Online Health Chat with Craig Newman, PhD & Sharon Sandridge, PhD
October 18, 2017
Have you noticed you no longer enjoy fully your favorite sounds – children laughing, birds chirping, soft rain falling? Even a mild hearing loss can compromise your quality of life by reducing the level of sounds around you. Or maybe you have noticed a new sound in your ears – a ringing or buzzing sound – known as tinnitus.
Approximately 30 million people in the United States have some degree of hearing loss (about one in every 10 people). Most people with hearing loss, however, can be helped by hearing devices, even those with a mild hearing loss. People with tinnitus (with or without a hearing loss) can also receive benefit from hearing aids. Today’s hearing aid technology is better than ever before, allowing you to enjoy the sounds around you and helping you to communicate better with family, friends and coworkers. The latest hearing aids also allow you to connect to your smart phone technology to control your hearing devices and extend your listening opportunities. We offer patients devices that meet their personal listening, lifestyle and financial needs.
Early warning signs or changes in your behavior that may be related to hearing loss include:
- Complaining that people mumble
- Continually asking people to repeat what they have said
- Avoiding noisy rooms, social occasions or family gatherings
- Preferring the television or radio to be louder than other people do
- Having trouble hearing at the movies or theater, your house of worship or other public gatherings
- Having difficulty understanding people when you cannot see their faces
- Having difficulty understanding conversations in a group
- Becoming more impatient, irritable, frustrated or withdrawn
- Being more tired at the end of the day because you had to spend more energy and effort to listen
- Finding yourself straining to hear conversations
About the Speaker
Craig Newman, PhD is currently a vice chair in the Head & Neck Institute, section head of allied hearing, speech and balance services, and professor in the Department of Surgery at the Cleveland Clinic Lerner College of Medicine. Dr. Newman's clinical interests include the audiologic treatment of older adults, hearing assistive technology and tinnitus management. He has presented and published numerous research articles and chapters in the areas of hearing, dizziness and tinnitus outcome measurement; amplification; balance function assessment; and auditory-evoked potentials.
Dr. Newman's most current research efforts focus on development of audiologic outcome measures and efficacy of sound therapy for tinnitus management. Dr. Newman serves as a reviewer for a number of scholarly journals and is an associate editor (Rehabilitation) for the Journal of the American Academy of Audiology. He is a Fellow of the American Speech-Language-Hearing Association and was awarded the Jerger Career Award for Research in Audiology in 2004 by the American Academy of Audiology (AAA). Dr. Newman has also served on the Board of Directors for AAA.
Sharon A. Sandridge, PhD is currently director of clinical services in audiology and co-director of the Tinnitus Management Clinic and Audiology Research Lab at Cleveland Clinic. Dr. Sandridge received her BA and MA from the University of Akron and her PhD from the University of Florida. Her primary clinical and research interests are in the areas of amplification, the evaluation and treatment of tinnitus, and auditory electrophysiologic assessment, including neurodiagnostics, intraoperative monitoring and identification of children with hearing loss and hearing loss prevention.
She and her colleague, Dr. Craig Newman, have completed a number of funded research projects and have authored a number of articles in the areas of amplification, outcome studies, electrophysiology and tinnitus. She serves as a reviewer for multiple journals. She was awarded the Presidential Award from the American Academy of Audiology, the Outstanding Research Award from the Ohio Academy of Audiology and Health Educator Award from the Cleveland Clinic Allied Health. Dr. Sandridge served as the 2007 convention chair for the American Academy of Audiology and is currently serving as the 2018 convention chair for the American Speech-Language-Hearing Association.
Let’s Chat About Hearing Aids
fdr: I know I have a hearing loss, but if people are facing me when they talk, I can hear and understand them. Is it time for a hearing aid?
Craig_Newman,_Ph.D.: The time for hearing aids is when you are motivated to hear better. Motivation is the number one predictor for success with amplification, so when you are motivated, you are ready to pursue hearing aids.
pilatesgirl: Is there any problem in delaying getting hearing aids?
Sharon_Sandridge,_Ph.D.: The best time to get hearing aids is when you are motivated to hear better. Research is showing that there is a relationship between hearing loss and cognitive function. That is, increased hearing loss may be related to decreased cognitive processing. It is always better to get amplification sooner than later so you can maintain quality of life and enjoy the sounds around you. Plus, the younger you are, the easier it is to adapt to the devices.
jercleclin: I had an examination by an audiologist who said I needed a hearing aid for both ears. She showed me only one company's hearing aids. I didn't feel comfortable dealing with her. My questions are: Shouldn't the patient be shown or offered the products of different manufacturers? Can a person with moderate hearing loss obtain hearing improvement with just one hearing aid?
Craig_Newman,_Ph.D.: Many audiologists work with just a few manufacturers rather than all of them. It is difficult to be proficient with too many manufacturers' devices, so I would not be concerned about only being shown devices from one manufacturer. All the major manufacturers offer similar quality devices, so it is more important that you respect and have confidence in the audiologist rather than the actual device. We are born with two ears and we hear with two ears, so it is best to have hearing aids on both ears if you have a loss in both ears. There may be unique situations where only one is recommended, but overall, if possible, two hearing aids are better than one for many reasons.
pilatesgirl: Are there certain brands that work better for certain hearing challenges?
Sharon_Sandridge,_Ph.D.: This is a discussion for your audiologist based on your listening needs and hearing loss. Most major hearing aid manufacturers offer a variety of solutions for different hearing losses.
mfgo: If someone has difficulty hearing a television broadcast or conversing in a crowded room, what are the hearing aid options available to ameliorate this situation?
Sharon_Sandridge,_Ph.D.: Several options exist. Hearing aids may help, especially if you use devices that allow you to connect directly to the television and “stream” to your hearing devices directly. There are assistive listening devices that allow you to use a headphone that receives the signal from the TV, either wirelessly or wired. These can be purchased online from sites like Google for TV listening devices. Finally, you can turn on the closed caption feature on your TV. My hearing is normal, but I use the closed caption all the time! It takes a little time to get used to, but I find it especially helpful when the dialogue is buried in background music/sounds or for foreign dialects.
meme9: When are over-the-counter hearing aids projected to become available?
Craig_Newman,_Ph.D.: While OTC devices have been approved, it will take several years for them to become available. Personal sound amplification products (PSAPs) are now available online or in stores. These devices are very generic and may not be appropriate for many hearing losses. Plus, it is strongly advised that you see an audiologist to assess your hearing before pursuing any amplification devices.
jfkac: As a musician, I sing in several choral groups. I need to hear different pitches in the room and also the accompaniment (piano, organ, orchestra). Is there a certain type of hearing aid for me?
Sharon_Sandridge,_Ph.D.: If you have a hearing loss, the device should compensate for the loss, allowing you to hear across the frequencies. Many devices allow the audiologist to program a special program for music. One word of caution is that you also need to protect your hearing from listening to sounds that are too loud for too long. I would recommend downloading an app to measure the sounds you are exposed to and determine if you are in a safe listening environment or not. I recommend the app by NIOSH, which, I believe, is available for both Apple and Android phones. Safe listening levels are explained in the app. If you are not in the safe zone, we recommend obtaining musician earplugs that reduce the intensity of the sound without compromising the sound quality.
kayike: It is my understanding that the FDA is reviewing low-cost devices. Do you know when these devices will be available?
Sharon_Sandridge,_Ph.D.: Low-cost hearing aids are available now. Most audiologists offer a wide range of hearing aid technology and prices that will meet your budget. The FDA ruling has allowed devices to be on the market that do not have to go through the stringent testing necessary to be labeled a hearing aid and thus released on the market. Those will not be available for several years yet. But again, their prices will be comparable to many hearing aids that are currently available.
Symptoms and Situations
pilatesgirl: Do people who get irritated by sounds have better hearing?
Craig_Newman,_Ph.D.: People may have differences in sound tolerances. That could be related to hearing loss or other issues. Generally, there is not a correlation between better than normal hearing and sound tolerances.
pilatesgirl: Do men hear lower sounds better and woman higher sounds better in general?
Craig_Newman,_Ph.D.: Men have lower voices than women, but that doesn't relate to hearing. If there is a high frequency (pitch) hearing loss, then male voices may be easier to hear because their voices are at a lower pitch.
Dodger: I like to go to the theatre, but I have a hard time hearing. Is there anything that can help me?
Sharon_Sandridge,_Ph.D.: Absolutely. Under the Americans with Disabilities Act, all public theaters are required to provide assistive listening devices. This includes stage shows and movie theaters. For example, if you go to one of the Playhouse Square theaters, you can go to the house manager's office and request an ALD, or a listening device. Generally, you have to leave your driver's license, which is returned upon the return of the listening device. The devices allow you to hear the production as if you are sitting on stage, without the noise of the paper wrappers or feet shuffling or quiet talking by those around you. I use ALDs every time I go see a theater production and strongly encourage their use.
pilatesgirl: Is there a specific, measured hearing problem when one can't differentiate conversation when there is a lot of background noise? Do hearing aids help this problem?
Sharon_Sandridge,_Ph.D.: We now know that exposure to sounds that are too loud for too long can cause what we call a hidden hearing loss. The hearing impairment cannot be measured using our standard audiometric measures, but causes increased difficulty understanding in background noise. Hearing aids do help, but you will still have difficulty in noisy situations. Then again, when your hearing was normal, you also had difficulty hearing in background noise. When we have a hearing loss, we just become more aware of the problem.
newjersey: I have experienced persistent ringing in my ears for the last several months. I do not know what has caused it. How do I get rid of it?
Sharon_Sandridge,_Ph.D.: Ringing, or tinnitus, has many causes and can cause many reactions. The first step is to be seen by an ENT (ear, nose and throat) physician to rule out any underlying condition that may need medical or surgical intervention. It is important to note that there is no single “cure” for tinnitus, but it can be managed through various options. If you find the tinnitus is significantly impacting your quality of life, we offer a Tinnitus Management Clinic at Cleveland Clinic.
EMG: I am 75 years old and have been diagnosed with a 35 percent hearing loss in both ears. I am still confused about the different styles/brands of hearing aids and which would be best. Any suggestions would be helpful. Also, about 30 years ago, I was diagnosed with no hearing on one level due to using a punch press machine two hours a day. This latest hearing test did not find any level of total loss. Should I find a different audiologist and be re-tested?
Sharon_Sandridge,_Ph.D.: Unfortunately, as audiologists, we do not deal with percentage of hearing loss, so it is unclear what degree of loss you have. Most likely, it is a high-frequency loss because of your history as a punch press machine operator. If your hearing loss is causing you difficulty in your life – communicating with your family or friends – then it might be time to talk to an audiologist about obtaining hearing aids. Also, there is not one BEST device or manufacturer. It is more important to have a good relationship with your audiologist to determine which device may be best for you based on your listening needs, budget and lifestyle.
mfgo: I have heard that zinc is helpful in reducing the impact of tinnitus. Is there any research documenting this assertion? If so, what dosage of zinc is most useful in that regard?
Craig_Newman,_Ph.D.: Unfortunately, there is no evidence that ANY supplement is effective in reducing tinnitus. You can refer to this resource: http://www.audiologist.org/_resources/documents/Exhibit1.pdf for further information.
jfkac: Is there any progress toward including hearing aids in Medicare?
Craig_Newman,_Ph.D.: No, and we don't expect to see Medicare covering hearing aids in the near future. Medicare does cover a hearing test one time without a medical referral, but only once (for example, during your Welcome to Medicare exam). If you have Medicare and need additional hearing tests, you must get a medical referral to have Medicare cover it. However, it is important to know that if the hearing test is for the sole purpose of obtaining hearing aids, Medicare will not cover the cost of the testing. Medicare will cover it only if you have a medical concern, such as decreased hearing or dizziness or ringing in your ears, to name just a few. There are, however, a number of supplemental insurances that do cover hearing aids. Check with those insurances.
prsgkee: I have a sudden sensorineural hearing loss. Is BAHA an effective remedy? I don't like the crossover system I was offered. My hearing loss was in my left ear only.
Sharon_Sandridge,_Ph.D.: Yes. A bone-anchored device (aka BAHA) is an option for unilateral hearing loss. Is the hearing in your right ear normal or near normal? If so, you might be a candidate. We offer a Sensory Device Evaluation to explore the options for people like you who have what is called single-sided deafness. You can call 216.444.8500 and ask to schedule a Sensory Device Evaluation to explore all your options.
On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online.
To make an appointment with Dr. Newman, Dr. Sandridge or any of the specialists in Cleveland Clinic’s Department of Audiology, please call 216.444.8500 (toll-free 800.223.2273, ext. 48500) or visit us at clevelandclinic.org/audiology for more information.
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About Cleveland Clinic’s Head & Neck Institute Section of Audiology
The mission of Cleveland Clinic's Head & Neck Institute Section of Audiology is to be a national leader in the provision of collaborative, patient-centered and comprehensive hearing health care for individuals of all ages, exemplified by excellence in patient outcomes, education, research and service.
We are one of the largest audiology programs in the country today, with more than 20 clinical and research audiologists located at either Cleveland Clinic's main campus (including our Hearing Implant Program) or one of the Family Health Centers throughout Northeast Ohio (Beachwood, Independence, Strongsville, Twinsburg and Westlake). Each audiologist is part of the hearing health care team at Cleveland Clinic, working closely with our physician partners in otolaryngology in the Head & Neck Institute and other professional colleagues in a variety of specialty areas including pediatrics, geriatrics, neurology, psychology, dentistry, speech language pathology, plastic/reconstructive surgery and oncology to treat hearing disorders.
Our goals in the Section of Audiology are three-fold. First, to provide state-of-the-art audiologic assessment and rehabilitative clinical services for patients of all ages with hearing loss using evidence-based practices with quantifiable quality outcomes. Second, we offer educational opportunities by serving as clinical preceptors for doctor of audiology (AuD) students and otolaryngology residents and by providing continuing education experiences for our staff and other professionals working in the community. Third, we maintain an active research program through the Audiology Research Laboratory (ARL) by focusing on clinical investigations in the areas of sensorineural hearing loss, tinnitus outcomes measurement, hearing aid signal processing and auditory electrophysiology.
Most importantly, our audiologists are dedicated to helping people with hearing loss improve their quality of life while dealing with the disorder. We understand that untreated hearing loss can interfere with relationships involving family members, friends and business associates. In turn, reduced communication function may cause feelings of frustration, isolation and withdrawal and even depression. By providing our hearing loss patients and family members with the most appropriate audiologic treatment plan, we continue to help each person overcome the consequences and achieve his or her individual communication goals.
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