doctorofaudiology
16 Years Experience
Marlboro, NJ
Male, 40
I've been an audiologist for 16 years. I work with all types of patients, focusing on balance disorders, tinnitus, and hearing aids. As I have worked in an Ear, Nose, Throat setting much of my career, I am also exposed to much of the medical side of audiology. ASK ME ANYTHING about being an audiologist.
DISCLAIMER: If you feel that you have a hearing or balance issue, please be sure to see your local ENT or audiologist. This Q&A is not designed to treat or diagnose your problems.
I can see the benefit from sonic weapons, however, an audiologist is probably not going to be on the top of the list for people asked about its benefits. Military is working on recovery for sudden hearing loss, so eventually, maybe sonic weapons won't be as effective down the line. Just a guess.
The million dollar question. This cannot be answered in a couple of sentences or even a paragraph. Much goes into whether a hearing aid is effective. A few factors include: 1) the patient's hearing loss and ability to discriminate speech. People with poor speech discrimination will have difficulty understanding with or without hearing aids. As inner hair cells of the ear die, they cannot be recovered. Thus, presenting loud sound may not be enough to make things "clear". Certain newer technologies combat this. 2) the product that a patient gets. Unfortunately, people will value money over performance all too often with hearing aids, and they pay for it in the end. The hearing aids purchased must fit a person's lifestyle. By lifestyle, I mean social lifestyle. A homebody will require a much less sophisticated hearing aid than someone who is social and active. This does result in a different price point, often significant. Yet some will buckle over the price. Other issues include the cosmetic component. Many "smaller" or "invisible" hearing aids have limitations, such as fewer directional microphones, shorter battery lives, or simply less power output. Getting a small hearing aid is not always appropriate given certain types of loss. 3) Education. This is the most important part of the process. Yes, hearing aids work, as many audiologists can attest. Yet the patient needs to truly understand that hearing aids are part of a rehabilitation process. Simply putting on hearing aids does not "make it all better". As the ears are learning to re-hear, many patients will indicate that things are loud or annoying, etc.. Having the hearing aids turned down or lowered for comfort prematurely will often result in poorer speech audibility and understanding. A good audiologist should indicate to the patient that things will be very different with hearing aids, but not perfect. While designed for speech intelligibility, hearing aids cannot choose specifically what a person wants to hear. They cannot "get rid of" all background noise. They cannot overcome massive amounts of background noise. They need to be worn all of the time to experience benefit. They need to wear two if appropriate. They need to be cleaned regularly. But the bottom line is that for hearing aids to be successful, you need three things. 1) A willing and understanding patient, 2) a good audiologist to help facilitate and assist in the rehabilitation process, and 3) the right pair of hearing aids to fit the patient's loss appropriately.
It depends upon what you are using them for. I have many patients who are professional or amateur musicians who do find extreme benefit with custom ear plugs. Many of them enjoy the interchangeable filters, offering different levels of protection depending upon what activity they may be engaged in. As someone with custom plugs, I do notice the difference. The firm seal of custom molds gives the user confidence that sound will not leak in. They also won't fall out.
Generally, the answer is no. However, each time you go to a concert, cilia (receptor hair cells) do get damaged. If you were to have a hearing test prior to the concert and after, the odds of a hearing loss appearing are small. There are plenty of instances where a loud concert can cause permanent hearing loss, just like any other form of traumatic event to your ears (i.e. explosions, head injuries, etc). To avoid this, be sure to wear hearing protection to concerts. I'm a huge hard rock fan; I rarely feel my experience is hindered due to wearing "plugs".
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Did you experience the notorious 100-hour work weeks?I used to use Mac's Ear Plugs. Simple and inexpensive. However, please be sure to follow instructions on how to insert them. Many people will try to place them deep into the ear canal; this is not appropriate and can be dangerous.
Some audiologists specialize in balance disorders and treatment. However, please be sure to have an evaluation of your balance system first. Go to an Ear, Nose, Throat specialist that has an audiologist who performs vestibular testing (not all do). Depending on the findings and case history, results may indicate that vestibular rehabilitation (balance therapy) is beneficial. There are specialized audiologists (as noted above), but more commonly, specialized physical therapists who can create programs to improve one's balance.
While I do not know the specifics, I do believe that soldiers are monitored by their local VA's to monitor their hearing. I am aware that research is being performed to address sudden onset hearing loss via a pill. However, I am sure, as with any occupation using firearms, there are risks of hearing loss. I have often been told by military and police, etc., that wearing hearing protection is not realistic given that they must respond to commands and orders in the field. So I guess that this is what happens. This article pretty much sums it up: http://www.military.com/news/article/army-fights-hearing-loss-in-soldiers.html
A long and strange road for me. Most don't even know what audiology is unless they or a family member has some sort of hearing loss or balance problem. A study was done years ago, whereas lawyers, doctors, and audiologists were asked at what age they decided to become a lawyer, etc. Doctors and lawyers were something like 6-8 years old, audiologist 21. I wanted to get into health care and wanted to specialize in something. I thought of becoming a dentist, optometrist, etc., but I'm not going to bore you with details. Just turned out that after learning about the ears, it became interesting and exciting...and here I am.
Many people believed at one point that IPOD earbuds were dangerous. Further research does refute this. You would essentially have to wear your earbuds for 8 hours a day or more at 80% or more volume almost every day for there to be any effect on your hearing. Additionally, Apple combat this by reducing the volume of later generation IPODs. Personally, I would recommend any earbuds or headphones that allow for a good seal in the ear. If background noises are not audible and the volume of the device is not too high, then you have a good pair.
Most likely, no. However, I urge you to follow-up with the audiologist and/or an ENT within one month to ensure that the fluid has resolved. Once the fluid resolves, your daughter should be back to normal. Just make sure you don't "leave it be".
It depends on what you do with the Q-tip. If you use the Q-tip to clean the external bowl of your ear, fine. If you decide to insert the Q-tip deep into your ear, you could risk puncturing your ear drum. You could also risk damaging the lining of your ear canal if you are too rough; this could also lead to ear infections. More commonly, when using Q-tips, wax simply just gets pushed farther down the ear canal, closer to the eardrum. Long story short, I don't use Q-tips at all. You shouldn't either. If you are prone to wax impaction, get a professional to clean it periodically.
It's the other way around....everyone asks for free advice. If it's a simple question regarding noise exposure or earwax, I'll address it. If people ask me questions about having a tumor or something that sounds serious in nature, I urge them to make an appointment with the appropriate medical professional. When I'm not a the job, I don't preach the job. =)
You name it. =) Aging of the ears, noise trauma, certain medications, stress/anxiety/tension, back problems, earwax, hair on the eardrums, tumors, blood circulation problems, circulatory problems...... Now before you start thinking that you have a tumor, please be sure to visit and audiologist for an evaluation. Having your hearing tested can be a gateway into learning about why tinnitus exists. Self diagnosis is not the answer.
Without getting into too many specifics, it's all over the place. It depends on whether you go into private practice, work for an ENT, a hospital, work for yourself, at a university, whether you sell hearing aids or not (and if so, the commission scale), and the region you are working in. For example, an audiologist in New York City may not make a huge salary, but may have relatively good commission given the amount of hearing aids sold and how much they sell for. Audiologists can make six figures, but that is usually done by selling a large amount of hearing aids.
Most audiologists will use their "bread and butter" test....the audiogram to assess hearing. However, if you want to get more technical, otoacoustic emissions (OAEs) test hair cell integrity. It is a non-invasive test that takes less than a minute via a probe.
I do not believe that hearing would be "basically" unchanged. The auricle (ear lobe) acts as somewhat of a funnel. Without this "funnel", sound cannot be trapped and led to the internal parts of the ear. As a result, hearing may be off somewhat. On the flip side, if you cupped your hand around your ear, you would pick up more sound.
Rock stars are wearing monitors. Monitors are used for hearing, not protecting. Monitors present the vocals and the instruments through a complex sound board through the monitors so that all of the musicians are in sync. Given the loudness of a rock concert, the band otherwise would not be able to know what the other members are doing.
Yes. But you need to be on a strict program....not just "whenever" you feel like participating.
If I had a year to answer this...I wouldn't have enough time. Audiologists are somewhat of an outbreak of Speech pathology, whereas many audiology programs were birthed from them. Same goes for professional organizations. They are completely different fields, but yes, do work together in certain environments. For example, children with hearing loss work with an audiologist and SLP to develop appropriate speech and hearing in a team approach.
CAPD is not widely acknowledged....simply because people don't know what it is! Best of luck!
Not at this time, nor do we prescribe medications. But as the profession develops, you never know.
Alas, in most cases, the answer is no. With the exception of a medically based tinnitus (sound in ears) that is structurally based, there is no cure for tinnitus. 90% of those who have tinnitus simply "just live with it". Those who cannot often will benefit from tinnitus therapy. Therapy may include the usage of a hearing aid, a device that masks tinnitus, change in diet, change in medications, accupuncture, etc. These are not guaranteeds to work. But again, they are TREATMENTS, not cures.
Exposure to sound at 120 dB for over 30 seconds is technically considered dangerous if repeatedly listened to. The degree of damage varies...it depends on the length of your career...how long you have been doing this...etc. But yes, there is danger. It is my belief that all officers have annual audiological evaluations.
I am unclear of your question. If your hearing aid was purchased in the Bahamas but is made by an international manufacturer, you can call the manufacturer directly and find a local audiologist to address the problem.
Yes...refer to the Americans with Disabilities act for more information.
I've answered the other parts above....so I will focus on the "dislikes". I think the biggest dislike is the role of audiologists in society. We are often not considered doctors, but we are "more important" than techs. Sometimes we are treated and thought of as techs. We are a rather young profession, still trying to find its niche. I wish the general population understood that we are comperable to an optometrist or that we went to school and own higher education degrees.
Perhaps the audiologist thought you just said a "cracking"....
Well, hearing aids send information to the ear. The ear then sends information to the brain. Whether you get hearing aids or not, the ear will age. You cannot stop this from happening if you get hearing aids. However, auditory processing can be adversely affected without hearing aids. If the ear and the brain are not in communcation over a period of time, auditory pathway fibers will wear down. We try to preserve that communication with hearing aids. So, in THAT sense, if you don't use it, you lose it.
Loaded question, my friend! Auditory Processing Disorders, in short, are related to how the brain processes auditory information and cues. Some will have difficulty understanding certain sounds, while others have difficulty hearing under specific listening conditions. Central Auditory Processing Disorders (CAPD) can be diagnosed through a battery of tests, generally lasting around 2 hours in duration. These tests focus on different listening conditions and different stimuli and how the ears and brain work to process it. An audiologist performs and interprets the results. Personally, it is hard to say "how common" it is, as many who suffer with CAPD do not have tests and "live with it" through adulthood. Testing is more common today, as parents test their kids for everything. As a result, more children are being discovered as opposed to being called dyslexic or Attention Defecit Disorders. Processing, as a rule, declines over the years...and TBI contributes. TBI can affect certain areas of the brain dealing with auditory stimuli and processing of that data.
I am not sure of your question, but I will answer in a few different ways. I am currently part of an ENT practice and utilize its software for my patient database. I personally do not like it, thus will not recommend it on here. As for other software, audiologists utiliize a program called NOAH for hearing aid programming. This is a database gateway that is pretty universal...we don't really know of any other. Each manufacturer has its own programming software as well. Some are more user friendly than others. I own a computer based audiology system by a brand called Interacoustics. It's not that user friendly, but once you get the hang of it, it's great to run. For my balance testing, I utilize Micromedical software. It's simple and easy to run.
I am not sure what you are referring to. Please clarify, especially if you have a website.
You may utilize alternate forms of response. Generally, if the person is verbal but has good receptive language, you can utilize button pressing for pure tones. If they are cognitively incapable, you may utilize child methods, such as play audiometry or visual reinforcement. Instead of an SRT, you may utilize an SDT, Speech detection threshold. This would be a cross check to pure tones. As for speech stimuli, there are also picture boards that the patient may be able to point to. More than one way to skin a cat!
Perhaps. It can vary case by case. Sometimes we can have delayed reponses...or rather, it may simply be something else that trips the problem into existence.
Sorry I did not get to you earlier as I didn't see this. The long and the short of it is that it depends on the type of clinic and what region of the country they are. I currently work in a large ENT practice with multiple doctors and audiologists. As a result, our hearing aid sales are in the hundreds. A small ENT practice may sell 150-250, depending on how hearing aids are promoted. Private practices will sell more as that is how the clinic stays in business. As for prices, the cost will vary. It varies by technology, as each manufacturer of hearing aids will put out 3-6 levels of sophistication. Additionally, each practice will set their prices, which may or may not include service, batteries, and specific warranties. At the end of the day, I've seen hearing aids sold for as little as $500 to as high as $4000 per unit.
While this page is not used to diagnose, I am a little confused about the story as written. If you have sudden loss, there is a specific time frame to improve your hearing via steroids. If steroids were not successful, your hearing may be your hearing. However, you claim that your hearing has worsened. Most certainly go to another ENT, have a CT scan, blood work, etc.. As I always say, there has to be a reason why something is happening. I don't understand the relevance of the headsets to your story.
I was just at a hearing aid manufacturer's plant and asked this question. They are actually researching it.
I don't know where you are, but most certainly, if this is a concern for you. please visit a higher level Neurotologist. They are a subspecialist ENT who is focused on the ear and internal structures.
Ok well that's something a little deeper. If the ear heard sound but there was a delay to the brain...that is a deeper issue. Definitely, get a second opinion.
As goofy as this sounds, it depends on how you are "getting by". I have a variety of patients who struggle with all different types of hearing loss. Low frequency sounds can include all of our major vowels, high frequency sounds past 4000 Hz can include "f", "s", and "th". This can reek havoc on the ability to understand in background noise as well as with soft speakers...as well as many other things. If you are having functional issues, meet an audiologist and left them demonstrate a hearing aid to see if you notice improvement.
I know having a sedated ABR may have been traumatic, but perhaps another one would be beneficial. Unless I am reading this wrong, the test was EXPLAINED as abnormal, THEN normal. Is that correct? The one test can only be interpreted one way. If your question actually indicates that two tests were done, one would be generally likely to accept the normal test. However, just to be safe, can you go to a different facility for a double check? If I did not answer your question well, please respond and give me more details.
Actually, that doesn't make sense. Bone response cannot be worse than air response. The only way that this is valid is if the test reached the maximum bone limits. If that is the case, the loss would be sensory, not structural. Personally, I would ask the audiologist performing the test to explain. There is no easy way to type this, but again, air cannot be better than bone.
Pros: Growing career. Many more people over the years will need hearing and balance services, as our population is growing and growing. Tens of millions of people will be aging longer, prompting even more need for vestibular and hearing services.
Cons: With all healthcare fields, insurance reimbursements often make it hard to function. With hearing aids, there are so many avenues to purchase them. The population may be focused on pricing and flashy newspaper ads over professional services. This kind of cheapens our profile.
In recent years, audiology is always listed as a top profession. However, we are still relatively young and don't have an official identity. Thus, we have a field of those with doctoral degrees, some without, those who are simply hearing aid dispensers, educational audiologists, etc, etc.. Our governing body is not very strong, financially and politically.
It depends on the level of functioning. Audiologists will work their way down the aging scale to see what kind of interaction a patient can give. We start with adult performance, then work our way down to pediatric test such as play audiometry and visual reinforcement audiology. If none work, consider an ABR, a brainstem test that does not involve response from the patient.
Any sound that a person hears "in their heads" is tinnitus. It is not normal. Please go to a hearing specialist for a hearing evaluation. This will give us more data on what is going on with the sound.
No dangers. Just be careful of disease. Like any other healthcare profession, look for blood or open wounds.
As long as you have some sort of protection, that is very important. The yellow 3M E-A-R plugs help, but I personally prefer the Mac's earplugs. Why? Because they splat over the entrance of the ear, so no matter what ear canal you have, it will work. I find that the 3M product doesn't always stay in well and sound can leak in. If you are a huge concert goer, consider going to an audiologist and getting custom noise reduction plugs. That could run you $150-$250 a pair, but you will be very happy you did it.
I liked this article, which sums it up. http://www.healthyhearing.com/report/51575-The-history-of-audiology
I only have knowledge of mercury fillings and their relationship to tinnitus. However, in general, jaw discomfort, stress, tension, etc., can contribute to the presence of tinnitus.
No, you cannot. One of my pet peeves in the industry is when a doctor tells the patient that s/he has "better than normal hearing" or "perfect hearing". We are not born with "100% of our hearing", then declines. We are generally all born within a normal limit, which declines over time. On the audiogram (hearing test), one can have test scores below 0 dB, which is great, but not "perfect" or "above average".One of the best ways to assist in hearing a teacher in the classroom is by utilizing ALDs (assistive listening devices). Many of these devices, which include FM systems or remote microphones, allow the speaker's signal to transmit more prominently to the person with a hearing impairment.
I am sorry, but I do not know.
As long as you have noise reduction support, resulting in non-dangerous levels of sound reaching your ear, you can be fine. With that being said, those with hearing loss or repeated trips to concerts should sometimes "double-up", using more than one protection at a time.
Wearing earplugs and headsets together is a great plan. As we age, however, tinnitus can increase as our hearing declines with age. But again, please do what you stated.
One could purchase in-ear monitors. They can be balanced to allow for better sound recognition without the impact of loud sound. As for tinnitus and hearing loss...if you have hearing loss, no matter how big or small, my belief is that hearing aids work. It will reduce the growing disconnect between the ear and the brain, allowing for more sound presentation and less chance of growing tinnitus.
To be honest with you, I don't necessarily think that many cell phones can emit sounds above 18KHz. So even though you couldn't hear them, perhaps that those sounds were not even presented. Speaks have limits as to volume and pitch. I doubt you hurt yourself. =)
How loud is the wax in your ear? I've never been asked that one, lol. I have no clue! If you really wanted to research, get a research audiologist to put a probe mic in your ear to determine volume. Sorry I can't be more help on that one.
-10 dB is a volume unit. People are often under the impression that if your hearing test reveals a response of "0", that means that your hearing is "perfect". It is not. We are also not born with "100%" hearing. We are born with whatever. If a person can hear a specific sound at -10 dB, he or she most certainly has great hearing.
Could you clarify? Do you mean the test or the actual reflex?
When you take the earplugs out they make a loud noise? Are you constantly getting hit in the head? I am sorry, I would love to help, but I still don't understand the situation.
Please kindly refer to my other answers above about these questions.
As an audiologist I cannot give a medical recommendation, per se, but given my history, steroid injections are essentially a "salvage mission". Depending on how long ago the sudden hearing loss was, oral steroids can help. Yet if there is still room for improvement, the steroid injection is a more direct approach...literally. Whereas with tablets the relief can be anywhere in the body, a steroid injection is most certainly isolated to the ear.
If you are worried, by all means, protect yourself. I am not sure what the volume of the movies are when they are in the "end credits", which is what I assume you are referring to time wise, but you absolutely should. If you are unsure of the volume, use a sound level meter app. It could help you learn about volume. If the volume exceeds 85 dB over an 8 hour span, protection is appropriate.
The relationship with LPR...not 100% sure but if you are getting congestion through your passageways, the muffled sensation may be Eustachian tube dysfunction. ETD can result in a clogged feeling in the ear, though the clog has not officially made its way behind the eardrum. Some MDs will give nasal steroids or recommend decongestants. Please consult someone else because there is more than "just the hearing test".
That is only one part of it. Fundamentally, the tiny hair cells in your ear age, then die. This is pretty much like a lot of other parts of the body. This, in tandem with noise exposure, medicines, health, medical conditions, and genetic create our own "perfect storm" to determine when our hearing goes.
It is called the occlusion effect. Caused by the bone-conducted sound vibrations reverberating off the earplugs, we often feel a sensation of hollow sound. It is not dangerous.
I prefer Widex. However, I am unaware of your specific loss. For many who lose hearing virally, sound quality may be affected. With that being said, make sure you demo aids from your provider to see what you like.
I'm confused by your question. If someone hit your headphones, most likely, that in itself would not cause hearing loss. However, if you notice a change in hearing or sound perception, please have your hearing assessed immediately.
I personally like Widex hearing aids for high frequency hearing loss. Widex allows for strong high frequency data, good feedback control, and the sound quality is full enough where you often do not feel the aids get tinny.
It depends on how long that the person has had the problem. If this had a sudden onset, please have your hearing assessed. If other symptoms are present, such as tinnitus (ringing, buzzing, etc), fullness, or vertigo, it may be part of a bigger problem. If this is something that has been around the person's entire life, it may just be a difference that certain people have. Nonetheless, a hearing assessment and case history will open up many doors on this one.
I unfortunately do not. However, an option would be to contact your state's disability services and ask for further information.
It is possible, albeit most likely that length of exposure should not result in permanent damage. Usually that volume’s permissible listening period would be approximately 2 min. Other factors would be distance from sound to your ear, including whether you wore earphones or if the sound just came from the phone itself. You may have caused a sudden threshold shift, whereas the sound temporarily paralyzed the hair cells. If this happened very recently (within the day), see if you improve. If you don’t, go to an audiologist/ent for a hearing test. Anomalies could then be addressed.
I think your statement about "I can't say I knew I could hear above that before hand" is telling. We are not all born with "perfect hearing". In fact, I hate that phrase. We are born with whatever we are born with. Is there a chance that your hearing was alway impaired in the higher frequencies? Absolutely. And to tell you the truth, most tests wouldn't even catch it. Those who test frequencies that high are mostly researchers. The tinnitus could also indicate hearing impairment. Does the gunshot exposure play a role? Possibly. Without comparison tests, it is difficult to tell.
Obviously...I'm amazing, aren't I? Lol
A few questions. How did you find this out? I ask because most audiologists do not test past 8 kHz, some 12 kHz. If you were using your cell phone or some low-lever speaker, do not be alarmed. Conversely, if you were tested or utilize high-level equipment, I personally would not be concerned if your responses 8 KHz and lower were normal (in fact, some research suggests that we start losing out hearing at age 2!) The x factor is if your hearing is changing drastically. If you had an evaluation with an audiologist, please repeat the test in one year to monitor for change. If you work in an occupation that involves loud noise, please use hearing protection. Hope this helps.
Of this Coronavirus...no. A virus can impact an ear and cause sudden sensory hearing loss. However, hearing loss is not a common symptom of what is going on.
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