AVA Hearing News

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

Lyme Disease and Hearing Loss

As warmer weather starts to return across the country, so too does the tick population. In Michigan’s Upper Peninsula, multiple counties have well-established tick populations due to heavily wooded and grassy terrains. In the Lower Peninsula, the first confirmed infected population of blacklegged ticks was detected in 2002 along Lake Michigan. Since that time, blacklegged deer ticks carrying spiral-shaped bacteria called Borrelia burgdorferi, have been invading northward along the Lake Michigan coast, leading to an increase in Lyme disease.

There are three stages of Lyme disease: 1) acute, 2) early dissemination, and 3) late dissemination. Problems with hearing, usually occurring in stage 2, can also be caused by Lyme disease. The symptoms that may be an indication that Lyme’s disease is impacting the hearing/balance system can include the following:

•  Hearing Loss (usually occurs suddenly)
•  Sensitivity to Noise
•  Ear Pain
•  Tinnitus
•  Dizziness
•  Facial Weakness

A study published in 2012 reported a progressive bilateral sensorineural hearing loss in stage 3 Lyme disease. This feature is different from hearing loss in stage 2 Lyme disease, which has been reported to be unilateral and sudden.

Several days or weeks after a bite from an infected tick, the patient may experience flu-like symptoms such as aches and pains in their muscles and joints, low-grade fever and fatigue. The classic symptom is a rash that looks like a bull’s-eye and can vary in size and duration. Later symptoms can include headache, stiffness of the neck, and tingling or numbness in the extremities.
Because its symptoms are similar to other diseases, Lyme disease may be misdiagnosed as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, lupus, or other autoimmune and neurodegenerative diseases. The progression of the disease can vary by individual, and not all people go through each of the three stages or react to the disease in the same way.
Hearing loss associated with Lyme disease is often misidentified as middle ear fluid and treated like an ear infection. The only real way to verify the nature of a hearing loss is through a diagnostic hearing test. It is most helpful if there has been a baseline hearing test established prior to onset of Lyme disease. This baseline test serves as a comparison for pre and post treatment efficacy.

Most people with Lyme disease who are treated right away with three weeks of antibiotics have a good prognosis. However, if you are not treated for weeks, months, or even years after infection, it becomes more difficult to treat. Like any other illness, the sooner you do something about it, the better the outcome. The good news is that Lyme disease usually responds well to antibiotic therapy, but the effect on hearing loss and tinnitus to treatment varies significantly from patient to patient.

In addition to seeing your physician to make sure you get properly tested for Lyme disease, don't forget to make an appointment with your audiologist. An audiologist will determine the extent of any hearing damage and keep your physician in the loop with any non-medical treatment recommendations.
Call AVA Hearing Center @ 616-365-1979 if you have had any sudden change to your hearing or call to schedule a baseline evaluation to help monitor any future changes to hearing sensitivity.


Still curious? Here are some great links for even more info-
http://www.michigan.gov/emergingdiseases/
https://www.audiologyonline.com/ask-the-experts/lyme-disease-and-hearing-loss-6823-6823
https://www.healthline.com/health/lyme-disease-symptoms
https://www.lymedisease.org/connection-lyme-disease-hearing-loss/
https://medlineplus.gov/ency/article/001319.htm




Right Ear Advantage

Are you right handed? Do you have one eye that is better than the other? Do you always use one particular foot first when climbing the stairs? Actually, that is not surprising at all. All of us have dominant features and that is true for our ears as well.

Most mammals in the wild have a symmetric hearing system designed specifically to localize to sounds in nature. It is necessary to rapidly locate predators or prey. The name of the game is to survive and the 2-eared system works great for that purpose. Information from the two ears are ?compared? in the brainstem using intensity (loudness) differences and intra-aural (timing) differences to judge the WHERE and WHAT for the sound of interest. From there it is the old FIGHT or FLIGHT question for survival.

Humans no longer rely on the HUNT or be HUNTED mode of survival. We have evolved into a species that relies on speech sounds to gather information about our environment. We still have the capability to localize sounds but for humans, the sound of fire approaching is much slower to discern than hearing someone yelling RUN or FIRE! This evolutionary modification has changed the way we process sound.

In order to process speech information the brain needs to recognize very rapid changes in volume and pitch (occurring in milliseconds) as well as overall slower changes in energy (occurring in seconds). The rapid changes give us information about vowels and consonant sequences. The Slower changes give us information about prosodic features like sentences and phrases.

So, what does this all have to do with being right ear dominant? Because of our human use of language, the left hemisphere of the brain became specialized in identifying consonants and vowels. The right hemisphere provided more information about location and cadence. The auditory system uses crossed and uncrossed neural pathways from both ears to both hemispheres of the brain. When both ears are stimulated simultaneously, the uncrossed pathways are suppressed; only the crossed paths are active. This means that the information from the right ear travels directly to the left hemisphere processor via the crossed pathway. The information from the left ear must cross over to the right hemisphere before it crosses back over to the left hemisphere via the corpus callosum (the bridge between the two hemispheres of the brain). Both ears are ultimately connect to the left hemisphere processor but because of the way the ears are connected, the input from the right ear reaches the left hemisphere slightly faster. The slight delay in timing provides a right ear advantage.

As we age the timing differences between the right and left brain hemispheres changes as well. Where 20 year olds on average have a 3% left ear disadvantage, average 80 year olds have a 37% disadvantage. This may be due to the progressive deterioration of the corpus callosum (the bridge between the right and left brain hemispheres). Age-related changes in size, fiber composition, white matter and metabolism result in increasing disparity between right and left ears and ultimately resulting in poorer speech recognition abilities. Ah, the joys of getting older.

Love, Marriage and Hearing Aids

One of the things that I love most about my job is the opportunity to meet with couples. I enjoy observing how they express their thoughts and emotions to each other. The happy couples I have met really know how to communicate, which can be challenging when one or both have a hearing loss.
A 2009 study asked 1500 hearing impaired couples (one or both had hearing loss) and found that:

•  44% of couples said their relationships have suffered because of their spouses? hearing loss.

•  34% have lost touch with friends as a direct result of the breakdown in communication caused by hearing loss.

•  69% said their hearing loss seriously hindered the ability to take part in everyday conversation with friends and family, causing 52% of those surveyed to feel left out and ignored in social situations.

•  Women (72%) were found to be more affected by social exclusion because of hearing loss than men.

•  65% indicated that they feel annoyed and aggravated with their spouse when they are asked to repeat.

I have seen evidence of this over the years. I have even seen some marriages fail because of poor communication and the apparent lack of willingness to do something about hearing loss. There are many reason why people don?t seek help: denial, cost, effort. But there are so many reason to take action: improved communication, better overall health, happy spouses.

I had a lovely couple in the office many years ago. The husband had tried hearing aids numerous times but always return them because he didn?t like wearing them. I asked his wife how she felt about him returning the hearing aids and she said to him ?Without hearing aids we struggle to communicate. When you refuse to wear hearing aids it makes me feel like what I have to say is unimportant to you. It make me feel like you don?t love me anymore.? Well, he did love her. He became a very successful hearing aid wearer. What a beautiful expression of LOVE for his wife.

Call or email today to schedule your appointment.
(616) 365-1979
avahearing.com

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Emotional Response to Sound


When I think of summer I think of hot dogs sizzling on the grill, kids splashing in the pool, dogs panting, and music all around. Our lives are filled with sounds that can transport us to a time or place with meaning. Although not all sounds are pleasant, they do evoke an emotional response. What researchers wanted to know, is whether or not people with hearing loss have the same emotional responses to sound as those without (Picou, 2017).
Music is a sound capable of eliciting a wide range of emotional responses, and as such, was the tool used to test this concept. The study divided sound into four categories; pleasant/excited, pleasant/calm, unpleasant/excited, and unpleasant/calm. Each participant rated their responses to the sounds and were scored accordingly. Participants ranged in age from 22 to 80 and severity of hearing loss from normal to moderately-severe sensorineural hearing loss.
The results of the study showed that as the severity of hearing increased (worsened), the emotional response lessened. Not only did participants with more severe hearing loss have less emotional reactions to the music, they also found more sounds to be unpleasant. There was no difference in results based on age, but a significant difference based on hearing. ?These data suggest that listeners with sensorineural hearing loss are less emotionally affected by sounds than their peers with normal hearing. As a result, people with hearing loss may not be fully benefiting from activities that their peers with normal hearing find pleasurable, like laughing with friends or listening to music.? (Picou, 2017, pp. 14-16).
The results of the study also showed that consistent hearing device users responded more similarly to the individuals with normal hearing when it came to pleasant or unpleasant sounds. This means that wearing an appropriately fit and programmed hearing device can make listening more enjoyable for individuals with hearing loss.
As an audiologist, I am always striving to improve the way individuals with hearing loss perceive their surroundings and interact with others. Difficulty in noise or with hearing music are common complaints for hearing aid users. The new Widex Beyond hearing devices are specifically designed to give the user a more authentic perception of music. They also have a unique soft sound input and new noise filtering technology which allows the wearer to hear sounds more like a natural ear. With improvements in technology, hearing aid wearers can enjoy music and laughter, ultimately connect to the emotions elicited by the sounds of life. As always, it is important to see a professional to ensure proper fitting and care of hearing devices.


REFERENCE:
Picou, E. M., Buono, G. H., & Virts, M. L. (2017, May). Can Hearing Aids Affect Emotional Response to Sound? Hearing Journal, 70(5), 14-16.

ABOUT THE AUTHOR:
Sarah Lundstrom, AuD is a private practice audiologist in Venice, Florida with HearCare Audiology Center. She has a Bachelor of Science in Biology from Central Michigan University and her Doctorate in Audiology from The University of Akron in Ohio. She has been in practice for two years in Florida and loves the sunshine.

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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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Visit on the Web:
    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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Visit on the Web:
    American Tinnitus Association

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