Many people suffer with hearing loss because they do not understand what is happening or what they can do about it. This article explains the symptoms of age-related hearing loss and what can be done to help.
Ears are complex mechanisms that have evolved over thousands of years to allow us to listen to and understand the wide spectrum of sounds that we are presented with every day. In order to understand what can go wrong with your hearing it is important to understand how it works.
- Your outer ear collects sound and reflects it down your ear canal to your eardrum.
- The eardrum absorbs sound and excites the middle ear mechanism.
- The middle ear mechanism is both a natural amplifier and it can protect against excessively loud sounds.
- The inner ear turns mechanical energy into electrical impulses sent to the brain to tell you that you have heard something.
- Your inner ear is also your organ of balance and it tells you which way up you are.
The healthy human ear can detect frequencies of sound from 50Hz to 20,000Hz and can pick up sounds so soft that when conditions are right, it can literally hear a pin drop. Our hearing is at its best when we are youngsters and it deteriorates as we get older. The rate of deterioration and the severity is dependent on a number of different factors including past exposure to loud noise, other health factors and possible hereditary or congenital conditions.
It is a popular misconception that you can either hear well or you are ‘deaf’. In actual fact, hearing loss is scaled into mild, moderate, severe and profound. It is profound hearing loss that is most commonly associated with being ‘deaf’. Of the 10 million people in the UK currently experiencing some degree of hearing loss, the majority of these will have a mild to moderate condition.
A gradual hearing loss is often noticed by those around us first. Most people with a hearing impairment will not perceive a day to day difference and it often only becomes more noticeable when surrounded by people who continue to hear well as they cope better with noisier environments. A sudden hearing loss is quite unusual and should be investigated immediately as this may be a symptom of some other underlying condition. Likewise, a loss of hearing only experienced in one ear; logically if our ears deteriorate naturally then they should both continue to perform in a similar way to each other.
As mentioned above, sudden hearing loss in one or both of ears is unusual and should be investigated straight away. Rapid onset of hearing loss should be obvious as you will quickly be able to perceive a difference. An example of this might be when you have a cold or the pressure imbalance caused by airline travel. Both of these situations can lead to your middle ear slowing down temporarily and you perceive a difference in your hearing immediately. Most of the time this will clear and you return to normal but if this does not happen you should get it checked out.
The gradual onset of hearing loss is far more common and the symptoms can be harder to spot, certainly in the early stages. Most cases of hearing loss result in a lack of clarity rather than volume and this is because of the way that the inner ear works. The human voice is made up of a range of frequencies and the healthy human ear can detect all of these and allow the brain to listen and understand even when there is background noise. Broken down in its simplest form the English language is made up of low frequency vowel sounds and high frequency consonant sounds. Because of the way our hearing deteriorates with age and exposure to noise, we begin to lose the ability to discriminate the consonant sounds whilst continuing to hear the louder, lower frequency vowels. The consonants tend to be at the beginning at the ends of words and without them, they all begin to crash into one another. This can lead to the frustrating situation of the voice still being audible but you can no longer make out what is being said. Even as a mild problem the individual affected in this way will sometimes misunderstand what is being asked leading to either humour or a possibly hurtful comment. An example of this might be: ‘It’s windy today isn’t it?’, and the answer comes ‘No, it’s Thursday.’
A further and more objective symptom of gradual hearing loss is the volume of the television. These days it is possible to benchmark how well people hear by the volume scale. This has been the subject of much discussion, even argument, between partners as they constantly turn up and turn down the volume on the TV depending on what they are watching. Many husband and wife teams know exactly what volume setting the other prefers and this in itself will define for them the difference in their ability to hear.
If you are in any doubt about your hearing then you should speak to a relevant Healthcare Professional. Here you have two options; your General Practitioner (GP) or an Audiologist. Both should be able to offer advice on what might be happening to your hearing and what you can do about it. In most cases, your GP is not equipped to carry out a hearing test and their first concern will be to find out if there is something medically wrong with your ears that may be causing the hearing loss. Examples of this include a build-up of ear wax or the presence of an infection. Your GP may feel that it is appropriate to refer you for a hearing test. Typically this will be carried out for you at the nearest Audiology Department, often located within a major hospital.
Another option is to seek the advice of an Audiologist working in a High Street Hearing Care Centre. Many of these registered individuals will use also use the protected title of Hearing Aid Dispenser and they can screen for hearing loss at the first appointment if appropriate. Hearing screening is a quick and easy way to learn whether you have some degree of hearing loss. This simple procedure need only take 5 or 10 minutes and if you pass then there will be no need to have it repeated for a couple of years. If you don’t pass then, you will be advised as to what you can do next; nothing (always an option), speak to your GP or have a full hearing assessment in the same location.
A full hearing assessment is nothing to fear and a good Audiologist will explain the steps to you before you start. Broken down into the various steps, these will include:
1. Case history – the Audiologist wants to learn whether you have had a hearing test before and what areas of difficulty you may have. They are also exploring whether there may be any referable conditions that they would like you to talk to your GP about.
2. Ear examination – using a torch like device called an otoscope, the Audiologist will look down your ear canals checking for any obstructions or signs of infection. If any are found, including excessive ear wax, you will be referred back to your GP.
3. Hearing Test – using a calibrated device called an audiometer, the Audiologist will place headphones over your ears and ask you to respond to a series of pure tone signals, sometimes described as ‘bleeps’. Do not be alarmed if you are asked to do this in a sound treated booth as it will depend on the location of the Hearing Care Centre and how noisy it is.
There are additional tests that may or may not be appropriate depending on what the Audiologist finds and at the end of the hearing test they should take some time to explain the results to you. What is produced at the end of a hearing test is an audiogram or a graph of how you hear. This shows the results of the hearing test in both ears at different frequencies and should reveal the extent of any hearing loss present and at what frequencies.
Based on this further information you will be advised on what your possible courses of action could or should be.
Now that you know whether or not you have a hearing loss and what you can do about it, it’s time to decide on a course of action. Your GP will manage any medical condition that may have been discovered and most people they will have found out that their hearing has just deteriorated as a result of getting older. Classically, your ears will wear out in such a way that you can no longer hear high frequencies as well as low frequencies. In medical terms age-related hearing loss is known as presbyacusis.
If we assume that this is the case then your options will be to do nothing or use some form of amplification. This does not automatically mean a hearing aid as there are amplified devices that can help those with a mild hearing loss even without a hearing aid. These could be an amplified telephone or doorbell, headphones for the TV or a louder alarm clock.
If a hearing system is advised then most Hearing Aid Dispensers will give you the option of trying one out. Based on your hearing loss, they can quickly programme a digital hearing aid and put it on your ear so that you can understand what it feels and sounds like. If you decide that a hearing system is the way forward then a Hearing Aid Dispenser will advise you about the up-front and running costs. If you would prefer to talk to your GP about an NHS hearing aid then you can ask to be referred for an assessment and fitting. Modern hearing aids have come a long way since the bulky and whistling devices of previous years. Today’s hearing systems are discreet and some of the smallest available can almost be described as invisible once in place. The latest digital signal processors are employed in these state of the art instruments and they also use wireless technology to connect seamlessly to phones and TV.
Whatever you decide to do, make sure you have sought all the advice you can and if in any doubt about your hearing, check it out.