More than 4,000 of you took us up on testing your hearing with the Mimi Hearing Test app — which is remarkable, considering the national stigma surrounding hearing loss. That may be why many American adults have not been tested.
But mobile technology like Mimi has increasingly made it possible for people to find out about their hearing ability. The challenge is that we can now access a form of health data without a medical professional to help interpret it.
So we brought some questions you've raised about your hearing results to Dr. Lawrence Lustig, professor and chair at Columbia University Medical Center's Department of Otolaryngology. You might remember him from our episode on deaf composer Jay Zimmerman.
How much hearing loss is natural and nothing to worry about? Average adults will naturally be unable to hear very high pitched sounds (above 8000 Hz) that young children can. Is there a good rule of thumb?
That is a tough question. There's no absolute or bright line. If you were a military veteran and were exposed to loud explosives, you probably have experienced some amount of hearing loss and the cause was clearly identifiable. It’s not that the hearing loss can be ignored, but one can be reasonably certain it doesn’t represent something like a tumor or infection causing the hearing loss.
But if you're young, under 40, and notice hearing loss affecting your day-to-day, that should be checked out as soon as possible.
Hearing loss above 8000 Hz is not a huge deal since a majority of the speech frequencies are between 500 and 2000 Hz. In general, high tones are lost first, and female and children's voices are higher pitched, and thus these are the voices that people with hearing loss generally have a harder time hearing.
For a lot of people, a moderate loss is manageable, if all they have to do is turn up the volume on the TV. However, those same people could have difficulty in a noisy background, at a restaurant, dinner table with family, or in a meeting at work. In the end, any hearing loss that affects your day-to-day life should be evaluated by a professional.
What are the risks of leaving your hearing loss untreated?
There is no inherent 'risk' of leaving your hearing untreated, barring such instances such as getting hit by a car or bus because you didn't hear it coming and you weren't paying attention!
But keep in mind that hearing loss is a form of brain deprivation, at least for someone who had hearing for most of their adult life (for the born-deaf, their other senses are amplified). If you wait too long, say decades, it becomes harder to address because the parts of your brain that would process that sound don't work as well.
In addition, there are some causes of hearing loss that need to be investigated to be sure there is not an underlying condition causing the loss, such as a tumor at the base of the brain, an infection, or other disease. Thus all forms of hearing loss should really be evaluated by a professional to be sure there are no underlying causes that need to be treated. In particular, hearing loss in only one ear, definitely needs to be looked at because it could be the result of a treatable infection. Similarly, sudden cases of hearing loss should be evaluated as soon as possible.
What can be done about tinnitus?
There's no magic pill to make it go away. Usually people have tinnitus in association with hearing loss, but they don't necessarily go together. We have only a crude understanding of the cause of tinnitus. There's some evidence that it starts in the ear and sets up in the brain stem. The lack of animal models is the part of the challenge in addressing the condition. You can't ask a lab mouse, do you have tinnitus?
We have some anatomical correlates of brain scans of what tinnitus looks like, but we're not 100% sure those relationships are accurate. That being said, there are a number of treatments, each with varying degrees of success, depending on the individual, including the use of tinnitus maskers, use of hearing aids for those that already have hearing loss, and retraining therapy with sound.
A few people have written to us about bad experiences with hearing aids - they were expensive and didn't work in all environments. Is that changing?
Hearing aids are getting better all the time. They are still not perfect: they cause trouble with feedback, with the 'occlusion effect' (sensation of something plugging the ear), and the challenges of amplifying not just what you want to hear but also what you don't want to hear. However, newer processing algorithms and directional microphones are making them better for amplifying what you want amplified while suppressing background noises. Smaller devices and better ear inserts are also improving the cosmetics and ear-plugging factor, and some now even come with tinnitus suppression software. Advances will continue to occur in the industry.
For less serious hearing loss there are many cheaper options such as smartphone apps or Bluetooth devices that can amplify voices in challenging environments, like noisy restaurants.
If you suspect that someone you know has hearing loss, what are some strategies for getting that person to seek help?
The best thing is to be upfront and non-judgmental. We tell people if we think they are losing weight, or look pale, or have vision troubles, and most are thankful for that feedback (well, maybe not the weight comment). If you think someone has hearing loss, let them know it's affecting their ability to interact, and also let them know the field is advancing and there are many new treatment options available that were not available even a couple years ago. In the end, the most important thing is to get people hearing again and not feel ashamed they have a hearing loss. For some reason, no one is embarrassed or ashamed to wear glasses! So why is there a stigma associated with hearing aids? There shouldn't be. We should all be accepting of this like any other medical condition.