Scared of Losing my Hearing
April 14, 2013 5:17 PM   Subscribe

I have been noticing recently that I have a hard time knowing what people are saying to me at work, so I usually just nod and laugh or something. my hearing feels a bit muffled and sometimes at night my ears ring for no real reason (tinnitus?). I also listen to music when I jog through ear buds. It doesn't feel like I'm playing the songs too loud, and I listen to my ipod about every other day for about an hour. I am gonna hold out on any more listening until i figure out what's going on. I recently went to my ear nose and throat doctor and had a hearing test. He said it came back next to perfect. This confused me. Should I consult an audiologist? I feel like I'm struggling to hear others, especially when there is background noise. If anyone can give me any feedback, I'd surely appreciate it. I am 30 btw.
posted by Thanquol180 to Health & Fitness (10 answers total) 2 users marked this as a favorite
Go to your primary care doctor and see if you have wax buildup in your ears. It can cause all of the symptoms you describe. Happens to me regularly. They just flush it out with water or maybe a little diggy tool.
posted by unannihilated at 5:24 PM on April 14, 2013 [6 favorites]

Get a proper hearing test. If you just did a "raise your hand" kind of hearing test in the office this isn't enough. An ear, nose and throat specialist should have given you a complete test - if not find a separate audiologist.

You should have been placed in a sound proof booth with headphones on and asked the "raise your hand" questions, then they should do a bone conduction test with a different set of "headphones", then they should do a test where they reflect sound waves from your ear drum. Finally they might do a test where they read you several words which you need to repeat. After all of these tests they should have pretty good idea what is going on...

Ask for a copy of the tests - it's not rocket science to read what kinds of sounds you are having a problem hearing...finding out how to successfully treat what might be causing a problem is where all of the training is required...
posted by NoDef at 5:45 PM on April 14, 2013 [7 favorites]

30 was when I started noticing similar things. I've always had a touch of tinnitus, but that's about when it started getting more noticeable. And the not being able to understand people in noisy situations as well.

But I've tested myself, and my ability to hear through the sound spectrum is still mostly intact. I can still hear well beyond 15khz. But obviously something changed, so my guess is that while I am still functionally "perfect", subjectively, my frequency response isn't quite as flat as it used to be.

But yes, I agree that more in depth testing beyond the blunt school screening type of test is probably in order.

Finally, be very careful with earbuds. Especially the kind that seal in your ear. They can cause damage at volumes that don't seem all that loud. Also, it may help to use some equalization on your playback device. I know my phone has different presets (low, high, club, rock, live, etc) for how the music comes out, and certain ones are much more comfortable to listen to at lower volumes.

Lastly, use OSHA approved earplugs whenever you are in a noisy environment. I even use the if I am in the car for a long time. I find that I am less fatigued when I use hearing protection in moderately loud environments.
posted by gjc at 6:00 PM on April 14, 2013

You should get a full battery of hearing tests done, certainly including a Hearing In Noise Test (HINT) in a sound booth. An audiologist is the person to go to. Most ENTs are not qualified to do everything that an audiologist would do (at least not in Canada).

You're describing symptoms of significant hearing loss plus tinnitus. Well, if your vision was a bit blurry you'd go to an optometrist. Since you're having trouble hearing people in conversation you go to an audiologist. It's not something to be scared of, it's a minor medical condition to be treated. Easy for me to say but true.
posted by justsomebodythatyouusedtoknow at 6:47 PM on April 14, 2013

My audiologist (I am hard of hearing and get tested yearly) explained tinnitus to me when mine got worse a few years ago. There can be several causes -- including build up, some types of medication etc. -- and many people have it to some degree. One major cause is loud noise, so do be careful with your earbuds.

Secondly, yes please go visit an audiologist -- the tinnitus could be a sign of some hearing damage or it could be something else. But getting tested is the best way to find out what's going on.
posted by Lescha at 6:50 PM on April 14, 2013

Response by poster: thank you, guys. I am gonna set an appointment up with my primary care doctor so he could recommend an audiologist. i had no idea ear buds could cause that kind of damage. i am definitely going to be more careful now.
posted by Thanquol180 at 8:53 PM on April 14, 2013

I am gonna set an appointment up with my primary care doctor so he could recommend an audiologist.

A referral is not normally required.
posted by justsomebodythatyouusedtoknow at 10:34 PM on April 14, 2013

earwax has done all this to me. unfortunately and disgustingly.
posted by stoneandstar at 11:54 PM on April 14, 2013 [2 favorites]

A referral is not normally required.

It is if you want your insurance to pay for it!
posted by kindall at 2:56 PM on April 15, 2013 [1 favorite]

Yes, go to an audiologist and get a full test. As mentioned above, there will likely be three or four or so components (though you may or may not get a speech distinction/threshold test), all conducted with an audiometer and in a sound treated room. As part of the test, the audiologist will also take a look at your ears with an otoscope, which will reveal things like cerumen (wax) build-up, or abrasions or other things on the ear drum.

The two main parts of the test, the headphone part and the bone conduction part, where you raise your hand when you hear the sine wave tone, are to determine if you have hearing loss and if it is in the conductive (outer/middle) ear (headphones), or in the cochlea (bone conduction). Having both these tests is critical to figure out where you're having trouble. The results of your test will be recorded on an audiogram, which you can ask for a copy of, though it takes a little expertise to properly interpret. Discuss it at length with the audiologist. You may also get a speech threshold test which tests specifically for your ability to recognize phonemic differences at low levels and to interpret speech. This test is really more functional than anything, as most people are chiefly concerned about losing the ability to hear speech if they have hearing loss, and narrowing down what types of phonemes they are having trouble hearing can make treatment easier.

If you're struggling to hear others in the presence of background noise, there could be any number of reasons for this, from hearing loss to auditory processing disorders to Big Scary Things (highly unlikely). Do you have trouble hearing others in the presence of all sorts of other noise, or just specific types? What type of masking (background noise) you have a hard time hearing through might be important, so pay attention to that and tell your audiologist (for example, background noises have a higher degree of masking in a narrow bandwidth around the primary sound, so depending on what two things are vying for your auditory attention, it may not have anything to do with your ears, per se).

If you're hearing ringing in your ears, it's definitely tinnitus. It sucks. It's also very common. It's usually caused by noise exposure, but not always. It usually occurs because you have these little cells on your cochlea that are tuned to different frequencies (to simplify). Specific frequencies cause them to open ion channels that convert the mechanical wave energy of a frequency to electrochemical energy which goes to the auditory cortex of your brain. These cells can become "broken" and basically become permanently "open," creating a constant flow of ions into that specific frequency channel and so you hear the ringing. It bothers people more at night simply because there is less masking and because your brain is less attuned to other sounds, but it is more than likely (but perhaps not) happening all the time. There are sort-of treatments for tinnitus, but no cure and it's something you have to more or less learn to deal with. It sucks.

The muffling is more worrying, and while it might be tinnitus, muffled sounds are usually indicative of high-frequency hearing loss or hearing loss in the conductive (outer/middle) part of your ear. This could also be caused by ear wax. The muffled-ness occurs because you're not receiving the full set of overtones properly in your cochlea. High frequency waves can't travel as well through ear wax or straight through your head into your ear ossicles because they are much shorter, and so if you have wax build up or conduction problems, you'll often get muffled sounds.

Ear buds are bad. Bad bad bad. They send the sound directly into your ear drum, with no space for the sound to disperse before it travels down your ear canal. That much direct barrage of waves into your ear drum can damage the drum, the ossicles, or kill the hair cells in the cochlea (which are finite in number and cannot be regrown). Get yourself some over the ear headphones and wear plugs in noisy environments.

posted by Lutoslawski at 11:25 AM on April 16, 2013 [1 favorite]

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