What do hearing aid ear molds cost ?


There are many different earmold styles, that are  used to conduct sound to the ear.

 Some of  the popular Audiologist/Laboratory earmolds are at the left in the above photo. They cost from $80 to $200 EACH, DEPENDING ON YOUR HEARING AID PROVIDER who sold and adjusted it.. 

These above, on the left, are made of Lucite, acrylic and Urethane hard plastic and these particular ones are made for BTE, Behind Ear Hearing aids. They require 7 to 18 days to be mailed and completed, after your ear impression is taken by your hearing aid provider.

The remaining earmolds above are DIY from HCPB Earmold Kits that are made from flexible Medical Grade Silicone rubber putty at a cost of $2 Each to $12 Each. They take only 10 minutes to make in your own home. You are in control for your satisfaction. They are available in 3 skin colors, Tan, Brown and Dark Brown. They work with ALL BRANDS and MODEL Hearing Aids and are shipped PRIORITY 2 to 3 day USPS FREE.

The 3 popular DIY Hearing Aid types are:

RIC, RIE Receiver in Ear Canal         24 to 30 earmolds Kit-  lowest cost per earmold: $2 ea

4 RIC Earmolds Kit (lowest cost kit: $5 ea.


.OPEN FIT Earmold kits  

24-30 earmolds Kit (lowest cost per mold $2 ea.

4 earmolds Kit   (Lowest cost kit $5 each


BTE  (BEHIND THE EAR                          Are (supplied by the Hearing Aid  factory is a hard over ear hook)

 A Sound tube is required and is included in the below kits.

24 to 30 Earmold Kit you choose from 1,2,3,or 4 HCPB Tubes                        4 Earmold kit with 2 HCPB Tubes                                                                             4 Earmold Kit with 1 HCPB Tube,  $12 each



There are also ALL IN THE EAR Hearing aids that can use the same  RIC Kits to improve the fit and seal, as well as EAR BUDS for music and Cell Phones.

Sound affects embryo development

Embryos of many species use sound to prepare for the outside world

Date: May 26, 2021Source: Cell Press Summary :It’s well known that reptiles depend on temperature cues while in the egg to determine a hatchling’s sex. Now, researchers say that embryos of many different animal species also rely on acoustic signals in important ways. They call this phenomenon ‘acoustic developmental programming. ‘Share:   

It’s well known that reptiles depend on temperature cues while in the egg to determine a hatchling’s sex. Now, researchers writing in the journal Trends in Ecology & Evolution on May 26 say that embryos of many different animal species also rely on acoustic signals in important ways. They call this phenomenon “acoustic developmental programming.”

“Acoustic developmental programming occurs when a sound informs embryos about the environment they’ll encounter postnatally and changes their development to better suit this environment,” said Mylene Mariette (@MyleneMariette) of Deakin University in Australia.

Because this is a newly discovered phenomenon, the evidence is just beginning to accumulate. And, yet, it seems to be rather widespread among animals.

“We have found evidence of this happening in birds, where parental calls can warn embryos about heatwaves or predators,” Mariette says. “Before that, there was also evidence that cricket nymphs use male songs to predict the level of competition for mates. However, what is most striking from the evidence we’ve gathered is how common it is for embryos across species to rely on sound information.

“For example,” she adds, “across all animal groups that lay eggs, such as insects, frogs, reptiles and birds, embryos use sound or vibration to know when the best time is to hatch. This suggests that acoustic developmental programming is likely to happen in many animal species and for a whole range of conditions. But, until recently, we did not know it was happening.”

Mariette got interested in acoustic developmental programming while studying how zebra finch parents communicate with each other through calls to coordinate parental care duties. “I noticed that when a parent was alone incubating, it would sometimes produce a strange high-pitched call,” she says.

She wondered if those calls had further implications for the developing embryos. To find out, she captured many audio recordings in nests and played them to eggs incubated artificially in the lab. It turned out that the finch parents only produced that particular call when it was very hot out. Upon hearing it from inside the egg, nestlings adjusted their development to prepare for the heat.

“I became very curious about how just hearing a sound before hatching could alter development,” Mariette says.

She started searching for evidence in the literature of embryos using sound in other animals. She also dug into the neurobiology to try and understand how it could happen. So far, it’s not clear exactly how it works, but the new report identifies some likely mechanisms.

“In crickets, when developing nymphs hear many sexy songs, female develop quickly to make the most of the opportunity, whereas males delay metamorphosis to grow bigger and invest more in reproduction,” Mariette says. “In zebra finches, embryos exposed to parental heat calls grow less to reduce the physiological damage of heat exposure, which then allows them to produce more babies at adulthood. But embryos cannot decide to change their development, it just happens.

“This is because sound directly impacts behavior and physiology, without any conscious processing,” she continues. “This is why, for example, music triggers spontaneous emotions of sadness or happiness, without us having to remember which movie that soundtrack came from, or in fact without us even noticing our reaction to the music. It seems to occur on its own, because there are direct connections in the brain between the auditory pathway and the areas that control emotion, reflex learning, and hormone production, so the higher cortical areas do not need to decode the information. Sound experienced early in life could trigger the same spontaneous reactions and, in fact, have long-lasting effects, because this is when the brain is developing, and consolidating connections. For the same reason, the downstream effects on physiology and then morphology can persist for life.”

The bottom line for now is that sound has a much more profound impact on development than had been realized. Mariette suggest that it may be important to preserve natural soundscapes that may be crucial for animal adaptation, particularly in fast-changing environments.

Mariette’s lab continues to study the physiological traits in zebra finches that may be affected by heat-calls. “It is quite amazing that sound alone can prepare babies for heat, particularly given the alarming rate of climate change,” she says.

This work was supported by ARC grants. Make a difference: sponsored opportunity

Story Source:

Materials provided by Cell PressNote: Content may be edited for style and length.

Journal Reference:

  1. Mylene M. Mariette, David F. Clayton, Katherine L. Buchanan. Acoustic developmental programming: a mechanistic and evolutionary frameworkTrends in Ecology & Evolution, 2021; DOI: 10.1016/j.tree.2021.04.007

some are more likely to get hearing loss

New study finds genetic predisposition for noise-induced hearing loss

by University of Southern California

Keck Medicine of USC-led study finds genetic predisposition for noise-induced hearing loss
Immunostained mouse auditory nerve synapses after noise exposure. A team led by Keck Medicine of USC neuroscientists first to publish genome-wide association study for noise-induced hearing loss in mice. Credit: Rick A. Friedman Lab

In a new genome-wide association study, an international team led by Keck Medicine of the University of Southern California (USC) neuroscientists has found evidence that some people may be more genetically susceptible to noise-induced hearing loss than others.

Noise-induced hearing loss is one of the most common work-related illnesses in the United States, according to the National Institute for Occupational Safety and Health. At especially high risk are troops in the Armed Forces. In 2013, the Department of Veterans Affairs reported hearing loss as one of the most common disabilities among veterans receiving disability compensation.

Those at higher, genetic risk for hearing loss may decide to take additional precautionary measures to protect their hearing prior to hazardous noise exposure, study authors say.

“Understanding the biological processes that affect susceptibility to hearing loss due to loud noise exposure is an important factor in reducing the risk,” said Keck Medicine of USC otologist Rick A. Friedman, M.D., Ph.D., professor of otolaryngology and neurosurgery at the Keck School of Medicine of USC and senior author of the study. “We have made great advances in hearing restoration, but nothing can compare to protecting the hearing you have and preventing hearing loss in the first place.”

The study, “Genome-wide association study identifies Nox3 as a critical gene for susceptibility to noise-induced hearing loss,” appears in the April 16 edition of PLOS Genetics, a peer-reviewed scientific journal.

While some gene association studies on noise-induced hearing loss in people have been conducted in the past, all were very small and their results un-replicated. Genome-wide association studies, or GWAS, search the entire genome for common genetic variants to see if any of those variants are associated with a trait. Mouse GWAS have lead to the discovery of hundreds of genes involved in complex traits that have immediate relevance to people.

In the USC study, conducted at the Zilkha Neurogenetic Institute, Friedman’s team identified the Nox3 gene, which is almost exclusively expressed in the inner ear, as a key gene for susceptibility to noise-induced hearing loss. Using 64 of the 100 strains of mice in the Hybrid Mouse Diversity Panel, the team was able to increase the statistical power of its investigation, leading to the first published GWAS for noise-induced hearing loss in mice.

More research is necessary before clinical recommendations can be made.

Explore furtherResearchers gain insight into protective mechanisms for hearing loss

hearing loss in women may be preventable

Women with osteoporosis and low bone density have higher risk of hearing loss

May 25 2021

Hearing loss is the third most common chronic health condition in the United States. Previous studies of people with hearing loss have uncovered higher prevalence of osteoporosis — a disease in which the bones become weak and brittle — and low bone density (LBD).

But research on whether these conditions may influence risk of hearing loss over time is scarce. It is also unknown whether hearing loss can be avoided by taking bisphosphonates, the primary medication used to prevent fractures in people with reduced bone density. As part of the Conservation of Hearing Study (CHEARS), researchers from Brigham and Women’s Hospital analyzed data from nearly 144,000 women who were followed for up to 34 years.

They found that risk of subsequent moderate or worse hearing loss was up to 40 percent higher in study participants with osteoporosis or LBD. The study, published in the Journal of the American Geriatric Society, also found that bisphosphonates did not alter risk of hearing loss.

Adult onset hearing loss is typically irreversible; therefore, CHEARS focuses on identifying potentially modifiable risk factors that may contribute to hearing loss. We were inspired by a recent study that found that bisphosphonates may help prevent noise-induced hearing damage in mice. We wanted to investigate whether bisphosphonates alter risk of hearing loss in adults, in addition to whether there is a longitudinal association between osteoporosis or LBD and risk of subsequent hearing loss.”

Sharon Curhan, MD, ScM, Study Leader, Channing Division of Network Medicine, Brigham and Women’s Hospital

For their analysis, the researchers used data from the decades-long Nurses’ Health Study (NHS) and NHS II, two large ongoing prospective cohorts of female registered nurses, established in 1976 and 1989, respectively. The researchers examined hearing loss that was moderate or worse in severity, as self-reported by participants on questionnaires completed every two years. Additionally, they used the CHEARS Audiometry Assessment Arm to incorporate data on participants’ audiometric thresholds (a measure of hearing sensitivity based on the loudness of sound).

In both the NHS and NHS II cohorts, the researchers found that the risk of hearing loss was higher in women with osteoporosis or LBD, and that taking bisphosphonates did not moderate the elevated risk. More research is required to understand whether the type, dose or timing of bisphosphonate use might influence its impact.

Related Stories

The researchers found that a history of vertebral fracture was associated with up to a 40 percent higher risk of hearing loss, but the same did not hold true for hip fractures, the two most common osteoporosis-related fractures. “The differing findings between these skeletal sites may reflect differences in the composition and metabolism of the bones in the spine and in the hip,” Curhan said. “These findings could provide new insight into the changes in the bone that surrounds the middle and inner ear that may contribute to hearing loss.”

While the underlying mechanisms by which osteoporosis and LBD may contribute to aging-related hearing loss remain unclear, the researchers suggest that abnormal bone remodeling and changes in the pathways involved in maintaining bone homeostasis may influence the integrity of the bone that protects the nerves and structures involved in hearing or alter ion and fluid metabolism in the cochlea, the main structure involved in hearing.

Advantages of using data from these well-characterized cohorts include the large study population, extensive array of detailed information, impressive follow-up rates and reliable information on health-related outcomes, as the participants are trained health care providers. However, the researchers note that their study is limited in its generalizability, as participants are predominantly white, with similar educational achievements and socio-economic statuses. Curhan points out that additional studies that examine these associations in men and non-white women would be informative.

Additionally, the investigators plan to examine in the future whether calcium and vitamin D intake are associated with hearing loss, as they have been shown to help prevent osteoporosis. Previously, the researchers found that eating a healthy diet, staying physically active, not smoking, and maintaining a healthy weight all help reduce the risk of hearing loss.

“Osteoporosis and low bone density may be important contributors to aging-related hearing loss,” Curhan said. “Building lifelong healthy diet and lifestyle habits could provide important benefits for protecting bone and hearing health in the future.”Source:

Brigham and Women’s HospitalJournal reference:

Curhan, S. G., et al. (2021) Osteoporosis, bisphosphonate use, and risk of moderate or worse hearing loss in women. Journal of American Geriatrics Societydoi.org/10.1111/jgs.17275.

zoom fatigue worse for women

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Zoom fatigue worse for women, Stanford study finds

In the first large-scale study examining the full extent of Zoom fatigue, Stanford researchers find that women report feeling more exhausted than men following video calls – and the “self-view” display may be to blame.


With the pandemic forcing many Americans to retreat into their homes, video calls have taken over people’s work and personal lives. Now, new Stanford research reveals how the shift from in-person meetings to virtual ones has taken its toll, particularly among women.

In the first large-scale study examining the full extent of Zoom fatigue, Stanford researchers find that women report feeling more exhausted than men following video calls. (Image credit: Getty Images)

The feeling of exhaustion that comes from a day of back-to-back online meetings – also known as “Zoom fatigue” – is greater for women, according to the researchers’ data. They found that overall, one in seven women – 13.8 percent – compared with one in 20 men – 5.5 percent – reported feeling “very” to “extremely” fatigued after Zoom calls.

These new findings build on a paper the Stanford researchers recently published in the journal Technology, Mind and Behavior that explored why people might feel exhausted following video conference calls. Now, they have the data to show who is feeling the strain. For their follow-up study, the researchers surveyed 10,322 participants in February and March using their “Zoom Exhaustion and Fatigue Scale” to better understand the individual differences of burnout from the extended use of video conferencing technologies during the past year.

These findings add to a growing understanding of how the COVID-19 pandemic is disproportionately affecting certain groups of people, said Jeffrey Hancock, professor of communication in the School of Humanities and Sciences and co-author of the new study released April 13 on the Social Science Research Network.

“We’ve all heard stories about Zoom fatigue and anecdotal evidence that women are affected more, but now we have quantitative data that Zoom fatigue is worse for women, and more importantly, we know why,” Hancock said.

The researchers found that what contributed most to the feeling of exhaustion among women was an increase in what social psychologists describe as “self-focused attention” triggered by the self-view in video conferencing.

“Self-focused attention refers to a heightened awareness of how one comes across or how one appears in a conversation,” Hancock said.

To measure this effect, the researchers asked participants questions such as: “During a video conference, how concerned do you feel about seeing yourself?” and “During a video conference, how distracting is it to see yourself?”

The researchers found that women answered these questions at higher rates than men – a finding that is consistent with existing research that shows women have a greater propensity to self-focus than men when they are in the presence of a mirror. That prolonged self-focus can produce negative emotions, or what the researchers call “mirror anxiety,” Hancock explained.

A simple solution is to change the default display settings and turn off “self-view.”

Also contributing to an increase in Zoom fatigue among women were feelings of being physically trapped by the need to stay centered in the camera’s field of view. Unlike face-to-face meetings where people can move around, pace or stretch, video conferencing limits movement. Another way to address this is to move farther away from the screen or to turn off one’s video during parts of calls.

The researchers found that while women have the same number of meetings per day as men, their meetings tend to run longer. Women were also less likely to take breaks between meetings – all factors that contributed to increased weariness.

The pattern of women being more burned out from videoconferencing than men appears to be robust. “We see this gender effect across multiple different studies, and even after taking into account other factors. It’s a really consistent finding,” Hancock said.

Other differences – personality, age and race

Action items organizations can make to reduce Zoom fatigue:

  1. Implement no-video meeting days. Have a day each week that does not require any video meetings.
  2. If video is not necessary for a meeting, make “video off” mandatory for that meeting. People should think hard about whether video is necessary for a meeting, and if it is not, make video-off mandatory so that no one feels the pressure to keep it on.
  3. Find out if your employees or colleagues are fatigued. Have your employees take the Stanford ZEF scale to measure their fatigue and find solutions to help reduce it.

Also associated with Zoom fatigue was personality types: Extraverts reported lower levels of exhaustion following video conferencing than introverts. Calm, emotionally stable people also reported less exhaustion than more anxious individuals, who may also have been affected by the self-attention triggered by the digital mirror.

Age mattered as well: Younger individuals reported higher levels of tiredness compared with older survey participants.

Another factor was race: The researchers’ preliminary data shows that people of color reported a slightly higher level of Zoom fatigue compared with white participants. The researchers are exploring what contributed to this finding in a follow-up project with scholars, including their Stanford colleagues, who study race and media.

“We are working to understand what might be causing this race effect and develop solutions to address it,” Hancock said.

Next steps

While individuals can make changes to their own work habits to avoid burnout, the researchers urge organizations to rethink how they manage their remote workforce. For example, companies could organize more meetings that are video-free, offer guidelines on how frequent and long meetings should be and specify more breaks between meetings.

The paper’s contributors include joint first authors Geraldine Fauville, who was a postdoctoral scholar in the lab when she conducted the research and is now a researcher at the University of Gothenburg, Sweden, and Mufan Luo, a doctoral student in the Stanford Social Media Lab. Anna Carolina Muller Queiroz, a visiting research student at the Virtual Human Interaction Lab, also contributed along with senior authors Jeffrey Hancock, the Harry and Norman Chandler Professor of Communication, and Jeremy Bailenson, the Thomas More Storke Professor of Communication.

Media Contacts

Melissa De Witte, Stanford News Service: mdewitte@stanford.edu

improve your understanding

How Music Training Can Improve Life with Hearing Loss

Julia Métraux

Health Writer

24 May 2021

Adjusting to life with hearing loss can be difficult, and some people need support beyond wearing hearing aids or cochlear implants to truly thrive. If you find yourself exhausted by concentrating while wearing hearing devices, auditory training could be a good boost. Training that involves music can be a fun and engaging option.

First, let’s take a quick dive into auditory training, sometimes called “aural rehabilitation.” The goal of auditory training is to strengthen the brain’s auditory processing capability. According to Anne D. Olson, Ph.D., it “can be defined as a purposeful and systematic presentation of sounds such that listeners are taught to make perceptual distinctions about those sounds.” This can improve listening accuracy.

When patients with suspected hearing loss enter her clinic, audiologist Jill Davis, AuD performs a cognitive screener as well as one with a background noise. “Seventy percent of patients performed well with just the hearing aids alone. For that thirty percent that need a little extra help, that’s when auditory training comes into play,” Davis told Hearing Tracker.

The role of music in auditory training

There are different types of auditory training, but an interesting avenue—and one that Davis implements at her practice—is music training. This involves learning to play an instrument and differs from music therapy, which is using music as a therapeutic tool to treat physical, emotional and/or cognitive symptoms.

When Davis begins working with people who may benefit from auditory training due to concentration issues, she asks if they play an instrument. “Research shows that playing music can help build up their abilities. Surprisingly, many answer that ‘I’ve always wanted to play an instrument,’ or ‘I have a piano that’s collecting dust that I’ve never played,’” Davis said. Music training may be even more beneficial for people who do not have a background in music.

How music training helps

Why is music such a good practice for those with hearing loss? In both researching the benefits of music training and seeing the results in her patients, Davis found that music training can help people who struggle with background noise. “What I found was that if you play an instrument, your brain ‘works’ faster, you hear better in background noise, and daily life is just easier,” Davis said. “So I wanted to use that to help people with hearing loss train their brains to hear better and [filter out] background noise.”https://www.facebook.com/plugins/video.php?height=476&href=https%3A%2F%2Fwww.facebook.com%2Fvictoryhearingandbalance%2Fvideos%2F1145990342484020%2F&show_text=false&width=269

And this isn’t just Davis’ opinion. A systematic review published in the Journal of Clinical Medicine found that music training offers an array of benefits to people with hearing loss. These include helping people with hearing loss tell sounds apart based on pitch, duration, and timbre. Music training can also enhance working memory in people with hearing loss, which is the “ability to temporally maintain and manipulate information,” which may ease the experience of listening exhaustion.

Who benefits from music training?

Music training can help those who have congenital or acquired hearing loss, according to Céline Hidalgo, PhD, one of the authors of the review published in the Journal of Clinical Medicine. She told Hearing Tracker, “For congenital deafness, this allows the development of general cognitive functions that will allow harmonious development of language and communication” through cochlear implants.

Music training, according to Davis, can be helpful to people with a range of hearing loss, and it can be useful for people who may have put off auditory training. “As long as they can hear the music that we are playing, no matter what their level of discrimination or the significance of their loss, we see that we can improve at any point in the journey,” Davis said.

How to participate in music training

For people who participate in music training, “most of the time” wearing hearing aids helps “but a part can also be carried out without the aids or the implant during the work of the rhythm, which can essentially be perceived at the tactile level,” Hidalgo said.

People who participate in music training may see changes after only three months, according to Davis, and the sessions don’t need to always be in person. “I was trying to find ways that my patients could play without having to do in-person instructions,” she explained. “I found and partnered with a piano-playing app” to allow for a virtual component to the program.

If you want to participate in music training yourself or encourage a family member to do so, you can find an instructor or a class online. Learn-to-play apps are a good option, too. Whatever route you choose, do speak to a hearing health professional to see if your program would qualify as auditory training. That way, you’ll ensure that the joy of music is also helping to improve your skills.

Julia Métraux

Health Writer

Julia Métraux is a health and culture writer with hearing loss and a member of the Association of Health Care Journalists. Check out her portfolio.Connect →

behear access Hearing amplifier


Hearing amplifier for live conversations, mobile calls, streamed audio, looped venues

  • Personalized amplification only where you need it
  • Large control buttons and charging cradle for ease of use
  • Integrated telecoil receivers for looped venues
  • Rechargeable for up to 13 hours of use
  • Developed by experienced sound engineers and certified audiologist

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I Phone is better hearing by customizing airpods

NewHeadphone Accommodations

Customize your headphones to your hearing needs.

Whether you’re listening to music, watching a movie, or talking to a loved one, Headphone Accommodations help you customize your audio experience to make the world sound crisp and clear. Amplify soft sounds and adjust certain sound frequencies based on your individual hearing needs. If you already have your own audiogram, you can add it to your settings. If not, you’ll walk through a series of listening tests that allow you to set up as many as nine unique profiles based on your personal sound preferences.2

Available on:

iPhone, iPad, AirPods Max, AirPods Pro, AirPods, EarPods, Beats


  1. Hands-free phone calls are coming to Made For iPhone (MFI) hearing aid users
  2. Direct input of audiograms into Apple Health
  3. Background Sounds adds masking sounds for tinnitus sufferers

Children lose hearing

 According to the Hearing Loss Association of America (HLAA), 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears. Furthermore, an estimated 1 in 5 American teens experiences some degree of hearing loss. Loud music with EAR BUDS is a major cause.

Bose Sound Control™ Hearing Aids introduced

, Bose has finally launched its new self-fitting hearing aids—Bose SoundControl™. The new hearing aids look a lot like traditional medical-grade hearing aids, but promise a radically different do-it-yourself experience that allows you to “tune it yourself”, “skip the appointments” and “pay (much) less”. The new hearing aids come with 90-day risk-free trial, dedicated product support, and will be available to purchase on May 18 in select states for $849.95 for 2 aids

SoundControl™ Hearing Aids, Carrying Case, Open eartips in sizes 1, 2, 3, Closed eartips in sizes 1, 2, 3, Cable sizing tool, Batteries size 312 zinc-air, Hearing aid brush

What’s in the box

  • SoundControl™ Hearing Aids
  • Open eartips in sizes 1, 2, 3 (tip 2 is installed on the product)
  • Closed eartips in sizes 1, 2, 3
  • Batteries, size 312 zinc-air (8)
  • Carrying case
  • Hearing aid brush
  • Cable sizing tool
  • Quick start guide
  • Instructions for use

Tune it yourself

Unlike traditional hearing aids, Bose’s new SoundControl™ hearing aids are designed to be adjusted by the user. Citing a study conducted with researchers at Northwestern University, Bose touts “clinically proven results” using its proprietary CustomTune™ technology. Based on the research, Bose makes three primary claims:

  • CustomTune™ provides audiologist-quality customization.
  • Users were happier with sound quality compared to prescription-fit users.
  • On average, there was no difference in hearing-in-noise performance or hearing benefit between CustomTune™ and prescription-fit.

The Bose Hear App (on Android or iOS) gives the users two primary controls:

  1. World volume – This control is the primary control for amplification. It adjusts the gain, compression, and output limiting across 12 bands to approximate the settings that would be required to professionally-fit 36 common audiograms.
  2. Treble – The treble control adjusts “spectral tilt” by applying “additional adjustment to the gain” across 12 bands.

In the research cited by Bose, most users found themselves in the ballpark of a good hearing aid fitting. This was established by running ear canal measurements to see how close research participants self-selected amplification output was to the output of a perfectly-fit hearing aid.

for more information LINK


musicians hearing loss

Musicians crisis due to hearing loss

Oscar-nominated film Sound of Metal depicts a drummer battling hearing loss. As rock stars like Myles Kennedy explain, it’s a debilitating and worryingly widespread problem

Myles Kennedy of Alter Bridge, who quit music for 18 months after contracting tinnitus
‘I thought my musician days were numbered’ … Myles Kennedy of Alter Bridge, who quit music for 18 months after contracting tinnitus. Photograph: Chuck Brueckmann

The Bafta-winning film Sound of Metal dramatises every musician’s worst nightmare. Ruben Stone, played by Riz Ahmed – who is up for a best actor Oscar this weekend – is a metal drummer who loses his hearing, and the film depicts Ruben’s loss exactly as he hears it, where the world around him and the intense music he plays suddenly fade to a muted and distorted drone.

These scary and involving scenes have highlighted a crisis in hearing damage right across the music industry, be it through deafness or tinnitus (a constant ringing in the ears). In a report published last month by the British Tinnitus Association (BTA), over half of the 74 tinnitus-suffering musicians surveyed said they developed the condition due to noise exposure, but nearly a quarter said they never wore hearing protection.

In 2002, before Myles Kennedy went on to front the hugely successful US hard rock band Alter Bridge – their last two albums have gone Top 5 in the UK – he was diagnosed with tinnitus. Kennedy had been playing in bands since the mid-80s and working with high levels of sound in his home studio. After his diagnosis, he left the music business for 18 months.

“I thought my days were numbered as a musician,” Myles says. “I stopped playing live and went back to teaching guitar.” When Guns N’ Roses guitarist Slash asked Myles to audition for the supergroup that would become Velvet Revolver, he declined. “I was concerned about my hearing,” Myles says. “The fear that it could get worse was the thing for me: how bad is this gonna get?”

Riz Ahmed in Sound of Metal
Every musician’s worst nightmare … Riz Ahmed in Sound of Metal. Photograph: Landmark Media/Alamy

“For a musician, losing your hearing is like losing a hand,” says Steve Lukather of Toto, who developed tinnitus in 1986 and also suffers from hearing loss. Hearing aids mean that Steve can continue his career, but watching Sound of Metal hit close to home. “The movie disturbed me,” he says. “I know what it’s like to be all muffled up like that. It’s terrifying – and a very real problem.”

“Noise-induced hearing loss and tinnitus usually occur over a period of time, starting with temporary changes that may initially recover,” says BTA president Tony Kay. “This may become permanent if continued exposure to noise without adequate protection persists. If the noise is loud enough, permanent changes can occur after one exposure.”

For Amos Williams, bassist in metal band Tesseract, his tinnitus began as a teenager, while playing drums in bands and percussion in the school orchestra. “The severity of not having hearing protection was never expressed to me,” Amos says. “[The ringing] was almost expected when you’re playing or attending rock and metal shows. It got progressively worse – and now there’s no such thing as silence.”

“No one used to talk about wearing earplugs,” says Lisa Cope, who works for a record label and has hearing damage and tinnitus after years of tour managing. “I can’t hear anything under a certain decibel, and when I get stressed the tinnitus becomes like a chorus of crickets.”

Tinnitus can be debilitating, both physically and psychologically, and it’s usually in quiet moments that it screams the loudest: many sufferers say it’s worst when going to bed. “I can’t sleep without a podcast on,” says Dan Smith, bassist in extreme metal band Calligram. “When I listen to quieter music on headphones, I can hear my tinnitus over the music.”

Extreme metal band Calligram, with Dan Smith, second left.
Extreme metal band Calligram, with Dan Smith, second left. Photograph: Nick Sayers

For those who work in music, there is the additional worry that it could affect their livelihood. Singer-songwriter Rosalie Cunningham experienced mild distortion in her ears in the past, but after contracting Covid, her symptoms worsened. Now, the prospect of returning to live shows is a concern: “I’m terrified that something will happen on stage, and I won’t know what to do,” she says.

“I used to worry that people would think I couldn’t do my job,” says Eleanor Goodman, deputy editor of Metal Hammer magazine. “But when I started talking about it, I found out that tinnitus is very common in the music industry. Being open about it has been so much better.”

Hearing protection is key – even if you already have tinnitus. “People can think, I’ve done the damage, I’ll just carry on,” says Georgina Burns-O’Connell, lead author of the BTA report. “But that can do more damage.”

Rosalie Cunningham.
Rosalie Cunningham. Photograph: Rosco Levee

In 2016, Help Musicians started the Musicians Hearing Health Scheme in partnership with the Musicians’ Union, which gives musicians access to hearing assessments and moulded earplugs at a reduced cost. “Musicians should care as much for their hearing as they do for their instrument,” says James Ainscough, the charity’s chief executive. So far, the scheme has helped over 12,000 people.

There are also services that offer mental health support, such as Music Minds Matter, and the BTA recently established monthly support groups specifically for musicians. “While there isn’t a cure, there are ways to manage tinnitus, and to live well with it,” says Burns-O’Connell.

Those affected say there are techniques that have helped them – including wearing in-ear monitors and moulded earplugs, staying hydrated, avoiding stress, using podcasts and music as distraction, and support groups and therapy. “CBT put me on a positive path,” says Michael Daniels, a trumpet player, conductor and educator who works in a variety of styles from classical and choral to big band and jazz. “Mindfulness has also been very helpful for me: it’s a way of coming to terms with what’s going on.”

Around two years after his tinnitus diagnosis, Myles Kennedy joined Alter Bridge and went on to tour arenas around the world. Through techniques like meditation and the advanced technology of in-ear monitors, his condition no longer holds him back.

“The tinnitus forced me to take care of my hearing,” says Myles. “Twenty years from now, if we have this same discussion, I want to be able to hear everything you’re saying. I had to learn how to shut off that anxiety, to stop obsessing – it took a long time to get to that point. The in-ear monitors mean that I can continue doing what I love, without doing more damage. I’m so grateful – I can’t imagine a life not making music.”

Hannah May KilroyFri 23 Apr 2021

hearing and seeing impairment -50% chance of dementia

 A new study says losing function in both senses may put you at greater risk of dementia and cognitive decline years later. The research is published in the April 7, 2021, online issue of Neurology, the medical journal of the American Academy of Neurology. The study did not find such a link between losing just one of those senses.

“Depending on the degree of hearing or vision loss, losing function in your senses can be distressing and have an impact on your daily life,” said study author JinHyeong Jhoo, M.D., Ph.D., of Kangwon National University School of Medicine in Chuncheon, Republic of Korea. “But our study results suggest losing both may be of particular concern.”

The study looked at 6,520 people between the ages of 58 and 101. Visual and hearing impairment was determined by questionnaire asking about using glasses or hearing aids. People rated their hearing as “normal,” “reduced, but able to communicate without a hearing aid,” “difficult communicating with a hearing aid” or “no hearing at all.” People rated their sight as “normal,” “reduced, but able to view newspaper or TV without wearing glasses,” “unable to view newspaper or TV with glasses” or “no sight at all.”

At the beginning of the study, 932 people had normal seeing and hearing, 2,957 had either visual or hearing impairment, and 2,631 said they had both impairments.

Dementia was more than twice as common in the group with both impairments at the beginning of the study. In that group, 201 people out of 2,631, or 8%, had dementia at the start of the study, compared to 2.4% with one sensory impairment and 2.3% with no sensory impairment.

Researchers evaluated people’s thinking and memory skills every two years for six years using a test that includes word recall and recognition. Then they analyzed the relationship between having a hearing or vision impairment and dementia and having both impairments and dementia.

During the six-year follow-up period, 245 people developed dementia. Of the 1,964 people with both impairments, 146 developed dementia, compared to 69 of the 2,396 people with one impairment and 14 of the 737 people with no impairments. In addition, 16 out of 142 people who could not determine whether they had a sensory impairment developed dementia.

After adjusting for factors like sex, education and income, researchers found that the group with both hearing and seeing impairment were twice as likely to develop dementia than the group with normal sensory function. People with just one impairment were no more likely to develop dementia than those with normal sensory function.

In addition, the decline on thinking test scores was steeper among people with both hearing and vision impairment.

Jhoo says that further research is needed to explain why people with two impairments have a greater risk for dementia than those with one.

“Older people with only a visual or hearing impairment can usually still maintain social contact, so they may not feel be as isolated or depressed as people who have both impairments,” Jhoo said. “However, when someone has both impairments, that may increase the risk of isolation and depression, which previous research has found may affect dementia risk and thinking skills later on.”

A limitation of the study is that participants completed a questionnaire about their hearing and vision. Not having objective measures of people’s hearing and vison could have affected the study results.


The study was supported by Research of Korea Centers for Disease Control and Prevention.

Learn more about dementia at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

3M on Trial for Failing to Protect SOLDIERS Hearing

3M on Trial for Failing to Protect Soldiers Hearing

Veterans claim that the 3M knowingly gave soldiers defective NOISE REDUCTION earplugs.

Julia Métraux

Health Writer

30 March 2021

1280px 3 M Building Maplewood Mn1

Image via Wikimedia Commons/Acroterion

The first trial began yesterday for multinational corporation 3M—for its defective military-issued earplugs. There are over 229,397 lawsuits from veterans and soldiers who claim that 3M knowingly gave defective earplugs to soldiers to use in combat. Two subsequent trials will take place in May and June.

“Combat Arms CAEv2” earplugs, sold by 3M-subsidiary Aearo Technologies, were designed for use by the US Military, and sold to the US government between 1999 and 2015. The Star Tribune reports that damages related to the faulty earplugs “could tally in the hundreds of millions of dollars, if not more, based on the outcome of other large mass tort cases in recent years.” The plaintiffs from the first trial are veterans, mostly between the ages of 30 and 49.

One plaintiff, U.S. combat veteran Dave Henderson, started to experience ringing in his ears and had trouble hearing people after using the Combat Arms earplugs in the field. Henderson told Reuters that “we had no choice but to use the 3M earplugs” because the soldiers “trusted that our equipment would work.” Henderson told Reuters that he has to sleep with a fan to help with the ringing in his ears, and sometimes cannot hear when his children are crying.

The plaintiffs claim that 3M knowingly hid product defects—namely that the CAEv2 earplug didn’t always fit properly—from the U.S. Department of Defense.  Aearo’s own laboratory tests, conducted in 2000, showed that the earplugs weren’t effective unless they were fitted “in a particular way.” According to Star Tribune, 3M claimed that it informed the military about “fitting issues”, but “in a 2018 report, the Army concluded that had the government known about tests […] it may not have purchased Combat Arms earplugs.” 3M also paid a $9.1 million penalty in a whistleblower settlement but did not admit liability. 3M also paid a $9.1 million penalty in a whistleblower settlement but did not admit liability.

Judge M. Casey Rodgers of U.S. District Court for northern Florida, who will hear all three consolidated claims, will not allow 3M to use the “government contractor defense”, which would potentially “offer protection from state law product liability actions arising out of a contractor’s compliance with a federal government contract,” according to the American Bar Association.

The key point in this trial is whether or not 3M knew that the Combat Arms earplugs were defective. Hearing loss is a major issue for veterans, and a costly service-connected injury for the VA. The U.S. Department of Veteran’s Affairs reported that  “more than 933,000 Veterans were receiving disability compensation for hearing loss, and nearly 1.3 million received compensation for tinnitus” at the end of the fiscal year of 2014.

Julia Métraux

Health Writer

Julia Métraux is a health and culture writer with hearing loss and a member of the Association of Health Care Journalists. Check out her portfolio.

Ear Buds to Hearing Aids

Samsung Galaxy Buds Pro are tested as a hearing aids — the results are here:

By James Archer 3 days ago

Study finds Samsung Galaxy Buds Pro can help with hearing loss

Samsung Galaxy Buds Pro

(Image credit: Samsung)

The Samsung Galaxy Buds Pro has an Ambient Sound mode that uses onboard microphones to pick up and amplify sounds that you’d otherwise struggle to hear with the headphones in. Conceptually it’s no different to the transparency modes on many other wireless earbuds, but a new study has suggested the feature could make the Samsung Galaxy Buds Pro an alternative to dedicated hearing aids.

The study, conducted by the Samsung Medical Center and published in the peer-reviewed Clinical and Experimental Otorhinolaryngology journal, involved 18 participants with mild or moderate hearing loss. Of these, 57.6% reported that using the Galaxy Buds Pro was beneficial to their hearing in quiet environments.

It’s important to note the limitations of such a small sample size, as well as the fact that conventional hearing aids outperformed the Galaxy Buds Pro — especially in noisy environments, where only 26.3% of participants reported a benefit from the Samsung earbuds.

But while Samsung isn’t advocating the Galaxy Buds Pro as a one-to-one replacement to hearing aids, the study does make a good point in suggesting headphones with ambient/transparency modes could be useful in low- and middle-income countries, where hearing aids are prohibitively expensive. RECOMMENDED VIDEOS FOR YOU…CLOSEVolume 0%PLAY SOUNDThis video file cannot be played.(Error Code: 203000)

The World Health Organization’s research on deafness and hearing loss, cited in the Samsung study, notes that 80% of people with disabling hearing loss live in these countries, and that only 17% of those who could benefit from a hearing loss actually wear one.

Hearing aids can be free at the point of use in some countries, like the U.K., though elsewhere the $199 Galaxy Buds Pro could feasibly be seen as a more attainable alternative to hearing aids that typically cost several times as much. Even if it’s not as effective, and has a battery life lasting a few hours (instead of several days like most hearing aids).

Samsung has focused on the therapeutic qualities of the Galaxy Buds Pro before. In January it released a software update that added the ability to adjust volume on the left and right Galaxy Buds Pro independently, potentially helping those with worse hearing in one ear than another.

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super hearing coming

Google’s Project Wolverine is a HEARING AID in the future

Google’s X division has been secretly working on a fascinating project it calls “Wolverine.” It has to do with technology that enhances augmented reality (AR) applications. Google’s X division focuses exclusively on “moonshot” projects.
Project Wolverine is all about supplying users with a wearable device that employs directional microphones to enable “super hearing.” It’s a reference to the X-Men character Wolverine. The technology is still being fleshed out. The idea is that these directional microphones will connect to ear pods and likely work in conjunction with both outward- and inward-facing cameras on a pair of glasses or some other wearable device. This will allow the sensor-packed hardware to know who we are focusing on in the noisy room. And then we can direct the microphones to zero in on what that person is saying. The mics will filter out the background noise so we can hear our target clearly. This technology is called speech segregation, and I think it is the future.

. Speech segregation solves the problem of hearing in a noisy environment. We can imagine using this device at events like restaurants or parties to focus in on the person we are speaking to. This cuts through all the chaos in common areas. Of course, the same dynamic is true for any other event or gathering. This tech would be useful even at our holiday dinners or cocktail parties. So I think that every company working on AR will ultimately adopt this technology. It just makes too much sense.
However, there are major privacy concerns with this. It’s easy to imagine how this tech could be used for nefarious purposes. Bad actors could eavesdrop on private conversations happening at coffee shops, restaurants, and town squares.

And then there’s Google… We already know that Google’s goal is to extract as much behavioral data from us as possible. The company packages this data into a detailed dossier that it sells to anyone willing to pay. In this way, the argument could be made that Google knows many of us better than we know ourselves. Now, imagine Google pairing facial recognition technology with speech segregation. Suddenly, Google can document exactly what we are talking about out in public. That gives it an even more invasive framework in which to build its profile on us. So this is incredibly useful technology that I believe will gain rapid adoption. But as with everything, we need to be diligent about how it is used. Let us hope that other Corporations will adopt this technology for the common good.

Many “DIRECTIONAL HEARING AIDS ” have been on the market beginning about 50 years ago with Maico Hearing aid Company. I introduced that hearing aid in the Los Angeles county on TV, radio and the Los Angeles Times 3/4 page advertisement. I formed an advertising group of Southern Calif. Specialists. I was the President of “The Guild of Hearing Aid Disp.”

The BTE Hearing aid had 2 mics (Knowles) in a behind ear hearing aid. The front facing mic amplified the full sound. The rear facing mic reduced the sound coming from the rear, about 40% . They provide a significant benefit. The idea has been copied by most every other company since.
But today, when these mics are coupled with more mics. and the advanced technology that is described above, we will see great advances of HEARING IN NOISY SITUATIONS..

hearing aid molds prices

Hearing aid molds prices range from $2 each to over $200 each.


Provider/seller ear molds cost from $80 to $250 each, hat is, the person who sold you your hearing aid.

 Some of  the popular Audiologist from Laboratory earmolds are at the left in the below photo. They cost from $80 to $250 EACH, DEPENDING ON YOUR HEARING AID PROVIDER’s FEE who sold and adjusted it.. 

Those above, on the left, are Lab molds, made of Lucite, acrylic and Urethane hard plastic and these particular molds are made for BTE, Behind The Ear Hearing aids. They require an impression of your ear be taken, mailed to a factory where the ear mold is made and mailed back to the seller. Upon receipt, the seller calls you for an appointment. This entire process typically takes from 9 to 21 days. You may also need to return to fix problems and make adjustments.

The remaining earmolds above on the right are made for BTE hearing Aids. Those in the center are for RIC and Open Fit hearing aids. They are  DIY from HCPB Ear mold Kits that are made from flexible Medical Grade Silicone rubber putty at a cost of $2 Each to $12 Each. They take only 10 minutes to make in your own home

You are in control HCPB rar molds for your satisfaction. They are available in 3 skin colors, Tan, Brown and Dark Brown. They work with ALL BRANDS and MODEL Hearing Aids and are shipped PRIORITY in 2 to 3 day USPS FREE.

For more information click here.

hearing loss and work, case study

By Sarah Ellsworth

Everyone has their own opinions about remote work, our “new normal” approach to office-based professions during the COVID-19 pandemic.

Some people still struggle with the lack of face-to-face interaction, while others became acclimated to their virtual environments instantly. Unlike many workers who commuted to a physical office each day prior to March 2020, my daily routine has not changed.

I have been working from home since 2014 for a company that provides remote accounting services to nonprofit organizations around the country. 

I know that I am lucky to have avoided a career disruption during this time. Still, I recognize that the transition from in-person to online work has been difficult for people like me. I have a hearing loss, and I can appreciate that visual cues are more likely to be missed when we can’t collaborate with coworkers in the same room. I don’t wear hearing aids, but rely on lipreading for communication. I was born with a genetic hearing loss, so it’s been part of my entire life.

Joining her current company as a remote employee was a dream come true for Sarah, who was born with a hearing loss. Technology helps Sarah to work with confidence. Image credit:    FreePik   .
Joining her current company as a remote employee was a dream come true for Sarah, who was born with a hearing loss. Technology helps Sarah to work with confidence. Image credit: FreePik.

As someone who’s only known a life with difficulty hearing, take it from me. I’m here to encourage folks with hearing loss that this new normal — my old normal — is actually something to embrace. I’ve had many different jobs in my life — outdoor recreation, retail sales, mail carrier, publicist, blogger — but I’ve always gravitated towards positions where I’m not working against my hearing loss. Joining my current company as a remote employee was a dream come true. 

If there was ever a time to live with hearing loss, it’s now. Technology has improved exponentially in recent years, and the internet has allowed people with hearing loss to participate in communities and real-time conversations in a way that used to be almost impossible. 

One significant recent technological development is the live captioning built into Google Meet video conferencing software. They’re surprisingly accurate! Many of the other tools that my colleagues and I use — email, instant messages, virtual project management systems — are also really helpful for people with hearing loss. 

Nothing is perfect, of course. While, like most Millennials, I do my best to avoid phone calls, automated phone menus are the bane of my existence. It can be especially tough for people with hearing loss to get through a phone tree or automated greeting when the robot on the other end doesn’t understand, “What? Could you repeat that please?” 

Sarah Ellsworth Headshot.jpg

Despite the challenges that remain, I’m excited to see what the future holds for those of us with hearing loss. From new advancements in technology to more flexible working environments, change can be a wonderful thing.

Sarah Ellsworth is Communications Director at Altruic Advisors, a virtual/remote accounting firm for nonprofit organizations. She lives in Colorado.

are on-line hearing tests reliable?

1. Know what online tests can and cannot reveal

Recognize that these assessments can be a first step in learning about hearing loss, but aren’t comparable to a highly accurate, in-depth evaluation by a trained professional.

“Online tests are intended to screen your hearing, but they are not audiogram tests,” said Sharron Nixon, hearing services manager. “They only indicate whether you may have loss. You still need a full test in a soundproof chamber with a professional.”

2. Look for tests with real-world scenarios

Auditory Insight president Nancy M. Williams was the lead author of a study that looked at how hearing tests can best engage users. “You want to interact with a test that will explain your hearing loss in real-world conditions, in real-world terms,” she said. In particular, she praised those by Miracle-Ear and Starkey for featuring relatable scenarios. For instance, Miracle-Ear’s test replicates being in a train station. “The announcement comes on and broadcasts the platform for your train,” Williams explained. “That’s a real stressor for people with hearing loss. The announcer is often speaking over a lot of background noise.”

In Starkey’s evaluation, users are in a café and need to tune into conversations over the hubbub around them. These tests can provide valuable intel on how the test-taker fares in these everyday situations.

3. Recognize that these tests offer privacy – which can be a relief

While hearing loss—especially the age-related kind—affects many people, shame surrounding this disability can hinder acceptance. “I think these tests are really important because a lot of people with hearing loss have a need for privacy,” Williams said. “Not everybody is ready to go to the audiologist and have their hearing loss announced to them.”

Dr. Archelle Georgiou, the Chief Health Officer of Starkey Hearing, previously told Hearing Tracker how an online hearing test helped her mother move forward and address her hearing loss. “It provided objective evidence that she did indeed have hearing loss, and I think that’s the moment she took it seriously,” Dr. Georgiou said.

4. Avoid the temptation to pump up the volume

Your computer’s volume setting may impact the results of an online test. ReSound’s hearing test, for example, tells users to make sure that “the volume is set at a comfortable level.” But a comfortable level could be much louder for someone with hearing loss than without—and it may also be higher than what an audiologist would use.

Amber Bright, who lives in Tennessee, took an online hearing test once and received different results than what her audiologist uncovered. “It’s not really comparable. It can be ‘cheated’ by adjusting the volume on the computer, and external equipment [like certain speakers] can also amplify sounds,” Bright said. So keep the volume at a moderate level, and consider your results directional but not definitive.

5. Go ahead and boost your product knowledge

If you have an appointment for a hearing test, the audiologist will likely suggest getting hearing aids if a loss is detected. Some online hearing tests also nudge this process along, according to Williams. “An example is getting a product recommendation based on the type of hearing loss detected,” she said. She highlighted Audicus as an example of this. This information about appropriate devices can help deepen your knowledge.

If an online hearing test does indicate deficits, you’ll be primed to make your next move: contacting an audiologist Hearing Aid Specialist, or ENT. They can then do a full-fledged assessment and recommend the right devices to support your hearing.

Opiods and hearing loss

Why Hearing Loss May Increase Your Risk of Opioid Addiction

Here’s a shocking statistic: Deaf and hard of hearing people are twice as likely to develop a prescription opioid-use disorder than their hearing counterparts. That finding was uncovered by Dr. Michael M. McKee, a family physician with hearing loss who leads the Deaf Health Clinic at Michigan Medicine.

Dr. McKee noticed that many of his new patients were taking controlled substances to address chronic pain. He began to wonder if hearing loss was a factor, and set out to formally explore the relationship between hearing loss and substance use. His findings were published the American Journal of Preventative Medicine.

Dr. McKee’s key finding was that adults (aged 18-49) with hearing loss were significantly more likely to develop an opioid use disorder when compared to their normal hearing peers, especially for those younger than 35. Older adults with hearing loss were no more vulnerable than their peers.

Understanding the hearing and pain connection

Dr. McKee became concerned that his patients’ high number of prescriptions might be due to communication issues. If information isn’t fully shared, it presents challenges to receiving optimal care. “Whether it’s back pain, fibromyalgia, [or both] of those conditions, chronic pain requires a lot of communication to address it,” Dr. McKee said. “Most doctors want to avoid controlled substances because of [the risk of] dependency. But when communication breaks down…these issues pop-up.”

During the current COVID-19 pandemic, communication barriers have intensified. Masks block lipreading; a dearth of interpreters at some in-person appointments due to social distancing requirements may also make matters more difficult. If deaf or hard-of-hearing patients cannot understand their doctors, “they are not being taken care of properly,” said Gregory Shuler, RN. BC. MSN., of Worcester Recovery Center and visiting instructor at Worcester State University, when talking with Hearing Tracker.

Why aren’t older Americans with hearing loss at risk?

Interestingly, the occurrence of opioid use disorder among older patients (50+) was the same regardless of whether they had hearing loss or normal hearing. Dr. McKee attributes this to doctors being more aware that older patients may experience age-related hearing loss, leading to improved communication about pain management with older adults with hearing loss.

Advocating for better care and communication

Dr. McKee finds it essential to empower patients to get their needs met but knows this isn’t always easy. Some are simply not comfortable discussing how their hearing loss affects them. “They get to a point where they give up because the barriers are huge. There’s stigma,” Dr. McKee says. “On top of that, some people are not comfortable saying ‘I can’t hear.’”

Dr. McKee cites the Hearing Loss Association of America’s Communication Access Plan as a way that those with hearing loss can address the situation with their doctors. It all boils down to “explaining what is the way to best communicate with me,” he said, “trying to be more proactive instead of reactive on how we address communication needs or combinations needed.” Having this alignment between patient and healthcare professional can improve how well symptoms and sentiments are shared, leading to better care.

How healthcare professionals can help

The medical community can also play an important role in diminishing opioid-use disorder. Previously the charge nurse at the deaf unit for psychiatric adult and adolescent patients at Worcester State Hospital, Shuler—along with other health professionals—outlined how providers could improve communication with deaf patients in Nursing. These steps could also apply to interacting with those who are hard of hearing, too.

  1. Ask the patient what you can do to help improve the communication process.
  2. Don’t assume the patient can hear and understand what you’re saying just because they are wearing a hearing aid.
  3. Ask the patient what communication tools (such as a whiteboard, computer, or tablet) work best for them
  4. Only one person should talk at a time in a group situation.

Shuler also advocates for professional sign-language interpreters in medical settings instead of relying on the patient’s family or friends, who may have their own biases when signing. “You need someone who is following a specific code of ethics, is a neutral party, and is trained to interact between the deaf person and the hearing person,” Shuler said. Patients may want to request an interpreter prior to their appointments as well.

Overcoming the opioid issue

To address the heightened risk of substance-use issues in deaf and hard of hearing patients, Dr. McKee says that doctors could benefit from communication training, starting in medical school. He says doctors must learn to take a step back and recognize risks that hard of hearing people face.

“These people often have higher rates of mental-health issues, which can go hand in hand with opioid-use disorders,” Dr. McKee said. “Many deaf and hard-of-hearing individuals have depression, anxiety, interpersonal violence, abuse from past, and they may struggle with lower socio-economic statuses.”

As the healthcare community recognizes this issue—and as patients demand appropriate communication—the link between hearing issues and prescription opioid-use disorder will hopefully be unraveled and eliminated.

How we hear science

Hearing Acrobatics

Dynamic, delicate grip between protein filaments enables hearing

By KEVIN JIANG February 8, 2021 Research

hair cells

A scanning electron microscope image of a hair bundle protruding from a sensory cell in the inner ear. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

The sense of hearing is, quite literally, a molecular tightrope act. Turns out, it involves acrobatics as well.

In a paper published in Nature Communications on Feb 8, researchers at Harvard Medical School and Boston Children’s Hospital show that a dynamic and delicate connection between two pairs of diminutive protein filaments plays a central role in hearing.

The tension held by these filaments, together called a tip link, is essential for the activation of sensory cells in the inner ear. The team’s analyses reveal that the filaments, which are joined end-to-end, work together like trapeze artists holding hands. Their grasp on each other can be disrupted, by a loud noise, for example. But with a two-handed grip, they can quickly reconnect when one hand slips.

Get more HMS news here

The findings present a new understanding of the molecular underpinnings of hearing, as well as the sense of balance, which arises from similar processes in the inner ear. Disorders of deafness and balance have been linked to mutations in tip links, and the study results could lead to new therapeutic strategies for such disorders, according to the authors.

“This tiny apparatus, made of less than a dozen proteins, is what helps change sound from a mechanical stimulus into an electrical signal that the brain can decipher,” said co-corresponding author David Corey, the Bertarelli Professor of Translational Medical Science at HMS. “Understanding how these proteins work provides insights into the secrets of the sensation of sound.”

The dynamic connection between the filaments may also function as a circuit breaker that protects other cellular components, according to the researchers.

“I think our study gives us a sense of awe for how perfectly engineered this system in the ear is,” said co-corresponding author Wesley Wong, HMS associate professor of biological chemistry and molecular pharmacology at Boston Children’s. “It maintains a delicate balance between being just strong enough to carry out its function but weak enough to break to potentially preserve the function of other elements that can’t be as easily reformed.”

Decoding a handshake

For hearing to occur, cells must detect and translate pressure waves in the air into bioelectrical signals. This task falls upon hair cells, the sensory cells of the inner ear. Protruding from these cells are bundles of hair-like structures, which bend back and forth as pressure waves move through the inner ear.

tip links
A close up of tip links connecting the stereocilia of a hair cell. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

Tip link filaments physically connect each hair to another and are anchored onto specialized ion channels. As the bundle moves, the tension of the tip links changes, opening and closing the channels like a gate to allow electric current to enter the cell. In this way, tip links initiate the bioelectrical signals that the brain ultimately processes as sound.

In previous studies, Corey and colleagues explored the composition of tip links and identified the precise atomic structure of the bond between the two protein filaments. Intriguingly, this bond was evocative of a molecular handshake, according to the authors.

In the current study, CoreyWong, and the team set out to understand the nature of this handshake. To do so, they applied single-molecule force spectroscopy, a technique that often uses optical tweezers—highly focused laser beams that can hold extremely small objects and move them by distances as short as a billionth of a meter.

The researchers, led by study first authors Eric Mulhall and Andrew Ward, both research fellows in neurobiology in the Blavatnik Institute at HMS, coated microscopic glass beads with strands of either protocadherin-15 or cadherin-23, the two proteins that make up the tip link. Using optical tweezers, they moved beads close to each other until the protein strands stuck together end to end and then measured the forces needed to pull the bonds apart.

Stronger than the sum

Each tip link is made up of two strands of both proteins. The team found that the strength of this double-stranded bond far surpassed the strength of the bond between individual strands of either protein. Under low tension, a double-stranded bond lasted ten times longer than a single-stranded bond before breaking.

This increased strength appears to be due to the dynamic nature of the connection, according to the authors. Rather than acting as a simple static rope, the filaments detach and reattach to each other within tenths of a second. A force may break one pair of strands apart, but the other pair can remain connected long enough for the broken pair to rejoin.

The bond between tip link filaments resembles an acrobatic “two-handed grip.” Image: David Corey
Trapeze artists
 Christina Saran and Daniel Simard. Image: Feld Entertainment

At extremely high forces, however, the double-stranded bond breaks rapidly. This feature may help to prevent catastrophic damage to other components of the hair cell, the authors said.

“If the tip link were super strong, then when exposed to a very loud sound it might rip the whole complex out of the cell membrane, which would be hard to recover from,” said Wong, who is also an associate faculty member at the Wyss Institute for Biologically Inspired Engineering at Harvard.

“The ability to break with loud sounds is analogous to a mechanical circuit breaker,” he added. “This use of multiple weak bonds to form a tunable biological circuit breaker could potentially be very interesting for synthetically engineered systems.”

Surprisingly, the team found that under resting tension, each tip link lasts only around eight seconds before it breaks. Their analyses, coupled with evidence from other studies, suggest that new tip links can form rapidly from other strands of protein nearby. Together, the results support a new paradigm of highly dynamic tip link formation and rupture that both enables and protects hearing.

The team also looked at mutations to protocadherin-15 that are linked to Usher syndrome, a rare hereditary disorder of deafness and blindness. Their experiments suggest that some of these mutations can greatly weaken the bond between the tip link filaments. This may be why the disorder leads to deafness, and further mechanistic understanding of this process could lead to new therapeutic approaches, the authors said.

“It’s hard to fix something if you don’t really know what’s broken, and we are optimistic that a better understanding can help lead to new solutions,” Corey said.

In addition, the new findings may help inform study in other areas of the body. 

“We have many different mechanical senses besides hearing, such as touch, the sensation of blood pressure, and certain types of pain,” Corey added. “We understand hearing in more molecular detail than any of the others—knowledge that can help us probe the workings of other mechanical senses.”

Additional authors on the study include Darren Yang and Mounir Koussa.

The work was supported by the National Institutes of Health (grants F31 DC016199, R01 DC000304, R01 DC002281, and R35 GM119537).

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