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.


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.