HEARING AND VISION

“Will wearing hearing aids interfere with my glasses?”

One of the most common questions patients ask me during a hearing aid consultation is, “Will wearing hearing aids interfere with my glasses?” I understand. Wearing one extra thing every day is a scary thought. After the rise of COVID-19 in 2020, we were all graced with yet another accessory–the facemask. Fortunately, hearing aids do NOT interfere with wearing your glasses. In fact, many patients wear both comfortably, mask included!

HEARING LOSS AND VISION LOSS

Hearing loss and vision loss are among some of the most common health conditions that our patients face. Nearly 38 million North-Americans experience some form of hearing loss, and one in three people in Canada and the United States between the ages of 65 and 74 has hearing loss. Noise exposure, aging, and genetics are just a few of the various factors that can lead to hearing loss.

Similar to hearing loss, vision loss also increases with age. Nearly 12 million North-Americans older than 40 experience a form of vision impairment, according to the CDC. Some of the most common causes of vision loss include macular degeneration and vision complications from diabetes, glaucoma, and age-related cataracts. Patients who experience vision loss face difficulties such as limited side vision, sensitivity to light, and reduced depth and color perception. These issues severely reduce one’s ability to perform everyday tasks.

THE EFFECTS OF HEARING LOSS AND VISION LOSS

Living with hearing loss can be exhausting! Adding vision loss is worse. Adding a mask that covers the mouth is inconceivable. During the pandemic, I’ve noticed now more than ever how much patients must strain their ears to hear what is spoken. With masks covering our mouths, many of the lip-reading cues we all rely on are out the window. I can tell when someone is leaning in, hyper-focused, trying to comprehend every word. Living with hearing and vision loss truly fatigues the brain. When the brain does not have adequate access to important speech sounds, it must work even harder to process what little it’s receiving. Hearing loss can significantly and negatively affect a person’s quality of life by causing embarrassment and social withdrawal or by making understanding speech and listening in noisy environments more difficult. 

If you couldn’t read street signs or if you noticed the words on a page were fuzzy, would you seek help? In my experience, many patients are well aware of their vision loss and have taken the appropriate steps to treat it. However, for whatever reason, hearing loss is a different story. Many people are hesitant to address their hearing problems because they feel embarrassed or even old. 

Generally, hearing loss tends to be a slow, gradual process. Many patients share initial comments such as, “Well, they mumble,” or “That restaurant was extremely noisy,” or “That person is so soft spoken,” when, in reality, those may be the early signs (years prior) that slight changes are happening to the auditory system! Most patients do not show up for a baseline hearing test until their hearing has regressed to a point at which they are extremely bothered by it or their family and friends are noticing. 

WHO CAN HELP?

Primary Care Physician: If you are experiencing hearing loss or vision loss, the first step is to consult your family doctor or primary care physician. They can evaluate your concerns and refer you to specialists to have your hearing and/or vision evaluated. 

Optometrist: A doctor of optometry can evaluate your vision and provide a rehabilitation program that addresses your needs. A wide variety of rehabilitation options are available to help people with low vision live and work more effectively, efficiently, and safely.

Audiologist: An audiologist or doctor of audiology can evaluate your hearing and balance related problems. An audiologist can perform a comprehensive hearing test, explain the results, and provide recommendations for hearing aids if they will benefit you.

TIPS FOR LIVING WITH HEARING LOSS AND VISION LOSS

Many of our patients wear glasses AND hearing aids! Many styles of hearing aids are available, and the following tricks can ensure an appropriate and comfortable fit:

• • Color indicators → Sometimes, patients must get creative by marking their hearing aids with small stickers or nail polish to identify which device belongs in what ear. For one patient with severe visual impairment, I ordered hearing aids with two different colors for each ear. The patient found it easy to remember that, “Light is right, and dark is left.” 
  • Tactile tricks→ Some patients prefer to have additional tactile buttons to help them remove their hearing aids from the charger or to identify the position of the device in the ear.

• Light indicators→ Many hearing aids are rechargeable and use blinking lights to indicate when the device is charging and when it’s ready to use.

• Large-printed materials in black & white→ Print a summary of what happened at the appointment in a large-print font that is easy to read and reference as needed. 
• CapTel phones→ Closed caption devices, such as CapTel phones, display a patient’s phone conversation in large text. The large text visually compliments what is being said, helping severely hearing impaired patients see and understand the audio they are receiving. CapTel phones are free with documented proof from a licensed professional of one’s hearing loss. CapTel phones are only available in the U.S. at the moment.

The month of March is “Save Your Vision Month.” In the words of Helen Keller, “Blindness cuts us off from things, but deafness cuts us off from people.” The combination of the two impairments can be isolating and difficult. At The Hearing & Dizziness Clinic, we aim to provide you with outstanding hearing health care that is personalized, professional, and improves your quality of life! 

References: 

1. Courtney-Long EA, Carroll DD, Zhang QC, et al. Prevalence of disability and disability type among adults–United States, 2013. MMWR Morb Mortal Wkly Rep. 2015;64(29):777-783. 
2. Deal JA, Betz J, Yaffe K, et al. Hearing impairment and incident dementia and cognitive decline in older adults: the Health ABC study. J Gerontol A Biol Med Sci. 2016;glw069.
3. Fast Facts of Common Eye Disorders. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 9 June 2020,www.cdc.gov/visionhealth/basics/ced/fastfacts.htm. 
4. National Eye Institute. All Vision Impairment. National Eye Institute website. https://www.nei.nih.gov/eyedata/vision_impaired. Assessed November 28, 2016
5. National Institutes of Health. National Eye Institute. All vision impairment. https://nei.nih.gov/eyedata/vision_impaired. Accessed January 4, 2016. 
6. Prevent Blindness America. Vision problems in the U.S.: prevalence of adult vision impairment and age-related eye disease in America. http:// www.visionproblemsus.org/. Accessed January 4, 2016. 
7. Rooth, Meredith Anderson. “The prevalence and impact of vision and hearing loss in the elderly.” North Carolina medical journal 78.2 (2017): 118-120.
8. Swenor BK, Ramulu PY, Willis JR, Friedman D, Lin FR. The prevalence of concurrent hearing and vision impairment in the United States. JAMA Intern Med. 2013;173(4):312-313.
9. Whitson HE, Lin FR. Hearing and vision care for older adults. JAMA. 2014;312(17):1739-1740.

Three Habits for Better Hearing in the New Year

Your habits may be sabotaging your hearing. In this article, discover how implementing exercise, hearing protection, and social interaction can help maintain your hearing even as you age.

Exercise

The pandemic has caused several of us to forsake the gym this year. Have you heard of the “quarantine 15?” Obviously, several factors contribute to gaining 15 pounds during quarantine, but the greatest of these is lack of exercise. In 2021, let’s purpose to improve our habits and, in doing so, lessen our risk of hearing loss.

Data on risk factors related to hearing loss are limited, but several reputable studies suggest that changing our daily habits can affect our hearing. One of those studies, published by the American Journal of Medicine, states that people who participate in physical activity reduce their risk of developing hearing loss. According to the article, this reduced risk is especially true of women who walk more than 2 hours per week.

Interestingly, hearing loss is not caused by strenuous exercise, but exercise can help maintain healthy hearing despite one’s age. As an audiologist, I counsel patients regarding the common stigmas associated with hearing loss, such as aging. These studies affirm that hearing loss isn’t always directly caused by age. 

Hearing Protection

Last year, a record number of people made improvements to their homes. Did you hear all the power tools running in your neighborhood? 

Everything from in-home offices to backyard decks were and still are being constructed as the pandemic sparks various home-improvement projects.

Tools such as table saws, drills, and sanders can cause hearing loss, especially if the sounds they make are long, repeated, or reach at or above 85 dBA. Before you start that new home improvement project, make sure to purchase over-the-counter hearing protection such as earplugs or earmuffs. 

If the over-the-counter options are not suitable, visit us to obtain custom hearing protection. You will be surprised by the functionality and durability of professionally made hearing protection. 

Interesting Facts

• • A handheld belt sander can reach up to 103 dBA, depending on the quality and condition of the tool.
  • An average table saw can reach up to 100 dBA.
  • The normal handheld drill produces between 90 and 94 dBA, and hammer drills produce in excess of 100 dBA.

Social Interaction 

During this pandemic, you have personally experienced social isolation. My patients have told me they haven’t interacted in-person with loved ones or friends for weeks, if not months. 

As humans, we thrive on healthy social interactions. Without them, your physical, mental, and cognitive health can suffer. According to a 2019 study led by Kassandra Alcaraz, Ph.D., MPH, a public health researcher with the American Cancer Society: “Our research really shows that the magnitude of risk presented by social isolation is very similar in magnitude to that of obesity, smoking, lack of access to care and physical inactivity.”

You might be thinking, “How can a lack of social interaction worsen my hearing?” While social isolation may not affect the level at which you can hear, it can affect your brain’s ability to process the information. Hearing is not just about your ears. Your brain plays a big role in how you process and understand sound.

As we age, our cognition can be affected by decreased social interaction. As our cognitive function declines, so does our ability to process information. For many, this change may seem like hearing loss, but what is actually happening is the loss of the ability to process the information while the function of hearing remains the same. 

Although safely interacting in [county name] may not be possible, make use of virtual communication methods this year such as Facetime or Zoom to keep your brain active and social.

Hearing Aids and Mobile Technology: How much can it change your life?

Streamer Solutions: “Well you could use this device that helps your cell phone talk with your hearing aids, yes you would have to wear it all the time around your neck”

Volume Remote: “You could use this remote control to turn up your hearing aids, yes you would have to carry it around with you”

TV Solutions: “Oh, we have a device that connects your hearing aids to the television, but you would need to wear this around your neck to adjust the volume”

These are phrases I don’t find myself saying very much anymore! All of these streaming devices were extremely popular (and still are if you don’t own a smartphone), however, smartphones now allow us to do it all in one application.

Hearing aids that are compatible with your smartphone allow for

– better understanding during a phone call

– better productivity

– optimizes sound while in background noise

– allows you to locate your lost hearing aid

– monitor brain and body health

– change volume and switch programs

Stream Audio Wirelessly*

Whether you’re on a walk, riding the bus or subway, if you have a podcast or audio book, you can enjoy hand and wire free entertainment. No need for headphones or to hold a book. Simply press play and your smartphone will stream the audio right through your hearing aids.

So many people have tons of books downloaded on their digital devices such as the Kindle reader. One commonality that most of them have is that they never have enough time to complete reading the books they’ve purchased. Drops make an ocean and you’ll be done with your books in no time at all.

Another option is to allow you phone to stream phone calls. This option is not only appealing because it’s hands free, but it also helps you understand the phone call better. When the phone call is processed through your hearing aids it reduces the background noise, streams through both of your ears, and it takes into account your hearing loss, only amplifying areas where you have hearing loss.

Monitors Brain and Body Health**

There is now hearing aid technology that is designed to help the wearer stay independent. With this technology falls can be detected and alert messages sent to selected contacts. Just like our smartwatches can track our steps and other movements our hearing aids can do that now too! Tracking fitness activities has shown to inspire people to continue or increase their activity. Lastly, we are all aware how social interaction can have a positive impact on our mental well-being. The smartphone applications can allow you to track your social interaction. Before our lives were changed due to COVID-19 a lot of my patients were intrigued by this feature!

Volume

There is no question that volume control is one of the most used features of the smartphone applications. Even though hearing aids will automatically adjust the volume on their own depending on your environment, some patients like to be able to manually adjust it themselves. Dare I say… there is a mute feature as well. 

Have hearing aids but struggling to understand someone with a mask on? Masks can actually decrease someone’s voice up to 12 decibels. When our patients’ hearing aids are fit we don’t account for that decrease. That is why a lot of our patients enjoy being able to make a “mask program” for themselves using their smartphone (or asking us to make it for them)! 

Location

Most smartphones applications also allow you to locate a lost hearing aid. Unfortunately, one of the downsides to wearing a mask and hearing aids is that sometimes the mask will remove hearing aids on accident. I’ve had a few patients lose their hearing aids this way. If they choose to allow the app to access their location they can ping the last known place they had their hearing aid.

Always remember that mobile technology is a tool that can help you immensely. Simplicity is the ultimate sophistication. Our moto at The Hearing & Dizziness Clinic is to keep things simple and straightforward when using them.

Each hearing aid and manufacturer has different features and each type of smartphone allows for different connectivity options. If you are interested in learning more please contact our hearing instrument specialist Celina at celina@youhear.ca our our communications disorders assistant Emily at emily@youhear.ca

*Depending on the type of smartphone.

** Available in certain Starkey Models

Diabetes: How It Impacts Hearing

If you or someone you love has diabetes you are probably aware that diabetes causes small blood vessel disease. What happens is blood vessels weaken and slow the flow of blood through the body which can lead to diabetic neuropathy or organ and tissue damage.

Since I am an audiologist I am particularly interested in what diabetes does to our inner ears. Both of our inner ears are made up of a cochlea and vestibular system.

Did you know that the same cranial nerve (8th nerve) innervates both the cochlea and the vestibular system? That is why I sometimes see patients with both hearing loss and balance issues. Since diabetes affects the entire neural system it is not uncommon for patients to report a disruption in the perception of hearing and balance as a whole.

Hearing Loss, How It Happens

Just like high blood glucose can damage organs such as eyes and kidneys it can also damage the inner ear. Our inner ears are extremely sensitive to blood flow and even our eardrums include a network of small blood vessels.

I often tell my patients a hearing evaluation is one of the easiest ways to identify if there has been any damage in the cochlea, the organ of hearing. Unlike a vision test where an optometrist can look into the back of your eye for signs of diabetic retinopathy we cannot look into your ears and visualize the inner ear, your eardrum is blocking our view!

If damage has occurred in the cochlea it will show up as a sensori-neural hearing loss. This type of hearing loss is referred to as nerve damage that can not be regained through surgery or medication.

Balance, How It Happens

As I mentioned above diabetes also affects balance. When there is too much sugar in the blood it can affect our balance in more ways than one:

• It affects the connective tissues inside the vestibular system making one feel off-balance.
• The myelin sheath that covers the vestibular nerves are damaged which doesn’t allow our inner ear to send messages properly to our brain.
• It can degenerate the hair cells inside the vestibular system just like it damages the hair cells inside the cochlea resulting in hearing loss.

As you can probably imagine we use several sensory inputs to remain balanced on our feet. One of the main inputs is our vision, can you see what is in front of you as you take a step? How about proprioceptive inputs like what your feet are telling you? If someone has a hard time feeling their feet they may be stepping on a surface that isn’t level, which will cause them to fall. Remember, diabetes affects the whole body so there are multiple systems at play when balance is an issue.

My Role As An Audiologist

Baseline Hearing Test

I tell anyone who is suffering from diabetes that a baseline hearing test is an important starting point. It is important to have a complete picture of hearing at the time of diagnosis! Therefore if any issues arise in the future we have something to compare to. 

Education

Another recommendation I commonly make may be diabetes education. Ask your physician about resources that are available in our area.

Balance Screening

Another recommendation may be a balance screening. We perform balance screenings here at The Hearing & Dizziness Clinic and if there are any concerns we can start a treatment plan.

I commonly will refer any of my patients to our occupational therapist for vestibular rehabilitation.

Vision Health

I will commonly ask my patients who their eyesight is if they are diabetic and having issues with balance. Make sure that you or your loved one is getting their eye exam with dilation at least once a year. As mentioned above, vision health plays an important role in balance.

Source:

Dowd, K. (2020). Audiology: diabetes in hearing & balance care. AudiologyOnline, Article 27259. Retrieved from http://www.audiologyonline.com

Swimming Accessories

Pool season is just around the corner, and we want to remind you that we do sell a different variety of swimming accessories for your ears. Swim molds should be considered if you have a perforated eardrum, are prone to “swimmer’s ear,” or have tubes placed in your eardrum. 

BIONIX AFTER SWIM WATER REMOVAL STRIPS (20/PK): Cost $8.00 plus tax

Safe, fast and alcohol-free drying strips designed to absorb water inside the ear canal

Flared tip design eliminates the risk of over insertion

No risk of damage to the eardrum; will never directly or indirectly come in contact with eardrum

Only needs to be inserted far enough into the ear to break the surface level of the water

Wicking action of the product will remove the water on its own

Can absorb over 5x the amount of liquid an average ear canal can hold

One strip can be used on both ears

Putty Buddies Floatable (3 pairs): Cost $10.00 plus tax

Soft, colored, silicone ear plugs that help keep water out of ears

For use with the Ear Band-It

Available in combinations of red, white and blue OR green, yellow and blue

Triple the size of most other kid’s plugs

Bright colors are easy to find in the pool or bath

They float!

This is a special order item, we place orders for it every two weeks.

Doc’s Pro Plugs (unvented one pair): Costs:$14.00 plus tax or Leash version $16.50 plus tax

Doc’s ProPlugs are inexpensive, long-lasting, ready-to-wear earplugs designed to keep water out of an individual’s ear canal    

For use with the Ear Band-It

Made of soft, hypo-allergenic Kraton with memory that provides a watertight seal        

Quickly and easily fitted             

Designed for patients with P.E. tubes or middle ear fluid to keep water and bacteria out of the ear canal       

Perfect for swimming, bathing, concerts, recreational and light industrial use 

This is a special order item, we place orders for it every two weeks.

Ear Band It Ultra: Cost $16.50 plus tax

Keeps water out of ears and holds earplugs in

For use with Putty Buddies or Doc’s Pro Plugs

Ultra version has better grip, comfort, and strength than the original Ear Band-It

Made of 100% super soft neoprene with Grip-Tek™ neoprene inner lining

Helps prevent swimmer’s ear

Ideal for those with Ear Tubes and Ear Perforations

Ultra version is NOT reversible

This is a special order item, we place orders for it every two weeks.

Custom Floatable Swim Molds: Cost starting at $180.00 plus tax

These molds are made just for you. We take a cast of your ears and send it to the manufacturer where they will create custom swim earmolds. These molds completely block the ear and ear canal to ensure no water will enter. It is made from a material that is able to float above water so you will not lose them while swimming. Perfect for children and adults to protect their ears from water while swimming or in the shower. Although suitable for children, remember children are growing and these may only fit their ears for a few months.