Hearing Loss
Hearing Loss
Avoiding the Silent Treatment
Most of us take hearing pretty much for granted. A bird sings and we feel good. A child calls and we come. A boss yells and we feel like running the other way.
But the actual act of hearing--the complex process that begins with sound waves entering our ears and vibrating through a complex channel of sensory hairs, fluids and structures to the brain--is something that we do without thought--until something interferes.
The major causes of hearing loss in women under the age of 45 are loud noise; degenerative diseases such as lupus, a chronic inflammatory disease that affects the skin, joints, kidneys, nervous system and mucous membranes; and otosclerosis, a condition in which bone grows over a tiny structure in the middle ear, according to Douglas Mattox, M.D., chairman of otolaryngology at the University of Maryland in Baltimore. Infections, trauma, tumors and Meniere's disease can also cause hearing loss, although they're less likely to do so.
Some scientists say that our ears were made for a primitive world in which the loudest sound might be a twig snapping underfoot, so just the normal cacophony of the twentieth century may be something of a challenge to our ears.
But add an extra 105 decibels--the pounding music in an aerobics class or from a portable tape player--and you have a good chance of having a significant hearing loss, says Edwin Monsell, M.D., Ph.D., director of the Division of Otology and Neurotology in the Department of Otolaryngology at Henry Ford Hospital in Detroit. And if you are in an aerobics class, keep in mind that at least one researcher suspects that the physical impact of aerobics on your inner ear may also cause hearing loss.
For the most part, however, how long it takes for these noises to damage your hearing probably depends on how your ear is built and how much noise it's been exposed to throughout your life. As a general guideline, scientists agree that if you listen to a sound at 85 decibels for eight hours, 88 decibels for four hours or 91 decibels for one hour, you are at risk for hearing loss, says Dr. Mattox.
Decibels are the units that are used to measure loudness of sound. The sound you hear when you're standing next to a running diesel truck engine is 84 decibels, and what you hear when you're standing 1,000 feet away from a revving propeller aircraft is 88 decibels.
The point is that the louder the noise, the less time it takes to cause a hearing loss, says Dr. Monsell. A 140-decibel gunshot can instantly tear apart a single sensitive organ in your ear, resulting in immediate and permanent hearing loss.
Dr. Monsell adds that most noise-induced hearing loss is related to factory work, loud motors and firearm discharges. He says it's very unlikely that women would be at risk from typical noise volumes in the office or at home.
The Quiet Zone
Fortunately, there are several simple ways to prevent noise-induced hearing loss.
Live quietly. Leaves rustling in the forest register only 20 decibels. Whispers register 30. Normal conversation registers 50, and busy traffic registers 70.
Clearly, no one who lives on a mountaintop will ever experience noise-induced hearing loss. But neither will those who live in city apartments, if they learn to keep their windows closed and televisions, radios and voices at a low volume.
Keep noise levels below a shout. If you have to shout when you're standing four or five feet away from someone, the surrounding noise is loud enough to damage your hearing, says Dr. Mattox.
Wear protection. Wear ear protectors whenever you know you'll be exposed to loud noise, says Dr. Mattox. The decibel level inside a subway car is 95. Standing beside a lawnmower, it's 96. A live rock concert can reach 130 decibels.
Earplugs that fit into the outer ear canal will reduce your exposure to noise by anywhere from 6 to 35 decibels. Look for the noise reduction rating (NRR), which provides a rough estimate of effectiveness, listed on the package of any earplugs you buy to figure out which pair is best for you. Some earplugs are premolded, while others are soft enough to be molded to the shape of your outer ear canal.
Protective earmuffs that fit firmly over the entire outer ear to form a seal will reduce the sound level by 14 to 29 decibels. They are available from industrial supply houses. Whichever kind of protective device you use, make certain you use it correctly.
Experts recommend that earplugs and earmuffs be worn together when the surrounding sound level exceeds 105 decibels--about the sound level you hear in an aerobics class.
Tinnitus: The Sounds of Silence Clang. Pop. His-s-s, bz-Z-z-t- . . . h-u-m-m-m-m-m. If you have tinnitus, the clanging, popping, hissing, buzzing and humming that are common to high-voltage wires or an electric generating plant are likely to be what you hear instead of silence. The sounds affect some 40 million men and women in the United States. Ten million have serious difficulty living with the condition, researchers say, while another million say that they can no longer live a normal life. Some, in fact, attempt suicide. Temporary tinnitus may be caused by something as simple as earwax or as complex as a drug. Caffeine and aspirin, as well as indomethacin (Indocin), carbamazepine (Atretol), propranolol (Inderal) and levodopa (Atamet)--drugs prescribed for pain, heart disease, high blood pressure and Parkinson's disease--can cause the problem. Chronic tinnitus may be triggered by "crosstalk" between nerve transmissions to and from the brain, a mistake in nerve cell transmission, an imbalance in the electrical charges normally found within the inner ear, or something no one's thought of yet, researchers say. And it frequently occurs with hearing loss and hearing-related diseases such as otosclerosis and Meniere's syndrome. Although tinnitus can sometimes be "masked" by other sounds such as radio static or running water, there is no medication or surgery that will cure it, says Douglas Mattox, M.D., chairman of otolaryngology at the University of Maryland in Baltimore. Surgery to knock out nerves that may be involved in transmitting the sounds has had varied results. In a study of 72 men and women at the University of Pittsburgh School of Medicine, only 18 percent of those who had surgery experienced total relief of symptoms--at least for a while. Twenty-two percent reported "marked" improvement, 11 percent had "slight" improvement, and 49 percent reported no improvement at all. Women had a slightly higher response to the surgery than men. Of the 31 women who had it, nearly 29 percent experienced total relief of tinnitus. But other treatments--including antidepressant and anti-epileptic drugs or tranquilizers such as benzodiazepine (Valium)--can achieve similar results, says Dr. Mattox. That's why researchers at the University of Maryland's Tinnitus Center are taking this approach to the problem. In place of trying to eliminate the source of tinnitus, researchers are stopping the signal from reaching a level of awareness or perception through sound retraining techniques.Since tinnitus normally can't be stopped, the idea is to train your brain not to hear it.
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Avoid certain drugs. Antibiotics such as streptomycin, some diuretics, salicylates such as aspirin, and anti-cancer drugs such as cisplatin (Platinol) are known to damage sensitive structures within the ear and may cause permanent hearing loss, doctors report.
Anytime a drug that falls into one of these categories is suggested by your physician, you might want to ask your doctor or pharmacist what the odds are that it will affect your hearing.
If you are thinking of becoming pregnant, you also need to know that exposing your baby to various drugs during pregnancy can cause a congenital hearing loss. Ask your doctor which drugs to avoid.
Listen to your ears. If you've ever walked off a plane or out of a concert and felt a ringing in your ears as though your hearing were muffled, you've probably experienced a temporary threshold shift. The threshold is the quietest sound you can hear; when it shifts, it means that you've lost some of your ability to hear.
In the No-Silence Zone Teresia Guinn is a dentist's receptionist in Gibson, Tennessee. She can no longer hear most of the high-pitched sounds that surround us, but she loves the sound of a dentist's drill because it obliterates the sounds of tinnitus. This is her story. I don't ever hear quiet anymore. I had someone tell me one day that she noticed the first thing I did when I came home was turn on the TV. She said, "You know, my kids are all grown and gone from home like yours. Wouldn't it be nice to just not turn on the TV and have everything quiet?" "Well, that would be nice," I told her, "but I can't." I could turn off everything that was making any kind of noise in this house and I'd never have quiet. What I hear is like a high-tension wire, a voltage wire. It's between a ringing and a hum. It started out real low and quiet three years ago, but then it got louder. And every once in a while I'll get a real high-pitched squeal, a real whistle sound almost. It lasts just a few seconds and it dies back down. But it just terrifies me because--God!--if I have to listen to that the rest of my life! Sometimes it sounds like what you hear when you're watching TV, flipping from channel to channel. Once in a while it'll come across and, for some reason, that noise agitates me so much. It's like people are shouting and screaming and it just really tears my ears up. My tinnitus eventually got so bad that my doctor prescribed tranquilizers. That terrified me. "Yes," I told him, "Yes, okay, give them to me. And if I have such a bad day I can't make it, I'll take them." But I got the prescription and I just sat down and I thought to myself, "There's got to be something else. There's got to be another way to deal with this." So I started looking for a support group. I called the American Tinnitus Association and I told them where I lived, and a woman said, "Let me look in the computer and see what we have in Tennessee." Well, she came back on the line and said, "Sorry, there's not one." So later I discussed it with my friends and they said, "Why don't you start your own?" And I did. How do we cope? Well, the majority of people in my group all said the same thing: You can mask tinnitus with certain kinds of sounds, like when you hear running water--a waterfall, or dishwater running in the sink. So I got a tape recorder, then went into the bathroom and turned on the cold water. I set the shower nozzle at a certain angle and recorded for about 45 minutes to an hour. Now I take a portable cassette player and headset everywhere. And when things are slow in the office--it really drives me crazy because it gets really quiet--I put it on and just turn it up to where I can just lose this other sound. After about 30 minutes, I noticed, the tinnitus will quiet down and stay that way for hours at a time. Then I can smile.
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The loss is probably temporary. But it may become permanent if you repeatedly expose your ears to noise levels that cause the shifts, doctors warn. That's why you should take your ears' hint and avoid any type of noise that causes this effect, doctors agree. Or at the very least, make sure you're wearing ear protectors the next time you're exposed.
Have your hearing checked. Check with your doctor if you're beginning to miss things in conversation, says Dr. Monsell. If you have to switch ears on the telephone to hear clearly, or if you have to ask people to repeat what they've said, you should have your hearing tested. Getting your doctor to work on the problem may prevent further hearing loss.
