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Noise harms more than the ears.


“Calling noise a nuisance is like calling smog an inconvenience. Noise must be considered a hazard to the health of people everywhere.”

– William H. Stewart, former U.S. Surgeon General

Noise isn’t just annoying. It isn’t just bad for your ears. It’s bad for your health. Noise causes higher blood pressure and cortisol levels, which leads to heart disease. Students learn less and workers make more mistakes when exposed to too much noise in the environment. Research continues on the effects of noise on the immune system and birth defects.

The New York Times published an article on noise in NYC establishments. “The New York Times measured noise levels at 37 restaurants, bars, stores and gyms across the city and found levels that experts said bordered on dangerous at one-third of them.” Some restaurants were simply unaware of the danger and pledged to look into it. Restaurants like to play loud music because it makes people eat faster and leave sooner, so significant change is unlikely. (If you’re looking for a quiet(er) place to eat in Santa Barbara, check out my patient-recommended restaurant list.)

As I was investigating this, I actually found an organization called Quiet Communities, whose mission is to make communities quieter. I love that.

The History of Oticon Hearing Aids


Acousticon Hearing Aid invented by Miller Reese Hutchison

Oticon began with a Danish man named Hans Demant in 1903, who wanted to help his hearing impaired wife. The popular Queen Alexandra of Great Britain had worn the first portable hearing aid at her coronation the year before and Hans traveled to England to buy one for his wife. Motivated to help others with hearing loss, he began importing them to Denmark. Eventually Oticon began manufacturing their own hearing aids in 1940.

Every hearing aid manufacturer seems to focus its engineers on a particular task. Most recently, Oticon spent its energies developing a faster processor. The theory is that it can handle noise better, especially when dealing with multiple talkers. While it’s not the hearing aid for everyone, I have been impressed with the results in the patients I have chosen it for. For all you engineers and, what my dad calls “tinkerers”, here is an explanation of what they did.

Hearing Aid Manufacturers

I love history, so I thought I’d start a series on the history of a few major hearing aid companies. I can fit, repair, and reprogram just about any hearing aid from any company, but these are the ones I work with most often. Stay tuned. Next week I’ll dive into Oticon’s history. This week I’ll keep the blog post short. Carol, my husband, and my kids all say I should learn to take a break. My husband even got me a rocking chair one Christmas as a hint.

Oticon: 1905, Denmark
Phonak: 1947, Switzerland
ReSound: 1984, USA
Siemens: 1910, Germany
Starkey: 1963, USA
Widex:1956, Denmark

Audio Spectrum Explained

A patient of mine just told me about a website that explains the audio spectrum, audio production, microphones, sound waves, sound perception, and more: Teach Me Audio: No nonsense guide to Audio Production. Speech is between 250 and 8000 Hz, so those are the frequencies that get tested in an audiogram. (Actually, sometimes I test higher than that if someone is starting chemotherapy. Chemo is ototoxic and the toxicity shows up first in the ultra high frequencies. So I test above 8kHz before and at intervals after chemo. If hearing drops above 8 kHz, the oncologist knows chemo has reached ototoxic levels and they may choose to tweak the dosage a bit.)

While the whole website is fascinating, the Audio Spectrum page can help you check your hearing aids. If you can’t hear part of the frequency range between 250 and 8000 Hz when you’re wearing your hearing aids, they may need to be reprogrammed.

Tinnitus

Tinnitus means noise in the ears or head. Hearing aids can help a LOT. Either the amplification of a hearing loss masks the tinnitus, or a tinnitus masker reduces stress by competing with it. It doesn’t seem like adding more sound to the tinnitus would help, but it does. One of my patients said, “It’s like it competes with the tinnitus, so it sort of keeps it in it’s place. Most manufacturers include a tinnitus masker in their hearing aids. Widex makes one that is particularly effective. Here are samples of the some of the masking “noises” it makes.

Sand
Aqua
Green
Lavender
Coral

Everyone’s experience is different. It can sound like ringing, buzzing, or whistling, among many other sounds. It is often just a minor annoyance, but not always. Sometimes it’s severely stressful, even to to the point of causing serious depression. William Shatner shared his experience when he was the spokesperson for the American Tinnitus Association.

Telecoils

Telecoils are an old technology from the late 1930s and most hearing aids have them. They were originally designed to help hearing impaired people hear clearly on the phone. Today, they are used more often in theaters with an induction loop. A room is “looped” with a wire that receives the sound signal from the stage and then transmits it to the hearing aid. This turns hearing aids into something like a custom headset. A California hearing aid impaired group recently tried to pass legislation requiring audiologists to include a telecoil in every hearing aid. I encourage everyone to choose one with a telecoil, but, for some people, they’d rather forgo the feature in favor of either a smaller hearing aid or another feature like rechargeable batteries. If you have hearing aids and aren’t sure if you have a telecoil, you’re welcome to come by and I’ll check. If it’s in the aid, but not activated, it’s pretty easy to do so. I have included a video explanation of how a looped room works with a telecoil in the Hearing In Noise section of this website. Ampertronic has a history of the induction loop on it’s website.

Hearing Aid Insurance Benefits

Always call the number on the back of your insurance card to see of you have hearing aid insurance benefits.  Ask if there is a special rate for in network providers.  If there’s no difference between in and out of network, then you can go to any hearing aid provider.  Also, ask about deductibles and how often they provide that hearing aid benefit.  Regardless of my status with an insurance company, I’m happy to submit claims electronically and that speeds up the process of considerably.  I’m in the process of applying to insurance companies.  Here is my current status.

 

In-Network

  • Blue Shield
  • MediCal/CenCal
  • The Department of Rehabilitation

 

Waiting to be In-Network

  • EPIC (Applied this month)
  • Aetna (Applied 2 months ago)
  • Cigna (Applied 3 months ago)
  • Anthem Blue Cross (Applied 8 months ago)

Medicare

Medicare does not cover hearing aids, but a lot of secondary insurances require the claim to go to Medicare first.  Once it gets rejected, Medicare forwards it to the secondary insurance.  Everyone who works with hearing aids knows that Medicare only covers an annual hearing test, not hearing aids.  For some reason we have to do the extra paperwork.

 

Credentialing

Because of a process called “credentialing”, becoming a provider takes a long time.  Credentialing is the process of establishing the qualifications of a licensed medical professional and assessing their background and legitimacy.  It takes months to become an in-network provider.  In the case of Anthem Blue Cross, it has taken 8 months so far.  We just signed a contract with them and now we’re waiting for them to sign it.  So far, I’ve been “credentialed” by Sansum Clinic, Blue Shield, Anthem Blue Cross, MediCal, Medicare, and the Department of Rehabilitation.  Maybe some day there will be a standard process where they just accept a diploma from a reputable university and call your last few employers.

 

Claims

It takes a lot of work to submit and process claims.  I usually spend a good portion of my Fridays working on insurance claims and it grows every year.  I anticipate there will be times when I will have to wait a month before I can see a new patient with insurance so that I have time to process the claim in a reasonable amount of time.  Maybe some day anyone with a hearing loss will have access to at least a good basic hearing aid, without lots of paperwork, regardless of income.