Hearing Loss For Dummies

Frank R. Lin, MD, PhD, is the Director of the Cochlear Center for Hearing and Public Health.

Nicholas S. Reed, AuD, is a clinical audiologist and an assistant professor at Johns Hopkins University.

Introduction 1

About This Book 2

Foolish Assumptions 2

Icons Used in This Book 3

Beyond the Book 4

Where to Go from Here 4

Part 1: Understanding Hearing Loss 5

Chapter 1: Cheers to Your Ears! 7

Understanding Why Hearing Loss Happens 8

Hearing takes place over two steps 8

Hearing loss happens as the inner ear wears out 8

Factors that affect your hearing over time 9

Putting Hearing Loss in Context 10

Hearing loss happens to everyone 10

How hearing loss impacts our health and well-being 10

The benefits of addressing hearing loss 12

What You Can Do about Hearing Loss 12

Know your hearing 12

Using communication strategies 14

Hearing technologies 15

Getting the Support You Need 17

Chapter 2: Understanding How Hearing Works 19

What Is Sound? 20

How sound gets its sound 20

What sound “looks” like 21

To Hear, You Need Your Ear! 23

External ear 24

Middle ear 24

Inner ear 25

Hearing with Your Brain 26

Two ears are better than one 27

It’s not just sound — “seeing” what you hear 28

Context matters 28

Pinpointing Where the System Can Break Down 29

When sound quality is poor 29

When the sound can’t get in 29

When the inner ear garbles the encoding of sound 30

When the brain struggles to process sound 31

Experiencing Trouble Hearing 31

Chapter 3: Looking at Types of Hearing Loss and Minimizing Risk 33

Discovering Why Hearing Gets Worse Over Time 34

Knowing the Causes of Hearing Loss Over Time 34

Biological aging processes 35

Cardiovascular risk factors 35

Genetics 36

Minimizing Your Risk for Hearing Loss 37

Noise exposure 37

Keeping your ear heart-healthy 40

Considering Other Conditions That Affect Hearing 41

The almighty ear infection 41

Earwax — ick! 43

Diseases of the ear 45

Medications 45

Causing Tinnitus 46

Tinnitus explained 46

Tinnitus triggers 47

Chapter 4: Realizing What You Lose When You Can’t Hear 49

Communicating Is Like a Game of Catch 49

Hearing loss affects how well you can play catch 50

Why playing catch is sometimes easier or harder 50

Communication and hearing loss in critical situations 51

Watching for a Reduction in Social Interaction 53

Monitoring Mental and Emotional Health 53

What is loneliness? 54

How loneliness hurts your health 54

Looking at hearing loss and loneliness 55

Losing Physical Abilities 55

How hearing affects your physical abilities 55

How hearing affects your balance 56

Dealing with a Decline in Cognitive Function 57

What are cognition and dementia? 57

Hearing loss and dementia — say what? 58

Hearing aids to prevent dementia? 59

Part 2: Evaluating How You Hear 61

Chapter 5: Recognizing Hearing Loss 63

Missing the Signs of Hearing Loss 64

Barely noticeable changes 64

Everyone else is mumbling! 64

Compensating until you can’t 64

Don’t know what you’re missing 65

Sussing Out Whether Your Hearing Has Declined 65

Knowing When to Get Your Hearing Tested 66

Screening, testing, and diagnostics 67

Establishing a baseline 67

Getting regular hearing checkups 69

Knowing when you should get tested immediately 69

Shrugging Off the Stigma of Hearing Loss 70

Caring about your hearing above what other people think 71

It’s okay to wear hearing aids 71

The stigma is fading 72

Chapter 6: Seeing a Hearing Loss Professional and Getting Tested 75

Getting to Know the Hearing Care Team 76

Audiologist: Assessing and addressing hearing loss 76

Otolaryngologist: Comprehensive medical care for the ear 77

Hearing instrument specialist: Focusing on the hearing aid 78

The most important team member: You! 78

Preparing for the Assessment 78

It all starts with history 79

To know the ear is to see the ear 80

Knowing What to Expect during the First Part of the Diagnostic Hearing Test 80

Picking up on pure-tones: “Listen for the beeps” 81

Testing your hearing with air and bone conduction 82

Checking Out Other Hearing Assessment Measures 85

Testing whether sound is getting to the middle and inner ears 85

Measuring your speech understanding 86

Evaluating how the brain reacts to sound 88

Testing when sound is clear but difficult to understand 89

One and Done or a Regular Occurrence? 89

Chapter 7: Making Sense of Your Hearing Test Results 91

Understanding the Importance of Reading Results 92

Introducing the Audiogram: What Does That Graph Mean? 92

Audiogram 101 93

Hearing loss categories on the audiogram 94

Defining Hearing Loss with the Audiogram 96

The Xs and Os of hearing 96

Diving into details of your hearing loss 97

Using the audiogram to make sense of how hearing loss affects you 98

The Hearing Number: An Easier Way to Make Sense of Your Hearing 101

Where the hearing number comes from 101

What the hearing number means to you 102

Does my hearing number change? 102

What to do with your hearing number 103

How to get your hearing number 104

Guiding Your Hearing Health Journey with Your Results 105

Monitor changes in hearing 106

Use it or lose it 106

Part 3: Taking Charge of Your Hearing 107

Chapter 8: Fine-Tuning Your Life to Hearing Loss 109

Discovering Where Adjustments Can Be Made 110

Finding No-Tech Communication Strategies for Everyday Situations 110

Get close 110

Be face-to-face 111

Summarize and repeat (“Huhs” don’t help!) 111

Optimizing Your Listening Environment 112

Turn down any background sounds 112

Avoid reverberation 113

Pick the right restaurants 113

Using Everyday Technology Strategies 115

Closed captioning 115

Voice over internet protocol (VOIP) calls and videocalls 116

Speaking Up for Yourself 117

Ways to identify that you’re having trouble hearing 118

Giving the speaker a solution 118

Practicing self-advocacy 119

Reading about others with hearing loss 120

Seeking Out Support Groups 120

Chapter 9: Looking at How Hearing Aids Work 123

Understanding Hearing Aids 123

The anatomy of a hearing aid: How hearing aids work 124

Hearing aids don’t make all sounds louder 125

Enhancing clarity of sound with hearing aids 126

Checking Out the Different Styles of Hearing Aids 128

Behind-the-ear 128

In-the-ear 132

Weighing the pros and cons of hearing aid styles 133

Chapter 10: Understanding Your Hearing Aid Options 135

Discovering Where to Start for Your Needs 136

Knowing Two Ears Means Two Hearing Aids 136

Is using only one hearing aid harmful? 137

The exception to the rule 137

Choosing a Prescription Hearing Aid 138

Working with a professional to purchase hearing aids 138

Customizing your hearing aids with a professional 140

Navigating the Over-the-Counter Hearing Aid Pathway 143

The basics of OTC hearing aids 143

Deciding where to buy your OTC hearing aid 146

How to choose from too many options 147

When to seek professional assistance with OTC hearing aids 148

Choosing Basic or Premium Hearing Aids 149

Chapter 11: You’ve Got Hearing Aids: Now What? 151

Setting Expectations Is Key 151

Getting Used to Your Hearing Aids 153

Practice makes perfect 153

Activities to get used to hearing aids 154

Trust the process 156

Adjusting and Manipulating Your Hearing Aids 156

Working with batteries 157

Putting hearing aids in your ears 158

Changing the sound of hearing aids 159

Caring for and Maintaining Your Hearing Aids 160

Establishing a maintenance routine 160

Avoiding situations that are bad for your hearing aids 163

Troubleshooting common problems with hearing aids 164

Knowing When It’s Time to Upgrade Your Hearing Aid to a New Generation 165

Chapter 12: Technology That Boosts Hearing and Hearing Aids 167

Captioning Your Life 168

Using captions on TV 168

Obtaining and using captioned phones (They’re free!) 168

Captioning in video conference calls 169

CART for live sessions 169

Outfitting Your Home with Hearing-Friendly Tech 170

Talking about Integration Technology 171

Working with Bluetooth and hearing aids 171

Navigating smartphone apps 172

Checking Out Hearing Aid Accessories 172

Using a remote control 173

Trying out a remote microphone 173

Connecting to the TV 175

Streaming all your devices 177

The Mighty Telecoil: Getting a Direct Connection to Sound Signals 178

Looping in telecoils in public spaces 178

Telecoils and telephones 180

Telecoil with FM and infrared systems 180

Has Bluetooth replaced telecoils? (No!) 181

Sounding Out Personal Amplifiers 182

Demystifying PSAPs versus hearing aids 182

The reality of using PSAPs 183

Navigating the unregulated amplifier marketplace 183

Will OTC hearing aids replace PSAPs? 184

Chapter 13: Medical and Surgical Treatment of

Hearing Loss 185

Looking into Medications That Treat Hearing Loss 186

Using steroids for sudden hearing loss 186

Taking medications for problems with the external or middle ear 187

Checking Out Different Surgeries for Hearing Loss 188

Surgeries for conductive hearing loss 188

Surgery for sensorineural hearing loss 189

Other surgically implantable hearing devices 192

Part 4: Supporting Hearing Needs 195

Chapter 14: Helping Those with Hearing Loss 197

Noting How Hearing Loss Influences Relationships 198

Understanding Hearing Loss from the Other Side 198

Emotions that often accompany hearing loss 199

Realizing hearing aids don’t cure hearing loss 199

Discovering How to Be a Good Communication Partner 200

Move close and speak face-to-face 201

Repeat and reword 201

Speak slowly and clearly 201

Get your partner’s attention before speaking 202

Choose the right environments for conversations 202

Using technologies to help communication 202

Figuring Out Hearing and Communication Needs 203

Noticing non-verbal cues 203

Using the hearing number as a guide 204

Supporting People on Their Hearing Care Journey 204

Chapter 15: Paying for Hearing Care 207

Paying for Hearing Services 207

Hearing testing 208

Medical and surgical evaluation 208

Hearing rehabilitative support services 208

Breaking Down Hearing Aid Costs 210

Weighing out-of-pocket-options 211

Checking on insurance coverage options for hearing aids 212

Looking to the future: Over-the-counter hearing aids 215

Tapping into Veterans Administration benefits 216

Seeking charitable foundations 216

Using health savings and flexible spending accounts 216

Chapter 16: Your Rights as Someone with Hearing Loss 217

Looking into Disability and Hearing Loss 218

How do you define disability? 218

How to follow a social model of disability 218

Understanding the Role of the Americans with Disabilities Act 220

Discouraging disability discrimination in the workplace 220

Accessibility and accommodations in public 220

Focusing on telephones and television 221

Navigating the Social Security Administration Disability Benefits 221

Determining hearing loss for Social Security disability benefits 222

Considering Claims for SSDI 224

Looking at Supplemental Security Income 225

Initiating a claim 225

Advocating to Advance Your Hearing Rights 225

Advocating for change 225

Improving organization policy 226

Part 5: The Part of Tens 227

Chapter 17: Ten (Plus One) Considerations When Purchasing Hearing Aids 229

Paying More Does Not Guarantee Better Outcomes 230

Selecting from the Many Styles 230

Choosing a Brand 232

Seeking Hearing Aids with Telecoils 233

Powering Your Hearing Aid with Rechargeable Batteries 233

Deciding on Open or Closed Fit 234

Insuring Your Hearing Aids with a Trial Period Warranty 234

Customizing and Supporting Your Hearing Aids 235

Monitoring Health with Hearing Aids 236

Accessorizing Your Hearing Aids 236

Setting Expectations and Practicing 237

Chapter 18: Ten Everyday Strategies to Hear Better 239

Get Close and Face-to-Face 239

Recognize the Hearing Needs of the People You’re Talking With 240

Turn Down the Background Sounds 240

Don’t Just Ask “Huh?” 241

Choose Good Listening Environments 241

Use Closed Captioning 241

Wear Headphones When Listening to Music or Watching Media 242

Use Video Calls or VOIP When Calling Others 242

Customize the Hearing and Sound Features on Your Smartphone 243

Know Your Hearing Number 243

Chapter 19: Ten Myths about Hearing Loss 245

Hearing Loss Is Just Part of Getting Older so It Can’t Be That Important 245

My Hearing Is Fine; It’s Just That Everyone Is Mumbling 246

Trouble Hearing? Just Have People Shout! 246

I’ll Wait to Get My Hearing Tested Until I Notice a Problem 246

I’ll Address My Hearing Loss Later When It Gets Really Bad 247

I Have Hearing Loss Now I Need Hearing Aids? 247

Hearing Aids Fix Your Hearing 248

I Can Just Put in My Hearing Aids and They’ll Work Fine 248

A Cochlear Implant Is Only for People Who Are Completely Deaf 249

I Should Keep My Hearing Loss to Myself 249

Index 251