Coping With Videoconferencing

We’ve all had to become accustomed to new things this year. Social distancing, masks, and curbside pickup. And then there’s video-conference life. Who knew what a Zoom meeting was a year ago?

For anyone with hearing issues, that has been a challenge. The basic fact is that it’s easier to deal with one’s loss of hearing in person, since visual communication during conversation — often picked up subconsciously — can help alleviate the loss of auditory information. Lip reading and body-language cues matter.

And truth is, a videoconference can become a visual and sound free-for-all.

Here are some tips to better manage pandemic communication norms:

  • Set up in a room away from any sources of noise and, if Internet speed is an issue in your location, make sure you have priority during your meeting.
  • Headphones or earbuds — or a Bluetooth connection to your hearing aid — may really improve your experience.
  • Do whatever you can to ensure that everyone in the meeting is on video and not opting for audio-only connectivity, which will make things much harder on you.
  • Ask to start with introductions before diving into the meeting so audio adjustments can be made and you can familiarize yourself with who’s who.
  • If it’s not a casual get together, then work off of an agenda so everyone can be on the same “page” and you can concentrate on listening.
  • Taking clear turns to speak will help everyone.
  • Use the tech and record the meeting — this way you can go back and make sure you got the information you needed.

And don’t expect everything to be perfect. Most people without hearing issues find videoconferencing less than ideal.

Classifying Hearing Loss

As with any scientific discipline, at a basic level audiology is founded on categorization. Observing phenomena, then organizing that reality so as to make the complex more understandable, is the core of the scientific method.

The fact that October is National Audiology Awareness Month is a good time to review how hearing conditions are broken down into four comprehensive categories —conductive, sensorineural, auditory processing, and mixed.

When seeing a new patient, one of the first things an audiologist will do is attempt to pinpoint the exact type of hearing loss the person is suffering from:

  • Conductive Hearing Loss — In many ways the simplest type, this is a situation in which something is blocking or intruding into the physical structure of the ear canal and/or its components. It could be earwax, swollen tissue, fluid from an infection, a tumor or fibrous dysplasia (abnormal bone growth), or a tear of the eardrum.
  • Sensorineural Hearing Loss — This is when the normal communication channel between the ear and the brain is damaged, degraded, or flawed. This occurs in the inner ear when either cochlea or vestibulocochlear nerve fail for any reason.
  • Auditory Processing Disorder — Hearing loss that is not because of anything happening — or not happening — in the ear. It’s when the brain fails to process the information it is receiving — or at least process it within the range of what is considered “normal.” People with such issues usually hear sounds, just not the same ones that the vast majority of people do. It is a condition with striking similarities to dyslexia.
  • Mixed Hearing Loss — As the name implies, when some combination of the above come into play simultaneously. Figuring out what’s happening is even harder when more than one thing is happening.

When working with a hearing health professional, this is the framework he/she will have in the back of their mind while trying to help you.

Allergies Can Wreak Havoc

With the change of season — even though COVID can make it seem like it’s been March forever — another allergy season upon us. Although the physical response to these annual transition periods is usually marked by respiratory issues, allergies can also adversely affect your hearing.

An allergic reaction is basically your body’s immune system overreacting. During allergy season, your body gets kind of overdramatic about pollen and other irritants (heating systems that have gotten dusty over the summer are another instigator) and acts like it’s under attack. Countermeasures are released. This usually results in swelling and the buildup of fluids.

And all of that can happen in your ears.

The proper functioning of the ear is founded on a number of things — an unobstructed ear canal and consistent air pressure around the eardrum are two of those things. Congestion, phlegm, and inflammation can wreak havoc with normal operating procedures in the ear.

This is especially true when the Eustachian tubes — which do the work of regulating air pressure and providing a path for fluid outflow by connecting the middle ear and the throat — get clogged up by those countermeasures that your body has unleashed.

Allergies can also, in many cases, cause the body to crank up the production of earwax, since it is actually part of the ear’s defense mechanism. It’s produced in the outer ear to guard the inner ear against debris.

All of this gets in the way of hearing.

Luckily, treating an allergic outbreak with over-the-counter medications usually reduces symptoms — including hearing loss or ringing in the ears. More severe reactions may require prescription medications and, if hearing issues linger for more than a week, then visiting your hearing health professional is a good idea.

 

The Ins and Out of Ear Infections

There are three types of ear infections that can wreak havoc not only with hearing but also with balance and overall health. Though more common in children, they can also happen to adults —often with harsher symptoms that indicate serious underlying conditions.

Types of ear infections are broken down to correlate with the structure of the ear. They are grouped as inner, middle, and outer ear infections.

  • Inner Ear Infections: Symptoms are pain in the ear, dizziness, nausea, and vomiting. Obviously, serious stuff that can indicate something as severe as meningitis.
  • Middle Ear Infections: The medical term is otitis media and it is a situation where fluid becomes lodged behind the eardrum, which can degrade the ability to hear. The ear feels clogged and fluid may drain from it. Fever sometimes occurs. Usually the byproduct of a respiratory infection that migrates into the ear via the Eustachian tubes (which run from the back of your nose and throat to the ears and are crucial to maintaining equalized air pressure and balance).
  • Outer ear infections: Often caused by bacterial infections like swimmer’s ear and known medically as otitis externa. Itchiness in the ear is usually the first sign, followed by tenderness and swelling. Excess moisture in the ear — along with existing skin abrasions in the ear canal — are the culprits leading to such infections. Keep ears dry and don’t clean them in such a way that skin can be scratched — which gives bacteria a growth environment.

Ear infections usually come and go, annoying but not life-altering. But if symptoms linger for a few days and you have a fever, then consulting a healthcare professional is advisable — especially if your hearing changes and/or there is fluid drainage occurring.

The Fine Art of Mask Wearing

The news regarding COVID-19 is not good. There’s renewed emphasis on the need for people to wear masks when out of their house.

This presents some challenges to anyone who uses a hearing aid.

Everyone “lip-reads” when speaking with someone else. The use of visual cues when conversing is so ingrained that we don’t even realize we do it. Body English is really a thing. But people wearing masks and talking will notice how strange it is to not see the speaker’s face. If you’re hearing-impaired, the loss of this information is even more challenging.

The only way to compensate is for people to speak slower and more clearly. Letting them know how challenging this all is with a hearing aid will help them do their best to communicate. Avoiding situations with a lot of background noise will help too.

And wearing a mask with elastic ear loops and a hearing aid can be a mess and take some getting used to — especially if eyeglasses are involved too. That’s just a traffic pile up at the ears.

One strategy is to use masks with tie strings instead. Less material in the ear area and no loop to catch hold of a hearing aid when being removed.

There are also mask holders that are popular with medical personal. They provide a way to connect the elastic ear loops behind your head. Something similar can be rigged up with plastic S-hooks or even large paperclips.

What’s clear is that there is a renewed push to make mask-wearing common and universal. Unfortunately, COVID-19 is not going away anytime soon.

Hearing: A Core Aspect of Sociability

If the past few months have brought any issue to the forefront, it’s the concept of social connectedness. As our ability to get together and socialize — to undertake the rituals of the every day — has been restricted, it’s become ever more apparent what social animals we are.

And for the vast majority of humans, hearing is a crucial part of that equation. This isn’t news to researchers and, for that matter, people who have struggled not fully participating in conversations due to hearing loss issues.

Studying this fact — especially as it relates to aging — has been a significant part of the work of Barbara E. Weinstein, who is a professor of audiology at the Graduate Center CUNY and an adjunct professor at the New York University Langone Medical Center. She is the author of the textbook Geriatric Audiology, published in 2012.

As part of her research, she developed the Hearing Handicap Inventory for the Elderly, now an industry-standard diagnostic tool.

In a recent interview, Weinstein goes in-depth about her life’s work. When she began, things were different (and not just technologically).

“It was a time when audiologists were just starting to dispense hearing aids. Theoretically, the early 80s wasn’t that early in the profession, but just, people were not focused on the person, they were focused on the new and emerging technology!” she explains. “After developing the Hearing Handicap Inventory, every single study in which I was engaged, was to get people to buy into the importance of the patient and how our interventions can improve the lives of older adults with hearing loss.”

That work that has culminated in today’s audiological philosophy, with the importance of hearing health to people’s overall health fully realized.

“Physicians know that isolation/loneliness is a bad thing, and that loneliness has negative effects on morbidity and mortality,” says Weinstein. “If they recognize that age-related hearing loss is a potentially modifiable risk factor for social isolation/loneliness and that we can make a difference in people’s lives by intervening with hearing aids, I think that’s the whole goal and that is the way to increase referrals to optimize hearing health and overall well-being.”

The full interview can be found at the Audiology Blog of the hearing aid maker Phonak.

That Was Then, This Is Now

A few weeks ago, Better Hearing and Speech Month — annually recognized each May to heighten hearing-related issues — was to focus on “Communication at Work.” Seemed like a worthy and simple enough topic.

But that was then.

On April 30, the president of the American Speech-Language-Hearing Association (ASHA) announced that the month would instead be marked by outreach on a wide variety of hearing issues. This is a recognition that people — both hearing health customers and their healthcare providers —are now dealing with a wide variety of unexpected issues during the COVID-19 pandemic.

Over the month several topics will be explored by ASHA via updates at the organization’s website.

These include “Early Intervention and COVID-19: Advice for Parents of Children Whose Services Are Interrupted,” “Helping Children With Language Disorders Maintain Social Connection While at Home,” “Zoom Meetings and Stuttering: Tips to Make Virtual Interactions More Successful,” and “Augmentative and Alternative Communication and COVID-19: Enabling Communication for Acute Care Patients.”

First established in 1927 by ASHA and today fully supported by the federal National Institute on Deafness and Other Communication Disorders (NIDCD) — which is part of the National Institutes of Health (NIH) — Better Hearing and Speech Month is meant to highlight hearing health issues.

But there’s only one overriding health issue this year.

“Our goal is to champion every person’s ability to communicate, including at this difficult time,” said ASHA President Theresa H. Rodgers when announcing the change.

From hearing loss research being disrupted to audiologists from coast-to-coast having to alter their visitation policies, COVID-19 is severely impacting not just individuals but an entire industry.

Hearing Aids Weren’t Always So Easy

Today, hearing aids are the embodiment of Moore’s Law. That was a predictive observation made in the 1960s that the number of transistors a microchip could contain would double every couple of years, which would lead to generation after generation of smaller yet more powerful computers.

This is why, as far as computer processing goes, a contemporary hearing aid does what a computer that would have taken up a couple of suitcases did in the 1950s.

But hearing aids didn’t always require computer technology.

The first ones were basically just horns — first those of animals, then customized from brass like a trumpet — with the narrow end held in the ear while the wide end cast a wider net for sound waves. So it was for centuries.

But when the telephone was invented it didn’t take long to adapt it to the hard-of-hearing. The basic premise of the telephone — electrical currents taking sound from a transmitter on one end to a receiver on the other, with an amplifier to boost volume — is the foundation of all modern hearing aids.

But some hardy souls had to literally do the “heavy lifting” in the early days to pave the way for today’s models, which are so small that users can forget they’re even using one.

The first widely available hearing aid — the Vactuphone made by the Western Electric Company — hit the market in 1921. It sold for the equivalent of $1,500 today and was … the size of a suitcase. And really too heavy to take out of the house.

It wasn’t until the invention of the transistor in 1948 that hearing aids easily integrated into everyday life became possible. Slowly but surely they became both better and smaller — though it wasn’t until the digital age that in-the-ear hearing aids with superb performance and interconnectivity with a wide range of other wireless devices became a reality.

Six Ways Hearing Can Be Lost

Hearing loss can happen for any number of reasons, though some things are far more likely to cause it than others. Here are the top six triggers for diminished hearing.

  1. Just Getting Older
    If you’re lucky and wait long enough, it’ll probably happen to you. The inner ear is a marvel, with lots of tiny moving parts that do what they do every day of your life. Eventually, parts start to wear out.
  2. Can’t Fight Genetics
    Speaking of marvels, all the genetic information that goes into a human being is astounding. A gram of human DNA holds about a zettabyte — that’s 10 to the 21st power (basically, a lot of zeroes) — of data. Sometimes some of it gets garbled, making genetic predisposition the second most prominent driver of hearing loss.
  3. Issues At Birth
    Birth issues such as maternal diabetes, neonatal jaundice, and premature delivery can cause hearing problems that are permanent.
  4. As Do Infections
    Most ear infections cause only temporary hearing loss, but severe ones can create enduring issues. Take ear infections seriously.
  5. There Are Bones In There
    A dislocated shoulder from a sports injury is not out of the ordinary. Unfortunately, that kind of hard contact can do the same to the tiny bones in the ear. Nerve damage can also result from a hard blow to the head. Concussion protocol includes tracking any potential hearing issues.
  6. Loudness Is The Enemy
    The most likely way to damage ears for most people is exposure to excessive sound. This can be extreme sound like a noisy work environment or not using ear protection when firing a gun. Or loud concerts. Or earbuds or headphones with the volume turned up too high. This is the easiest culprit for people to control.

There’s nothing you can do — other than to manage the problem with hearing aids —about several items on this list. But not number six. Take care of your ears when you can.

Tinnitus: Here Today, Maybe Here Tomorrow

If it becomes persistent, tinnitus can truly become one of life’s not so little annoyances.


There are some strategies for dealing with it—but no known permanent cure. It’s a perplexing syndrome that isn’t fully understood and, unfortunately, not as rare as one would hope. It is generally understood to be the manifestation of underlying damage to the auditory system, usually due to aging or exposure to excessive noise.


Simply put, tinnitus is the hearing of sound that’s not really “there.” There’s no doubt that those dealing with the condition hear “it,” but what they’re hearing is not a sound that’s coming from outside of their bodies. It’s coming from inside the hearer — and they can’t make the sound go away.
The American Tinnitus Association states on its webpage that it “can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music.”


Studies show that well over 10 percent of Americans experience it at some point, though luckily in many cases it’s only temporary.


If one is not so lucky, then ways to manage it include shunning silent environments (since whatever sound is being heard is harder to ignore), protecting ears from loudness (which can make matters worse), and practicing relaxation techniques (to lessen the stress that can be caused by tinnitus). Some people have also found that certain foods or activities will consistently worsen the situation or bring on a new bout.


If a sound of unknown origin becomes persistent and bothersome, then visiting a hearing health professional is the first step to managing the situation.