A physician attending a recent seminar asks an
important question about their patients who wear
hearing aids. Reader inquiries may be directed to
digicarenet@aol.com or by faxing to (719)676-6882.
Replies are for educational purposes only, and are
not to be construed as medical advice or opinion.
Q: As a geriatrician I’ve noticed that some of my
hearing impaired patients can still hear reasonably
well for about a half-hour after removing their
hearing aids. How is this possible? --- Dr. K.O.
Dear Dr. K.O.: Though you and I talked about this in
a recent seminar, I thought I’d introduce our
readers to concepts in regards to the plasticity of
the human brain and its role in rehabilitation.
When one’s hearing deteriorates, for a period of
time they will usually compensate for the loss
rather well, through subconscious speechreading,
context, and phoneme substitution. Over time,
though, when the compensation begins to add stress
to one’s life, deep-seated emotional and
psychosocial responses set in to the point that most
observers begin thinking of the impaired individual
as “aloof”, “not all there”, “not paying attention”.
By the time a progressive hearing loss has
deteriorated to the point of affecting personal
relationships, speech discrimination ability
plummets and social isolation set in. In this case,
a slight decline in thresholds can make one appear
to go from “hearing” to “not hearing” almost
overnight.
Conversely, when everyone decides the patient is
really a good guy with a bad hearing loss, the first
obstacle they bump into is Phonemic Regression. This
central auditory condition is exposed upon wearing
hearing aids for the first time, so that even with
appropriate amplification the patient may still have
tremendous difficulty understanding speech for a
time.
The rehabilitative timeline to overcome this delay
usually lasts about 90-120 days of continuous
hearing aid use before the neurological system of
the brain “relearns” forgotten sounds of speech.
This requires patience and understanding on
everyone’s part.
But let’s say the patient has finally acclimated to
their hearing aids, resuming a more communicative
lifestyle. Now the portion of the brain dedicated to
the sense of hearing and communication is able to
process sound closer to the “normal” format.
So that when they take their hearing aids off for a
short period of time they enjoy the ability to again
compensate somewhat for the momentary loss of
hearing. That is because the “memory” of sound and
utilization of acoustic clues is still fresh and
stimulated.
But should our hypothetical patient only wear their
hearing aids on Sundays, for instance, they surely
continue to suffer from Phonemic Regression,
preventing their neurological system from ever
adapting to the world of sound.
Using myself as an example to the extreme, I am
bilaterally and profoundly deaf. But with my
cochlear implant of 10 years, people tend to think
of me as relatively “normal” in speech and social
interaction.
Should I remove my implant speech processor for,
say, two weeks’ time, my speech will soon
deteriorate into “deaf speech” and everyday social
situations will become unbearable.
Time and the deprived ear can work havoc on one’s
happiness and social well-being in ways few can
imagine. Likewise, time and appropriate hearing
correction can restore life and enjoyment in ways
one would least expect until they get it all back
again.
Questions may be directed to www.digicare.org or
faxed to (719) 676-6882. Due to space limitations,
questions may be edited. |
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