Wednesday Health Watch

Restaurants Helping Those with Hearing Loss

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Restaurant Week is in full swing! Many look forward to this week to get out in the community, support local businesses, and sample their way through town. But for those with hearing challenges, the noisy restaurant setting can present difficulties. 

Restaurants in Baltimore are working to change this. Several participated in the Hearing Hospitality Initiative in preparation for Baltimore Restaurant Week. This initiative involved training and providing resources and tips to servers and other restaurant staff to help patrons who suffer from hearing loss. Areas covered in the training included body language, seating, and tips for taking orders and reservations. HASA is the organization leading this program. According to its website, "because 33% of adults over the age of 65 and half of adults over the age of 75 are hard of hearing, there are a large number of guests in a restaurant at any given time who could benefit from an enhanced environment."

Kudos to HASA and those restaurants participating in this initiative. What a great example; we hope many others follow.

Read more about this initiative from the CBS affiliate in Baltimore. We also encourage you to share this information with some of your favorite local restaurants!

Nutrition and Hearing: Top Foods to Consume and Avoid

You're probably aware that certain foods can help with vision (carrots, anyone?), but nutrition also affects your hearing. In celebration of March as National Nutrition Month, we've compiled a list of foods and nutrients that can help improve your hearing, as well as a list of foods that can have a negative impact.

Consume More:

  1. Vitamin B12, contained in meat, eggs, poultry, dairy products, and other foods from animals. Strict vegetarians and vegans are at high risk for developing a B12 deficiency, which can affect your balance, among many other things. This is especially important for those of you with Tinnitus and Balance Disorder.
  2. Folate/Folic Acid/Vitamin B9, found in spinach, bok choy, romaine, asparagus, turnip greens, broccoli, and beans (especially lentils and garbanzo beans). Folate has been shown to improve Tinnitus, as well as sudden and age-related hearing loss, although more testing is needed. Folate helps increase circulation, improving blood flow to the inner ear.
  3. Omega 3s, found in many fish (most notably salmon), walnuts, and flax and chia seeds. A 2014 study showed that regular consumption of fish (2 or more servings/week) was associated with a lower risk of hearing loss in women. 
  4. Magnesium, included in fruits and vegetables, such as bananas, artichokes, potatoes, spinach, tomatoes and broccoli. Magnesium helps combat free radicals and acts as a protective barrier for the delicate hair cells in the inner ear. University of Michigan researchers found that this nutrient, combined with Vitamins A, C & E, helps prevent noise-induced hearing loss by blocking the creation of free radicals. 
  5. Zinc, found in protein-rich foods like oysters, grass-fed beef, pumpkin seeds, tahini (ground sesame seeds), cashews, almonds, spinach, and dark chocolate. Zinc has shown to improve sudden sensorineural hearing loss (SSNHL) — a sudden, unexplained loss of hearing. Zinc boosts the body’s immune system and is also responsible for cell growth and healing, so it’s potentially helpful in warding off ear infections. Some studies suggest it’s also effective in treating tinnitus in individuals with normal hearing.
  6. Potassium, found in bananas, potatoes, spinach, lima beans, tomatoes, raisins, apricots, melons, oranges, yogurt and low-fat milk. Potassium is responsible for regulating the amount of fluid in your blood and body tissue. That’s important to your hearing health because fluid in the inner ear is dependent upon a rich supply of potassium, especially in that part of the ear that translates the noises we hear into electrical impulses the brain interprets as sound.

Studies have shown that a deficiency in nutrients, such as B12 and folic acid, can impair hearing by as much as 39%, while increasing these nutrients can protect hearing by as much as 20%. Folic acid deficiency specifically has been linked with high-frequency hearing loss. Much of this damage is due to free radicals. Antioxidants like B12, folic acid, Omega 3s, and vitamin A are all important because they help fight off damaging free radicals. Here is a good webmd.com article about antioxidants and free radicals.

Avoid or Consume Less:

  1. Vegetable oils, as they contain too many Omega 6 fatty acids. Instead, use EVOO or Canola oil, which are rich in Omega 3s. 
  2. Margarine/Partially Hydrogenated Oils found mostly in processed foods 
  3. High fat meats, especially those treated with nitrates/nitrites (preservatives)
  4. Whole/2% milk - use a dairy substitute such as almond, rice, or coconut milk
  5. Cream cheese - replace with goat cheese or part skim organic ricotta
  6. Processed cheeses, such as American - opt for organic/grass-fed hard cheese 
  7. Sugar and artificial sweeteners - limit these or replace with Stevia, honey, or real maple syrup
  8. Refined carbohydrates - These include white breads, pasta, and any foods containing “enriched” flour, which means nutrients have been removed from the grain 
  9. Sodium - We need it in small quantities, but you should maintain a higher ratio of potassium to sodium. Packaged and processed foods have WAY too much sodium.
  10. Chemicals/pesticides - Wash your produce! Buy organic when you can. Here is a list of EWG's 2017 "Dirty Dozen," the produce with the highest pesticide residue, as well as the "Clean Fifteen," with the lowest.

As a general rule for foods to avoid, eat food the way it was meant to be eaten. Food doesn't grow in a box, so don't buy it that way! Use herbs instead of heavy sauces and creams for added flavor. 

As always, feel free to contact us if you have any questions! Happy eating!

Wednesday Health Watch: High Blood Pressure and Hearing Loss

There are many reasons hypertension (high blood pressure) should be taken seriously. It is the leading cause of strokes. If left untreated, it leads to cardiovascular, or heart, disease. It also increases your risk of kidney damage, vision loss, memory loss, fluid in the lungs, and ,yes, hearing loss. We want to focus on that last correlation.

What Is Blood Pressure?

Blood pressure is a measure of the force of blood against your arteries and veins. The top number (systolic) notes the pressure when your heart pushes blood out, and the bottom number (diastolic) notes the pressure when your heart rests between beats and is not pumping any blood. Your blood pressure is considered high when the upper number (systolic) is higher than 120 and the lower number (diastolic) higher than 80.

Why Is Hypertension Bad?

Healthy arteries are made of muscle and a semi-flexible tissue that stretches like elastic when the heart pumps blood through them. When your blood pressure is high, it means the blood is pushing through your arteries very fast. To accommodate, your arteries stretch to allow maximum blood flow. Over time, if the force of the blood flow is often high, that stretchy tissue is damaged. This leads to weakened blood vessels, making them more prone to rupture and cause strokes and aneurysms. It also leads to an increased risk of blood clots; plaque build-up, which causes heart attacks; and tissue and organ damage. 

High Blood Pressure and Hearing Los

Blood vessels are present throughout your body, including your ears. When your blood pressure is high and these blood vessels are weakened or damaged, your hearing could be impaired. 

In 2015, Dr. Stacy Kerschen and Raymond Hull, PhD, professor of communication sciences and disorders in audiology and neurosciences at Wichita State University, analyzed 84 years of work from scientists worldwide on the connection between cardiovascular health and the ability to hear. Their work confirmed a direct link.

According to Hull, “Our entire auditory system, especially the blood vessels of the inner ear, needs an oxygen-rich nutrient supply. If it doesn't get it due to cardiovascular health problems, then hearing can be affected."  The full article detailing results of this study can be found here

Because hearing loss can have a great impact on a person's quality of life, those with high blood pressure should get their hearing checked by a trained audiologist. On the other hand, if you have hearing loss, make sure you are checking your blood pressure on a regular basis. 

 

It's Noisy Out There: Protect Your Hearing

October is National Protect Your Hearing Month. As audiologists, we see the effects that noise has on our patients' hearing on a weekly, if not daily, basis. It's not just our patients: approximately 26 million Americans between the ages of 20-69 have hearing loss caused by exposure to loud noises. 

Noise-induced hearing loss 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. 

How Loud is Too Loud?

The loudness of sound is measured in units called decibels (dB). Noise-induced hearing loss can be caused by prolonged exposure to any loud noise over 85 dB, or by a one-time, intense exposure to a noise like an explosion. ƒTo give you some perspective:

  • Normal conversations are around 60dB.
  • Hair dryers and blenders are 90dB.
  • Concerts, car racing and sporting events are 110 dB
  • Ambulance, police and fire sirens are 130 dB.
  • Gunshots and fireworks are 140 dB.

A good rule of thumb is that if you have to raise your voice to speak to someone an arm's length away, the surrounding noise is too loud. If you hear ringing, buzzing or experience temporary hearing loss when leaving work or a concert, the noise is too loud. Parents - if you can hear sounds from your child's headphones or earbuds while standing next to them, the volume is too loud.

Occupational Hazards

The risk for noise-induced hearing loss is especially high among factory workers, transportation workers, military personnel, construction workers, musicians and entertainers, those who work frequently with heavy machinery, and first responders. 

The Occupational Safety and Health Administration (OSHA) requires that employers implement a Hearing Conservation Program if workers are exposed to an average noise level of 85 dB or higher over an 8-hour work period. According to OSHA, Hearing Conservation Programs require employers to measure noise levels, provide free annual hearing exams, free hearing protection, provide training, and conduct evaluations of the adequacy of the hearing protectors in use unless changes to tools, equipment and schedules are made less noisy and/or worker exposure to noise is less than the 85 dBA.

Hearing Protection Solutions

If you are attending a sporting event, concert, parade, fireworks show, or any other type of event, you should always pack a set of earplugs that can be purchased at your local pharmacy. This is especially true for children. 

For people who are exposed to loud noises on a daily basis, we offer custom-molded earplugs, made from medical-grade silicone. Our earplugs offer a level of comfort and protection that you won't find in standard, generic earplugs. These earplugs are vented to allow sound to pass both ways, so you don't get that "plugged up" feeling. 

If you're often having to speak over the noise in your work or leisure environments, call us for a hearing protection consultation. 

 

Wednesday Health Watch: Smoking and Hearing Loss

At this point, we've all been educated on the health risks of smoking. However, one area that hasn't been covered extensively is the correlation between smoking and hearing. 

The most cited clinical study of hearing loss and smoking appeared in the June 1998 issue of the Journal of the American Medical Association. It showed that smokers are 70% more likely than non-smokers to experience hearing loss. It also showed that non-smokers living with a smoker were twice as likely to develop hearing loss as those who were not exposed at all. A more recent study conducted at NYU's School of Medicine in 2011 found that teens exposed to cigarette smoke are to two to three times as likely to develop hearing loss compared to those with little or no exposure. 

Here are a few ways that smoking negatively impacts your hearing: 

  • Nicotine and carbon monoxide deplete oxygen levels and constrict blood vessels in your inner ear, which is responsible for maintaining hair cell health.
  • Nicotine can cause tinnitus, dizziness and vertigo.
  • The chemical messengers between the ears and the brain, or neurotransmitters, are susceptible to the dangerous chemicals in cigarette smoke, including nicotine. Chronic nicotine use can impair neurotransmitter function adversely affecting the brain’s ability to interpret sound.

When smoking is combined with additional risk factors for hearing loss, including age and noise exposure, the effects appear to be cumulative. Therefore, the longer a person smokes, the more likely their smoking will contribute to their hearing health. 

The good news is 20 minutes after your last cigarette, your blood pressure decreases and circulation improves. Your oxygen and carbon monoxide levels return to normal eight hours after a cigarette. In 48 hours, your nerve endings begin to regenerate.

It's never too late to quit!

Wednesday Health Watch: Tinnitus

We get many inquiries about Tinnitus. We've attempted to answer the most common questions relating to causes, symptoms and management of Tinnitus in this post.

First, we'll start with how you say it (because that's one of the main questions we receive). There are two pronunciations, and both are correct. 

  • ti-NIGHT-us (typically used by patients)
  • TINN-a-tus (typically used by those in the medical field)

WHAT IS TINNITUS?

Tinnitus is commonly referred to as "ringing in the ears," although it can also manifest as whistling, buzzing, hissing, roaring, swooshing, clicking, and many other sounds. According to the U.S. Centers for Disease Control, more than 50 million Americans, nearly 15% of the population, experience some form of Tinnitus. 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. 

CAUSES OF TINNITUS

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. According to the American Tinnitus Association, there are approximately 200 health disorders that can cause Tinnitus. Here is a list of 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

SYMPTOMS OF TINNITUS

As indicated above, most people experience Subjective Tinnitus, meaning the sound is only perceived by the patient. The American Tinnitus Association has put together a list of sounds that we feel best conveys what we hear our patients describe. You can listen to these sounds here. (Be sure to turn down the volume to the right of each sound before you hit "play.")

TINNITUS MANAGEMENT

Unfortunately, there is currently no scientific cure for most types of Tinnitus. The best thing we can do for our patients is to help determine an underlying health disorder to treat. This could be as simple as removing excess earwax, treating an ear infection, or changing your medication. It could also mean testing your hearing, and if applicable, fitting you for hearing aids. Or, providing ear protection if you're constantly subjected to loud noises.

There are other "remedies," as well, including devices that play white noise or music to distract your brain and/or mask the Tinnitus. A Reader's Digest article, published in July, offers "14 Effective Remedies for Relief." 

If you think 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. 

Interested in more news about Tinnitus? Check out our tinnitus page or read our latest blog post, Bose's New Sleepbuds Touted for Tinnitus.