The jury is still out about the use of electronic nicotine delivery systems. Their manufacturers have proposed them as a “safe” alternative to tobacco smoke. But are they? A recent review of the scientific and medical literature on the subject (Palazzolo DL (2013) Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review. Front. Public Health 1:56. doi: 10.3389/fpubh.2013.00056) didn’t reveal much. There is no evidence yet of harm reduction. There definitely is no sign that they decrease cigarette smoking or increase quit rates.
We don’t even know what happens to the lungs when this vapor is inhaled. Do the flavorings cause harm, or not? What is the level of inhaled nicotine relative to cigarettes? Is second hand vapor better or worse than second hand smoke? All of these questions remain to be answered. And likely over time they will be.
I hope that vaping does turn out to be a safe alternative to tobacco smoking. But, in the long run, neither is your best bet. As hard as it may be to quit, your life and health improve in the absence of nicotine.
Mark T. Brown, MD, FACS
Image from Alice's Adventures in Wonderland by Lewis Carroll (1869)
Q Tips are bad!
Somebody finally confirmed what ENT’s and audiologists have been telling you all along. Quit cleaning your ears. That wax is not “dirty” but is important to your ear canal skin. It helps the ear canal stay healthy, repels bacterial invaders, and filters our dust and dirt that might otherwise get stuck in there. I know, it feels REALLY good. But you are more likely to cause a problem than solve one with a Q-Tip (apologies to Johnson and Johnson).
Check out the USA Today article here. http://www.usatoday.com/story/news/nation/2017/01/05/now-hear-stop-cleaning-your-ears/96193598/
Mark Brown, MD, FACS
In October 2015, PCAST (President’s Council of Advisors on Science and Technology) delivered a letter report to the President detailing hearing loss, implications should it go untreated, the current hearing aid “market,” and recommendations to increase accessibility of amplification. While I could talk for 18 years about the implications hearing loss has on a patient the longer it is not addressed (increased fall risk, increased risk for developing dementia, withdrawal from social interactions… I mean, the list goes on), that’s for another day. It is within the recommendations made in this letter that a serious problem arises: PCAST wants to treat hearing aids like a commodity, a cute pair of shoes you can purchase and wear without any further thought behind it.
(Obtained from: http://www.thebrainydeafsite.com/p3.html)
NEWSFLASH: HEARING AIDS ARE NOT GLASSES FOR YOUR EARS!
Hearing aids do not treat hearing loss in the linear way that eyeglasses address vision impairment. Rather than presenting hearing aids as something we can window shop for, we should be calling for them to be seen as a medical solution! Hearing aids ARE treatment options for those suffering from hearing loss-a medical condition that varies between individuals. They ARE NOT an over-the-counter remedy that works universally.
PCAST’s first recommendation within the aforementioned letter presents the idea that hearing aids for mild to moderate hearing loss should be approved by the FDA for sale over-the-counter WITHOUT a single evaluation performed by or consultation with an audiologist or hearing aid dispenser. Imagine self-deciding that you need to wear a full mask CPAP machine every night for the rest of your life without undergoing a sleep study or a consultation with a board certified sleep medicine doctor? You wouldn’t! Or I hope you wouldn’t…
Additionally, PCAST calls for audiologists and hearing aid dispensers to provide a simple programmable profile based on a diagnostic hearing evaluation for such OTC hearing aids. Here’s an example that highlights the most glaring issue here: 3 people may present with the exact same audiogram, but process sound inputs completely differently. Picture these 3 individuals with the same allergy to mold and oak (hello springtime in Central Texas!)-the treatment of each person will vary based on patient need. A single dose of Flonase in the morning may offer relief to one patient and have zero effect on another. Hearing aids are extraordinarily similar: one manufacturer with one prescribed programming strategy will not work for all patients.
Hearing aids are therapy tools-treatment devices that should be adjusted based on patient need. Success with amplification requires an honest relationship between patient and provider. An audiologist is not a shoe salesman! We don’t help you pick out the pair you like and send you on your way, never to be heard from again. It’s an ongoing relationship to ensure proper treatment of a patient’s hearing loss and improvement in quality of life. For that, don’t expect some OTC device to provide the same level of success. Don’t go see a dentist for Lasik eye surgery. Don’t trust your auto mechanic to manage your banking portfolio. See an audiologist to improve your hearing health. Demand better.
New Hearing Aids: The Top 10 Things To Expect After Leaving the Office
â€‹ Every day I am blessed with the ability to help the people of Austin and the surrounding areas rejoin their families and lives by helping them hear again. This may sound routine and mundane, but it is not. It is estimated that a person will make the decision to seek help for a significant hearing loss 7 years after it is first noted or is diagnosed as an aidable condition. After years of living and coping with hearing loss, your brain may freak out over some "normal, every day" sounds."
Here are the Top 10 things you need to be aware of after you leave my office with new hearing aids:
- Your Clothes rustle when you move, kinda like a grocery bag
- Your voice is going to sound different, louder kinda "boomy"
- Birds chirp, probably a lot more than you remember
- Your stomach growls... a lot
- There will be a sound if you scratch your head or touch your hair
- The refrigerator and icemaker may sound like someone breaking into your home. And for that matter the air conditioner might sound the same.
- Footsteps make a noise, if you have hardwood be prepared
- Chewing food, notably cereal and ice, is loud. Breaking teeth loud.
- Running water in the sink will seem LOUD
- Flushing a toilet sounds like your roof is being torn off!!
â€‹There are others of course, everything from the kitchen timer sounds different to the sound a car makes when you lock it not being what you are used to. The key thing to remember is:
Everything mentioned above is temporary, I can not stress that enough.
You have spent years acumulating your hearing loss, it will take a few weeks for your brain to accept that there is a new signal and that you aren't in danger from being eaten by a bear. Be kind to yourself, know that you will need to identify some sounds in your environment and that this is a learning process for you and your brain.
For more blog posts on hearing loss:
Paige Peterson AuD, PhD, CCC-A, FAAA, ABA
Dr. Paige Peterson is an Audiologist at Great Hills ENT in Austin, TX and specializes in hearing related disorders including tinnitus and hearing loss, neurophysiological disorders as well as dizziness/balance disorders. Dr. Peterson is Board Certified in Audiology and is currently accepting new adult and pediatric audiology patients. Great Hills ENT serves the greater Austin area including the Arboretum, Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, hearing aids, dizziness/vertigo and sleep disorders.
For years I have recommended that those with diabetes have an annual hearing test to accompany their yearly eye exam and physical.
The National Institute of Health (NIH) has found that hearing loss is twice as common in people with diabetes as it is in those who don’t have the disease. Also, of the 79 million adults thought to have pre-diabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar.
How does diabetes contribute to hearing loss?
Hearing depends on small blood vessels and nerves in the inner ear. Researchers believe that, over time, high blood glucose levels can damage these vessels and nerves, diminishing the ability to hear. Specifically, that hearing impairment in the low/mid- and high-frequency range to be associated with low HDL and coronary heart disease history, respectively. The current theory is that hearing loss accompanies an atherosclerotic mechanism affecting the inner ear.
Hearing loss due to diabetes is typically a high frequency sensorineural (nerve) hearing loss which can be treated successfully with hearing aids. The earlier a hearing loss is diagnosed the earlier it can be treated.
Studies have shown that untreated hearing loss can have a negative impact on quality of life. Thus for diabetics, the sooner the hearing loss is treated the better. It is also recommended that those with diabetes have an annual hearing test to accompany their yearly eye exam and physical.
If you or a loved one has diabetes and have not had a hearing test, make an appointment today.
Dr. Paige Peterson is an Audiologist at Great Hills ENT in Austin, TX and specializes in hearing related disorders including tinnitus and hearing loss, neurophysiological disorders as well as dizziness/balance disorders. Dr. Peterson is Board Certified in Audiology and is currently accepting new adult and pediatric audiology patients. Great Hills ENT serves the greater Austin area including Georgetown, Cedar Park, Lago Vista, Jonestown, Steiner Ranch, Lakeway, Spicewood and Point Venture. We are proud to provide excellent care to our patients for general Ear, Nose and Throat (ENT) services, hearing loss, hearing aids, dizziness/vertigo and sleep disorders.
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