How To Prevent Hearing Loss

Hey, it's Anna and Mandy from our podcast Sisters in the City and we're currently sponsored by the Department for Work and Pensions. Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP, otherwise you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work-related costs. Or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. Tired of thee? I know it's here somewhere. Moment. The new ScanSnap IX 2400 scanner means you'll never search for a receipt again. Our simplest ScanSnap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one-touch scanning, 45 pages per minute speed, and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more missed expense claims or lost warranties. Just peace of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit ScanSnapit.com slash podcast and discover how simple document management can be. ScanSnap. The smarter way to work. Here's the new Citroen C3 Aircross. The perfect SUV for bears and lovers of the great outdoors. Sure, and comfort too. Inside it easily goes from five to seven seats and for you cubs, look it's got Apple CarPlay and your favorite apps. Yes, Mr Grizzly available in petrol, full electric or hybrid. So ready for a family adventure? The new Citroen C3 Aircross for lovers of the wilderness and everyday comfort. Now with a 1500 pounds electric car grant. Hi, I'm Raj Panjabi Johnson, Head of Identity Content at HuffPost. And I'm Noah Michelson, Head of HuffPost Personal. Welcome to Am I Doing It Wrong, the show that explores the all-too-human anxieties we have about trying to get our lives right. All right Raj, so have you been preventing hearing loss wrong? You know, I'm pretty sure I've been doing it wrong because I haven't thought much about that. But when we decided to do this episode on hearing loss, I realized that I listened to music really loud, you know, in my apartment and on my headphones. Like just jacking the volume up and really enjoying myself. It sounds so good. It sounds amazing to hear everything really crisply and now I'm like, uh-oh. Like am I putting myself in danger? Am I already experiencing a little bit of hearing loss? So yeah, I need to know some things about you. I have some friends and family who recently have been diagnosed with some hearing loss. I didn't really think about it before that. And now, same thing, I'm kind of like, huh, should I be worried? Yeah, I mean, add it to the bundle of things we're worried about. Oh wait. So I have some questions and luckily we have Dr. Craig Casper. He's an audiologist who founded New York Hearing Doctors and he's been working in hearing health care for almost 30 years. Let's get it Dr. Craig. Craig, welcome. Thanks for being here. I appreciate it. This is awesome. To start, let's just get right to it. Why does hearing loss happen? Is it always something a response to external conditions or can it be genetic? Can it be other things? Give us the lay of the land. So when it comes to hearing loss, there's a number of different factors that we have to take into consideration. The first is genetics. Genetics play a role in everything from a health perspective for us. So it's really hard for us to kind of just forget about the genetic part of the equation. We know that there's babies that are born with severe profound hearing loss and that's a direct result of some sort of a genetic mutation abnormality. For all of us that plays a role, there's no doubt. But there's so many other things that can contribute to hearing loss, things like noise exposure, which is really the number one preventable cause of hearing loss. So power tools, concerts, motorcycles, even questionable, I'm sure we'll get into the concept of a noisy city in terms of what that does for our hearing as well. But noise exposure, number one preventable cause of hearing loss. Then we have medications that play a role as well. Most medications are fine, but there are certain medications that can cause some damage to our hearing system. On the very extreme end, some of the chemotherapeutic drugs for cancer are known to be what's called ototoxic, which ototoxic just means toxic to your ears. High doses of aspirin can actually cause hearing loss as well. Certain drugs, and we won't see it that much in a place like New York, but malaria drugs like quinine can cause hearing loss as well. So we have to be mindful of the medications that we're taking. Chronic illnesses such as high blood pressure, high cholesterol, diabetes, put us at a higher risk for hearing loss versus our non-diabetic and non-hypertensive peers. Okay. So that's something to keep in mind as well. And then there's the elements of kind of things that we're exposed to in our environment, perhaps even occupational things. Certain solvents can cause hearing loss as well. Right, I was reading about that. Yeah. Wait, can you tell me a little more about that? Like just things we used to clean the house? I wouldn't be too concerned about that necessarily, but there are studies if you take a look at people who work in paint factories. Okay, so like heavy exposure. Exactly. So all of these things come together. So general health related things as well as external environmental factors, as well as genetics, they all kind of interplay to lead to potential for hearing loss. Okay, this is a very dumb question to follow up, but what is actually happening when we have hearing loss? Is there a part of our ear that is actually being damaged? Peeling off. Yeah. Or is it something else? Like I'm trying to visualize what's actually happening. That's not a dumb question. It's a great question. I think it's a great question because anatomy can kind of be fuzzy for a lot of us, right? So when it comes to the hearing structure, there's actually a series of different parts that work together in order for us to actually hear sound. So the first part is the obvious. We see this thing on the side of our head. This is basically just a funnel that collects sound from the environment and it funnels it down to the ear canal. So when you hit the ear canal, that's the first place where hearing loss might actually occur. And the reason is if you have a complete blockage of earwax, which serves like an earplug, that can cause some hearing loss. Now the good thing with wax blockage or cerumen as it's medically called, that can be removed. That's easy stuff to fix. Go a little further down the ear canal. At the very end of the ear canal, you have the eardrum, which is essentially just three layers of skin. That just vibrates back and forth when the sound waves bounce on the eardrum. Anything that would prevent the eardrum from moving, whether it's scar tissue or behind the eardrum, we have what's called the middle ear space. We'll talk a little bit about this in a second because I'm sure you'll actually, we can talk about it now. So if you come down in an airplane and your ears are clogged, right? Right. And then you chew gum or you yawn and you pop your ears. There's a little tube that goes from the back of your nose to the middle ear, that place right behind the eardrum that's called the Eustachian tube. The purpose of that tube is just to equalize pressure on both sides of the eardrum. So if you have sinus problems, allergies, a cold, that Eustachian tube might not function properly, cause some blockage, you can get some congestion behind the eardrum. That can result in some hearing loss, again, temporary. Okay. There's the three smallest bones in the body that are found in that space also. The hammer, the anvil, the stirrup you might have learned in school years ago. Or the operation game I'm thinking of. It's perfect. We have to remove, yeah. Those are the worst bones because they're the smallest. Right. So if there's a problem with those bones, that can cause a hearing loss as well. Now, everything that I just described typically results in what's called a conductive hearing loss. That's just a type of hearing loss, which means there is a problem with the conduction of sound through a part of the system. It's usually mechanical. Right. All of those things, for the most part, medically treatable. That only represents about 95% of hearing loss that we see though. The third part of the ear looks like a snail. It's called the cochlea or the inner ear. It's basically the size of a green pea. And it's a pretty remarkable thing because inside the cochlea, you have tens of thousands of these microscopic hair cells. Those hair cells ultimately are connected to nerves that send the information to the brain. But what happens for all of us is those hair cells over time become damaged. Again, direct result of noise exposure, genetics, all the things we kind of pointed. Medications, high fevers, cholesterol, viruses. COVID's been a big thing in recent years. Yeah. We've seen a lot of COVID related hearing loss. And if the hair cells are damaged, there's no mechanism to pick up the sound and then transmit it through the nerve up to the hearing parts of the brain. That's where we actually hear sound. So if I touch a hot stove, right, the finger feels the pain. Not really. It's actually that part of my brain that feels the pain. If I'm looking at a beautiful sunset, the eyes pick up the information transmitted to the visual centers of the brain. All of the things I just described from an ear perspective just transmit the information to the hearing parts of the brain. That's where we actually hear sound. So the part with the hair cells, the nerve, the brain, if there's an issue along that part of the system, that results in what's called a sensory neural hearing loss. Sensory the hair cells, neural the nerve. That's not something that's typically medically treatable. And that's what affects about 95% of us as we go through life. Usually gradually over time, sometimes suddenly if there's an insult of some sort. Right. You can't do it like a transplant of those hairs, obviously. Once they're damaged, they're damaged. Yeah. There's definitely no real gain for those hair cells. No trip to Turkey for a transplant. Yeah. No, definitely not. Although it's such an interesting thing though, because I was in Buffalo for grad school and I was really lucky to work with some amazing neuroscientists up there doing some crazy research on the brain and also on these inner ear hair cells and the whole nervous system. One of the parts of the lab, they were working with a chicken. And you're like, why are they working with chicken? And the coolest thing was that chicken can actually regenerate their hair cells. So birds can regenerate their hair cells. The key for us as researchers, and I'm not a researcher, but the key for the research community is how do you actually make that happen for mammals now? We're not quite there yet. So that's why when everybody says, hair cell regeneration, I hear all these great studies, there are great studies, but we're not quite there yet. They're in non-human animals, I'm sure. Correct. And there's some human studies. Okay. And there's some really kind of nichey stuff that's going on right now. But for the general public, we're not there yet. Yeah, that makes sense. Can you just tell us a little bit about how stress can affect our hearing? That's a really important question because we're all stressed out. Yes. I don't know if stress is a direct cause of hearing loss. Now, can stress impact our ability to communicate? So if we're in an environment that's noisy and we're stressed or group situations, processing can actually be impacted. So it's not just what we hear, it's what our brain does with the sound once it actually gets there. So it's kind of like processing figure from ground. If I'm in a noisy environment, I have to pick up the person I'm listening to from all the nonsense that's going on. Yeah. And a lot of people have difficulty with that. It's a processing issue. But when we're stressed, there's no doubt that our processing ability can be impacted. Totally. Stress becomes more of an issue for a related symptom of hearing loss, which is called tinnitus, ringing the ears. That definitely has a massive impact in terms of how much that impacts the individual who's bothered by tinnitus. So I wouldn't say it impacts our hearing per se. Maybe some processing, but more on the tinnitus side of the equation. Okay. Can you tell us a little bit more about that now? Because I feel like I've recently spoken to some younger people who have it and it sounds like a nightmare. Yeah. So tinnitus is one of the most common things that we see in clinic. I've specialized in tinnitus for decades at this point. I've been exposed to a lot of loud noise throughout my life. I was a bass player as a kid. Love concerts, worked with tons of musicians throughout the years, been front stage, back stage, side stage, all that. So a lot of noise exposure. I have worn hearing protection for the majority of it, which is critical. But tinnitus is something that is, at the end of the day, is a symptom of hearing loss for most people. Okay. Basically what happens, and we talked a little bit about what happens when the system is disordered and we lose those hair cells. When we reduce input to the brain, the brain actually changes. So it's called brain plasticity. If I want to learn a new language, the way I get better at learning that language is repetition and practice. If I want to learn how to play piano, scales are usually how I start and I just get better and better. Over time, my brain understands what to do. And what's essentially happening is you're literally forging connections in the brain and strengthening them with repetition. So that's positive brain plasticity. Negative brain plasticity is me forgetting how to do all that stuff because I'm not practicing. If I'm not using the language for six months a year, I'm rusty. And it takes me a little while to pick it up. But if I do it more, I'll get it back. Right? Same thing happens with our sensory systems. So if I have some hearing loss, even if it's subtle, mild hearing loss, what I'm doing is I'm reducing the input to the hearing centers of the brain. It's just not hearing as well as it should. The shortest version I can give you without getting too deep into the science to make it make sense is that when the brain realizes that it's not getting input from the auditory system, it literally jacks up its internal amplifiers. So I don't know if you guys ever watched Spinal Tap. So the movie Spinal Tap, the biggest joke in the in the movie was the amps go up to 11. They're the loudest amps on the planet. Right? So if you crank up your internal amplifier because the brain is searching for this sound, if you turn on an amplifier, turn it up full blast with nothing attached, that amp will make a speaker hum. Right? Yes. That's essentially what the brain is doing when you have some hearing loss. Metaphor. So your brain turns up the internal amplifiers, creates this phantom auditory perception. And as a result, we perceive this normal benign symptom of hearing loss. Now I say benign and that's for the vast majority of people because if you put anybody in a quiet enough room, they're going to hear body noises. They're going to pay attention to their heartbeat. They're going to pay attention to their breathing, their digestion. It's all normal stuff, but because the brain perceives that stuff as benign, not a threat, it pushes it into the background of awareness, like your bottom on the chair. Right? As soon as the brain perceives something as a threat, like if you're on the subway in New York at midnight by yourself and there's a strange character at the end of the car, you're kind of using your peripheral vision to check in periodically. That's what happens with this noise in our head that has been there. There's typically some sort of a stress event. Lost a loved one, lost a job, got sick. COVID happens, everybody's stressed. All of a sudden another part of our brain gets lit up. It's called the limbic system, the emotional centers of the brain. All of a sudden we start paying attention to the tinnitus. The limbic system notices that, we get more stressed, we pay more attention. And then because the brain is plastic, meaning it learns stuff, now we've gotten really good at paying attention to this benign normal thing, and it becomes a problem for us. So that's the short version of the tinnitus story. No, it's helpful. Yeah. But some people just want experience. That they'll just experience not being able to hear as well. That's correct. So not everybody that has hearing loss has tinnitus. And not everybody that has tinnitus has clinically relevant hearing loss. Interesting. Tinnitus is a neurological phenomenon that's a symptom of something. More likely than not, it's a symptom of some changes that have occurred to the hearing system. Even subtle changes to the hearing system. Wow. I knew none of this. Yeah, I didn't need this. Let's get into a little bit more of what can contribute to hearing loss. Annie asks, how much does living in a loud city contribute to hearing loss? We talked a little bit about this, but... Yeah, just being around like traffic, construction, sirens. So much construction. Yeah. Yeah. Is that a problem? Look, there's scare tactics out there. I'm not the person who's going to put fear into people, but I want to educate. So I'm science-based and also kind of real-world evidence-based. So if you take a look at a place like New York City or any really loud city, there's noise all over the place, but just because there's noise doesn't mean it's dangerous for our hearing. When it comes to any sort of noise exposure, there's two variables that are critical for us to consider. The first is how loud the noise is. And second, how long we're exposed to that noise. So there's a time constant there that's really important. If we take a look at very conservative standards that are used for things like the Occupational Safety Health Administration for people who work in noisy industries, the critical tipping point is an 85-decibel tipping point, which some might say a hair dryer. You are able to be exposed to that type of a noise continuously for eight hours straight without any concern that it's going to damage your hearing. Wow. Now, some people are more susceptible than others, so we have to keep that in mind. But for the general public, I would say that's a good reference point, it's 85-decibels. And for every five-decibel increase, we literally reduce our safe time in half. So there's a formula for this. Got it. Okay. Interesting. Really interesting studies were done by Columbia Mailman School of Public Health. They've done a lot of kind of noise studies in New York City. They looked at noise measurements on the subways, the buses, the path trains, streets, etc. And what they found is that the vast majority of places in New York are not really getting to the level where they're dangerous to your hearing. Yeah, and it's not like long periods of time you're hearing. That's the point. Yeah. So you're not standing at a screen. Now, granted, there are some places where the screeching of its subway station really loud echo in those kind of tunnels, right? Yeah. The best thing to do is literally just stick your fingers in your ears for that period of time. Yeah. But you're not exposed to that for five hours, six hours. Right. So for the most part, we're fine in those environments. Is it cumulative at all though? Let's say you're getting 85 decibels for eight hours a day. If you stop, does the clock restart? And a repair. Or if you're doing that every single day, is it going to start to build up and then actually take a toll? Yeah. Look, there's wear and tear on all of our systems. But what I would say from a pure kind of noise research perspective, what we know is, even if you go to a concert or if you're a musician and you're exposed to some noise, just taking a 10, 15 minute break. It doesn't reset the clock completely for that time. But it definitely gives your ears enough of a respite where you can jump back in and have a longer period of time. Got it. Now, I am a big advocate for hearing protection. There's a lot of great options. So best thing to do is just protect our hearing. Because as we said, it's the number one preventable cause of hearing. Totally. It's noise exposure. Okay. Let's take a quick break and we'll be right back. Tired of thee. I know it's here somewhere. Moment. The new ScanSnap IX 2400 scanner means you'll never search for a receipt again. Our simplest ScanSnap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one touch scanning, 45 pages per minute speed and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more missed expense claims or lost warranties. Peace of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit ScanSnapit.com slash podcast and discover how simple document management can be. ScanSnap. The smarter way to work. Hey, it's Anna and Mandy from our podcast Sisters in the City and we're currently sponsored by the Department for Work and Pensions. Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP. Otherwise, you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work-related costs. Or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. Here's the new Citroen C3 Aircross, the perfect SUV for bears and lovers of the great outdoors. Sure, and comfort too. Inside, it easily goes from five to seven seats and for you Cubs, look, it's got Apple CarPlay and your favourite apps. Yes, Mr Grizzly, available in petrol, full electric or hybrid. So ready for a family adventure? The new Citroen C3 Aircross for lovers of the wilderness and everyday comfort. Now with a £1500 electric car grant. Welcome back to Am I Doing It Wrong? Let's get into a lot of that. How do we mitigate some of these issues? To start, you just said if you're by a subway or firetrucks going by, put your fingers in your ears, how much protection is just doing that offering us? I do that actually. I do too. Like emergency, what are they called? Ambulances when they go by. Those things are allowed. So loud. Like I just do this. But I have no idea whether or not that's actually doing anything. I just do it for the comfort. Yeah. Well, that's an important thing also. Some people have sound sensitivity issues when they do that. It totally makes sense. Just putting your fingers in your ears is totally protecting you for that. I wouldn't worry about that at all unless there is an explosion next to you. Right? Yeah. That's a totally different type of a situation. But for your run of the mill sirens, ambulance, driving by, etc. Subway rolling into the station, bus screeching, especially during the winter with assault on the roads, their brakes squeak. Just put your fingers in your ears when they approach the station and you'll be totally fine. Would you actually recommend that though, as opposed to not doing anything? I always do it. Okay. And maybe it's just because I'm super aware. I think that anything that we can do, and I don't want to drive people crazy with, you know, prevention really matters. Don't get me wrong. But I don't want people to be completely psycho about the fact that they have to like stick their fingers in their ear every time a baby cries in the environment. Right. Right. That's not the... That's not... Okay. Okay. I would just be mindful of it and if you remember... It's a good practice. Yes. It's a good practice. Okay. I walk around the city, you know, I try to not do what I'm crossing the streets and things like that, but I love noise canceling headphones and I love listening to like SZA and just like her voice is so loud and it's just for me. Is that damaging my ears in any way? Yeah. This is a great conversation. And this conversation really started and I think before we started to roll, we started to talk a little bit about Walkman back in the 80s, but the conversation was reignited when the first Apple iPod came out. Yeah. And then all of a sudden, everybody's freaked out about people losing hearing. Yeah. Which great. Love the conversation. It's important to have the conversation. There's a couple of variables that we have to consider here as well. Noise exposure, the headphone doesn't matter. Okay. So if you have an in ear bud versus an over ear bud, over ear headphone, it doesn't matter at all. What matters is how loud it is and how long you're exposed to it. Okay. Right. Now there are some benefits though to sound isolating versus noise reduction and I'll give you the difference here. So sound isolating is if you have something that completely plugs up the ear and all you hear is the music and it's physically isolating you from the outside world. Right. Those are great because and I've used those for years. Musicians will use them on stage. They're called in ear monitors. Yeah. So it really kind of isolates you from the outside environment. And so you don't have to crank it up. Correct. You're not competing with the train noise, the street noise, etc. Right. The problem with that is that you are isolated. Yeah. And especially if you're by yourself or you're walking around the city, you need to be aware of what's going on. Totally. Yeah. How many times do you see somebody crossing the street? They're on their phone, their headphones are in and they're almost getting crushed by a cab. Yeah. So that's really the caveat there. Yeah. Be careful. Yeah. The noise cancellation headphones are really interesting because what they do is it's an electronic cancellation of the low frequencies, which are typically where like airplane noise might be or street hum and things like that. The outcome is lower your volume as well because you don't have to compete with outside noises as much. Right. That's a great thing as well because anything that's going to allow you to drop your volume, not compete, is going to give you longer time under headphones and also save your ears at that point too. Yeah. Interesting. Is there a volume that we shouldn't go above? I mean, is there like a, you know, you can draw a line in the sand and say it shouldn't be any higher than this? I've been, I said this to Noah last week that I'm starting to get nervous because when I listen to music on any headphones, it's like almost, it's like two notches under the maximum. And I'm like, that's where I find it enjoyable. I'm like, uh-oh. See, I'm at like 15%. That's how low I try and keep it because I freak out about it. So I don't even, I'm not even at the halfway point because I'm just like, I don't want to go there. I'm scared. I think it's a really important question to ask and there's the element of comfort. Yeah. Music sounds good loud. It sounds good loud. It sounds good loud. I get it. Done. Yeah. It sounds great loud and I'm guilty. I love my music and here's what I would say though is that the best research we have was a buddy of mine up in Boston. So during this time when the iPods came out and everybody's freaking out about noise, I sound isolation versus in here, all the different headphones that were out there, he actually did some measurements in the ear canals with microphones of the output of these headphones. Okay. The long and the short of it is if you take a look and it might have changed a little bit based on the output of the current kind of iPhones iPods, but I think it's a good rule of thumb. If you're at 65% of your volume and lower, you're pretty much good all day long. Okay. The more you get up into those upper ranges, one song at that level is fine, but once you start listening for hours at that level, then you're going to encounter some issues. Okay. That's a great, those are great measures though, because I'm not usually listening for more than like 20 minutes. Right. Okay. That's good to know. I'd still probably drop your volume a little bit. It's just, why is everything I love not good for me? Martini's bacon and really loud music. Bacon's really good. Okay. So Monica is asking, what happens if you use noise canceling headphones all the time? I don't think this is good for us, but I would love an expert to weigh in. Is noise canceling in general bad for us or no? You're saying it's a good thing. I don't think that there's any net, there's not like there's some emission coming from the headphones. Right. And there's, there's debates out there about cell phones and all this stuff. I will never touch that because I have no idea. Yeah. But in terms of purely hearing. But from the headphone perspective, I think noise canceling headphones, you're great, especially if you're in noisy environments. Yeah. It just allows you to listen at lower levels as a result, protecting your hearing. So. Okay. That's, that makes sense. Okay. Talk to me about earplugs. Should we be wearing them? When should we be wearing them? And what are the best ones? The best ones. I'll start with that. So for someone like me, goes to a lot of concerts. I want to be able to hear the music clearly. I just want to be in a safer, safer range in terms of the volume. Wearing kind of foam roll up earplugs that you can get in the drug store are great if you're using power tools or something where you don't need to hear clearly. Right. Right. But for music, we have filtered earplugs that have been around for decades at this point that literally allow you to hear exactly what's going on. It just literally drops the volume. At a low level. That's genius. And they're passive. These are an electronic and there are some electronic versions of earplugs too, but you don't need to go into the super expensive stuff. You can go on Amazon and there's a, and I can give you a name, which is easy. They're like less than 20 bucks. They're called ER20s, Edimotic Research 20-Decimal Filters. They'll last as you take care of those, they'll last you for a bunch of shows, load up on those and you're fine when you go to the show. There's custom versions of that, which requires someone going to a professional, make a silicone impression of the ear and we can make a custom old one. And there's soft silicone, super nice and comfy. Yeah. Those will last for a bunch of years. So I would start with those for anybody who's interested in hearing clearly, but just making sure that it's safe. Even dentists wear these. So if you have a dentist who's drilling all day long or dental hygienists who are kind of with the power tools in your mouth all day long, we know that that actually causes hearing loss. It's an occupational hazard. So they wear those types of plugs as well. So you can get them in a generic form. You can get them in a custom form. If you're completely at a loss, foam rollups are great when you have nothing. Tissues, toilet paper, anything else. It's fuzzy. It's not going to give you much hearing protection. Okay. It's just window dressing, essentially. So if you're at a loud show and you stick toilet paper in your ears, chances are it's not going to be doing much. People are just going to look at you funny. Yeah. What about if you were at a show and you didn't bring anything and you put your headphones in? Would that help? Like your AirPods? That's a really, really good question. I think it really depends on the seal that you get. The seal. Yeah. So those are notorious for not everybody's ear canals are different shapes. And that's why I'm such a big fan of custom at the end of the day, because we know it fits you perfect. And we know that the reduction that is advertised, you're getting. With generic, you're not 100% sure. And I think the same thing holds true for AirPods. AirPods are really interesting because they've kind of, Apple just released this kind of OTC hearing aid version of a hearing test, which I think is an awesome thing. Yeah. Most audiologists might be threatened by this type of a tool. I think it just draws awareness to people when they're hearing. We're here talking about it now. And more people are going to learn about the importance testing your hearing. It's just normal health. I want to come back to hearing tests in a minute, but again, if you're going to a concert, are you saying every time you go, you should wear your plugs? Let's say you go to two concerts a year and you're like, it's not that big of a deal. Is it a big deal? It could be. Yeah. Look, you can get, you can suffer noise induced hearing loss from one episode. So I'll give you an example. Wow. I've worked with a ton of musicians throughout the years and they've had noise exposure. It's just an occupational hazard. You'll get musicians who were standing in front of an amp or a wedge or monitor in front of them and a bolt of feedback blasts through. And all of a sudden they have this high volume of sound that just is in their face and they can suffer an immediate hearing loss as a result of that because there's trauma to those delicate little hair cells inside the inner ear. Right. And unfortunately sometimes those things you can't turn around. So what I would say is if you have any potential for a serious noise exposure, just protect your hearing. Okay. You know what's funny is that my husband is a jazz musician and in our home, the amount of times a day, what they, what they, like I'm like, oh my God. I'm like, and he's told me this before. He's like, I'm a musician. I like definitely have a little bit of hearing loss. Does he play? Just curious. I use the saxophone. Okay. So he's got the luxury of him not being exposed to his own noise necessarily. But he's around the amps a lot. That's the point. It's all the other things. So you have, if you're exposed to the drummer, if you're in front of the trumpets, that's trumpets are notoriously loud. Even a piccolo can produce sound levels that are damaging to violence. We know violinists, especially if you're say right-handed violinist, where the violence on the left side. Right by your ear. You get more hearing loss on that side, the left side versus the right side. Oh my God. Because there's a little bit of a protection because of what's called the head shadow effect. So yeah, there's, and the biggest misconception, this is such an important concept also is that everybody thinks rock musicians are like most susceptible. Right. It's like they're just getting exposed to all that noise all the time. Yeah. The reality is that orchestral musicians have just as much, if not more, they're rehearsing more. Yeah. Yeah. And they're just in this wall of sound around them all the time. Wall of sound, absolutely accurate. Yeah. That shit is powerful. Has Calvin ever had his hearing tested? I don't think so. I don't think so. And I just want to ask because like we do talk about younger people kind of being like, do I have hearing loss, et cetera? And I was just having lunch with my dad who's 75 and he wanted me to ask like, why is there so much stigma against hearing loss and not against like people wear glasses when they can't see. And it's like not a thing. And I was like, dad, it's a sign of aging. That's why people like feel weird about it. Is that, that's how you feel, right? About the stigma? Well, I think the stigma is starting to soften quite a bit. Yeah. Because look, we're just wearing stuff in our ears all day every day. And it's really hard for the general public to differentiate now between what a hearing it is and what a Bluetooth device is. Yes. And they're oftentimes the lines are crossed with both where they're multi kind of faceted devices. Look, the stigma, it's been with us. It made people believe that someone with hearing loss was less than, right? I've seen even in my 25, 30 years in the field, it's changed quite a bit. There's no age associated with hearing loss. It's not a one-to-one relationship. Although we do see older folks having hearing loss, but we also see a lot of young people with hearing loss too. But the beautiful thing is that we're seeing more younger people actually do something to treat their hearing now. Because these, look, I personally don't dispense hearing aids. It's not my wheel well. We do it in our practice in the city. I have colleagues who's great at doing that stuff. But these things are tiny. They're computers. They've got AI elements in them now. So cool. You can talk on your phone and like there's just, it's totally different. So I think that's a part of the reason why the stigma is lifting also is because these things actually do what they're supposed to do now. They help people hear better. And they look different. They look different. It's a quality of life issue more than anything. Absolutely. Yeah. You have somebody who has untreated hearing loss and their life is very different than somebody who has normal hearing. Yeah. They're socially isolated at times. They are more stressed. They're more anxious. They're more depressed. And what we know is if you just treat the hearing loss, that resolves a lot of those things for those patients. There's an essay I edited about a woman. She's experiencing anxiety and depression. And she got a hearing aid and felt better immediately and got off the other. Like there's no shame in meds, but she was like, this is affecting my life so much. Yeah, I believe that. The isolation you said is crazy when you're, you can't hear what's going on. Can't communicate with people for sure. Let's take a quick break and we'll be right back. Hey, it's Anna and Mandy from our podcast, Sisters in the City. And we're currently sponsored by the department for work and pensions. Life's busy and admin gets forgotten. But if you're claiming benefits, listen up. If something changes, you need to tell DWP. Otherwise you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work related costs. Or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. Tired of thee. I know it's here somewhere. Moment. The new ScanSnap IX 2400 scanner means you'll never search for a receipt again. Our simplest ScanSnap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one touch scanning, 45 pages per minute speed, and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more missed expense claims or lost warranties. Just peace of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit scansnapit.com slash podcast and discover how simple document management can be. ScanSnap. The smarter way to work. Here's the new Citroen C3 Aircross, the perfect SUV for bears and lovers of the great outdoors. Sure, and comfort too. Inside it easily goes from five to seven seats and for you cubs, look it's got Apple CarPlay and your favorite apps. Yes, Mr Grizzly available in petrol, full electric or hybrid. So ready for a family adventure? The new Citroen C3 Aircross for lovers of the wilderness and everyday comfort. Now with a 1500 pounds electric car grant. Welcome back to Am I Doing It Wrong? If we have hearing loss, we are treating it though, we can't cure it, right? It's just that's just once you've lost some hearing, you're just stuck in a way. Yeah, at this point until we have the ability to regenerate those hair cells and the nerves and things like that, we're aiding a hearing loss, right? But we're doing that better than we've ever done before. Especially the technologies improved, but the fitting ability of the professionals has improved significantly as well. So you're correct, we're not curing hearing loss. But there's not many cures for chronic health ailments out there that I know of. Thinking about my vision. Should we be seeing an audiologist or an ear doctor more regularly? I mean, I've never seen one in my entire life. Should people be seeing one in general? There's this interesting phenomenon that occurs, especially when we're kind of leaving our earlier years and getting middle age, that we typically don't see doctors unless something goes sideways. My suggestion to everybody is get a baseline hearing test regardless what age you are. It's really important because there's things that go undiagnosed for years that could be treated and then ultimately could improve quality of life or in some cases even save somebody. So prevention and being on top of these things and being proactive is critical. So what I would say is get a baseline hearing test. If everything is normal, maybe every other year get a hearing test, just like you get your visual exams. Now that's for the run-of-the-mill person that doesn't have any general health conditions. But if you're somebody who has diabetes, type one or type two. If you're someone who has cardiovascular disease, if you have somebody who has high blood pressure, because we know that those are things that impact our hearing, get your hearing tested every year just like you do for your diabetic, you get your feet checked, you get your vision checked, you get your HBA1C checked every three months. Not a bad idea to stay on top of these things. And you just named all of the conditions that run in my community as we age. There you go. Yeah, I need to. Well, I'm finding this closed. I've been a type one diabetic for 25 years and it was because I had sudden hearing loss when I was at Columbia years ago. And for some strange reason, after I took your traditional treatment, which is a steroid, I think it's inflammation, it just completely pooped out my pancreas. So no, it's all good. Don't feel bad for me. No, I don't feel bad for you, but it's like kind of like a revelation that we don't think these things are connected sometimes. Yeah. Yeah. Well, if you're diabetic, you're twice as likely to have hearing loss than your non-diabetic So it's really important to keep that in mind. So endocrinology should be talking to their patients about this. Yeah. And it's about education. So how do you feel about the new Apple hearing test? I just took it two days ago because I knew we were going to talk to you. It said I was fine, but I don't know if I really trusted it. Is it a real like diagnostic? You put your ear AirPods in and then you go through a hearing test. That's really interesting. Yeah. But do you feel like that maybe that's a first step? Like maybe you take that and see what the results are and then come see someone like you. It's definitely a first step. But here's what I would say is we've actually had, I've had friends, patients, we've even done this internally in our practice, comparing contrast that kind of iPhone based test with diagnostic test. It's a really good estimate and understanding of what your hearing pattern looks like. Is it a perfect diagnostic? No, don't make diagnostic decisions based on the Apple and they will tell you that. But again, I think the beautiful thing is it's just drawing attention for the general public on the importance of actually testing your hearing. So use that test if anything seems a little off, schedule an appointment with your audiologist, get your hearing tested, and they'll be able to tell you the real deal. I mean, I have to say, like I never thought about testing my hearing until that popped up on my phone and then I also had no way to do it before. And so I did think it was kind of cool. Yeah, I don't know. That was so interesting. Yeah, no. And I just think of all the data that they're collecting as well and what that's going to mean in the future from a health perspective, positive. Look, there's potential for data going sideways also. But I really do appreciate the fact that there's real potential for goodwill here. I never thought about it that way, like collecting data for good. And you're right, it is going to be like a health outcomes measure. I want to go really down to basics if I might. We have a listener question. How are we supposed to clean our ears with Q-tips? I've heard never use a Q-tip. Yeah, don't use Q-tips. So if you look at the box of, let's not pull on just Q-tips, but... Anything you're like swabs. Has it trading your ears? I don't want you guys to use the sponsors. Right, right. Sorry Q-tip, big Q-tip. Yeah. But if you look on the box of cotton swabs, there's nothing in there that says it's used for cleaning ears. It's for cleaning electronics, taking makeup off, all that stuff. It's just, I don't know where this started. If you take a look at the diameter of the cotton swab, it's about the diameter of your ear canal. Yeah. And if you just stick that in your ear, all you're doing is plunging the wax further down into the ear canal. And you might get a little satisfaction out of, oh, it's... No, you get a little wax on the Q-tip, but you're not really getting anything out. No, you're not cleaning anything. So Q-tips are not meant for cleaning ears. Now, you can use them on the outside of the ear. Yes, that's what I've heard. Yeah. I do that every single day. I get out of the shower. I don't like water in my ear a little bit here on the opening of the ear canal. And then around, that's fine. But my wife sticks Q-tips down her ears. Some people have this thing with... It feels good. Well, that's the thing. It's a tactile thing, right? And I've seen horrible things happen where people put Q-tips in there, and then they start brushing their teeth. The Q-tip's still sticking in their ear, and then... Makes you so unholy. Q-tip goes through the ear drum. That's very cringe. So then you have what's called a conductive hearing loss, because you punctured the ear drum, right? And it's painful too. So no Q-tips in the ear canal outside of the ear is totally fine. Okay. Okay. But to clean it, so I had a doctor who once said, literally when you're in the shower, using shampoo or whatever, just put a soapy finger in there, and that should be fine. How would you clean an ear? Oh, put a soapy finger in there? That sounds disgusting, now that I think about it. This show totally took a turn. Completely. It's once every episode, and it's usually because of me. And today it was because of that one. Yeah. But how do you feel about a soapy finger in there? Here's what I would say, is that if you look at the ear canal, so ear wax is a normal protective mechanism for the ear canal. Right. It actually is toxic to bugs also. So it actually keeps bugs out of your ears. Oh, that's so cool. Now, the ear canal itself is just skin tissue, and the wax is produced from what's called sebaceous glands. They're little glands in the ear canal. Right. Normal, should be there, keeps the ear canal healthy. The ear canal skin is kind of like a conveyor belt, where as it starts to die off, it migrates outward, taking along with it the wax as well. Ah, interesting. So if you just run water in your ear in the shower, it should flush that out. Now, some people produce a ton of wax, and some people have really hairy ear canals. Okay. It's a little more difficult to get the wax out. In those particular cases, don't dig, go to a professional, have them look in your ears. There's easy, simple ways to get it out that are safe. I would even say, be careful with those over-the-counter ear washes, and definitely don't stick things like bobby pins, or pen caps in your ear. None of that stuff is safe. How do you feel though, about hydrogen peroxide, or those drops that you get? That's fine. The drops soften up the wax, and then it'll flush out. And then it'll flush out. Not safe. But don't do it too much, because the last thing you want to do is over-clean your ear. Because again, you want some wax in the ear canal, that's healthy. Okay. I did a segment for Dr. Oz years ago, and he had a segment during Halloween for a gross or not. These were health-related. People had. So you had experts come on, and in any case, there was a woman in the audience who was actually eating her ear wax. Oh my gosh. So that's worse than sticking your Q-tip all the way in your ear. That's crazy. I had to go through the whole kind of, is it safe? Is it not? Is it toxic? It's basically like eating snot, right? It's gross, but it's not going to harm you in any way. So at the end of the segment, Mehmet turns over to the lady and says, Dr. Casper said it's kind of gross. So what do you think? You going to stop? It was like a five-second pause. She's like, nope. I mean, you know what? We try and we- It's so hard to be too, like, too serious right now. We try to be not judgmental on the show. So if you're listening and that's your thing, we're not going to yuck your yum, but I cannot imagine that. I'm yucking your yum. There's a lot of things that I'm totally fine with. This is just not one. And I'm the one who looks at ear wax all day long, pretty much. Don't eat your ear wax. Okay. I need a minute. Yeah. We like to ask when we have experts come in, what is one thing as an ear, a hearing expert, that you would never do? Ear wax. Besides the ear wax. But from like a safety point of view, what is something that you would- Or that you see around often. Yeah, you see people doing that. You just sort of like, don't do that. Yeah. I hate to be like the old curmudgeon guy. I want everybody to enjoy life and everything in moderation. Yeah. But when I take a look at the things that are preventable, those are the things that I kind of wrap my arms around quite a bit, is how can I actually live a longer, healthier life? It's not just about lifespan. It's about health span. Yeah. And when we know the importance of hearing in terms of our cognitive ability, we know it in terms of our social interactions and how meaningful things like music and sound are to us for connection. I just think it's silly not to protect our hearing when we go to concerts. Yeah. And look, I'm not walking around the floor of a concert and just waving my finger at people. That's not my point. And I don't look at them strange either, but I wish that more people would understand the importance of protecting their hearing. And we are not immune. It doesn't matter how young you are. It doesn't matter how healthy you think you are. Noise is noise. We are all susceptible. And at the end of the day, why not be able to enjoy sound for as long as possible? It's a connector. You want to enjoy the concerts until you're good and pruney. Yeah. Right. I love the concerts when I see the old hippies there. Yeah. Now, I don't even know what their hearing looks like, but they're still enjoying the heck out of their time there. For sure. That's the guy I want to be. Yeah. So. We all want to be that guy. Dr. Craig, thank you. This was great. So great. I'm a little... We end the show so often where I'm like, I've learned so much. Worried and empowered. Also, yeah, worried and empowered, terrified and feeling great at the same time. Beauty and terror. All in one. But thank you for being here. Awesome. I appreciate the time and it's great to talk to you guys. It's time for Better in 5. These are your top five takeaways from this episode. Number one, hearing loss can happen at any age, so get your ears checked. Number two, living in a loud city actually shouldn't be too much of a problem. It's how long you're exposed to the noise that matters. Number three is hard for me. Keep your headphone volume at about 65% or less. Number four, wearing ear protection can prevent hearing loss, so get out those ear plugs. And number five, stop using cotton swabs to clean your ears. Okay, Noah, were you protecting your hearing wrong? So you know what? I think I'm pretty good because my anxiety protects me in a lot of situations. Just so afraid. So like I said, the volume is low on my headphones, but here's the thing. I could definitely be wearing your plugs at concerts. And every time that Benji and I go to a concert, I'm not lying. Literally every time we forget our ear plugs, so we go to a drug store and buy a new pack. We have like eight to 12 packs of full your plugs at home, and then we forget to put them in when we're there too. We just don't even wear them. It's just not a part of, I feel like it's not in the kind of conversation enough. No, so I want to get better about that. What about you? You know what? I, like you said, it wasn't thinking about it as much because I have other things to be worried about too. But yeah, I think I'm going to be a little more cognizant about the volume that I listen to, and I'm going to go and get a hearing test because I right now fortunately have insurance. If you have it, exploit it, as much as possible. So yeah. And the sooner you know if there is any issue, if you do have even mild hearing loss, then maybe it'll- Start working on it. Yeah, exactly. You will lower the volume. You'll wear that your plugs, all the things before all those little hairs that are in our ears just disappear. God save my ear hairs, please. Anyways, until next time, as long as there are things to get wrong, we're going to be right here to help you do them better. You heard me. Do you have something you think you're doing wrong? Email us at amiddoingitwrong at huffpost.com and let us know. Tired of thee? I know it's here somewhere. Moment. The new ScanSnap IX 2400 scanner means you'll never search for a receipt again. Our simplest ScanSnap experience yet. Just press the blue button and instantly convert documents into digital files you can find in seconds. Perfect for busy professionals who need organization without complexity. With instant one-touch scanning, 45 pages per minute speed, and automatic data extraction, the IX 2400 saves your files exactly where you need them. No more missed expense claims or lost warranties. Just peace of mind knowing everything important is safe and instantly accessible. Ready to stop wasting time hunting for paperwork? Visit scansnapit.com slash podcast and discover how simple document management can be. ScanSnap, the smarter way to work. Hey, it's Anna and Mandy from our podcast, Sisters in the City, and we're currently sponsored by the Department for Work and Pensions. Life's busy and admin gets forgotten, but if you're claiming benefits, listen up. If something changes, you need to tell DWP. Otherwise, you could face a penalty. That could be a partner moving in, even if they keep their own place. Or if your car doubles up as a taxi and a family car, you must only report work-related costs or forgotten savings like premium bonds. To find out if you need to report a change, search tell DWP. Here's the new Citroen C3 Aircross, the perfect SUV for bears and lovers of the great outdoors. Sure, and comfort too. Inside, it easily goes from five to seven seats, and for you, Cubs, look, it's got Apple CarPlay and your favourite apps. Yes, Mr Grizzly, available in petrol, full electric or hybrid. So ready for a family adventure? The new Citroen C3 Aircross, for lovers of the wilderness and everyday comfort, now with a £1,500 electric car grant. At AJ Bell, we believe every customer deserves brilliant service, which is just one reason we're rated excellent on TrustPilot. And we all trust pilots, with their smooth, captainly voices that make you feel like you'd let them land anywhere they like. Sorry, where was I? Right, AJ Bell, rated excellent by sexy pilots. I mean TrustPilot. I'm a flight risk. AJ Bell, feel good investing. The value of your investments can go up or down.