Speak into my good ear... hearing loss question
August 4, 2013 7:48 AM   Subscribe

I am somewhat of a hypochondriac; however, I have in the past few years experienced frustration with hearing other people. I often cannot understand the words that people say unless they are facing me. If someone doesn’t have a line-of-sight with me, it’s almost certain that I’ll have to ask them to repeat what they say. If I’m watching TV, I’ll sometimes put the captions on because I can hear most of what is said, but not all. Today I took a few online tests and scored that I don’t require hearing aids. I hear perfectly if I’m wearing headphones and listening to music or tv. I’m around 40 years old, and male. What else can be going on? If I don’t have a hearing problem, do you have any recommendations for mitigating what I’m experiencing?
posted by Draccy to Health & Fitness (15 answers total) 7 users marked this as a favorite
Could it be a wax build up? My mom had the same problem and her doctor gave her an ear washing (cleaning?) Kit. She had to use it a few times but it removed most of the unnecessary wax and she van hear much better.
posted by missriss89 at 8:00 AM on August 4, 2013 [1 favorite]

People strongly favor one or the other of their ears for understanding speech, in the same way people are right or left handed. (If you think about it, you'll probably realize you always hold your cell-phone up to the same ear.) If you have hearing loss in that ear, you'll have trouble understanding what people are saying even though you can still hear sounds OK.

You should get your hearing checked, and not just rely on internet tests.

(Like missriss89's mom, I've had the problem you're describing because of earwax, and, yeah, it's annoying. Hopefully, it's as simple and easily fixable as that, but you should get it checked out.)
posted by nangar at 8:21 AM on August 4, 2013

Can you get a professional check-up of both your ears and your audition? That is, an external ear exploration and an audiogram made by an ENT specialist, which is way more precise than online tests. This is the best way to check your audition and to find the best solution possible.
Also, hearing loss is as much about a loss of decibels in general as it is about loss in certains frequencies. Only the ENT specialist will detect all this.
posted by mugitusqueboom at 8:24 AM on August 4, 2013

Best answer: IANAD, IANYD, but go get a screening done at a doctor or at one of the mobile hearing vans that larger areas seem to have.

I went to an ear specialist five or six years ago for the same thing and the tests showed that while I had mild hearing loss in my left ear, it wasn't enough for a hearing aid. But, tests aside, I have a problem hearing/understanding conversation in noisy places, or if a conversation is happening in the cubicles behind me at work. Whether it's a hearing problem or a comprehension issue, it's definitely an issue.

My mitigation strategy is just telling people that I have a hearing problem. "Sorry, can you repeat that? My hearing is off." People are more than happy to speak louder and/or more slowly. For my own part, I make sure I'm not the one sitting under the television or the music speakers at bars/restaurants. And I work harder to pay attention.
posted by kimberussell at 8:26 AM on August 4, 2013

I have the same problem. I do have some hearing loss, but I find that it's not so much background noise as background chatter (humans speaking) that really messes me up. I've always thought of it as a concentration issue...when there's other talking going on, my brain seems to have trouble focussing exclusively on the conversation at hand and instead tries to hear everything around me - televisions, other people, whatever.

When I first figured it out and tried to start to mitigate it, I had a hard time. I'd notice that I was starting to lose focus on the discussion I was having, then I would get wrapped up in noticing and lose the thread with the person talking to me AND whatever I was overhearing. Now, though, I just really tune in on what the person is telling me. I find if I stare at a fixed spot slightly behind the person with whom I'm speaking, they aren't put off by the fact I'm not looking them in the face and they seem to see that by not looking around I'm paying attention. YMMV
posted by nevercalm at 8:48 AM on August 4, 2013

I've been partially deaf in my right ear my entire conscious life. (It wasn't noted at my birth, and I was very ill when I was two; my mom only noticed it when I was three or four.) The range that my bad ear can hear is only from about 150-1500kHz, and even in that range everything is attenuated 70%. (however, if a sound is loud enough to be picked up by my bad ear, I have perfect pitch in it. Annoying when someone is loudly singing the Star Spangled Banner on my right, poorly.) The damage is nerve-related--my balance is also a bit off--so it's not something that can be fixed.

As a result, I make a point to sit to the far right of a row of friends at a show, or so that everyone but my loudest friend is to my left at the dinner table. Car conversations when I'm driving must be done with the radio off. I lead with my left side; even though my right eye is technically dominant, I look at people with my left so that my left ear is crooked toward them. Everything except writing, then, is done with my left hand so my good ear can be closer to the action. (I have some difficulty telling right from left; I know I"m right handed, but I'm left-bodied as a result of my hearing loss, so I have to sort that out.)

You may have mechanical blockage or some other remediable problem. If so, great. If not you'll wind up doing a lot of the same things I do. If you would like any other advice for dealing with it don't hesitate to contact me via mefi mail.
posted by notsnot at 9:25 AM on August 4, 2013

I have a similar problem in that if there's a bunch of ambient noise, I have a really hard time picking out your voice if you're not facing me, and if you're not facing me, I can't cheat and read your lips. I've had this problem my whole life, but I definitely feel your pain so to speak.

Definitely go see a doc, online tests are garbage, and you might actually have some sort of a medical issue rather than simple age.

Welcome to getting old.
posted by Sphinx at 10:30 AM on August 4, 2013

Go to your doctor; they can check your ears for wax, and can do a basic hearing test. Go to an audiologist - health insurance usually pays for it - and have your hearing tested. Modern digital hearing aids are really, really good, although expensive, and can make a substantial improvement in your life, if you need them.
posted by theora55 at 10:57 AM on August 4, 2013 [1 favorite]

I apologize if this answer is too detailed. It is from a research perspective and not a clinical one (although an audiologist might allude to some part of this idea). Personally, I have a similar problem, where I have to ask people to repeat what they are saying, and after waking up when my ears appear to be just too sensitive (although that might be a general state of arousal issue)

This issue is something very specific to the outer hair cell system in your ears, among other factors (cortical). There is a pathway from the auditory cortex down to your ear, which controls the activity of the outer hair cells. This efferent pathway is implicated in a bunch of functions, sound localization, hearing sounds in noise (suppression of ambient noise), protection from loud noises, and allowing you to focus on one signal out of many ( like at a cocktail party). The outer hair cells amplify sounds before they are converted to electrical signals by the inner hair cells in your ear. They provide an increased contrast that helps you detect signals better. They are also part of a neural system that suppresses the neural response to noise, thereby increasing the signal to noise ratio. When the efferent system fails/performs in a less-than-perfect way, one side effect is that there is difficulty teasing apart signals/voices from surrounding noise and other voices. This means one has difficulty in say a party setting in trying to listen to one person to the exclusion of others, or in trying to hear something above the ambient noise.

The system can fail in many ways. The outer hair cells can be destroyed at some frequencies, in which case the input is not available for the noise response suppressing system to work. The pathway from the auditory cortex may be functioning abnormally. There is some speculation that this might be the case in sensory processing disorders and a cohort of attentional disorders.

The most common cause is noise induced hearing loss (NIHL). Continued exposure to high noise levels will result in damage to the hair cells and nullify any beneficial effects the outer hair cells have in enabling you to hear better.

In my understanding, this is a mild problem and the brain does a great job of adapting to it on both micro and macro levels (not completely, of course). But if it is affecting your daily life, a hearing aid would help.
posted by ssri at 12:21 PM on August 4, 2013 [3 favorites]

There are two separate issues. One, is hearing loss across frequencies, and losing the human voice frequencies can obviously be a problem. The other, completely separate problem, is losing the ability to separate sound. If you get a simple audiologist test of your loss of frequencies, you might come up perfectly fine - no loss (for your age), and be told "your hearing is perfect". BUT that doesn't mean you can actually follow a conversation in a situation where there is noise interference - that is a totally different capability, and you may experience a loss of that ability (which, similarly to high frequencies, attenuates with age). Background noise, especially background speech, can really interfere with comprehension if you have that problem. You may have one or the other, or both in varying degrees. Best to consult a doctor.
posted by VikingSword at 12:22 PM on August 4, 2013

It sounds like Central Auditory Processing Disorder, which is not hearing loss, it is misprocessing of the information. You can have excellent hearing and fail to process it. My oldest son is like that.

I say that in part because of this comment in your question:

"I often cannot understand the words that people say unless they are facing me. If someone doesn’t have a line-of-sight with me, it’s almost certain that I’ll have to ask them to repeat what they say."

This suggests you are lip-reading, which is common for people with CAPD. They use lip-reading, often without realizing it, to help them figure out what they hearing. Background noise makes language hard to understand, so headphones help filter that out.

Some people with this issue benefit from magnesium supplements. Also, avoid talking in situations with a lot of background noise. Listen to music without lyrics or only via headphones. Try to arrange line of sight for talking.
posted by Michele in California at 1:40 PM on August 4, 2013 [1 favorite]

You know, I'm all for starting out simple and working up from there. I have bad earwax problems. The last nurse who cleaned my ears said it was one of the worst she'd ever seen. I remember so vividly walking outside afterwards and it was all SO loud! I have to go back every 6 months from now on, and getting your ears cleaned sucks, but maybe at least let your GP take a quick peek in there?
posted by twiggy32 at 6:18 PM on August 4, 2013

I have found that I need to ask the audiologist to screw around with the timing of beeps, or else my brain expects a beep at a particular time and helpfully supplies it. I bet I would pass an Internet hearing test in spite of the 60% loss on my left side for just this reason. (I passed hearing tests until I was 12, the loss was present for years at that point.) Also, I have many of the issues you describe and have been told I'm just this side of needing a hearing aid, so even if you have loss it might not change anything. In any case, a doctor won't hurt, might help, and isn't super urgent.
posted by tchemgrrl at 6:57 PM on August 4, 2013

I have the same problem and could have written kimberussell's comment word for word. As far as I can tell, it's just something you have to put up with and adjust to. I tell people that I don't hear well on my left side, try to sit with my right ear to the bulk of the talkers and avoid loud places. If I'm having a hard time understanding people, I'll also speak a little louder myself, which I've found tends to encourage others to increase the volume. My television has a bunch of different sound settings, including one for hearing loss and another that minimizes background noise and emphasizes speech. That helps a lot.

If you suffer from tinnitus at all, that can exacerbate things, especially in a crowded place where the buzz in your ear is close to the buzz in the room.

Anyway, you have my sympathy, not being able to hear sucks.
posted by looli at 7:32 PM on August 4, 2013

People do not generally favor one ear for understanding speech. There is something to be said for the right ear being more attuned to speech only because most speech processing is done on the left side of the brain and the ears run to the contralateral auditory cortex, but that is a vast oversimplification.

This does not sound at all like an auditory processing disorder. Auditory processing disorders are not well understood but they are neurological/cognitive and have to do with how your brain is processing sound and coding information, which it really doesn't sound like what's happening. Yes, it is possible that you're having some issue in the auditory cortex that is suddenly making it hard for you to focus on the 'important' sounds in noise, but it is unlikely.

IANAAudiologist, but this sounds almost exactly like good ole presbycusis (age-induced hearing loss) or noise-induced hearing loss. Two tell tale signs of age or noise related hearing loss are 1) difficulty hearing speech in noise, and 2) finding yourself having to turn up the television. Classic signs.

Part of the reasoning there is that with noise-induced, the first frequencies you lose are in the 3-6k Hz range, and with age-induced it's a sloping loss, so you lose high frequencies first. In both cases, those critical frequencies for speech start to go early, so you're going to have a lot harder time deciphering, for example, those fricative "s" sounds and such when there is other masking noise happening. Yes, the reason, like ssri says, for noise and age-related hearing loss is largely the death of outer hair cells in the cochlea.

Wax impaction of course could always be a complicating factor.

Tests on the internet will tell you nothing. Go see an audiologist. They will give you a battery of tests and figure out exactly what's going on and if a technology may help you.
posted by Lutoslawski at 11:28 AM on August 6, 2013

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