For Those With Hearing Loss, the Noise Can Be Awful

Mestayer pierced her hearing aid, treating it like a fashion accessory.
Mestayer pierced her hearing aid, treating it like a fashion accessory. (Provided By Kathi Mestayer)
By Kathi Mestayer
Special to The Washington Post
Tuesday, June 5, 2007

The hardest thing I've had to come to terms with in the 17 years since my hearing started to fail is not silence but intrusive noises: They ring in my ears, obscure the sounds I want to listen to and startle me when they amplify themselves without warning. There I am, working quietly at my desk, when the knock at my door becomes -- Crash! -- a tympanic interruption, and I leap to attention.

There are times when I want to stand up and yell, "Keep it down!"

Mine is what's called sensorineural hearing loss, which can be caused by loud noises and is often associated with aging (I was 35 when it began) but in my case is probably genetic. Most of my immediate family members have lost their hearing as they've aged, and they walk around, like me, with hunks of beige-ish plastic in and around their ears.

Fifteen percent of American adults have some kind of hearing loss, according to the National Institute on Deafness and Other Communication Disorders. Those of us in that group have learned to adapt to a world that ever larger numbers of people are likely to share because more of us are getting, well, older.

You have to wonder whether kids these days are ruining their hearing with all that loud music piped from iPods directly into their ear canals. There's no doubt that noise causes hearing loss, but there is no hard evidence yet that noise-induced hearing loss is on the rise. In any event, I'm hardly in a position to give that lecture, having danced through my share of rock concerts, right in front of amps that were bigger than I was.

Now I live with my own noisy reminders of my hearing loss. The ringing in my ears is known as tinnitus. The American Tinnitus Association says that of the estimated 50 million people in the United States who have it, 12 million are affected severely enough to seek help. In one of his letters, Ludwig Van Beethoven wrote, "My ears whistle and buzz constantly day and night. I can say I am living a wretched life."

It's a condition in which the inner ear produces noise. (My tinnitus played mariachi music to me for several days, as my brain tried to make sense of the input from my inner ear.) Researchers have discovered that it is typically heard in the particular frequency range in which there is a hearing loss.

Treatment often consists of retraining the brain with low-level "white" noise (delivered through a device that looks like a hearing aid) that can, over time, minimize the tinnitus.

Then there's hyperacusis, an increased sensitivity to sound that often occurs soon after the onset of hearing loss. It can be stressful and exhausting. One treatment consists of gradual desensitization to sound using noise at a volume just below the discomfort threshold. My stepmother, for example, wears a special noise-generating device in her ear. Hyperacusis makes people cringe at sounds that don't cause discomfort to others.

Another manifestation of increased sensitivity is known as recruitment, which is a sudden, abnormal increase in perceived loudness. Richmond audiologist Deborah Ogilvie describes it as "sounds getting too loud too fast." It's as if there's no middle ground, like that knock on my office door. One possible explanation is that the damaged hair cells -- or cilia -- in the inner ear "recruit" nearby healthy cells, turning the volume up very high, very suddenly.

Background noise is also a huge problem for those of us with hearing loss. Tolerance of noise and the ability to understand speech in a noisy environment are distinct, and they vary markedly between individuals, according to a study published in the Journal of the American Academy of Audiology in 2006. In a noisy gathering, I'm left perplexed and exhausted as I try to distinguish the conversations I want to listen to from the surrounding racket.

According to Ogilvie, most digital hearing aids can be programmed to take some of the edge off recruitment, and many have features for reducing background noise. But even the most advanced aids and cochlear implants, with their increasingly miraculous bells and whistles, cannot bring one's hearing back to normal.

The truth is that, for many people, they can't even make the bells and whistles go away. For me, having a hearing loss is like living in a quieter place, except when it's noisier. ยท

Kathi Mestayer, a consultant, writes the blog

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