I Have Hearing Loss, What Now?
Photo credit -Jacob Sierra, Pexels. Man with dark hair wearing sunglassess and headphones with coloured stars on his cheek. He has one had behind his ear as if trying to listen to something.
If you’ve just been diagnosed with hearing loss it’s a lot to take in. Sometimes the explanations and terminology can be confusing.
So here’s a guide to the different types of hearing loss, how to understand your audiogram, and what support is available.
How the ear works
When we hear something, sound waves are captured by the outer ear and travel along the ear canal where they cause the ear drum to vibrate. In the middle ear, 3 tiny bones vibrate and amplify the sound waves. The eustachian tube opens into the middle ear. It’s role is to balance the pressure between the middle ear and the air outside.
The sound waves continue into the inner ear and cochlea. The cochlea is shaped a little like a snail shell and is full of fluid which moves in response the the sound vibrations. It is also full of thousands of tiny hair like nerve endings, which move with the fluid. These change the movements into electrical impulses which travel along the auditory nerve to the brain where they are translated into recognisable sounds.
The vestibular organ is also in the inner ear, which along with vision and other sensors in the body helps you to keep your balance. (1)
Three categories of hearing loss.
Conductive hearing loss
This happens in the outer or middle ear. It happens when there is damage or an obstruction which prevents sound waves reaching the inner ear. An obstruction could be due to infection, ear wax or a build up of fluid in the middle ear, the eustachian tube not working properly, a cholesteatoma (benign tumor) or head injury
Sensorineural hearing loss
This occurs in the inner ear (cochlear) or the acoustic nerve. It happens when the nerves in the cochlea or acoustic nerve become damaged and cannot send signals to the brain. This can be caused by infection or illness, head injury, exposure to loud noise, certain drugs, genetics, acoustic neuroma and aging. This type of hearing loss can occour gradually over many years so you barely notice it, or suddenly.
It's unknown why sudden hearing loss happens but if you have concerns you need to see a specialist doctor as soon as possible.
Mixed hearing loss
This is a combination of both. unilateral or single sided deafness (SSD) or bilateral hearing loss for both ears (2)
What happens now
As you can see, there are many different causes. Some are treatable – through medication or surgery, others are not. Your ENT consultant or doctor will be able to help you decide the best way forwards.
How do I understand my audiogram?
A hearing test will determine whether you need hearing aids, and which type of hearing aids will be best for you. Copies of audiograms aren’t always given automatically so you may have to ask for it. It may look confusing at first but understanding your own hearing loss will help you to determine what sort of support you need.
Your audiogram shows your hearing thresholds (the quietest sound you can hear). The axis of the graph show Hz (sound frequencies low to high pitched. And decibels – the loudness of the sound from 0 to 100db.
A blank audiogram showing decibels (volume) and frequencies (pitch). On the right is a rough guide of normal hearing range and mild, moderate, severe and profound hearing loss. (3)
A row of circles and triangles will plot your hearing thresholds for your right or left ear. It will also show the results from air conduction (the vibrations that pass through the outer and middle ear) and bone conduction, bypassing any blockage in the outer or middle ear.
If your hearing threshold is above 25db, you have normal hearing. between 25 and 40 decibels you have mild hearing loss. Between 41-60 decibels is moderate hearing loss, severe hearing loss is a hearing threshold of 61-81 decibels.
You may have lower hearing thresholds in some frequencies and better hearing in others, so you might struggle with high pitched sounds but hear lower sounds well, or vice versa.
Support for hearing loss
Hearing aids, when fitted and tuned correctly can increase your hearing threshold. Whether they bring your hearing within the ‘normal’ range will depend on the type and severity of hearing loss you have.
They may take some getting used to if you’ve been putting off getting them for a while. Everything may be too loud or seem distorted, but it’s important to persevere. Start by wearing them for a few hours each day and gradually increase the time.
Revisit your audiologist if you have any questions or problems.
There is lots of tech available from tv streamers, amplified telephones, loop systems and microphones. Some only work with certain hearing aids so its important to discuss your needs with your audiologist.
There are also amplified telephones, flashing doorbells, doorbells that send an alert to your mobile, vibrating alarm clocks, vibrating baby monitors and smoke alarms that connect to flashing lights or a pillow shaker. Many of these are available for free from your local council so it’s worth contacting them for advice before you buy anything.
Some mobile phones have captions for calls and conversations, transcription apps are also available. Although they aren’t always accurate, it’s constantly improving.
Talking to family and friends about how this effects you can help them to support you. They may need reminding to look at you when talking or get your attention before they speak. You may need support at work so speak to your boss or HR department.
If you’re struggling to come to terms with your hearing loss and it’s impacting other areas of your life it may help to get support from a counsellor or coach who can help you to accept and adapt to your hearing loss, and help you to move forwards.
References
(1) https://rnid.org.uk/information-and-support/ear-health/how-the-ear-works/
(2) https://rnid.org.uk/information-and-support/hearing-loss/