Saturday, July 23, 2016

Hearing Loss is Hearing Loss is Hearing Loss, Right? Think Again!


hearingplus.in


  • About 20 percent of Americans, 48 million, report some degree of hearing loss.
  • At age 65, one out of three people has a hearing loss.
  • 60 percent of the people with hearing loss are either in the work force or in educational settings.
  • While people in the workplace with the mildest hearing losses show little or no drop in income compared to their normal hearing peers, as the hearing loss increases, so does the reduction in compensation.
  • About 2-3 of every 1,000 children are hard of hearing or deaf
  • Estimated that 30 school children per 1,000 have a hearing loss.

(http://hearingloss.org/content/basic-facts-about-hearing-loss)

Staggering statistics, if you really think about it. And here is another. According to the CDC in the US, 70% of young adults with hearing loss are employed. That means a 30% unemployment rate for young adults with a hearing loss. (http://www.cdc.gov/ncbddd/hearingloss/data.html)

But is all hearing loss the same? After all, if you can't hear, you can't hear, right? Wrong.
nationalhearingtest.org


Hearing loss is as different as the person with it. To start with, you have different degrees of hearing loss.

The picture above shows what a typical audiogram may look like for a person with hearing loss. The frequencies refer to the pitch. Low frequency, low pitch sounds. High frequency, high pitch sounds.

It also shows the different decibels of hearing loss. In this case, low tones are normal, but as the frequency increases, it falls through mild, to moderate, to severe. This person would not hear women's voices well. Higher pitches would be lost.

But that is only part of the story. It only shows the level of loss, not the kind of loss. Yes, there are different kinds of hearing loss.

Hearing loss comes in three flavors, if you will. They are conductive loss, sensorineural loss, and combined loss.

Conductive loss happens when there is an obstruction in the flow of sound to the inner ear (cochlea). The inner ear is where "hearing" takes place. (Really, it takes place in the brain, but that is another subject.) Some causes of conductive hearing loss include:
  • Fluid in the middle ear from colds
  • Ear infection (otitis media)
  • Allergies (serous otitis media)
  • Poor eustachian tube function
  • Perforated eardrum
  • Benign tumors
  • Impacted earwax (cerumen)
  • Infection in the ear canal (external otitis)
  • Swimmer's Ear (otitis ecxterna)
  • Presence of a foreign body
  • Absence or malformation of the outer ear, ear canal, or middle ear
Hearing aids would probably perform poorly, or not at all, in this type of hearing loss. Making things louder when they can't get into the cochlea is of no use. And chances are, the cochlea may be perfectly healthy.

What needs to happen is for the underlying cause to be fixed, in some of the cases, or for the sound to find another route to the cochlea. This can be done with bone conduction. Some examples are bone conducting headphones and bone anchored hearing aids, but it takes a healthy cochlea to work.

Notice what wasn't on the list of causes of conductive loss? Meniere's disease. That is because that type of hearing loss is the second type, sensorineural.

Sensorineural loss happens when the tiny hairs in the cochlea are damaged or broken. The sound gets to the cochlea, but how it interacts with the hairs is changed. Instead of it flowing across them at an even rate, some are bent or missing, and so are those pitches in hearing. That is why things sound off. The letter T sounds like the letter D, so Tom sounds like Dom, or Dumb. Or it is missing completely and sounds like OM. That is why comprehension of words and conversations become hard. Things sound different or aren't there. In the case of Meniere's, the low pitches go first, so all you may hear is TA instead of Tom. Setaces beco ipossa to udderstad. (Sentences become impossible to understand) See what's missing?

Sensorineural is typical hearing loss. It is the type that happens with aging, as shown in the picture, or noise exposure, or disease, such as Meniere's. The only difference is the slope. With Meniere's, the slope reverses from the picture and is called, surprisingly, reverse slope hearing loss.

This type of loss CAN be helped with hearing aids up to the point of severe or profound loss. After that, the sounds are amplified to such a degree that things are loud, very loud, and likely still not able to be understood. That is where advance solutions, such as cochlear implants come in.

The third type of hearing loss is a combination of conductive and sensorineural. It takes the best (or worst) of both and puts them together. Challenging, but not necessarily impossible to help.

I think it is wise to learn the types and degree of your loss before going out and spending endless money on things that will never help you hear. That only leads to frustration and aggravation.

If your current hearing specialist hasn't or doesn't help you understand these things, find a new one. It's your ears and your hearing. You deserve to have it explained to you in a way you understand and to be helped in a way that does more than line their wallets. Far too many hearing aid dispensers will put a hearing aid on anything to gain a sale. Their goal should be to help people they can actually help and send those they can't to someone who can.

'Til next time

Dennis

Just a guy trying to live with an invisible, potentially debilitating illness

Friday, July 15, 2016

Finding the Passion Again

Warning! This post has nothing directly related to Meniere's disease!

Now that that is out of the way, I've been struggling. Not with the disease, that has been relatively silent (pun intended). What I've been struggling with is my purpose. My first love and passion was farming. That's gone for now, although I still have some land I could do something with.

What I find myself struggling with is what do I find as a second passion? Of course, I am back in school for accounting. I enjoy it, both school and what I have done with accounting, such as taxes and a bit of consulting. But it isn't my overall passion. Don't get me wrong, I am good at school. I will be very good as an accountant. It just isn't what drives me to go on to bigger and better things.

Nothing does anymore.

I've dabbled in other things. They're fun, but not something I could see myself immersed in for the next 15 to 20 years.

I feel lost.

Drifting around waiting for something to slap me upside my head and say "hey, this is it! Let's get busy!"

It's a real challenge.

I've always been a worker. I guess you could say I'm a blue collar kind of guy.  No, more of an enigma.

You see, while I loved the hard, physically draining work, it was never mentally challenging enough to satisfy me. Yet when I now find myself in the classroom giving my brain a workout, at least in some classes, I find myself longing for the days of yore when I could proudly say to myself that I could outwork men half my age, and usually did.

I just mentioned to my wife this evening that while I farmed, I always felt more comfortable talking to doctors, lawyers, professors, etc. than I did to other farmers.

Yet that is where my heart is at- farming.

So that is the dilemma I find myself in.

Do I find a way to go back into some type of farming? I have enough land that I could do small scale, direct market type ventures. Fresh produce, chickens, eggs, maybe expand on the small ruminants I have. Will I find my passion in that? Or is that relegated to the status of hobby, hopefully profitable. I am not wild on the whole farmers market scene. It seems like a whole lot of work for the amount of sales generated. Maybe it is used more for making a direct connection to long term markets than it is to make a living carting produce and products from town to town. From the successful people I know in this type of venture, it takes years to build a clientele.

Or do I put all my efforts into the accounting aspect of life. As I said, I will be a very good accountant. Can I be good enough and respected enough to gain back my passion? Many I have talked with at the college have told me that bachelors degree accountants have people looking for them rather than them looking for work. And that is only projected to grow-rapidly.

I've always believed that if you have passion for what you do, you will never work a "job". I have never had a job, and I certainly don't want to start now.

'Til Next Time

Dennis

Just a guy trying to live with an invisible, potentially debilitating illness

Sunday, July 10, 2016

Memories, Truths, and a Mini Rant

Image result for memories truth and a mini rant
mrwriteon.wordpress.com



This morning I was greeted by this "memory" shared by my wife from Facebook from July 10th, 2013.

"We have finished testing and consult for Dennis. Plan is to do cochlear implant in the left ear. Just have to wait for insurance approval before we can schedule. This will restore some hearing. We still have to deal with having episodes related to the right ear."

This brought out some of my memories of the last three years and things that are still as true today as they were then, and even back when first diagnosed in 1992.

  • I did nothing to "get" this disease. It's a disease, not a result of some activity I did or did not participate in. This makes blaming ourselves a pointless waste of time and energy.
  • There is no known cause.  The name implies that for true Meniere's disease. Idiopathic Endolymphatic Hydrops- Idiopathic means no known cause. Those who claim they know the cause do not. And if they do know a cause, then you do not have true Meniere's disease.
  • There is no known cure. Again, those who claim a cure do not have one, and if you are "cured" you likely did not have true Meniere's disease. Stopping your symptoms is NOT a cure.
  • Hearing loss is likely.
  • Along the same lines, I did nothing to cause my hearing loss. Quit blaming me! In my case, quite the opposite was true. At the first sign of hearing loss, I did everything possible to prevent it. I used ear plugs, hearing protection, avoided (as best I could) situations where loud, prolonged exposure would happen.
  • Hearing aids may not help. Accept the fact that my hearing is bad. Endlessly telling me to "get a hearing aid" is only going to aggravate me. I know my hearing history and test results. Unless you are a licensed AuD, keep you opinions to yourself.
  • Despite my very best efforts, I may still have vertigo attacks. That is the very nature of the disease. It comes, it goes. The length of time for each will vary from person to person and from time of year to time of year. It will also vary from one point with the disease to another. That is the difficult part. You have no idea if, when, or how long you are going to have any aspect of the disease.
  • Everyone deals with things differently. Don't tell me so-and-so was or wasn't able to do certain things. That's them. This is me. I may be stronger than some. I may be weaker. Comparing me with others won't make me feel better or worse, just tired of hearing about them and tired of you.
  • There ARE things that will help control symptoms. Some more easily for some than others. Ultimately, a completely destructive treatment should control my symptoms. If not, it is likely I was misdiagnosed. No one WANTS to have the destructive treatments, but sometimes they are necessary. No one wants to be left deaf or without any balance function, but that is what destructive treatments do. Don't condemn me for delaying them as long as possible, and don't condemn me for using them. If I, in consult with medical professionals, decide it is the best way to control life altering attacks, it is my choice. I know the possible outcomes. I'm willing to take that risk because it is better than living the way I am.
Three years ago I was ready to jump right to the destructive on my right ear as I had good results from it 18 years prior with my left. It would have been far better than what I was living with in July 2013. I even told my ENT that. I remember telling him "if given a choice between being deaf and feeling good, or hearing and feeling like crap, I would choose deaf in an instant."

He proceeded to give me a Cochlear implant and work on treating my right ear.

Thankfully, I have had great results from the implant and the treatment-so far.

'Til next time

Dennis

Just a guy trying to live with and invisible, potentially debilitating illness