piano.  This made me curious about the organ and so I decided to learn in hopes that I can be a church organist someday.

This post originally appeared in Grand Piano Passion™.It was repurposed with permission. 

Getting Married? Turn It Down

By Emilio Cortez, Ed.D

Wedding day celebrations often include music, but when music is too loud, you and your guests may experience hearing loss as a result. The problem of loud music is rampant and has contributed to the growing number of 48 million Americans who suffer from hearing loss.

Many bands and disc jockeys play music at 100 decibels (dB). If you’re not wearing earplugs, 100 dB can cause hearing loss in just 14 minutes, according to the Centers for Disease Control and Prevention. A telltale sign that music is too loud is when you need to shout to the person next to you just to be heard. If the music at a wedding is played consistently at 90 dB of loudness, hearing loss can occur after two hours of exposure.

Since we are all the targets of dangerous decibels, we need to remember, “Be decibel-wise: under 85 keeps hearing alive.”

When interviewing bands or DJs for a wedding, insist that you want the music to be no louder than 80 dB—and then be prepared for bewildered faces. Since many musicians and DJs are accustomed to playing very loud music, some of them have already lost hearing, so 80 dB won’t seem loud enough; an alternative plan would be to make earplugs available to your guests (see below).

The louder music is played, and the more guests that attend a wedding, the louder guests must talk to converse which adds to the total loudness. You may want to appoint a wedding helper to monitor the music’s loudness and to remind musicians to turn down the volume as needed. Also, by having the music alternate between loud songs and softer music, you can give your guests and their ears a healthy rest from potentially dangerous decibels.

Many free decibel meter apps are available for both Apple and Android smartphones. You can check it for accuracy by talking into it in a normal speaking voice. You should be getting a reading somewhere between 60 and 70 dB, which is a normal reading for conversational speech. The National Institute for Occupational Safety and Health has blogged about the accuracy of decibel meter apps.

If you choose to use earplugs that conform to your ear canal size, refer to the YouTube video, “Fitting Foam Earplugs.” In essence you want to roll the earplug down to toothpick size and then insert it into your ear, allowing it to expand in order to provide the most effective hearing protection.

My daughter is getting married this August, and I had her share this information with the prospective DJ so he knows exactly what I will be expecting as the father of the bride! Noise is the most preventable cause of hearing loss. Don’t squander it on your wedding day.

Emilio Cortez, Ed.D., is a member of the Hearing Loss Association of America of Pennsylvania and a co-chair of its Turn Down the Volume Committee.

Telehealth Tools Can Change Your Hearing Care

By Carol Meyers, Au.D.

We continue to benefit from incredible technological advances that assist in the diagnosis and treatment of many health conditions. One rapidly growing technology with the potential to revolutionize hearing care is telehealth, which utilizes telecommunication technologies like smartphone apps to provide virtual healthcare and education services to patients.

Many hearing aid wearers already use apps that serve as remote controls or audio streamers for their hearing aids. As manufacturers develop more ways to leverage smartphone apps, consumers can also expect to change the way they interact with their hearing care professional for the better. Here are some ways telehealth hearing care apps can help you.

Save time and effort.

Nothing will ever completely replace face-to-face interactions with your healthcare providers. However, some issues can be resolved with a brief conversation. Telehealth apps offer text, voice, and even video calls so that you can consult your hearing care professional without making a trip to the office. Furthermore, apps can store useful information, such as care and usage instructions and troubleshooting guides, so you can use them to solve problems at your convenience. This is particularly advantageous if you live in a remote area, cannot take time off work, or have difficulty getting around.

Adjust to wearing new hearing aids.
Getting used to wearing new hearing aids involves actually retraining your brain to process all the sounds that you were missing before amplification. Hearing care apps can assign you simple daily exercises to complete, such as rustle a newspaper or have group conversation during a family meal. These exercises encourage your exposure to a variety of listening situations. As you complete these tasks, you can rate your satisfaction with the experience, which is then transmitted to your hearing care professional.

Let hearing care professional monitor your hearing needs.

Your hearing care professional wants to ensure your satisfaction and success just as much as you want your questions and concerns about your new hearing aids resolved. Your ratings and feedback regarding new listening experiences can be transmitted via the app to your hearing care professional, who can then contact you if necessary.

Have your hearing aids adjusted remotely.

Not only can your hearing care professional interact with you via apps, they can also access your hearing aid settings directly without your needing to visit the office. Based on your feedback (via a text or call) they can adjust your hearing aid settings and send the update through the app to your hearing aids. Once you accept the change, those adjustments take effect so you can try them out immediately.

Finally, telehealth apps are safe. They are secured via end-to-end encryption so that interactions and conversations between you and your hearing care professional remain private. The next time you visit your hearing care professional, ask how a hearing aid telehealth app can help you.

With more than 25 years of clinical practice, Carol Meyers, Au.D., is an educational specialist for Signia responsible for the training and education of staff and hearing care professionals in the U.S. on the company’s products, technology, software, services, and audiology-related topics.

Paying Tribute on Armed Forces Day

By Siera Whitaker

May 20 is Armed Forces Day and Hearing Health Foundation is paying tribute to the men and women who serve in our armed forces.

The number one and two war wounds for active service members and veterans are hearing loss and tinnitus, directly impacting their ability to conduct missions and follow instructions. According to the U.S. Department of Veterans Affairs, by the end of 2014 over 933,000 veterans received disability compensation as a result of hearing loss, and about 1.3 million received compensation for tinnitus.

Extended, unprotected exposure to noise that reaches 85 decibels (the sound of a lawnmower) or higher can cause permanent inner ear damage. The Centers for Disease Control and Prevention (CDC) states difficulty with hearing is the third most commonly reported chronic health condition in the U.S.; approximately 40 million Americans ages 20 to 69 have hearing loss in one or both ears, and one main cause is excessive, loud noise.

When it comes to hearing loss and tinnitus, soldiers are at an increased risk. They are susceptible to noise-induced hearing loss (NIHL) because they are exposed to loud machinery and explosions on a constant basis. In combat, soldiers are often exposed to sudden noises, such as from an improvised explosive device (IED) or other similar weapon, which are difficult to predict and be protected against. These sudden noises can result in temporary hearing loss and put military personnel at risk. However, the word “temporary” should be approached with caution. Repeated short-term hearing loss can damage the sensitive hair cells in the inner ear, leading to hearing loss that becomes permanent.

Hearing loss as a result of noise is 100 percent preventable. Wearing hearing protection such as noise attenuating helmets, which use ear cups to protect against hazardous sound, or Tactical Communication and Protective Systems (TCAPS), can go a long way to reduce overall exposure.

Since these brave men and women are disproportionately impacted by hearing loss and tinnitus that likely affects many other aspects of their lives, Hearing Health Foundation is proud to pay tribute to them on Armed Forces Day. If you are a veteran, current service member, or have family or friends who have bravely served our country, please check out our veterans' resources and share your story about hearing loss or tinnitus with us.