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April 26, 2018

Seeing Your Hearing Loss is Believing

I recently went in for my semi-annual dental appointment and found that a cavity was growing under a current filling. Turns out, I clench my teeth when I sleep so my tooth wore a hole into the filling which resulted in this new cavity. My dentist is this charismatic guy who believes in being transparent so after removing the old filling he gave me a mirror, so I could see the cavity for myself. I thought this was fascinating and it made me wish I could do the same for my clients.  Wouldn’t it be great if I could hold a mirror up to someone’s ear and say “See there’s your hearing loss”? How much easier would it be for everyone if that were possible. Of course, that is not possible but as I lay there with my mouth half numb I came up with another way of showing you what hearing loss would look like.

All the sounds we make in the English language occur between the frequencies of 250Hz and 8000Hz. And the volume when speaking at normal conversational level varies from 15dB to 50dB depending on the sound that is made. Typically, when someone begins to lose their hearing it occurs first in the high frequencies. So, someone with beginning stages of hearing loss or the equivalent of a very mild high frequency hearing loss between 4kHz and 8kHz would miss only a few voiceless consonants such as f, s, and th.

Seeing is Believing

To help me show you what this hearing loss would look or sound like imagine your family is watching TV and Rocky Balboa is talking to his son. The family member with a very mild high frequency hearing loss would hear this:

“Let me tell you _ome_ing you already know. __e world ain’t all _unshine and rainbow_. It’_ a very mean and na_ty pla_e and I don’t care how tou__ you are it will beat you to your knee_ and keep you __ere permanently i_ you let it.

Not too bad right. I’m sure most of you could fill in the sounds missing just based on context. If not, the translation is: “Let me tell you something you already know. The world ain’t all sunshine and rainbows. It’s a very mean and nasty place and I don’t care how tough you are it will beat you to your knees and keep you there permanently if you let it.”

Now imagine that this hearing loss progresses a little more starting just one frequency sooner at 2kHz. This slight change now affects the sounds above (f, s, and th) as well as t, and k. Here’s how that would sound:

You, me, or nobody i_ gonna hi_ a_ hard a_ li_e. Bu_ i_ ain’_ abou_ how hard ya hi_. I_’_ abou_ how hard you _an ge_ hi_ and _eep moving _orward.

Surprising how losing hearing in one more frequency or struggling with just 2 more sounds can make such a big difference. Even though this person is hearing some words without difficulty other words are almost completely lost. This is the person who would start to turn up the television or if it was a face to face conversation they might accuse the speaker of mumbling. Of course, Rocky was not mumbling as those family members with normal hearing would have heard this: “You, me, or nobody is gonna hit as hard as life. But it ain’t about how hard ya hit. It’s about how hard you can get hit and keep moving forward. How much you can take and keep moving forward.”

So, what if we add in one more frequency and make the loss 1-8kHz, which is a very common loss I see on first time hearing instrument users. Adding in 1kHz means that the hearing loss is now also affecting the mid-frequencies. Which if it is mild means we also loose p, h, and g. What does that sound like?

_ow much you _an _a_e and _ee_ moving _orward. __a_’_ _ow _innin_ i_ done! Now i_ you know __a_ you’re _or__ __en go ou_ and ge_ __a_ you’re _or__.

Need the translation this time? Here it is: “How much you can take and keep moving forward. That’s how winning is done! Now if you know what you’re worth then go out and get what you’re worth.”

As you can see the mid frequencies have a huge affect on how we hear. If that loss progresses just 10dB more putting it at a moderate loss you would also drop the ch and sh sounds which results in something along these lines:

Bu_ ya _o__a be _illin_ _o _a_e __e _i__, and no_ _oin_in_ _in_er_ _ayin_ you ain’_ __ere you _anna be be_au_e o_ _im, or _er, or anybody! _oward_ do __a_ and __a_ ain’_ you! You’re be__er __an __a_!

Unless you have this movie memorized I’m sure you will need the translation: “But ya gotta be willing to take the hits, and not pointing fingers saying you ain’t where you wanna be because of him, or her, or anybody! Cowards do that and that ain’t you! You’re better than that!”

Now remember all the above excerpts assumed the listener had normal low frequency hearing. The loss was only affecting the mid to high frequencies. A loss that starts in the low frequencies as mild gradually sloping to moderate in the highs would mean that sounds like v, z, w and possibly j would also be affected. Which makes hearing even more difficulty or similar to this:

I’m al_ay_ _onna lo_e _ou no ma__er __a_. No ma__er __a_ _a__en_. _ou’re my _on and _ou’re my blood. _ou’re the be__ __in_ in my li_e. Bu_ un_il _ou __ar_ belie_in_ in _our_el_, ya ain’_ _onna _a_e a li_e.“

Certainly, doesn’t sound like something I would want to sit around listening to. At least not without a hearing instrument or closed captioning. Which if this person had a hearing instrument they would have heard this: “I’m always gonna love you no matter what. No matter what happens. You’re my son and you’re my blood. You’re the best thing in my life. But until you start believing in yourself, ya ain’t gonna have a life.”

The Speech Banana

I could keep going and progressing the hearing loss, but I think you’ve got the idea. I use this type of “mirror” with all my client’s by superimposing their audiogram results on a speech banana; which is a graph showing all the sounds in the English language at a normal conversational level. This might not be as transparent as a physical mirror, but it is a great way to help them visualize the effects of their hearing loss and what exactly a hearing instrument will be helping. Curious to see what sounds you or your significant other might be missing? Call me. Mention this blog and receive $100 off your initial consult.