SAN LUIS VALLEY HEALTH AUDIOLOGY CLINIC

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1 SAN LUIS VALLEY HEALTH AUDIOLOGY CLINIC January 2019 Editor s corner It s hard to believe that a new year is upon us and I am just now getting around to completing the new year edition of the HEAR NOW newsletter. Although I ve been in the Valley for several years, there are so many new providers and faces that it is one of my New Year s resolutions to introduce myself and Audiology to the San Luis Valley community. So let me begin first by introducing myself. My name is Linda Vaughan and I am currently the clinical audiologist at the San Luis Valley Health and I provide diagnostic hearing services to all-ages populations. Although I am a native Coloradoan, I ve been away from home for a long time. Most recently, I had been in Maryland where I was the Director of Infant Hearing for the State of Maryland. But, after working in all areas of audiology all over the country, my husband and I are now thrilled to be back in the wide open spaces and high roaming places of Colorado. It s good to be back home. Audiology provides direct clinical support to the ENT Clinic as well as to all referrals of patients with hearing issues. Audiology is located in the hospital on the second floor in the General Surgery/ENT/ Allergy/Audiology Clinics area. I am currently able to provide complete hearing evaluations and counseling to newborns, pediatrics, adults, and geriatrics. Beyond routine hearing evaluations, Audiology also provides auditory brainstem response (ABR) testing for hearing thresholds, as well as site of lesion testing for retrocochlear pathology. My office hours are Monday -Thursday and I can be reached directly at and by at linda.vaughan@slvrmc.org. If you would like to schedule an appointment, please call HEAR NOW is to serve as a communication vehicle to disseminate information about hearing, audiology, and ears to providers and from providers. It s my deeply held belief that good patient care happens when we actively listen to our patients and work as a team to support the health and wellness of our patients. That kind of service delivery is always a challenge, but communication has to be at the center of achieving that goal I m hoping that the newsletter is informative and that you ll feel free to send your comments, suggestions, information, and even pictures to make this a meaningful read for all. I look forward to meeting each and every one of you and providing you and your patients with first class audiologic care. Happy New Year, Linda Vaughan, M.A., CCC-A Audiologist

2 P A G E 2 H E A R N O W Quick statistics on hearing loss From the National Institute on Deafness and Other Communication Disorders (NIDCD), some quick statistics on hearing loss: Men are more likely to experience hearing loss than women. Of adults ages 65 and older in the United States, 12.3 percent of men and nearly 14 percent of women are affected by tinnitus. Tinnitus is identified more frequently in white individuals and the prevalence of tinnitus is almost twice as frequent in the South as in the Northeast. Approximately 17 percent (36 million) of American adults report some degree of hearing loss. There is a strong relationship between age and reported hearing loss: 18 percent of American adults years old, 30 percent of adults years old, and 47 percent of adults 75 years old or older have a hearing impairment. About 2 to 3 out of every 1,000 children in the United States are born deaf or hard-ofhearing. Nine out of every 10 children who are born deaf are born to parents who can hear. The NIDCD estimates that approximately 15 percent (26 million) of Americans between the ages of 20 and 69 have high frequency hearing loss due to exposure to loud sounds or noise at work or in leisure activities. Only 1 out of 5 people who could benefit from a hearing aid actually wears one. Three out of 4 children experience ear infection (otitis media) by the time they are 3 years old. Roughly 25 million Americans have experienced tinnitus. Approximately 188,000 people worldwide have received cochlear implants. In the United States, roughly 41,500 adults and 25,500 children have received them. Approximately 4,000 new cases of sudden deafness occur each year in the United States. Hearing loss affects only 1 ear in 9 out of 10 people who experience sudden deafness. Only 10 to 15 percent of patients with sudden deafness know what caused their loss. Approximately 615,000 individuals have been diagnosed with Ménière's disease in the United States. Another 45,500 are newly diagnosed each year. Approximately 3 to 6 percent of all deaf children and perhaps another 3 to 6 percent of hard-ofhearing children have Usher syndrome. In developed countries such as the United States, about 4 babies in every 100,000 births have Usher syndrome. One out of every 100,000 individuals per year develops an acoustic neuroma (vestibular schwannoma).

3 P A G E 3 Protect your Hearing! Noise-induced hearing loss can result from a one-time exposure to a very loud sound, blast, impulse, or by listening to loud sounds over an extended period. Hearing loss can result from damage to structures and/or nerve fibers in the inner ear that respond to sound. This type of hearing loss, termed noise-induced hearing loss, is usually caused by exposure to excessively loud sounds and cannot be medically or surgically corrected. YYou and your patients should know that you can protect your ears from hearing damage by avoiding or controlling loud noise exposure. If a place is so loud that you cannot hear talking in a normal voice, move to a quieter place or wear ear protection. If you move away just ten feet from a loud noise, such as at parties or a dance floor, you significantly reduce the potential for damage to your ears. Teens too can start by turning down the volume on their ipod or MP3 player. If you wear headphones and cannot hear someone speaking to you in a normal voice, the volume is too high. When doing yard work, consider using hearing protection while mowing the lawn, driving the tractor, and using the chain saw or other tools. Always use hearing protection when hunting or shooting. Remember, only one gunfire can give you permanent hearing loss! For electronic gadgets, avoid setting the vol-ume higher than 50 percent of maximum level. Avoid listening to personal devices like ipods and MP3 players for more than 60 minutes. Some of these devices now offer free vol-ume-limiting software that can be installed. Audiologists can fit you with customized ear plugs for hearing protection to fit perfectly in your ear, and can explain how and where to effectively use them. Additionally, you can purchase inexpensive foam earplugs from drugstores, sporting good stores, etc, which when used correctly, can provide excellent hearing protection. If you are going to be exposed to dangerously loud sounds, (see table below for examples), it is advisable to use both foam earplugs and ear muffs. Again, it is important that the foam plugs are inserted correctly and that the ear muffs fit correctly. A leak in the seal of the hearing protection will reduce their effectiveness significantly. Sound Levels in Decibels (db): Painful & Dangerous - Use hearing protection or AVOID 140 Fireworks, Gun Shots, Custom Care Stereos (at full volume Uncomfortable Exposure over 30 seconds DANGEROUS 120 Jet Planes during take off Very Loud Exposure over 30 minutes DANGEROUS 110 Concerts (any genre), Car Horns, Sporting Events 100 Snowmobiles, MP3/IPod players at full volume, Motorcycles 90 Lawnmowers, Power Tools, Blenders, Hair Dryers Loud+ 80 Alarm clocks 70 Traffic, Vacuums Moderate 60 Normal Conversation, Dishwashers 50 Moderate Rainfall Soft 40 Quiet Library 30 Whisper Faint 20 Leaves Rustling

4 P A G E 4 H E A R N O W Preventing Noise-Induced Hearing Loss According to the National Institute on Deafness and other Communication Disorders, an estimated 12.5% of children and adolescents aged 6 19 years (approximately 5.2 million) and 17% of adults aged years (approximately 26 million) have suffered permanent damage to their hearing from excessive exposure to noise. Hearing loss caused by exposure to loud sound is preventable. To reduce the risk of noise-induced hearing loss, adults and children can do the following: Understand that noise-induced hearing loss can lead to communication difficulties, learning difficulties, tinnitus, distorted or muffled hearing, and inability to hear some environmental sounds and warning signals. Identify sources of loud sounds (such as gas-powered lawnmowers, snowmobiles, tractors, farm equipment, power tools, gunfire, or music) that can contribute to hearing loss. Adopt behaviors to protect their hearing: Avoid or limit exposure to excessively loud sounds; 12.5% of children and adolescents have permanent noise induced hearing loss... Turn down the volume of music systems; Move away from the source of loud sounds when possible; and Use hearing protection devices whenever exposure to loud sounds exists Seek hearing evaluation by a licensed audiologist if there is concern about potential hearing loss.

5 P A G E 5 What s that sound? Most of us have experienced tinnitus, even Tinnitus if just briefly. retraining. However, A wearable for those device negatively delivers individually impact a person s pro- life. The American Tinnitus Association reports that that hear the ringing, buzzing, or hissing sounds constantly, it becomes difficult to ignore and can more than 50 million Americans suffer from tinnitus. Approximately 12 million seek medical attention, while 2 million are unable to grammed tonal music to mask the live normal lives because of their tinnitus. For many seeking medical attention they re told just live with it get used to it. However, untreated it can lead to stress and debilitating specific depression. frequencies Tinnitus of the tinnitus can also be a sign of other otologic disease such as Meniere s Disease, sensorineural hearing loss, you ototoxic experience. hearing Specially loss, and trained acoustic neuroma. audiologists provide this therapy What causes tinnitus? technique that over time, may accustom the tinnitus sufferer to the tinnitus, thereby helping them not to Tinnitus can be caused by noise trauma, head focus trauma, on it. certain Counseling medications is an integral such as high doses of aspirin, quinine based medicines, antibiotics, cancer therapies, and diuretics, high blood pressure, blood vessel disorders, TMJ disorders, neck injury, glomus tumor, acoustic neuroma, Meniere s Disease, component stress, depression, of tinnitus and retraining. ear wax impaction just to name a few. But, the most frequent cause of tinnitus is sensorineural hearing loss. Medications The tiny, delicate hair cells in the inner ear move in relation to the pressure of sound waves. This triggers the release of an electrical signal through the acoustic nerve to the Drugs brain. can't The cure brain tinnitus, interprets but in these some signals as sound. If the hair cells inside the cochlea are bent or broken, as seen with sensorineural cases they hearing may help loss, reduce they can the randomly severity of symptoms or complications. Possi- fire electrical impulses to the brain causing tinnitus. ble medications include: How can tinnitus be treated? First, it is important to identify any underlying, treatable condition that may be associated with the tinnitus symptoms. Examples include: Earwax removal. Removing impacted earwax can decrease tinnitus symptoms. Treating a blood vessel condition. Underlying vascular conditions may require medication, surgery or another treatment to address the problem. Changing medication. If a medication being taken appears to be the cause of tinnitus, stopping or reducing the drug, or switching to a different medication may provide the patient with tinnitus relief. Noise suppression. In some cases "white noise" or other masking techniques may help suppress the sound so that it's less bothersome. Devices include: White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. These devices can be utilized with pillow speakers to improve sleep and reduce bothering the patient s sleeping partner. Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus. Hearing aids can improve hearing but also may act as a masking device by bringing more of the auditory world into the patient s ear and to the brain. Masking devices. Worn in the ear, similar to hearing aids, these devices produce a continuous, low -level white noise that suppresses tinnitus symptoms.

6 What s that Sound? c o n t i n u e d Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Specially trained audiologists provide this therapy technique that over time, may accustom the tinnitus sufferer to the tinnitus, thereby helping them not to focus on it. Counseling is an integral component of tinnitus retraining. Medications Drugs can't cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications. Possible medications include: Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success. However, these medications are generally used for only severe tinnitus, as they can cause troublesome side effects, including dry mouth, blurred vision, constipation and heart problems. Alprazolam (Niravam, Xanax) may help reduce tinnitus symptoms, but side effects can include drowsiness and nausea. It also can become habit-forming. Standard tinnitus precautions recommended to all tinnitus patients include: Noise avoidance/hearing protection. Noise exposure can increase the perceived level of tinnitus. Patients are advised SAN LUIS VALLEY HEALTH San Luis Valley Regional Medical Center Audiology Clinic 106 Blanca Ave. Alamosa, CO Phone: Fax: linda.vaughan@slvrmc.org to avoid loud noise, but if they have to be in a noisy environment they should use hearing protection. Sometimes just a loud restaurant or crowded store is enough to trigger an increase in tinnitus. Restricting salt and caffeine. Salt and caffeine can affect blood and oxygen flow and thus increase the tinnitus. Patients will often complain that their ears ring worse after they eat Chinese food after all that soy sauce! Stress management. As with all physical conditions, being stressed, tired, and anxious can increase the loudness of the tinnitus. Managing stress is key to managing this condition that may very likely have no cure or effective medical treatment. Evaluation of a patient s tinnitus begins with a complete hearing evaluation by an audiologist. The audiologist will be able to assess the status of the patient s hearing that will assist the otolaryngologist in determining the possible cause of the tinnitus and determine an appropriate course of treatment.