Child Health Day: Early Signs of Hearing Loss

Photo Courtesy of Today Show

Photo Courtesy of Today Show

Hearing loss in infants is a hidden disability. Infants can't express themselves or alert parents that there is a problem. That's why it's important for parents to understand and look for signs of hearing loss. Some of these include:


  • Not startling or awakening at loud noises (0-3 months)
  • Not calming at familiar voices (0-3 months)
  • Not responding (smiling, cooing) to your voice when spoken to (4-6 months)
  • Not turning toward sounds (4-9 months)
  • Not showing normal babbling development (4-9 months)


  • Not babbling different voices (9-15 months)
  • Not responding to his/her name (9-15 months)
  • Not responding to changes in your tone of voice (9-15 months)
  • Not repeating some sounds you make (9-15 months)

Regardless if your infant is showing signs of hearing loss, we hope that parents take advantage of our free hearing screenings next Tuesday in Crozet. The procedure is quick and painless for infants and provides peace of mind for parents. It's a win-win! 

More information about infant and childhood hearing loss can be found here on our web site. 

Meniere's Disease


What is Meniere's Disease?

Named after French physician Prosper Meniere after he experienced this condition in the 1800s, Ménière’s Disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or pressure in the ear. 

Meniere's Disease is caused by the buildup of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and hearing (the cochlea). When it fills with fluid, it interferes with the normal balance and hearing signals between the inner ear and brain. This interference causes vertigo, tinnitus, and other symptoms. 


A Meniere's episode generally involves severe vertigo, imbalance, nausea, and vomiting, and may come on suddenly or after a short period of tinnitus, hearing fluctuations, or "fullness" in the ear. A sudden fall without warning, called "drop attacks," may also occur if patients feel they are tilted or off balance (although they are standing straight). These episodes of vertigo can last anywhere from 2-4 hours and are usually followed by extreme fatigue. There may be no other symptoms between these attacks, which can be years apart, although hearing loss tends to get progressively worse with time. 

Ménière’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age.

Causes of Meniere's Disease

Although still relatively unknown, Meniere's Disease is often associated with autoimmune disease, head injuries, allergies, viral infection, and genetics. 

Meniere’s Disease and Hearing Loss

Hearing loss associated with Meniere’s disease usually affects low frequencies and is present in one ear. Hearing tends to decline during an attack and improve after an attack. In the initial stages of the disease, hearing may be normal between attacks. As the disease progresses, however, hearing can permanently decrease in the low frequencies and eventually extend to all frequencies. Hearing loss associated with Meniere’s disease is a “sensorineural” hearing loss, meaning that it is the nerve endings that are affected. In most cases, a sensorineural hearing loss entails permanent loss; a fluctuating sensorineural hearing loss is unusual and a strong indicator of Meniere’s disease. 

Diagnosing Meniere's Disease

Diagnosing Meniere's Disease can be difficult. Often, other conditions need to be considered and ruled out, as there are many conditions that can cause symptoms of vertigo, tinnitus, and hearing loss. Diagnosing Meniere's involves looking closely at the symptoms and conducting a hearing test to document hearing loss after an attack. It may also include an ENG test to measure eye movement, blood tests, or a MRI. 

Treatment of Meniere’s Disease

Unfortunately, there is no cure for Meniere’s disease, nor is there any one treatment that covers all cases. Treatments may include reducing salt, caffeine, processed foods, alcohol and nicotine in your diet; medications, such as diuretics, vestibular suppressants, steroids, and immune system suppressants; and, surgery for extreme cases. If permanent hearing loss is detected, it can be treated with hearing aid technologies.

It is important to note that Meniere's Disease should not be self-diagnosed or self-treated. If you are experiencing symptoms similar to Meniere's, please seek the care of a medical professional, such as your primary physician, audiologist, or ENT specialist. 

Tinnitus or "Ringing in the Ears"


Tinnitus (ti-NIGHT-us or TINN-a-tus) is also known as "ringing in the ears;" however, it can manifest as whistling, buzzing, hissing, roaring, swooshing, clicking, and many other sounds. Regardless of the sound, it can be extremely bothersome. It's also common. According to the Mayo Clinic, approximately one in five people experience Tinnitus at some point in their lives. More than 90% of those experiencing Tinnitus also have hearing loss.

In general, there are two types of Tinnitus:

  1. Subjective Tinnitus: Noises perceived by the patient only. This type of Tinnitus primarily results from auditory and neurological reactions to hearing loss, but it can also be caused by other health conditions. More than 99% of cases reported are subjective.
  2. Objective Tinnitus: Noises that can be heard by the patient, as well as others. These noises typically are produced by blood flow or the body's musculoskeletal systems. 


Tinnitus is a symptom of an underlying health condition; it's not a health disorder. It can be temporary or ongoing and is usually a reaction in the brain to damage in the ear and auditory system. Although there are many health disorders that cause Tinnitus, here are some of the most common:

  1. Hearing Loss - This is the most common cause of Tinnitus, whether it's age-related or noise-induced hearing loss. 
  2. Obstructions in the Outer and Middle Ear - Excessive ear wax, fluid, congestion, or foreign objects
  3. Head and Neck Trauma
  4. Temporomandibular Joint (TMJ) Disorder - Damage to the muscles, ligaments or cartilage of the TMJ, where the lower jaw connects to the skull in front of the ears
  5. Sinus Pressure
  6. Traumatic Brain Injury (TBI) - One of the major causes of Tinnitus among our military and veterans.
  7. Ototoxic Drugs, including Non-Steroid Anti-Inflammatory Drugs (NSAIDs), certain antibiotics, cancer medications and diuretics. In some cases, stopping the medication will cause the Tinnitus symptoms to improve; however, this is a decision that must be made with a medical professional.
  8. Certain Medical Conditions, such as Hypo- and Hyperthyroidism, Anemia, Lyme's Disease, Fibromyalgia, High Blood Pressure, Depression, Anxiety and Ménière's Disease


We use the word "management" because, unfortunately, there is currently no scientific cure for most types of Tinnitus. However, there are good, well-established tools and treatments that can significantly reduce the burden. Our most effective method is working with patients to identify an underlying health disorder to treat. This could be as simple as removing excess earwax, treating an ear infection, changing medications, or fitting patients with hearing aids if hearing loss is detected.

If you are experiencing Tinnitus, please feel free to give us a call. We will be happy to consult with you and determine the next steps. In the meantime, it may help for you to read from others who have lived with Tinnitus (including William Shatner) so you understand you are not in this alone. 

How to Talk to Your Doctor: Choosing the Right Hearing Aids for You

If you're reading this post, hopefully you've already familiarized yourself with how to talk to your doctor about hearing loss. This is Part 2 of our "How to Talk to Your Doctor" series and will focus on the conversations following the initial hearing screening, after it has been determined that your level of hearing loss requires support from hearing aid technologies. 

First, you'll want to familiarize yourself with the various hearing aid options. There are in-the-ear, behind-the-ear, rechargeable-battery, iPhone-compatible, and many more hearing aid options from which to choose. Make a list of what is most important to you from a hearing aid perspective. Here are some things to consider:

  • How active is your lifestyle? Do you spend most of your days in a quiet or more social setting? Are you just trying to hear the TV better, or do you need to actively participate in group conversations? This will help you decide which features will work best with your lifestyle, such as noise reduction, directional microphones, wireless technologies, additional programming, and more.
  • How often are you on the phone? If your answer is "often," you should consider the iPhone/mobile phone compatible hearing aids. 
  • How important is discreetness? Hearing aids vary in discreetness, ranging from the most discreet completely-in-the-canal options to less discreet behind-the-ear technologies. Of course, each type also has its pros and cons. Be sure to discuss these with your audiologist.
  • Do you have a budget? Hearing aids also vary in costs, so it's important to discuss your personal budget with your audiologist when deciding which technology is best for you.
  • Are rechargeable batteries important? The latest hearing aid technologies offer rechargeable battery options. This is an important consideration from environmental, maintenance and cost perspectives. 
  • Can you take the hearing aid for a test drive? Hearing aids are an important investment. Before settling on a final option, ask if you can take them for a test drive. Even if it's not exactly the hearing aid you plan to order, it will give you a good idea of what you can expect and will help you prioritize features and programs. You can read one of our patient's reviews after a demo with the iPhone-compatible hearing aids. 

Finally, find a reputable, local audiologist. During the first few months, you'll be getting used to your hearing aids and will probably have many questions or will need to visit the office for minor adjustments. This is why it's important to find a local audiologist that you trust. It's also the reason we recommend against buying something as important as hearing aids online. There is no "one size fits all" when it comes to your hearing. You'll need to work with your audiologist until you find the best solution for your hearing loss and lifestyle needs.


Protect Your Ears From Loud Summer Sounds

Crozet, VA, Fireworks. Photo credit: M.C. Andrews Photography

Crozet, VA, Fireworks. Photo credit: M.C. Andrews Photography

For many of us, Summer sounds are pleasant and nostalgic. Crickets chirping, children splashing in the pool, the ocean, and campfires crackling are some common sounds associated with fond Summer memories. But, some of the most harmful sounds to your ears are also associated with this season: fireworks, lawnmowers, power tools, and outdoor concerts are among the loudest. 

More than 26 million Americans ages 20-69 have noise-induced hearing loss. This is caused by damage to the hair cells that are found in our inner ear. Hair cells are small sensory cells that convert the sounds we hear (sound energy) into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back, causing permanent hearing loss. 


The loudness of sound is measured in units called decibels (dB). Noise-induced hearing loss can be caused by prolonged exposure to any noise louder than 85 dB, or by a one-time, intense exposure to a noise like an explosion. ƒHealth experts recommend protecting your hearing when exposed to:

  • Noises louder than 100 dB for more than 15 minutes
  • Brief, one-time noises of 120 dB (for children) and 140 dB for adults

To help you understand when it's appropriate to protect your ears, we've created the infographic below. 

If you hear ringing, buzzing or experience temporary hearing loss when operating machinery, leaving work, or following a concert, hearing protection is crucial. Parents - if you can hear sounds from your child's headphones or earbuds while standing next to them, the volume is too loud.

If you're constantly exposed to noises over 85dB at work or home, please contact us. We provide many types of hearing protection and can work with you to find the best solution. If you think you're experiencing noise-induced hearing loss, call us for an appointment. We provide hearing evaluations and carry the latest in hearing technologies.

We wish you all a happy, healthy Summer. And, please remember to protect your ears!

How to Talk to Your Doctor About Hearing Loss: The Initial Appointment

Dr. Douglas Cameron, Hearing Health Associates Roanoke

Dr. Douglas Cameron, Hearing Health Associates Roanoke

Because we know that hearing plays such an important role in our overall wellbeing, it's important to be aware of the signs of hearing loss and consult a doctor as soon as those first signs appear. 

During the initial appointment, you'll want to address:

  1. Any family history of hearing loss.
  2. Medications you take or have taken in the past. Some medications can increase the risk of hearing loss.
  3. Health conditions, such as diabetes, cardiovascular disease, and kidney disease.
  4. Frequent exposure to noise on the job or during everyday activities.
  5. Your symptoms. It's especially important to provide as many details and scenarios as possible. In fact, leading up to the appointment, it's a good idea to document those exact moments when you're having a difficult time hearing. Was it during a social gathering? Is it during conversations with men? Women? On the phone? The more details you can provide, the better.

If your initial appointment is with a general practitioner, ask them to either provide a baseline hearing screening or refer you to an audiologist for a more comprehensive screening. You also can check with your provider to see if you need a referral. If not, you can make an appointment directly with an audiologist. 

If you receive a hearing screening from an audiologist, ask that those results be shared with your general practitioner. This way, everyone is familiar with the extent of your hearing loss.

If you're not sure whether to make that first appointment, take our online Hearing Questionnaire. We'll contact you with your results and make recommendations about whether an appointment is necessary.

Our next blog post will focus on talking to your doctor about hearing aids. Stay tuned!

Custom Ear Plugs Help Avoid Swimmer's Ear


Has your child ever had swimmer's ear? If so, you know how painful it can be. Swimmer's ear, also known as acute external otitis or otitis externa, is an infection in the outer ear canal (running from your eardrum to the outside of your head). The most common cause of swimmer's ear is bacteria invading the skin inside your ear canal. It's often brought on by water that remains in your ear after swimming. Usually, you can treat swimmer's ear with eardrops, but it can wreak havoc on your fun summer plans if you have kids who love to be in the water. 

Ear plugs are a great way to prevent swimmer's ear; however, the trial-and-error process to determine which over-the-counter ones work and fit best can be quite frustrating for parents (and kids). Since this is our area of expertise and we've spent many years testing different products, we can help eliminate the guessing game. Our recommendation? The AquaSeal Custom Flotable Swim Plugs.

AquaSeal Custom Floatable Swim Plugs

These swim plugs are custom molded with easy-grip molded handles for placement and removal; include "right" and "left" markings; and are made with a soft, velvety silicone. Kids love them because they get to pick the color (or color(s) if they want the swirl option) to match their swimsuits, swim team, or just their fun personalities. Parents love them because they're bright (read: easy to find), they float (again, easy to find), and they keep ears perfectly clean and dry. With AquaSeal swim plugs, we simply take an impression of the ear (a quick, easy, and painless procedure), send off the impression with the color choice(s), and then the new ear plugs arrive 7-10 days later. 

If you're interested in scheduling an appointment or learning more, feel free to call us. Don't wait until the last minute; swim season is right around the corner!

Are You Living Your Potential?

May is Better Hearing Month and a good reminder to have your hearing checked to make sure you're not missing out on life's precious moments.

Here are some common signs that you or someone you know may be experiencing hearing loss:

  • Difficulty understanding speech in noisy environments (e.g. restaurants, cars)
  • Complaining that people seem to "mumble" all of the time
  • Responding to questions inappropriately
  • Asking family, friends, or colleagues to repeat themselves often
  • Having trouble hearing people who are in another room or not directly facing you
  • Having trouble following phone conversations
  • People complaining that your TV is turned up too loud
  • Experiencing a ringing, buzzing or hissing sound in your ears

Do any of these sound familiar? If so, please don't hesitate to contact us or an audiologist you trust to schedule a screening and learn more. Hearing impairment can drastically decrease your quality of life, or the quality of life of someone that you care about. 

If you're not sure whether to make that first call, you can complete our questionnaire, and we can contact you instead.

For more information about the different types of hearing loss, visit the Hearing Information pages of our web site. 

Rechargeable Hearing Aids: How ZPower is Changing the Landscape

Update: We now carry these in our Roanoke and Charlottesville (Crozet) offices. Call us to find out if you're eligible for this rechargeable battery upgrade. If you're in the market for a new pair of hearing aids, some manufacturers offer the ZPower batteries at no additional charge, as well as other incentives!

A new generation of rechargeable battery technologies has set out to make life easier for hearing aid consumers. The most common complaints we hear among hearing aid users relate to batteries: they fail at the most inconvenient times; they can be expensive to replace; and, they're bad for the environment.

Depending on the sophistication of your technology, such as streaming capabilities, they may only last a few days! According to a study of over 500 hearing aid users, 70 percent said they want rechargeable hearing aids, even though only 11 percent said they currently have them. Our "No More Batteries" blog post from last year continues to be our most-read post to date, so we know this is a topic that many of our patients are interested in learning more about.

The ZPower silver-zinc batteries are the latest to hit the market. ZPower is an independent battery company, which means its rechargeable batteries can be used instead of standard disposable batteries in many manufacturers' hearing aid models. This works by replacing the original battery compartment with ZPower’s retrofit battery compartment, which we can do right in our office.

Why ZPower?

ZPower’s silver-zinc rechargeable batteries offer hearing aid wearers 24-hours of use time—even with streaming technology. If you forget to charge the battery, you can replace the ZPower batteries with the standard disposable zinc-air batteries - they're interchangeable! Additionally, ZPower batteries are safe, 100% recyclable, mercury-free, and non-flammable. (Remember the recent lithium-ion Samsung phone recall? Lithium-ion batteries are used in many rechargeable hearing aid models and, therefore, have to be placed in sealed cases to ensure safety.) ZPower's proprietary silver-zinc battery technology also can be recharged hundreds of times without losing significant capacity. An extra bonus: they're made in the U.S.A. The silver-zinc technology was originally developed by NASA for its Apollo moon missions. 

What's Next?

The hearing aid industry is making vast strides with the introduction of new technologies every year. Looking to the near future, we should expect to see further developments from other major hearing aid manufactures and third-party companies. Battery life in hearing aids is getting shorter as technology improves. That's why we're so grateful that companies like ZPower are offering our patients more innovative solutions. 

We will continue to post about rechargeable hearing aid batteries as news of new products becomes available. In the meantime, feel free to call us for more information or ask about it at your next appointment. 

A Review: Pairing New Hearing Aids with My iPhone

I'm 40 years old and have worn hearing aids since my late 20s due to a (lucky me) hereditary hearing loss. I'm a working mom with an active lifestyle, so when it was time for a new pair of hearing aids, I immediately gravitated towards the new styles that would pair with my iPhone. I'm on the phone a lot during the day with my job and have numerous conference calls during the week, so having my calls stream directly through my hearing aids sounded ideal to me.

Hearing Health Associates allowed me to demo a pair of AGXO G-Series hearing aids and paired them with the RemoteLink app on my iPhone. After one week of testing these new hearing aids, I asked Dr. Cameron and Dr. Garber if I could share my experience. Hearing aids are a large investment, and I feel it's better to read personal reviews rather than the manufacturers' specs. 

Here are my top takeaways for those of you considering this investment:

1. Easy Setup - I was in and out of the office in about 15 minutes. I downloaded the app on my phone. Dr. Garber walked me through the steps of pairing the new hearing aids with the app. I watched a quick tutorial on how to use the app, and then Dr. Garber created two programs - one for every day use, and one that I call the "restaurant" program, which helps minimize noise in a loud space so you can hear the person/people you're talking to. That's it! I was ready to go!

2. My "Aha!" Moment: First Phone Call - I immediately left the office, got in the car, and called my husband. The clarity of his voice was reason enough to purchase these. It's comparable to wearing earbuds while talking on the phone - the sound is streaming through both ears - only there are no wires and no removing and inserting the hearing aids and earbuds. Prior to this, I would have a hard time talking on the phone, never knowing quite where to hold the phone for optimal listening. I often found myself putting it on speaker. 

The phone also rings in your ears, so you don't have to miss important calls. Note: I disconnected the Bluetooth on my phone if I didn't want to be disturbed. Also, you can mute the ringing on your hearing aids and on the phone if it's nearby.

Drawback: I have bluetooth in my car, and sometimes my phone would get confused - was it supposed to send calls to my hearing aids or to my car? There were times when a single conversation went back and forth between the two, which drove me a little crazy. After giving this feedback to Dr. Garber, she said you can set your iPhone so it defaults to the hearing aids. 

3. No More Earbuds! - I listened to music, podcasts, and my favorite shows on my phone without having to remove my hearing aids to use my earbuds. This also was a huge benefit to me.

Drawback: This took some getting used to when it came to my kids using my phone to play games or watch videos. The noise would suddenly blast through my hearing aids. I once jumped and yelled at dinner with friends because my youngest borrowed my phone and started playing YouTube videos upstairs. I had to remember to disconnect the Bluetooth before I gave my phone to the kids. I also put a password on my phone so they couldn't just grab it and use it without my permission.

4. A Heads Up on Battery Life - Another one of my favorite features was checking the life of my batteries through the app. If I was leaving the house for the day, I could see if I needed to bring backup batteries. I can't tell you how many meetings I've been in where my hearing aids start beeping, giving me a 5-minute warning that the battery was about to die. With this app, I was much better prepared.

5. Separate Volume Adjustment - I loved that I could adjust the volume of each hearing aid through the app. I was recently sitting beside someone VERY soft spoken on my right, so I just increased the volume in that hearing aid to hear her better. This way, you're not distracted by other noises in the room by having to increase the volume in both ears.

I also loved the overall volume feature when watching TV. Usually, I sit with the remote in my hands because I have to turn up the volume when people are conversing and turn it down during music, loud blasts or other noises. With the new hearing aids, I could make these adjustments from my phone and share the remote with my family again! I realize I could do that by pressing the buttons on my old hearing aids, but this was different somehow. Perhaps there is greater control of the volume levels? With my old ones, it just seemed easier to use the remote control. Note: There is a TV adaptor that you can purchase that allows the TV to stream through your hearing aids like your phone. I didn't test this, but it sounds great!

6. Discreet Adjustments - Changes to volume, settings, and more is just a quick swipe on your phone. No more reaching up behind your ear to click on buttons only to find that you clicked the wrong one so you have to reach up again. The app is super easy to use, and people think nothing of you having your phone out.

Overall, I loved just about every aspect and am definitely purchasing these. The biggest learning curve was remembering to turn off the bluetooth during meetings or social settings, in the car (if I just wanted to use my car bluetooth), and when my kids used my phone. It's similar to turning off the ringer on your phone - you just have to train your brain so that it becomes second nature. I'm also hoping the app gets updated so I can make more specific adjustments, like directional adjustments for the microphone or increases in volume for certain difficult-to-hear pitches. 

Drs. Garber and Cameron at Hearing Health Associates have been wonderful during this journey. They constantly keep me up to date with the latest technologies since they know that's important to me. 

Feel free to leave comments or questions. Hope this helped some of you who have been thinking of updating or making the jump to hearing aids.