Hearing loss has many causes, but when it comes on gradually, the signs can be difficult to identify as our bodies adjust over time.
If you experience any of the signs of hearing loss we discussed in this episode, schedule your annual hearing evaluation with your local hearing healthcare provider.
Not sure where to start? Feel free to send us an email and we will connect you with a trusted local hearing healthcare provider to assist you on your new hearing journey!
Blaise M. Delfino, M.S. - HIS (00:06):
You're tuned in to the Hearing Matters podcast, the show that discusses hearing technology, best practices, and a growing national epidemic: Hearing Loss. Before we kick this episode off, a special thank you to our Partners Sycle - Built for the entire hearing care practice. Weave - the all-in-one patient communication and engagement platform. Redux - Faster. Drier. Smarter. Verified. Fader Plugs - the world's first custom adjustable earplug. Welcome back to another Hearing Matters podcast episode. And as a friendly reminder, this podcast is separate from my position at Starkey. Now, with all that said, let's dive into this episode. A frequently asked question I would receive in the clinic from patients was, "Blaise, what are some of the most common signs of hearing loss?" There are many signs of hearing loss, but we wanted to review and discuss the 10 most common signs of hearing loss. Stick with us until the end so you can decide when to make your annual hearing evaluation appointment with a licensed hearing care provider.
Let's dive right in. We're gonna talk about sign number one, which is frequently asking others to repeat themselves. Again, the first sign we're gonna talk about today is frequently asking others to repeat themselves. This can be in one-on-one conversations and or in noisy situations, like a restaurant setting or a crowd setting. And you could be in one room and your spouse or family member is in another room, and they're trying to talk to you. You are then going to ask them to repeat themselves. Now, we're gonna dive a little bit deeper into that a little bit later in this episode. So, uh, hang tight <laugh>, but this sign very well might be the most common sign of hearing loss accompanied by the word, "huh?" Or "what?" The problem here is that when individuals present with hearing loss and they're frequently asking others to repeat themselves, their communication partner -
Now this doesn't happen every single time, and this doesn't happen all the time. However, their communication partner might become a little frustrated and signals to the individual with the hearing loss that, Hmm, I don't feel like they want to talk to me and I'm just gonna stop talking. And when I'm in a large group, I'm gonna nod my head and that'll be that. This is not what we want, because we know that untreated hearing loss is linked to depression. So, I'd encourage you and challenge you. Ask yourself, do you ask friends and family members to repeat themselves? Sign number two that you might present with hearing loss. Number two is turning the TV or the radio to a volume that others find loud. When I was practicing full-time in the clinic working with patients, the TV was always brought up in the initial hearing evaluation, but even following the hearing aid fitting appointment if that patient did not also purchase a TV streamer.
One example I can give you, and I remember this couple so vividly. I loved working with all my patients, but this particular case sticks out to me for sign number two, turning the TV or radio to a volume that others find loud. So ,during my time in clinic, I've worked with many patients whose spouse would always tell me they have the TV up so loud that when I want to say something or, you know, comment on the TV show or movie we're watching, we need to pause the television show or the movie, we're gonna comment on that specific scene. Maybe, just maybe my husband hears what the heck I'm saying. Then we unpause the movie, and it is not the best viewing experience at all. And I bring up that one case. But to be transparent, often every time that I would fit a patient and whether it be their spouse or their family member, the television was always what they were most excited about.
Number one, to hear better. And I'd like to go a little bit deeper here with regard to increased speech understanding, specifically for watching television. If you are a current hearing aid user and you struggle to understand speech coming out of the TV, and if it is a flat screen tv, one of the reasons you're having difficulty is because the speakers in today's television are often and most commonly in the back of the television. So, this means that if you're watching a television show or you're watching a movie, the sound is hitting the wall behind you reflecting off the wall. So, by the time that acoustic signal even hits your hearing aids, it is not a clean signal. So, I'd encourage you, if you're a current hearing aid user, talk to your hearing care provider and ask them about a TV streamer. What this technology does is it streams the television or movie that you are watching directly into your hearing aids.
It is awesome technology. Sign number three is struggling to hear or understand on the phone. This has gotten better over the years with advancements in technology, but for individuals who present with untreated hearing loss, struggling to hear and understand on the phone is one of the most common signs of hearing loss. So, the phone is difficult as it is, and we totally understand that. However, when you do present with hearing loss, it's going to be very difficult to understand what your communication partner is saying on the other end of the call. And while patients might be able to turn up the volume on the phones like they have phones nowadays, that you can just blast the volume, however louder doesn't always necessarily equal clearer. So I'd, I'd err on the side of caution with purchasing one of those phones because again, we don't want to cause any additional hearing loss.
But also turning up the volume doesn't always equal a clear sound. When you are talking on the phone, patients will usually use the phone with a better ear, whether this be a landline or a cell phone, but this is what we call like a, a mono signal or you're listening monaurally, so it's not in stereo. And what the heck do I mean by this. "Blaise, how could I hear the phone call in stereo?" Well, with today's hearing technology that is Bluetooth technology and a friend, family member, colleague calls you on your cell phone, you are going to hear that phone call through your right and left hearing aid if you are fit binaurally, right and left ear through your, uh, hearing aids. So, that is a stereo signal, really is a nice crisp sound. And, um, listening to phone calls in stereo, for me personally, I will either use my AirPods to listen or talk on the phone, uh, because I really like that stereo signal.
Obviously love audio, so, um, that just makes sense to me. But with that Bluetooth technology, so sign number three, struggling to hear or understand on the phone when you make the appointment with your hearing care provider and they prescribe you your hearing technology, ask them to counsel you on the use of Bluetooth technology if you do have a smartphone, because that Bluetooth technology, patients are able to stream those phone calls directly to the hearing aids, uh, which provides, like I said, a really nice stereo sound. And it is what we call a direct audio input. Let's go to sign number four, sign number four that you may present with hearing loss. This is actually most likely the most common, if not the most common, uh, challenge that individuals and patients say, "I have trouble understanding conversations in noisy places like a restaurant, crowd, small family gathering, large family gathering."
If there's background noise, you struggle to understand speech. Now here's the thing, understanding and hearing are two completely different things. You might hear what someone said, but you may not understand what was said. Oftentimes the patients that I've personally worked with in the clinic will say, "Blaise, when I leave a noisy situation, I am so fatigued, I am exhausted." And the reason why is this, when you present with hearing loss and you are in a complex listening situation like a restaurant, let's just say you go to your favorite restaurant. So, what I want you to do right now, picture yourself in your favorite restaurant, eating your favorite meal with your loved ones around you. What does that look like? And who are you talking to? So, right now you're having a conversation. You're more or less leaning in to that conversation. You might be squinting, you might be focusing on the mouth of your communication partner because you've most likely learned to lipread by default and as a compensatory strategy to work in tandem with your decrease in hearing sensitivity.
So, what does that look like? And when you go home, you might be exhausted because you just had to exert so much energy, and you get home and you experience this listening fatigue. Other side of the coin is we would have patients come in and they would say they would just go out to dinner and sit there. To me, that really pulls my heartstrings. and here's why. We are social beings. We are hardwired to communicate with each other to be social. We don't want our patients to just go out and sit there. Now I understand we might have some patients who are more so introverted or they might be ambiverts, and I get it, I'm not, whenever I would work with a patient, that's why we would ask them what their social activity level was like before they got fit with hearing aids. That's a telltale sign that trouble understanding conversations in noisy situations.
We have that listening fatigue. You might go out to dinner and just sit there and here's the thing, you might, and this is the next sign, uh, but you might not communicate out of fear of responding inappropriately. Um, but here's how today's technology can help you. So, our goal is that you listen to this episode because better hearing and speech month is coming up in a couple of days. And we want to encourage you, these are 10 of the most common signs of hearing loss. Chances are you may experience a few of these, one, two and and maybe some, all of these. But with today's technology, when you present with hearing loss, and when you go to your hearing care provider, ask them to conduct a speech in noise test, and here's why. You're going to hear the tones, which is called a pure tone test, and they're gonna run a full battery of testing on you.
But we need to understand and we need to know how well or how poorly you perform in a noisy situation. When you're fit with the technology, today's technology, the, the premium level hearing instruments are phenomenal because what they do is they decrease overall listening effort and they increase speech understanding. And they do this through way of adaptive directionality. So the hearing aids know the difference between the /s/, /th/ sound, different consonants, but they also know the difference between soft sounds, loud sounds, and they know how to adapt. So, they're scanning your environment and they're learning your environment that you're in, and they're making adjustments for you based off your hearing loss because again, these hearing aids are prescribed for your hearing loss. Sign number five, before we go forward, I'm gonna take a sip of my iced coffee. I think I took a swig of my coffee last, uh, last episode.
too. However, this is iced coffee cuz I just went on a walk. It is, uh, 81 degrees here in Arizona and it's hot. But I needed a little caffeine boost to make sure that I can, uh, really provide y'all with the best value <laugh>. And, uh, so hopefully you have your favorite beverage poured while we listen in on the top 10 or the 10, uh, most common signs of hearing loss. So, we're gonna go to number five. Number five, answer or respond inappropriately in conversations. Now, we have all been here, whether it be you present with hearing loss or you have normal hearing, there might be times if I'm traveling and going through the airport and going through security, which is always the most nerve wracking thing because you know, they're yelling and shouting and <laugh>, you're trying to take your shoes off and get everything through.
But there are words that some individuals might say in that situation. You know, they may say, you know, uh, put your laptop in the box please. And I might just say, or think they said, oh, you like blue cheese <laugh>. It doesn't make any sense, but I may hear them say a certain or a different word. But if you are consistently answering or responding inappropriately in conversations, absolutely call your local hearing care provider. One of the reasons this happens, and most of the patients that I fit with hearing technology presented with very similar hearing loss. It was often moderate to severe high frequency sensorineural hearing loss, which means that the high frequency consonant sounds are compromised. So, what do I mean by this? Well, sounds like /f/, /s/, and /th/. Well those sounds, the consonant sounds, those high frequency consonant sounds are very important for speech understanding and intelligibility.
And if those sounds, those consonant sounds are compromised, you might hear what someone says, but you might not understand what they said. And we talked about that a little bit earlier in this episode. The difference between hearing and understanding. And I wanna share an example. So, I like to go on walks in the morning, uh, just to kind of get my day started and literally just be in the present moment. And every person I walk by I'll say, "Have a great day." Now, there are mornings that I'll walk in a retirement community and some of these individuals might present with hearing loss and the responses I get sometimes are not appropriate as I follow up to what I've said. So, for example, I'll say, "Have a great day." And they might hear, and, and we're passing too. So, they might think that I said, it's a great day.
And they'll say, yeah. Now, granted, they might not present with the hearing loss. They're walking past me. We have head shadow effect going on there. Uh, but if you find yourself consistently responding inappropriately in conversations, please visit a hearing healthcare provider. And, and as I said, there are different types and degrees of hearing loss, but the majority of the patients I've personally worked with present with that high frequency sensorineural hearing loss. So those fricatives, those high frequency consonant sounds are compromised. Let's go to sign number six. Sign number six, difficulty hearing women and children's voices. Now, women and children have high frequency voices and oftentimes what we call a higher fundamental frequency. Bear with me here, I am not gonna go deep into what a fundamental frequency is. Um, but women and children do have higher pitched voices and often present with what we call lower intensity.
So, they have high pitch low intensity. So right now I'm speaking to you, I have a stronger voice. I was recently at an event, and this is the perfect example to share with, with you tuned in right here. I was at an event and it was me and two colleagues - two males, one female. And my colleague said, I'm having really difficult time hearing what she's saying. And it was in a noisier situation. There was some background music. And the reason being is because our communication partner, who was a female, she had a high pitch voice, it was lower in intensity, and she was competing with background noise. Now my voice, I have a deeper voice, more intense. So, it was easier for our communication partner to hear my voice. So, having difficulty hearing women and children's voices is a sign that you may very well present with hearing loss.
Sign number seven, you feel like others are mumbling or garling their words. I would hear this time and time again in the office, my patients would say, "Oh, you know, my husband just mumbles." This is definitely one of the top signs of hearing loss patients share with us when they first come in for the appointment. They'll say, "I hear just fine. They just mumble." And if you listened to our most recent episode about grief and hearing loss, we talked about that as well. Let's go to sign number eight. You might miss important information in meetings. So, this one, I'm going to extend on this one a little bit more. I've worked with patients in the past who were still working full-time and they would travel a lot. So, I remember one in particular would travel almost twice a month, uh, to different parts of the country, even outta the country.
And he said, "Blaise, listen, I need to be able to understand what I am hearing in meetings." Now, there's a few compensatory strategies here. Number one, uh, if you do present with hearing loss, and if this is a sign that you just heard and are saying, "yeah, that does sound like me," please, I encourage you, visit your local hearing healthcare professional, get your hearing tested, and if you do present with hearing loss, move forward with prescription hearing aids. Your hearing care provider is absolutely gonna be able to take great care of you. When you miss important information in meetings, this can absolutely affect your overall performance. And there's a statistic that, uh, reports that untreated hearing loss is linked to $1 billion in lost U.S. earnings. So, we know that untreated hearing loss has a major impact on the workforce. So, if this is you, I encourage you, get your hearing tested.
If you do present with hearing loss and you do move forward with hearing technology, I have some exciting news. There are a few accessories for you. Uh, for example, Starkey has a table mic for patients that wear Starkey hearing aids. So, what this table microphone actually does, it's a really small accessory, but you put it in the middle of the meeting table and whoever is talking, it has microphones in this table mic and it has a beam form, b-e-a-m, beam form. So, whoever's talking, that microphone latches onto that patient's voice and it streams directly into your hearing aids. There's also other remote microphones where one communication partner can wear a remote microphone, or if you have a remote microphone currently, put it in the middle of the meeting table to increase overall speech understanding and intelligibility. And I will say, vouch for yourself.
Say, "I present with hearing loss and I wear hearing technology, may I put my table mic in the middle to increase overall speech understanding." Going one step further: utilization of closed captioning. I myself, if I'm on a zoom call or a teams call, although I present with no hearing loss. So, for me, it helps me understand in a meeting of, all right, now I have a visual cue, but I am also able to link that with the, the captions. It just helps me personally. So, give that a try. When you get your new technology, your new hearing aids, use the table mic, use the captions, uh, it's gonna help tremendously. Sign number nine, did not mean to rhyme there. You avoid social situations that you once enjoyed. Social isolation can lead to depression. And we touched upon this in last week's episode titled "Grief and Hearing Loss."
And I'd encourage you after you listen to this episode, if you did not tune into the grief and hearing loss episode, please do that. Share it with friends and family because we are trying our hardest to just raise awareness of that mind-brain connection when it comes to untreated hearing loss. I've seen this with patients time and time again. And this was a really, this was one of the most beautiful things when it comes to fitting patients with hearing technology. We would have patients who said they were socially isolating themselves, they're withdrawing, we fit them with hearing technology, and they would come back for their first follow up, then second follow up and if they needed a third follow up, you know, we got that on the schedule. But I am telling you, there have been so many instances and so many cases where patients would come back to the office and they were a different person.
And the reason being is because they, they found themselves again. They're out, they're socializing. We have to understand that we are social beings. Even though if you are an introvert, you may very well still like to be around people and the presence of people. So, that to me was always the coolest thing to see and to experience. Patients coming back and they've, they've found themselves again and it's so incredible. So, if you do present with this sign that you are avoiding social situations that you once enjoyed, please go get your hearing tested, get prescription hearing aids, visit that hearing care provider. We always say "Hear Life's Story," so do us a favor and do that. We're here for you. And the very last sign, number 10. So again, we talked about the top 10 most common signs of hearing loss - regularly told by others you should get your hearing tested.
And I've heard this time and time again and I would encourage communication partners. So if you're listening right now and you don't suspect that you present with hearing loss, but you're listening in because you're trying your hardest to encourage your husband or your wife or your partner, whoever, to visit their hearing care professional, give them grace, be patient with them, encourage them, don't withdraw from them. Say, "I'm here for you. What can I do for you to understand my voice a little bit better?" That might be better lighting, that might be decreasing the distance that you're speaking to each other. But if you're tuned in right now and you're saying, you know, I am being told by a lot of people in my life that I need to get my hearing tested, take that first step and get the hearing tested. And I said this I think two episodes ago, obviously I'm human <laugh>, um, you know, but there are times I don't like to go to the doctor because of fear of the unknown.
And I get it. It can be scary. And again, we talked about this in the grief and hearing loss episode, where patients might feel as though that they're losing their identity and their identifying with who they were, that individual that had great hearing and they could hear so well. But I'm encouraging you, take that first step, find that accountability buddy, whether it be your friend, your neighbor, whoever. Take the first step and visit your local hearing healthcare provider. Again, I wanna thank you all so much for the continued support. Next month, in a couple of days actually, we will be celebrating Better Hearing and Speech Month. And this is a month we are so excited to celebrate because that means that we are able to continue to raise awareness of the importance of hearing healthcare. You're tuned in to the Hearing Matters podcast, the show that discusses hearing technology, best practices, and a growing national epidemic: Hearing Loss. Until next time, Hear Life's Story.