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Beholding the Sounds of Life, From the Audiologist’s Booth

As featured in the June 2, 2016 edition of the Flatbush Jewish Journal.

By Dr. Hadassah (Norowitz) Kupfer, Au.D., CCC-A

The nation stood before Har Sinai, unconditionally accepting the Torah as one. “Na’aseh V’Nishmah!” At the pinnacle of Jewish History, we resounded these famous words in unity: We will do, and we will listen! Amidst this lofty level achieved by our ancestors, crowns of honor were placed on each of their heads, and the commentaries explain that all Jews were cured of their ailments! A most wondrous event occurred as those with physical disabilities stood tall and free of pain. Visual impairments were lifted so that every eye beheld the picture perfect beauty of Matan Torah. And an audiological miracle restored normal hearing to every ear, so that everyone heard each syllable of the Ten Commandments with absolute loudness and clarity. There were no barriers of the senses between us and this monumental experience.

As an audiologist, I spend my days helping people hear better and regain a certain quality of life they have been missing. Thus, I have a deep appreciation for the magnitude of this phenomenon that occurred at Matan Torah. Hearing loss is one of the most common chronic health conditions, affecting 50 million people in the United States. It affects people of all ages, but, as you would expect, it is more prevalent in older adults. Though, in this “iPod generation” where people are consistently exposed to loud music, younger people will be affected to a greater degree as well.

Understanding the different types of hearing loss can assist one in recognizing the need to seek treatment. In most cases, hearing loss is permanent, gradually occurring as the ear is used over a person’s lifespan. Of course, some people are predisposed to developing a hearing loss, while others expose themselves to loud noises on the job (e.g., construction workers, members of the armed forces, musicians, dentists) which may accelerate deterioration of the ear and cause hearing loss to set in sooner.

What are some signs of a hearing loss? Contrary to popular notion, hearing loss does not mean total deafness. Hearing losses due to age or loud noise typically affect high pitched sounds at first. This means that the person may continue to hear the rhythm of speech, but certain consonants in words cannot be distinguished. Female and child voices become more difficult to understand. As the hearing loss progresses, other sounds will also be heard at reduced volume, or they may cease to be heard at all. Interestingly, there can also be reduced tolerance for loud sounds, causing them to seem painfully loud. Tinnitus, or ringing in the ears, is another symptom of hearing loss which should signal to a person to seek treatment.

With the decreased volume and clarity of a hearing loss, a person tends to “mishear.” It is common for people with hearing loss to request repetitions, or they may become embarrassed and rely on their fill-in-the-blank abilities instead. This difficulty becomes most obvious in group conversations such as the Shabbos table; in the presence of other background noise such as at a Simcha or in a restaurant; with distance from the speaker such as when listening to a live shiur; or over the telephone.

Hearing loss may not always be permanent. At times, a temporary hearing loss results from a treatable blockage, such as fluid behind the eardrum or a buildup of earwax. Symptoms of these hearing losses could be a muffled sound sensation, or a fluctuating hearing ability.

Sometimes symptoms and occurrence of these hearing losses overlap. A classic scenario would be a permanent age-related hearing loss only made worse by a temporary accumulation of wax in the ears. A standard hearing test is usually performed by an Audiologist, who can determine whether a person’s hearing loss is temporary or permanent in nature and thereby make appropriate recommendations.

There are various tools and strategies to help deal with all types of hearing loss, including but not limited to amplification. While no technology can come close to Hashem’s pure gift to us at Matan Torah, treatment advances and today’s hearing aids are more effective and less noticeable than ever.

What about a cochlear implant, which is a surgically implanted device that acts in lieu of the inner ear and sends sound directly through the hearing nerve to the brain? This is not an option for everyone, as most hearing losses will benefit from hearing aid use. However, when an individual has little to no usable hearing in terms of volume or clarity, a cochlear implant may be chosen as a last resort. Connexin-26 is a gene needed to form the structure and vitality of the inner ear cells, and its recessive variants are well-recognized in the professional literature as a common cause of hereditary deafness in the Ashkenazi community. If the gene defect causes a severe enough hearing loss, such an individual may require cochlear implantation during early childhood in order to hear and develop spoken language.

Like all of our senses, hearing is a true miracle that is often not appreciated until it has been compromised. Using our sense of hearing, we are able to communicate and connect with others, and conversely, a hearing loss places a strain on daily activities and relationships and can lead one to become more withdrawn. Treatment options are available for people of all ages. Just as vision impairments are routinely treated with glasses, lenses or surgery, hearing loss need not be something we just have to live with. Na’aseh V’Nishma: Let us all continue to be productive and have quality of life, through the best hearing ability possible.

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Author:

Just an audiologist trying to share useful information and personalize the process of achieving better hearing- no matter what stage of life you are in. I'm a daughter, granddaughter, wife and mother, which shapes my outlook on healthcare and life. Feel free to pick my brain :)

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