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TINNITUS – THE END OF QUIET MOMENTS?

Tinnitus is the perception of sounds that have no external source. The severity of tinnitus varies from an occasional awareness of ringing, hissing, buzzing, roaring, clicking, or other rough sounds in one or both ears, to an unbearable and incessant noise that drives some people to consider suicide.

Tinnitus isn’t a “phantom sound” or “condition” — it’s a symptom of an underlying medical problem, such as noise trauma, age-related hearing loss, ear injury, or disease of the circulatory system.

Tinnitus is relatively common, but in rare cases it can be a symptom of a serious underlying condition, such as a vascular tumor or a slow growing acoustic neuroma (a generally benign tumor that forms on the vestibular nerve that leads from the inner ear to the brain).

Tinnitus facts: If you have tinnitus you aren’t alone. More than 50 million Americans have tinnitus symptoms. 9 in 10 patients with tinnitus also have hearing loss, and 1 in 5 patients find the symptoms hard to endure. 10-15% of Americans experience chronic troublesome tinnitus, lasting more than 6 months.

Tinnitus is frequently caused by prolonged exposure to loud sounds from industrial, recreational, or military noise, or from a sudden impulsive sound from an explosion, gunshot, etc. Tinnitus can also be caused by ear injuries, cardiovascular disease, age-related hearing loss, wax build-up in the ear canal, medications (aspirin, certain antibiotics, diuretics, chemotherapy), ear or sinus infections, misaligned jaw joints (TMJ), head and neck trauma, and Meniere’s disease.

Auditory Pathways and tinnitus. Sound waves travel through the ear canal to the middle and inner ear, where sensory hair cells in the cochlea help transform the sound waves into electrical signals. (See the figure) The electrical signals then travel through the auditory nerve to the auditory cortex of the brain, where they are processed. When hair cells are damaged (figure inset)  by loud noise or drugs known to cause hearing loss, the brain doesn’t receive the signals it expects. This stimulates abnormal neuron activity, which causes the illusion of sound, or tinnitus.

What are the consequences? Tinnitus causes fatigue, stress, sleep difficulties, trouble concentrating, memory problems, anxiety and irritability, and trouble with both work and family life. The degree to which tinnitus invades a person’s life depends on the volume, frequency, and duration of the perceived noise, and on the emotional reaction provoked by that irritation. Tinnitus is no laughing matter; the fear and depression associated with tinnitus can destroy a person’s well-being.

Tinnitus can’t be cured…but it can be managed! Our Doctors of Audiology have the knowledge and training to help you manage your tinnitus. They will assess the personal impact of your symptoms, and then present options for alleviating those impacts. The initial assessment takes 2 hours, and guides us in determining the best therapy for you.

The goal of tinnitus management is to “train your brain” to ignore tinnitus sounds as unimportant. This process is called habituation, and empowers tinnitus patients to overlook the disturbing emotional trauma of tinnitus, in the same manner that many of us have learned to overlook the disturbing effects of a train whistle at night. Other tinnitus remediation therapies include sound therapy, which can be supplied by smart phone apps through hearing aids.

Tinnitus therapy is highly tailored to account for your perception of symptoms and their disturbing impacts. There is no “one size fits all” therapy! Effective treatment strategies generally focus on counseling, sound therapy, relaxation, and stress-reduction methods. If you have tinnitus AND hearing loss, hearing aids can improve your hearing while relieving the negative impact of your symptoms, and this can help restore your quiet moments!

Dr. Li-Korotky, AuD PhD is a Gold member of the American Tinnitus Association

Audiologists or Dispensers – Part 2

In Audiologists or Dispensers – Part 1, we introduced corporate and professional business models for hearing health care, and indicated that the level of professional service you receive is linked directly to the business model of the hearing care provider you choose. 

Audiologists or Dispensers – Part 2 details the vastly different academic and knowledge requirements for audiologists vs. hearing aid dispensers, and how these differences dictate the legal responsibilities available to each group. It should be noted that audiologists fit hearing aids just like dispensers, but they can legally do much more for your hearing health, whereas dispensers are fundamentally permitted to sell hearing aids.

Audiologists

Audiologists must earn a Doctor of Audiology (AuD) degree. This requires 4 years of undergraduate study in Communication Sciences (speech and hearing) and an additional 4 years of specialized academic work, including high-level training in the prevention, identification, assessment, and treatment of hearing disorders.

Their extensive academic credentials, professional certifications, and licensure, allow audiologists to legally provide a full range of patient-centered care, a set of professional standards that include a thorough patient assessment, comprehensive diagnostic tests, a consultation to discuss treatment options, highly specialized hearing aid fitting and programming, and a process of post-fitting adjustments and counseling.

Profit is certainly important to independent audiologists, but it doesn’t generally dictate the patient process. Many of the diagnostic and counseling efforts that define professional standards of patient-centered care offer low-profit margins compared to hearing aid sales…but these are critical elements of comprehensive hearing care. Take away any of the links from a patient-centered chain and you also disrupt the process of end-to-end care.

Hearing Aid Dispensers

Hearing aid dispensers, (AKA hearing aid specialists) are limited primarily to hearing aid sales. They can recommend, select, or adapt hearing aids and may alter, adjust or reconstruct hearing aid specifications for functionality, such as taking ear impressions for proper fit, but hearing aid sales keep them in business. Hearing aid dispensers can sell hearing aids in many states if they have a high school diploma or GED Certificate, pass a license exam, complete a brief apprenticeship with a licensed hearing aid specialist, and earn continuing education credits (usually from correspondence courses).

Reduced standards for hearing aid dispensers have caused a rapid spread of clinics with superficially trained staff, whose primary lawful focus is limited to hearing aid sales…not audiological services.

The next and following weeks will provide the truth about dispensers, Big Box corporate culture, hearing aid franchise stores, ENT surgeons,  and Online hearing aid sales. You will come to understand business models and their consequences…and you will discover that discount can be very expensive!

Hearing Loss Linked to Dementia

A Cautionary Tale

Mounting evidence has established a  strong link between untreated hearing loss and diminished cognitive function, including dementia. Studies also link untreated hearing loss to other medical and emotional problems, including depression.

This is a cautionary tale, but a light shines brightly to guide our passage away from danger: Hearing Loss Can End Badly—but we have options!

First, the bad news. Mounting evidence has established a strong link between untreated hearing loss (HL) and diminished cognitive function, accelerated mental decline, rapid rates of brain tissue loss, and other disabling conditions, such as dementia and Alzheimer’s disease. People who don’t hear well tend to withdraw from social activities, and that can lead to depression and early mortality.

The link between HL and dementia is reinforced by statistical and brain scan studies from hearing and social neuroscience research, and backed by compelling theories for how HL promotes dementia.

Dr. Frank Lin from John Hopkins Medicine has identified three primary pathways to dementia and other bad health outcomes:

  1. HL increases the cognitive load on the brain. Struggling to understand speech causes the brain to focus on sound processing at the expense of memory, thinking, and learning processes. Robbing Peter to pay Paul leads to a cascade of bad consequences, leaving seniors vulnerable to dementia and Alzheimer’s disease.
  2. Even mild HL hastens brain tissue loss, and seniors with untreated hearing problems are much more susceptible to brain tissue loss and other unwanted brain structural changes than seniors with normal hearing. This is significant because the brain tissue loss occurs where memory and sensory integration are processed, causing a negative feedback loop that leaves seniors vulnerable to dementia.
  3. People who can’t hear well tend to avoid social engagement. This puts them at a higher risk for becoming socially isolated, lonely, and depressed—and that exposes them to a perfect storm for developing dementia and early death.

Now the good news: new research just published in the Journal of the American Geriatrics Society by researchers at the French National Institute for Health and Medical Research in Bordeaux, France found that hearing aids reduce the threat of accelerated cognitive decline. The Bordeaux study revealed that elderly people with HL who used hearing aids were spared the augmented levels of cognitive decline suffered by others with HL who didn’t use hearing aids.

Social neuroscience research found similar results

Dr. Cacioppo is the Director of the Center for Cognitive & Social Neuroscience and Chair of the Social Psychology Program at the University of Chicago. Decades of research inform the doctor that we are social by design. That means we are hard wired to connect with others. In fact, our need for social interaction is as fundamental as our need for food and water because the consequent social behaviors helped us survive & reproduce.

Highlights from social neuroscience research:

  • Socially connected people are more likely to have good physical health and psychological well-being.
  • People with strong social networks generally live longer. They also have lower rates of anxiety and depression.
  • Forming strong social bonds creates a positive feedback loop of social, emotional and physical well-being.
  • Conversely, lack of social bonding often contributes to a negative feedback loop of isolation, deep loneliness, and antisocial behavior, often leading to bad health outcomes for aging adults, including depression and dementia!

But you can’t connect with people if you can’t hear them, so it is vitally important that hearing and communication problems aren’t keeping you from a socially rewarding life.The bottom line? Hearing empowers social health and social health empower life!

See our Brochure on Hearing Loss and Dementia, here

 

Breaking News - Hearing Aids prevent Dementia study

 

Noise-induced Hearing Loss

When Noise Hurts

Noise induced hearing loss (NIHL) is irreversible hearing damage resulting from exposure to high levels of noise. NIHL affects an estimated 10 to 15 million people in the USA, making excessive noise exposure the most common cause of hearing loss.

What causes NIHL? Exposure to traumatic noise will cause permanent damage to the sensitive hair cells of the inner ear and possibly the hearing nerve.

NIHL is related to both noise intensity and the duration of exposure. Louder sounds require shorter exposures before damage occurs. Why? Because a 10 dB increase in sound level causes a 10 fold increase in sound intensity.

This means that the sound of an MP3 player set at a volume of 115 dB is about 1000 times more intense than a vacuum cleaner sound volume of 85 dB, and a Rock concert can produce sounds (120 dB) that are 100 times more intense than a lawnmower (100 dB)!

NIHL is Permanent. It can be treated to some extent (depending on the damage), but it can’t be reversed!

See our Brochure on Noise-induced hearing loss, here

Tinnitus: The End of Quiet Moments

Tinnitus is the perception of sounds that have no external source. The severity of tinnitus varies from an occasional awareness of a noise (ringing, hissing, buzzing, roaring, clicking, or rough sounds) in one or both ears, to an unbearable and incessant sound that causes a variety of psychological stresses.

Tinnitus isn’t a “phantom sound” or a single disease, but a symptom that can be associated with many causes and made worse by other factors.

Tinnitus is relatively common, but in rare cases it can be a symptom of serious disease such as vascular tumor or acoustic neuroma (a benign, usually slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear).

Tinnitus facts: If you have tinnitus you aren’t alone. More than 50 million Americans have signs of tinnitus. 9 in 10 patients with tinnitus also have hearing loss, and 1 in 5 patients find the symptoms hard to endure. 10-15% of Americans experience chronic tinnitus, lasting more than 6 months.

See our Brochure on Tinnitus, here

Untreated Hearing Loss

The consequences can be severe but treatment offers hope!

Untreated hearing loss has been linked to disabling medical conditions such as dementia, Alzheimer’s disease, depression, and cardiovascular disease. Studies and observational evidence indicate that untreated hearing loss can damage your physical, emotional, and social health and well being.

Your family, friends, and others will not escape these changes. In a very real sense they will share the unwanted consequences of your hearing loss.

The good news is that the worst effects of hearing loss can be moderated with hearing aids, cochlear implants and post-fitting rehabilitation. When people with mild-to-profound hearing loss use hearing aids, they experience less depression, less anxiety, and less emotional stress… while showing significant improvements in their quality of life and well-being.

Given the undesirable consequences of untreated hearing loss, it would be a good idea to get a hearing exam by a well qualified Audiologist, especially if you suspect that you are developing hearing problems. Being more safe than sorry has real meaning when the consequences of inaction are potentially so severe.

See our Brochure on Untreated Hearing Loss, here

There was a Time…

…when hearing aids weren’t cool.

But that time isn’t now! The stigma of hearing loss is settling quickly into the past as hearing aids become cool. Why? Because Bluetooth technology allows hearing aids to communicate wireless with an iPhone, iPad, and iPod touch… directly or through the use of external streamers. That’s right..no wires..cool!

And you aren’t limited to IOS products! High end wireless accessories are also available with Android and Windows products. That means you can have all the benefits of wireless streaming with your favorite devises!

The bottom line: you can stream audio from Skype calls, TVs, MP3 players, smart phones, or other computing devices, or connect directly to an iPhone, iPad, or iPod touch. That will let you bring the world to your hearing aids…and that is cool!

See our Brochure on new wireless technology, here.

Age-related Hearing Loss (ARHL)

The ‘baby boom’ generation is aging. In 2009, people over 65 represented 12.9% of the population, but by 2030, they will be 19.3%. From the Administration on Aging, the number of Americans over 65 is expected to double between 2008 and 2030 to around 72 million.

Why should we be concerned? Because Hearing loss is the third most common chronic health condition among older adults! According to the National Institute on Deafness and Other Communication Disorders, hearing loss increases with age. Approximately one third of Americans between 65 and 74 and nearly half of those over 75 have hearing and communication problems.

What is Age-related Hearing Loss? ARHL is a gradual and progressive hearing loss that affects most people as they age. Due to the slow progression, adults with ARHL may not realize that their hearing and communication abilities are declining, or they may accept it as a normal part of aging.

ARHL has serious consequences for the elderly because it diminishes their ability to communicate and reduces their functional independence.

See the complete article on age-related hearing loss here

 

Choices and Consequences

Audiology Business Models

Introduction

We get many customers who initially responded to “Big Box” discount advertising, only to discover later that they had expensive products that didn’t help them communicate any better than they did before spending a large chunk of cash. This article was written as a response to that sad fact of life…and to give consumers the fire power they need to make informed choices. If you are in a hurry look for the Einstein Icons, but we recommend reading the entire article…it could save you from considerable frustration and disappointment.

You may not be aware of it…but when you choose a hearing provider you are also choosing their business model. One model works off the proposition that profits alone are the bottom line for generating future profitability. This corporate model is exemplified by “Big Box” stores such as Costco, and their legion of minimally trained hearing aid dispensers. A competing business model assumes that customer satisfaction drives customer loyalty…and customer loyalty drives profitability and growth. This business model is typified by audiologists, who are trained in an end-to-end process of patient-centered hearing care. The following paragraphs will show that consumers adopt not only a business model, but also the consequences of that business model.

It will be shown that hearing care business models are strongly related to the education requirements necessary to lawfully provide various audiological services. Well credentialed audiologists can pursue a full course of professional services…but less credentialed hearing aid dispensers are legally bound to a limited set of services focusing on the sale of hearing aids.

Audiologists

Audiologists must earn a Doctor of Audiology (AuD) degree. This requires 4 years of undergraduate study in Communication Sciences (speech and hearing) and an additional 4 years of specialized academic work, including high-level training in the prevention, identification, assessment, and treatment of hearing disorders.

Their extensive academic credentials, professional certifications, and licensure, allow audiologists to legally provide a full range of patient-centered care, a set of professional standards that include a thorough patient assessment, comprehensive diagnostic tests, a consultation to discuss treatment options, highly specialized hearing aid fitting and programming, and a process of post-fitting adjustments and counseling.

Profit is certainly important to independent audiologists, but it doesn’t generally dictate the patient process. Many of the diagnostic and counseling efforts that define professional standards of patient-centered care offer low-profit margins compared to hearing aid sales…but these are critical elements of comprehensive hearing care. Take away any of the links from a patient-centered chain and you also disrupt the process of end-to-end care.

Hearing Aid Dispensers

By contrast, hearing aid dispensers, (AKA hearing aid specialists), can recommend, select, or adapt hearing aids and may alter, adjust or reconstruct hearing aid specifications for functionality, such as taking ear impressions for proper fit. Hearing aid dispensers can sell hearing aids in many states if they have a high school diploma or GED Certificate, pass a license exam, complete a brief apprenticeship with a licensed hearing aid specialist, and earn continuing education credits (usually from correspondence courses). Reduced standards for hearing aid dispensers have led to a proliferation of clinics with superficially trained staff, whose primary lawful focus is limited to hearing aid sales…not audiological services.

 

choices and Consequences

ENT Physicians

An increasing number of Ear Nose and Throat (ENT) physicians are using audiology as a supplementary service to boost their bottom line profits. This is accomplished by hiring audiologists and/or dispensers to administer basic audiological exams, often with dated equipment, to support their surgical requirements. Since ENT physicians focus on surgical solutions, you shouldn’t expect broad audiological support at an ENT clinic.

Corporate Hearing Centers

The hearing health market is expanding. In response…the number of corporate hearing centers is also increasing. Why is this important? Because corporate hearing centers (many owned by hearing aid manufacturers) are motivated by the dictates of corporate growth and bottom-line profits, and these profits are achieved through hearing aid sales…not diagnostic or rehabilitative services. Large corporations are purchasing independent practices across the country, often stripping them of important diagnostic capabilities, and staffing their new hearing centers with non-audiology staff, including hearing aid dispensers.

“Big Box” Stores

Using the power of their marketing wealth, corporate retail giants like Costco are repositioning hearing care as a commodity based solution. These stores are typically staffed by hearing aid dispensers, and their business model is dominated by profit concerns...so don’t expect a full range of audiological services at any of these Big Box giants.

 The Bottom Line

Hearing aid dispensers and audiologists are both licensed to fit and program hearing aids…but that is where the similarities end. There’s a vast difference in education and training requirements between Doctors of Audiology and hearing aid specialists. This training edge allows audiologists to pursue a rigorous process of professional diagnosis, treatment (including hearing aid fitting, programming and verification), and rehabilitation. In contrast, most hearing aid dispensers work for large corporations such as Costco, and must, by law, concentrate their efforts on a narrow range of services, including hearing aid sales, fitting, and programing.

It is important to understand that corporations are motivated to control the distribution of hearing care, and profit margins dictate their treatment process. They are not in the business of marketing comprehensive audiological services to consumers because their corporate model lives and dies by sales and profits. Since they are “bottom liners” they are primarily in the business of selling hearing aids.

Choices 2

Choose Your Business Model

There’s an ongoing struggle between opposing business philosophies to define the scope and practice of hearing care. Most Audiologists believe hearing care should be patient-centered and managed by Doctors of Audiology. This business model emphasizes an end-to-end process of professional services, including consultation and diagnosis, hearing aid fitting and programming, validation of hearing aid functions with advanced technology such as Speech Mapping, and post-fitting counseling and rehabilitation.

Opposing business models …represented by hearing aid dispensers, hearing aid manufacturers, and retail giants such as Costco …are much more focused on high profit margin sales. With these business models, hearing care is managed primarily by non-audiologists and hearing aid sales defines their bottom line …often at the expense of professional audiological services. Ear Nose and Throat (ENT) practices are also in the mix, as they increasingly train technicians to perform basic audiometric and vestibular testing under minimal supervision to support their primary focus of surgery. So…if you need hearing care…choose your business model!

The World In Your Hearing Aids!

The World

The days of uncool hearing aids are gone!

and the stigma of hearing loss is settling quickly into the dust of the past. That is because Apple, the symbol of cool consumer electronics, is working with hearing aid manufacturers to pair hearing aids with the iPhone, iPad, and iPod touch through Bluetooth wireless technology. That’s right…no wires…cool!

But what if you don’t use an iPhone, iPad, or iPod touch?

Don’t worry! Similar technology can, or soon will achieve the same results with other operating systems, including Android and Windows. Whether it’s streaming audio from Skype calls, a TV, MP3 player, smart phone, or other computing device, or connecting directly to an iPhone, iPad, or iPod touch, you can bring the world to your hearing aids…and that is cool!

How is this new technology changing everything?

Control! Traditional hearing aids offered limited user control because the electronics and buttons were restricted to hearing aids the size of a kidney bean. But that has changed with wireless connectivity, which allows hearing aid functions to be managed…without wires…by smart phones and other devices. Cool!

What does this mean to consumers?

Among other things, wireless connections allow users to view battery status, locate their hearing aids, change the settings of their hearing aids, and quickly apply an audiologist’s environmental presets when they enter different acoustic locations. With user controls outside the hearing aids, consumers can also listen to directions from a GPS while driving, participate in phone conversations, listen to music, and use a growing list of additional functions from iOS, Android, and Windows apps. Cool!

The Bottom line?

  • Wireless connections let users adjust their hearing aid settings with a smart phone
  • Connectivity provides apps to improve the lives of people with hearing loss
  • Hearing aids are becoming desirable, even for those who don’t need them
  • The stigma of hearing loss is gone…the future is filled with better hearing opportunities
  • This is very very cool!

Pacific Northwest Audiology Is Leading The Way

Connection productsWhether it’s streaming audio from Skype calls, a TV, MP3 player, smart phone, or other computing device, or connecting directly to an iPhone, iPad, or iPod touch…we have a solution just for you.

Our Special Holiday Gift through December

  • A special discount and risk free trial for you to sample the future of connectivity
  • Free home support to get you connected with our products
  • We will bring the world to your hearing aids!

 We Bring the WorldThe World in your hearing aids!

Whether it’s streaming video and audio from your TV, phone, or computing devices, or connecting directly to an iPhone, iPad, or iPod touch…we have a solution just for you.