Monday, October 14, 2019

Denial ain’t just a river in Egypt

By: Dr. Dawn MacMillan, Audiologist

"Denial ain’t just a river in Egypt"

Mark Twain 

"I watch PBS and most of the people have British accents..."

"My wife mumbles when she talks to me..."

"The checkers at <insert grocery store here> don’t speak clearly."

"Our new pastor--his voice trails off..." 

What do the above statements have in common? They’re all excuses we’ve heard when people try to explain to us that they don’t have hearing loss, they hear what they want to hear, and their difficulty understanding has everything to do with everyone else and not them. Sound familiar? 

There’s no denying (see what we did there?) that accents, background noise, and distance can make conversations hard to hear. But adding hearing loss on top of factors we have little control over makes it that much more difficult to understand .

The 5 stages of grief and loss are: 

1. Denial and isolation; 

2. Anger;

3. Bargaining

4. Depression; 

5. Acceptance. 

People who are grieving do not necessarily go through the stages in the same order or experience all of them. 

For many people, admitting their have hearing loss does bring about significant grief. After discussing the test results, we’ve seen a full scope of emotions. Some are tired of struggling and armed for battle--ready to do whatever it takes to address the hearing loss and seek help. Others are arms-crossed-jaw-set angry, certain our results are wrong, our equipment faulty. Many are in denial. "I hear what I want to hear." "It’s not that bad." "I get by ok." 

It’s hard to "convince" someone they need help. We can present their results to them and make a plan of care recommendation but ultimately, we can’t force people to actually do something about their hearing loss. An orthopedic surgeon can’t force someone to get a hip replacement. Only when someone is in tremendous pain, their mobility limited to the point that it disrupts their quality of life, will someone decide to finally schedule the surgery and go to physical therapy to rehab the joint. 

Hearing loss is much the same. You can deny it all day long, but it’s only when you can no longer perform your job, you miss an important phone call, your grandkids stop speaking to you, you get embarrassed when you misunderstand-- only then will you decide to do something about your hearing loss. 

Bad news doesn’t get better with time. The wait and see approach doesn’t work with hearing loss. If you suspect you have hearing loss, schedule an appointment to be checked out. If a hearing loss is identified, don’t wait to do something. You may need to take a day or two to decide a few details, but waiting years to take action doesn’t make the problem go away. In fact, it may only exacerbate the problem. 

Call us today to schedule your evaluation, (912) 748-9494. You may also schedule an appointment from the home page of our website. If you have Flexible Spending Accounts or Health Savings accounts that have to be spent down before the end of the year, time is running out to use them or lose them in many cases. 

"Denial ain’t just a river in Egypt"

Mark Twain 

Saturday, August 10, 2019

Let’s Talk S’more about preventing hearing loss! 

By: Dr. Dawn H. MacMillan, Audiologist

Happy National S'mores Day! To celebrate, we are sharing with you tips on how to prevent hearing loss. Each day in our office, we treat patients who feel like they are doomed to have hearing loss because someone in their family has hearing loss. While there may be a greater likelihood of developing hearing loss in those with a genetic link, often times it is because unhealthy hearing habits are passed down from generation to generation! Nights spent under the lights at the racetrack with no hearing protection, mowing the lawn with no hearing protection, smoking--there are things you can do to reduce your risk of hearing loss.

1.) Move away from the noise-This doesn't mean you can't enjoy a good outdoor concert. While being near the action may be good for your soul, it's bad for you hearing. By putting some distance between you and the noise source, you are reducing he level of hazardous noise reaching your ears which is good for your hearing. If you aren't sure what level of hearing loss is dangerous, install a sound level app on your smart phone. There are many that are free and will tell you when you are in dangerous levels of noise. Even Apple has introduced a safety feature on their watches to alert you when you are in noise that may be hazardous to your health.

2.) Protect your ears-You've heard us bang this drum! Use hearing protection! When doing yard work, wear earmuffs, While hunting, invest in some Electronic Shooters Protection (ESP). If you play in a band, use monitors to reduce the noise level reaching your ear. If your children play in the school band, educate the band director and insist your children wear musician's ear plugs designed for the instrument(s) they play. We are happy to provide an in-service to your child's band director about the dangers of noise-induced hearing loss and how they can help prevent it in their students. Noise-induced hearing loss is 100% preventable and irreversible.

3.) Stop smoking. Better yet, don’t start-It is well documented that smoking is bad for us. Direct exposure, secondhand, even in utero--all negatively impact our health including our hearing. Both nicotine and carbon monoxide lower oxygen blood levels and constrict blood vessels all over your body–including those in your inner ear responsible for maintaining hair cell health. Also nicotine and cigarette smoke are thought to interfere with neurotransmitters in the auditory nerve, which are responsible for telling the brain which sound you are hearing. Additionally, nicotine and carbon monoxide irritate the Eustachian tube and lining of the middle ear.
trigger the release of free radicals that can damage DNA and cause disease.

4.) Watch your medications-Certain medications can damage the ear, resulting in hearing loss, ringing in the ear, or balance disorders. These drugs are called ototoxic. There are more than 200 known ototoxic medications (prescription and over-the-counter) on the market today. Medications like aspirin (and those medications containing aspirin) can cause tinnitus (ringing in the ears), Typically, once these medications are stopped, the tinnitus will subside. These include medicines used to treat serious infections, cancer, and heart disease.Hearing and balance problems caused by these drugs can sometimes be  reversed when the drug therapy is discontinued. Sometimes, however, the damage is permanent. When a decision is made to treat a serious illness or medical condition with an ototoxic drug, your doctor should not only consider the effects of the medications on the illness they are trying to manage but also how it may effect your hearing and balance systems. Quality of life should certainly be discussed to determine if the treatment you're seeking is worth the potential for damage to your hearing and/or  balance system.

5.) Control your diabetes- Right now, we don't have solid research on exactly how diabetes and hearing loss are linked.  It's possible that the high blood glucose levels associated with diabetes cause damage to the small blood vessels in the inner ear, similar to the way in which diabetes can damage the eyes and the kidneys. Like other parts of the body, the hair cells of the inner ear rely on good circulation to maintain health. These hair cells are responsible for translating the noise our ears collect into electrical impulses, which they send along the auditory nerve to the brain to interpret as recognizable sound. These sensory hair cells, known as stereocilia, do not regenerate. Once they are damaged or die, hearing is permanently affected. Recent studies indicate that hearing loss is twice as common in those with diabetes than without. Controlling blood glucose levels aids in managing your diabetes which can lessen the impact on your hearing.

6.) Get your hearing tested-Everyday in our office, we test people who self-report that "they think they hear fine" or "they have trouble when it is noisy but don't think they have hearing loss." yet when the test is complete, the results indicate at least a mild level of hearing loss. From the first few teeth we get as infants, we are taught to get dental cleanings every six months to maintain good dental health. Annual eye exams are the norm and even necessary for those wearing corrective lenses. But hearing exams are something we get in grade school, perhaps before entering the military, or a baseline test if starting a job. Yet adults rarely get a hearing test otherwise unless there is a problem. It is past time to see hearing as healthcare. Baseline hearing tests and testing annually to monitor changes should be the norm, just like dental and eye exams. This is especially true for those with chronic health conditions such as diabetes. When was the last time you had a hearing test? If it was more than a year ago, you're overdue.

7.) Limit headphone use-According to the World Health Organization (WHO), over 1.1 billion people ages 12-35 are at risk of hearing loss due to the use of headphones on personal listening devices. The recommendation from WHO and other health firms recommend is listening to mobile devices for a maximum of one hour per day, and the volume should stay around 60 percent. Headphones are better than earbuds. The exception is with custom monitors as they seal the ear better, requiring less overall volume. Regardless, volume should be no greater than 60% and for no more than one hour per day.

To schedule a hearing test or hearing conservation consult with us, please call (912) 748-9494 or schedule directly from our website.

Sunday, July 21, 2019

Hearing Loss & Children: Five ways parents can help prevent hearing loss in their children

By: Dr. Dawn H. MacMillan, Audiologist 
It's hard to believe, but school starts locally in just about two weeks. Like so many other parents, I've been running around buying school uniforms and shoes because my kiddos have outgrown almost everything this summer. We've been busy with school supply lists and finishing all the back to school tasks required before August 5th when they return to school. For my little one who will begin kindergarten, I had to verify she had her required hearing test to enter school  (funny to me considering her mama is an Audiologist!) and was up-to-date on her vaccinations. All this running around and list-checking got me thinking about my pediatric patients. How my back to school lists mirror the lists of the parents of my pediatric patients with hearing loss but they have more things they need to do to prepare their little ones for the new school year. It got me thinking about childhood hearing loss and what I can do to help prevent hearing loss in not only adults, but also children. 
According to research, 40 percent of hearing loss is caused by genetic factors. The remaining 60 percent of factors are preventable according to the World Health Organization. Some preventable causes of hearing loss at a young age include infections, birth complications and exposure to toxic medications among others. Loud noise too can be a contributing factor to hearing loss.Below we discuss some of the ways in which hearing loss can be prevented. Symptoms such as tinnitus (or ringing in the ears) may be the first sign of hearing loss, not difficulty hearing. Parents should be mindful that children may not say they have hearing loss, rather they may report ringing in the ears and/or muffled hearing as the first sign of hearing loss. They may play the TV too loud, as well as their personal electronic devices. It is up to us as parents to educate our children on noise-induced hearing loss and how to prevent it. Below are five ways to help prevent hearing loss in children. 

Practicing Safe-Listening Habits

Teaching your child on the various causes of hearing loss such as loud music and the importance of protecting themselves from such is critical. It is imperative to discuss hearing loss and the fact that noise-induced hearing loss is preventable. How it is irreversible. How wearing hearing aids later in life may help, but it doesn't restore hearing lost. By discussing types of noises that cause hearing loss, it creates an awareness of the dangers these sounds possess. By discussing hearing loss and its causes, you are setting your child up for a lifetime of awareness at a young age. Much like putting suncreen on our kids and encouraging them to continue when you aren't there to apply it anymore, practicing safe listening habits is something to establish from an early age. Practical ways of achieving this include turning down the television or other electronic devices when the noise is too loud and teaching your kids to cover their ears when they are abruptly exposed to loud noise in the environment. Encouraging schools to also raise awareness of hearing dangers to students is another important step. Band and music teachers can teach their students about safe listening and ways to preserve and protect their hearing so they can enjoy the music for years to come. 

Buy Noise-Limiting Headphones

Despite the fact that young children can be very noisy,  kids are more sensitive to noise as compared to adults. They also tend to turn up the volume so high that it might in the long term affect their hearing--on video games, headphones, car stereos. Exposure to sound levels above 85 decibels can be particularly harmful to your child. Experts also advise parents not to let their children listen to headphones for more than two hours, even if the sound is limited and can’t go beyond 85 decibels.Most noise-limiting headphones nowadays come with a child-friendly design and are comfortable to wear. Many modern smart phones have parental controls that allow you to impose an upper limit on your kids' electronic devices. It is important to get children noise-limiting headphones that they are attracted to since this ensures that a large percentage will use these headphones even when you are not around.

Noisy Toys

Toys which are too loud can hurt your child’s ears. The damage is not noticeable at first but may affect your children’s hearing when they are middle-aged.The damage from these toys is cumulative, and this makes them very dangerous. Even though most of these toys when operated in the right way are harmless, children often misuse them. Their arms are shorter than an adults. That means toys are closer  to your child's ears than they may have been designed for use. You need to screen these toys first by holding them a distance of about a foot from your face and listen to them.If you wince at the noise, they are not safe.You should either put tape over the speakers to reduce the noise or keep them away from your child. You can also report such toys to the Consumer Product Safety Commission. Annually, the Sight and Sound Association publishes a list of noisy toys which may cause permanent hearing loss ahead of the holidays. Before holiday shopping for your children, take a look at this list and heed the warning that these toys may be harmful to your child's hearing. 

Insist & Invest in Hearing Protection--EVERY time.

Sometimes certain aspects of the environment are unavoidable. Fireworks around the fourth of July. Yard tools such as blowers, lawnmowers, and weed eaters. Noise from concerts too can be inevitable.In these cases, you can get your child noise canceling headphones. These reduce noise from places such as concerts, places with loud music and occasions where fireworks are used.Other types of hearing protectors can also be used.Earmuffs too are a great investment, and they ensure that your child’s delicate ears are protected from loud noises in the environment. Earmuffs with child-like designs are available. You should discourage your children from using earbuds or headphones as hearing protection as the level of music they mist listen to in order to hear above the equipment noise is most certainly loud enough to cause permanent noise-induced hearing loss. 

Vaccinations to prevent childhood illness

Vaccinations are a hot topic and have been for years. Regardless of which side you're on, vaccinations do prevent several childhood illnesses known to have hearing loss as a potential side effect. Measles, mumps, and rubella are the leading causes of hearing loss worldwide. You need to vaccinate your child early enough against these diseases to prevent hearing loss. Early vaccination also prevents the spread of these diseases to other children who have not been or cannot be vaccinated due to various health conditions. While many choose not to vaccinate their children due to the risk of vaccine injury or high-risk for vaccine injury, there is no doubt that vaccinations do prevent these serious illnesses. 

Ototoxic Medications

Ototoxic drugs are can damage the ear or cause balance disorders. At the moment there are about 200 known ototoxic drugs both prescription and over the counter in the world.The damage posed by these drugs may either be reversible through therapy and other times they can cause permanent damage. Before a medication is prescribed to your child, you need to discuss with your doctor the possible effects it may have on your child. If the condition is severe and administration of these drugs cannot be halted, the audiologist can advise on ways to manage the effects of the drugs. Often times these medications are prescribed to help with a life-threatening infection or illness, such as cancer. You should of course heed the warning of your physicians who prescribe these medications but beware of their potential side effects and ask if other non-ototoxic medications can be prescribed and be just as effective. 
It is never too early to talk to your kids about hearing protection and ways to prevent hearing loss.  We are pleased to offer a full line of hearing protection products in our office from custom earplugs to instant-fit ear muffs. Please contact us to learn more about what may be right for your child, (912) 748-9494. 
Please click here to return to Coastal Audiology's website. 

Tuesday, July 9, 2019

Hearing Aid Success IS possible!

By Dr. Dawn MacMillan, Audiologist

Hearing aids are wonderful tools to assist those with hearing loss! They can make things louder when needed, brighter-sharper-clearer if that's what is needed. Modern digital hearing aids are based off a prescription, your hearing test, so your Audiologist can program in precisely the sounds you need. Instant-fit and over-the-counter (OTC) options cannot do this as they are typically programmed to a particular hearing loss shape and configuration. This is bad because it means some sounds you need to hear will be UNDER-amplified while other sounds are OVER-amplified, leading to dissatisfaction with the sound quality and for most, poor wearing habits.
To get the most out of your investment, here are five tips to maximize success with hearing aids:

 1.       Learn how your hearing aids work. Spend some time with your Audiologist, and really learn how hearing aids work.  A hearing aid fitting appointment can be a little bit like drinking water out of a fire hose! A tremendous amount of information in a relatively short amount of time! While we joke about 'reading the instructions' all new hearing aid fittings come with an instruction book. Additionally, your Audiologist can typically print or email a quick reference guide for the instant, need-to-know high points to get you going immediately upon fitting. You’ll need to practice wearing your devices in various settings. For first time users, getting used to the sound of your own voice may be funny initially. We recommend reading aloud to yourself. As silly as you may feel, it really does help you get used to how your voice sounds slightly amplified. Then, continue to follow up with your audiologist to adjust programming as needed. Additionally, if your devices pair with other wireless devices around your home, you will need to learn how to connect. While your Audiologist can walk you through most of these tasks, many hearing aid manufacturers have direct-to-consumer numbers that operate 24 hours a day and can assist hearing aid wearers connect devices from home.

 2.      Care for your hearing aids properly. It is positively vital to care for your hearing aids properly. Keep them dry in a dehumidifying case if you perspire a lot or work in a humid or moisture-prone area. We have a full range of products to combat moisture. If you suspect you may need something like this, just ask! We want to help you protect your investment as we know you depend on them. Make sure to keep your wax guards clear. This is done by wiping your hearing aids down after you remove them for the day. Use the brush that came with your hearing aids or the complimentary toothbrush we provide to brush any dead skin and/or wax.  Additionally, it is important to keep your devices in a safe place in order to avoid loss or damage. It’s true -- caring for your devices properly will lead to hearing aid success.

 3.       Keep extra batteries on hand. Make sure you have what you need on hand in order to maximize the use of your hearing devices. This will also ensure your overall hearing success. Keep batteries in a central location in your home, and always keep a new pair on your person so you can change them as needed. If you wear rechargeable devices, make sure you place your hearing aids in the charging unit overnight to fully charge them, allowing you to enjoy a full day's wear. It is important to note that your hearing aids should not be stored in the charger if the charger is unplugged as it will deplete your rechargeable batteries.

 4.       Track your progress over time. Keep track of your progress by noting your events and your calendar. Our office provides a workbook to our patients with exercises you can work through to rate your progress as you acclimate to your devices. Notate how well you were able to hear in various situations. It takes time to adjust to new devices, and you WILL see progress. But, you need to track how your devices are serving you in order to experience hearing aid success.

 5.       Trust the process. Better hearing is a journey, NOT a destination. Give yourself time. Your hearing will not be perfect overnight, and that is OKAY! Research indicates it may take up to 6 months for someone to acclimate to hearing devices. That's with daily, consistent use as prescribed. After you invest in devices, it will take some time to get used to the devices. And, your brain will need to adjust to the additional sounds and clarity you take in. We often hear, "we hear with our brains, not our ears." and there's truth to that. The sound may come to us by way of our ears but it is our brain that decides what to do with the sound. Wear your hearing devices more and more, and wear them in a wide array of situations. Do not get discouraged. Just keep going. And if you find yourself getting discouraged, please reach out to us so we can work together at solving the problem.

There you have it! Five tips to hearing aid success.

Tuesday, July 2, 2019

Hearing Loss & Cognitive Decline

Approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Having trouble hearing can make it hard to understand and follow a doctor's advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Hearing loss can also make it hard to enjoy talking with family and friends, leading to feelings of isolation.
Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you may not realize that you've lost some of your ability to hear.
There are many causes of age-related hearing loss. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear, or from complex changes along the nerve pathways from the ear to the brain. Certain medical conditions and medications may also play a role.

Why do we lose our hearing as we get older?
Many factors can contribute to hearing loss as you get older. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as long-term exposure to noise.
Noise-induced hearing loss is caused by long-term exposure to sounds that are either too loud or last too long. This kind of noise exposure can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they do not grow back and your ability to hear is diminished.
Conditions that are more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medications that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.
Rarely, age-related hearing loss can be caused by abnormalities of the outer ear or middle ear. Such abnormalities may include reduced function of the tympanic membrane (the eardrum) or reduced function of the three tiny bones in the middle ear that carry sound waves from the tympanic membrane to the inner ear.
Most older people who experience hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.

Can I prevent age-related hearing loss?
At this time, scientists don't know how to prevent age-related hearing loss. However, you can protect yourself from noise-induced hearing loss by protecting your ears from sounds that are too loud and last too long. It's important to be aware of potential sources of damaging noises, such as loud music, firearms, snowmobiles, lawn mowers, and leaf blowers. Avoiding loud noises, reducing the amount of time you're exposed to loud noise, and protecting your ears with ear plugs or ear muffs are easy things you can do to protect your hearing and limit the amount of hearing you might lose as you get older.
What to do in case you have trouble hearing?
Hearing problems can be serious. The most important thing you can do if you think you have a hearing problem is to seek advice from your primary care physician, an otolaryngologist, an audiologist, or a hearing aid specialist. Each has a different type of training and expertise. Each can be an important part of your hearing health care.

The connection between hearing loss and cognitive decline
Multiple studies have tackled the issue. One meta-analysis from February analyzed 11 studies dating back to 2016 to find that older people with moderate to severe hearing impairment had a 29 to 57 percent greater risk of cognitive impairment than those with normal hearing. It did not find that wearing hearing aids reduced the risk.
A 2016 study analyzing health insurance claims of 154,783 seniors concluded that hearing impairment increases the risk of dementia and that to some extent this happens regardless of medical treatment. Though the authors said hearing aids might delay or prevent dementia, they didn’t have details on whether patients were prescribed hearing aids or were using them regularly.
However, a 2017 article in Frontiers in Aging Neuroscience cited two studies that found people wearing hearing aids improved their performance on cognitive tests. The article said hearing aids, when prescribed at the beginning of age-related hearing loss, can postpone cognitive side effects
Most types of hearing loss occur gradually over time making it hard for you or a loved one to notice there has been a change in hearing. Just like vision and dental care it is always a good idea to have your hearing health evaluated once per year. We'd love to be your guide as you start your journey to improved health. Please call us to schedule your evaluation, (912) 748-9494. You may also schedule directly through our website 24 hours a day by visiting You deserve to hear well!

Thursday, May 2, 2019

Healthy Habits

By: Dr. Dawn MacMillan,

Imagine this. You make the decision to eat better and lose a few pounds. You go to the grocery store and buy a cart full of fresh fruits, vegetables, and lean protein. You arrive home from the grocery store, put all the food away. You are ready to take control of your waistline!
But the next time you go into the kitchen for a snack, you pick up a sugary, pre-packaged snack made by a lady named Debby.
You repeat this over the next week, eating lunches out when friends ask, foamy coffee drinks when the late afternoon slump hits. You step on the scale and are shocked! What?!? You didn’t lose a single pound!

Are you really shocked? Of course not! The fruits and veggies you bought are moldy and furry! You bought the food but didn’t get in the habit of eating it.

Hearing aids are no different. You can have the test, buy the aids, have them professionally fit and that fitting verified but if that’s all you do when you leave their office, the hearing aids won’t help you.

You have to wear them as prescribed. Every day during your waking hours. Keeping them clean and free of moisture, dirt, and wax. You must change the batteries as needed or use the charger. Hearing aids aren’t maintenance free and you won’t hear better if they’re sitting in the box.

"I wear them when I go to church!"
"I wear them when my daughter comes over."
"I wear them when I go to the doctor."

When that is the only time they are worn, the statement that usually follows the above is "But I’m still not hearing well." You won’t. If you aren’t regularly wearing your hearing aids as prescribed, your brain never learns to hear the new amplified and clarified sounds. The neural pathways that need mapping when you lose your hearing and subsequently seek treatment never get used. The result is sounds that never quite sound the way you think they should. Simply put, the brain does the processing of the sound that comes into the ears. The brain is responsible for taking the signal and deciding what to do with it. When hearing aids are worn irregularly and sporadic at best, your success with them will be minimal at best.

Just like we wouldn’t expect to lose weight if we don’t eat the healthy food we bought, we cannot expect to hear better with the hearing aids we rarely (never?) wear.

If you or someone you know has hearing aids but isn’t getting the desired result, a return visit to your audiologist’s office is imperative! A no-holds-barred, completely transparent and honest conversation needs to happen in order for you to achieve success. Most modern digital hearing aids have a usage indicator. If you’re not wearing them, your Audiologist will be able to tell! You may as well ‘fess up and start again down the road to better hearing. It IS possible if you face the music and are realistic about your use of the devices and your willingness to wear them and retrain your brain to hear again.

The month of May is Better Hearing & Speech Month. Make this the month you commit to changing your habits and finding success with your aids.

We are waiting for you!

Sunday, April 28, 2019

9 tips to help you adjust to hearing aids

By Dr. Dawn MacMillan, Audiologist

1. Realize that getting used to new hearing aids takes time. You probably didn’t lose your hearing overnight; you won’t adjust to new hearing aids overnight.
Ask anyone who wears hearing aids and they’ll tell you their hearing aids probably didn’t sound “good” when they first put them on, they probably sounded “different”. Not necessarily ‘bad different’ but just different. Hearing aids may feel strange at first on your ears, especially if you wear glasses. Wearing glasses with hearing aids is ok! You may just not be used to having both glasses AND hearing aids behind your ears, don’t be alarmed if you need to wear them for a few days, or even weeks, before they become comfortable.
When your Audiologist first puts your hearing aids in your ears, you may notice a big difference or no difference at all! This alarms some users but is normal. Depending on your level of hearing loss, you may have heard your audiologist in their quiet office even without your hearing aids! This is the reason why there is an adjustment period and while audiologists tell their patients to go and do all the things they normally do in those first few days and weeks after being fit with hearing aids. The real-life road test.  Jot down notes in a journal, in your phone, in your user’s manual—wherever you can quickly make notes as questions and comments arise.

2. Start small. Be patient.
Re-acquiring your hearing skills takes practice. While some people can wear their hearing aids 8-12+hours a day after they are fit, some start by wearing them for only a few hours at a time. If it gets to the point where you feel exhausted or overwhelmed you can remove them, but try to wear them a little longer every day. The longer you wear them, the better you’ll get at identifying sounds, interpreting voices, and focusing on what you’re hearing. You may do best while finding a quiet spot at home and listening to all the sounds around you—a humming refrigerator, a ticking clock, a trickling fountain. If you live with other people, you will likely be listening to their voices, perhaps television too. Depending on your hearing loss, you may notice an immediate improvement in hearing television and movies and conversations around you and involving yourself. It’s important to make notes about your experience so you can work with your audiologist to maximize the journey to better hearing.

3. Read aloud.
A good way to get used to the sound of your own voice (which will sound different after you get hearing aids) is to get in the habit of reading to yourself while wearing your hearing aids. It doesn’t matter what you read! Whether the newspaper, Bible, your user’s manual. It not only helps you determine the appropriate volume for speech, but it also will help you get better at recognizing the sounds of words and speech again. Your voice may sound funny; you may sound like you have a lisp. Some people say it sounds the way they hear themselves on an answering machine or other recording. It’s perfectly normal!

4. Enlist the help of family and friends—they are likely a big reason why you finally got hearing aids to begin with!
What we as audiologists hear consistently from our patients is that someone they love told them “you need to get your hearing checked!” or “You need to get hearing aids!”. Once you have made the choice to be fit with hearing aids, loved ones can be helpful during the hearing aid adjustment process. Try to practice with people you know well, since these familiar voices are the easiest for your brain to identify and interpret.  This is one of the reasons we encourage you bring a someone with you to your fitting appointment.
Your loved ones also can help you adjust by setting the television at a comfortable volume to their ears, giving you the chance to listen and adjust to these new volumes. You shouldn’t be turning the volume on your television higher than a person without hearing loss would, or you could further damage your hearing.

A special note **
It’s not realistic to expect to hear people from the next room, around corners, through walls, while someone is walking away from you. While hearing aids can help make things louder, brighter, sharper, clearer, they aren’t magic! Depending on your level of hearing loss, you may hear them. However, expecting to hear someone 40 feet across a room with time, space, and distance—just isn’t realistic for someone with normal hearing, much less for someone with hearing loss.

5. Keep a journal of your journey to better hearing.
At your fitting appointment, your audiologist will likely fit your hearing aids to your prescription (your hearing test). Those first few weeks, it’s important to keep notes about your experience. What you like, what you don’t like, what is uncomfortable, etc. Keep track of and write down any noises that you hear that bother or irritate you. If your clock’s ticking seems too loud and starts to annoy you after a couple days, make a note of it. If you still struggle to hear conversations in a crowded restaurant, write it down. By keeping track of your hearing struggles, you can later discuss these issues with your audiologist. Subsequent hearing aid appointments will be used to customize your fitting to make it more for you and your lifestyle.

6. Be realistic.
While we sometimes compare wearing hearing aids to wearing glasses, it is a very different experience. While your eyeglass prescription may correct your vision to 20/20 while wearing your glasses or contact lenses, there is no equivalent of 20/20 in hearing. With your hearing aids, once they are fit and adjusted to your prescription (which may take a few weeks!) you should be able to hear most people in most situations. This doesn’t mean you’ll hear everything every time. Think about phone conversations. Even with the best phones, there is still that subtle difference to the sound as a voice is transmitted over a phone line or via cellular signal. The same goes for the sounds you hear with your hearing aids.  You’re going to experience those sounds a little different through hearing aids than you remember experiencing them before hearing loss. That’s okay! Celebrate the improvements to your hearing, even if it’s not the same as before.

7. Take advantage of telecoil technology.
Hearing aids now have the ability to wirelessly connect with other electronic devices with what is called “telecoil technology” or “telecoil mode.”  This can be especially helpful when using a land-line phone or in environments that are looped such as performance halls, banks, and churches. If you aren’t sure if you have a t-coil, ask your audiologist. If you are considering hearing aids and frequently attend performances with looping technology, make sure you tell your audiologist how important this is as not all hearing aids have t-coils or can be made with t-coil technology.

8. Recognize you may need a little more extra help.
Today, hearing aids can be paired with assistive devices such as remote microphones, phone clips, and remote controls in addition to pairing with certain smart phones. This is so that the sounds being emitted (like the voices on a cell phone) can be sent directly to your hearing aid, further improving the clarity with which you hear these devices. This can also help you hear people from a distance, such as in a meeting or at a long table. This is especially helpful as the background noise increases. Depending on your level of hearing loss, realistically, it may require you to use your hearing aids along with these assistive devices. Talk with your audiologist to determine if these devices are right for you.

9. Be patient.
When it comes to helpful tips for first time hearing aid users, we cannot stress this enough: the new hearing aid adjustment process takes time. In Georgia, patients have no less than 30-days from the date of fitting to decide if hearing aids are right for them. Most states have similar laws.  Many times, you can have more time if you need it just communicate this desire to your audiologist. You need to be patient with yourself and your hearing aids. We want you to have ample time for the hearing aid adjustment process before you decide if the hearing aids are right for you. And with time, you should grow accustomed to hearing again.

We are waiting for you!

Monday, April 15, 2019

Tips to help you enjoy a picnic despite your hearing loss

We are finally beginning to experience some warm weather! I for one am so grateful. It's nice to be outside for a bit before the oppressive heat takes over. As we get outdoors for the family reunions, graduation parties, and more, here are nine tips to help you enjoy the festivities while living with hearing loss.

1.  Wear your hearing aids: This seems obvious but you wouldn't believe the number of times we hear that people went to special events only to forget their hearing aids. Whatever you need to do to get out the door with your hearing aids on, do that. Make a list. Tie a string around your finger. Ask someone to remind you. Whatever it takes. Your hearing aids are merely tools, but you'll do better with them than without. You wouldn't attempt to build a house with a hammer and nails. Don't try to socialize without your hearing aids. Experiment with a couple of different settings to find which is best for being outdoors. Most modern digital hearing aids can be configured with an Outdoor setting which is accessible through either an on-board push-button, remote control, or app. You can practice at home if you don’t want to spend time experimenting at the event. Check with your Audiologist if there is a setting that can cut down on wind noise if it will be a windy day.
2. Have reasonable expectations: Hearing aids are just that-an aid. An augmentative device that uses residual hearing to help the wearer hearing and understand better. Better. Not perfectly. Hopefully a picnic isn't your first stop after getting hearing aids and you've had time for your brain to adjust to new sounds and to learn to use the hearing aids to their full capacity. You probably won’t hear everything that everyone says, but that is ok and completely normal. Even normal hearing listeners don't hear everything all the time. 
3. Converse with a variety of small groups: Picnics offer a more casual seating experience typically. In contrast to a large seated dinner where it can sometimes be hard to follow the conversation, at a picnic, the seating is usually less formal. Seek out small group conversations in well-lit areas where you can see the speaker's face. Away from noises sources is also best-no bands, speakers, generators, or fans to interfere with the conversation. 
4. Be an active, engaged listener: We all get more of the conversation when we are actively listening and engaged with the person speaking. Make eye contact. Put down the phone (unless you're adjusting your hearing aids through an app!), and let the speaker know f you didn't catch what they said. If you are having trouble hearing, you can cup your ear with your hand to indicate to the speaker to speak louder without interrupting the flow of the conversation.
5. Don’t fake it: We've all done it. Even normal-hearing listeners who didn't quite hear what someone said. The nod-and-smile. It is very tempting to just nod along and pretend that you hear what others are saying or laugh just because others are laughing. But it can be dangerous, particularly if someone is asking you a question. Be brave and be honest with others if you are having trouble hearing. It will make your interactions more memorable on both sides.Additionally, people will respect and appreciate that you cared enough to get clarification of what they said. 
6. Position yourself in a good spot: Usually at a picnic, the seating is fairly casual, so join a group that is in a quiet and well-lit location. Sit so that your back is to the sun to avoid glare on people’s faces when trying to lip read.Don't hesitate to ask the people you're talking to if you can move away from noise and distractions. 
7. Limit background noise: If hosting, try to keep background music to a minimum. Other hosts may like to play music more loudly. When outdoors, music is typically less of an issue, but if it is, choose a spot away from the speakers or ask the host to lower the volume. I can bet you aren't the only one who will be grateful for the reduction in background noise and distractions. 
8. Take a break: Don’t hesitate to take a break away from the action for a few minutes to give your ears and brain a rest. Listening fatigue is real! Excuse yourself and head to the restroom, find a quiet place inside to sit for a bit, or even your car. If only for a few minutes, this short break can clear your head and allow you to focus on enjoying yourself once you return to the picnic. 
9. Be realistic: Yes. This is listed twice. But it's important enough to mention twice. Give yourself (and others!) grace when attempting to communicate with a hearing loss. Hearing aids are assistive devices, not miracle workers. If you have a little warning, it isn't a bad idea to schedule an appointment with your Audiologist to have a thorough clean and check on your devices before the event. And if you struggle at the event, don't give up. Communicate the difficulties you encountered and work with your Audiologist to find a solution to the issues you faced. There sometimes isn't a fix, but your Audiologist will strive to do all they can to give you the best chance at success that is possible. 

Monday, April 30, 2018

When should you replace your hearing aids?

Over time, like any other piece of equipment used on a daily basis, hearing aids will break down and need to be replaced. While most hearing aids are built to last for several years, they will need to be replaced at some point. The better you take care of your investment, the longer it will last. But no pair of hearing aids will last forever. 
At Coastal Audiology, we want you to get the most out of your investment but we also don't want you "throwing good money after bad." At some point, we have done all we can to extend the life of your hearing aids and it will be time to upgrade them. Here are some guidelines for when it may be time to so. 

  •  Your hearing loss changes

Annual hearing exams are vital to determine if your hearing needs change, as well as for having your hearing aids fine-tuned to adjust for any changes. Your hearing test is your "prescription". It is how your Audiologist fine tunes your devices to match your hearing loss. While we at Coastal Audiology will recommend something that gives you a little "room to grow", we cannot predict future hearing loss. More severe changes in your hearing can often mean that a new pair of hearing aids are in order. At Coastal Audiology, we specialize in advanced diagnostics and believe that your hearing problems are unique and you deserve an individualized plan of care and be recommended a device that will best suit you, your hearing loss, and lifestyle. 

  • Technology changes

Hearing aid technology is constantly evolving, just as it is for cell phones, computers, and other modern devices. In the last several years, advances in hearing aid technology include wireless connectivity to phones and other devices as well as enhanced speech-in-noise detection. Most of of the "Big 6" manufacturers now have direct-to-iPhone hearing aids with their own apps for connecting to cell phones, allowing users to adjust volume, change programs, choose favorite location settings, stream phone calls, listen to music and more--all through your hearing aids! Moreover, hearing aids are not only advancing but also are becoming less expensive. A lower-priced hearing aid today is very likely to have a wider frequency response and better fidelity. While you may be comfortable with your old pair of hearing aids and reluctant to change, you may be surprised by the latest improvements – and function – of digital hearing aids. 

  • Lifestyle changes

Your lifestyle can change in countless ways and indicate that it’s time to consider a new pair of hearing aids. Perhaps you need hearing aids that are easier to handle because you have arthritis or dexterity problems, more power because you’ve retired and now require less directness, or you’ve taken up a healthy activity such as swimming that requires waterproof hearing aids. Or, you’ve taken up jogging or hiking – activities that may require hearing aids that can stand up to more rugged environments.

  • New insurance benefits

Most insurance companies that have a hearing aid benefit will allow members to upgrade their hearing aids every two to five years and can help offset the cost of a new pair of hearing aids. In other words, there may be no better time for trying out the latest in hearing aid technology. And, as previously mentioned, improvement in lower-priced hearing aids have made high-quality hearing more affordable for everyone. Additionally, need-based hearing aid assistant programs often allow hearing aid wearers to re-apply to their program every 3-5 years. If they still meet the qualifications, this can give even those on a tight budget access to newer, more sophisticated hearing aid technology. 

  • Frequent repairs are needed

Like your car, repairs to your hearing aids can become more frequent as they age. Another point to consider is that most manufacturers stop making parts for hearing aids after five years. For those that do make parts, repairs for hearing aids over five years old are significantly more expensive and the work is warrantied for no more than about 6 months typically. While plunking down money for a new set of hearing aids may be tough, repairing the same hearing aids over and over can get quite costly when the reliability goes down. At this point, it’s important to weigh your options. The price of repairing an out-of-warranty pair and buying a new pair of hearing aids is probably not that much different, especially if insurance benefits are helping to pay for a new pair. Again, you may be perfectly comfortable with your current pair of hearing aids and would rather opt for repairs rather than buying new. Your best bet is to talk with your Audiologist to see if replacing your current pair is your best option.

At Coastal Audiology, we want you to hear your best for your lifetime. Sometimes that means upgrading your hearing aids. Sometimes that means using assistive listening devices in conjunction with your hearing aids. Other times it means aural rehab classes or programs that help you learn to use your hearing to it's full capacity. Improved hearing is a journey--not a destination. We would love to partner with you and be your tour guide on your journey to better hearing for a lifetime!

Monday, April 23, 2018

Summer Travel Tips for Hearing Aids

Though you wouldn't know it from the up and down temperatures we've experienced lately, it will be hot and humid before you know it! And then the kick-off of the summer travel season. Follow these simple tips to keep your hearing aids in tip-top shape while away from home.

Don't use your hearing aids in environments where they may get wet, dirty, sticky.

During summer vacation, you may find yourself enjoying swimming pools, sprinklers, saunas, and hot tubs. But those are no-no's for hearing aids. Avoid activities where your hearing aids may become wet from a dip in the pool, kids splashing, or the hot steam of a sauna or hot tub. Going on a cruise and signing up for off-ship excursions? Make sure to pack an extra case that you can use to safely tuck away your hearing aids temporarily until conditions improve. If you haven't done so already, now is a great time to invest in a dehumidifier that can aid in removing any moisture that may build up inside the hearing aids from humid climates, freak rainstorms, and more.

Don't keep your hearing loss a secret

Let people know you have a hearing loss and wear hearing aids. Uber/Lyft drivers, cab drivers, bell hops, concierge--these individuals are there to make your transport to your destination and your time when you arrive at your destination more comfortable. By filling them in on the fact that you have a hearing loss, they are better-able to assist to make sure you understand directions, instructions, travel alerts, and more. Additionally, they may know about accommodations for hearing-impaired listeners, such as captioned tours and alerting systems in the event of an emergency.

Don't forget the extra supplies!

It's a fact: resorts charge more for things like snacks, medicine, and first aid items. Hearing aid batteries are no exception. Speciality items such as dessicant bricks and wax guards are likely not available unless you can find a hearing aid shop at your destination that has your same brand of hearing devices. While packing for your trip, take an inventory of batteries, wax guards, and extra domes. Call us before you go so we can help you get the supplies you'll need for the duration of your trip. Finding supplies is the last thing you want to have to worry about while trying to relax and enjoy your vacation!

Seek out hearing-loss friendly destinations

Going to a Broadway show? Anxiously anticipating the talent on-board your cruise ship? Taking a tour of a museum? Many public venues have hearing-impaired friendly technology to help you make the most of the experience. Hearing loops allow hearing aid users with t-coils to have direct input of the venue's sound system which cuts out background noise, allowing for a clearer sound to be transmitted through the user's hearing aids. It is inconspicuous and works simply by activating the telecoil on the wearer's hearing aid with the flip of a switch or push of a button. Smart phone apps, captioned services--all can enhance the experience of the hearing- impaired traveler.

Don't let a hearing loss spoil your vacation. With a little planning, your trip can be seamless. For more tips and tricks, contact us! We'd love to help!

Sunday, April 15, 2018

"She STILL can't hear me!"

This is going to be a much more personal, passionate post than past blog entries. The issues discussed below are obstacles I face everyday as a Doctor of Audiology and they aren't solved by slapping a widget on someone's ear and yelling "next!". I hope you will stick with me through it and return frequently for other entries regarding hearing healthcare.

I fit numerous sets of hearing aids each week. Most of them on new users who have never worn hearing aids before. I always encourage my patients to bring someone with them to this visit. I find people respond better when they have a familiar voice to hear first through their hearing aid versus MY voice that they may not be familiar with beyond our first visit at their hearing test and subsequent hearing aid evaluation. I find that most people do not bring a communication partner with them. Whether is is because their adult children don't live here or are at work and can't break away or because they are trying to keep their hearing loss and decision to wear hearing aids--I'm not sure. Regardless of the reason, this can sometimes make adjustment to the devices more difficult than it has to be. But we adapt and hopefully overcome.  This isn't a post about the importance of bringing a communication partner with you to the hearing aid fitting, although that IS important and should be done if at all possible. This post dives a little deeper into hearing loss, what happens when it goes untreated, and what hearing aids can and cannot do.

Hearing Loss

Ask anyone if they know someone with hearing loss and they will most likely tell you emphatically, "YES!"  Hearing loss is the THIRD most common chronic health condition behind arthritis and heart disease. Yet only 1 in 5 people who would benefit from amplification actually use it. Perhaps it is because it is largely an "invisible" disability. It may also be due to the fact that it can be an expensive out-of-pocket investment not typically covered by private health insurance or Medicare. Perhaps it is the perceived stigma of hearing loss and it being "an old person's problem." I could spend all day hypothesizing on the reasons. I've heard so many of them over my career as an Audiologist. The bottom line is this: the average person waits 7-10 years from the time they think they have a hearing loss until the time they actually take steps to do something about it. What I've found in my office is there is some precipitating event that brings about the decision to FINALLY do something about their hearing loss. Some of the more common ones I've heard over the years are:
  • Finally having health insurance that covers part of the cost.
  • Losing a promotion or job (or the threat of it) due to the untreated hearing loss.
  • Losing a marriage or relationship (or the threat of it) due to the untreated hearing loss.
  • An embarrassing event that occurred because of the untreated hearing loss.
There are many, many more but these are the ones that come to mind immediately. People typically wait a long time, longer than they should, to do something about their hearing loss. It isn't just that it irritates family members, co-workers, or employees. It isn't just the social or emotional toll the hearing loss can take on a person. The problem goes much deeper. 

How we hear

While we tend to think the ears are responsible for hearing, they really only play a small part in hearing. In the most simplistic explanation, the ears capture the sound, sound waves then vibrate the eardrum, which then transmits the sound through mechanically moving the three bones in the middle ear. This starts a traveling wave of fluid, causing tiny nerve fibers (hair cells) to move along the cochlea and this movement of the hair cells change this movement to an electrical signal. This electrical signal then transmits the sound to the acoustic nerve where the information is sent to the brain. The brain perceives these electrical signals as sound. The brain then decides what the sounds mean and how to respond.  That is how we hear in a very simple nutshell. 

But what happens when the ear itself is damaged? Well, then you have hearing loss. In cases of sensorineural hearing loss, the most common type of hearing loss, there is some type of damage along the cochlea or acoustic nerve which impacts the electrical signal that gets sent to the brain. The hair cells in the cochlea, they all don't move at the same time. Certain hair cells move at certain times when a sound that is a specific pitch or frequency activates it. Because of the anatomic arrangement of the cochlea, the hair cells that pick up high frequency/high pitch sounds are at the entrance of the cochlea and they curl around, just like a snail's shell going from highs to lows at the center of the cochlea. For this reason, high pitched sounds like jets, jackhammers, and gun shots can irreversibly damage the delicate hair cells. This may occur over time or it may take just one exposure to cause damage. As for how this relates to how we hear this is the over-simplified reason why people say "It's not that I can't hear, it's that I can't understand what they said!" Hair cells that contribute to understanding, sounds like /t/, /f/, /s/, /th/ which are high-frequency sounds. When those hair cells are damaged and/or destroyed, one may hear someone speaking, but not be able to understand what the speaker is saying.  

While the brain actually does the heavy-lifting when it comes to figuring out what needs to be done with the sound when it comes into the brain via the electrical signal, the ears do play a vital role. And if the ears are "broken", meaning the hair cells are damaged or destroyed, the brain is getting a garbled signal which effects how the brain processes the sound coming into it. Hearing aids help--but they aren't the great equalizer.

So what can hearing aids do to help?

Modern digital hearing aids improve everyday! When I think back to the beginning of my career to now, I'm overjoyed with the advancements that have been made in hearing aid technology. Hearing aids used to just amplify sounds. Which was great if you needed everything overall louder. But in the cases of those with primarily just high-frequency hearing loss, volume and loudness isn't what is needed; clarity and understanding is what is needed. Today's modern digital hearing aids can be programmed based off the prescription, which is the hearing test.

It is important to note that hearing aids are just that--aids.  They use the residual hearing, which is the hearing someone has left, to process sound. Hearing aids are not restoring the hearing someone has lost.  In a hearing aid fitting, we are attempting to use the remaining hearing to maximum capacity to make sounds louder when needed and brighter, sharper, clearer to improve the understanding of speech. This won't restore speech understanding to 100%. There is no visual equivalent of 20/20 in hearing loss. Hearing aids will not make someone hear perfectly with hearing aids. Even individuals with hearing loss don't hear and understand 100% of what is said.

"She STILL can't hear me!"

I recently fit a second pair of hearing aids on a long-time patient. Her first set of hearing aids were over 8 years old! They had long seen better days! (The average life span of a pair of hearing aids is about 4-6 years.) Sadly, in the past eight years, her overall health has declined dramatically. She has a caretaker that assists her and her husband a few days a week and on this day, the caretaker brought her in for a hearing aid check to see how the hearing aids were working for her. She was quite despondent when she arrived and her caretaker was expressing frustration that she wasn't hearing well with her new hearing aids. 

We first addressed a fit issue. The new set of hearing aids are a different style than her first pair so I had to counsel her again on proper insertion and removal. We made some adjustments and she was pleased with what we did. The next issue was that her caretaker said she wasn't hearing her and she wasn't hearing her husband. Issues like this often take several questions to unpack and figure out what the actual issue is. At one point, her caretaker got quite upset with me and said "I've helped three grandparents with hearing aids and they could all hear me! She has brand new hearing aids and she STILL can't hear me!" This is where I realized we needed to take a step back and discuss things unique to my patient that couldn't be compared to anyone else the caretaker had ever helped. That hearing loss, environment, other health conditions, and cognitive issues needed to be discussed. What hearing loss is and how the hearing aids are trying to "fill-in-the-gaps" where damage has occurred and that often means that someone will still miss parts of the conversation even with great hearing aids. 

First and foremost, even if someone's audiogram (their hearing test) looks identical to another person's, you cannot make generalizations about their hearing ability based on the test alone. I have no idea what the audiograms looked like of the three grandparents the caretaker helped; what I do know is that MY patient has a significant hearing loss as well as a number of other health problems. I know her husband has breath-support issues and is often in another room entirely when he attempts to talk to his wife. I know from my interactions with her caretaker that she (the caretaker) has a very low voice that even I have struggled to hear in the past, and I have normal hearing. I know that because of her other heath issues she doesn't get out as much as she used to and watches a lot of TV now. This is what I do know. 

More than anything else, I want patients to be successful with amplification. I want them to have the confidence to return to activities they once loved but shied away from due to their hearing loss. I want relationships restored and improved that struggled due to a hearing loss. I want people to get new jobs and promotions because they are hearing better, understanding directions, and contributing to their team. I want people who were once plagued with overwhelming feelings of listening fatigue more present in their life because they are now able to listen with less effort. I want so much for my patients. But we have to first tackle the realistic expectations of what hearing aids can and cannot do. There are an infinite number of scenarios regarding background noise, male versus female speakers, ceiling height, carpet versus hard floors, distance from the speaker, room acoustics, etc. that can impact how successful someone is with hearing aids. This is one reason hearing aids aren't something you just go pick off a shelf at a big-box store. It is a face-to-face discussion about listening needs, struggles, other health conditions, and more so I can assist with choosing the technology I feel will best meet someones needs and wants. Success isn't achieved by picking the least expensive, the most expensive, the one your insurance will pay for, or what your best-friend's-aunt's-neighbor's-sister-in-law was fit with last year! It needs to be decided after a thorough hearing evaluation and a hearing aid evaluation where YOUR listening troubles and needs are discussed and a solution that may best suit YOU is recommended. Only then can you begin a (hopefully) successful journey to better hearing.