0:00

This message comes from NPR sponsor Progressive

0:02

Insurance, where drivers who switch could

0:04

save hundreds on car insurance. Get your

0:07

quote at progressive.com today. Progressive

0:09

Casualty Insurance Company and affiliates.

0:12

You're

0:13

listening to Life Kit from

0:15

NPR. Hey,

0:18

everybody. It's Marielle. So

0:21

a couple weeks ago, our producer Margaret Serino

0:24

went to this techno concert with a friend. They

0:27

were pumped.

0:28

So when we got there, we like squeezed all

0:30

the way up to the front, like right next

0:32

to the loudspeakers and stayed there

0:34

the whole time. And my friend

0:37

brought her earplugs and I left mine at home.

0:40

Classic mistake.

0:41

And I was like, oh, this is this will be fine.

0:43

It's like one night.

0:49

She was only there for a few hours, but the whole

0:52

next day, everything sounded muffled.

0:54

If you've ever gone to a concert and

0:56

you come out and maybe your

0:58

ears are ringing or there's

1:01

a muffled feeling, that

1:03

is how hearing loss happens. That's

1:05

Barbara Kelly, executive director of the Hearing

1:08

Loss Association of America. There

1:10

are all these public health messages that we have memorized.

1:13

You know, buckle your seat belts. Wear sunscreen.

1:16

But we don't tend to think about hearing the

1:18

same way.

1:19

At least not yet. Margaret

1:21

took a personal interest in this topic after

1:23

the concert. So on this episode of Life

1:26

Kit, which she reported, what you need to

1:28

know about protecting your ears. She'll

1:30

cover the common questions like what to do

1:32

about earwax, which earplugs work

1:34

best, and what volume is actually

1:36

safe on your phone. And she'll also

1:38

talk about how you can find support if you

1:41

do have hearing loss. A

1:43

quick disclaimer. In this episode, we're

1:45

specifically focusing on mild to

1:47

moderate noise induced hearing loss

1:49

that's caused by repeated noise exposure

1:51

over time. Also, if you'd like a transcript,

1:54

go to our episode page at NPR.org.

2:06

Support for NPR and the following message

2:09

come from Airbnb. Maybe you've stayed

2:11

in an Airbnb before and thought to yourself,

2:13

this actually seems pretty doable. You

2:16

might have set up a home office, and now you're back

2:18

at work. You could Airbnb it and make

2:20

some extra money on the side. Whether you could

2:23

use a little extra money to cover some bills,

2:25

or for something a little more fun, your space

2:27

might be worth more than you think. Find

2:30

out how much at airbnb.com

2:32

slash host.

2:34

This message comes from NPR sponsor

2:36

BetterHelp. Life comes with a lot

2:38

of decisions, and it can be hard to know

2:40

the right path sometimes. A therapist

2:43

can help you map out what you really want,

2:45

so you trust yourself to make great choices

2:47

and feel excited about the future. BetterHelp

2:50

offers convenient, professional online

2:52

therapy on your schedule however you

2:54

want it by phone, chat, or video

2:57

call. Let therapy be your map

2:59

with BetterHelp. Visit betterhelp.com

3:01

slash NPR today to get 10%

3:04

off your first month.

3:08

When Cole Burkhardt was in college, he began

3:10

to notice something that really distressed him. He

3:13

wasn't hearing certain sounds anymore.

3:16

I think the most

3:18

obvious issue was I went home

3:20

to visit my parents and couldn't hear

3:22

my cat purring. Like

3:25

I could feel the rumbles

3:26

of the purr, so I knew it was a thing

3:28

he was doing but just couldn't hear him,

3:32

which was really upsetting. Cole,

3:35

like me, is an audio producer.

3:37

He depends on his hearing to do his job. Sound

3:40

is about 95% of my work. When

3:44

I sound design, it is

3:47

all about

3:49

bringing a scene to life. So

3:52

when he noticed his hearing worsening,

3:54

it felt like

3:57

I had finally found the thing I wanted

3:59

to do.

3:59

and I couldn't do it.

4:04

Cole would go to at least three

4:07

doctors before he finally got

4:09

diagnosed with noise-induced hearing

4:11

loss from a doctor at a military

4:14

hospital.

4:15

Noise-induced hearing loss happens when

4:17

you have constant repeated

4:19

exposure to sounds that are at

4:21

a dangerous level. And according

4:24

to the WHO, nearly 2.5 billion

4:28

people are projected to have some

4:30

degree of hearing loss by the year 2050.

4:34

Barbara Kelly is executive director

4:36

of the Hearing Loss Association of America,

4:39

or HLAA.

4:41

She told me that with our noisy world,

4:43

this is on the rise for all age

4:45

groups. A recent study found that one

4:48

billion

4:50

young people are at risk for noise-induced

4:52

hearing loss. People between the ages

4:54

of 12 and 34. I

4:57

think there's a specific mindset

5:00

of like,

5:01

only older folks suffer

5:03

from hearing loss and not someone who's

5:06

in their early 20s. Eventually,

5:08

Cole found a community of other audio

5:10

producers with hearing loss that really helped

5:12

him out. And he takes extra precautions

5:15

now to protect his ears, which we'll

5:17

get into later in this episode, but he

5:20

says this is something that just needs

5:22

to be on more people's radars.

5:27

Now, hearing loss looks different for

5:29

everyone. It shapes people's auditory

5:32

perceptions of the world in

5:34

infinite ways. But

5:37

to know if you have some level of noise-induced

5:39

hearing loss, there are some

5:41

common symptoms you can watch out for.

5:44

So take away one, pay

5:46

attention to what and how

5:48

you're hearing. Noise-induced

5:51

hearing loss is often something that's gradual,

5:53

so if you're not paying attention, you

5:56

might not notice it at first. And

5:58

how it happens in the first place.

5:59

might not be what you expect.

6:02

So we have tiny hair cells that respond to different

6:04

frequencies, and over time those hair

6:06

cells become damaged. That's Dr. Ariella

6:09

Naeem. She's the senior audiologist

6:11

at Audio Help Hearing Center. I

6:14

actually paid

6:15

a visit to her office in Chelsea.

6:18

Hey. Hi,

6:20

Ariella. Yes, so nice to meet you. She

6:23

told me common misconception,

6:26

noise-induced hearing loss has nothing

6:28

to do with your eardrums bursting

6:31

or anything like that. It's actually

6:33

the hair cells inside your ear

6:35

that matter the most. That's right, the hair

6:38

cells. Because

6:39

each of those little hair cells is

6:41

tuned to convert specific frequencies

6:43

of sound into an electrical signal,

6:46

which your hearing nerve delivers to your

6:48

brain. And if those hair cells are

6:50

damaged over time, you know, by noise

6:52

exposure or one really big,

6:55

sudden noise, they won't transmit

6:56

that sound as well to the

6:58

brain, because at the end of the day, it's

7:01

all about our brain hearing and our brain

7:03

processing what's going on. So

7:05

it's not just about your ability to hear external

7:07

sounds. It's how your brain interprets

7:10

those sounds. When we have hearing

7:12

loss, that becomes harder to filter out

7:14

the speech from the noise, or

7:17

I should put it as the sound source that

7:19

we want to hear versus the sounds that we don't want

7:21

to hear. And since it has to

7:23

do with your brain as much as your ears,

7:25

there are a few

7:28

different ways noise-induced hearing loss might

7:30

affect you. One sign to watch

7:32

out for, if you can't hear your conversation

7:34

with someone over, you know, lots of other

7:36

people talking in the background, another

7:39

sign, if you can hear someone talking,

7:41

but you can't

7:42

understand the words they're saying.

7:46

But one of the most common symptoms

7:48

to pay attention to is tinnitus.

7:51

Yeah, it's pronounced tinnitus, not

7:54

tinnitus. It's a common

7:56

mistake. And it's usually

7:58

defined by a-

7:59

ringing or buzzing or hissing

8:02

in the ears. But it can also manifest

8:04

itself like crickets or

8:07

like my tinnitus sometimes is marching

8:09

bands in my ears. Your tinnitus

8:12

might sound really different than your

8:14

friends or anyone else's because

8:16

it's not caused

8:17

by an external sound.

8:20

There's this one hypothesis that it happens

8:22

when your damaged hair cells just leak

8:25

random electrical signals to your brain

8:28

and it's up to your brain how those signals

8:30

get interpreted as different phantom

8:33

sounds. And the way I compare

8:34

it is what

8:37

happens when you take a big

8:39

speaker and you turn the volume all the

8:42

way up but you're not playing anything.

8:44

What do you hear? Like a... You just

8:46

stat it I guess. Exactly

8:47

like a buzzzzz right? Yeah.

8:50

So in order for the brain to make up for the sounds

8:52

that it's missing it's

8:54

turning on its internal amplifiers

8:57

and then that's what patients hear as tinnitus. And

8:59

the number one cause of tinnitus is

9:02

hearing loss. Besides tinnitus,

9:04

trouble understanding certain words

9:07

or trouble hearing your conversation

9:09

in noisy places, you

9:11

might also experience some sounds as

9:13

muffled and you might even be hypersensitive

9:16

to certain sounds. And all

9:18

of these symptoms are compounded

9:20

if English isn't your first language and

9:23

if numbers, people's names, or

9:25

geographic locations are already

9:27

tricky for you to understand. So

9:30

pay attention to what your ears are

9:32

picking up.

9:33

If you have any of these symptoms just go

9:35

and get your hearing tested. In fact,

9:37

you should get your hearing tested even

9:40

if you have none of these symptoms because

9:42

it's important to establish what your baseline

9:45

level of hearing is. And

9:48

that's takeaway two. Get

9:50

a hearing test. A diagnosis

9:52

can help you manage any potential hearing

9:54

loss. Actually Dr.

9:57

Naeem kindly gave me a hearing

9:59

test. when I went to see her. I

10:01

went to a very loud concert this weekend.

10:04

I was like, oh, right. Well, you're

10:06

here at the right time then. She

10:08

had me sit in this white and black

10:11

isolated sound booth, and then

10:13

she stuck this black tool

10:15

in my ear, kind of like

10:17

what you're used to when you go to see your primary

10:19

care doctor. So the first thing that we do is

10:21

we take a look in your ears just to make sure there's no

10:24

wax that's occluding the ear canal. Then

10:27

we look at the movement of the eardrum.

10:29

That tells us if there's any fluid or congestion

10:31

behind the eardrum, typically

10:34

in the space where ear infections typically

10:36

form. I'm gonna take a quick peek in

10:38

your ears.

10:39

Okay. So Dr.

10:41

Naeem had me put on this pair of headphones

10:44

and listen to a series of beeps at

10:46

different frequencies.

10:47

So we send little signals

10:50

to the hair cells and healthy ones will respond

10:52

back. And then what we

10:55

do is find the thresholds. So

10:57

those are the lowest level that you can detect

10:59

sound across different frequencies or

11:01

pitches.

11:08

Next, she played some words for me, had

11:10

me repeat them back to her. So we hear with

11:13

our brains, not just our ears. And

11:15

when I have you repeat back some words, that's

11:17

actually looking to see if there's any distortion

11:19

set in at the level of the brain.

11:21

Say the word your, say

11:23

the word been, say the word

11:26

way. So the American

11:27

Speech Language Hearing Association

11:30

recommends that if you're 50 or older, you

11:33

should get your hearing

11:34

tested every three years. More

11:36

frequently, if you're exposed to noise a lot

11:38

or have any risk factors. And if

11:41

you're under 50, you should get

11:43

screened once per decade after that

11:45

initial test. But you

11:47

know, if something feels off to you, trust

11:49

your gut. Oh, it looks like I have

11:52

one ear that is worse than the other. No, no,

11:54

no, this is just the movement of the eardrum.

11:56

Okay, cool. My hearing test

11:58

came back within.

11:59

the normal range, but I'll be back in a few

12:02

years for a checkup.

12:04

Barbara from HLAA

12:06

told me that if you're unsure how, you

12:09

can start by asking if your primary

12:11

care doctor can refer you to

12:13

a hearing specialist for a test covered

12:15

by insurance.

12:16

And if your physician doesn't do

12:18

it, you know, there's free

12:20

screenings in, you know, community

12:23

health fairs with the Lions Clubs and Sertoma,

12:26

or now there's apps on the phone that can

12:28

screen your hearing.

12:29

You can also find a test online. You

12:31

could take a test at hearingnumber.org

12:34

and hearing.org, both of which

12:36

are free. Those aren't going to give you as

12:38

much information as like a full

12:40

audiological exam, but they're a

12:43

place to start. And you can

12:45

also get a free hearing aid screening

12:47

at Costco.

12:48

So you've got options, but

12:51

even more importantly, you need to protect

12:53

your ears moving forward. And

12:56

that's takeaway three.

12:58

Reduce your noise exposure and always

13:00

wear protection if you know

13:01

you're going to be at a loud event like a concert.

13:05

Now you could still have hearing loss, even

13:07

if you're not going to concerts or listening

13:09

to your music at full volume,

13:11

you know, through your headphones, but those

13:13

noisy environments are extra damaging.

13:17

Dr. Naeem has this one guideline

13:19

that she likes to give patients. The rule

13:22

of thumb is that when you're listening to a sound

13:24

at what's considered 85 decibels, you

13:26

are safe.

13:27

The American Speech Language

13:29

Hearing Association does note that

13:31

listening to 85 decibels for eight

13:34

hours straight can lead

13:36

to hearing loss though. But when you

13:38

increase that sound by five decibels,

13:41

you have to cut the time in half. So

13:44

city traffic can be around 85 decibels,

13:47

but an approaching subway train

13:49

is a hundred decibels and hearing

13:51

loss is possible after 15

13:54

minutes of that noise. A

13:57

nightclub or a loud bar comes

13:59

in at around 110 decibels

14:02

so that noise can actually damage your hearing

14:04

in less than 5 minutes. Basically

14:08

it's like one big exponential

14:10

curve where the louder the noise,

14:12

the less time you can listen to

14:14

it unprotected.

14:16

But there are steps you can take to minimize

14:18

that risk. Like wearing earplugs.

14:22

Now earplugs won't block out everything

14:24

you hear. They're just a tool

14:27

to take everything down a notch. In

14:29

fact, if you love music and

14:31

you want to preserve how it sounds, you

14:33

can

14:34

even get filtered plugs. Those

14:36

maintain the natural resonance of sound

14:38

and music. Dr. Naeem makes

14:41

custom versions

14:41

of those for her patients who

14:43

are musicians. So it's not like

14:45

you're just blocking everything out. You're still

14:48

able to listen to the sounds

14:50

around you, play your music, get

14:52

the feedback from the audience, but it's still

14:54

protecting what we have. You can also

14:57

find commercially available versions

14:59

as well.

14:59

And while over the earplugs

15:02

are better, those foam ones

15:04

are still much better than nothing. You

15:06

know, the kind that they give out on airplanes.

15:09

Just make sure you put them in properly. You

15:11

roll them really thin into a small,

15:13

small cylinder. Pull your ear back

15:16

and up and then push them in nice and deep

15:18

and let them expand. Besides earplugs,

15:20

the other thing to watch is your phone

15:22

volume. So there's actually no official

15:25

guidance on how loud is

15:27

too loud. But this

15:29

is what Dr. Naeem told me. As

15:31

long as you play your music or podcasts,

15:34

audiobook, anything like that, at 60% of the volume

15:37

bar or less, you would be safe.

15:40

Okay. It's

15:42

time to talk about what you might have been wondering

15:44

about this whole time. Earwax.

15:48

The last component to your ear care

15:50

regimen is cleaning your ears.

15:53

Or I should say not cleaning

15:55

your ears because you don't actually

15:57

need to.

15:58

Take away four. Avoid. Q-tips

16:00

and cleaning unless it's super

16:03

super gentle. There's

16:05

an old adage that nothing smaller

16:08

than your elbow should go inside your ear. That's

16:11

definitely true. Not only because

16:14

Q-tips can actually push earwax

16:16

further in your ear canal, but

16:18

also our ears naturally produce oils

16:20

that help keep it healthy and moist. And

16:23

when you stick a Q-tip in there, you're actually stripping

16:26

those oils that are naturally produced. And

16:29

then that could lead to dry and itchy

16:31

ears. If you're still itching to

16:33

clean them,

16:33

make sure you're doing it lightly

16:36

and carefully. So what

16:38

I do when I, you know, come out

16:40

of the shower, I take a Kleenex or tissue

16:43

and I

16:44

just put it over my pinky and

16:47

gently dry out the outside of the ear. Keep

16:50

in mind wax is actually healthy

16:52

for our ear canals. Keep it in there unless

16:55

it becomes to a point where it builds up so much

16:57

and then just have it removed by a professional.

16:59

Yeah, I think

17:01

it's so funny that like to take care of

17:03

most of our body parts, usually the answer is just

17:05

like let it do its thing. Let

17:07

them do their thing. That's it. That's

17:09

it.

17:09

And if you're wondering

17:12

how much earwax is too much

17:14

earwax, it might be time

17:17

to get your ears cleaned by a professional

17:19

if they feel clogged or

17:21

if sounds are muffled. It

17:23

might also be time if you have any

17:25

irritation or pain in your ear.

17:28

So when you go and get your hearing tested,

17:30

your audiologist can also check your

17:32

earwax. And if you're looking

17:34

to try at home remedies, you know, like

17:36

those earwax candles, save

17:39

your money. Not only do they

17:41

often not work,

17:43

they can also burn your ear canal or eardrum,

17:46

which yikes. But

17:49

if you're part of the large population

17:51

that's already dealing with some level

17:53

of noise-induced hearing loss,

17:54

your regimen might and

17:57

probably will look a little different.

18:00

For example, earwax can definitely be more

18:02

of an issue for people who use hearing aids.

18:04

If you use one, you might feel more comfortable following

18:07

a really light, careful

18:09

cleaning regimen, like the one shared earlier.

18:13

That brings us to take away five. If

18:15

you're dealing with hearing loss, come up with a

18:17

plan with your audiologist. What

18:20

works best for you is going to vary depending

18:22

on your symptoms, lifestyle,

18:24

level of loss, like if you have

18:27

tinnitus or use your hearing for

18:29

work. And

18:30

if you want to do more to treat your hearing loss,

18:33

you have options for assistive technology,

18:36

like hearing aids. There are two main

18:38

categories. There's something that sits

18:40

behind your ear and something that sits inside

18:42

your ear. These options range in how

18:44

visible they are, but they also offer

18:46

different functions. Some hearing

18:48

aids are rechargeable. Some have batteries.

18:51

Some have Bluetooth capabilities or

18:53

are telecoil enabled,

18:55

which means they allow you to pipe audio

18:58

in public places directly into

19:00

your aids. And that can help cut

19:02

back on background noise. Some

19:05

are prescription hearing aids and some

19:07

you can get over the counter. A lot

19:09

of it depends on what you want out

19:11

of your

19:12

aid. Some people

19:14

in their early stages of hearing loss aren't

19:17

ready to wear a hearing aid seven days a week,

19:20

eight hours a day. Some people just

19:22

need a little situational hearing.

19:24

That's Barbara again. She says in that

19:27

case, something over the counter is a

19:29

good first step for you. Something

19:31

to keep in mind, aids can range

19:33

a lot in price. I

19:36

mean, certainly there are sophisticated

19:39

hearing aids that run five, six,

19:41

seven thousand.

19:43

One of the biggest obstacles to treating hearing

19:45

loss is cost and most

19:47

insurance doesn't cover hearing aids.

19:51

If you go the over the counter route, those

19:53

tend to be a bit cheaper. But

19:54

keep in mind, they're only for adults

19:57

with self perceived mild

19:59

to moderate. hearing loss. But

20:02

Barbara says don't be afraid to try

20:04

out a few and figure out which one works best

20:06

for you. After all, it

20:08

takes time for your brain to adapt

20:10

to them. You don't just put a hearing aid

20:13

in your ear and immediately

20:16

hear. You know like a pair of glasses

20:18

usually we put on a pair of glasses and it corrects

20:20

our vision. We can see pretty well but if you

20:23

put in a pair of hearing aids our auditory

20:26

system has to adapt. And also

20:28

adjusting to the change

20:29

of using hearing aids can

20:32

vary. You know it depends on the severity

20:34

of your hearing loss, the quality of the aids,

20:37

and what situations you're using

20:39

them in. So definitely ask about

20:41

a trial period when you're buying one.

20:44

There are also a lot of people who are

20:46

hard of hearing and choose not

20:48

to use hearing aids because of cost,

20:51

stigma, ageism, tons

20:53

of factors.

20:54

Cole, who we heard from before and whose

20:57

job revolves around his hearing, decided

21:00

against hearing aids for the time being. I'm a

21:02

broke college student at the moment

21:03

and don't have the money to buy hearing aids.

21:06

I will just continue to try and take care

21:08

of my ears and hope

21:11

for the best. He makes

21:13

sure to take breaks when he starts to feel

21:15

listening fatigue or ear pain. He

21:18

schedules his heavier sound design projects

21:20

to allow for that. I've normally spaced

21:22

things out enough that I can go and do that kind

21:24

of thing without then having to go right back to

21:27

work.

21:27

That strategy works well for him

21:30

but if you're

21:30

interested in hearing aids, weigh your

21:33

options, consider what your budget is, and

21:35

consult an audiologist. You

21:38

can also look into getting financial help. For

21:40

example, depending on your

21:41

age or income, some Medicaid

21:43

programs cover aids and you can

21:45

find a full list of financial assistance

21:48

options at hearingloss.org.

21:51

You can also find other info there like about

21:53

working accommodations and if

21:55

you have broader questions about navigating

21:58

jobs, career, anything else. it

22:00

might help to consult others with

22:02

similar experiences. That

22:04

helped Cole navigate his career

22:06

in audio. So another audio

22:09

producer, Caroline Minx, they reached out

22:11

to him to collab on a fiction podcast

22:13

called Scene and Not Heard,

22:15

which explores lay-onset deafness. Through

22:19

Caroline and their podcast, Cole

22:21

said he got to see other producers who are deaf

22:23

and hard of hearing doing the things

22:25

that I was doing, and honestly

22:29

doing it better. Cole says that now,

22:31

when he's making things, he has this whole

22:34

community of other creators supporting

22:36

him, and making his work even

22:39

stronger. I don't know about other people,

22:41

but when I am creating, I

22:44

will put parts of myself into that, sometimes

22:46

that is dealing with disability.

22:51

And even if it's not central

22:53

to the overall theme, you'll still

22:55

see bits and pieces of me in

22:59

everything I do.

23:07

Okay, it's time for a recap.

23:11

Pay attention to how you hear the sounds around

23:13

you, and notice if you're having any

23:15

symptoms of noise-induced hearing loss.

23:18

Get your hearing tested no matter

23:20

how old you are.

23:22

Reduce your noise exposure. So

23:25

wear earplugs at loud events, and

23:27

keep your phone volume at a reasonable

23:29

level.

23:30

Clean your ears safely,

23:33

or better yet, just let

23:35

them clean themselves. And

23:37

if you're dealing with noise-induced hearing loss,

23:40

go to an audiologist or an ENT doctor

23:43

and come up with a plan.

23:44

You can also look into hearing aids and other

23:46

assistive technology.

23:59

down your medical bills. You can

24:02

find those at npr.org slash lifekit.

24:04

And if you love life kit and want even

24:07

more, subscribe to our newsletter at npr.org

24:10

slash lifekit newsletter. This

24:12

episode of Life Kit was produced by Margaret and

24:14

Malia Agudelo and edited by

24:16

Sylvie Douglas. Our visuals

24:18

editor is Beck Harlan and our visual producer

24:21

is Kaz Fantoni. Our digital editors

24:23

are Mollica Greave and Claire Marie Schneider.

24:26

Megan Kane is our supervising editor and Beth

24:28

Donovan is our executive producer.

24:29

Our production team also

24:32

includes Andy Tegel, Audrey Nguyen,

24:34

and Thomas Liu. Engineering support

24:36

comes from Hannah Glovna, Valentino

24:38

Rodriguez Sanchez, and Josh Newell.

24:41

Sensitivity readings from Emily Abshire

24:44

and Laura Soto Barra. I'm

24:46

Mariel Cigarra.

24:47

Thanks for listening.

24:58

you