Unilateral Hearing Loss

Adults with Unilateral Hearing Loss

People occasionally ask if they really need two hearing aids. The answer is, yes, you do. If you need to save money, it’s much better to get two less expensive hearing aids than one high tech hearing aid.

There two reasons why, but first I have to explain that if one ear is at least 30dB better than the other, you brain ignores the poorer (unaided) ear. Even if the sound is loud enough for the unaided hear to hear, the brain can’t use it. Having explained that, unilateral hearing loss presents two problems:

1) Inability to tell where sound is coming from, which is a safety issue.

2) Significant difficulty hearing in noise. (For anyone who has normal hearing, I strongly recommend you experience this by putting one earplug deeply in one ear and have dinner at a loud restaurant. You’ll see how much harder it is to hear in noise with only one normal ear.)



Unilateral Hearing Loss in Children

For kids, unilateral hearing loss is an even bigger deal than doctors and teachers often think.

1) Kids with a hearing loss on one side are 10 times more likely to fail a grade or need help keeping up in school.

2) Kids with hearing loss in one ear are 5 times more likely to have some problems getting along with others. As Hellen Keller said, “Blindness separates us from things, but deafness separates us from people.”

It’s also more important to act as soon as possible than doctors and teachers may assume. Children pick up most of their language between ages one and five. The time between ages one and five is called the critical period.

Schools will set up special individual support for kids with hearing loss. It’s referred to as an IEP or a “504”. Here are a few typical accommodations, but there are many more:

1) Preferential seating
2) Extra time for taking tests.
3) FM amplification systems
4) Classroom noise reduction
5) Buddy system for notes and in class explanation
6) Dictation apps

Karen L. Anderson, PhDSupporting Success for Children with Hearing Loss

Quiet Restaurants in Santa Barbara

It’s hard to find quiet restaurants in Santa Barbara.  If you wear a hearing aid, this is pretty important.  I posted this a while back, but a patient of mine just recommended a new one for the list, Louie’s. Email me if you have another for me to add:

Paradise Café (Veranda)
La Playa Azul (Veranda)
Scarlet Begonia (Patio)
Lure (in the back of the restaurant)
Rose Café
Stella Mare’s
Tree House
Max’s (after 1pm)
D’Angelo Bread

Maslow 2.0

Carol and her husband, Hal, started Interpersonal Communications in 1985. Hal, a psychologist, and Carol, a nurse, saw hearing aids as more than just a device that aids hearing. It’s about communicating and being close to friends and loved ones. Hearing loss isolates people. It affects cognitive health. Even more importantly, it affects emotional health.

Maslow’s famous “Hierarchy of Needs” was re-examined by Dr Ed Diener and I think the results support what Carol and I think: that connection with other people is a bit more important for happiness that Maslow’s theory says it is.

The Atlantic wrote an article about the study in 2011:

“As it turns out, the needs that are most linked with everyday satisfaction are interpersonal ones, such as love and respect.” The study author writes, “It shows clearly the importance in all societies of human connections and social supports, something that’s been ignored in recent years.”


I thought this article was interesting. It talks about two eras in medicine and the need to evolve into a third. First there was the era of “professional trust and prerogative” and then there was the era of “accountability, scrutiny, measurements, incentives, and markets.” Dr Donald Berwick suggests we need to move on to a third era where we focus on quality instead of revenue.

I studied the first era a bit out of an interest in the history of ethics in clinical trials. So much of the knowledge we have today about cardiology, anesthesiology, nephrology, and cancer was learned at major universities, that conducted dangerous clinical experiments on patients without their knowledge or consent. Dr. Maurice Pappworth finally blew the whistle in 1967 and things started to change.

Carol, an RN, has some funny stories about the start of the second phase. Hospitals were evaluated for competence and efficiency. Some conclusions were funny, like expecting a nurse not to make an unscheduled stop at a patient’s room if a patient had fallen down, because it’s inefficient. Or the recommendation that the department needed to hire two and a half nurses.

Anyway, Carol and I agree with Dr Berwick that medicine needs to focus quality over revenue.

Central Processing Disorder

Hearing starts with sound vibration, which becomes neural signals, which are brought up to the brain, where the sounds become all kinds of things we recognize, including words. Kids with hearing loss can be misdiagnosed. Without a hearing test, hearing loss can be confused with developmental delay, ADD, or defiance. And if there is a Central Processing Disorder, hearing can be difficult even when the standard pure tone hearing test is normal. That’s because the problem is higher up in the brain where speech sounds are decoded into words.

About Central Processing Disorder

Here is an online screening test:

Central Processing Disorder screening questionnaire

If there is any question about hearing loss, get it checked out by an audiologist and an ear, nose, and throat doctor.

Affordable Hearing Aids

A hearing aid can cost $3000. The expensive ones are better in tough listening situations, give me more options to tailor it to my patient, and the sound quality is better. But $1000-3000 is too much for most of us, so here are some more affordable options.

I have basic hearing aids starting at $900 and so does Costco.

I can get refurbished hearing aids from Starkey for around $500 and they have a 1 year warranty.

A PSAP (Personal Sound Amplification Product) is an amplifier you can get online. Etymotic Research is a reputable manufacturer.

The first two are actually programmed and validated with testing to fit your hearing loss. PSAPs are designed for people with mild hearing loss and are not custom fit.

Whatever you choose, keep your receipt. By law, you always get a 45 day trial with a full refund.

Donating Old Hearing Aids

Don’t throw out old hearing aids. A few options for old aids:

I called Starkey and left a message with their Hearing Foundation director asking what international hearing missions use their donations. We have a box in our office that you can put old dead aids. When we get a bunch we send them in to Starkey.

Friends and Family
You can also give an old hearing aid to a family member or friend if it’s a hearing aid that goes behind the ear. It can be reprogrammed to fit their hearing loss. Call me if you have questions about this.

Santa Barbara Audiology
You can donate them to us too. I program them and give them to people who don’t qualify for Medical (CenCal).