AVA Hearing News

Get up to date information on hearing issues and technologies from AVA Hearing Center.

Exercise Your Body, Not Your Ears

Hi there, Jillian here!

I’m taking over the newsletter for this month! Some of you may have seen me around the office at AVA, I’m a “Jill of all trades” here. I’m happy to answer your phone calls, schedule your appointments and clean your hearing aids. And on occasion, write an article or two for the monthly news letter!

When I’m not in the office assisting patients or Dr. Jacobs, I like to keep moving. I would call myself a fitness enthusiast. I enjoy working out at the gym, running and taking Barre or other group fitness classes. We all know that staying fit and active as we age is very important. Exercise decreases the risk of cardiovascular disease, diabetes, osteoporosis, depression and premature death (Warburton et al, 2006). But have you ever thought about the affects of your fitness routine on your hearing?

Most fitness related classes have accompanying music, with the possible exception of yoga or Pilates; there is almost always some kind of background music. I like to think it is because the instructors are trying to distract people from the physical discomfort (torture!) they are about to make people endure or maybe it’s just easier to keep moving if the music is good! But in all seriousness…Group fitness instructors use music that feature a tempo (i.e. beats per minute or BPM, that corresponds to the intensity of the class). But did you know that the combination of the music and the instructors’ voice can create an environment in which noise levels can exceed the recommended exposure limit. For example, have you ever taken a class where the instructor is using a microphone headset? And even with that microphone headset you are still struggling to hear what is being said? Or the instructor is yelling directions but you can hear them over the music?

This past week, I went to my Barre class and found my spot next to my friend as usual. Class began and we were doing our fitness thing and about half way through the warm up section of class my friend asked me a question. And you know what happened? I had to ask her to repeat herself! I had no idea what she had asked…and that’s when it hit me, the music was blaring! Why had I never noticed that before? Why does it need to be that loud? Do other people in class realize that it is so loud?
I’ll admit, my hearing is not what I’m thinking about when I head into my fitness classes. In fact, I didn’t think about it at all until Dr. Jacobs showed me an article in the Audiology Today magazine. And after reading, I had a realization about the fitness world…group fitness classes are loud! I think I always knew the music was loud but never REALLY thought about it or what it was doing to my hearing until reading about it from an outside source.

Here are some suggestions for your next exercise class-
• Find a spot and position yourself away from the speakers. Generally, the speakers are located in the front corners of the room. Try finding a space near the rear of the room but still in sight of the instructor.
• Try using musicians’ earplugs- they let sound in so that you can hear at a comfortable listening level (Can be ordered from AVA if interested).
• Talk with the class instructor about your concerns. Healthy hearing is an element of an overall healthy lifestyle after all.

If you’re interested in reading the full article, you can find it in the archives section at audiology.org

Gaeta, Laura, and Andrew B. John. "Noise-Induced Hearing Loss and Leisure Activities."Audiology Today Nov. & dec. 2016: 18-27.

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    audiology.org

Balance

That Amazing Ear!

The ear is an amazing, complicated, delicate system that does more for us than provide hearing. Did you know that the ear is also responsible for our sense of equilibrium and balance? The hearing and balance systems or Auditory and Vestibular systems are connected in the Inner Ear and are protected in the hardest bone in our body – the temporal bone. Where the Auditory system provides our ability to hear - our Vestibular system provides our balance, helping us stand, walk, run, and move without falling. It allows us to be able to fixate our vision so we can drive a car and shake our head without getting dizzy. Our vestibular system tells the brain where we are in relation to gravity and tell us if we are moving or standing still.

The Vestibular system consists of three semicircular canals that contain fluid and “sensors” that detect head movement. Each of the three semicircular canals lie at right angle to each other, giving us a “3D picture” of our location in the environment. The semicircular canals deal with different movement: up-and-down, side-to-side, and tilting from one side to the other. Each semicircular canal has sensory hair cells that are activated by movement of inner ear fluid known as endolymph. As the head moves, hair cells in the semicircular canals send nerve impulses to the brain. When the brain receives the impulses, often reinforced by visual feedback, it sends a signal to the muscles, telling them to contract or relax in order to maintain balance. When the brain receives faulty or missing signals from the vestibular system, dizziness or disequilibrium result.

Approximately 1/3 of all adults will experience dizziness severe enough to report it to their physician. Most often dizziness is mild, causing a sensation of lightheadedness, off balance or a feeling of movement even when there is none. Occasionally dizziness can be more severe causing an inability to stand or walk. Dizziness is typically fleeting as the brain corrects or compensates for the faulty signal (like when you get off of a boat and still feel like there is a rocking sensation). Occasionally dizziness is persistent causing a high risk for falls. There can be additional symptoms associated with dizziness such as: nausea, hearing loss, ringing or buzzing in the ears (tinnitus), aural fullness, anxiety and nervousness.

If you experience dizziness, it is important to report it to your physician. There are many causes for dizziness so its origin may be difficult to diagnose. Part of the diagnostic process will be to rule out any serious underlying causes. Common causes can be medications, problems in the inner ear like Benign Paroxysmal Positional Vertigo (BPPV), Meniere’s Disease or a viral infection. Dizziness may also be a sign of a cardiovascular problems like high blood pressure or anemia. Dizziness may occur with hypoglycemia or diabetes. Sudden, severe vertigo may also be an indication of a stroke. Seek immediate medical attention if you experience this. Early identification and treatment are important.

Contact AVA Hearing Center for a diagnostic hearing evaluation if you have dizziness, tinnitus or hearing loss.

AVA Hearing Center
5344 Plainfield Ave NE, Suite 4
Grand Rapids MI 49525
616-365-1979

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Tinnitus

Do you hear ringing, buzzing or chirping in your ears even when there is no noise in the environment? You may be experiencing Tinnitus (TIN-i-tus). Tinnitus is a fairly common complaint, affecting 1 out of 5 adults.

It is often described as a high frequency sound that seems to get louder when the environment is quiet. It can also be described as a hissing, buzzing, chirping, roaring and rarely it may be perceived as unclear voices or music. It is even common for there to be multiple sound simultaneously and can be present in one or both ears. Some people report that their tinnitus is always present while others may report that their tinnitus is only noticeable occasionally or only in quiet situations.

Tinnitus can be triggered by a number of different causes like: medications, hearing loss, blood pressure, noise exposure, diabetes, TMJ, head trauma, allergies, congestion, Meniere ’s disease, stress and rarely, a benign brain tumor. It is always important to mention tinnitus to your physician and audiologist in order to rule out some of the more serious pathologies associated with tinnitus.

There are two kinds of tinnitus as defined by the Mayo Clinic:

•Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. Most often it is caused by damage in the cochlea (hearing loss) and auditory nerve. The faulty electrical signal being sent to the brain gets interpreted as tinnitus. Tinnitus does not cause hearing loss but hearing loss is often accompanied by tinnitus.

•Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, a middle ear bone condition or muscle contractions in the middle ear (often heard as a fluttering).

The Michigan Ear Institute further identifies types of tinnitus as:

Muscular Tinnitus
Tinnitus may result from spasm of the two muscles attached to the hearing bones or from spasm of muscles attached to the eustachian tube in the middle ear to the back of the nose. There are two muscles in the middle ear: the stapedius and the tensor tympani. These muscles normally contract briefly in response to very loud noise. On occasions one or both of these muscles may begin to contract rhythmically for no apparent reason, for brief periods of time. The clicking or fluttering, although annoying, is harmless and usually subsides without treatment.

Vascular Tinnitus
There are two large blood vessels intimately associated with the middle and inner ear; the jugular vein and the carotid artery. These are the major blood vessels supplying the brain. It is not uncommon to hear one’s heart beat or to hear the blood circulating through these large vessels. This may be heard when an individual has a fever, a middle ear infection, or is engaging in strenuous exercise. The circulation sound in these instances is temporary and is not audible to others. On occasions the sound of blood circulation will become audible to others. This can be due to thickening of the blood vessel wall (a normal occurrence as one grows older), a kink in the vessel or an abnormal growth on the vessel wall. This pulsing sound can also be due to increased spinal fluid pressure. Further testing may be necessary to determine the cause and treatment indicated in these uncommon cases.

External Ear Tinnitus
Obstruction of the external ear canal by wax, foreign bodies or swelling may produce a hearing impairment or pressure on the eardrum. This frequently results in a pulsating type of tinnitus.

Middle Ear Tinnitus
Disturbance of function of the middle ear may result from allergy, infection, injury, scar tissue or impaired motion of the three middle ear bones. These disturbances often result in hearing impairment and may lead to head noise. But there is no relationship between the degree of hearing loss and the intensity of the tinnitus.

Inner Ear Tinnitus
Any condition which disturbs the inner ear chamber may produce head noise. This may be due to infection, allergy, or circulatory disturbances which produce changes not only in the fluid but also in the encasing membranes of the inner ear.

Nerve Pathway Tinnitus
The nerve pathways are the most delicate structures of the hearing mechanism. The small hair cells which serve to transform fluid waves into nerve impulses are analogous to the cells of the eye retina which transforms light waves into nerve impulses. The slightest swelling of interference with these delicate cells from any cause readily produces impairment of function and irritation. This may occur from a variety of causes: infection; allergic swelling; systemic diseases, either acute or chronic, with resultant toxic effects; sudden exposure to high noise levels in susceptible persons; certain drugs to which the patient may be sensitive; minute changes in the blood supply and changes in nutrition.

Pressure changes may produce swelling both from outside and within the nerve as it transverses the bony tunnel through which it passes to the brain. In these instances, the tinnitus occurs on one side of the head. The balance and facial nerves pass through this bony tunnel and can also be affected by the pressure. Rupture or spasm of one of the small blood vessels occurring anywhere in the auditory pathway produces pressure and interference with circulation. Consequently, sudden tinnitus, with or without partial or total loss of hearing function, may occur. If the blood clot is small it may absorb with little or no permanent changes. This condition, like the pressure phenomenon, occurs only on one side and because it has occurred once does not mean it would necessarily occur again either.

TREATMENT
Treatment options for tinnitus have changed over the past 25 years. In the 1980’s tinnitus sufferers were counseled to “learn to live with it” or treated with Valium. Though there is no ONE cure for tinnitus, relief can be obtained for most people. Some options address tinnitus by improving nutrition, reducing inflammation and/or treating allergies or underlying causes. More in-depth treatments may use Cognitive Behavioral Therapy, hearing aids (Unitron Moxi), tinnitus maskers (Widex Zen), and sound therapy (Neuromonics). Often treatment is multifaceted and may incorporate 3-4 simultaneous treatments. Recommendations are based on the specific nature of the tinnitus and the degree of adverse reaction to the tinnitus.

If you or someone you know suffers from tinnitus, contact AVA Hearing Center for an evaluation at 616-365-1979.

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    American Tinnitus Association

Hearing Loss in Children

Hearing Loss on the Rise

The number of Americans with hearing loss has doubled over the past 30 years according to the National Center for Health Statistics. Despite the fact that there is greater public awareness of the effects of noise exposure, a decline in the incidence of diseases associated with hearing loss such as scarlet fever, meningitis, measles, mumps and rubella and earlier identification/treatment of damaging ear infections, hearing loss continues to be on the rise. It is estimated that hearing loss affects over 32 million Americans, many of these are children.
Hearing loss can be broadly divided into two identifying categories:
Congenital causes
Congenital causes may lead to hearing loss being present at or acquired soon after birth. In the US 1.4/1000 births have congenital hearing loss. Hearing loss can be caused by hereditary and non-hereditary genetic factors or by certain complications during pregnancy and childbirth, including:

• maternal rubella, syphilis or certain other infections during pregnancy;
• low birth weight;
• birth asphyxia (a lack of oxygen at the time of birth);
• inappropriate use of particular drugs during pregnancy, such as aminoglycosides, cytotoxic drugs, antimalarial drugs and diuretics;
• severe jaundice in the neonatal period, which can damage the hearing nerve in a newborn infant.

Acquired causes may lead to hearing loss at any age, such as:

• infectious diseases such as meningitis, measles and mumps causing permanent loss;
• chronic ear infections;
• collection of fluid in the middle ear;
• use of particular drugs, such as some antibiotic and antimalarial medicines; Ototoxic medications;
• injury to the head or ear;
• excessive noise, including occupational noise such as that from machinery and explosions, and recreational noise such as that from personal audio devices, concerts, nightclubs, bars and sporting events;
• ageing, in particular due to degeneration of sensory cells;
• ear wax or foreign bodies blocking the ear canal causing temporary loss.

Children born with congenital hearing loss are most typically identified by newborn hearing screening techniques used within the first few hours of birth. This is a big change from where we were 20 years ago when hearing loss was typically identified around age 2, when children were expected to have developed language skills. Early identification is key to providing treatment and educational options. Under the Individuals with Disabilities Education Act (IDEA) Part B, 2010 approximately 1,000,000 children between ages 6-21 received educational services for hearing loss.

Children are also at great risk for Acquired hearing loss. One of the greatest threats to healthy hearing is from noise exposure. The World Health Organization estimates that “1.1 billion children under the age of 18 are at risk for developing hearing loss due to the unsafe use of personal audio devices and exposure to damaging levels of sound in noisy entertainment venues”. In the US an estimated 19% of children and young adults under age 21 already permanent hearing loss, many as a result of noise exposure. These numbers continue to climb at a significant rate urging the WHO to identify Hearing Loss as the #1 most preventable chronic disease in the world.

Noise induced hearing loss (NIHL) is the only type of hearing loss that is completely preventable. Understand the hazards of noise and how to practice good hearing health, can protect your hearing for life. Remember, it is never too late to start protecting your hearing.

Here’s how:
1. Know which noises can cause damage (those at or above 85 decibels).
2. Wear earplugs or other protective devices when involved in a loud activity (activity-specific earplugs and earmuffs are available at hardware and sporting goods stores).
3. If you can’t reduce the noise or protect yourself from it, move away from it.
4. Be alert to hazardous noises in the environment.
5. Protect the ears of children who are too young to protect their own.
6. Make family, friends, and colleagues aware of the hazards of noise.
7. Have your hearing tested if you think you might have hearing loss.

The National Institute on Deafness and Communication Disorders (NIDCD) sponsors It's a Noisy Planet. Protect Their Hearing®, a national public education campaign to increase awareness among parents of preteens about the causes and prevention of NIHL. Armed with this information, parents, teachers, school nurses, and other adults can encourage children to adopt healthy hearing habits. Visit their website to get more information www.nidcd.nih.gov/health/noise-induced-hearing-loss

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Five Heart-Health Reasons to Get a Hearing Test

•  Your heart and your hearing have more in common than you may think. There is over 60 years of research that shows a correlation between cardiovascular health and hearing sensitivity. Hypertension/High Blood Pressure is an accelerating factor in the degeneration of the auditory system. Improved cardiovascular health has been shown to slow down the progression of hearing loss.

•  The ear may be a window to the heart. Patients with Hearing Loss of unknown etiology are 8 times more likely to have Ischemic Heart Disease (IHD) than patients with normal hearing. Awareness of Hearing loss often precedes awareness of IHD and can be used as an “early marker” of vascular or generalized arteriosclerosis.

•  The same lifestyles behaviors that affect the heart impact hearing. More evidence of the interconnectedness between cardiovascular and hearing health is found in 3 studies on modifiable behaviors: One found that a higher level of physical activity is associated with lower risk of hearing loss (and cardiovascular disease) in women. Another revealed that smokers and passive smokers are more likely to suffer hearing loss (and have increased incidence of heart disease). And a third found that regular fish consumption and higher intake of long-chain omega-3 polyunsaturated fatty acids are associated with lower risk of hearing loss (and heart disease) in women.

#Bull Addressing Hearing loss improves the quality of life. A recent BHI study found that 8/10 hearing aid users say that they are satisfied with the improvements in their lives due to hearing aid use. They further report an overall satisfaction with their interpersonal relationships, experience reduced anger, frustration and improved emotional stability. This in turn reduces anxiety and stress leading to lower blood pressure! Lower blood pressure means less degeneration of hearing.

•  Treating hearing loss early in its progression has been shown to decrease the likelihood of dementia (people with untreated hearing loss have a 33% greater incidence of dementia), provides a higher hearing aid success rate and makes the people around you happy about better ease if communication.

So don’t put off getting a hearing test. Everyone should have a baseline test by age 50 in order to monitor progression of loss due to heart disease, medications, aging and sudden changes to hearing. It also allows for early intervention or treatment if necessary.

Call AVA Hearing Center TODAY to schedule your complete evaluation.

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Hearing Loss: Now the Third Most Common Health Problem in USA

Hearing loss affects more than 36 million Americans. More than half of all hearing-impaired persons are younger than 65.

An audiologist is a specially trained, clinically experienced health-care professional who specializes in evaluating, diagnosing, and treating people with hearing loss and balance disorders.

"Hearing loss may be caused by many things; noise exposure,ear infections, illness, medications and deterioration due to normal aging," explains Dr. Karen Jacobs, pictured above at left working with AVA office manager Kari Paepke. Adults should have a baseline hearing test at age 50 or younger if you notice difficulty understanding conversation in group settings, difficulty hearing over the telephone, have tinnitus or ringing in the ears or feel one ear is better than the other. A hearing test takes only a few minutes but may provide valuable information for maintaining good communication.

To learn more, call AVA Hearing Center.

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Hearing Information and Aural Insight

Download and print these pages. If you, a friend or a family member is struggling with hearing loss, you may find help here.

What to Expect from a Hearing Aid?
How to Know if You Have Hearing Loss?
Overcoming Hearing Loss
Neuromonics Tinnitus Treatment
New Data: Neuromonics Tinnitus