Here`s a little hearing test for your spouse or ”good” friend:
Assuming he or she is in the same room, stop reading at this point and whisper, ”I want to make love.”
Whisper it so softly at first that there is no possibility of it being heard. Then, as you repeat the test sentence, gradually increase the volume of your whisper.
If the loudest whisper elicits no response, boost your voice to conversational level and then add decibels each time you repeat the statement. If there is still no response and it is necessary for you to finally shout ”I WANT TO MAKE LOVE” so loud that a grinning neighbor shows up at the door and asks if you need help, your beloved definitely has a hearing loss and you have now proven it to him or her in a manner that should preclude argument.
The ”test” is not just for grandma and grandpa types: it is also for rock-music fans and Walkman-style radio users who have pumped awesome levels of decibels into their ears and now likely have a hearing loss, admitted or otherwise.
Pete Townshend of the British rock group The Who, who traditionally amplified the smashing of his guitar to climax a thunderously loud
performance, said at a news conference in 1989 that after 20 years of rock `n` roll, ”You wake up with a piece of your ears gone.” The price of prolonged exposure to loud rock, Townshend said, is ”premature deafness and ringing and slotty hearing.” This was the reason he stopped performing, he added.
Just what Townshend means by ”slotty” hearing is not clear, but research by audiologists has shown that rock concerts, Walkman-type radios and customized car stereos commonly produce decibel levels equal to those from jet engines, jackhammers and chain saws and that these noise levels destroy sensory cells in the ear. The result is permanent hearing loss because the hair cells do not regenerate.
However, it is one of those quirks of a youth-oriented society that although vision problems and their correction with glasses are accepted and glasses can often be stylish, hearing problems and hearing aids have traditionally carried the stigma of warts. As a result, denial of a hearing loss has caused millions to suffer communication frustration, personal withdrawal and social isolation. This denial also works hardship on family members who are typically accused by the person with the hearing loss of mumbling and not ”speaking up.”
The television show ”L.A. Law” dealt with this circumstance in one episode when senior partner Leland McKenzie, played by Richard Dysart, overcame great reluctance and finally began to wear a hearing aid.
”This perception of hearing loss as socially unacceptable is a very troubling thing,” says Dr. Vijay Dayal, professor and vice chairman of otolaryngology at the University of Chicago Medical Center. ”It probably has to do with associating hearing loss with some deficiencies that come with old age or reflects on mental ability. It is tragic that this causes people to deny a hearing loss because there are so many ways that they can be helped.” Dayal says that ”tremendous strides” have been made in medical and surgical procedures to correct hearing deficiencies, and he added that the technology of hearing aids has also advanced rapidly in recent years.
A hearing aid, of course, is a device that fits either outside or inside the ear or in the ear canal to receive and amplify sound, and it is the most common ”treatment” for hearing loss. Some 4 million Americans wear them, and it is estimated that at least 12 million more could be helped by them.
There are obviously many reasons why more people do not wear hearing aids, but one is that they signal ”socially unacceptable” hearing loss. This ”signal” is getting increasingly faint, however, as miniaturization now permits quality instruments to be virtually invisible. Also, some progress has been made in the social acceptance of hearing aids, due in part to their use by such luminaries as former President Reagan and former Surgeon General C. Everett Koop.
Before he began to wear a hearing aid in 1987, Koop told the American Association of Retired Persons that if he wanted to hear what a woman was saying at a reception, he would have to bend over and practically put his ear in her mouth, which was embarrassing. With a hearing aid, Koop says he could
”stand upright, talk to people, hear them and make appropriate responses.”
Potential hearing-aid wearers may also be put off by remnants of the somewhat unsavory reputation that a free-wheeling hearing-aid industry had several decades ago. However, a spate of federal and state laws regulating sales and setting up licensing requirements has helped to eliminate most of the abuses, and Karen Hedberg, director of clinical audiology at the University of Chicago Medical Center, says, ”More sophisticated technology requires better qualified people, and the industry is much different than it once was.”
”The old-time, poorly trained hearing-aid salesperson is pretty much a thing of the past,” Hedberg says, ”and professional audiologists are much more involved in the dispensing of hearing aids. I think it is now a responsible industry.”
Mark McShane, director of the Illinois Hearing Aid Consumer Protection Program, says, ”Over the years, the number of complaints has gone down dramatically, and most of them are now due to miscommunication.”
The testing of hearing ability is possible from the first to the last day of your life, according to Hedberg, and infants who are considered at risk for a hearing loss-preemies, for example-are tested within the first weeks of life.
”It is very important to diagnose a child`s hearing loss as early as possible because it can have a profound effect on their development,” Hedberg says.
Diagnosing a hearing loss in an adult should also be done as early as possible, Dayal says. ”A hearing loss can indicate a tumor or an infection, and early treatment can be crucial,” he says.
Most hearing loss is caused by damage to the hair cells in the inner ear, which wither with age or are damaged by exposure to loud noise. Estimates vary, but anywhere from 18 million to 28 million people in this country suffer hearing loss, and in using the higher figure the American Medical Association says that the hearing impairments of 10 million people are due in part to exposure to loud noise.
Research shows that prolonged exposure-more than eight hours-to sound measuring as low as 85 decibels is potentially harmful. This sound level is only appreciably louder than the 65- to 70-decibel level of conversation, the AMA says, and you should suspect exposure to harmful noise if you have difficulty communicating while in the sound, if you have ringing in the ears after exposure to it or if sounds are muffled after leaving the exposure area. Audiologists have measured levels of 130 decibels blasting from car stereos and 115 decibels going directly into the ear from personal stereos. A rock concert can produce 120 decibels, and audiologists say that this can mean ear damage in less than a half hour.
Our increasingly noisy society, along with inadequate awareness of and protection from this noise, will translate to many more people who`ll need help in dealing with hearing loss in the future, the U. of C.`s Dayal says.
The gradual decrease in hearing ability, with higher-pitched sounds going first, occurs naturally as we age. It is called presbycusis and may be noticeable as early as age 40 as the hair cells lose their ability to pick up certain frequencies.
Just how hair cells function is not clearly understood at this point, but thanks to the North American red-eared turtle and Jonathan Art, assistant professor of pharmacological and physiological sciences at the University of Chicago Medical Center, some of the hair-cell mystery is being solved. Using the auditory systems of turtles, which have the unique property of continuing to function for 12 hours without oxygen, Art has studied how each cell responds to various frequencies and how the cells are programmed by signals they receive back from the brain.
”We need to know how the system works together,” Art says, ”and we need to try to figure out how we might send signals directly to the brain when the hair cells do not function. This knowledge could lead to more sophisticated hearing aids and could give hearing to those who have never had it.”
While Art and his colleagues proceed with their basic research with turtles, the most significant fact of auditory health remains the reluctance or refusal of millions of people to deal with a hearing loss. ”So many people could be helped,” says Gloria Wong, director of audiology for the Chicago Hearing Society.
The Society (312-939-6888) is one of two organizations that operate hearing-aid banks that charge according to ability to pay. The other is the Lions of Illinois Foundation (708-681-8800), which sponsors a program conducted by the University of Illinois at Chicago.
Both organizations encourage the donation of used hearing aids, which are refurbished and provided to people who need them. More often than not, however, cost is not what keeps people from dealing with a hearing loss-usually it is vanity, stubbornness or ignorance.
An examination by a physician, preferably one whose speciality includes auditory health, is the recommended first step in dealing with hearing loss. Such an examination is, in fact, required by federal law before a hearing aid can be sold. The requirement can be waived, though doing so is not in your best interests and cannot legally be encouraged by hearing-aid sales people.
After a physician`s examination of your ears, you should have a hearing test administered by a qualified audiologist, who can determine the nature of your hearing loss and recommend the appropriate corrective device. Most audiologists now also sell hearing aids.
Hearing-aid prices range from $400 to $1,200, with the smaller, in-the-ear-canal models being the most expensive.
”There are dozens of manufacturers,” Hedberg says, ”and working with a reputable audiologist is the best way to make sure you get the hearing aid that will work best for you.”
”Do not buy one through the mail,” she adds, ”and remember that those hearing aids that get the most advertising may not be the best ones for you.” Hearing aids are very individual, Hedberg says, and must be carefully fitted, from a standpoint of hearing loss and physical characteristics.
”Learn as much as you can about hearing aids so that you can be an informed consumer,” Hedberg advises.
That is obviously good advice. Given the dictates of genetics and the noisy society we live in, the odds are great that many of us will one day need hearing aids. We should not be vain about it and delay the issue unduly, lest we find a leering neighbor at the door simply because we could not hear our spouse or ”friend” whispering at us from across the room.
WHERE TO GET HELP
Some sources for help for people with hearing loss and prospective hearing-aid buyers are:
American Speech-Language-Hearing Association, 10801 Rockville Pike, Rockville, Md. 20852.
American Association of Retired Persons, 1909 K St. NW, Washington, D.C. 20049.
National Hearing Aid Society, 20361 Middlebelt, Livonia, Minn. 48152.
Food and Drug Administration Office of Consumer Affairs, HFE-88, 5600 Fishers Lane, Rockville, Md. 20857.
National Information Center on Deafness, Gallaudet University, Kendall Green, 800 Florida Ave. NE, Washington, D.C. 20002.
Self Help for Hard of Hearing People, 7800 Wisconsin Ave., Bethesda, Md. 20814.
Illinois Hearing Aid Consumer Protection Program, Illinois Department of Public Health, 535 West Jefferson St., Springfield, Ill. 62761. Phone:
1-800-572-3270.
