What you give up when you lose your hearing can be different for everyone, but the things you will miss most are conversations, sounds and the feelings you get in return from them. Some familiar examples may include laughter with your family, discussing politics, listening to your favorite music, and watching crimes being solved on a TV show like NCIS
If you’ve accepted that you will be saying “what?” or “huh?” anytime that anyone says anything, then the rest of this article may not be for you.
For the rest of you, imagine driving on a rural country road while talking on your cellphone. As anyone knows, poor cellphone reception can make conversations very frustrating and difficult. Developing a hearing loss is like living with poor reception, except you never get to your destination so you can call back.
Life is full of many wonderful sounds, like a shriek of laughter when you find your (grand)child during a game of hide and seek. Perhaps, it is when you went to church on Sunday and felt everything you heard was being said directly to you. Having meaningful conversations with people is what really connects us to others. Now, imagine your life without these everyday experiences. What happens when you can’t hear what you need to?
Hearing loss is typically gradual; you lose bits and pieces of certain words, forming the audio equivalent of a “blind spot”. This is well illustrated by looking at a Speech Banana Graph. The graph shows where these blind spots tend to form along a graph based on how difficult certain parts of words are to understand.
Women and children become more difficult to hear. Over time you find yourself guessing at what they said more often. You learn certain tricks like focusing harder on what was said or watching the lips of someone who is talking, and filling in the blanks visually. Having to focus intently to understand conversation is not sustainable. Eventually having conversations become much more challenging than it used to be.
We asked someone with hearing loss a simple question. What is it like giving up music?
It’s lonelier. The most beautiful instruments like the piano and violin lose some of their spark that makes them so lovely. Nothing sounds like it used to, for instance one of my favorite things used to be listening to the radio when driving to the the store, but now I just get frustrated that I can’t hear and everything sounds a little wrong. The worst part of it all is I know exactly why this happened. When I was younger, I used to go to a lot of concerts where they blasted loud music, and I thought it was great. It is the worst thing to realize that music made me lose my hearing. We just didn’t know everything back then that we know now.
As your hearing loss becomes progressively worse, you start to adapt to receiving less sounds and slowly “turn off” that part of your brain. This process is called Auditory Deprivation. It is conceptually very similar to becoming blind, and having your brain adapt to relying less on vision to get around. It might seem odd, but you don’t actually hear with your ears, they are more of a mechanical device that transmits sound to your brain. Hearing is what happens when sound waves stimulate your auditory cortex (via the outer, middle, and inner ear, and lower neural circuits), creating signals that you can understand.
“Use it or Lose it” is a common phrase that means if you aren’t actively “using” something, you are much more likely to “lose” it. This is very applicable to your hearing. Your auditory system can become less sensitive, and poorer at understanding the meaning of sounds, if it isn’t stimulated regularly by audible sounds. This occurs over time as people with hearing loss age. The part of your hearing system that handles high frequency sounds is the first to go. This does not happen overnight; it is a slow process that can take years.
The way we actually lose our hearing requires a simplified scientific explanation. We have tiny hair cells in our ears that vibrate and our brain interprets and translates those vibrations to the sounds that we hear and understand. The long hairs sway as if moved by a breeze (in this case, a sound wave); this movement creates a signal that is sent to our auditory nerve. There are thousands of these hairs at different locations in your cochlea, and different groups of hairs transmit certain frequencies. Over time these hairs may become damaged by loud noise exposure, ototoxic medications and old age. With these damaged hairs, it now takes a “bigger breeze” (louder sound waves) to vibrate and relay the message to our nervous system, making it harder to hear well. Your hearing is only as good as the connection between your brain, your nervous system, and your ears.
Hearing Aid Technology
We are fortunate to live in a day and age where miracles of modern technology are constantly being developed. Modern digital hearing aids can help fill the gaps in hearing created by the damaged hair cells in our ears. The amplified sounds generated by a modern hearing aid can be carefully tuned by an audiologist or a hearing healthcare provider to match up with your lost hearing and provide louder sounds only where you need them.
In contrast, there is no easily accessible technology available to support the loss or decline in the functioning of some of our other senses, such as taste or sight. There is no artificial tongue that can help you experience flavors, if you lose your sense of taste, Nor are there bionic eyes easily available which can enable the blind to see. When described in this context, what hearing aids are tasked with doing seems like science fiction or something we will perpetually have “in 10 years”. This is not the case for hearing aids which are readily available in most parts of the United States. There are healthcare providers nationwide who can fit people with these devices everyday.
Losing your hearing today is very different from how it was a few decades ago. Today’s hearing aids are much more advanced. They are much better at separating speech from background noise and are sleeker and more discrete. Many of them work with your favorite technology like televisions or smartphones. This is timely since there are more people suffering from hearing loss today than at any point in human history. Part of this is due to the increased size of our population worldwide, along with a world which is increasingly louder than it used to be. Our ancestors did not have to deal with excessively loud sounds like rock concerts, jackhammers, and constant road traffic. Any other public health issue that was as commonplace and as serious as hearing loss would be declared an epidemic, but because it isolates individuals over time without causing immediate physical suffering or visual symptoms, hearing loss is thought of very differently.
The primary issue untreated hearing loss must overcome is that it separates people from their community and support networks. Medical issues often bring families and friends together, and help strengthen ties between people. Hearing loss has the opposite effect. It makes conversation and dialogue more challenging for both listener and speaker alike. When it is hard to connect with someone, eventually most people become frustrated and tend to give up. Hearing loss makes connection much more difficult and can compromise communication and relationships. Choosing to avoid treatment for hearing loss is an active choice to become less involved with the world around you.
There’s No Going Back
While hearing loss is almost always permanent damage to your nervous system, it is also generally treatable. The only reason hearing loss is a nationwide problem is because so few people are actively dealing with their hearing loss. When your hearing loss is due to old age and damage to your stereocilia (hair cells in the cochlea), your hearing loss is generally considered irreversible. The condition is progressive and the longer you have it, the worse it gets. Treatment options are also most effective when they are used early on, before serious damage has eroded the nervous system that handles hearing.
The most unfortunate aspects of hearing loss are not just the loss of music, human interaction, and quality of life. Hearing loss is linked to other serious conditions, including dementia and Alzheimer’s Disease. Decades of research spearheaded by Johns Hopkins University shows the connection between untreated hearing loss and dementia. A recent “headline statistic” concluded that people with serious untreated hearing loss are up to five times more likely to develop dementia (causation has not been established). This discovery, and the call for awareness on this issue has motivated hundreds of thousands of people to take action to address their hearing loss.
Sound is a part of everyday life. If you lose your ability to hear, everything around you is affected. The consequences of inaction are very high, and this problem affects millions of people in the United States alone. Too little has been done by the community of hearing care professionals to educate people about the profound consequences of hearing loss and to make them aware there of simple and easily accessible treatment options. While your hearing loss may never go away, it does not mean you need to go without hearing for the rest of your life.
About Andrew Lekashman
Andrew Lekashman is a Hearing Instrument Specialist based out of Red Oak, Iowa. He works with ClearValue Hearing, ASI Audiology, and Libel Hearing Aid Centers to educate people about hearing loss around the United States.
Last modified: May 26, 2017