Khoo Bee Kim
CNA – When it comes to hearing aids, many of us associate these devices with elderly grandparents and, by extension, a sign of old age and vulnerability. As did Soh Lee Lee.
The 29-year-old was first fitted with hearing aids in both ears about eight years ago – a decision she deliberated on for a whole year after being diagnosed with high-frequency hearing loss. This meant that she couldn’t detect sounds that are higher than 2,000Hz such as birds chirping, consonant sounds in speech and ringtones.
“I was devastated and even cried when the clinician asked me about my thoughts on hearing aids. I struggled to accept the idea as I perceived them as a sign of weakness,” she said.
Soh remembered sensing that there was something wrong with her hearing as early as seven years old. “My ears felt blocked. And I could hear my breathing and chewing quite loudly from time to time. But I thought it was normal and didn’t tell anyone since I could still hear well most of the time.”
After several years of straining to hear the teacher in class, Soh finally told her parents, who took her to see a general practitioner at age 11. She was told that she had impacted ear wax in both ears. The doctor flushed her ears to dislodge and remove the wax but the feeling of fullness persisted.
“I assumed that this was probably a normal sensation, so I didn’t mention it to my parents again.”
It was in university when the cause of Soh’s blocked ears was finally diagnosed. A specialist assessed that she had sinusitis and enlarged ear canals, which meant that ear wax and dead skin were more likely to build up in her ears than usual.
But by then, Soh’s hearing had already been affected. “There was a permanent mild-to-moderate drop in detecting high frequencies in both ears,” she said. “I was able to hear well when the environment was quiet but I would miss out certain words in noisy places or during group conversations, and would often need others to repeat what they said.”
Soh may seem to be too young to suffer from hearing loss but the condition is certainly not limited to silver-haired individuals. Sadrina Shah, a clinical audiologist at Hearing Partners, said that 20 per cent of her patients are in their 30s and 40s. One of the common causes of such early hearing loss could be genetics, she said, or ear diseases such as cholesteatoma, otosclerosis, Meniere’s disease, chronic ear infections or viral infections of the inner ear.
In these age groups, the signs may manifest as a “sudden sensorineural hearing loss” or “viral labyrinthitis, which is a condition where vertigo and hearing loss occur together suddenly”, said consultant ear, nose and throat (ENT) surgeon and the medical director of Aurion ENT and Hearing Centre at Farrer Park Medical Centre Dr Liu Jiaying.
Soh’s decision to use hearing aids did not only improve her hearing, she was also inspired to pursue a degree in audiology and become a clinical audiologist. Today, she uses her personal experience to help others, who are grappling with hearing loss, come to terms with using hearing aids.
Sharing her perspectives on the importance of early intervention “usually help to speed up the process of moving them through the stages of grief to accept their hearing loss and proceed with solutions/management”, she said.
The misconceptions that surround the use of hearing aids may also be other hurdles.
Here’s a look at what the experts say about these common ones:
MISCONCEPTION 1: You have to meet certain criteria before you are eligible for hearing aids
Hearing loss presents differently in different individuals, so there are no specific criteria that you need to meet before hearing aids are prescribed, said Shah. For instance, some may struggle to hear high-frequency sounds like Soh; others may only be able to hear loud sounds.
During the appointment at the ENT doctor’s, patients are usually asked how their hearing has impacted their everyday lives. “This is followed by an examination of the ears and a comprehensive hearing test, which reveals the type of hearing loss and its severity at various frequencies,” said Dr Liu, who added that an MRI or CT scan may sometimes be required.
MISCONCEPTION 2: Hearing aids are only for old people and those with severe hearing loss
Just like how spectacles are devices to help improve your eyesight and are worn by all age groups, hearing aids are just the same, said Dr Liu. “They are worn to improve hearing, regardless of age.” In fact, for very young children with hearing loss, hearing aids are especially crucial to the development of their speech and language skills, said Shah.
“Research has shown that the use of hearing aids before six months of age provides the best outcome.”
In adults, those with moderate and severe hearing loss are three times and five times more likely, respectively, to develop dementia, said Dr Liu. And this can happen in three ways: One, “long-term hearing loss causes irreversible brain shrinkage due to the lack of auditory stimulation”. Two, the straining from listening shunts “brain energy away from higher executive function like thinking and planning”.
“People with untreated hearing loss also tend to withdraw themselves from social activities due to impaired communication with others. This lack of social stimulation results in reduced brain activity, setting the stage for cognitive decline seen in dementia,” said Dr Liu.
MISCONCEPTION 3: Hearing aids make everything too loud
Hearing aids do indeed amplify sounds using a microphone-amplifier-speaker system, said Shah. “However, sounds consist of different frequencies (low versus high pitches) and varying levels (loud versus soft). For example, a loud sound such as drilling would not be amplified as much as a soft sound such as footsteps.”
Hearing aids are also different from hearing amplifiers that don’t require an audiologist’s prescription (they can usually be bought online or over the counter) and might provide “insufficient or too much amplification at certain frequencies”, said Shah. These amplification devices may simply make all sounds equally loud.
This is where a trained audiologist will ensure that you’re getting the appropriate amplification suited for your hearing loss. Put simply, a hearing aid is personalised to meet your hearing loss pattern by the audiologist and it only amplifies the sounds that you can’t hear well, said Dr Liu.
MISCONCEPTION 4: You can’t work out or listen to music on your earphones/headphones when using hearing aids
Hearing aids can function as earphones, too, said Shah. “Modern hearing aids usually come with a Bluetooth function, allowing you to stream music and phone calls directly into your hearing aids.”
Speaking of Bluetooth connectivity, some models can also enable phone calls.
“In fact, most people report better clarity as they can listen to the call with both ears instead of just one,” said Shah.
Size-wise, hearing aids have scored another win. “Invisible-in-the-canal hearing aids are so discreet that they are considered invisible and unable to be seen in nine out of 10 cases,” said Shah.
“Some patients have even shared that others thought they were using Bluetooth earpieces when they wear their hearing aids.”
As for working out with the hearing aid on, that’s not an issue either as the devices are water resistant. “Just give the aids a good wipe after your workout and everything will be fine,” said Shah.
MISCONCEPTION 5: You don’t need hearing aids when you’re at the movies or a noisy event such as a rock concert
It depends on the level of noise, said Shah. “Movies are generally fine and hearing aids might even help you hear the dialogue better.” Even in noisy environments such as a busy shopping mall or noisy restaurant, the devices’ smart noise-cancellation function does wonders to enhance patients’ hearing, said Dr Liu.
But for louder events such as rock concerts and locations such as night clubs, it is advisable to remove your hearing aids, said Shah.
Instead, use hearing protection such as earplugs. “Musicians may also consider the use of musician earplugs, which help to attenuate sound while still preserving the sound quality of the music. Even those with normal hearing should protect their ears in these situations,” she said.
MISCONCEPTION 6: Hearing aids cost a lot
In general, each piece of hearing aid in Singapore can range from SGD800 to SGD8,000. The higher the price tag, the better the sound quality and more features and functions you’ll get out of the device. So, it is a matter of choosing the right one that fits your budget
and needs.
“The Singapore government offers subsidies such as the Seniors’ Mobility and Enabling Fund and Assistive Technology Fund that helps to alleviate some of the costs of purchasing a pair of hearing aids,” said Shah. “Hearing Partners also offers free hearing check-up, so patients can check with our in-house audiologist on which hearing aids work best for them.” Now, that should be music to your ears.
