Alert

Published on February 27, 2020

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Say What? Seven Tips for Getting in Tune with Your Hearing

Do you need to keep turning up the television volume to understand the actors? Does it seem like nearly everyone you talk to is mumbling? These may be early signs of hearing loss, and you’re not alone.

About 15 percent of American adults (37.5 million) ages 18 and over report some trouble hearing. While there are millions of adults who experience hearing loss as a child or in middle age, hearing loss is strongly associated with aging. Approximately 1 in 3 people between the ages of 65 and 74 have hearing loss, and nearly half of those older than 75 have difficulty hearing.

We talked to UNC audiologist Patricia Johnson, AuD, to learn seven things that can help prevent and mitigate hearing loss.

1. Have your hearing checked even if you don’t have trouble hearing.

Just as you have your eyes and cholesterol evaluated regularly, Dr. Johnson says it’s a good idea to have your hearing checked, even if you aren’t having any problems. This way, you have a baseline measurement.

“Hearing loss tends to be gradual over time,” Dr. Johnson says. “Before you have difficulty, having that baseline that we can compare future exams with can be really helpful. This way, when you begin to have a problem we can determine if it is a recent problem or one that has been happening for the past 10 years.”

2. Pay attention to early warning signs.

Dr. Johnson says the first warning signs of hearing loss are:

  • Needing to increase volume on everyday electronics around you such as the television and your cellphone.
  • Difficulty hearing the small “ding types of sounds” such as an elevator or your microwave.
  • Feeling as though everyone is mumbling or has unclear speech.
  • Difficulty distinguishing between high-pitch types of speech sounds such as f, th and sh.

3. See an audiologist if you’re concerned about hearing loss.

It is important to have your hearing tested by a doctor of audiology, who is a licensed hearing health care provider who specializes in the diagnosis and treatment of hearing loss and balance disorders. The testing takes place in a soundproof room called a calibrated test booth.

Once in the booth, the audiologist will ask you to listen to sounds through headphones to identify the faintest tone you can hear at different pitches. This is called an air conduction test.

Then the audiologist will conduct a speech reception test, which helps determine the faintest level at which you can understand spoken words. The audiologist will also check your ability to understand spoken words in a quiet or noisy environment by asking you to repeat words at various volume levels.

“We’re trying to determine sensitivity to sound: What’s the threshold at which you can detect a sound being present or not present, and we’re also going to test how well you’re able to understand speech,” Dr. Johnson says.

They do this because for some people, even if the sound is loud enough, there’s distortion in how the auditory system interprets speech.

Your audiologist is trying to determine the severity of the hearing loss and how much it is impacting you. “Your perceived level of disability is going to guide where we end up in terms of treatment,” Dr. Johnson says.

4. Work with an audiologist to determine what is causing your hearing loss.

Sometimes an ear infection can cause a blockage in your ear, making it hard to hear. When this happens, your primary care doctor can prescribe antibiotics to clear up the infection, which should restore your hearing.

Some people can have growths on the tiny ear bones behind their eardrums, which prevents the sound from being transmitted. These growths and other middle ear abnormalities may require medical or surgical treatment and follow-up by an ear, nose and throat (ENT) physician.

These types of hearing loss, called conductive hearing loss, make it hard for sounds to get to your inner ear. They can be treated medically or surgically and account for only 10 to 15 percent of all hearing loss.

For everybody else, hearing loss is caused by damage to the cochlea, which contains the sensory organ for hearing. This type of sensorineural hearing loss cannot be surgically or medically treated and is usually permanent. Sensorineural hearing loss is best managed by an audiologist through technology—such as hearing aids and cochlear implants.

5. Modify your surroundings to help with mild hearing loss.

Even if you have mild hearing loss, your audiologist can offer you communication strategies to help you cope. So if you’re OK hearing in most settings but just can’t hear the TV well, try adding closed captioning. There are also over-the-counter assistive devices such as Bluetooth headphones that can help.

If you have trouble hearing people when there is background noise, face them so you can focus on what they are saying better and even read their lips, Dr. Johnson says.

However, if your inability to hear is affecting your quality of life and relationships, then it may be time to get a hearing aid.

Today’s hearing aids are “small, customized mini-computers in the ear to help with hearing,” Dr. Johnson says.

6. If you need a hearing aid, get it from an expert.

A hearing aid is more than just a piece of technology to make sounds louder. It is a complex medical device, and it’s important to have a trained doctor of audiology assist you to make sure it is fitted properly and safely and meets your unique hearing needs.

Special computer software is needed to program and verify your hearing aids, and it takes time to get used to your hearing aids. During follow-up visits, your audiologist will fine-tune your hearing aid and provide you the support you need to make your hearing aids work for you. You can’t be sure that you will get this professional help if you buy your hearing aid online or at a store.

“Do you want to be a patient or do you want to be a customer?” Dr. Johnson says. “I’ve had plenty of patients spend an incredible amount of money on top-of-the-line hearing aids, but if the salespersons don’t know what they’re doing, those hearing aids can be pretty useless.”

Sometimes hearing loss is so severe that a hearing aid is not strong enough or the inability to understand speech is so profound that you need a cochlear implant, a small electronic device that electrically stimulates the cochlear nerve. It is implanted in the ear by an otologist, a surgeon who specializes in disorders of the ear, and can help restore or improve your ability to hear and understand speech.

7. Take steps to protect your hearing.

Even if you’re not experiencing a loss of hearing, there are steps you should take to protect it.

If you go to a lot of concerts or if your job or hobbies involve loud noise, such as race car driving or spectating, attending large sports events or even just mowing the lawn, you’re exposing your ears to potential damage, Dr. Johnson says.

“We’re born with a finite number of these little hair cells that respond to sound, and the louder the noise, the quicker it can cause those ear hair cells to die and not come back,” Dr. Johnson says.

If you’ve been to a loud event and you notice that your hearing is muffled or your ears are ringing, that’s a warning sign.

“It’s kind of like a sunburn where the hearing system is depressed for a short period of time,” Dr. Johnson says. “It will probably recover, but if we keep doing it over and over again, at some point, it recovers, but not all the way to full capacity. And that sneaks up on you over time.”

When you’re in a loud environment, use over-the-counter earplugs that fit properly and limit your exposure to loud sounds. Also, know that exercise and a healthy diet benefit many parts of the body, including your ears.

“Things that are good for your blood circulation,” Dr. Johnson says, “are good for your ears, too.”


If you have trouble hearing, talk to your primary care doctor or local audiologist. If you do not have a doctor, find one near you.

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