Hearing Loss For Dummies

Frank R. Lin, MD, PhD, is the Director of the Cochlear Center for Hearing and Public Health.Nicholas S. Reed, AuD, is a clinical audiologist and an assistant professor at Johns Hopkins University.

• Introduction 1About This Book 2Foolish Assumptions 2Icons Used in This Book 3Beyond the Book 4Where to Go from Here 4Part 1: Understanding Hearing Loss 5Chapter 1: Cheers to Your Ears! 7Understanding Why Hearing Loss Happens 8Hearing takes place over two steps 8Hearing loss happens as the inner ear wears out 8Factors that affect your hearing over time 9Putting Hearing Loss in Context 10Hearing loss happens to everyone 10How hearing loss impacts our health and well-being 10The benefits of addressing hearing loss 12What You Can Do about Hearing Loss 12Know your hearing 12Using communication strategies 14Hearing technologies 15Getting the Support You Need 17Chapter 2: Understanding How Hearing Works 19What Is Sound? 20How sound gets its sound 20What sound “looks” like 21To Hear, You Need Your Ear! 23External ear 24Middle ear 24Inner ear 25Hearing with Your Brain 26Two ears are better than one 27It’s not just sound — “seeing” what you hear 28Context matters 28Pinpointing Where the System Can Break Down 29When sound quality is poor 29When the sound can’t get in 29When the inner ear garbles the encoding of sound 30When the brain struggles to process sound 31Experiencing Trouble Hearing 31Chapter 3: Looking at Types of Hearing Loss and Minimizing Risk 33Discovering Why Hearing Gets Worse Over Time 34Knowing the Causes of Hearing Loss Over Time 34Biological aging processes 35Cardiovascular risk factors 35Genetics 36Minimizing Your Risk for Hearing Loss 37Noise exposure 37Keeping your ear heart-healthy 40Considering Other Conditions That Affect Hearing 41The almighty ear infection 41Earwax — ick! 43Diseases of the ear 45Medications 45Causing Tinnitus 46Tinnitus explained 46Tinnitus triggers 47Chapter 4: Realizing What You Lose When You Can’t Hear 49Communicating Is Like a Game of Catch 49Hearing loss affects how well you can play catch 50Why playing catch is sometimes easier or harder 50Communication and hearing loss in critical situations 51Watching for a Reduction in Social Interaction 53Monitoring Mental and Emotional Health 53What is loneliness? 54How loneliness hurts your health 54Looking at hearing loss and loneliness 55Losing Physical Abilities 55How hearing affects your physical abilities 55How hearing affects your balance 56Dealing with a Decline in Cognitive Function 57What are cognition and dementia? 57Hearing loss and dementia — say what? 58Hearing aids to prevent dementia? 59Part 2: Evaluating How You Hear 61Chapter 5: Recognizing Hearing Loss 63Missing the Signs of Hearing Loss 64Barely noticeable changes 64Everyone else is mumbling! 64Compensating until you can’t 64Don’t know what you’re missing 65Sussing Out Whether Your Hearing Has Declined 65Knowing When to Get Your Hearing Tested 66Screening, testing, and diagnostics 67Establishing a baseline 67Getting regular hearing checkups 69Knowing when you should get tested immediately 69Shrugging Off the Stigma of Hearing Loss 70Caring about your hearing above what other people think 71It’s okay to wear hearing aids 71The stigma is fading 72Chapter 6: Seeing a Hearing Loss Professional and Getting Tested 75Getting to Know the Hearing Care Team 76Audiologist: Assessing and addressing hearing loss 76Otolaryngologist: Comprehensive medical care for the ear 77Hearing instrument specialist: Focusing on the hearing aid 78The most important team member: You! 78Preparing for the Assessment 78It all starts with history 79To know the ear is to see the ear 80Knowing What to Expect during the First Part of the Diagnostic Hearing Test 80Picking up on pure-tones: “Listen for the beeps” 81Testing your hearing with air and bone conduction 82Checking Out Other Hearing Assessment Measures 85Testing whether sound is getting to the middle and inner ears 85Measuring your speech understanding 86Evaluating how the brain reacts to sound 88Testing when sound is clear but difficult to understand 89One and Done or a Regular Occurrence? 89Chapter 7: Making Sense of Your Hearing Test Results 91Understanding the Importance of Reading Results 92Introducing the Audiogram: What Does That Graph Mean? 92Audiogram 101 93Hearing loss categories on the audiogram 94Defining Hearing Loss with the Audiogram 96The Xs and Os of hearing 96Diving into details of your hearing loss 97Using the audiogram to make sense of how hearing loss affects you 98The Hearing Number: An Easier Way to Make Sense of Your Hearing 101Where the hearing number comes from 101What the hearing number means to you 102Does my hearing number change? 102What to do with your hearing number 103How to get your hearing number 104Guiding Your Hearing Health Journey with Your Results 105Monitor changes in hearing 106Use it or lose it 106Part 3: Taking Charge of Your Hearing 107Chapter 8: Fine-Tuning Your Life to Hearing Loss 109Discovering Where Adjustments Can Be Made 110Finding No-Tech Communication Strategies for Everyday Situations 110Get close 110Be face-to-face 111Summarize and repeat (“Huhs” don’t help!) 111Optimizing Your Listening Environment 112Turn down any background sounds 112Avoid reverberation 113Pick the right restaurants 113Using Everyday Technology Strategies 115Closed captioning 115Voice over internet protocol (VOIP) calls and videocalls 116Speaking Up for Yourself 117Ways to identify that you’re having trouble hearing 118Giving the speaker a solution 118Practicing self-advocacy 119Reading about others with hearing loss 120Seeking Out Support Groups 120Chapter 9: Looking at How Hearing Aids Work 123Understanding Hearing Aids 123The anatomy of a hearing aid: How hearing aids work 124Hearing aids don’t make all sounds louder 125Enhancing clarity of sound with hearing aids 126Checking Out the Different Styles of Hearing Aids 128Behind-the-ear 128In-the-ear 132Weighing the pros and cons of hearing aid styles 133Chapter 10: Understanding Your Hearing Aid Options 135Discovering Where to Start for Your Needs 136Knowing Two Ears Means Two Hearing Aids 136Is using only one hearing aid harmful? 137The exception to the rule 137Choosing a Prescription Hearing Aid 138Working with a professional to purchase hearing aids 138Customizing your hearing aids with a professional 140Navigating the Over-the-Counter Hearing Aid Pathway 143The basics of OTC hearing aids 143Deciding where to buy your OTC hearing aid 146How to choose from too many options 147When to seek professional assistance with OTC hearing aids 148Choosing Basic or Premium Hearing Aids 149Chapter 11: You’ve Got Hearing Aids: Now What? 151Setting Expectations Is Key 151Getting Used to Your Hearing Aids 153Practice makes perfect 153Activities to get used to hearing aids 154Trust the process 156Adjusting and Manipulating Your Hearing Aids 156Working with batteries 157Putting hearing aids in your ears 158Changing the sound of hearing aids 159Caring for and Maintaining Your Hearing Aids 160Establishing a maintenance routine 160Avoiding situations that are bad for your hearing aids 163Troubleshooting common problems with hearing aids 164Knowing When It’s Time to Upgrade Your Hearing Aid to a New Generation 165Chapter 12: Technology That Boosts Hearing and Hearing Aids 167Captioning Your Life 168Using captions on TV 168Obtaining and using captioned phones (They’re free!) 168Captioning in video conference calls 169CART for live sessions 169Outfitting Your Home with Hearing-Friendly Tech 170Talking about Integration Technology 171Working with Bluetooth and hearing aids 171Navigating smartphone apps 172Checking Out Hearing Aid Accessories 172Using a remote control 173Trying out a remote microphone 173Connecting to the TV 175Streaming all your devices 177The Mighty Telecoil: Getting a Direct Connection to Sound Signals 178Looping in telecoils in public spaces 178Telecoils and telephones 180Telecoil with FM and infrared systems 180Has Bluetooth replaced telecoils? (No!) 181Sounding Out Personal Amplifiers 182Demystifying PSAPs versus hearing aids 182The reality of using PSAPs 183Navigating the unregulated amplifier marketplace 183Will OTC hearing aids replace PSAPs? 184Chapter 13: Medical and Surgical Treatment ofHearing Loss 185Looking into Medications That Treat Hearing Loss 186Using steroids for sudden hearing loss 186Taking medications for problems with the external or middle ear 187Checking Out Different Surgeries for Hearing Loss 188Surgeries for conductive hearing loss 188Surgery for sensorineural hearing loss 189Other surgically implantable hearing devices 192Part 4: Supporting Hearing Needs 195Chapter 14: Helping Those with Hearing Loss 197Noting How Hearing Loss Influences Relationships 198Understanding Hearing Loss from the Other Side 198Emotions that often accompany hearing loss 199Realizing hearing aids don’t cure hearing loss 199Discovering How to Be a Good Communication Partner 200Move close and speak face-to-face 201Repeat and reword 201Speak slowly and clearly 201Get your partner’s attention before speaking 202Choose the right environments for conversations 202Using technologies to help communication 202Figuring Out Hearing and Communication Needs 203Noticing non-verbal cues 203Using the hearing number as a guide 204Supporting People on Their Hearing Care Journey 204Chapter 15: Paying for Hearing Care 207Paying for Hearing Services 207Hearing testing 208Medical and surgical evaluation 208Hearing rehabilitative support services 208Breaking Down Hearing Aid Costs 210Weighing out-of-pocket-options 211Checking on insurance coverage options for hearing aids 212Looking to the future: Over-the-counter hearing aids 215Tapping into Veterans Administration benefits 216Seeking charitable foundations 216Using health savings and flexible spending accounts 216Chapter 16: Your Rights as Someone with Hearing Loss 217Looking into Disability and Hearing Loss 218How do you define disability? 218How to follow a social model of disability 218Understanding the Role of the Americans with Disabilities Act 220Discouraging disability discrimination in the workplace 220Accessibility and accommodations in public 220Focusing on telephones and television 221Navigating the Social Security Administration Disability Benefits 221Determining hearing loss for Social Security disability benefits 222Considering Claims for SSDI 224Looking at Supplemental Security Income 225Initiating a claim 225Advocating to Advance Your Hearing Rights 225Advocating for change 225Improving organization policy 226Part 5: The Part of Tens 227Chapter 17: Ten (Plus One) Considerations When Purchasing Hearing Aids 229Paying More Does Not Guarantee Better Outcomes 230Selecting from the Many Styles 230Choosing a Brand 232Seeking Hearing Aids with Telecoils 233Powering Your Hearing Aid with Rechargeable Batteries 233Deciding on Open or Closed Fit 234Insuring Your Hearing Aids with a Trial Period Warranty 234Customizing and Supporting Your Hearing Aids 235Monitoring Health with Hearing Aids 236Accessorizing Your Hearing Aids 236Setting Expectations and Practicing 237Chapter 18: Ten Everyday Strategies to Hear Better 239Get Close and Face-to-Face 239Recognize the Hearing Needs of the People You’re Talking With 240Turn Down the Background Sounds 240Don’t Just Ask “Huh?” 241Choose Good Listening Environments 241Use Closed Captioning 241Wear Headphones When Listening to Music or Watching Media 242Use Video Calls or VOIP When Calling Others 242Customize the Hearing and Sound Features on Your Smartphone 243Know Your Hearing Number 243Chapter 19: Ten Myths about Hearing Loss 245Hearing Loss Is Just Part of Getting Older so It Can’t Be That Important 245My Hearing Is Fine; It’s Just That Everyone Is Mumbling 246Trouble Hearing? Just Have People Shout! 246I’ll Wait to Get My Hearing Tested Until I Notice a Problem 246I’ll Address My Hearing Loss Later When It Gets Really Bad 247I Have Hearing Loss Now I Need Hearing Aids? 247Hearing Aids Fix Your Hearing 248I Can Just Put in My Hearing Aids and They’ll Work Fine 248A Cochlear Implant Is Only for People Who Are Completely Deaf 249I Should Keep My Hearing Loss to Myself 249Index 251