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October 17, 1997     Cape Gazette
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CAPE GAZETTE, Friday, October 17 - October 23, 1997 - 33 HEALTH & FITNESS Computers reduce hearing aid background noise By Kerry Kester New technology is allowing those with hearing aids the option of having equipment that allows for more discrimination in sounds. A state-of-the-art design equips the tiny devices with microchips that, when programmed through a computer, individualize the types of sounds best suited to the wear- er's lifestyle. A common complaint with those who wear hearing aids is that, although sounds such as from conversation are magnified, background sounds, too, are mag- nified and often create frustration and difficulty interpreting speech. "They've developed hearing aids with two channels, and one even has three channels," said Mary Ann Gaskin, M.A., CCC-A, Bayside Health Association audi- ologist. Some hearing losses, she said, involve not hearing low tones; others involve not hearing high A wide variety of hearing aids and hearing products are available. tones. The new digitized aids al- low adjusting for both. Low pitches, for example, can be left alone, while high frequency can be adjusted, or vice versa, said Gaskin. "For many patients, I find that I can make the hearing aid sound more natural that way, especially with a new user," she said. "There's a computer chip in the hearing aids," said Gaskin, and the aids now have compression circuitry that compresses back- ground noises. "So there's better speech recognition," she said. "No hearing aid can eliminate background noise, but they can improve understanding of speech. "Hearing is part of language, and we communicate through lan- guage," said Gaskin. "If there's a breakdown in hearing, there's a breakdown in language. We ad- dress those concerns. I try to train my patients to identify noises." Diagnosing hearing loss Diagnosing a bearing impair- ment is an involved procedure, re- quiring evaluation from both a physician and an audiologist. "We workmainly within the healthcare system," said Gaskin. "The starting point is with family doctors. Many people who have a hearing loss misinterpret words. They respond inappropriately to what you say." Some patients may experience dizziness or tinnitus (ringing in the ears). Following an initial ex- am, said Gaskin, a specialist such as an eye, ear, nose and throat physician, may examine the pa- tient to rule out physical impair- ments such as ear wax, fluid be- hind the eai" drum or tumors. Once physiological problems have been addressed, "Medical clearance is given by the physi- cian for a hearing aid," said Gaskin. The audiologist then gives a hearing test that gauges speech recognition skills and pure tone recognition. Pure tone recognition shows what people may do with the level of hearing they have. After that, said Gaskin, audiologists need to find where loudness sensitivity levels are, so they can begin pro- gramming the computer. "That's so the hearing aid is comfortable to wear," said Gaskin. "We want to stay in the most comfortable listening range." Getting outfitted Patient education is also a key part of being outfitted with a hear- ing aid. "The most important thing for me is that they under- stand their hearing loss," said Gaskin. She explained that she wants patients to realize what the hear- ing loss does to them in everyday listening situations. "It actually gets them to verify their hearing loss," said Gaskin. For example, she said, some patients may say, "Everybody's mumbling." Some- times patients don't need sounds to be louder; they need them to be clearer, said Gaskin. "Making it louder doesn't make it better," she said. With ampli- Mary Ann Gaskin, M.A., CCC-A, Bayside Health Association audiologist, uses a computer to adjust settings on a digitized hearing aid. fied background noise, speech un- derstanding can be impaired. With some of the new models of programmable hearing aids, up to seven levels may be programmed for particular types of situations. For example, tones may be modi- fied for a situation such as dinner conversation in a small group set- ting, to a different setting for a sit- uation, such as sitting in a stadium with a large crowd. "Most patients won't use seven, but they're there," she said. "Then, a person has to make a decision," she said. They learn how hearing aids can benefit them and then must decide whether they want them. "The decision is made with the patients on which is the most ap- propriate hearing aid for them," she said. Several health insurance companies assist with the cost of getting a hearing aid, said Gaskin, including U.S. Healthcare, Aetna Senior Choice and AmeriHealth. "Some will pay $500 to the cost of the hearing aid," she said. Hearing aids range from $700 to $2,200 per ear. Many health maintenance organizations (HMOs) and Medicare makes a contribution to hearing aid costs. "That makes it a little easier for some patients to make the deci- sion," said Gaskin. "And all our patients get a good communicati0n-skills handout," she said. "The reason they're get- ting a hearing aid is to enhance their communication skills." The guides provide tips for both those who hear well and those who are hard of hearing. Bayside Health Association re- cently expanded its audiology ser- vices. For more information, call the Georgetown office, 856-3597, or the Milford office, 422-2555. Impinged nerves lead to pain and long recovery A deep radiating pain or numb- ness flowing down the arms, rep- resent painful effects of an im- pingement to a spinal-nerve root. Nerve roots are bundles of nerve fibers that emerge from the spinal cord and form a single spiral nerve. When a nerve becomes im- pinged, it alters the transmissions of electrical responses and often leads to pain, which is referred to a different part of the body. For example, irritation of a cervical nerve root may lead to shoulder, arm, hand and neck pain. While a traumatic injury, such as whiplash, may prompt the con- dition, most of the time the im- pingement results from a gradual degeneration of the joint or disc. Found in both younger and older adults, the irritation to the nerve roots always occurs at the site where the nerve root exits the spinal cord (between two verte- brae). Another potential cause for spinal-nerve impingement is the heign of a disc i n the spine. i.:.g:_..t' * ".:.- ::!" .  ... -,., Patients often get this condition by improperly loading a disc in the spine by prolonged sitting with poor posture or by incorrect- ly lifting. When excessive force is placed on the disc, the nucleus of the disc migrates backward and herniation begins. As the herniation occurs, it places pressure on the nerve root and causes extreme pain. The first warning signals of the condi- tion include numbness, neck pain, back pain and tingling in the ex- tremities. The feeling can vary from a deep aching to a sharp pain, char- acterized by an overall dull ache. A tingling sensation in the hands or feet may also accompany the sharp, radiating pain. As we consider impinged nerves, it's important to realize that if you are feeling this type of pain, visit your family physician as soon as possible. Early intervention for this con- dition can significantly boost re- covery times. Physicians often use x-rays or magnetic resonance imaging scans to identify the pain source. With this information, the physician can prescribe an appro- priate course of action, Options for treatment include surgery and/or physical therapy. By working with a physical thera- pist, patients suffering from this condition can significantly reduce the pain associated with the dis- ease. For acute impingements, physi- cal therapists may use a technique called soft-tissue massage to de- crease the muscle spasm and tenseness that occurs around the affected area or a variety of treat- ment modalities, including moist heat, cold packs and ultrasound. These treatment options allow the relief of acute symptoms. To specifically take care of the nerve impingement, a physician may prescribe traction, joint mobiliza- tion, or specific exercises de- signed to reduce the bulging disc, strengthening and correct posture are important for managing the nerve-root impingement. In some cases, people suffer from repeat symptoms. Patients recovering from this condition must practice proper posture to maximize the benefits of their recovery and guard against a reoccurring impinge- ment. To enhance posture, simply lift the breastbone up to the ceiling, imagining that an invisible string is attached to the chest. Proper posture will not only correct alignment in the head and neck, but will also benefit alignment of the shoulders, rib cage and lumbar spine. To strengthen your back, a se- ries of exercises can be performed that will gradually increase the stability of individual segments of the back as well as the overall trunk. These exercises, which are of- Robert Cairo, P.T. which will subsequently decrease ten incorporated into a patient's the pressure on the nerve root. daily routine, can ease the overall Once pressure !s rFiie,ve&:panand a3rd tgginst,: r epead nerve-root impingement. However, as with all medical conditions, anyone experiencing the early warning signals should visit a family physician as soon as possible. Editor's Note: October is Na- tional Physical Therapy Month. HEALTH TOPICS Robert Cairo is a Hcensed physical therapist at Tidewa. ter Physical Therapy, 945- r throughout. [the; Eastern .  i