AVA Hearing News

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

Shingles and Hearing Loss

Hearing Loss and Shingles

According to the CDC, about 1 in every 3 people will develop shingles. Anyone who had the chickenpox may develop shingles, and our chances of getting the virus increase as we age. About one third of those who get the virus will experience hearing or balance issues. The shingles virus lays dormant in the body and once reactivated, follows nerve pathways in the body. The virus can expand along the cochlear nerve, facial nerve, or vestibular nerve or a combination of these nerves. Usually one-sided, a painful, visible rash that develops from shingles can affect the auditory system and facial nerves if it occurs near the ear.

Two common complications of shingles include Ramsay Hunt Syndrome and Labrynthitis. Ramsay Hunt Syndrome affects the facial nerve leading to facial paralysis and hearing loss. Labrynthitis is an infection or inflammation of the the inner ear where hearing and balance are located. Decreased hearing, vertigo, nausea, tinnitus, facial pain or weakness are some of the symptoms that can occur with these pathologies.This hearing loss can be temporary or permanent, but with early intervention and treatment, long-term effects can be much less severe. As recommended by the CDC, healthy adults over the age of 50 should get vaccinated to prevent shingles.

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Concussions and Hearing Loss

Ahh, September. One of the best months of the year in Michigan (in my opinion). The sun is still warm, the horse flies have died off, the apples are ripe and football season has arrived. I come from a football family. My father played football in college – Go Gators! My husband knows every statistic of every LIONS football player and my son played football in High School. He was a Running Back which meant that he got hit a lot. As any mother, I used to worry about his safety. Schools did their best to keep players safe by offering modern helmets with special padding that prevent players from serious harm. Despite efforts, every year someone on the team ended up with a concussion. They would sit out of the game for a few weeks but athletes seemed to bounce back quickly and in a short time they were out on the gridiron again. I never really worried about the long term effects of concussions.

Today we know more about concussions and the auditory damage that can result from head trauma. We also know that loss of consciousness is no longer a criterion for diagnosis. Symptoms can vary in intensity from mild to severe and classified into four categories:

•  Cognitive impairments – such as difficulty concentrating or high distractibility
•  Physiological impairments –such as blurry vision, ringing in the ear and loss of hearing sensitivity
•  Emotional problems – such as depression, lethargy and/or anxiety
•  Sleeping disturbances – inability to fall asleep, stay asleep or constant sleepiness

A concussion is a traumatic brain injury (TBI) caused by a sudden external force. That force can be met in many different ways including falls, car accidents and SPORTS. In the United States there are 3.8 million sports-related concussions reported annually.

The anatomy of the hearing or auditory system makes it susceptible to damage from a concussive force. The auditory system has more neural connections to the brain than any other sensory system like eyes (vision), nose (smell) or tongue (taste). Nerve axons can be stretched and sheared by a concussive force, initiating a metabolic response that can lead to improper signaling between cells or even cause axons to die (Giza and Hovda, 2014). The position of the auditory cortex in the temporal lobe of the brain makes it particularly susceptible to contusions and swelling.

Concussions cause hearing damage in two different ways.
•  Peripheral Damage: This is damage occurring in the ear itself, the peripheral system. A concussive force can perforate the tympanic membrane or ear drum, dislodge the small bones in the middle ear cavity causing up to a 60 decibel hearing loss. Force of the stapes crushing into the Inner Ear can cause hearing loss similar to that seen with noise exposure resulting in temporary or permanent shifts in hearing, introduction of tinnitus and ear pain.
•  Central Damage: This is damage occurring in the brain, the central system. Damaged neural activity and disrupted electrical impulses cause increased difficulty with auditory and speech processing.

Studies (Krause et al, 2017, Musiek et al, 2004) have found delayed auditory processing and diminished speech details, weeks after a sports-related concussion in adolescents. Those processing and diminished speech sound details were seen months to years after recovering from sports-related concussions in collegiate student athletes. Older adults suffering from a concussion may have these issues for the rest of their lives.

So as kids and grandkids head back to the sports fields be aware of the hidden dangers of head trauma. If your child or grandchild has suffered a concussion, be watchful for the unseen, often undiagnosed auditory damage resulting from head trauma. If you or someone you know has suffered a concussion or had significant head trauma and complains that their hearing has changed, call and schedule an auditory evaluation at AVA Hearing Center.

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Spatial Cues and Hearing Loss

“I can hear people talking but I can’t understand what they are saying if there is background noise.”

This is a common complaint of millions of hearing impaired Americans. Unfortunately, noisy situations are the most common place people notice their hearing loss. Social gatherings are fraught with spontaneous topic changes, people talking over one another, chaotic background noise and unfamiliar speakers.

Part of the problem is AUDIBILITY or the ability to detect the presence of voices in noise. Hearing aids are really helpful for making voices louder and audible but for many people, audibility does not result in speech intelligibility, especially in noise. So if hearing aids make things loud enough to hear why doesn’t it solve the speech-in-noise problem?
Scientists have wondered the same thing. The answer is not entirely clear but recent studies by Dr. Shinn-Cunningham, an auditory neuroscientist at Boston University, identifies poor spatial resolution as a major contributing factor. Her study found that hearing-impaired listeners were worse than normal-hearing listeners at discriminating differences between when sound arrives at the left and right ears, a major brain task needed to locate from where sounds are coming. She found that Hearing-impaired listeners were poorer at identifying a simple melody when competing melodies were playing from the right and left side simultaneously. Her study proved that hearing impaired listeners were particularly poor at using spatial cues to focus attention and localize on a target. In other words, people with hearing loss have difficulty focusing on the speech when in the presence of background noise.

So do hearing aids even help?

Yes! First and most important, sound has to be audible. If a sound cannot be heard, there is NO speech to which to pay attention. If there is no signal detection, sound cannot be used to localize toward speech. Therefore, just wearing hearing aids will help improve detection of sound which will improve speech-in-noise performance. But historically that improvement has not been enough for many people, especially those with diminished aural processing skills.

Hearing aid research started looking at the importance of spatial cues and effective speech understanding in realistic noisy environments. Hearing aid development started to use sophisticated, high-speed data transferring between two hearing aids to help improve spatial cues as well as synchronization of noise reduction filters, provide adaptive directionality and most importantly, preserve the natural cues that tell us which sounds are closer and which are further (and less important). Technology has also been able to expand the range of frequencies into the higher pitches. Though there are not a lot of speech sounds located in these higher frequencies, there are localization cues that have historically been inaudible in previous generations of hearing aids.
There are several hearing aid manufacturers that now have new generation hearing aids that offer improved capabilities in noise. They offer:

•  E2E (Ear to Ear) communication to transfer spatial data between the ears
•  Extended high frequencies for more localization cues
•  advanced noise filters that better detect noise vs speech
•  easy to use accessories that improve the speech-to-noise ratio

AVA Hearing Center works with many different manufacturers to help ensure you have options that fit your unique needs. Call us today if you want to talk about what is right for you. Remember, we have a 30-day trial period and demonstration models available. Give us a call at 616-365-1979

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Summer Activities that are Dangerous to your Hearing

Summer is in full swing and we are excited! Grab the sunscreen, grab the bug repellent and grab your…ear plugs?

At the beach we protect ourselves from the sun and UV rays by applying generous amounts of sunscreen, wearing hats and finding shade under umbrellas. At night time, when we sit by the bonfire or out on the front deck we protect ourselves from mosquito bites by lighting citronella candles, tikki torches and using copious amounts of bug spray. But have you ever thought about protecting your hearing while you participate in all the fun summer activities? Some summertime activities can unknowingly cause damage to our hearing.

•  Outdoor Concerts
Summer is a great time to attend a music festival or outdoor concert. You may be less likely to think about hearing protection at these types of venues when you should really be thinking just the opposite. At 85 decibels (or dB) hearing protection is recommended, while most concerts exceed 100 dB!

We recommend choosing lawn seats or sitting away from the speakers. Use a pair of disposable ear plugs or invest in a pair of reusable EARASERS. EARASERS are nearly invisible and filter out loud noises while allowing you to hear at a safe dB level and can be purchased at AVA Hearing Center.

•  Motorcycles, Speedboats and Convertibles…Oh my!
Motorcycles, speedboats and cars like convertibles can have loud engines there is no doubt about it but did you know that wind noise from riding at high speeds can also cause hearing loss? Riding a motorcycle without a helmet at 65 mph can produce noise levels in excess on 103dB, that’s louder than a chainsaw or lawnmower! At this level of sound, permanent hearing loss can occur after just 15 minutes. Take your convertible for a spin but keep the windows up to avoid hearing damage and a pair of disposable ear plugs would be a great choice for hearing protection on the water in the speedboat. State laws vary but noise filtering earplugs that allow the wearer to hear road noises, such as EARASERS, would be a great choice for when riding a motorcycle or in a convertible.

•  Target Shooting
Warm weather and target practice go hand in hand for those who enjoy the sport. A single shot from a firearm can cause immediate and irreversible damage to your hearing with a noise level of 140 dB. Even small caliber can result in 120 dB when fired. Earplugs should always be worn when shooting a firearm, double the protection if possible by wearing earmuffs as well as earplugs.

•  Fireworks
There are many reason to celebrate in the summer- Memorial Day, the 4th of July, Labor Day and what better way to celebrate than with a display of fireworks. Enjoy the celebration responsibly with ear protection for yourself and your family. Most fireworks can have a sounds of 125 dB or more. The sound level can be unsafe for babies and small children, ear plugs work well for older children but you’ll want to look for light weight earmuffs for babies and toddlers.

•  Baseball Games
Baseball is almost synonymous with warm weather... Hot dogs, peanuts, the crack of the bat and the roaring of the crowd. But did you know that sports stadiums are louder than ever these days. In attempts to create a more exciting atmosphere stadiums are turning up the volume on the speakers, blasting music in between innings, celebrating home runs and game winning plays with fireworks. This causes your average baseball game to reach 94 dB and as much as 114 dB. 30 minutes is the max exposure time before hearing loss occurs at this level. Reduce your risk by wearing ear plugs and make sure children are also protected by providing them with ear muffs as mentioned above.

•  Yard Work
Good landscaping is always so nice but it’s not worth losing your hearing over. 85 dB is the beginning of OSHA regulations, when hearing protection should be used. While most lawn grooming equipment measures 80-105 dB. Generally speaking, electric tools are quieter than gas powered. Properly maintaining your equipment can also help reduce noise levels. Either way, hearing protection should be worn at all times when operating equipment such as chainsaws, lawnmowers, leaf blowers and hedge trimmers.

•  Air Shows
The National Cherry Festival in Traverse City, Michigan hosts a wonderful air show if you ever have the opportunity to attend. You can feel the vibrations in your entire body as the jets zoom by overhead performing their aerial stunts. But the proximity of the action can be dangerous to your hearing and your children’s hearing. You would most likely bring sunscreen, a hat, sunglasses and bottled water with you to the air show, so remember to bring ear protection as well.

Go outside, soak up the sun and take advantage of all the fun that summer has to offer but don’t forget to protect your hearing also. You certainly won’t regret it later. If you don’t think you are hearing as well as you could be, have ringing or buzzing in your ears then give us a call at AVA Hearing Center (616) 365-1979.

Packer, Lisa. “Top 10 Summer Activities That Are Dangerous to Your Hearing.” Healthyhearing.com, Healthy Hearing, 2 June 2016, www.healthyhearing.com/report/52654-Top-10-summer-activities-that-are-dangerous-to-your-hearing.

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May is National Better Hearing Month

This is a dedicated time to bring attention to hearing loss and hearing loss prevention. Hearing loss is very common. It is also non-age discriminating affecting 5% of the world’s children (0-14 years of age). Hearing loss affects 1 out of 6 Americans between ages 18-64 and 1 out of 3 adults aged 65+. Many of these hearing losses could have been prevented by using ear protection and limiting exposure to hazardous noise levels.

The World Health Organization identifies Hearing Loss a major health crisis estimating that by 2030 there will be over 630 million people with disabling hearing loss and by 2050 that number will increase to 900 million globally.

Untreated Hearing Loss not only causes mental and physical decline, it also costs over 750 Billion US dollars annually for increased health costs (for treatment of depression, anxiety, mental decline, and loss of independence), increased education costs (classroom and staff resources) and reduced employment revenue (loss of productivity, unemployment and reduced wages).

Despite these devastating numbers only 25% of people who could benefit from hearing aids have actually worn hearing aids. There are a lot of reasons for this:

1. Hearing loss is so gradual people don’t realize that their hearing has changed and they change their behavior to accommodate their hearing loss, like avoiding social situations or turning the television volume up.

In fact: Family, friends and loved ones usually identify hearing loss sooner than the HL sufferer. They may see changes in behavior, are often asked to repeat, recognize the TV volume is going up. They may be frustrated with having to interpret conversation or being accused of mumbling. Hearing loss does not go unnoticed. It is difficult to start the conversation about hearing loss but it never hurts to begin with “I care about you and I want what is best your health and well-being”.

2. Many people suspect they have hearing loss but are unwilling to have a test because they are embarrassed. They somehow feel that hearing loss is a failure or a weakness. Others feel that hearing loss is a sign of aging. They may feel betrayed by their own bodies.

In Fact: Hearing loss is not age discriminating and due to noisy activities and noise exposure from insert ear buds there is a whole generation of kids with hearing loss at a young age. Hearing loss does become more prevalent as we age but so does our loss of vision, our finger dexterity, our sense of touch and taste. Baseline hearing testing should be done at age 50 and checked every 1-2 years to monitor the progression of loss in order to have early intervention to reduce the side effects of hearing loss.

3. Even when a person is willing to have their hearing loss identified they believe hearing aids are too expensive or too inconvenient to wear.

In Fact: there are many options for hearing aid assistance, financing and low cost amplification options. There are community grant programs and national foundations that can provide hearing aids at little to no cost for those who qualify. Your audiologist should work with you to provide options.

4. Some people have gone so far as to getting hearing aids only to return them after a short time stating that they just didn’t work for them – especially in noise.

In Fact: Hearing aids aren’t an instant FIX for hearing loss. The ear needs to hear sound but the brain has to interpret that signal. This takes practice. Many people wait TOO LONG before getting hearing aids. This means that their brains have actually “forgotten” how to use the auditory signal. It takes practice, adjustments and most of all, CONSISTENT USE to train the brain to process information better, faster and ignore the sounds that aren’t important – like background noise.

These are all common excuses used to avoid treatment but in reality these excuses can cause long term, irreparable declines. Waiting too long to restore hearing sensitivity can also make it much more difficult to acclimate to hearing aid use. Don’t wait.

Be aware of your hearing levels. Get a baseline test at age 50 and have your hearing checked every 1-2 years. PROTECT YOUR HEARING by using ear plugs, muffs or both. Know which medications may cause further hearing loss and work with your physician and audiologist to monitor and protect your hearing.

If you get hearing aids – give yourself time to LEARN how to listen again. It will take consistent use, practice and time to acclimate to normal hearing again. Talk with your audiologist about good listening techniques and reasonable expectations. Most of all -Be patient with yourself.

If you have questions, service or need a baseline hearing test, give us a call. We can help.

AVA Hearing Center
5344 Plainfield Ave NE Suite 4
Grand Rapids MI 49525

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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-

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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.

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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

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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.

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.

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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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

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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 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

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