hearing loss journey

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A Noise-Filled Hearing Loss Journey

Joel Streed

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Suffering from severe hearing loss and struggling to find answers, Dianne Lee Needham turned to Mayo Clinic's Cochlear Implant Program. Here she shares in her own words how the care she received has dramatically improved her quality of life.

Written by Dianne Lee Needham

Three years ago, my hearing was fine until I flew from New York City back home with a bad head cold. Once home, the cold worsened and required a family doctor visit, antibiotics and then an ENT [ear, nose and throat] appointment not far from where I reside in Arizona.

"Let's get you some hearing aids, honey," said the ENT doctor (the first of many I went to for help) as he ushered me toward his audiologist's door. The audiologist, wearing a panda print design scrub top, gestured toward the sound booth. Taking a seat on the toddler-size chair, I saw them: the milk-drinking bunny, the cymbal-clapping monkey and the drum-playing frog with their gazes fixed on me. Smiling, the audiologist asked if she could wind up the mechanical toys for me. I had no response. I did not get hearing aids at that time.

A few days prior to seeing that first ENT physician, I had recovered from the upper respiratory event but noticed an awful fullness on both sides of my head. I was not aware of what was happening, but my hearing function was failing, and the horrible noise in my head would never leave.

No physician seemed to know what to do with me. For 12 weeks from the onset of my cold, I couldn't sleep, eat or function normally. I had suicidal thoughts.

Searching for answers

I bounced from my internal medicine physician practice to one ENT doctor after another, one neurotologist to another, and finally to an independent audiologist. The doctors' diagnoses seemed uncertain and recommended treatments varied greatly. They all agreed I had progressive bilateral sensorineural sudden hearing loss with extreme tinnitus . They eventually deemed a cochlea virus stemming from my head cold as the likely culprit.

An MRI showed no tumors or issues with my internal auditory canals. Blood work was completely normal, and I had no prior history of hearing function problems or contributing disease factors. I was basically very healthy.

Name it, I tried it, for both my hearing loss and my tinnitus: intratympanic steroid injections, low-salt diets, sound therapy, meditation, vitamin supplements, focused activities, custom harmonics software and earbuds, and more.

Leading with self-advocacy

Finally, an independent audiologist fitted me for hearing aids. For a while, I had improved hearing and a fair amount of relief from tinnitus when I used the sound generator feature on my hearing aids.

After a year or so, however, I noticed I couldn't hear well at all, especially on the left side with the right a very close second. Tinnitus was, and is, in both ears — a freight train roar wrapped by fluorescent light bulb buzzing on the left and crickets blended with Morse code on the right. It is hearing loss coupled with 24/7 noise nonstop. Day and night. Intolerable. I longed for silence. I longed to be able to hear better and to understand anyone who spoke to me.

"My tinnitus was rated as catastrophic — always heard, disturbs sleeping and makes all activities difficult." — Dianne Lee Needham

At this point, I decided to lead, not follow, in the pursuit of help. I had to. My self-advocacy led me to the Mayo Clinic Cochlear Implant Program . Mayo's dedicated multidisciplinary cochlear implant team approaches each case individually. They consider all aspects and parts of a patient's otolaryngological medical circumstances. Their goal is to bring improved hearing and, when possible, tinnitus relief.

Qualifying for an implant

My first appointment at Mayo Clinic as a potential cochlear implant candidate was for specialized hearing tests conducted by Amy Olund, Au.D., a cochlear implant audiologist. Severe hearing loss was displayed on my left side and moderate to severe hearing loss on my right. My tinnitus was rated as catastrophic — always heard, disturbs sleeping and makes all activities difficult.

I then consulted with Colin Driscoll, M. D. , in Otorhinolaryngology . He greeted me, asking how I was doing. "Anxious," I replied.

"Dianne, we make it very difficult to pass the audiology exams for an implant, and you failed at every critical juncture," he said. "It is highly likely you will hear better with an implant than you do with your hearing aid."

Having already reviewed my related medical history and MRIs, he indicated I qualified to receive a cochlear implant. Both Drs. Driscoll and Olund agreed that the combination of my severe progressive hearing loss and disruptive tinnitus made me a good implant candidate.

Hearing restoration

A cochlear implant goes past the damaged parts of the inner ear, directly stimulating the auditory nerve. The surgically implanted medical device can improve hearing in individuals with severe or profound hearing losses. It produces an array of sounds; however, normal hearing is not replaced.

When the brain is not receiving sound information, it creates phantom noises or tinnitus. A cochlear implant transmits sound information to the cochlea nerve cells. The implant is not a cure for tinnitus. But when the device is activated, it can suppress the brain noises.

"Bilateral asymmetric sudden sensorineural hearing loss with associated severe tinnitus can be a challenge. We see a lot of unilateral cases, but bilateral loss is observed less often in adults," Dr. Driscoll says.

"What happened to Dianne physiologically is speculation. Was there really a virus in the inner ear? Who knows. Is it autoimmune or other inflammatory process? Unknown," Dr. Driscoll adds. "There is no way to look at the pathology of the ear or test the actual tissue or fluid. Nobody lets us take their ears out at the time to study them."

Making clear progress

I received my cochlear implant a month after meeting the Mayo team. The diligent, practiced care and eloquent surgical techniques of Dr. Driscoll and his resident team (in my opinion the best in the country) completed the outpatient procedure in approximately an hour and a half. Postoperatively there is no pain to speak of, and minimal blood loss and scarring. I found it daunting and amazing.

A few weeks after the surgery, my device was activated by Dr. Olund. I could hear in my ear and the tinnitus noise intensity dropped immediately. The initial ambient sounds that come through the device are mechanical, and human voices have a Darth Vader-like quality. But only weeks after implantation, I clearly heard my car turn signal clicking, the toilet flushing and the coffee maker percolating. And most importantly, my husband Howard's voice saying, "I love you."

"At Mayo, for the first time in my hearing loss journey, I felt like the medical specialists cared enough to truly listen to me." — Dianne Lee Needham

I will return to Mayo for a year's worth of aural rehabilitation to retrain my brain how to hear.

Because I wear an implant on my left hearing side and a hearing aid on my right side, I am bimodal — wearing electric and acoustic assistive hearing devices.

"Bimodal listening is challenging because users are required to learn two different pieces of technology. The cochlear implant and hearing aid have different features and controls and are often adjusted independently," Dr. Olund says. "On a positive note, these technologies have begun to merge, making it easier for bimodal listeners."  

Hearing and listening

Mayo cochlear implant team members and my loving husband, Howard, have saved my life and given me an improved quality of life — with better hearing and the defeat of tinnitus. Now I hope my Chicago Cubs return to the World Series, so I can really hear the game (not like when we attended Game 4 of the 2016 World Series, Chicago Cubs versus Cleveland Indians).

At Mayo, for the first time in my hearing loss journey, I felt like the medical specialists cared enough to truly listen to me. I once read that "hearing is involuntary; listening is a choice." The Mayo otorhinolaryngology specialists exemplify this statement in all ways. They are accessible, patient, kind, medically astute, and willing to teach and educate you.

And both Dr. Driscoll and Dr. Olund tell me it will "only get better from here."

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What I Learned From My Hearing Loss

While hearing loss presents many challenges, it is also a wonderful teacher..

Posted August 23, 2021 | Reviewed by Davia Sills

• When you have hearing loss, listening requires effort, which can take a toll on your energy level as the day progresses.
• If you don't ask for assistance, it is unlikely to be forthcoming. Hearing loss is an invisible disability, so you must self-identify.
• You may need to use workarounds, but hearing loss should not hold you back from achieving your goals or enjoying your life.

Big birthdays breed reflection, and so it was a few months ago that I realized I have had hearing loss for almost half my life—probably longer since it often takes time for someone to notice their own hearing problems. I've been using hearing aids for less time—it took me a while to come out of my hearing loss closet—but I now wear them with pride. I am grateful daily for the help they provide, even if they are far from perfect.

While my hearing loss presents constant challenges, looking back, I realize it has also taught me so much. I share those lessons with you below.

1. You hear with your brain, not with your ears.

This means that auditory fatigue is a critical factor in how well we hear. It also explains why people with hearing loss may have trouble remembering information that is presented orally or learning new words. People with hearing loss are expending significant brain processing power simply to listen, meaning there is less brain capacity available for other activities.

2. There is no need to suffer alone.

Hearing loss is difficult to understand until you have lived it yourself. Find other people with hearing loss with whom you can commiserate, share tips, and find solace. Hearing loss friends provide wonderful support, especially on a particularly difficult hearing day. Over time, my hearing loss friends and I discovered that we have much more in common than our unsatisfactory ears. I am inspired by all they achieve, despite their challenges.

3. Self-advocacy is the key to success.

Don't be shy ! If you don't ask for the assistance you need, it is unlikely to be forthcoming. Hearing loss is an invisible disability, so you must self-identify. Get comfortable with declaring your hearing loss publicly and asking for the help that you want.

The more specific you can be in your requests, the better the results are likely to be. You can practice with strangers first if you feel more comfortable. Once you find the right words, advocating for yourself will become part of your everyday routine.

4. Hearing aids alone are rarely enough.

Unfortunately, hearing aids are not like glasses, meaning they will not restore your hearing to normal. While hearing aids amplify sounds, they do not make them sharper or clearer. In fact, in settings with a lot of background noise, hearing aids sometimes do the opposite. Explore assistive listening devices, hearing loops, and captioning alternatives to help you navigate these challenging situations. With the advent of OTC hearing aids, our choices will only widen. Stay current on advancements to glean the most benefit.

5. Hearing loss is exhausting.

When you have hearing loss, listening requires effort, which can take a toll on your energy level as the day progresses. Once you know this, you can factor in listening breaks as needed and schedule important conversations for the morning, when your brain is fresher. Even with proper pacing, by the end of a long day of listening, I often crave only peace and quiet. Don't beat yourself up for it—it is part of the experience.

6. Squash stigma right away.

My father had hearing loss but rarely disclosed it because of the stigma . He eventually distanced himself from his friends and family for fear of discovery. When I first noticed my hearing loss, I was devastated because I had learned that it was shameful and something to hide. What a waste of time! Once I got over the stigma, I felt free. The expectations I had set for myself to hear everything perfectly fell away, and with that, a lot of stress .

7. Those closest to you might disappoint you.

It hurts when your friends and family forget to use communication best practices, especially after you have reminded them for what feels like the umpteenth time. It is frustrating when they neglect to get your attention before speaking to you or talk to you with their hands covering their mouths, but we have to learn to forgive . Because our friends and family are with us the most, there are more opportunities for them to get it wrong. Try to focus on what they are doing right, but accept the fact that you will need to remind them over and over again.

8. You can lead a full life with hearing loss.

You may need to use workarounds, but the hearing loss should not hold you back from achieving your goals or enjoying your life. Despite my hearing loss, I practice yoga, enjoy outings to the movies and the theater, converse with friends and family, raise my children, and engage in meaningful work. You can too.

What have you learned from your hearing loss?

Copyright: Shari Eberts/LivingWithHearingLoss.com. Reprinted with permission.

Shari Eberts is a hearing health advocate, founder of LivingWithHearingLoss.com, and author of Hear & Beyond.

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1. Vercammen, C., Ferguson, M., Kramer, S.E., et al. (2020). Well-Hearing is Well-Being. Hearing Review, 27(3), 18-22.

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Hearing loss program, part of stanford health care ear, nose, and throat, what we offer you for hearing loss care.

• Careful diagnosis from world-renowned ear, nose, and throat specialists. Go to Conditions Treated
• Groundbreaking treatments ranging from helpful devices to advanced microsurgery. Go to Treatments
• Clinical trials to provide eligible patients with early access to promising therapies available only at Stanford Health Care. Go to Clinical Trials
• A collaborative team that specializes in hearing and balance support, cares for you with compassion, and prioritizes your needs. Go to Your Care Team
• Ease of access to providers, treatment, and support services at convenient locations across the Bay Area, making it simple to get the care you need—anywhere and anytime. Go to Connecting to Care

Conditions Treated

At Stanford Health Care, our specialists have experience with all hearing loss and ear conditions. When you lose your ability to hear—whether it is a mild or severe change—we help you figure out the cause with advanced diagnostic tools.

We also treat conditions that may lead to hearing loss or affect the health of your ear and surrounding structures. When it comes to complex issues, we collaborate with other Stanford Health Care specialists if needed to give you comprehensive care.

We see a wide range of conditions, including:

The Stanford Health Care Hearing Loss Program is part of the Stanford Health Care Ear, Nose, and Throat (ENT), ranked one of the top ENT hospitals in the nation by U.S. News & World Report.

The stanford health care hearing loss program is part of the stanford health care ear, nose, and throat (ent) service, ranked one of the top ent hospitals in the nation by u.s. news & world report..

A cholesteatoma is a skin cyst in the middle ear made of trapped skin cells and debris that damages your eardrum. It can also grow and damage your middle ear, inner ear, and even your brain if left untreated. A cholesteatoma can cause hearing loss, dizziness, infections, and injury to your facial nerve.

Conductive hearing loss happens when sound can’t reach your inner ear. It develops from problems with your outer or middle ear, such as an infection, fluid buildup, or malformation of the ear.

Ear cancer most commonly starts as skin cancer on your outer ear or in the ear canal. Tumors can also develop in the ear canal, and may involve nearby structures, such as your mastoid (bone behind the ear) or inner ear organs of hearing and balance. Symptoms of ear cancer may include hearing loss, pain, bleeding, drainage from your ear, and weakness in your face.

Trauma to your ear can cause a number of injuries , including blood pockets (auricular hematoma), eardrum rupture (tympanic membrane perforation), bone fractures (temporal bone fracture), and bone dislocations (ossicular dislocation). These conditions lead to hearing loss and other complications, and often need surgical treatment.

The Eustachian tube connects your middle ear to the back of your nose, draining mucus created by your middle ear and opening when you swallow or yawn to balance the pressure in your ear. Eustachian tube dysfunction happens when the tubes do not open or close properly and air gets trapped inside. The two most common types of Eustachian tube dysfunction are obstructive Eustachian tube dysfunction (the valve of the Eustachian tube does not open properly, most common in young children) and patulous Eustachian tube dysfunction (the valve of the Eustachian tube is stuck open).

Exostoses , sometimes called surfer’s ear, are bony growths in the ear canal. They usually develop from exposure to cold water and can cause hearing loss or infections. Sometimes, your doctor may have to remove skin cells and debris trapped by exostoses, or may surgically remove large exostoses. 

Microtia is an underdeveloped ear that is present from birth. Microtia ranges from a slightly smaller ear than normal to the complete absence of your outer ear and ear canal. Treatment may include an ear prosthetic, surgery to adjust the shape of the ear and ear canal, or implanted hearing devices.

Otosclerosis is an inherited disease of the bone surrounding the inner ear (the otic capsule). The disease causes bone growth, bone loss, and bone scarring. Otosclerosis often causes conductive hearing loss and inner ear hearing loss.

Sensorineural hearing loss happens after damage to the inner ear (the cochlea) or the nerves involved in hearing. There are many causes of sensorineural hearing loss, such as aging, exposure to loud noise, or autoimmune disease. Treatment commonly involves hearing aids or implanted hearing devices.

Your tympanic membrane (eardrum) is a thin piece of skin separating your outer ear from your middle ear. A hole in your tympanic membrane ( eardrum rupture ) can happen from trauma, such as a sharp object pushed into the ear, a rapid change in pressure, or an extremely loud noise. The hole can cause hearing loss and increase your risk for infections and skin cysts ( cholesteatomas ).

Hearing Loss Treatments

We understand how hearing loss and ear conditions affect not only your ability to engage with your environment, but also how your loved ones connect with you. These conditions can be challenging to navigate, but our specialized team offers treatment plans that work.

Our therapies allow you to live a full and vibrant life. We help you regain as much hearing as possible, improve your ability to communicate, and work to prevent hearing loss in the future. If needed, we partner with additional specialists, such as Stanford Health Care Neuroscience and Stanford Medicine Cancer Center, to treat all aspects of your condition.

Your treatment plan may include:

Sometimes we don’t need to take immediate action. Active surveillance means we’ll keep a close eye on your condition. If your condition worsens or poses a risk to your health, then we’ll discuss a treatment plan with you.

Medications help treat certain causes of hearing loss, such as ear infections, autoimmune problems, and otosclerosis. Your doctor may prescribe antibiotics to treat infection or corticosteroids to reduce swelling and inflammation in your ear.

We offer hearing aids to amplify the sound around you and change it into something you can hear. Our specialists work with you to figure out the type, fit, and settings that work best for you. You may receive:

• In-the-ear (ITE) hearing aids
• Behind-the-ear (BTE) hearing aids
• In-the-canal (ITC) aids

When hearing aids don’t work well enough, our skilled surgeons can implant a hearing device. These devices include:

• Bone conduction hearing devices, including bone-anchored hearing aids
• Cochlear implants , which preserve or enhance hearing, at our dedicated Cochlear Implant Center

We specialize in advanced microsurgery procedures to help improve your hearing. Your treatment plan may include surgery to:

• Fix the tiny structures and bones in your ear
• Remove blockages or growths
• Place an implantable hearing device, such as a cochlear implant

If your ear condition affects your balance, you have access to our Stanford Balance Center . Our team combines neurology, otolaryngology (ENT), rehabilitation medicine, and orthopaedic expertise. We do complete evaluations that help us make personalized treatment plans to improve your balance. 

We offer all types of radiation therapies for ear cancers, which may include skin cancer or tumors in the ear and surrounding structures. Radiation destroys cancer cells while minimizing damage to healthy tissues. Our radiation specialists figure out the right approach for your specific cancer diagnosis.

To treat advanced ear cancer, you may need cancer medications. These medications work to shrink tumors and kill cancer cells throughout your whole body. We most commonly use a group of strong drugs called chemotherapy . Your doctor may recommend you receive these medications in pill form or as an injection into your blood vessels, muscles, or skin.

While we may focus on your ear, we care about maximizing your overall wellness. Your total health plays a role in the success of your treatment. We offer a range of support services to assist you and your family throughout your hearing loss journey.

Innovation Through Clinical Research

As a leading academic and research institution, we are always striving to find new techniques and apply the latest and best technology to your treatment. Specialists at Stanford Health Care ENT work with each other and with teams across the nation to spark groundbreaking research. We are committed to bringing you clinical trials that test new and better ways to diagnose, treat, and manage ENT conditions. Participating in a trial may give you access to the latest ENT therapies before they are widely available.

Clinical Trials

Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials for hearing loss.

Our providers in the Hearing Loss Program actively participate in groundbreaking research to find new and better ways to diagnose, treat, and manage hearing loss. We also collaborate with the Stanford Cancer Institute , an NCI-designated comprehensive cancer center, and the Wu Tsai Neurosciences Institute to develop comprehensive treatments for complex ear conditions.

Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.

Your Circle of Care

A diagnosis of a complex ear, nose, throat, or neck condition can disrupt your life. We are here to guide you through every challenge using our Circle of Care approach. You have a team supporting you and placing your needs at the center of every decision. Our multispecialty team works together to tailor treatments to your needs. Depending on your condition, you will be cared for by our otolaryngologists (ear, nose, and throat and head and neck surgeons) and advanced practice providers. Together, we prioritize your overall health and give you renewed hope for a better quality of life. 

Your Care Team

Through teamwork, our doctors continually advance our approach to diagnosis and treatment and improve the care experience. At weekly review meetings, experts from multiple disciplines review cases that require more complex recommendations.

Our extended care team embodies the same cooperative spirit to provide support for all your individual physical, emotional, and daily living needs. Our goal is to maximize treatment success while minimizing the impact that hearing loss can have on your life.

Your Doctors

Otologic and neurotologic surgeon.

Doctors in the field of otology-neurotology specialize in problems affecting your ears, skull, and brain. Otologic and neurotologic surgeons have expertise in treating these conditions with techniques such as microsurgery and implantable hearing devices.

Otologists specialize in conditions and injuries relating to the ears. They have expertise in the structures and functions of the entire ear. These doctors diagnose and treat all ear problems, ranging from mild to complex.

Neurologist

A neurologist is a doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system, including those affecting balance.

Advanced Practice Provider

Our skilled physician assistants and nurse practitioners specialize in diagnosing and treating conditions of the ear, nose, throat, and neck. They see patients independently and occasionally alongside your doctor. APPs can give you a thorough exam, write prescriptions, and help prevent or treat any issues. Our APPs meet weekly to discuss patient needs.

Extended Care Team

Audiologist.

Audiologists are trained, licensed, and certified health care professionals. They measure and evaluate your ability to hear, and have unique expertise in treating hearing conditions. They also measure your inner ear function as it relates to balance and balance disorders.

Nurses and Nurse Coordinators (RNs)

Nurses and nurse coordinators are registered nurses (RNs) who coordinate your care with your hearing loss and ENT team. They guide you from your first contact through follow-up care and help you find counseling, financial, and other support services. 

Care Coordinators

Care coordinators provide you with information and assistance before and during your appointment.

• Medical Assistant: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
• Patient Care Coordinator: Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see your provider and will guide you during your hearing loss care.
• Patient Access Representative:  Patient access representatives can answer your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors. 

Research Coordinators

Doctors at the Stanford Health Care Hearing Loss Program participate in research efforts to advance the understanding and treatment of hearing loss and complex ENT conditions. Research coordinators help find patients who may be eligible for participation in clinical research trials. 

Hearing Loss Support Services

Part of your care involves managing your emotional and spiritual health. We offer you and your loved ones services that can help you stay strong through your hearing loss journey, treatment, and recovery.

Access to Excellence

We strive to make access to care as simple as possible. We have a network of convenient locations across the Bay Area and a wide range of support services. User-friendly virtual health tools and video appointments help you stay connected with your care team from home. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We make it easy for you to get the care you deserve. Our team guides you through each step, so you can make decisions that are right for you.

Connecting to Care

Hearing loss care is accessible and convenient at Stanford Health Care. Our scheduling staff can coordinate your appointments if needed, so that you can see multiple providers during a single trip.

• Insurance and billing : We make it easy to see our doctors by accepting most insurance plans and self-referrals. If you come to us by referral, we coordinate with your referring doctor and share updates.
• MyHealth : Our  MyHealth  system allows you to access your records and view test results through a secure, online portal and device app. You can also communicate with your care providers.

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You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at [email protected] .

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A journey with midlife hearing loss

Don't wait to seek help for hearing issues.

Stephen Ferranti

Stephen Ferranti knew he had to address his hearing loss issues when he realized it could affect his job.

As a product strategy manager in his mid 50s working for a financial software company in New Hampshire, Stephen found himself nodding in agreement with colleagues, but not knowing what they were actually saying.

"I work with a lot of startup companies and with 20-something-year-old millennials who tend to have a lot of social and business gatherings in noisy restaurants and cocktail bars," he says.

"I was tired of apologizing for my age and my hearing." - Stephen Ferranti

When presenting at conferences or talking with colleagues and clients in busy restaurants, he found himself agreeing to do tasks for colleagues or saying "yes" to high-end customers who had not asked a 'yes' or 'no' question. "It was embarrassing," he says.

Stephen realized that not being able to hear people would affect his job and career. He needed to do something about his hearing before it became a big problem.

"What triggered it for me was that I was working in an environment where 50-year-olds are not the majority," he says. "Most of the people I work with are young, and they have perfect hearing."

His doctor suggested that Stephen see an audiologist. Audiologists are health care providers who focus on hearing and balance disorders. His audiologist told him he had typical hearing loss of people in their early 70s, although most people don't address the issue until they are much older.

"He told me I was one of the lucky ones, because I addressed my hearing issues 15 years earlier than most people do," Stephen says.

The audiologist report gave Stephen two options: do nothing or get hearing aids. After much research, Stephen found a few options available for the type of hearing aids he needed.

"Unfortunately, the type of hearing aids I needed were not covered by my medical insurance," he says. "They were expensive. I am fortunate that I can pay for them, but I know many people can't afford them."

The new normal

Stephen has been wearing his hearing aids for almost three years now, and is very happy with his choice. He says it took a couple of months to get used to the hearing aids, because the devices allowed him to hear high frequency sounds that he hadn't heard in a long time. "Your brain needs to adjust to the new normal," he says.

Social situations became easier. "I was tired of apologizing for my age and my hearing. I'm not afraid to point out that I wear hearing aids and eyeglasses," says Stephen. Best of all, he keeps up with conversations in noisy places.

Stephen's advice to anyone with perceived mild-to-moderate hearing loss is to seek help immediately: "Own it. It's not 100 percent like your old hearing, but it's much better than before."

October 13, 2017

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• Patient Care & Health Information
• Diseases & Conditions
• Hearing loss

Hearing loss that comes on little by little as you age, also known as presbycusis, is common. More than half the people in the United States older than age 75 have some age-related hearing loss.

There are three types of hearing loss:

• Conductive, which involves the outer or middle ear.
• Sensorineural, which involves the inner ear.
• Mixed, which is a mix of the two.

Aging and being around loud noises both can cause hearing loss. Other factors, such as too much earwax, can lower how well ears work for a time.

You usually can't get hearing back. But there are ways to improve what you hear.

Parts of the ear

The ear is made up of three primary parts: the outer ear, middle ear and inner ear. Each section is composed of structures that play distinct roles in the process of converting sound waves into signals that go to the brain.

The outer ear is composed of the visible part of the ear (pinna) and the ear canal. The cup-shaped pinna (PIN-uh) gathers sound waves from the environment and directs them into the ear canal.

• The middle ear is an air-filled cavity that holds a chain of three bones: the hammer (malleus), the anvil (incus) and the stirrup (stapes). These bones are separated from the outer ear by the eardrum (tympanic membrane), which vibrates when struck by a sound wave.
• The middle ear is connected to the back of your nose and upper part of your throat by a narrow channel called the auditory tube (eustachian tube). The tube opens and closes at the throat end to equalize the pressure in the middle ear with that of the environment and drain fluids. Equal pressure on both sides of the eardrum is important for normal vibration of the eardrum.

Bones of the middle ear

The middle ear contains three tiny bones:

• Hammer (malleus) — attached to eardrum
• Anvil (incus) — in the middle of the chain of bones
• Stirrup (stapes) — attached to the membrane-covered opening that connects the middle ear with the inner ear (oval window)

The vibration of the eardrum triggers a chain of vibrations through the bones. Because of differences in the size, shape and position of the three bones, the force of the vibration increases by the time it reaches the inner ear. This increase in force is necessary to transfer the energy of the sound wave to the fluid of the inner ear.

• The inner ear contains a group of interconnected, fluid-filled chambers. The snail-shaped chamber, called the cochlea (KOK-lee-uh), plays a role in hearing. Sound vibrations from the bones of the middle ear are transferred to the fluids of the cochlea. Tiny sensors (hair cells) lining the cochlea convert the vibrations into electrical impulses that are transmitted along the auditory nerve to your brain. This is where the initial damage and hearing loss occur due to age, noise exposure or medication.
• The other fluid-filled chambers of the inner ear include three tubes called the semicircular canals (vestibular labyrinth). Hair cells in the semicircular canals detect the motion of the fluid when you move in any direction. They convert the motion into electrical signals that are transmitted along the vestibular nerve to the brain. This sensory information enables you to maintain your sense of balance.

Traveling to the brain

• Electrical impulses travel along the auditory nerve and pass through several information-processing centers. Signals from the right ear travel to the auditory cortex located in the temporal lobe on the left side of the brain. Signals from the left ear travel to the right auditory cortex.
• The auditory cortices sort, process, interpret and file information about the sound. The comparison and analysis of all the signals that reach the brain enable you to detect certain sounds and suppress other sounds as background noise.

Products & Services

• A Book: Mayo Clinic on Healthy Aging
• A Book: Mayo Clinic on Hearing and Balance

Symptoms of hearing loss may include:

• Muffling of speech and other sounds.
• Trouble understanding words, especially when in a crowd or a noisy place.
• Trouble hearing the letters of the alphabet that aren't vowels.
• Often asking others to speak more slowly, clearly and loudly.
• Needing to turn up the volume of the television or radio.
• Staying clear of some social settings.
• Being bothered by background noise.
• Ringing in the ears, known as tinnitus.

When to see a doctor

If you have a sudden loss of hearing, particularly in one ear, seek medical attention right away.

Talk to your health care provider if loss of hearing is causing you trouble. Age-related hearing loss happens little by little. So you may not notice it at first.

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To understand how hearing loss happens, it can be helpful to understand how hearing works.

• How you hear

The middle ear includes three small bones. They are the hammer, called the malleus; the anvil, known as the incus; and the stirrup, known as the stapes. The eardrum lies between the middle ear and outer ear. The middle ear connects to the back of the nose and throat by a narrow area called the eustachian tube. The snail-shaped cochlea is part of the inner ear.

The ear has three main parts: the outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause the eardrum to vibrate. The eardrum and three small bones of the middle ear make the vibrations bigger as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped part of the inner ear, known as the cochlea.

Attached to nerve cells in the cochlea are thousands of tiny hairs that help turn sound vibrations into electrical signals. The electrical signals are transmitted to the brain. The brain turns these signals into sound.

How hearing loss can occur

Causes of hearing loss include:

Damage to the inner ear. Aging and loud noise can cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. Damaged or missing hairs or nerve cells don't send electrical signals well. This causes hearing loss.

Higher pitched tones may seem muffled. It may be hard to pick out words against background noise.

• Buildup of earwax. Over time, earwax can block the ear canal and keep sound waves from passing through. Earwax removal can help restore hearing.
• Ear infection or unusual bone growths or tumors. In the outer or middle ear, any of these can cause hearing loss.
• Ruptured eardrum, also known as tympanic membrane perforation. Loud blasts of noise, sudden changes in pressure, poking an eardrum with an object and infection can cause the eardrum to burst.
• Mayo Clinic Minute: What is hearing loss?

Vivien Williams: Hearing loss is very common.

Matthew Carlson, M.D.: There's a lot of different types of hearing loss.

Vivien Williams: Dr. Matthew Carlson says temporary hearing loss can happen when your ears are plugged with wax or fluid behind the ear drum, for example. Nerve-related hearing loss is usually permanent.

Dr. Carlson: We call it sensorineural hearing loss. There are thousands of different causes of sensorineural hearing loss. The most common is probably just being over the age of 50…

Vivien Williams: …or having a history of loud noise exposure. Dr. Carlson says just about all types of sensorineural hearing loss have to do with the loss of the function of hair cells in your inner ear.

Dr. Carlson: The hair cells, which are the end part of the inner ear that actually take the mechanical sound and turn it to electrical sound…

Vivien Williams: …become fewer or don't function well. Hearing aids help to increase volume. For people with profound hearing loss, cochlear implants work by bypassing the hair cells and sending signals directly to the hearing nerve and brain. Once health care professionals figure out your type of hearing loss, they can tailor treatment that's best for you. For the Mayo Clinic News Network, I'm Vivien Williams.

Risk factors

Factors that damage or lead to loss of the hairs and nerve cells in the inner ear include:

• Aging. The inner ear breaks down over time.
• Loud noise. Being around loud sounds can damage the cells of the inner ear. Damage can happen by being around loud noises over time. Or the damage can come from a short blast of noise, such as from a gunshot.
• Heredity. Your genes may make you more likely to have ear damage from sound or from aging.
• Noises on the job. Jobs where loud noise is constant, such as farming, construction or factory work, can lead to damage inside the ear.
• Noises at play. Exposure to explosive noises, such as from firearms and jet engines, can cause immediate, permanent hearing loss. Other activities with dangerously high noise levels include snowmobiling, motorcycling, carpentry or listening to loud music.
• Some medicines. These include the antibiotic gentamicin, sildenafil (Viagra) and certain medicines used to treat cancer, which can damage the inner ear. Very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics can cause short-term effects on hearing. These include ringing in the ears, also known as tinnitus, or hearing loss.
• Some illnesses. Illnesses such as meningitis that cause high fever can harm the cochlea.

Comparing loudness of common sounds

The chart below lists common sounds and their decibel levels. A decibel is a unit used to measure how loud sound is. The Centers for Disease Control and Prevention says noise above 70 decibels over time can start to damage hearing. The louder the noise, the less time it takes to cause lasting hearing damage.

Longest amount of time to be around loud sounds

Below are the loudest noise levels people can be around on a job without hearing protection and for how long.

Complications

Hearing loss can make life less pleasant. Older adults with hearing loss often report being depressed. Because hearing loss can make it harder to talk with others, some people with hearing loss feel cut off from others. Hearing loss is also linked to loss of thinking skills, known as cognitive impairment.

Hearing loss also is linked to risk of falling.

The following steps can help prevent hearing loss from loud noises and keep hearing loss from aging from getting worse:

• Protect your ears. Staying away from loud noise is the best protection. In the workplace, plastic earplugs or glycerin-filled earmuffs can help protect hearing.
• Have your hearing tested. If you work around a lot of noise, think about regular hearing tests. If you've lost some hearing, you can take steps to prevent further loss.
• Avoid risks from hobbies and play. Riding a snowmobile or a jet ski, hunting, using power tools, or listening to rock concerts can damage hearing over time. Wearing hearing protectors or taking breaks from the noise can protect your ears. Turning down the volume when listening to music helps too.
• Mayo Clinic Minute: Can you slow down age-related hearing loss?

Are you increasing the volume on the TV or asking others to speak up? You're not alone, especially if you're over age 50.

"Age-related hearing loss is called 'presbycusis.'"

The older you get, the more wear and tear you have on your ears says Dr. Gayla Poling.

"That's when we start noticing age-related hearing loss."

Dr. Poling says the majority of hearing loss is preventable. Hunters, for instance, are at risk of hearing loss.

"If you can wear hearing protection, especially designed hearing protection typically for hunting, where you can reduce the loud noise exposure but still hear the environment around you, that can really prevent long-term damage."

Dr. Poling says a hearing test can help evaluate whether you've experienced hearing loss.

"We're looking at the threshold that which you can hear sounds the softest, and you're usually pressing a button or raising your hands or somehow responding to when you hear those sounds. And we're evaluating the entire auditory system in that process - not just with the earphones, but we do some other tests to evaluate your middle ear and the inner ear, as well."

So before you have to turn up the sound, consider turning it down. For the Mayo Clinic News Network, I'm Ian Roth.

More Information

Hearing loss care at Mayo Clinic

• Weber PC. Etiology of hearing loss in adults. https://www.uptodate.com/contents/search. Accessed Nov. 4, 2022.
• Age-related hearing loss. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/age-related-hearing-loss. Accessed Nov. 4, 2022.
• Loscalzo J, et al., eds. Disorders of hearing. In: Harrison's Principles of Internal Medicine. 21st ed. McGraw Hill; 2022. https://accessmedicine.mhmedical.com. Accessed Nov. 7, 2022.
• Noise-induced hearing loss. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/noise-induced-hearing-loss. Accessed Nov. 7, 2022.
• Decibel levels. Hearing Health Foundation. https://hearinghealthfoundation.org/decibel-levels. Accessed Nov. 7, 2022.
• Reducing noise exposure. Guidance and regulations. National Institute for Occupational Safety & Health. https://www.cdc.gov/niosh/topics/noise/reducenoiseexposure/regsguidance.html. Accessed Nov. 7, 2022.
• Weber PC. Evaluation of hearing loss in adults. https://www.uptodate.com/contents/search. Accessed Nov. 7, 2022.
• Ami TR. Allscripts EPSi. Mayo Clinic. Accessed Nov. 4, 2022.
• Chandrasekhar SS, et al. Clinical Practice Guideline: Sudden hearing loss (update). Otolaryngology — Head and Neck Surgery. 2019; doi:10.1177/0194599819859885.
• Hazan A, et al. Home-based audiometry with a smartphone app: Reliable results? American Journal of Audiology. 2022; doi:10.1044/2022_AJA-21-00191.
• Hearing aid parts
• Hearing aid styles
• Hearing aids: How to choose the right one
• Mayo Clinic Minute: Hearing aids not 'one-size-fits-all'

News from Mayo Clinic

• Mayo Clinic Q and A: Are over-the-counter hearing devices a fit for you? Feb. 09, 2023, 02:00 p.m. CDT
• Hunting? Be sure to protect your hearing Oct. 12, 2022, 02:16 p.m. CDT
• What Mayo Clinic experts want you to know about over-the-counter hearing aids Aug. 19, 2022, 06:00 p.m. CDT
• Mayo Clinic Minute: How hearing affects your brain health June 28, 2022, 04:00 p.m. CDT
• Mayo Clinic Q and A: Tips for reducing risk of hearing loss June 16, 2022, 01:33 p.m. CDT

Mayo Clinic in Rochester, Minnesota, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for ear, nose and throat by U.S. News & World Report.

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Hearing Loss and Anxiety: Why It Happens and How to Cope

Whether you’ve just been newly diagnosed or have lived with it for a while, hearing loss can cause or worsen anxiety and other mental health symptoms. As you can probably imagine, feelings of worry and unease around uncertain outcomes related to hearing loss might creep into all areas of life: social, professional, physical, financial, and emotional.

With this in mind, our Reviews Team set out to understand the connection between hearing loss and anxiety by diving into research on the topic and interviewing real people who have experienced anxiety due to their hearing loss.

Why does hearing loss make you anxious?

Hearing loss can make communication and social interactions more challenging, which can potentially impact your overall well-being. Difficulty understanding conversations, feelings of isolation, concerns about missing important information, and the constant strain to compensate for hearing loss can contribute to heightened anxiety levels.

Anxiety can affect hearing

Somewhat unknown or overlooked phenomenon: anxiety can affect your ability to hear . [1] Folk, Jim. Reduced Hearing, Deafness, Diminished Hearing – Anxiety Symptoms. AnxietyCentre.com. May 19, 2021. Found on the internet at https://www.anxietycentre.com/anxiety-disorders/symptoms/hearing-loss-deafness-anxiety/ This can occur in a number of ways:

• Stress response: The physical symptoms of anxiety, which can be referred to as a fight-or-flight response, are increased heart rate, muscle tension, and shortness of breath . [2] Anxiety. MedlinePlus/ Updated May 22, 2020. Found on the internet at https://medlineplus.gov/anxiety.html These symptoms can cause tinnitus . [3] Tinnitus and Anxiety. Baptist Health. Aug. 24, 2021. Found on the internet at https://www.baptisthealth.com/blog/health-and-wellness/tinnitus-anxiety In fact, studies have repeatedly shown a correlation between anxiety and tinnitus . [4] Bhatt, Jay M, et al. Relationships Between Tinnitus and the Prevalence of Anxiety and Depression. The Laryngoscope. February 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812676 . Ringing, pulsing, or “fullness” in the ears is often reported at the height of a panic attack. In an online poll by AnxietyCentre.com, 76% of respondents said they had pulsatile tinnitus as an anxiety symptom . [5] Folk, Jim. Pulsing in the Ears (Pulsatile Tinnitus) and Anxiety. AnxietyCentre.com. Updated May 5, 2023. Found on the internet at https://www.anxietycentre.com/anxiety-disorders/symptoms/pulsing-in-the-ear . Fortunately, anxiety-related tinnitus is usually temporary and goes away once the person is no longer in a hyper-anxious state.
• Attentional bias: Anxiety can cause a person’s activated nervous system to focus on perceived threatening stimuli , including sounds. This means during high anxiety situations, you might find it harder to concentrate during a conversation, while sounds, like creaks or bumps, may be more pronounced. [6] Micha Abraham. How Anxiety Affects Hearing. Calm Clinic Website. Oct. 10, 2020. https://www.calmclinic.com/anxiety/signs/affected-hearing
• Catastrophic thinking: Anxiety may lead to a tendency for anticipating the worst possible outcome or interpreting neutral situations as threatening. [7] Shirley Davis. Catastrophic Thinking. CPTSD Foundation website. Nov. 1, 2021. https://cptsdfoundation.org/2021/11/01/catastrophic-thinking/ This can manifest as heightened sensitivity to all sounds, or a tendency to interpret benign sounds as distressing. [6] Micha Abraham. How Anxiety Affects Hearing. Calm Clinic Website. Oct. 10, 2020. https://www.calmclinic.com/anxiety/signs/affected-hearing This can become a vicious circle where the anxiety causes hypersensitivity to sound, and then the sound causes even more anxiety, and so on.

Hearing loss creates anxiety

Just as anxiety can affect hearing, hearing loss and conditions like tinnitus can be significant sources of anxiety. A review of studies involving more than 17,000 people with hearing loss found the prevalence of anxiety was higher among people with hearing impairment than the general population, with the severity of the impairment correlating with the severity of anxiety. [8] Shoham, Natalie, et al. Prevalence of Anxiety Disorders and Symptoms in People With Hearing Impairment: a Systematic Review. Social Psychiatry and Psychiatric Epidemiology. Dec. 13, 2018. Found on the internet at https://link.springer.com/article/10.1007/s00127-018-1638-3

Hearing loss may lead to anxiety in several ways:

• Communication difficulties: As hearing worsens or when there is significant hearing loss, people may find it increasingly difficult to communicate effectively with others. They may struggle to understand conversations, miss important information, or find it difficult to express themselves. These difficulties can lead to feelings of frustration , embarrassment, and even isolation , all of which are anxiety-provoking states. [9] Hearing Loss: A Common Problem for Older Adults. National Institute on Aging. Last Reviewed: Jan. 19 2023. Found on the internet at https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults#health [10] Depression and Hearing Loss. American Academy of Audiology. Found on the internet at https://www.audiology.org/consumers-and-patients/hearing-and-balance/depression-and-hearing-loss/
• Cognitive strain: People with hearing loss can experience mental strain and fatigue from the extra effort constantly required to function with reduced hearing. [11] Bess, Fred H., et al. Commentary: Listening Can Be Exhausting—Fatigue in Children and Adults With Hearing Loss Ear and Hearing. Sept. 19, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603232/ They often must concentrate hard, fill in gaps, and work to decipher speech and unclear sounds, which can create fear regarding their ability to keep up with conversations or perform in various listening situations.
• Social impact: Communication difficulties can lead to anxiety around social interactions . [12] Shukla Aishwarya, et al. Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology Head and Neck Surgery. March 10, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292986/ People with hearing loss may feel self-conscious and withdraw from social situations and avoid group gatherings. This can lead to feelings of isolation and loneliness. In his book, “ A Quiet World: Living With Hearing Loss ,” David Myers , a social psychologist, discussed the struggles he and his mother had with hearing impairment, including feeling humiliated and fearful during social situations. His mother wrote in her journal, “I would chime in and say the same thing someone else had just said—and everyone would laugh. I would be so embarrassed, I wanted to fall through the floor.” [13] Myers, David G. A Quiet World: Living With Hearing Loss. Yale University Press. Nov. 1, 2000.
• Tinnitus ⓘ A condition that is often linked to hearing loss and causes constant or periodic ringing or buzzing in the ear -related distress: About 30% of people with hearing loss also have tinnitus . [14] Ehrenfeld, Temma. Tinnitus and Hearing Loss: What’s the Connection? HealthyHearing.com. Nov. 19, 2019. Accessed Nov. 19, 2019. Found on the internet at https://www.healthyhearing.com/report/53029-Tinnitus-and-hearing-loss . When tinnitus is ongoing and persistent it can cause significant anxiety and emotional distress and can even make you feel trapped. Constant tinnitus can make it difficult to sleep and focus, worsening anxiety. [4] Bhatt, Jay M, et al. Relationships Between Tinnitus and the Prevalence of Anxiety and Depression. The Laryngoscope. February 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812676 .
• Uncertainty about the future: We all experience some level of anxiety about the uncertainty of our futures. But if you have hearing loss, you may also worry about progressive loss, potential limitations on career opportunities, and the impact of your hearing impairment on personal relationships. Research shows that as hearing loss progresses, anxiety increases as well. Compared to individuals without hearing loss, those with mild hearing loss have a 32% greater chance of having anxiety, while those with moderate or greater hearing loss have a 59% chance of having anxiety. [15] Contrera Kevin J., et al. Association of Hearing Impairment and Anxiety in Older Adults. Journal of Aging and Health. Feb. 29, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704938/

Common sources of hearing loss anxiety

Certain anxiety-provoking thoughts are common to those experiencing hearing loss . [17] Eberts, Shari. 6 Things That Scare Me Most About My Hearing Loss. Living With Hearing Loss. October 24, 2017. Found on the internet at https://livingwithhearingloss.com/2017/10/24/6-things-that-scare-me-most-about-my-hearing-loss . They may include:

• “I’m missing important information”: People with hearing loss may worry about not being able to hear or understand important conversations, instructions, or announcements, leading to anxiety about missing out on crucial information.
• “People are judging me”: Concerns about being judged or misunderstood due to hearing difficulties can lead to anxiety in social situations. People may worry about being thought of as inattentive, uninterested, or unintelligent because of their hearing loss.
• “I’m becoming isolated”: People with hearing loss may withdraw from conversations or avoid social events due to difficulties in communication, which can make them feel disconnected.
• “I can’t participate fully”: People may feel left out, frustrated, or anxious about their limited engagement or contribution.
• “I’m a burden to others”: Some people with hearing loss may feel guilty or anxious about inconveniencing others by needing repetition or accommodations. They may worry about being a burden to their loved ones or colleagues.
• “What if my hearing worsens?”: Concerns about the progression of hearing loss can generate anxiety about the future. People may worry about their ability to cope or adapt if their hearing deteriorates further.
• “I can’t enjoy certain activities anymore”: Hearing loss may limit participation in activities, such as watching movies, attending concerts, or enjoying music. People may feel anxious and sad as a result of missing out on enjoyable experiences.
• “I can’t rely on my senses”: Reduced reliance on a person’s hearing can create feelings of vulnerability or unease. People may worry about their safety and the ability to detect potential dangers or emergencies without the full use of their hearing.
• “My relationships are affected”: Hearing loss can strain relationships with friends, family, and romantic partners. People may be anxious about misunderstandings, strained connections, or the loss of intimacy in relationships.
• “I’m losing control”: Feelings of helplessness and loss of control over one’s hearing abilities can contribute to anxiety. People may worry about their ability to manage their daily lives, make decisions, or maintain independence.

Other anxiety considerations

In addition to hearing loss, it’s important to recognize how anxiety can be influenced by other factors. Considering the complex interplay of various factors can help individuals with hearing loss and their loved ones understand and address anxiety more comprehensively:

• Other mental health conditions: People with hearing loss have a higher likelihood of experiencing other mental health conditions , such as depression, social anxiety disorder, or generalized anxiety disorder. [18] Kvam, Marit H., et al. Mental Health in Deaf Adults: Symptoms of Anxiety and Depression Among Hearing and Deaf Individuals. The Journal of Deaf Studies and Deaf Education. September 2006. Found on the internet at https://academic.oup.com/jdsde/article/12/1/1/435942 . These conditions can interact with each other, worsening anxiety symptoms and making the overall experience more complex.
• Other medical conditions: People with hearing loss may also have other medical conditions, such as cardiovascular diseases, diabetes, or neurological disorders. Chronic health conditions can be associated with higher levels of anxiety due to their impact on daily functioning, lifestyle changes, and uncertainty about health outcomes. [19] Chronic Illness. Cleveland Clinic. Reviewed May 10, 2021. Found on the internet at https://my.clevelandclinic.org/health/articles/4062-chronic-illness . Additionally, Rachel Magann Faivre, AuD , owner of Oklahoma City-based ASH Audiology, said: “Acute medical conditions, like cancer treatment or injuries (especially head traumas), can also have similar effects that chronic ones do regarding anxiety.”
• Medications: Certain medications can have side effects that include anxiety or worsened anxiety symptoms. [20] Robinson, Kim. 7 Medications That Could Be Causing Your Anxiety. Optum Perks. Oct. 22, 2021. Found on the internet at https://perks.optum.com/blog/7-medications-that-could-be-causing-your-anxiety . These include ADHD medications, antidepressants, migraine medications, corticosteroids, decongestants, rescue inhalers, and thyroid hormones. It’s important to be aware of the potential effects of medications and discuss any concerns with health care professionals.
• Cognitive factors: Cognitive distortions , such as negative thinking patterns, thinking the worst (catastrophizing), or excessive worrying, can contribute to anxiety. [21] Grinspoon, Peter. How to Recognize and Tame Your Cognitive Distortions. Harvard Health Publishing. May 4, 2022. Found on the internet at https://www.health.harvard.edu/blog/how-to-recognize-and-tame-your-cognitive-distortions-202205042738 . These cognitive processes can be influenced by personality traits, past experiences, and your overall coping style, all of which may be independent of hearing loss.
• Support systems and social environment: The availability of social support networks, understanding of friends and family, and a supportive social environment can play a significant role in managing anxiety. [22] Ozbay, Fatih, et al. Social Support and Resilience to Stress. Psychiatry (Edgmont). May 2007. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311/
• Access to health care and treatment: Limited access to health care services, including audiology and mental health resources, can impact someone’s ability to seek appropriate treatment for hearing loss and anxiety. Barriers to access, such as financial constraints or lack of availability, may affect the overall experience and management of anxiety.
• Coping skills and resilience: The presence of effective coping strategies, resilience, and self-care practices can influence how you navigate anxiety related to hearing loss. Developing and using healthy coping mechanisms can help you manage anxiety  and overall well-being. [23] Coping Mechanisms. Good Therapy. Updated Sept. 26, 2018. Found on the internet at https://www.goodtherapy.org/blog/psychpedia/coping-mechanisms .

Feeling anxious in the face of these conditions is entirely normal and quite common. The impact of hearing loss and related conditions on mental health, including anxiety, is well-documented.

It’s crucial to emphasize that anxiety can occur at all levels of hearing loss, from mild to severe. Even those with mild hearing loss or tinnitus may experience anxiety due to the challenges and adjustments they need to make in their daily lives.

Physical signs of anxiety

Anxiety can sh0w itself in different and multiple ways from person to person. Here are some common signs and symptoms of anxiety and the potential impact on other mental health concerns: [24] Rooyakkers, Molly. Generalized Anxiety Disorder. Seattle Anxiety Specialists. Found on the internet at https://seattleanxiety.com/generalized-anxiety-disorder-gad

• Restlessness and irritability: Anxiety can contribute to a constant sense of restlessness, feeling on edge, or being easily irritated or agitated.
• Intense fear or panic: Intense feelings of fear or panic are often accompanied by physical sensations, such as rapid heartbeat, shortness of breath, and chest tightness.
• Muscle tension: Anxiety can cause muscle tension throughout the body, resulting in stiff or sore muscles and overall discomfort.
• Fatigue and sleep disturbances: Falling asleep, staying asleep, or experiencing restful sleep can be more difficult when you’re feeling anxious, which can lead to daytime fatigue and impaired functioning.
• Gastrointestinal issues: Anxiety can result in digestive problems, such as stomachaches, nausea, diarrhea, or irritable bowel syndrome symptoms.
• Sweating: Sweat glands are often activated as part of a person’s stress response. [25] LeWine, Howard. What Can I Do for My Excessive Sweating? Harvard Health Publishing. May 1, 2021. Found on the internet at https://www.health.harvard.edu/diseases-and-conditions/what-can-i-do-for-my-excessive-sweating .
• Trembling: Your muscles tense when the hormones adrenaline and cortisol are released during stressful situations , which is why you may shake or tremble until the stressor fades. [26] What is Anxiety Shaking? PsychCentral. May 23, 2022. Found on the internet at https://psychcentral.com/anxiety/anxiety-shaking
• Increased or decreased activity levels: You may feel more restless, leading to increased physical activity or a constant need to stay busy. On the other hand, some people may experience a decrease in motivation or engagement due to anxiety-related fatigue or withdrawal.
• Avoidance behaviors: Anxiety may prompt some people to avoid situations or places they perceive as anxiety-inducing. This avoidance can limit their engagement in activities, social interactions, or responsibilities.

Coping with anxiety

Susan Drumm , a licensed therapist and owner of Peak Counseling Solutions of Denver, Colorado, told us, “The first step in addressing anxiety is awareness, then understanding how anxiety works.” Taking control over your source of anxiety is an important step in addressing it—even if it may feel uncomfortable to ask for help or accommodations. The relationship between hearing loss and anxiety is much better understood now than in the past, and there are now many support resources available.

Tools and support for anxiety and hearing loss

• Therapy and counseling: Seeking professional help from therapists, counselors, psychologists, or psychiatrists can provide valuable guidance and support in managing anxiety. Cognitive-behavioral therapy (CBT) and mindfulness-based therapies can help people develop effective coping strategies and address underlying thoughts and behaviors contributing to anxiety. Psychiatrists can prescribe medications to treat anxiety. You can search for professionals through your health insurance provider or through the Anxiety and Depression Association of America (ADAA) . The American Psychological Association has a psychologist locator webpage to connect you with psychologists in your area. Online therapy platforms offer convenient access to therapy from the comfort of your own home. Websites and apps like BetterHelp , Talkspace , and Amwell provide online counseling services and connect people with licensed therapists via video, voice, or text chat.
• Licensed medical professionals: When seeking assistance for hearing loss, it’s essential to work with licensed medical professionals, such as audiologists and otolaryngologists (ear, nose, and throat specialists). They can provide comprehensive evaluations, recommend appropriate interventions, and guide you through the process of acquiring and adjusting to hearing devices if necessary. Trusted sources for finding professionals include the American Academy of Audiology and the American Speech-Language-Hearing Association websites, where you can search for providers in your area.
• Social support: Connecting with supportive friends, family members, or support groups can provide a sense of belonging and understanding. Online communities, forums, and virtual support groups for those with hearing loss can offer valuable emotional support and practical advice. Connecting with national or local hearing loss associations can offer a wealth of resources, including information on support groups, educational materials, and advocacy efforts. Organizations, like the Hearing Loss Association of America (HLAA) and the American Tinnitus Association , provide valuable resources and support networks for people with hearing loss and tinnitus. The ADAA also has a support group search page .
• Breathing and relaxation techniques: Deep breathing exercises, progressive muscle relaxation, and mindfulness meditation can help reduce anxiety symptoms. Mobile apps, like Calm , Headspace , and Insight Timer , offer guided relaxation and meditation exercises.
• Physical exercise: Engaging in regular physical exercises, such as walking, yoga, or dancing, can help reduce anxiety by releasing endorphins, improving mood, and promoting overall well-being.
• Self-care practices: Prioritizing self-care activities that promote relaxation and well-being, such as getting enough sleep, maintaining a healthy diet, engaging in hobbies, and practicing self-compassion, can help manage anxiety symptoms. [27] Tips and strategies to manage anxiety. Anxiety & Depression Association of America. Found on the internet at https://adaa.org/tips .
• Journaling and expressive writing: Writing down thoughts, feelings, and concerns in a journal can provide an outlet for self-reflection and help process emotions related to anxiety. It can also serve as a tool for identifying patterns and triggers. Journaling apps, like Day One and Daylio , have become popular.
• Limiting stimulants: Reducing or avoiding stimulants, such as caffeine, nicotine, and alcohol, can help manage anxiety symptoms, as these stimulants can contribute to increased restlessness, irritability, and sleep disturbances. [27] Tips and strategies to manage anxiety. Anxiety & Depression Association of America. Found on the internet at https://adaa.org/tips .
• Assistive listening devices: For people with hearing loss, using assistive listening devices, such as hearing aids , cochlear implants, or amplified telephones can enhance communication, ease frustration, and reduce anxiety related to hearing difficulties. A 2020 study found hearing aid use to be associated with decreased odds of psychological distress compared to those with hearing loss who did not use aids. If you need hearing aids, there are lots of affordable hearing aids and over the counter hearing aids on the market. [28] Bigelow, Robin T., et al. Association of Hearing Loss With Psychological Distress and Utilization of Mental Health Services Among Adults in the United States. JAMA Network. July 20, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372323 .

Remember, everyone’s journey with anxiety and hearing loss is unique, and it’s important to find the strategies and resources that work best for you. Generally, a combination of these tools can help in managing anxiety and promoting overall well-being.

Research from 2017 shows that people who use hearing aids had a 15% lower odds of anxiety than those with hearing impairment not using hearing aids. [29] Ayonayon, Hilsa, et al. Association of Hearing Impairment and Anxiety in Older Adults. Journal of Aging Health. February 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704938/ . Although the study authors were careful to point out that this is not statistically significant due to limitations in their study.

Supporting a loved one with hearing loss-related anxiety

Supporting a loved one who is experiencing anxiety due to hearing loss requires empathy, understanding, and effective communication. Here are four helpful strategies for supporting someone with hearing loss-related anxiety: [30] Clason, Debbie. How to Support Someone With Hearing Loss. Healthy Hearing. March 29, 2023. Found on the internet at https://www.healthyhearing.com/report/51841-How-to-support-someone-with-hearing-loss .

1. Educate yourself about hearing loss and anxiety:

• Learn about hearing loss: Take the time to understand the nature of hearing loss, its impact on communication, and the common challenges associated with it. This knowledge will help you to empathize with someone’s experiences and provide better support.
• Understand anxiety: Educate yourself about anxiety , its signs, symptoms, and how it can be related to hearing loss. This understanding will allow you to recognize anxiety-related behaviors and respond with compassion. [31] Boyes, Alice. Seven Ways to Help Someone With Anxiety. Greater Good Magazine. July 25, 2018. Found on the internet at https://greatergood.berkeley.edu/article/item/seven_ways_to_help_someone_with_anxiety .

2. Effective communication strategies:

• Practice active listening: Be patient and attentive when talking. Give your full attention, face people directly, and maintain eye contact to improve communication.
• Speak clearly: Use clear and concise speech, avoiding mumbling or speaking too quickly. If necessary, ask about their preferred communication strategies and adjust accordingly.
• Give them time: Allow extra time to process and respond to conversations. Avoid interrupting or finishing their sentences, as this may increase feelings of frustration or dependency.

3. Emotional support and encouragement:

• Validate their feelings: Acknowledge and validate emotions related to hearing loss and anxiety. Let them know their feelings are valid and you’re there to support them.
• Offer reassurance: Be encouraging by emphasizing their strengths and abilities rather than focusing solely on their limitations. Remind them they’re not alone in their journey and you will be there to support them every step of the way.
• Be patient and understanding: Recognize that anxiety and the challenges of hearing loss may sometimes lead to frustration or withdrawal. Offer patience and understanding, creating a safe space for them to express their feelings and concerns without judgment.

4. Encourage professional help and resources:

• Suggest seeking professional support: Gently recommend seeking help from licensed professionals, like audiologists or therapists, who specialize in hearing loss and anxiety. Explain how professional guidance can provide valuable coping strategies and support tailored to their needs.
• Share relevant resources: Provide information about support groups, online forums, or organizations that offer resources specific to hearing loss and anxiety. Direct them to websites mentioned above, like the HLAA and the ADAA.

Remember, supporting someone with hearing loss-related anxiety requires patience and understanding. Encourage open and honest communication, validate their experiences, and be a trusted ally as they navigate their journey.

Have questions about this review? Email us at [email protected] .

• Folk, Jim. Reduced Hearing, Deafness, Diminished Hearing – Anxiety Symptoms. AnxietyCentre.com. May 19, 2021. Found on the internet at https://www.anxietycentre.com/anxiety-disorders/symptoms/hearing-loss-deafness-anxiety
• Anxiety. MedlinePlus. Updated May 22, 2020. Found on the internet at https://medlineplus.gov/anxiety.html
• Tinnitus and Anxiety. Baptist Health. Aug. 24, 2021. Found on the internet at https://www.baptisthealth.com/blog/health-and-wellness/tinnitus-anxiety
• Bhatt, Jay M, et al. Relationships Between Tinnitus and the Prevalence of Anxiety and Depression. The Laryngoscope. February 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812676
• Folk, Jim. Pulsing in the Ears (Pulsatile Tinnitus) and Anxiety. AnxietyCentre.com. Updated May 5, 2023. Found on the internet at https://www.anxietycentre.com/anxiety-disorders/symptoms/pulsing-in-the-ear
• Micha Abraham. How Anxiety Affects Hearing. Calm Clinic Website. Oct. 10, 2020. https://www.calmclinic.com/anxiety/signs/affected-hearing
• Davis, Shirley. Catastrophic Thinking. CPTSD Foundation website. Nov. 1, 2021. Found on the internet at https://cptsdfoundation.org/2021/11/01/catastrophic-thinking
• Shoham, Natalie, et al. Prevalence of Anxiety Disorders and Symptoms in People With Hearing Impairment: a Systematic Review. Social Psychiatry and Psychiatric Epidemiology. Dec. 13, 2018. Found on the internet at https://link.springer.com/article/10.1007/s00127-018-1638-3
• Hearing Loss: A Common Problem for Older Adults. National Institute on Aging. Last Reviewed: Jan. 19 2023. Found on the internet at https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults#health
• Depression and Hearing Loss. American Academy of Audiology. Found on the internet at https://www.audiology.org/consumers-and-patients/hearing-and-balance/depression-and-hearing-loss
• Bess, Fred H., et al. Commentary: Listening Can Be Exhausting—Fatigue in Children and Adults With Hearing Loss Ear and Hearing. Sept. 19, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603232
• Shukla Aishwarya, et al. Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology Head and Neck Surgery. March 10, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292986
• Myers, David G. A Quiet World: Living With Hearing Loss. Yale University Press. Nov. 1, 2000
• Ehrenfeld, Temma. Tinnitus and Hearing Loss: What’s the Connection? HealthyHearing.com. Nov. 19, 2019. Found on the internet at https://www.healthyhearing.com/report/53029-Tinnitus-and-hearing-loss
• Contrera Kevin J., et al. Association of Hearing Impairment and Anxiety in Older Adults. Journal of Aging and Health. Feb. 29, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704938
• Ehrenfeld, Temma. Hearing loss and Anxiety: What’s the Connection? Healthy Hearing. Updated March 9, 2021. Found on the internet at https://www.healthyhearing.com/report/53166-Hearing-loss-anxiety
• Eberts, Shari. 6 Things That Scare Me Most About My Hearing Loss. Living With Hearing Loss. Oct. 24, 2017. Found on the internet at https://livingwithhearingloss.com/2017/10/24/6-things-that-scare-me-most-about-my-hearing-loss
• Kvam, Marit H., et al. Mental Health in Deaf Adults: Symptoms of Anxiety and Depression Among Hearing and Deaf Individuals. The Journal of Deaf Studies and Deaf Education. September 2006. Found on the internet at https://academic.oup.com/jdsde/article/12/1/1/435942
• Chronic Illness. Cleveland Clinic. Reviewed May 10, 2021. Found on the internet at https://my.clevelandclinic.org/health/articles/4062-chronic-illness
• Robinson, Kim. 7 Medications That Could Be Causing Your Anxiety. Optum Perks. Oct. 22, 2021. Found on the internet at https://perks.optum.com/blog/7-medications-that-could-be-causing-your-anxiety
• Grinspoon, Peter. How to Recognize and Tame Your Cognitive Distortions. Harvard Health Publishing. May 4, 2022. Found on the internet at https://www.health.harvard.edu/blog/how-to-recognize-and-tame-your-cognitive-distortions-202205042738
• Ozbay, Fatih, et al. Social Support and Resilience to Stress. Psychiatry (Edgmont). May 2007. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311
• Coping Mechanisms. Good Therapy. Updated Sept. 26, 2018. Found on the internet at https://www.goodtherapy.org/blog/psychpedia/coping-mechanisms
• Rooyakkers, Molly. Generalized Anxiety Disorder. Seattle Anxiety Specialists. Found on the internet at https://seattleanxiety.com/generalized-anxiety-disorder-gad
• LeWine, Howard. What Can I Do for My Excessive Sweating? Harvard Health Publishing. May 1, 2021. Found on the internet at https://www.health.harvard.edu/diseases-and-conditions/what-can-i-do-for-my-excessive-sweating
• What is Anxiety Shaking? PsychCentral. May 23, 2022. Found on the internet at https://psychcentral.com/anxiety/anxiety-shaking
• Tips and Strategies to Manage Anxiety. Anxiety & Depression Association of America. Found on the internet at https://adaa.org/tips
• Bigelow, Robin T., et al. Association of Hearing Loss With Psychological Distress and Utilization of Mental Health Services Among Adults in the United States. JAMA Network. July 20, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372323
• Ayonayon, Hilsa, et al. Association of Hearing Impairment and Anxiety in Older Adults. Journal of Aging Health. February 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704938/
• Clason, Debbie. How to Support Someone With Hearing Loss. Healthy Hearing. March 29, 2023. Found on the internet at https://www.healthyhearing.com/report/51841-How-to-support-someone-with-hearing-loss
• Boyes, Alice. Seven Ways to Help Someone With Anxiety. Greater Good Magazine. July 25, 2018. Found on the internet at https://greatergood.berkeley.edu/article/item/seven_ways_to_help_someone_with_anxiety

18 episodes

The Hearing Wellness Journey Podcast helps people with varying degrees of hearing loss share their personal stories to help others. It's an exploration of determination, hope, self-discovery, and triumph. We'll share the personal experiences of those that are living with hearing loss and provide a haven for their stories to show others that they are not alone in this journey. Your hosts: Dr. Dawn Heiman and Lindsey Doherty. Our mission is to educate, empower, and attempt to eliminate the negative stigma that may be associated with hearing loss. We also want to help bring people together and help create a positive community. To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

Hearing Wellness Journey Podcast Dawn Heiman, AuD, Lindsey Doherty

• Health & Fitness
• 5.0 • 6 Ratings
• SEP 3, 2022

Over-The-Counter Hearing Aids

Tune in to hear our discussion of the new Over-The-Counter Hearing Aid classification, what the FDA ruling means and how this could be a great thing. To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

• JUL 23, 2022

Paul's PART 2 Hearing Loss Story

Tune in to hear PART 2 of Paul's unique hearing loss story. He incurred hearing loss as an adult and then suddenly lost more hearing a few years later. Since we last heard his story last year, in episode 5, he has received a cochlear implant on his right side and worked on improving his hearing with three months of auditory training therapy. To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

Dr. Michelle Hu's Hearing Loss Story

Tune in to hear more about Dr. Michelle Hu's story of triumphs with hearing loss. Identified as a child, becoming an audiologist, and now running with her passion to help more by helping children and families who have hearing loss through online platforms. She is now known as Mama Hu Hears. You won't want to miss this amazing story! To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

• JUN 24, 2022

Shari Eberts' Hearing Loss Story

Follow Shari's story as she grew up with hearing loss in her family and how she came to accept her hearing loss as it occurred. She has recently written a book and wants to help more people who also have a hearing loss. You don't want to miss this episode! You won't want to miss this episode! To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

• JUN 12, 2022

Nancy's Hearing Loss Story

Follow Nancy's first steps to better hearing after years of waiting to do something about it, even though her career keeps her surrounded by others with hearing loss. Find out how a holiday party turned her world around for the better...and, as she says, "Just do it". You won't want to miss this amazing story! To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

• OCT 16, 2021

Karen's Hearing Loss Story

Karen MacIver-Lux shares her hearing loss story that began as a child and inspired her to become an audiologist, specializing in Auditory Verbal Therapy. She shares the trials and triumphs along her journey that includes hearing aids and making the decision to receive a cochlear implant. You won't want to miss this amazing story! To see the video edition of this episode with closed captioning, please go to Hearing Wellness Journey Podcast at https://hearingwellnessjourney.com/podcast.

• 1 hr 15 min
• ©2021 EntreAudiology, LLC. All Rights Reserved.

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Genetic hearing loss: the journey of discovery to destination – how close are we to therapy?

Arti pandya.

1 Division of Genetics and Metabolism, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina

Introduction

Hearing loss (HL) is an extremely common neurosensory deficit with a heterogeneous etiology including environmental and genetic causes. The incidence of profound sensorineural HL in the United States is 186 per 100,000 births (Morton and Nance 2006 ). In developed nations, more than 60% of individuals affected with HL have a genetic etiology that can be classified by the mode of inheritance and the presence or absence of other clinical characteristics that permits the diagnosis of specific syndromes associated with HL (Willems et al. 2000 , Tekin et al. 2001 ; Nance 2003 ). The vast majority of individuals (70%) have nonsyndromic hearing loss (NSHL) which can be inherited as a recessive (80%), dominant (15%), X‐linked or mitochondrial trait (5%). In 30 % of individuals with HL, one may identify a recognizable pattern or syndrome of which nearly 400 forms have been described (Toriello and Smith 2013 , Oxford Univ. Press). Among syndromic forms, a few such as Pendred syndrome (Reardon et al. 1997 ), Usher Syndrome (Petit 2001 ), or Waardenburg syndrome (Nance 2003 ; Schultz 2006 ) occur with a frequency of 1–4% among the deaf.

As suggested by analysis of large collections of family data, genetic heterogeneity was expected with HL (Nance and Pandya 2002 ). As the loci were identified, they were numbered chronologically, and cataloged where DFNB represents recessive inheritance, DFNA represents postlingual dominant forms, and DFN represents X‐linked loci. An updated list is maintained at the Hereditary Hearing Loss homepage with loci mapped, genes identified at the locus and references (Hereditary Hearing Loss home page: http://hereditaryhearingloss.org/ ). In view of our knowledge that a large number of genes are involved with HL, and that mutations in each gene would account for a small proportion of all HL, the discovery that mutations in a single gene GJB2 (DFNB1 locus), encoding connexin 26 (Cx26), accounted for a large proportion of recessive NSHL, came as an unexpected surprise (Kelsell et al. 1997 ; Pandya et al. 2003 ). Mutations in Cx26 are the most frequent form of nonsyndromic deafness and its contribution to deafness exceeds 60% in some Western populations (Pandya et al. 2003 ; Azaiez et al. 2006 ). Docking of hexameric hemiconnexins on the adjacent surface of two cells forms a complete gap junction which is critical to the flow of ions, especially potassium ions, in the inner ear (Steel and Bussoli 1999 ). More than 100 mutations of the connexin 26 gene have been reported with some common ethnic specific variants including the 35delG mutation in Caucasians, the 167delT allele in Ashkenazi Jews, and the 235delC allele in Asians (Connexin – Deafness Homepage: http://davinci.crg.es/deafness/ ). Interestingly, del Castillo et al. ( 2002 ) reported a 342 kb deletion spanning the connexin 30 (Cx30) locus, in individuals heterozygous for Cx26, as the cause of their HL. The Cx26 and Cx30 loci are located on 13q11 region within 40 kb of each other; however, the Cx26 locus is not involved in the deletion. Thus, it is unclear if the hearing loss in individuals carrying a mutation in Cx26 and a deletion of Cx30 in trans occurs due to haploinsufficeincy of Cx30 or whether the deletion of Cx30 perturbs the expression of the adjacent normal Cx26 (Rodriguez‐Paris and Schrijver 2009 ).

Since the identification of GJB2 as a major cause for nonsyndromic autosomal recessive HL, there has been tremendous progress in elucidating the genetic etiology for both nonsyndromic and syndromic forms of HL, with nearly 1% of the genome coding for transcripts determined to be important in the development and functioning of the hearing apparatus.

Molecular Advances in Understanding Genetic Etiology of Hearing Loss

Despite the remarkable genetic heterogeneity known with hearing loss, tremendous success in mapping and identifying the several hundred loci for HL can be attributed to several factors and advances occurring in parallel. First, innovative approaches and methods to map genetic loci in consanguineous families or population isolates was instrumental in mapping genes for various nonsyndromic AR forms of HL such as the DFNB3 (Guilford et al. 1994 ; Friedman et al. 1995 ). The initiation of large‐scale mouse screening project for HL at the Jackson Laboratory in the USA (Zheng et al. 1999 ) and the ENU mutagenesis initiative at the MRC and Wellcome Trust Sanger Institute in the UK (Hardisty et al. 1999 ), have provided valuable information from mouse models of HL. These data allowed rapid identification and validation of candidate human genes in a specific mapped region, adding to the repertoire of total genes with a role in hearing and its aberration. Last but not the least, The Human Genome Project has been a major factor which catapulted these discoveries at a much faster pace. As of 2016, a total 169 loci have been mapped for nonsyndromic forms of HL (Hereditary Hearing Loss home page), and 85 of these genes have been identified (Jasper et al. 2015 ). An additional 42 genes have been identified for syndromic forms of hearing loss, making the total number daunting when it comes to offering diagnostic testing. This recent explosion in gene discovery for HL can also be attributed to technological advances in massively parallel sequencing (MPS) also referred to as Next Generation Sequencing (NGS). Between 1995 and 2010, nearly 75% of the genes were identified using more traditional methods; however, since 2010 another 25% of genes have been identified in a short span, emphasizing the impact of these technologies in enhancing gene discovery (Atik et al. 2015 ). Although the initial identification of genes such as TRPN for DFNB79 relied on homozygosity mapping to filter whole exome sequencing data (Rehman, 2010 ), more recent reports of genes such as EPS8 and FAM65B identified in consanguineous families with HL had no prior mapping studies to guide the search (Behlouli et al. 2014 ; Diaz‐Horta et al. 2014 ). This sudden explosion in our knowledge of genes important for hearing has guided functional studies in animal models, to elucidate the cell biology and auditory physiology (Dror and Avraham 2009 ; Richardson et al. 2011 ). For example, we can now better understand the architecture of the hearing apparatus, with genes involved in the cytoskeleton including the actin‐rich stereocilia in the hair cell bundles, such as myosins ( MYO7A , MYO6 , MYO3A , MYO1A , and others), cell‐cell junctions (includes gap‐junction proteins such as connexin‐26 and connexin‐30 and others), membrane transporters such as SLC26A4 encoding the pendrin protein and the other potassium channels ( KCNQ4 ) as well as regulatory elements including several transcription factors. The discovery of various genes, mutations in which can cause Usher syndrome, have helped elucidate the molecular mechanisms underlying hair bundle development and mechano‐electrical transduction (Richardson et al. 2011 ).

Early Hearing Detection and Intervention (EHDI) Programs

Another major milestone in this journey of understanding the etiology and mechanisms of hearing loss has been the introduction and implementation of universal audiologic newborn hearing screening in the United States and several other Western nations. Since its introduction in early 2000 in a select few states, it is now adopted by all states in the USA (NCHAM website). The advent of newborn hearing screening has made it possible to detect HL by 2–3 months of age, and infants who begin rehabilitation by 6 months of age have much improved language and scholastic outcomes compared to those whose HL is detected after 6 months of age (Yoshinaga‐Itano 2003 ). With improved technology and education, the EHDI programs have been successful in decreasing the false‐positive rates, and have improved their loss to follow‐up of infants identified at birth for confirmatory testing (Smith et al. 2014 ). Despite the tremendous success of these programs, there remain the issues of missing select forms of congenital HL which do not present at birth such as due to congenital CMV infections, Pendred syndrome, and the late onset dominant forms of HL. We have also shown that a small percent of neonates with GJB2 HL are missed by audiologic newborn screening (Norris et al. 2006 ). In response to these limitations, there has been a push to add etiologic diagnosis via molecular testing in newborns although this has not been implemented in clinical practice (Gardner et al. 2006 ; Giersch et al. 2016 ). Another major impetus to having an etiologic diagnosis for the HL has been the promise of newer therapies shown to have benefits in mouse models which are specific for a genetic defect as discussed below. Unfortunately, despite the recommendations of professional organizations (Professional Practice and Guidelines Committee 2014 ) and the Joint Commission on Infant Hearing, systematic genetic evaluation and counseling are still not a standard practice for infants confirmed with HL through screening.

Advances in Etiologic Diagnosis of Hearing Loss

Although the pace of discovery of genes for both nonsyndromic and syndromic HL has been phenomenal, the extreme genetic heterogeneity has precluded comprehensive genetic testing that is cost effective and easily accessible. Until a few years ago, testing was limited to the more common genetic forms of HL including the GJB2, GJB6, and select mitochondrial genes. This no doubt was helpful in those families where a pathogenic mutation was identified. These results helped stop the diagnostic odyssey, offer precise genetic counseling and recurrence risks, and prevent onset of HL if a mitochondrial A1555G change was detected prior to administration of aminoglycoside antibiotics (Pandya and Arnos 2006 ). With the advent and availability of technology using massively parallel DNA sequencing, it is now possible to interrogate most genes identified for syndromic and nonsyndromic hearing loss using large gene panels (Shearer et al. 2011 ). Currently, such platforms and panels are offered through a few laboratories in the USA; however, there remains variability in the number and types of genes included on these panels (Jasper et al. 2015 ). Additionally, prospective studies and literature review to assess the sensitivity of panels using MPS suggest an overall diagnostic rate of 42%, with higher values if an individual has bilateral AR NSHL versus milder forms of HL (Shearer et al. 2013 ; Shearer and Smith 2015 ). No doubt, the current platforms of gene panels have facilitated dramatic improvements in the diagnostic yield, but there remains the need for HL diagnostic panels which are more comprehensive that include genes implicated in both syndromic and nonsyndromic HL. Although one can consider using whole exome sequencing (WES) in lieu of using targeted gene panels for HL, considerations favoring the latter approach include the high cost, and the identification of secondary findings unrelated to the presenting phenotype with WES (Shearer et al. 2013 ). Not only does having an etiologic diagnosis for HL provide knowledge about the natural history, progression of HL, associated organ system involvement, and precise recurrence risk, but in the near future it will form the basis for novel gene‐ or mutation‐specific treatment options to ameliorate or treat genetic HL.

Advances in Management of Hearing Loss

Despite the significant progress made in the last decade in our understanding of the causative genes which result in hearing loss, the cornerstone of treatment for deafness remains nonspecific, irrespective of the etiology. The main treatment modalities available include the use of hearing aids for individuals with residual hearing and cochlear implantation in those with severe to profound hearing loss. Both forms of therapy have come a long way with significant technological advances. Cochlear implants (CI) are now offered to infants and placed in both ears to offer the maximal benefit. However, management approaches and options for sensorineural hearing loss continue to lag behind the significant understanding of the basic genetic defects causing HL. The past few years have seen a glimmer of hope for treatments focused on the basic genetic defect for HL, albeit in animal models. Hearing restoration to near normal was demonstrated in a gene therapy study which reinstated the expression of vesicular glutamate transporter 3 (VGLUT3) using postnatal AAV‐mediated delivery (Akil et al. 2012 ). Askew et al. ( 2015 ) demonstrated restoration of the mechano‐transducer current and partial hearing in mice, with transmembrane channel‐like 1 and 2 (TMC‐1 and TMC‐2) gene constructs using AAV vectors. Antisense oligonucleotide treatment injected intraperitoneally against a splicing mutation in Usher Syndrome Type I C mouse model (Ush1c216AA knock‐in mice) ameliorated auditory function (Lentz et al. 2013 ). Therapeutic approaches beyond gene replacement or transcript correction are slightly further along as with a FDA‐approved clinical trial to use adenovirus for ectopic expression of AtoH1, a transcription factor, in cochlear nonsensory cells (Clinical Trials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT02132130","term_id":"NCT02132130"}} NCT02132130 ). Despite the progress in these therapeutic approaches, there remain several key questions about the optimal timing for such a therapeutic approach – should it be at the time when the gene is expressed, or when the phenotype is manifest, and determining the location for introduction of a gene of interest (Minoda et al. 2015 )

Future Directions

This is an exciting time for those involved in the field of hearing loss, given the explosion in our understanding of the molecular basis of deafness, and the mechanisms and function leading to hearing loss. The implementation of audiologic newborn screening allows early diagnosis of HL with appropriate interventions to prevent language delay. However, as we have got a glimpse into the future of specific gene‐ and mutation‐based therapeutics for HL, it becomes imperative that we focus our attention on enhancing the EHDI programs with complementary molecular diagnosis in newborns for an etiologic diagnosis. Until we determine a specific etiologic diagnosis for the HL, offering timely gene‐based therapeutics may not be feasible. In contrast, it is possible that modalities for hair cell regeneration may not need a specific etiologic diagnosis. However, based on experience with newborn metabolic screening, we have learnt that understanding the natural history and having a specific diagnosis are crucial to implementing state of the art patient care and therapies. There is also a need for additional research to understand the molecular basis for the auditory neuropathy spectrum disorders as well as age‐related hearing loss in the future.

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Vasculitis Disease and Hearing Loss

2022 holiday gifts for people with hearing loss

Life coaching: improving lives of people with hearing loss.

Transformational life coach Carly Sygrove is filling a niche in the coaching sector. After experiencing sudden sensorineural hearing loss in 2016, Sygrove noticed a gap in rehabilitation once her treatments had been exhausted. Hearing Like Me spoke with her about how life coaching can improve the lives of people with hearing loss.

More about carly sygrove.

Transformational life coach Carly Sygrove started a blog, My Hearing Loss Journey, to document her experiences. The Spain resident who is from the UK realized the power of connecting with others in similar situations. In not wanting others to feel the same, lonely confusion she did, she became a qualified life coach. Through this, she offers her services specifically for the hard of hearing community. Now she supports people in moving forward positively with hearing loss. “I got to the stage where there was nothing else the hearing specialists could do for me,” she recalls. “I was left to live my new normal with little understanding of how to navigate the practical or emotional aspects of living with hearing loss.”

Hearing Loss & Mental Health

Mental health struggles are common in hearing loss. “The first research of its kind in 1994 found that 40 percent of the deaf or hard of hearing population were affected by mental health issues, compared with 25 percent of the hearing population,” writes Deaf Advisor Lenka Novakova, on the official NHS site . She works for a national Deaf mental health service based in South West London.

Recent studies tell us that over 20 years later, the statistics have not improved by much. A study by Clear Living in 2020 analyzed the impact of hearing loss on mental well being and lifestyle. Their data found that 89 percent of participants cited social and personal problems as a key impact of hearing loss. The 3,767 respondents seemed to all have one continuous thing in common – “addressing hearing problems appropriately always leads to a happier and healthier lifestyle.”

Despite these statistics, hearing treatment continues to prioritize focus on the physical aspects of hearing loss. While this obviously has to be the priority, there is a clear gap in the rehabilitation process regarding emotional well-being. It is common to experience mental health difficulties related to the life altering changes that hearing loss presents. If these negative feelings are not resolved, they can lead to serious disorders such as anxiety and depression.

Read more: Study: the impact of hearing loss on mental health

The Difference Between Coaching & Counseling

While both help to develop new ways of thinking, coaching should not be confused with counseling. Counseling is a much more complex service that focuses on recovering from symptoms. Counselors and psychologists use professional knowledge to explore causes of psychological trauma and guide emotional healing often through talk therapy. Coaching is not therapy, but rather is about helping you to find your potential.

“The focus of my sessions is always forward-facing: which is one of the ways it differs from counseling, which will often delve into a person’s past or childhood,” Sygrove explains. “That’s not to say we can’t talk about the past in a coaching session, but only if it’s relevant to moving forward with my client’s goal. For example, if they are working on exploring a new career path, they might reflect on previous jobs, determining what they enjoyed/didn’t enjoy and what they learned, in order to help them determine the key elements they would like in a new role.”

The focus of my sessions is always forward-facing.

Coaching offers a process aimed to help you achieve your goals by identifying obstacles and strategize how to overcome them. Sygrove’s coaching style is supportive and empowering rather than directive. Through questioning and reflection, she helps clients explore, organize, expand on their thoughts, and find a positive way forward.

Achieving Your Goals

In essence, coaching is a conversation-based approach to moving someone from where they are to where they want to be. In Sygrove’s coaching sessions, she explores a client’s inner world of beliefs, assumptions, values, and expectations in order to create greater possibilities for ways of being in life. “It is a pragmatic journey of self-exploration, which is likely to create long-term change,” she says.

In order to make connections with her clients, Sygrove went through extensive training where she received coaching herself. This gave her great insight into how she can pass this gift on to others. “In one session I had to speak about a limiting belief (that little negative voice in your head that holds you back from accepting great opportunities),” she says. “I said, ‘Because of my hearing loss, I can’t study Spanish.’ We worked through this together, until they finally asked me, ‘What if this belief is faulty in some way?”

Coaching helped Sygrove realize she had lost a lot of confidence in her language-learning since losing her hearing. This low confidence was preventing her from reaching her goals.

The First Steps

To ensure she is the right coach for the person seeking guidance, Sygrove offers a free 30 minute consultation. This introduction allows space for the client to tell their story. During the conversation, Carly asks questions to obtain a  understanding of one’s situation, goals they would like to achieve, and what they hope to get out of coaching. “This call is important because it gives both the potential client and me, as the coach, the opportunity to determine whether we might be a good fit to work together,” she says.

This half hour clarifies for the client how everything works and the general structure of a coaching session. Once she has identified her client’s needs, they can determine whether or not they will be a good fit.

Supporting Different Hearing Loss Journeys

Often, people find that their hearing condition impacts certain parts of their lives, which can affect their sense of self. For example, a person with hearing loss may not enjoy activities they used to due to communication difficulties. Such difficulties can include socializing in noisy environments. A person with tinnitus may avoid music concerts they used to enjoy, etc.. Both situations can lead to the individual questioning their sense of identity.

“If my clients have different focuses, e.g. one person wants to explore identity as someone with hearing loss, and the other wants to explore effective communication techniques while living with tinnitus, the discussion will naturally take a different path,” says Sygrove. In the coaching sessions, she delves deeper into how the client’s hearing condition has impacted their identity and how they want to move forward with this or make a change.

Coaching for Hearing Loved Ones

When a family member has hearing loss, it impacts the whole family. It can be difficult for people to know how to support loved ones with their hearing loss. This is especially true if the person with hearing difficulties finds it upsetting or uncomfortable to talk about. Talking about their thoughts and feelings with someone who is not emotionally involved in the situation can be helpful.

“I help loved ones of the HOH community to have more empathy,” Sygrove says. “We work on themes including accepting their loved one’s hearing loss, how to stay calm in challenging communication situations, and how to speak to their loved one about their hearing loss and the challenges this brings to the relationship.”

Sygrove answers any questions regarding living with hearing loss that they might feel they’re not able to discuss with family. She focuses on helping them move forward with whatever goal they bring to the session.

Accepting Your Hearing Loss

Accepting our hearing loss often means dealing with feelings of grief. This is something that Sygrove has experienced first hand and is a common topic of discussion in her Facebook group .

“I feel that it’s something that often takes us by surprise and that is rarely mentioned to us by hearing care providers,” she says. “For me, it wasn’t until a few months following my hearing loss that I realized I was grieving. I needed to experience the sadness and anger I had at my body before I could reach a level of acceptance. Once I reached this stage, I was able to start making plans and focus on moving forward with living my life with hearing loss.”

Through coaching, Sygrove helps her clients accept the changes hearing loss brings to their lives by supporting them in envisioning a positive future with hearing loss. When we identify specific challenges of hearing loss, we can work on overcoming them. By creating subtle changes in their  routines, she helps clients create a plan that will guide them towards acceptance.

Becoming a Hearing Loss Advocate

In addition to accepting our hearing loss, an important and empowering part of healing is learning to advocate for ourselves. We spoke about becoming an advocate for both yourself and for the hearing loss community through coaching. Sygrove relayed a story of a client who came to her soon after losing their hearing in one ear. Their general goals were around learning to cope with their new normal and eventually becoming their own advocate.

In addition to accepting our hearing loss, an important and empowering part of healing is learning to advocate for ourselves.

“Recently they told me how they had advocated for themself in a restaurant,” Sygrove says. “They told the waiter that they had hearing loss and asked to move from a table in the middle of a restaurant to one in a corner where they would be able to hear their friend better. This is someone who in the early days didn’t want anyone to know about their hearing loss! It’s so wonderful to see this kind of transformation in people, and to see them living their lives successfully and happily!”

Contemplating on the work she has put into becoming an advocate for herself, Carly told us, “Becoming a coach has helped me work on my advocacy skills further since I am now more self-aware. I make sure I check in with myself every now and then and evaluate communication situations. But I think, after six years of living with hearing loss, I am still learning to be my own advocate! It’s not a linear process.”

Read more: New to hearing loss? 3 ways to be an advocate for your hearing loss journey

Overall Benefits of Coaching for Hearing Loss

Life coaching is an option that can be used to prevent, rather than treat ill mental health. By having someone championing you to advocate for yourself, coaching empowers you to lead a life you’re in control of. This positively impacts our lifestyle which is directly linked to well-being.

Seeking emotional support is crucial in reducing the psychological symptoms of hearing loss. If you think you or a loved one could benefit from life coaching, visit Sygrove’s official website to learn more. Sygrove takes clients from all over the world, time zones permitting. Most of her clients are UK and US based. She has also recently joined Instagram . There, she shares informative posts about living with different hearing conditions and self-advocacy.

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7-month-old OC girl, among youngest to receive cochlear implants, embarks on journey to hear

ANAHEIM HILLS, Calif. (KABC) -- Cochlear implants to help those with profound hearing loss have been around for decades, but patients are getting younger and younger. One Anaheim Hills infant is one of the youngest to receive these devices.

The procedure marks the beginning of 7-month-old Zara Ahmed's journey with sound.

A week ago, doctors at Providence Saint John's Health Center Pacific Neuroscience Center surgically embedded cochlear implants. Now, it's being activated for the first time.

"It's not like Lasik eye surgery where you see the first day. With the cochlear implant, we are replacing the sensory system. With the cochlear implant, we are replacing the sensory system with an electrode array," said Dr. Rebecca Lewis, audiology director of the cochlear implant program.

Zara is hearing static, beeps and robotic sounds that will eventually take shape.

"Children have so much neural plasticity in their brain. They're able to adapt and learn what they're hearing really well," she said.

Seeing his daughter's reaction to the sensation of hearing left Haroon Ahmed without words.

"Your emotions are running high and I just couldn't think of anything or do anything. I was frozen," he said.

When Zara was born, she didn't pass her newborn hearing test.

It would take three audiologists and several tests to figure out exactly what was going on.

Doctors concluded that she was born with profound sensorineural hearing loss. It occurs when the cochlea, auditory nerve, or auditory center is damaged.

After hearing aids didn't work for her daughter, Mursal Ahmed found Lewis and neurotologist Dr Courtney Voelker and Lewis.

"I came across a video on YouTube and it was the doctors doing an activation on a cochlear implant on a six-month-old," said Ahmed.

In 2020, the FDA approved cochlear implants in children as young as nine months old. At seven months, Zara is one of a handful who received one earlier.

"If you meet kids who were implanted young, you would not know that they have cochlear implants. They do fantastic," said Lewis.

Doctors expect Zara will meet all her language milestones.

"Whatever she decides to do. Honestly, if she wants to hear and speak in that sense we will support her. If she wants to sign when she gets older, then that's her decision, then we will support that," said Mursal Ahmed.

"As far as what I want for her, I just want her to be happy. Whatever it is that makes her happy," said Haroon Ahmed.

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Teen writes book about hearing loss journey to inspire others with hearing loss

Home » Hearing loss success stories » Hearing loss in children » Teen writes book about hearing loss journey to inspire others with hearing loss

Valli G. shares the story of setting the bar high for children’s hopes and dreams after their hearing loss diagnoses. After finding her daughter’s fourth-grade school journal, she tells the story of how her daughter set out to create a book to encourage kids to believe that they are special, represented and most importantly, to never give up:

“When my son was born and diagnosed with hearing loss , he was the first deaf person I had ever met. To say we were overwhelmed charting this new territory would be an understatement.

Once the shock wore off and acceptance kicked in, we were able to roll our sleeves up and get to work, providing him with all the things necessary to set him up for success. We surrounded ourselves with a team of experts and champions who all wanted the best for our child. Together, we created a plan and soon we felt less alone. Our son Battle, who was perfectly named, received hearing aids as an infant. Then, well before his second birthday, he underwent surgery for a cochlear implant . He was progressing and meeting milestones. We were encouraged and set the bar high.

When our daughter, Harper, was born 21 months later with the same condition that caused our son’s hearing loss, we were prepared. We had a road map, and although it wouldn’t be easy and without challenges, we knew what needed to be done in order to set her up for success. We were well versed by this point and knew what was possible.

Setting the bar high for our kids

Early on, we were given priceless advice from a well-respected therapist. He told us to set the bar high for our kids. He encouraged us to measure them against all peers not just hard of hearing ones. ‘They will rise’ to wherever the bar is set for them.

When I began writing about our family’s experience in my blog, My Battle Call , I was frequently told I should write a book. I didn’t really have the burning desire to write a book at the time, but I did feel compelled to continue to build my online community which offers support and encouragement for others.

Then, my daughter came home from her last day of fourth grade and tossed her over-stuffed backpack onto the couch. I started going through all the papers and packages buried inside the torn and tattered bag.

What caught my eye was her ‘Writing Journal.’ I started reading the scribbled entries within the daily writing prompts when I came across one that stopped me in my tracks:

‘What Makes You Unique?’

What came next were pages about all the things about being deaf that made her unique. The light switched on: THIS IS THE BOOK. It wasn’t my story. Our book would be Harper’s story.

Harper’s book

Told in Harper’s voice with wit and charm, she shares how she has never seen hearing loss as something that has limited her.

Geared towards grades second through fifth, but also appropriate for younger and older readers, too, our book is designed for any child who has hearing loss and those who love and care for them.  Harper encourages kids to reach for the stars and to chase their dreams. In addition to a healthy dose of inspiration, the story also includes ways others can better support someone with a hearing loss.

The book that can help others

‘We are as unique as a fingerprint. The one thing we have in common is that we want to be treated like any other kid. We want to be included and accepted.’

And I can’t think of any message more important than that. We hope our book: ‘Now Hear This—Harper Soars with her Magic Ears’ will be on every child’s nightstand who has hearing loss as well as in every school library and classroom. Representation matters. Inclusion is important. Education is key.

Harper’s book has soared to Amazon’s #1 New Release. And before schools being switched to remote learning, she was traveling to schools across our county to read to classrooms and participate in book fairs. But she didn’t let COVID-19 deter her and was the guest on several podcasts and performed read-alouds of her book via Zoom to classrooms across the country. She would say she is definitely rising above the bar we set for her while continuing to reach for the stars.

The book is available on Amazon or Barnes and Noble .

Was your child diagnosed with hearing loss? Like Harper’s book about hearing loss teaches, never give up! Check out these resources to learn more.

• Hearing loss in children

Cara Lippitt

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Don't Ignore These 4 Signs That Experts Say Could Mean You're Experiencing Hearing Loss

Hearing loss can happen at any age.

HuffPost Contributor

While we often think of hearing loss as something that only happens to much older people ― that’s actually not the case.

According to the National Institute of Deafness and Hearing Disorders , 1 in 8 people in the United States over the age of 12 have hearing loss in both ears, and about 28.8 million U.S. adults could benefit from hearing aids. 

While struggling to hear may be the most obvious sign that you need to get your ears checked, it’s not the only one. We asked audiologists to share the top signs that it’s time to get your hearing checked. Here’s what they had to say:

1. You’re struggling to keep up with conversations.

If you constantly find yourself saying “what?” during conversations, it may be time to get your ears checked.

“Straining to hear when talking with others or keeping up in conversations is a big one,” said  Terry Zwolan , director of Audiology Access & Standard of Care for Cochlear Americas. “This can include finding it difficult to hear in the presence of background noise, and regularly asking people to repeat what they’ve said or mishearing often.”

2. You have to turn the volume on the TV way up. 

Whether other people tell you to turn the TV down regularly or you’re astounded by the number you see on the volume button, that can be a sign that it’s time to get your ears checked.

“You may find yourself turning up the volume on the TV or radio to a level that is louder than others prefer or feel like people are mumbling,” Zwolan said. 

3. Your ears are ringing.

While ringing in the ears (or tinnitus) isn’t always a sign of hearing loss, it certainly can be. “Some people may experience persistent ringing, buzzing, pain or pressure in one or both ears,” Zwolan said. “It also may be hard to hear on one side, difficult to discern where sounds are coming from, or your own voice may sound different.”

Katie Koebel, an audiologist and senior manager of audiology at HearingLife Canada, emphasizes that experiencing symptoms of tinnitus is a solid reason to look into a hearing test. “Tinnitus, or ringing in the ears, is commonly associated with hearing loss conditions,” she said. “If you experience this for a prolonged period, it is a good idea to book a hearing test.”

4. Natural sounds may be difficult to hear.

If you’re suddenly finding it difficult to hear the sounds of nature — think birds chirping or rain falling — this can be a red flag, according to Zwolan.

Amy Bishop , a corporate audiologist at Lucid Hearing, noted that this can apply to common household sounds as well. “Some folks say they have trouble hearing common everyday sounds, like their turn signal, boiling water, or the laundry machine chime,” she said. 

Getting your hearing checked is crucial ― even if you’re young.

While it’s certainly annoying (both for yourself and others) to not be able to hear anything, there are also long-term health consequences to a late hearing loss diagnosis. 

“If left unaddressed, hearing loss poses significant challenges to healthy aging. Research has proven untreated hearing loss is connected to increased social isolation and loneliness, balance issues and risk for falls, and there’s continued emerging evidence associating untreated hearing loss with diminished brain health and mental sharpness as well,” Zwolan said. “Hearing words fully and clearly can help keep the brain active and sharp.”

Indeed, research shows that older adults with hearing loss are more likely to develop dementia and that the use of hearing aids can slow cognitive decline .

“Managing hearing loss typically involves a combination of strategies tailored to the individual’s needs,” Bishop said. “The most common approach is hearing aids, which can improve hearing and communication abilities. Hearing aids come in various styles and technologies, so it’s essential to work with an audiologist to determine the best option for your specific type and degree of hearing loss. Finding the right hearing aid will help you to achieve the best outcome.”  

There are also ways you can protect your ears as you age.

Whether you suspect you have hearing loss or want to prevent it from happening, there are a handful of solid strategies that can help you protect your hearing as you age.  

“Avoid noisy places whenever possible and use earplugs, protective earmuffs, or noise-canceling headphones when near loud noises,” Zwolan said. “It’s important to keep the volume down when watching TV, listening to music, and using earbuds or headphones. And finally, be sure to get your hearing checked as you age.”

Koebel added that if you live in a noisy city, it can also be helpful to soundproof areas of your home.

“To do this, you can use acoustic foam paneling, or if you’re looking for a cheaper option, things like wall tapestries, additional blankets and pillows throughout the home, and thicker curtains are effective noise dimmers.”

Hearing loss can be incredibly annoying and isolating for anyone experiencing it, but knowing the signs (and getting a yearly hearing test!) can help you get ahead of any hearing issues. Treating hearing loss sooner rather than later can help prevent longer-term health problems, so if it’s been a while since you got your ears checked, reach out to your doctor.  This article originally appeared on HuffPost.

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‘The Bachelor’ star Daisy Kent shares hearing loss journey — what to know about Ménière’s disease

L ast Monday, “The Bachelor” contestant Daisy Kent stole America’s hearts while courting the Season 28 lead, Joey Graziadei, opening up about her profound hearing loss on their first one-on-one date.

The 25-year-old received a cochlear implant last year after losing her hearing, which she believes may have been triggered by Lyme disease and, subsequently, Ménière’s disease, an inner ear condition common in adults that causes poor fluid balance in the ear, tinnitus, vertigo and can destroy the cochlea, the hearing organ.

The Minnesota native has documented her journey from surgery to implant activation and beyond on TikTok, where she now boasts more than 142,000 followers and her candid conversation about her condition has inspired others experiencing hearing loss.

“There’s a stigma with hearing loss, and there’s a stigma with hearing aids as well,” board-certified ENT otolaryngologist Dr. Aaron Fletcher told The Post.

“If you’ve ever seen someone with a cochlear implant, it just looks different — it’s literally anchored into the skull with a magnet.”

According to Fletcher, there is no proven link between Lyme and Ménière’s disease, although Kent has said online that a combination of the two is what her doctors believe could be behind her hearing loss at such a young age.

Ménière’s disease, which is managed like a diet low on salt, is typically hereditary, explained Fletcher, although Kent has previously explained that no one in her family has a history of the condition.

Management of Ménière’s disease — by way of maintaining fluid balance through lowering salt intake, for example — is vital to having “more time with your hearing,” he added.

“If you’re not managing the Ménière’s, in the span of years or decades, you can lose your hearing completely,” he explained, adding that, traditionally, it takes “many years,” decades even, for hearing to go completely, which is why it’s more common in older adults.

While an estimated 40 million people over the age of 18 have trouble hearing to varying degrees, Kent’s case, he said, must have been “severe.”

“It’s not really common to see it in someone 25 that actually has Ménière’s that’s caused hearing loss completely,” he noted.

Cochlear implants, as Kent has, are reserved for patients who struggle to hear clearly, he added, since such hearing loss cannot be mitigated by hearing aids, which “basically just turns up the sound.”

The implants, however, take a substantial amount of time for the brain to get used to — Kent said that, upon first activating her implant, everyone’s voices were high-pitched and sounded like chipmunks.

While experiences vary from person to person, it could take years, Fletcher said, for someone’s hearing to be fully rehabilitated.

But because of the stigma surrounding cochlear implants and hearing loss in general, Kent’s transparency about her own journey could educate those who aren’t familiar with the condition and devices.

Fletcher said that some patients who use hearing devices are “constantly having to educate people” about them.

“I think it’s good to have somebody on the national scene that is helping to break the ice on that topic, because…there’s some kids that are actually having cochlear implants and having to go to school and probably explain ad nauseam what it is and what it does,” he said.

“But it’s good when you have some national attention to these kind of things.”

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• Hearing Protection Program for Dental Students: The Journey

Mar 29, 2024 | Plugs & Tips , Prevention | 0 |

Musician earplugs and hearing health education can be beneficial to members of other professions, including dentists, who also suffer from hearing loss.

By Catherine Palmer, PhD

The University of Pittsburgh Medical Center Audiology group ( UPMC Audiology ) currently provides non-custom musician earplugs for every student in the University of Pittsburgh Dental School. This program is paid for by the University of Pittsburgh Dental program. In addition, we provide custom musician earplugs to those students who prefer a custom solution, which is purchased by the students. Each year, we provide a lecture to the new class of dental students (approximately 80 students per year) that includes information about hearing health and hearing protection as well as good communication strategies for working with patients with hearing loss and positioning for individuals with vestibular issues.

This article describes the journey that led us to this relationship with the dental school and a comprehensive hearing care program that is introduced to each student at the beginning of their program. Figure 1 illustrates the steps that led us to this ongoing program.

Getting Started with Hearing Care Education in Dentistry

This program started when dental school professor Thottala Jayaraman, PhD, reached out and asked if someone from the medical center audiology clinic could provide a guest lecture on hearing within the Human Physiology course. The lecture would be 90 minutes long, so we thought about what we could include that would warrant 90 minutes. We decided to break the content down into patient-focused and dentist-focused topics.

For the dental patient, there are issues of untreated hearing loss as it impacts communication and potential vertigo induced by patient position during a visit for individuals prone to benign paroxysmal positional vertigo. There are considerations for those who wear hearing aids (e.g., do they want the drill sound amplified) and there are potential solutions for communication challenges (e.g., use of simple amplifiers when taking the case history, providing instructions, etc.). Awareness of positional vertigo assists the dentist in asking questions that help manage patient positioning in a dental chair to reduce discomfort.

For the dentist, the focus was on the potential for sound induced hearing loss, tinnitus, and hearing challenges over time. In addition, we presented information about hearing protection including the use of musician earplugs to protect the dentists’ hearing, reduce hearing challenges, and reduce the chance of experiencing tinnitus while still maintaining the ability to hear patients. The extended exposure over a dental career to both constant lower level sounds as well as the high intensity sound of drills contribute to noise-induced threshold change as well as cochlear synaptopathy (hidden hearing loss), so these topics were discussed in detail. This filled the 90 minutes.

Introducing Musician Earplugs in Dental School

The second year we brought non-custom musician earplugs to show the group and for any students who came up at the end to ask questions, we gave them a pair of non-custom musician earplugs. This prompted a handful of students to reach out to purchase non-custom earplugs from our clinic. By year three, our guest lecture was a permanent part of the course, so all dental students received information on hearing health and hearing protection toward the beginning of their program.

It was in year four that we learned that one of the most sound-intense exposures in the dental school program is in the first year when the students are all practicing drilling on models in one laboratory space. In year five, an interested student named Stephanie Cisek went to the Dental School administration and asked that hearing protection be provided for all incoming students. The reasoning being that they learn about the need to protect their hearing from activities that are part of their educational program and therefore, like any other safety equipment that is provided in the program (gloves, masks, eye protection), hearing protection should be provided as well.

Instrument Management Service Manager Kristen Felser rose to the occasion and worked with the student and our group to make this program a reality. The school now purchases non-custom musician hearing protection for all students and faculty. Cisek was interested in custom hearing protection and worked with our group to create a discount that is offered to the dental students if they want to individually purchase custom musician earplugs. To accommodate their very busy clinic schedules, we hold a specialty clinic before regular clinic hours a few times a year to make custom musician earplugs for interested students.

Further reading: NIOSH Study Tracks Usage of Hearing Protection

Elements of a Successful Hearing Protection Program

This journey illustrates the steps that we have found essential in developing hearing loss education and prevention programs with a variety of groups, including the numerous high school and college bands and university schools of music with whom we work. Our most successful, sustained programs start when the entity reaches out to us as opposed to us reaching out to them to convince them that they need to provide education and/or action related to hearing protection.

This does not mean that audiologists should not promote hearing protection. We do this through information on our website (e.g., we have a Musicians’ Hearing Center) and we promote hearing protection at community health fairs and in talks whenever possible. But our experience indicates that the group needs to have their own motivation to pursue these programs. Perhaps someone in leadership has become more aware of the importance of hearing and the risk of hearing damage due to the activity. Or a student has experienced a hearing protection program in a previous activity (e.g., high school band prior to joining a university band).

Tailoring our response to the actual request is critical. If the group simply wants education, that is what we provide. Rather than jumping right to proposing a comprehensive hearing protection program, we have found that the education leads organically to this conclusion—that the entity needs to provide hearing protection or at least provide access to hearing protection for their constituents. Again, we have been more successful when the interested group asks us to partner with them to provide needed hearing protection along with the ongoing educational program rather than when we are the party asking for a hearing protection program to be put in place.

All of this takes time, as indicated in Figure 1 , but we have found that these are the programs that stand the test of time. It may be frustrating for the audiologist when we know these groups should have hearing protection, but being patient can mean that many more individuals will experience hearing protection once these programs are in place and the group has taken ownership.

Catherine Palmer, PhD, is a professor in the Departments of Communication Science and Disorders and Otolaryngology at the University of Pittsburgh and serves as the Director of Audiology for the UPMC Integrated Health System. Dr Palmer conducts research on the relationship between hearing, cognitive health, and health outcomes, and matching technology to individual needs. She has published over 150 articles and book chapters in these topic areas as well as provided over 200 national and international presentations. Palmer serves as editor-in-chief of Seminars in Hearing . She is a past president of the American Academy of Audiology.

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The Accidental Tax Cutter in Chief

President biden says he wants to rake in more money from corporations and high earners. but so far, he has cut more taxes than he’s raised..

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In his campaign for re-election, President Biden has said that raising taxes on the wealthy and on big corporations is at the heart of his agenda. But under his watch, overall net taxes have decreased.

Jim Tankersley, who covers economic policy for The Times, explains.

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Jim Tankersley , who covers economic policy at the White House for The New York Times.

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An analysis prepared for The New York Times estimates that the tax changes President Biden has ushered into law will amount to a net cut of about $600 billion over four years.

“Does anybody here think the tax code’s fair?” For Mr. Biden, tax policy has been at the center of his efforts to make the economy more equitable.

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