COVID Brings Hearing Consequences

In an unfortunate, but perhaps not a surprising turn of events, it appears that COVID-19 is amplifying, as it were, hearing issues for many.

Recent articles in medical publications are beginning to chronicle the rise in tinnitus that some are experiencing in the age of COVID — and not necessarily simply because they’ve gotten the disease itself.

The study “Changes in Tinnitus Experiences During the COVID-19 Pandemic” appeared in Frontiers in Public Health. It summarizes a study of over 3,000 that focused on those who already suffered from the condition, known to many as simply a constant ringing-in-the-ears (though other sounds can also plague people).

“Having COVID-19 symptoms exacerbated tinnitus in 40% of respondents, made no change in 54%, and improved tinnitus in 6%,” states the article. “Other mediating factors such as the social and emotional consequences of the pandemic made pre-existing tinnitus more bothersome for 32% of the respondents.”

A host of consequences from COVID were listed in the report’s findings as perhaps contributing to the rising rate of tinnitus, including poor sleep patterns, the inability to exercise regularly, loneliness, depression, anxiety, and economic stress.

In contrast, a study in the Ear, Nose & Throat Journal entitled simply “COVID-19 and Tinnitus” discusses “… the first reported case of hearing loss and tinnitus in a COVID-19 patient, in the State of Qatar, and this case report strives to contribute to the ocean of literature highlighting the need for otorhinolaryngologists [nose and sinus specialists] to be aware of its correlation with COVID-19 virus.”

The study’s conclusion argues, “…this case report highlights the importance of detailed audiological diagnostics in COVID-19 patients who experience isolated tinnitus and hearing loss.”

These are sadly probably not the last studies regarding hearing loss, tinnitus, and COVID.

What Apps Can Do For You

It’s more and more a truism today: “There’s an app for that.”

And the wonderful world of apps — what a few years ago were called programs that ran on computers, before smartphones became computers people carry in their pockets — has expanded to include your hearing aid (whether you know it or not).

Back in the days when dinosaurs roamed the earth, adjusting a hearing aid meant fumbling with small knobs and buttons, trying to get the thing to perform in the way it was intended (without knocking it out of your ear in the process).

But today’s hearings aids — which like smartphones are as much computer as a sound-amplifying device — incorporate the ability to communicate wirelessly with other devices (like that smartphone, or a laptop, tablet, or desktop workstation).

Much like refrigerators, ovens, washing machines, doorbells, and vehicles are now woven together with the Internet of Things (IoT), hearing aids can become a part of a matrix of communication that can not only include your own devices but also those of your hearing health specialists and hearing aid manufacturer. Data can be collected and shared that, ultimately, can be used to increase the performance of the machine that you’re depending on to hear.

Using the Bluetooth communication conduit, apps can be the tool to:

  • Make straightforward adjustments to volume and sound quality settings.
  • Create sound models for specific environments that are challenging — whether a workplace, a favorite restaurant, or any regularly visited site — that can be activated when returning to that space.
  • Check on the hearing aid’s specs, including how much juice is left in the battery.
  • Connect with devices to patch streaming music, television audio, or phone calls directly into your hearing aid.
  • Using “if this, then that” tech (IFTTT) to link tasks together. For example, turning off your hearing aid at night can turn any lights downstairs off that were left on.

Yup, there’s an app for that.

How Long Will Your Hearing Aid Last?

If you recently purchased a hearing aid — especially if you paid for it out-of-pocket — then you’re probably pretty motivated to keep it going as long as you can.

Luckily, that’s mostly up to you. There are some things out of your control but there are plenty of things you can do extend the life of this small device that would amaze a computer engineer transported to the here-and-now from the 1950s.

You should expect to get at least three years out of a modern hearing aid. But you could get a decade too, depending on luck and good judgment.

First, what you can’t control. The fact is some people sweat more than others, or produce more earwax, or have oily skin. Or the trifecta. All of these things do nothing good for a hearing aid, so it’s possible you might have drawn the short straw when it comes to hearing aid longevity. Also, certain environments more prone to dusty and/or humid conditions can be a problem as well.

But, taking good short- and long-term care of your investment can better your odds.

Cleaning a hearing aid daily is a great first step. There are kits available that allow you to get rid of debris that will, eventually, muck up the works of any hearing aid.

Storage is also a key factor. An overnight dehumidifier case will not only protect you from knocking it onto the floor when reaching for the alarm clock in the morning, but will also remove moisture and do wonders for its life expectancy.

And once or twice a year it’s paramount to bring it into the shop and let your hearing health provider give the unit the once over, doing a deep clean while replacing any parts that are showing signs of wear and tear.

Like any investment, a hearing aid demands some preventive maintenance to allow it to reach its maximum potential.

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.

 

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.

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.

Alcohol and Hearing Function

The negative effects of drinking too much are pretty well advertised. Less obvious is that drinking too much over both the short-term and long-term can also cause hearing issues.

Believe it or not, too much alcohol in the bloodstream can cause stress on the tiny hairs inside the ears that send electronic signals to the brain. One of the reasons hearing loss is common in many older people is because these hairs stop regenerating. And alcohol can cause the same kind of damage.

On the other hand, this one is not so hard to believe — alcohol affects the brain. This includes the auditory cortex, where the sound transmitted from the ears is processed. Long-term drinking can shrink the auditory cortex.

Temporary or permanent tinnitus — an incessant ringing in the ears — can also result from alcohol consumption. This is due to the increased blood flow that drinking causes, which throws the inner ear mechanism awry. And since that blood is full of alcohol, the fluid within the ear that is an important part of its functioning is infused with alcohol. This has a number of repercussions, including altering one’s sense of balance — which is why the room starts to spin and “falling down drunk” is a thing.

And there’s a term for getting oblivious about how loud an environment is. It’s called “cocktail deafness.” Getting drunk at a concert or in a loud bar can result in basically forgetting to process how loud it really is. This leads to one of the worst things for hearing health — prolonged exposure to high-decibel sound that can do permanent damage.

Hearing health, another reason to be mindful of your alcohol consumption.

A Not Subtle Hearing Issue

Though rare, sudden hearing loss (SHL) is not unknown. And though the medical community does not fully understand the phenomena, any abrupt cessation of hearing in an ear is cause to seek urgent medical attention.

SHL can be temporary or permanent. Only time will tell. It can also affect one or both ears. Early intervention is key.

The cause of SHL is not clearly understood but there are a number of factors believed to be at play, either singly or in combination. These include the delayed effects of ear infections or spinal injuries; issues stemming from chronic blood circulation problems like obesity, blood clots, arteriosclerosis, and diabetes; and bouts of stress that curtail blood flow.

The “sudden” part of SHL is meaningful. Oftentimes hearing loss is clearly related to disease — meningitis, mumps, or chickenpox for example — or exposure to high-decibel sound that directly damages the inner ear. SHL happens suddenly, with no clear cause or even an earache of any kind.

A bout of tinnitus — an unremitting ringing sound that is heard but not produced by anything in the hearer’s environment — does sometimes happen as part of a SHL event. Fluctuating pressure in the ear and numbness also are accompanying symptoms.

As a first step, medical care providers will deliver treatment that produces better blood circulation to the head, since this sometimes clears up the problem. If this isn’t successful, then further testing will be required. An ear microscopy and/or MRI can find evidence of the underlying issue that has caused the SHL.

The key is to seek immediate medical care. SHL is a medical crisis and can be a sign of other underlying medical issues. Don’t wait for it to “clear up” on its own.