Did you know – musicians have occupational hazards? Yep, the two biggest dangers to musicians are hearing loss and tinnitus (ringing in the ears). (The occasional food truck burrito gets honorable mention). The quality of life of a musician is diminished over time due to hearing loss, unless proper precautions of hearing protection are taken.
Did you know — that loud music at concerts and festivals can reach decibel levels higher than 110 dB, which is like hearing the ambulance siren on loop?
Would you voluntarily stand right by an ambulance for a 90-minute set? I sure hope not. But concert-goers and musicians do about the same at loud concerts.
While music is very beneficial for our mental wellbeing and happiness, continuous loud music is not. The good news is that there’s an ingenious way to prevent it, which we’ll get to in a bit.
There's a strong link between hearing problems and professional musicians. Musicians have a 60% greater chance of experiencing tinnitus or ringing in the ears. A large study looked at more than two thousand musicians and found that more than 10% of them suffered from significant hearing loss.
Given that musicians are able to hear a broad range of sounds, their sensitivity to different sound level is high as well. That increase in risk however, overshadows much of the enjoyment of being surrounded by loud music.
Music lovers are affected too. There are growing concerns regarding ever-increasing noise levels in entertainment settings like concerts, cinemas, and festivals. Personal music devices and digital games emit sounds whose levels are dangerous. Loss of hearing can be temporary or permanent. It might take just one concert to cause major damage.
What happens in the ear, exactly?
There are very sensitive hair-like cells in our inner ears called cilia. These hairs become overactive when the noise levels are high. On repeated stimulation, the hairs become weakened and they stop responding to sound. In turn, the nerve that is attached also gets stressed because of not getting any signal. As a result, the brain generates a typical ringing sound. This ringing sensation is called tinnitus. The whole impact of loud noise can be temporary. If the ear gets a break from loud noise — it gets a lifeline.
If you stop the loud music, chances are that the tired hair cells may return to their active state. However, years of prolonged exposure to loud noise may ultimately permanently kill these hair cells and then, unfortunately, the loss of hearing becomes permanent, and the tinnitus becomes challenging to treat.
Awareness and prevention
There should be a raised awareness of the cumulative effect of loud music and lack of protection. The sound levels in parties, restaurants, movie theaters, music festivals and even gyms should be clearly mentioned and advise the visitors to take the necessary protection.
Young musicians should take precautions to reduce the long term impact of loud noise. Generally, moderated use of headphones and earbuds would be a good start. The volume of the personal sound system should be turned down and switched off at regular intervals. All concert halls and music studios should incorporate acoustic designs with sound absorbing panels to reduce the effect of loud noise on people who are inside the room, rather than just soundproofing them.
What can you do?
As a start, being aware of loud environments and ear pressure is important, and removing or distancing yourself from the source is helpful.
Bringing earplugs to events you think might be loud is the next step. We have our recommendations for earplugs beyond the cheap foams, which we list below.
If you feel concerned about your hearing and are experiencing symptoms of tinnitus or hearing loss, it’s not too late. Tinnitus is treatable and loss of hearing can be managed.
Audiologists at the Tinnitus and Hearing Center of Arizona offer a specialized hearing service for the needs of musicians, sound engineers, and members of the entertainment industry.
As trained audiologists, we would diagnose and treat a musician effectively. An initial consultation may include a pressure test, testing your eardrum and a few other standard hearing tests. They are all very quick and painless. The next steps will be taken based on the test results.
We would discuss hearing protection, conservation and preservation. You may be offered custom-fit or musicians earplugs or in-ear monitors (IEM). These would help empower you to improve your quality of life while keeping your condition discreet and you can continue to enjoy the music.
There’s no easy way to say this, but…
Loud music damages the ears. Before you realize it, loud music has altered the inner ear, causing a ringing or buzzing sensation called tinnitus, or causing hearing loss – or both.
Plenty Of Excuses To Go ‘Round
Even with all the evidence that loud music causes hearing issues, surveys have found a few common threads, so let’s discuss them here:
1) “By the time I need hearing aids or have tinnitus, technology will have developed replacement ears.”
A patient told me that he thought that very thing 20 years ago, but of course we still don’t have replacement ears. Research is still being done with replacing the cilia (the tiny hair cells that are the receptors of sound in your ear), but even that has its complications. Will we have better technology 20 years from now? Sure, but don’t risk your hearing on the hope of technology saving you. Keep and preserve what you’ve got now, which is certainly better than robot ears.
2) “I just can’t hear the same with earplugs on stage, and it affects my performance.”
If you’re using the cheap foam earplugs you find at the pharmacy, then that would explain why you can’t hear naturally. They’re simply not designed for sounding good. They sound plugged up, mid-range heavy, and congested. By contrast, there are speciality earplugs made specifically for musicians, called, you guessed it – “Musicians Earplugs.” These custom molded earplugs have two great features:
a) They are "flat frequency" designs, so you’ll hear the same spectrum of frequencies – from the deep bass to the shimmer of cymbals – but the sound pressure level is lowered, so it’s like you turned down the volume on everything. Again, remember the ambulance scenario referenced above – if you can reduce the decibels you can reduce your risk of hearing damage.
b) Musician ear plugs have removable filters that you can customize to your environment. These little discs pop in and out of the earplugs, and come in three dB (decibel) levels – 9dB, 15dB, and 25dB. Loud concert? Use the 25’s. Restaurant or nightclub conversation? Use the 9’s. We feel this is the customizeable and best hearing protection you can buy.
3) “Earplugs are uncomfortable and hard to get in and out.”
This is common with people that use the cheap foam earplugs, and they’re right – they feel unnatural and are hard to insert properly. By contrast, the Musician Earplugs are customized to your individual ear canal, so they’re a perfect fit every time you use them. You’d schedule a visit with your audiologist (like us, hello!), and they would take an impression of your right and left ear canals. The impressions get sent in to the manufacturer, and in a week or so you’d get the reusable ear plugs back.
These custom ear plugs usually cost about $150 or so. One patient reported that "it's the best $150 I ever spent." Certainly more than the $5 at the pharmacy for the cheap foamies, but, how much is your hearing worth? How valuable is it to not have ringing in your ears, night and day, or struggling to hear everyday conversations due to hearing loss? Your future self will thank you profusely for taking care of your ears now.
What are the best earplugs for musicians?
We're proud distributors of the Sensaphonics brand, which are made of premium silicone unlike other manufacturers. Vinyl used by other companies shrinks over time, and will progressively get looser in your ear canal, allowing sound to enter in - the very thing you're trying to prevent! We carefully chose Sensaphonics and we've been extremely happy with their products and service. They even make sleeves for those generic fitting Shure monitors, giving them a more customized fit, feel, and look.
Sensaphonics also happens to be our choice for the best earplugs for concerts. You can read more about our Musician's Clinic products and services here.
The most valuable instrument you own
At Tinnitus and Hearing Center of Arizona, we’ve fit countless musicians with custom ear plugs – from members of the Phoenix Symphony to the Gin Blossoms and members of Pink’s band. We just had a member of Night Ranger in here, as well as jam band Spafford to get fit for musician ear plugs and in-ear monitors.
We understand musician’s needs – so much so that we’re known as “The Musician’s Clinic.” We know the concerns musicians have about their ears and hearing, and have designed effective strategies to combat hearing loss, tinnitus, and other hearing conditions.
Curious about the status of your hearing? Schedule a hearing test today. Just like we get our vision tested every so often, when is the last time you had your ears checked? Musicians value their hearing, so treat your hearing like the most valuable instrument you own.
Call us today at (480) 831-6159, or use our convenient online scheduler.
It's not uncommon in today's noisy world to experience a gradual loss of hearing. However, left undetected or unaddressed, it can become problematic to one's everyday lifestyle.
If you are unable to hear as well as a person with normal hearing, which is about 50 decibels (dB), then you may be affected by hearing loss. It can affect one or both your ears.
To give you an understanding of the decibel levels, city traffic noises are usually 85 dB and sirens are 120 dB. Regular exposure to sound levels above 75 dB might cause hearing loss.
How would you recognize hearing loss?
Newborns are usually tested after birth and the audiologists take appropriate steps. If a child is slow to learn talking or if their speech is not very clear, then their hearing should be checked.
If you, whether young or old, talk very loudly, find it hard to hear a conversation or even hear the alarm, doorbell or watch television very loudly, then you should see an audiologist.
Hearing loss has a stigma and it should not be. According to the World Health Organization, around 466 million people experience from severe loss of hearing, worldwide. Estimates suggest that the numbers will double in the next thirty years.
This means, you are not alone.
Causes of hearing loss
Besides hereditary cause, newborns may be affected with loss of hearing if they have a difficult birth or have jaundice. If the mother had complications during her pregnancy with illnesses like rubella or syphilis, or had certain strong medications, the newborn may have a loss of hearing.
Aging is one of the most common causes of progressive hearing loss. Hearing loss affects their daily life. They may find it difficult to have a conversation or even respond to the doorbell. There is a risk of older people falling into depression and memory loss because of their problems with hearing.
The other common cause of hearing loss is long term exposure to loud noise. Modern life tends to be noisy, including traffic noises, various modern gadgets and loud music. When surrounded by such loud noise, people may experience a gradual loss of hearing.
How does hearing actually work?
In the center of the hearing mechanism is the eardrum, present in the inner ear. The ear is a very sensitive and complex organ. It converts the sound wave to an electrical wave in the brain through a series of steps. The middle ear is a bony structure that vaguely looks like a snail. This structure called cochlea and the fluid inside it helps the sound wave to reach the eardrum which sits deep inside the inner ear. The vibration of the eardrum, in turn, triggers the tiny hairs on it converting it into an electric wave. This wave travels to the brain via the auditory nerve.
What causes hearing loss?
Loud noise, ear infection or putting objects in the ear like a cotton swab can injure the hair cells in the eardrum. A very loud burst of noise like an explosion may cause sudden loss of hearing. Fluid or earwax in the ear acts as a sound barrier and cause a temporary loss of hearing. Otosclerosis or growth of excess bone and Cholesteatoma, which is an abnormal collection of skin in the ear are two conditions where hearing is affected.
Illnesses like Meningitis, Meniere’s disease and certain conditions like high blood pressure, diabetes, stroke, heart conditions, and viral infection can cause loss of hearing. The chances are higher in older people.
Use of certain medicines used for treating severe infections, heart conditions and cancer may affect hearing. These medicines known as ototoxic drugs may damage the eardrum. Otosclerosis is thought to be a heredity condition that affects hearing.
If you feel that you or a loved one might be experiencing gradual hearing loss that is becoming noticeable or problematic, we recommend contacting us at Tinnitus & Hearing Center of Arizona to schedule a simple, quick, and non-invasive hearing test is a great idea. Our friendly audiologists will welcome you into our clinic, discuss your situation, and conduct a painless (and even fun) hearing exam.
Just as you might have an annual eye exam to measure your vision, you should have a hearing test to measure your other important sense - your hearing.
We provide hearing tests for Scottsdale AZ and Phoenix residents, and any patient in the Valley. Call us directly at (480) 831-6159 or use our convenient online scheduler to book an appointment on your computer or phone.
Tinnitus is the sensation of noise or "ringing" in the ears - a common problem that affects approximately 15 to 20 percent of individuals, so roughly 1 out of 6 people suffer from it. With those kinds of numbers, we feel it's a topic worth exploring, and in fact, it's an important part of our practice at Tinnitus & Hearing Center of Arizona. The Rohe Method® of Tinnitus Treatment was created as a unique blend of Cognitive Behavior Therapy (CBT) and Tinnitus Retraining Therapy to facilitate retraining the brain. Retraining activates plasticity in the brain, which allows the nervous system to change its function in various ways, typically for learning or self-repair.
Tinnitus is not an actual condition; it is a symptom of some type of underlying condition, such as an ear injury, circulatory system disorder or age-related hearing loss.
Although tinnitus is annoying and can be incredibly frustrating, in the majority of cases it is not normally a sign of anything physically serious. It may worsen with age, for some individuals; if treated, tinnitus may improve. Sometimes it helps to treat an identified underlying cause such as a hearing loss or TMJ disorder, which a trained audiologist can help identify. Other treatments mask or reduce the noise, which can make tinnitus less intrusive and bothersome.
The Two Types of Tinnitus
There are two types of tinnitus: One type is called subjective tinnitus, which is the type of tinnitus that only can be heard by you. It is the most common form of tinnitus. This may be caused by problems in the inner, middle or outer ear. It may be caused by problems with the part of the brain where the nerve signals are interpreted in the form of sound (auditory pathways) or with the hearing (auditory) nerves themselves.
Objective tinnitus is the type of tinnitus that your doctor is able to hear when she or he performs an examination. It is a non-ringing sound - more typically rushing, clicking, thumping, or other atonal sounds. It is a less common type of tinnitus that might be caused by vascular issues such as turbulent blood flow through blood vessels in the neck or abnormal muscle contractions (activated by grinding your teeth for instance) that compresses some part of the auditory system. This type of tinnitus more often has an identifiable cause and may be treatable.
When you should visit your Audiologist about your Tinnitus
What Causes Tinnitus?
Cell damage within the inner ear hair is one of the most common causes of tinnitus. Delicate, tiny hairs within the inner ear known as the cilia move in relation to sound wave pressure. That triggers cells to release an electrical signal via a nerve in the ear (auditory nerve) over to the brain. Those signals are interpreted by the brain as sound. If the hairs inside of the inner ear are broken or bent, random electrical impulses may be leaked to the brain and cause tinnitus.
Other issues that cause tinnitus include chronic health conditions, other ear problems and conditions or injuries that affect the hearing center inside the brain or the nerves inside the ear. Many health conditions may cause or even worsen tinnitus. An exact cause, in many cases, is never found.
Other Tinnitus Causes
Some other common causes of tinnitus include the following:
Pulsatile Tinnitus and the Link with Blood Vessel Disorders
A blood vessel disorder may cause tinnitus in rare cases. The type of tinnitus is referred to as pulsatile tinnitus. The causes may include the following:
Medications that may cause tinnitus
There are a number of different medications that may worsen or cause tinnitus. In general, the higher the dose of the medication, the worse the tinnitus will become. Frequently, the unwanted noise will disappear once you stop using the drug. Some of the medications that are known to cause or make tinnitus worse include the following:
Also, some herbal supplements may cause tinnitus, as well as caffeine and nicotine.
Anybody may develop tinnitus. However, the following factors can increase your risk:
The Impact of Tinnitus
Tinnitus may have a significant impact on your quality of life. Although it can affect various people in different ways, if you develop tinnitus, you might experience any of the following as well:
Treating those linked conditions might not directly affect tinnitus, but can improve how you feel.
Tinnitus in many cases is caused by something that cannot be prevented. However, there are still precautions that may be taken to help prevent certain types of tinnitus from developing.
What To Do About Your Tinnitus
Tinnitus can be successfully managed and thankfully there are a variety of therapies and tinnitus treatments that you can read about in detail here. These include:
The good news is that there is hope and relief for tinnitus, and research continues to progress. Some exciting research to watch is going on in Ireland at this time, https://www.neuromoddevices.com/.
It's worth mentioning here that Dr. Rohe is currently the only audiologist in the US that is trained and experienced in audiology, Tinnitus Retraining Therapy and Cognitive Behavior Therapy, making him uniquely qualified to address all aspects and options for your tinnitus treatment, whether in his Tempe AZ clinic, or online via Skype conference.
To schedule a consultation, please call the Tinnitus & Hearing Center of Arizona at (480) 831-6159, or use their online scheduler here.
There are several potential drawbacks or risks that come with buying hearing aids online or in a "megamart" store. We get asked if "Costco hearing aids" are any good, and our answer is the same: there are many factors to consider, and your hearing and quality of life are at stake. While we at Tinnitus and Hearing Center of Arizona don't have "cheap hearing aids," we do offer affordable hearing aids from the best brands on the market (in our experience) that have impressive and significant investments in research and leading technologies.
Cheap doesn't always get you what you need
In our opinion, it is best to buy hearing aids from a local provider who will be able to provide ongoing adjustments and service for the lifetime of the hearing aid (normally the purchase price includes this). Free unlimited office visits on the life of the hearing aid are offered by Tinnitus and Hearing Center of Arizona if you purchase the hearing aid from us.
A hearing aid is a type of medical device. There are many reasons why you should not buy one online. You should get tested before you buy hearing aid so that you know what your hearing loss is. Hearing aids are also custom and must be adjusted. If you buy hearing aids online, a majority of medical professionals will not be able to program your hearing aids. It is recommended that you consult with a professional before you make a decision on any of your medical needs, including hearing aids.
The greatest risk, which is something you should be concerned about, is your overall hearing health. Without proper evaluation and testing, you will not know why you have suffered a hearing loss. Without that knowledge, you easily could mask serious problems that could potentially put your health at risk. It could potentially be an undiagnosed medical problem that is causing your hearing loss that could even result in death. Even if you don't have a medical issue that has to be addressed, a hearing aid that is improperly adjusted could damage your auditory system, and lead to even more hearing loss. You should take your hearing aid device purchase very seriously and realize that hearing sciences training is necessary for treating hearing loss properly. I recommend that you find a reputable local audiologist (us, preferably :) ) who can treat your loss properly and who is available for future adjustments and follow-up. When it comes to your hearing health, you definitely get what you pay for.
With hearing aids, it is important to allow your brain to adjust to being able to hear sounds again. If it is the first time you have used hearing aids, be aware that often they will need to be set lower and adjusted several times until you are accustomed to hearing sounds accurately and comfortably according to your preferences (and everyone is different).
You can't just take your hearing aids and be done
It is important to have a good service program with an actual audiologist so that they can be programmed properly for your specific hearing loss, and help you make the adjustments to them. To ensure they are working properly, you need to visit your audiologist regularly for checkups and cleaning. When you purchase hearing aids online or from a supermarket bulk store, chances are you won't be getting service from experts that are necessary when you buy hearing aids.
The following are a couple of "regrets" we hear from customers that bought hearing aids online:
1. Sound is really personal. If you had visited an audiologist instead and gone through the process with them, you might have picked out a different hearing aid than the one you bought online.
2. When you purchase through an internet provider, you can only buy instant fit CRT aids. You might need custom aids or custom tips.
3. Although they might suggest having an audiogram with the hearing aid, what about Real Ear Measurements, over-all levels, feedback, and more? Just sending a hearing aid and audiogram to a patient is not an actual fitting.
It is essential for hearing aids specifically be programmed for the person's individual ear that is based on an audiometric test. Therefore, the first issue is to ensure that the hearing aids are programmed using a current hearing test.
While there are numerous places online that sell hearing aids, some do this without the manufacturer's permission. One manufacturer sent a letter out that stated it wouldn't honor the warranty for any of the hearing aids that were sold through a specific company (second risk).
Although mild hearing losses may be accommodated through an initial fitting, a majority of hearing losses need to be fit by programming the hearing aid below the loss followed by the hearing aid amplification being increased over time (and over several different office visits) as the person's brain continues to accommodate the increased hearing level.
This is not done by online companies themselves. Some contract with a local provider to do the initial fittings and a certain number of follow-up visits. There are other online companies that don't provide any local service.
That leads to the third risk, and it is a major one. Hearing aids all need periodic maintenance and readjustment in order for the patient to get the best results. Even if some initial support is provided by an online company, usually it is not for longer than the first year. You are completely on your own after that and will need to find someone who is willing to work on your hearing aids that they didn't sell to you. That means you will have to pay for each office visit from that point forward. That can cost up to $150 per visit as a single fee and as much as $1,500 to $2,000 for lifetime services. Even warranty-covered repairs require that a licensed dealer send the hearing aid to the manufacturer so it can be refitted. After the hearing aid has been repaired it is then returned, but you will then have another office visit to pay for.
Here are more reasons to avoid cheap hearing aids.
Guest post by Scott Novak - patient of Tinnitus & Hearing Center of Arizona
In Part 1 of this article (found here), I mentioned an elderly couple that I approached on my bike that didn't hear me. As you might have noticed, I theorized several reasons why that man might be resisting getting hearing "assistance." Since then, I started thinking more about the possible association with hearing loss and simply being elderly.
When I turned 42, I noticed my eyesight getting blurry when I would read printed material or the computer. Okay, I thought, I'm probably going to need glasses. There's a certain "resistance versus resignation" to getting older that I think we all struggle with. We can't fight Father Time though, as much as we try. Perhaps admitting to a hearing loss is also admitting to getting older, and even to one's own mortality.
So why not take every opportunity to maximize the enjoyment of every day? Every minute? Why do some people resist going to a hearing doctor (an audiologist) and explore options for hearing aids, but are perfectly fine going to an eye doctor and paying for glasses? We talked about that in the last article, but I wanted to explore the idea of the hearing loss stigma a little more, and found some interesting research.
The Impacts Caused By The Hearing Loss Stigma
Despite how prevalent hearing loss is (around 20 percent of Americans report that they have hearing loss to some degree), the stigma still persists. Whenever people are ashamed of having a hearing loss, they might refuse to acknowledge their problem. There was another study that Southall, Gagne, and Jennings conducted where participants experience a high level of stress when attempting to conceal or deny their hearing loss. Both professionally and personally they were afraid of being labeled and put off going to see an audiologist.
Even after they visit a doctor, an individual may reject hearing aids since they are afraid of looking old, and feeling inferior or ashamed, or view hearing devices as being signs of weakness and being handicapped. Unfortunately, failing to seek treatment may cause long-term effects.
Untreated hearing loss can result in lower signal quality inside of the brain (which can be held to higher cognitive load), behavior changes, social disengagement, changes in the brain's structure, and health problems like anxiety, fatigue, depression, and dementia.
Fighting the Stigma
How can we effectively fight the hearing loss stigma? Education is the key. By educating the public (including individuals with hearing loss) about the various challenges involved with hearing loss as well as the benefits that treatment can provide, empathy can be fostered which can lead to a more positive outlook for hearing health.
Finally, if you are suffering from hearing loss, don't allow the stigma to hold you back. You might feel as if a hearing aid makes you look old, but it actually will help you in many ways in maintaining your youth. After all, young people who have excellent hearing do not continuously ask other individuals to repeat themselves constantly. They don't respond in conversations inappropriately because they are unable to hear the other part of the conversation. They don't disconnect socially because they are struggling to hear the conversation.
These days, hearing aids are very effective and can help you maintain your mental faculties, your social life, and maybe even your career. Modern hearing aids are also very inconspicuous and small, so you won't have to worry that you will stand out in a crowd. If you really want to hide the fact that you are suffering from hearing loss, then check out the discreet styles such as receiver-in-the-ear (RITE) and completely-in-the-canal (CIC) hearing aids. Also, search for a hearing aid that comes with an inconspicuous remote, to allow you to not draw attention to yourself whenever you are wanting to press the program button or change the volume. There are some devices that connect to a smartphone, which makes them technologically savvy and very convenient. Whenever you need to use your hearing aid's control center, it will just look like you are using your cell phone.
Get a dang hearing test already!
If you have been procrastinating having a hearing test, you are not alone. Most people wait, on average, almost seven years from the time when they first notice there is a change in their hearing before they actually seek out help. Seven years worth of strained relationships at work and at home, missing out on so many of the sounds all around you, and risking health problems that are associated with hearing loss.
Keep in mind that it is critically important to treat hearing loss for your future and current health. Rather than hiding your struggles, help to reverse the hearing loss stigma by using hearing devices and helping to encourage other people that you know to go see an audiologist.
I'm so glad that I listened to my wife and scheduled a hearing test with Dr. Allen and Amy Rohe. Not only were they knowledgeable about their craft, but hey were just genuinely kind people, so the hearing test and conversation about options was very casual and friendly. I was able to try a pair of hearing aids for a week or so, and Dr. Rohe actually let me try a few other pairs until I got the set that I loved. Who does that? Having those options and such an enjoyable interaction is plenty to highly recommend Tinnitus & Hearing Center of Arizona.
If it's any consolation, my wife is happier that she doesn't have to repeat herself all the time, and I'm happier knowing that I can hear most any conversation now. And that, to me, is priceless.
If you're interested in hearing aids in Tempe or the surrounding Phoenix metro, it's worth a call to Tinnitus and Hearing Center of Arizona: (480) 831-6159 or use their convenient online scheduler so you can book online and see what times are available.
Tinnitus and Hearing Center of Arizona, LLC
2034 E. Southern Avenue, Suite I
Tempe, AZ 85282
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Dr. Rohe is a nationally-recognized audiologist specializing in Tinnitus Therapy and other hearing conditions.