Address subtle signs of onset of hearing loss

<p>It's called the Invisible Handicap. There are few, if any, outward signs of hearing loss and those signs that are visible are not sexy. But the effects of being unable to hear are serious.</p><p>Helen Keller once said, "The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune." She knew that while blindness isolated her from the material world, being hard of hearing isolates one from the social world, which is truly painful.</p><p>The signs of age-related hearing loss are initially subtle. Over time we lose the ability to hear high frequency sounds, people around us appear to mumble, and we find it difficult to discriminate voices in crowds. We find ourselves turning up the TV, asking people to repeat what they just said, and withdrawing from conversations. Family members and co-workers may get impatient and irritable, thinking they are being ignored. Slowly we become socially isolated.</p><p>Hearing loss is not always caused by aging ears. Obstructing ear wax, trauma and rare tumors are a few other causes of deafness. Some are easily treated, so if hearing loss is sudden or clearly one-sided, a visit to an ear specialist is recommended. Abnormalities in the outer and middle ear can cause problems, but the most common cause of hearing loss is presbycusis, a sensorineural hearing loss associated with aging in the inner ear.</p><p>Critical to our ability to hear is the cochlea, a snail-shaped structure in the inner ear. The fluid-filled cochlea is lined with tiny hairs attached to nerve cells. When soundwaves travel from the outer ear, through the middle ear and to the cochlea, they create vibrations in the fluid. The cells in the cochlea translate these fluid vibrations into electrical signals that are sent to the brain.</p><p>Over time the hair cells in the cochlea may break or become bent because of use, abuse or simply because of genetic predisposition. When the nerves and hair cells are damaged or missing, electrical signals are not transmitted efficiently and hearing loss occurs.</p><p>There are about 30 million Americans exposed to dangerous levels of noise every day and 10 million Americans already have hearing loss from noise exposure. Noise-induced hearing loss is 100 percent preventable -- earplugs and protective earmuffs can help -- but once the inner ear is injured, the damage is permanent.</p><p>We also can reduce the number of children, teenagers and adults suffering from noise-induced hearing loss by avoiding prolonged exposure to sounds above 85 decibels. This level of sound includes lawn mowers, shotguns, motorcycles, rock concerts and screaming iPods.</p><p>If you or a family member appears to be withdrawing from social interactions or showing some signs of hearing loss, you may benefit from using the "Hearing Dependent Daily Activities Scale" (see accompanying resource list). This is a useful questionnaire for evaluating the impact of hearing loss on daily life. If hearing loss is significantly affecting your everyday world, you may want to consider a hearing aid.</p><p>All hearing aids require an audiogram, which is a simple hearing test that graphs your ability to hear different frequencies. Most aids are digital sound amplifiers, but some are more elegant, pricey and personalized than others.</p><p>No matter what age you are, there is something you can do to address healthy hearing. First, protect your and your family's ears from damage. If you have signs of loss, use the HDDA Scale to evaluate yourself. And if a loved one appears to be socially withdrawn or depressed, or if you find yourself having difficulty staying connected to the world around you, consider a visit to an ear specialist or an audiologist.</p><p>Hearing aids can be discreet but powerful tools to remaining vital and connected.</p><p>Dr. Stacey Kerr, a longtime Sonoma County family physician, graduated from UC Davis Medical School and is certified in her specialty by the American Board of Family Medicine. Her columns are not intended as a substitute for hands-on medical advice or treatment. Consult your health care provider before adhering to any recommendations in this column. E-mail comments to drkerr@the-doctors-inn.com.</p>