I'm 45 years old, I'm too young to have a (mild) hearing loss.

Updated: May 29, 2019

"You have a mild hearing loss" is a misleading sentence.

Mild as defined by the oxford dictionary states not severe, serious or harsh and in medical terms it implies gentle in nature or behaviour; has a mild disposition or moderate in action or effect; a mild sedative.

Mild is a misleading word.

Mild means different things to different people and when a health professional uses it to describe your hearing loss, it is merely a categorisation, rather than a definitive answer, to your hearing concerns. For example, a mild Thai green curry may seem wildly hot to one, yet easy to palate to another. Similarly, a mild hearing loss to one may have little impact on their communication needs, compared to another who has a list of issues hearing and communicating.

Conversations and the brain
Missing some of the conversation? Time to find out if your hearing is involved.

Behavioural symptoms of hearing loss or hearing issues:

> Asking for repeats

> Volume of TV or radio progressively being turned up

> Communication behaviours are different, for example numerous repeats are needed to get the question answered compared to a few months or years ago, when you could ask the question once and your partner would answer

> Lack of active/passive engagement at home or at social events

> Lack of clarity in your own speech

> Reduced confidence through mishearing or misinterpreting words or questions

> Exhaustion from asking for repeats

> Reduced cognitive function, meaning the brain has to work harder to fill in gaps leaving you more fatigued at the end of the day

> Beginnings of social withdrawal, using your hearing loss to stop going to social functions for fear of misinterpreting the words or missing the punch line

> Change in the clarity of your speech (you speak the way you hear and if you can't hear your speech because of hearing loss, this changes the clarity of your words)

Is a mild hearing loss really that bad?

A mild untreated hearing loss has implications on your quality of life when not addressed in the earlier stages. Research shows that untreated mild hearing loss impacts on cognitive load or how the brain distributes its energy and resources (2019). A person with a mild hearing loss needs to use more brain power to bridge the gaps and fill in the circles of conversation compared to someone with normal hearing. I am not saying that normal hearing individuals don't have issues with speech in noise, because I can anecdotally confirm they report this clinically, but that's an article for another time.

What I am stressing is you shouldn't ignore a mild hearing loss, especially if you report complaints or changes in your behaviour.

Further to the social-emotional behavioural changes that occur, physiologically a remapping of neural pathways in the auditory system of the brain occurs. As neuro-plasticity (how the brain changes) changes over the life time, proactively managing risk factors is a smart way to reduce the changes. As a loose comparison, it's like having a sport injury or niggle and not giving your body the appropriate rehabilitation to allow for full function again. This injury can result in larger problems down the track, which is similar to a mild hearing loss. Unlike a sports injury, hearing loss and the brain can never go back to hearing and listening like you did when you were in your twenties.

Audiograms are a useful tool when used with other measurements and discussions to understand individual hearing and listening needs. An audiogram or hearing test typically measures the softest sounds an individual can hear across the speech frequency range (250 Hz to 8k Hz is a standard measurement for most hearing clinics). A mild hearing loss is often defined as a 25dB to 40dB HL thresholds on an audiogram, as per the World Health Organisation standards. In isolation, the audiogram is merely a graph that represents the softest sounds you can hear at the time of assessment across a set of most of the speech frequencies.

It's important to have a baseline hearing test, if issues arise an audiologist or Ear, Nose and Throat specialist can refer back to your initial results, allowing for a better picture of your hearing health.

I recommend getting a hearing test at age 45-50, unless there are hearing concerns prior to this.

Getting a hearing test at age 45-50 should be thought of as part of a healthy overall check, as part of the blood pressure, eyes, heart, prostate or breast check up. These are standard healthcare checks and hearing needs to be included, especially if you work with/in or around noise (E.G Musician, Dj, boiler maker, machine operator, dentist). Further, this baseline gives you something to work with; a noticeable hearing loss to manage or peace of mind for hearing protection. As we understand the intricacies and co-morbities of the ear and hearing loss more and more, individuals, healthcare professionals and the medical community are beginning to understand the value of a full audiological assessment with an audiologist.

Hearing loss is invisible and it's usually the significant other, family or friends that notice your hearing loss behaviours first.

You request repeats, the volume of the TV or radio goes up and you miss the punch line. You say 'Huh?' a lot and look absent from the conversations. I see it a lot in clinic and real life where those with hearing loss blame others for their miscommunications. For example, they mumble, they didn't get my attention first, they looked the other way or they don't articulate their words well. One family member of mine pretends to hear what has been said and has been increasingly, incorrectly answering the questions. When they are met with a puzzled look they simply laugh the situation off or ignore the person.

I still find the behaviours and attitudes towards hearing loss and the use of hearing aids unusual.

A large misunderstanding when it comes to hearing loss is that turning up the volume will give you clarity.

Loudness does not equate to clarity, that's just not how the intricacies of the inner ear or hearing works, nor how the brain processes the information it is receiving.

Think of it like this. If you have a mild visual deficit in both of your eyes and you don't get help to fix it, your brain starts to misinterpret the image. The brain can cope, however the image is not clear, you use more energy to get clarity and it becomes frustrating and tiring. You squint more and your eyes hurt or are fatigued at the end of the day. Most people would proactively manage this visual deficit. Hearing loss is more difficult because you can't immediately hear the deficit, we don't know what we don't hear. Until it's too late when we can't cope.

The value of a hearing check goes beyond the results of the test.

With the help of an audiologist or hearing healthcare professional the results of a hearing check are a tool that can help improve the quality of life you have to the ones around you. We've all got ears and it's important to change our attitudes and the culture towards hearing loss and hearing technologies. As we become a more connected world, ears and hearing aids are going to be able to do a lot more and should be viewed as hearing technologies, at a medical grade level.

Got questions about your hearing, hearing loss or tinnitus? Shoot over to the main page and book an online consult. Getting answers or reassurance from an earlier age is the start to managing your hearing healthcare.

Cheers 2 ears, Kat Penno

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