New Pine Plains Herald

Good Medicine: Listen Up: Act Now to Protect Your Hearing

Hearing loss is twice as common as diabetes in the United States, afflicting over 48 million American adults.

Do you have trouble following conversations on the phone or in a restaurant? Do you accuse your family of mumbling, or frequently ask friends to repeat themselves? You’re not alone: Hearing loss afflicts 48 million Americans, or 15% of all adults. Most wait 10 years to see an audiologist, but the longer it goes untreated the more the brain’s ability to understand speech decreases. In other words, if you don’t take steps to preserve the hearing you have, you risk permanently losing it. 

Hearing loss poses other problems, including isolation: Those who don’t hear well may withdraw from conversation or avoid social events, then feel frustrated and disconnected from the world. It can also increase the chances of dementia and depression, and triple the likelihood of a fall. For all those reasons it’s important to understand the causes of hearing loss and how to prevent it.

Hearing aid technology has improved dramatically in the past decade.
Credit: Jeff Elkins/

Adult hearing deficit is split into three categories. Sensorineural (inner ear nerve damage), responsible for 90% of all cases in people over age 50, can be managed with hearing aids. Conductive hearing loss — often curable but less common — occurs when sound waves can’t reach the inner ear because of wax buildup or fluid accumulation from chronic allergies or infections. The remainder of sufferers have a combination of sensorineural and conductive deficits, dubbed “mixed.”

Aging is the leading cause of sensorineural hearing loss, but it’s not only the elderly who are affected: The CDC reports that one in seven teens have measurable auditory deficits from overuse of personal listening devices at high volume. Usually affecting both ears, the loss is so gradual it may not seem to be a problem. Injury from exposure to loud noise (acoustic trauma) is almost as common, and independent of age. Nerves can be damaged permanently from a one-time event (fireworks, a gunshot) or from exposure to loud noise over an extended period of time (motorcycle riding, attending sporting events).

If you think you’re having trouble hearing or your loved ones insist that you doconsult your medical provider. Your ears will be checked for wax and middle ear fluid. You may be referred to an audiologist for hearing tests. 

Hearing aids can improve comprehension and communication skills, in turn increasing independence. For mild hearing loss, FDA-approved OTC hearing aids may work well (akin to using readers instead of prescription glasses). Sufferers with moderate to severe hearing loss benefit from customized prescription hearing aids. Most models are almost invisible to an observer and rechargeable. Many connect to smartphones: Phone calls and TV can be streamed directly to the hearing aid, and it’s easy to make adjustments for different environments (dinner parties versus a movie theater).  

The majority of hearing loss is caused by inner ear nerve damage; less commonly, sound is blocked by wax or fluid in the middle or outer ear.

While it can take a few months to get used to the devices — at first your voice may sound too loud or you may hear too much background noise — most people do if they wear them consistently. Using hearing aids regularly keeps inner ear nerves active, slowing the progress of hearing loss. Studies show significantly less cognitive decline in daily wearers (compared to non-wearers). The downside of hearing aids is that they range from $1,200 to $7,000 for a pair and usually must be replaced every three to seven years. Medicare covers none of the cost, and private insurance just a small amount.   

Cochlear implants are complex electronic devices that bypass the damaged inner ear to directly stimulate the auditory nerve. Used in children with profound hearing loss and deafness, they are a consideration for adults if hearing aids don’t help.  

There are steps you can take to preserve your hearing. Avoid loud noise when possible: Choose a quiet restaurant, turn the volume down on your television, position yourself far from amps and speakers at concerts. Take breaks from noisy environments to give your ears time to rest and recover. Consider using headphones instead of earbuds — the distance between the receiver and the eardrum makes a difference. And wearing pre-molded earplugs, special earmuffs and headsets can cut the decibels in half when you’re engaged in a loud activity, such as using firearms, working with power tools or mowing the lawn. 

Mary Jenkins recently retired after nearly 40 years as a family practice physician in New York state.


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