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About Hearing and Hearing Loss 2 3 Where is your hearing today? Contents If you were to pause for a moment This booklet provides insight into to consider how good you are at Why you should treasure your hearing . . . . . . . . . . . . . . . . . . . . . . . . 4 how your hearing works and how to listening and communicating in spot the telltale signs of hearing different situations, how would you loss. This information will help you rate your abilities? If you sometimes make the right decisions when it find it hard to keep up, and you comes to looking after your hearing. often feel tired and overwhelmed, it is important to consider the cause. A hearing loss does not have to Do family or friends complain that prevent you from enjoying life, you are not listening? You might be and it will not – as long as you in great shape physically – but what do something about it now! kind of condition is your hearing in? Don’t be the last one to know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 What causes hearing loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Types of hearing loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 How your hearing can change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 How we hear sounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The emotional impact of hearing loss . . . . . . . . . . . . . . . . . . . . . . . . . 10 How hearing loss can affect people . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Recognising the signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Visiting the experts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 What a hearing test can tell you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 How the ear functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Your next step . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 4 5 Why you should treasure your hearing Don’t be the last to know Of all the five senses, our hearing is As well as helping us communicate Hearing loss can creep up so recognise it and do something perhaps the most precious. and socialise, our sense of hearing slowly that the person affected is about it early on. To avoid this fate, Deprived of this, we lose contact helps to keep us safe. A fire alarm often the last one to know. In fact, you need to be able to recognise the with the people we love and the ringing, a car honking friends, co-workers or family signs and get your hearing checked. world in general. its horn, or a child shouting “Help!” members are likely to spot the are just a few examples problem before you do. They might People get their eyes and teeth Consider all the sounds you encoun- of vital signals that we need to say, “You are not listening to me.” checked on a regular basis, so ter, every single day: friends be able to hear. They may get annoyed because the why not add your ears to the main- TV is too loud. And they might tenance list? It takes less than an chatting, children laughing, a favourite song, a loving remark. It is We rely on our hearing in so many wonder why you do not react when hour to assess your hearing health this invigorating, informative ways, which is why we should a friend calls you or when the – and the sooner a hearing loss is symphony of sounds that makes life treasure and protect it. doorbell rings. detected, the better. richer. Is this you? Do you suspect that your ? The real problem is often not the condition itself – but that we do not hearing is not as good as it used to be? For instance, do you find yourself having to look directly at people’s faces to understand what they are saying? Did you know that more than 500 million people ! worldwide experience some degree of hearing loss? About half are of working age. 6 7 What causes hearing loss Types of hearing loss Hearing loss is often associated blocks of speech is a far more with advancing age, but this is not challenging affair. always the case. Although it can Noise-induced hearing loss strike people at any age, the condition most often appears after This is often caused by over- the age of 65. But it can also be caused by infections, injury or birth defects. Age-related hearing loss In general, there are three types Sensorineural hearing loss of hearing loss: conductive, sen- This type of hearing loss happens sorineural or mixed hearing loss (a when the delicate sensory cells or combination of both). nerve fibres in the inner ear get damaged. This stops them transmit- exposure to excessive noise. It Conductive hearing loss threatens the hearing of military Conductive hearing loss is common causes of sensorineural personnel, police officers, construc- caused by problems in the outer and hearing loss are the natural process tion workers, factory middle ear, which can prevent of ageing or excessive exposure to ting sound properly. The most workers, farmers, dentists and sounds getting through to the noise. This condition is in most cases As we get older we may lose our kindergarten teachers – to name inner ear. The most common permanent. ability to hear softer, high-pitched but a few. Rock concerts and mp3 cause can be a build-up of wax sounds. Birdsong is fairly easy to players can also damage people’s in the ear canal, perforated ear- live without, but getting by when hearing. drums, fluid in the middle ear, or you lose some of the building damaged or defective ossicles (middle ear bones). Everyday Sources of Noise Soft Whisper Leaves Rustling Quiet House Vacuum cleaner Electric Drill/Lawnmower 20 dB Hazard Zone Protection must be 40 dB worn by law in the 60 dB workplace 80 dB 120 dB Jet Engine 120 dB part of the ear’s delicate mechanism can break down or ! simply wear out? Some people experience a significant loss of 100 dB Nightclub/Rock concert Gunshot/Explosion Did you know that over time, 140 dB Regular exposure to loud noise will accelerate hearing loss. Even transient loud noise, such as the sound of a hammer, can cause permanent damage to your hearing. Always wear ear protectors if you are exposed to excessive noise. sensory cells at the age of 50, while others only have a negligible loss even at the age of 80. 8 9 How your hearing can change How we hear sounds Even with a hearing loss you might decrease before you become a Sounds can be described as loud or At meetings and social events there feel that life sounds just as loud as teenager. It is a very slow process, soft, high-pitched or low-pitched. A is nothing worse than having to ask ever. Some sounds – like a lawn- therefore it is difficult to recognise. violin, or birds singing are examples people to repeat themselves. You mower – remain audible while of high-pitched (or high frequency) might blame others for mumbling, others become harder to hear. Take Knowing more about what to be sounds, while a double bass, or when it is actually your hearing that the voices of women and children, aware of will help you monitor your traffic in the street are examples of is at fault. Communication will for instance. You will have to work own reactions: If you find yourself low-pitched (or low frequency) become increasingly difficult, until doubly hard to follow what they are saying “What?” and “Sorry – could sounds. eventually you will withdraw from saying, as their voices are softer you repeat that?” you will know that and higher pitched than men’s it is time to take action and get your Keeping up with speech voices. hearing tested. What makes speech so hard to social situations completely. follow with a hearing loss is that it Our hearing gets weaker over involves so many different sounds in the years, it basically starts to a rapid flow. The softer, highpitched consonants such as ‘f’, ‘s’ or ‘t’ can be drowned out by the louder, low-pitched vowel sounds – such as ‘a’, ‘o’ and ‘u’. So if someone says Is this you? ? Do you have difficulty hearing someone calling from behind or from another room? And do you try to avoid talking on the phone? “statue” and all you can hear is ! “s_a_ue”, you will be forced to try Did you know that and guess the rest – by which time sounds such as birdsong, the conversation will have moved footsteps, and leaves on. rustling in the wind are some of the first to fade away unnoticed? If you are missing these everyday sounds, you may also be missing key speech sounds, which makes words sound muffled and blurred. 10 11 The emotional impact of hearing loss How hearing loss can affect people We all want to feel in control of our Left unattended, hearing loss can Hearing loss does not only strike Your partner and family are expect- lives. We all want closely-knit lead to feelings of isolation and yourself; it hits the people with ed to show compassion and consid- families, loyal friends, and active depression. whom you interact. Whether eration – but they do not really lifestyles with interesting pastimes. through meaningful conversation or understand your problem and they But when you allow a hearing loss to Happily, things do not have to get playful teasing, the exchange of may not always have the time and go untreated, you put all these life out of control. Surveys show that ideas suddenly becomes slower and energy. Rather than waiting for qualities at risk. treating a hearing loss has a far more tedious. them to run out of patience and positive impact on people’s physical push you into taking action, why not You may start to experience all and emotional well-being. There is Imagine having your best friends take the initiative and set the pace sorts of emotions – from worry and no doubt that taking the responsi- over for dinner. You try to follow yourself? embarrassment to sadness and bility to look after your hearing will what they are saying, but their loneliness. You will also feel tired turn your life around! voices sound blurry. When they are and irritable from having to concen- telling jokes you strain to catch the trate harder. punch line. You laugh when they do Did you know that, left untreated, hearing loss can ! – but you did not really get it. And in the end you just drift away. lead to social and psychological problems? Inter-personal relationships suffer, self- esteem diminishes and feelings Is this you? of isolation increase. Have family, friends or ? colleagues made any com- ments about your hearing? And do they often have to speak loudly or say things twice? 12 13 Recognising the signs Like so many things in life, our hearing changes, but the transition to a quieter world happens so slowly that it can easily go unnoticed. That is why it is impor-tant to be able to recognise the telltale signs. The questions on the following page cover a whole range of everyday listening situations. If any of the problems listed seem to apply to you, you should contact a hearing care professional for a consultation. Is this you? ? Can you see birds in the trees – Do a quick self-check These questions will allow you to make a quick assessment of your hearing. Yes! No! Do people seem to be mumbling? o you have to strain to hear when D someone talks or whispers? o you have difficulties hearing someone D call you from behind or from another room? o you need to watch a speaker’s lips D more closely to follow the conversation? Do you find it hard to keep up in meetings, in restaurants, or in lectures? Do you have to turn up the volume on the TV or radio? Do you find it hard to hear clearly on the telephone? o you have difficulties hearing at the theatre, D cinema or other entertainment venues? Do you find it hard to hear in noisy environments like in the street or in a car? Do you tend to limit your social activities because it’s difficult to hear and communicate? Do family, friends, or colleagues mention that they often have to repeat themselves? but not hear them chirping? Watch a tap leaking – but not perceive the falling droplets? Turn on your PC without registering it whirring into life? If you end up answering ‘Yes’ to some of these questions, do not be disheartened. It does not mean that you have a hearing loss – you might just have severe earwax! Only a hearing care professional can tell you for certain. 14 15 Visiting the experts What a hearing test can tell you Visiting a hearing care professio-nal hobbies. And consider some specific When you visit a hearing clinic you is a huge step towards better situations in which you would like to will be in caring hands. Trained test will be recorded as an audio- hearing – and it is easier to take hear more clearly. audiologists will be ready to deal gram (a line of x’s and o’s). From than you might think. It does not them. The results of this very simple with your concerns and give your these markers the audiologist will take long. It does not hurt. Remem- Lots of people have difficulty hearing a full check up. The test be able to tell you: ber to take someone with you to hearing speech in noisy places such itself takes place in a quiet room or a keep you company and to help you as meeting rooms, parties, restau- sound-proof booth, where you will H ow much you can hear in remember what is being said. rants, supermarkets, etc. Once you put on a headset, sit comfortably, each ear. have decided which situations are and listen. H ow well you hear the loudness Before the appointment it is a good important, list them in order of idea to make some notes regarding priority, ready to discuss with your The audiologist will play a series of your family life, social life and hearing care professional. pure whistling tones – from bass What impact this has on your through to treble – and you will ability to communicate. and pitch of different sounds. press the buzzer when you can hear Did you know that it takes less than an hour to get an accurate evaluation of your hearing? And that the ! Audiogram Soft Soft Left ear Right ear Loudness Loudness (Decibels) (Decibels) process is completely painless? Loud Loud Low High Frequency (Hertz) Low Frequency (Hertz) High The audiogram is a simple graph showing the sounds you can or cannot hear. 16 17 How the ear functions The human ear is a precisely tuned The middle ear: system with a sensitivity and range Contains the eardrum and three tiny that easily outperforms the most bones: the Hammer, Anvil and elaborate sound system ever Stirrup (also called the Malleus, manufactured. The ear contains Incus and Stapes). These amplify many physiological mechanisms, the sound waves. and a breakdown or disruption in any of these can result in hearing The inner ear: difficulties. Sound waves are changed into Outer Ear Middle Ear Anvil Hammer Inner Ear Nerve fibres Stirrup electrical impulses by the cochlea. Fortunately, in most cases you can There are tiny sensory cells along improve your hearing by wearing the entire length of the fluid-filled hearing instruments. cochlea. The cochlea transmits the The anatomy of the ear Cochlea message via the nerve fibres to the area of the brain in charge of The ear is made up of three differ- processing and interpreting what ent parts. we hear. Auditory canal The outer ear: The shape of the outer ear helps to collect the sound waves and direct them through the auditory canal to the eardrum. Did you know that the smallest bones of the human body are found inside the ear? ! They are called the Hammer, Anvil and Stirrup. Eardrum 18 19 Your next step Enjoy birdsong and the rustle of leaves in the wind. Tell where sounds are coming from. Listen to TV or radio at a normal volume. Be the first to answer the telephone instead of the last. Keep up and participate in meetings. Making the decision to have your hearing tested is the first step If, like us, you feel your hearing is towards improving your quality of worth fighting for, call your local life. Just think what it would mean to hearing clinic for a consultation. Be you and your family if you could: good to yourself, and take that next step straight away! Hear and understand much more. Laugh with – and get closer to – the people you love. Feel relaxed rather than drained after a long conversation. Hear and understand the soft voices of children. For more information on hearing and hearing loss please visit: www.oticon.com People First People First is our promise to empower people to communicate freely, interact naturally and participate actively 906 00 610 00 / 02.12 Hearing Care Professional: