Hearing Loss or Ear Wax?

Ear wax is a common and easily treatable cause of hearing loss, discomfort, and sometimes ringing in your ears. Wax is produced by all of us. It only causes problems when it builds up. This usually is due to over-production or difficulties in the natural clearance of the wax. Some people produce wax at a faster rate. Others have ear canals that are narrow, or that are at an angle which slows the natural passage of the wax causing it to build up. The skin cells lining our outer ear canals include tiny glands, similar to sweat glands, which produce wax. Its purpose is to act as a protective layer which traps dust and other particles that get into the ear. Wax will then slowly and naturally work its way out taking the trapped debris with it.

When wax gets trapped, the build up acts as a barrier between your ear canal and the outside world. If left untreated, wax may eventually block off the ear canal all together causing hearing loss. Whether it is wax or a permanent hearing loss, a hearing healthcare professional can assess the cause of your hearing troubles.

Top 10 Signs of Hearing Loss

Hearing loss is incredibly common, yet often ignored. Why? In pondering, I have came to the following. The full answer is a measuare of two parts. First, there are various causes of hearing loss and even different type of hearing loss. The most common cause of hearing loss, presbycusis, is simply due to aging. With this, you will notice the person struggling most often with high frequency sounds. They will feel like they can hear, but will struggle to fully understand conversation or pick up on every little sound. Speech is complex and utilizes the entire frequency spectrum. While someone is missing parts of words, they still may be fine at lower frequencies. This allows them to compensate by filling in the gaps of what they are missing, and use what they can hear to carry on a conversation. The subconscious ability for the brain to compensate for a hearing loss can make it difficult for one to detect the early stages of a hearing loss.

Compounded by this, we have to consider inevitable aging. It is not uncommon to have your loss accelerated by genetics and exposure to loud sounds throughout your lifetime. However, unless you experience some form of extreme trauma to your hearing, the natural aging process is so gradual that a hearing loss often will go unnoticed. The break down of someone's physiological ability to hear rarely happens overnight. Until the loss becomes severe enough to affect everyday life, the minute degradation in a person's ability to hear is extremely hard to detect.

With any medical condition, the sooner you address the hearing loss the better treatment outcome you will have. For those of you reading this that suspect you or a loved may struggle with hearing, below are the ten most common signs of a hearing loss.

1. Telephone Trouble

Most phones come with a volume control setting, so you might not have trouble hearing your friend because you have amped the telephone to the max. Check the volume setting on the telephone receiver. If it is at max volume, chances are you or someone at home has a hearing loss. If the people around you comment that you talk too loud on the phone, this is another telling sign you may have a loss. People will talk louder usually because they cannot hear themselves. They may be assuming the other person is having just as hard a time, or may not even notice they are doing it.

2. Conversation Trouble

Our ability to process multiple incoming and competing signals deteriorates over time. Let’s say you are at a meeting at work or eating dinner with the family. When two or more people talk at the same time, do you have a hard time keeping up? Many with a hearing loss complain they cannot follow conversation when too many things are happening at once.

3. TV Trouble

When your family complains that the TV is too loud, you probably have a hearing problem.

4. Straining To Hear

I do this all the time with my vision without noticing it. If I am too lazy to go find my glasses, I will automatically start squinting to try to read. I honestly do not even realize I am doing it until someone around me points it out. Same with hearing. If you find yourself straining to hear the speaker in the boardroom or at the podium, what does that tell you? If everyone else was able to hear with ease, have you considered having your hearing tested?

5. Trouble In Noisy Environments

You are with some friends at the new restaurant in town. It is noisy. All that background noise makes it difficult to hear the folks at your table. People with hearing loss often have problems masking out background noise. Good news. Today’s hearing aids – even the entry-level variety – come with directional microphones and digital noise reduction. Directional mics pick up sound in front of you, while reducing the cacophony of ambient noise surrounding you. Digital noise reduction reduces the din of background noise to improve comfort.

6. ‘What?’

If “what?” is the most commonly-used word in your vocabulary, you are not getting the sound signals you need to process information.

7. Clarity Trouble

They mumble. They do not speak loud enough. While that may be true for some, if you are having problems frequently with understanding conversation, it could be your hearing. People start to complain about muffled hearing when they are not picking up the full range of sound. Those low to high frequencies all sound like mumbling.

8. Word Discrimination Trouble

“You want me to eat a frog?” “No, Fred, I said, ‘See the fog’.” If you are having problems with word discrimination, a hearing test will cover that. During our free tests, we will do a speech test which will target specific sounds that may be giving you trouble.

9. Trouble Hearing Women/Children

As previously discussed, with age you are more likely to experience trouble in the higher frequencies. If you are struggling to hear women and children it could be because they speak at a higher pitch which is out of your hearing range. That is why it is harder to hear what your granddaughter is saying than your best friend with a big, booming, deep voice.

10. Family Trouble

Hearing loss is not soley about the ears. Loss of hearing can be associated with depression, anxiety, and isolation. Many times I see a spouse get frustrated that their significant other cannot hear them. They want the other person to repeat themselves and speak up. This blame game cycle wears on them, and can cause unneccary strain on the relationship. In reality, they are not aggrevated at their spouse, but that they cannot communicate as effectively as they once did. They are annoyed that they cannot hear. Healthy hearing is a quality of life issue. If you are missing out on conversations with your spouse, if you do not hear the birds tweeting, or your grandchild’s laughter, you are not living life to the fullest. Fortunately, there are lots of hearing solutions availabe. You just have to find the one that is most comfortable for you.

Hearing Aid Style Breakdown:Receiver in Canal

Small, discreet, and quick to fit.
Behind the Ear hearing instruments that place an earbud directly in the ear are referred to as Receiver in the Canal hearing aids. For our office, this style of aid is by far our most popular. Visually they are very similar to a classic Behind the Ear hearing aid. They are also worn the same way. Side by side, the case on a Receiver in the Canal (RIC) hearing aid is much smaller than a BTE. Even though a RIC instrument often is best fit without using a traditional custom earmold, its modularity allows this option to be used on patients when beneficial. If you forego an earmold, it is possible to fit your hearing aids the same day as your test. There is no need to take impressions, send them off to the factory, and wait for a couple weeks before having your aids ready.

While many see the RIC's convienance as a major advantage, the real selling point is in the design.  At times, offering a discreet fit can sacrifice performance. Making instruments smaller can result in increased acoustic feedback, a shorter battery life, and additional fit and comfort complaints. Well aware of these issues, the design of a RIC style hearing aid works to bring patients a small, yet effective product.

The RIC style features a receiver that is placed in the ear canal rather than in the case behind the ear. The receiver is then connected to the sound processor, which is worn behind the ear, via a wire link. A benefit of placing the receiver in the canal rather than behind the ear is that it provides an overall increase in sound pressure level, especially in the high frequencies. This added "gain," allows the hearing aid to function without the additional increase in amplifier gain needed with thin tube BTEs to compensate for acoustic anomalies. Additionally, multiple receiver units are available during the fitting process that can accommodate the appropriate power and acoustic needs for each patient. Multiple sizes of wire connectors can be chosen to optimize the comfort, performance and appearance of the instrument.

The design of the RIC instrument also offers a distinct advantage for feedback management due to the physical separation of the microphone and receiver. Mechanical feedback occurs when vibrations from the receiver pass through other components or the hearing aid case and enter the microphone. Acoustic feedback results from sound waves coming out of the receiver and re-entering the microphone. Consequently, for instruments that fit all in the ear, or in the canal, the feedback path is relatively short. The RIC design provides a greater separation of transducers over any other device, thus reducing both mechanical and acoustic feedback sensitivity.

Let us end with dicussing custom earmolds more in depth. The following also applies to custom hearing aids that fit down into your ear canal. If you have a custom earmold or a Completely in the Canal hearing aid, have you ever had that 'plugged up' feeling? That is a common complaint that is caused by the occlusion effect. There are two ways to reduce or eliminate the occlusion effect. The first is by venting or open fitting. The second is to obtain a sealed fit in the bony region of the canal. Both methods are possible with a modular RIC instrument. The open fitting can provide a very comfortable and easy fit for patients with high-frequency loss. However its benefits are limited when low-frequency amplification is needed. It allows non-amplified sound to pass dir­ectly to the eardrum naturally while also allowing low-frequency sounds to escape from the canal, thus reducing or eliminating the occlusion effect, but also reducing low-frequency amplification. Sealing the ear canal in the bony region also keeps the low-frequency sounds of the user's voice from passing to the tympanic membrane, therefore reducing and/or eliminating the occlusion effect, but additionally is able to retain low-frequency ampli­fication as needed. Therefore, the RIC style fitting can reduce occlusion effects for all levels of hearing loss and amplification.

May Fillmore and Delta Openhouse!

We have added a schedule to our blog! You will notice some events are labeled as a 'clinic' and others as an 'openhouse'. Clinics are an opportunity for our current patients to call and schedule a cleaning, service, or adjustment appointment. An Openhouse is a special event for new and prospective patients to have their hearing tested for free and see the latest technology. We will continue to update our monthly schedule so you will know where we will be in advance. Please call to make an appointment for a location close to you.

This month, May 8th through the 10th, House of Hearing Orem will be in both Fillmore and Delta UT. We will be at the Bird Senior Center in Delta, and the Best Western Resort (Paradise Inn) in Fillmore. With the recent success of our Richfield Openhouse, we have again invited NuEar Product Representative Don Bain to our event. He will be offering tremendous incentives and factory discounts toward the purchase of any hearing aids sold during this event. During this special event, we will be working with Mr. Bain to offer the following free of charge:

*Complete Hearing Evaluation
*Product Demonstrations
*No Obligation Consultation
*Complete Clean and Check of Your Current Aids

If you are in the Fillmore or Delta area, contact us for an appointment. Our number is 877-432-7457 or 801-221-1220. Call and take advantage of our limited time no cost services!

Hearing Aid Style Breakdown:Behind the Ear

Hearing aids come in a variety of styles. My upcoming posts will breakdown the advantages and limitations of a popular styles of hearing aids. Selecting a style that is right for you depends on a number of factors. You will need to consider the severity of your hearing loss, the size and shape of your ear, and your personal preferences.
The Behind the Ear (BTE) hearing aids are housed in a curved case that fits neatly and comfortably behind your ear. The hearing aid picks up sound, amplifies it and carries the amplified sound to an ear mold that fits inside your ear canal. A custom ear mold is made to the exact shape of your ear. The custom ear mold directs the sound from the hearing aid into your ear and secures the hearing aid in place.

A Behind the Ear hearing aid is the largest, most visible type of hearing aid. This could be seen as a draw back for some. Many of our patients prefer their hearing aids to be barely visible. They are also particularly vulnerable to sweat and wax build up. It is important to keep your hearing aids clean to have them run properly. I have also heard some complain of feeling "plugged-up" from the earmold. If this is a concern for you, ask about having your BTE vented.

As the world's most popular style, there are some clear advantages to this hearing aid. For many, versatility makes it a popular choice. This style is appropriate for a wide range of hearing losses and age groups. They are even a good fit for children. Because the main components are housed outside of the ear, these aids tend to be more durable. With that, they need less repairs and have a longer life expectancy. Traditionally, their size has allowed them to provide the most amplification. With ever-changing technology, other options have been developed which allow similar styles to surpass the BTE in power. This is accomplished through purchasing additional power molds that can be added onto a similar style of hearing aid: Receiver in the Canal. We will take a closer look at this style next post.

What Is a Hearing Evaluation?

A hearing evaluation is essential to understanding and diagnosing your hearing loss. During your evaluation, a licensed hearing instrument specialist or audiologist will conduct a series of tests to access how well you hear. I get asked often about the cost of such an exam. House of Hearing Orem provides everything mentioned in this post completely free of charge. We simply want to help you hear, and a proper hearing evaluation will provide us with valuable insight to your loss.

1. Patient Paperwork
Before proceeding, you will be asked to fill out basic contact information and answer questions about your medical history. At our office, we use these questions to pinpoint your specific needs. Maybe you have been exposed to excess noise at work, or have suffered physical damage to your ears. It is important for us to know about past illnesses and any other basic medical history that may have had an impact on your hearing. Once you have filled out our paperwork, your actual hearing exam will begin.

2. Looking Into Your Ears
At the beginning of your hearing exam, we will ask to look into your ears with an Otoscope. This helps us see into your ears and determine if there are any abnormalities in the ear canal or maybe if you are plugged up with wax. If your loss is just from wax, we will give you a free cleaning kit to take home with you.

3. The Pure Tone Test
The next step is conducted in a quiet room. We try to keep our front room as quiet as possible to ensure outside noises will not interfere with test results. For a Pure Tone Test, you will be asked to insert a small set of earplugs into your ears. Testing each ear individually, we will play tones of different frequencies one at a time. When you hear the sound, we ask that you raise a finger. Each tone is played at softer and softer levels until you no longer respond consistently. The softest level you can hear is your threshold for that particular frequency. Your responses are charted on an audiogram, and the resulting graph indicates how well your outer and middle ear structures are processing sound. The various frequencies played represent the range of sounds you commonly hear in the world.

4. The Speech Test
The Speech Test is broken down into two parts. The first part requires you to repeat a series of two-syllable words that are played at successively lower levels. This test helps to determine the level at which you can detect speech. You will then be asked to repeat one syllable words set at a comfortable listening level, to see how well you understand speech. Identifying these levels helps to further determine your hearing aid candidacy. If your hearing exam shows you could benefit from hearing aids, these speech tests help customize your hearing devices so it is easy to comprehend conversation in multiple listening environments.

5. Results
From all of this, we will sit down and analyze your results. It is important to us that you understand these. We are happy to take as much time as you need to explain and go over everything. If you have a question, or simply do not understand something, please ask! It is possible to be tested and have no hearing loss. If your results do indicate a loss, we will provide free demonstrations of a variety of hearing aid brands and styles that will suit your lifestyle. We believe no two hearing losses are the same. At our office, we aim to give you a customized, personal fitting experience. We look to be the best at fitting hearing aids that are comfortable for your ears, your price range, and your lifestyle.

Can One Restore Their Hearing?

Be it naturally, surgically, or with the help of hearing aids, many wonder if their hearing can be restored after a loss. The simple answer is, it depends. You first need to identify what caused your loss. In our previous post, we focused on noise-induced hearing loss. While that may be one of the more popular causes, there are a variety of factors to consider. Some others include genetics, injury, ear infections, tinnitus, wax, and obviously age. Recognizing the contributing factors for your loss is essential to finding the solution. Below are ways in which you may be able to improve your hearing.

1. Naturally
New research shows that certain supplements, vitamins, and minerals can be used to improve hearing. While this is not my area of expertise, let me clarify this statement. There is a difference between improving and curing hearing loss. Once you have damaged hair cells, those are not regenative. If you are looking to use natural methods to improve your hearing, the sooner you start the better. Note that supplements are not an instant cure. The most common, and possibly easiest, way that I recommend to improve your hearing is to remove ear wax. If you suffer from muffled hearing, the culprit could simply be wax. Q-tips are not recommended for removing wax as they can puncture your eardrum. We give out free wax cleaning kits to our patients to use at home. You can purchase them about anywhere!

2. Surgerically
If the loss is conductive, that is, caused by a problem with the ear canal, ear drum, bones behind the ear or middle ear cavity, there is a good chance that it could be treated surgically. Conductive hearing loss is caused by a problem with sound waves getting from the air around us to the cochlea. A sound wave travels through the ear canal, eardrum, and middle ear bones before going to the cochlea. Any problem along that pathway will dampen the sound wave and cause hearing loss. A long list of problems can cause conductive hearing loss, ranging from the above mentioned earwax impaction to a tumor behind the eardrum. Popular surgical treatments, either tympanoplasty or mastoidectomy, involve removing a cyst from the ear and rebuilding the eardrum. A stapedotomy is another surgical procedure in which the stapes and incus, both bones in the middle ear, are separated. A hole is made in the footplate of the stapes. Through this hole an artificial prosthesis called a stapes piston is inserted and connected to the incus, thus restoring the transmission of sound waves to the cochlea.

What about a cochlear implant? As opposed to the above treatments for conductive hearing loss, cochlear implants restore hearing to people with severe to profound sensorineural hearing loss who do not achieve benefit from hearing aids. They can be performed in patients ranging from adults down to children. Cochlear implants are devices that have an external processor connected to a coil of electrodes which are surgically implanted directly into the cochlea. The external processor converts sound waves into electrical impulses and sends them to the coil within the cochlea. Directly stimulating the cochlear nerve, sound is now produced.

3. Hearing Aids
As you have probably noticed, hearing loss is categorized into two main types:conductive and sensorineural. A conductive hearing loss is caused by a barrier or hiccup in the transporting of sound waves. On the other hand, if the hearing loss is due to changes in the nerves it is a sensorineural hearing loss. With this, there is no surgical, medical or alternative treatment that will improve the hearing once it is lost. This is the most common type of loss, often associated with aging, and most cases are compensated well by hearing aids. Now you might groan at the idea of hearing aids. Maybe you think they are too expensive, they hurt, do not work well, or maybe you dislike how they look. Hearing aids have changed drastically over the past decade, and I guarantee the technology is only getting better. Researchers are always finding ways to improve. In the coming weeks I will be putting together multiple posts to address these concerns. Additionally, I would like to do a couple posts about specific brands and styles of hearing aids that may interest you. In the mean time, if you have any questions you would like to see addressed, feel free to leave them in the comments below!

How Loud is Too Loud?

I am a self-professed loud music listener. I use my iPod at the gym, and I love it. Ever wonder how loud is too loud? Ever wonder how much hearing loss your iPod is causing? Music has evolved. Loud gets attention, and sells records. How this is associated with hearing loss depends on the person. It depends on how long you are listening, and it depends on the level at which you are setting your iPod. There is huge variation in how people are affected by loud sound. Certainly a huge part of this is underlying genetics. Put that aside and physiologically, noise-induced hearing loss is caused by damage deep inside the ear. The primary area where the ear is damaged is not the eardrum, not the part of the ear that you can see and not the bones that make up the middle ear — it is actually even deeper inside. It is where the nerve that brings the sound message up to the brain connects with the inner ear, and it involves some very specialized cells. These are hair cells, and specifically we are looking at the outer hair cells. When they are overexposed or stimulated at too high a level for too long a duration, they end up being metabolically exhausted. They are simply overworked. Once fatigued, they temporarily lose their function. What do we do to compensate? We turn up the volume. Sound has to be made louder in order for you to hear it. Ever got into your car and immediately had to turn the radio down? This is the perfect example of hair cell fatigue. In your prior car ride, you had become use to the volume of the radio and did not perceive it as loud anymore. After letting your hair cells rest, re-visiting that level of volume was startling, even uncomfortable. Your hair cells can recover after a single exposure, but if you overexpose them often enough, they end up dying. Once this happens you lose that functional ability inside your inner ear. The cells that die are not replaceable.

As far as a rule of thumb goes, the figures show that people using their iPod could listen at about 80% of maximum volume for 90 minutes per day or less without increasing their risk for noise-induced hearing loss. But the louder the volume, the shorter your duration should be. At maximum volume, you should listen for only about 5 minutes a day. Below is a chart which visually illustrates this relationship.

Miley Cyrus & The Starkey Hearing Foundation

Have some old hearing aids? As part of the NuEar family, we support the Starkey Hearing Foundation. Founded by Bill Austin, the Starkey Hearing Foundation focuses to bring understanding among people through hearing care. Traveling around the world, Starkey helps people with hearing loss by collecting your donated aids, refurbishing them, and fitting them on those in need. Because hearing aids are a medical device, your donation will have tax incentives for savings. Drop off your old aids at our office for an assessment of their value, and we will mail a donation letter for your taxes and records. Below is a promotional video featuring Miley Cyrus with the Starkey Hearing Foundation in Haiti. Upcoming trips include Tanzania, Ethiopia, and Lebanon.

April Richfield Openhouse!

House of Hearing Orem is pleased to introduce and demonstrate our newest products in hearing technology, NuEar's Look Wireless hearing aids! These aids feature an innovative noise reduction and speech preservation system designed to help you hear conversations better. To showcase our new products, we will be traveling to the Quality Inn located in Richfield, UT. Myself, along with a NuEar product representative, will be there beginning April 10th through April 12th. During this special event, we will be offering the following free of charge:

*Complete Hearing Evaluation
*Product Demonstrations
*No Obligation Consultation
*Complete Clean and Check of Your Current Aids

If you are in the Richfield area, contact us for an appointment. Our number is 877-432-7457 or 801-221-1220. Call and take advantage of our limited time no cost services!

P.S. Our NuEar Product Representative will be offering tremendous incentives and discounts toward the purchase of any hearing aids sold during this event.

Brian Quigley: Hearing Instrument Specialist

With the start of a new blog, I felt it best to introduce myself and my business. My name is Brian Quigley, and I am a licensed Hearing Instrument Specialist. I began working for my uncle in the hearing instrument business in 2005. Gaining valuable experience, I decided to open my own office in Orem, Utah. House of Hearing Orem has provided ample opportunity for me to meet and help so many with a hearing loss. My wife, Jessica, and two children have been extremely supportive of my dream to help people hear again.

In addition to educating our readers about hearing aids and the available technology, I also hope to target those common concerns many people are having. I have brainstormed a number of topics which I hope will prove helpful in answering your inquiries. If anything, I hope you find our future posts informative as well as interesting. If you have a topic or question you would like to see addressed, feel free to comment below!