The Listening Lab team tackles on the issue about Hearing loss and Hearing Aids availability in Singapore in Facebook Live event by 963 FM. If you missed the event, you can watch it below.
English transcript below:
Anna Basically, I see a lot of people using headphones nowadays. Young people seems to use those large headphones, similar to the ones we professionals use, or those earphones that come with mobile phones. It seems like everyone frequently uses these things. When using these, what should we pay attention to?
Today, we have Kelvin from Listening Lab (K: Yes), along with *impressed*, an expert in hearing, Jenny.
So, first, what should we pay attention to in terms of using those gadgets?
Jenny Don't turn the volume too high, and when using, don't use for too long. Avoid listening to loud music for an extended period, as it can have an impact on your hearing.
Anna Alright. Usually, when we do live streaming with our faces, we use headphones to capture our voices, right? So, you'll hear me speak loudly, or else, because many listeners often say, "I can't hear, I can't hear," haha. So, please, both of you, speak louder; otherwise, they might think they have hearing loss later on.
Kelvin No problem, no problem.
Anna Okay, so today, let's have Kelvin demonstrate first (K: Okay), and Jenny will also be showing how professionals check for ear problems.
Kelvin, let’s have you as our model. Shall we look at your ears? (C: Yes, let's look at my ears.) Come, have a seat first.
Kelvin Firstly, we need to conduct an otoscope test. That is, we use an ear light to look into my ear canal. The reason for looking inside is to check for any blockages in the ear canal, whether the eardrum is ruptured, or if there is inflammation. If everything seems fine, we can proceed with the pure-tone hearing test.
Jenny, please help me demonstrate.
Anna This piece of equipment look like a drill. Haha
Crew I will have to come nearer to capture this.
Jenny Just this one with the light, shine it into the ear.
Crew Wait a moment, let me take a close shot here to show the viewer how the equipment will go into the ear.
Jenny Just a light, and then like this, shining into the ear.
Kelvin And the image will be here.
Jenny Yes, that's the eardrum.
Anna Ah, this is Kelvin's eardrum?
Kelvin Yes, my eardrum.
Anna I want to see. I want to see because I can't see my own eardrum, so I'll look at yours.
Kelvin Yes, because everyone can't see their own eardrum, so professionals are needed.
Anna Which one is the eardrum? (K: The translucent skin in the middle)
Crew Got it, got it. (A: Oh)
Jenny Then, look at the ear canal. This means it's very healthy, no white or red, which means no infection.
Anna No inflammation. How does inflammation occur?
Jenny Inflammation occurs when some people are sensitive to certain substances. After swimming, for example, they may get inflamed, itchy, and have pus. We always check for that first.
Kelvin The small yellow part you saw earlier, that's earwax. Everyone's ears will have earwax; it's normal.
Anna I thought there was gold in your ears. *laugh*
Kelvin I wish there were; I'd dig it out myself.
Anna Let's emphasize, don't dig your own ears.
Kelvin Right, don't dig your own ears.
Jenny Now let’s have a look at Kelvin's left ear.
Anna Both ears need to be checked. Yes, so the left and right ears might be different.
Kelvin So, the left ear is the same, you can see my eardrum, a bit of earwax on the side, but it's not obstructing. (A: It's a bit red) Because it's been itching lately, but I don't know why, it feels a bit itchy inside. (A: What will you do?) You can use ear drops, you can buy them at the pharmacy.
Anna But you don't know what it is.
Kelvin My skin has been a bit sensitive lately.
Anna It's not that someone is missing you, so your ears are itchy. (K: No, it should be eyes twitching. J: It should be sneezing)
Anna So, is this the examination?
Kelvin This is our first examination. The second is using sound to examine. This is a very simple demonstration. In reality, a pure-tone hearing test is not like this. This is just a demo.
Anna This is just a simple check.
Kelvin So now, I'll play some pure tones for you to listen to. If you can hear it, it means your hearing is fine. If you can't, there might be an issue, but we don't know the degree or which ear.
Jenny Everyone, listen together.
Anna Oh yes I can hear it. Did you hear that? Could you not hear? It's like this.
Kelvin Most people can hear this frequency, but we start with low frequency, gradually move to mid-frequency, and high frequency.
Kelvin Can you hear it? (A: Noise) Noise is good.
Anna Heard it. Did you notice I moved farther away? Because I found it piercing.
C Very good.
Jenny I can't walk away.
Kelvin 3 more to go
Anna Yes, heard it.
Anna Anything else?
Kelvin Yes, very sharp.
Anna Oh! I can't hear it. Wait. I need to be this close. You see, I stood far away earlier because I found it piercing. So, for the one you played earlier, I have to stand this close to hear it.
Kelvin If you have healthy hearing, completely healthy, in your twenties, you can stand on the other side of the room, and you'd still hear the sound.
Anna Sorry, that's already my past tense.
Kelvin The last one.
Anna Wow, even this close, I can't hear it. My ears.
Jenny It's very sharp, big sister.
Anna I told you, it's an occupational hazard. Could you play again?
Crew For those of you watching our Facebook live, can you hear it? Please comment.
Anna Did you play it?
Kelvin & Jenny Yes, yes, it’s playing.
Anna Oh no, I can't hear it at all. Ha, you all heard it?
Kelvin So, if... *laugh*
Anna Are you all lying to me? Are you all lying to me? I don’t believe it, play again.
Kelvin Can you hear it? The sound is playing now.
Anna I can't hear it. Like this, I can't hear it. What's wrong with me?
Kelvin I played six sounds. If you could only hear less than four sounds, we would suggest getting a hearing test. But just now, you only missed one sound, and your hearing loss is average for your age. But unfortunately, once you're over forty, some people...
Anna Please don't sentence me to death. Come on, show us the hearing aid. I need to do that traffic update.
Jenny Alright, the hearing aid.
Crew Let's take a look at which hearing aids we have.
Anna If you've watched my live stream at 963.anna, we were doing a simple hearing test demonstration. For example, when you want to test your hearing, some sounds may not be very clear. The last sound, everyone in the entire studio heard it, except me. It seems I need to pay attention. So, for the upcoming live stream, you have to come and listen for the traffic updates.
*Anna doing traffic update at the background*
Time Stamp @ 8:43
Anna Can’t be. What was the last sound just now?
Kelvin 14 KHz.
Crew A very sharp sound, a high frequency
Kelvin Actually, it was more similar to environmental sounds, non-communication sounds. Normal speech sounds cannot reach such high and sharp frequencies.
Anna Why can't I hear it, and you all can? It’s hard for me to accept this. I mean this is a very normal reaction, the feeling of being so left out when everyone around you can hear clearly what is happening except for yourself.
It’s okay, I get it, I'm getting old.
Let’s get right into this.
Jenny Alright, if there is hearing loss, from mild to moderate to severe, you can use in-ear hearing aids. And this type is custom-made. We'll take a model of your ear and customize the hearing aid.
As for this one …
Anna Wait a moment, is this one inserted into the ear?
Jenny Yes, this is to be inserted into the ear, hidden, invisible like this. (A: Are you going to take it out?) Yes, this is for taking out, and it's like this when inserted into the ear, completely invisible.
Crew No one knows you're wearing it.
Jenny Yes. And these are all digital hearing aids.
Anna What is a digital hearing aid?
Kelvin It can be controlled by a computer, accurately find the appropriate frequency, and set the sound you need.
Anna But it's not something you can randomly adjust by yourself right?
Kelvin No, it requires a hearing specialist to help you set it up.
Jenny So for example, you’ve done the hearing test earlier, we'll use your results and adjust it with customised software.
Anna But it's okay that I couldn't hear the last sound you played just now, right?
Kelvin The kind of not hearing just now is quite common. Hearing aids can't help with that.
That's because the auditory nerves are gradually degenerating.
Anna Again calling me old. Let’s look at this.
Jenny And then we have another type of hearing aid. This is a behind-the-ear hearing aid, and it can be charged. It's the latest model of hearing aids.
After taking it out, this behind-the-ear type hangs on the ear (A: Like what bodyguard wears). It can also be used as a bodyguard because it's a smart earphone (A: Hey, but this one it hangs on the ear). Yes, it's also invisible, quite discreet because your hair covers it on one side (A: But withs shorter haircut like most men it won’t be). Only a little is visible.
Kelvin This type of hearing aid is usually more comfortable because it has less contact with your skin, making it comfortable and clear to hear. So, this kind of technology is currently considered more .. (A: Expensive?) not really, the price is approximately the same, but many would prefer this model over the rest of the other designs/model.
Jenny Smart earphones, because they have Bluetooth and wireless capabilities, can connect to your phone, adjust your volume, just like this, download this app for free, and you can (J: the app). If the environment is loud, you can lower the volume or turn off all the sound, for example, if you're in a movie or a concert and find it too loud, you can turn it off.
Kelvin You can also set it. If you often go to concerts, the adjustment for concert settings are different from daily communication settings. You switch to the concert program, it will specifically capture the sound of the music. Otherwise, it might consider the sound as noise.
Anna Let me ask a question. Many people say that when they wear hearing aids, they can hear clearly, but they can't accept that as they consider those noises that they usually won’t be. Like suddenly every noise is very enhanced and clear, and it makes them uncomfortable. Does this problem exist?
Jenny This is indeed a real problem because when you have hearing loss, for a long period, you haven't been in contact with normal sounds. You may feel/remember that your world is very quiet. However, when you wear hearing aids, the sound returns to normal, and you might think, "Why is the sound so loud? I'm not used to it." But normal and accustomed are different things. You can gradually get used to normal sounds, but since you have been without sounds for a long time, your normal is no longer quite normal. So, it takes some time to gradually expand the sound for you until you reach a normal stage.
Time stamp @ 13:48
Anna What is the price range for these hearing aids? Because the prices on the market vary, so could you share an estimation?
Kelvin Hearing aids are what we call medical device-grade machines; they are not consumer electronics. So, they need some regulations. In the United States, some laws state that this machine is a medical device. The price of this type of hearing aid starts from 1,000 dollars and above.
So, if you want something that can be charged, eliminate background noise, and has high technology, the price will be relatively high.
Time stamp @ 14:43
Jenny And these hearing aids are designed for patients with mild, moderate, and severe hearing loss. If you have profound hearing loss, you would need a cochlear implant.
Kelvin This is a demo set. A cochlear implant consists of two parts. One part is surgically implanted into the cochlea, and you would need an ear, nose, and throat specialist to perform a check-up and a simple surgery to place this device into your cochlea.
Once this device is implanted, you would need to use a speech processor. This is our speech processor, which may look like a large hearing aid on the surface, but its operation is entirely different from a regular hearing aid.
You wear it on your ear, and the magnet on it connects directly to the cochlear implant placed by ENT surgeons, allowing you to hear.
So, for those with conditions like deafness or complete hearing loss, it's now possible to regain a significant portion of their hearing with this technology.
Crew But, after being implanted, when you are wearing this [cochlear implant], it will have a component …
Kelvin Yes, this part is for communication; the microphone is here, and the processor is here. We will use this electromagnetic signal to communicate with the part implanted inside you. This way, it uses electrotherapy—using electricity to directly stimulate your nerve lines.
Hearing aids use air to amplify sound, whereas this [cochlear implant] uses electricity. So, the technologies are completely different.
Anna No, I am worried because of how pricey this piece would be
Kelvin These are all demo set, don’t worry.
Crew But if it's like this, do you not need to support it with your hand, like you did just now? After implantation, will it stick directly or how does it work?
Kelvin It's a magnet, so when you put it on, it will stick directly. Then, when you remove it, it will come off, and when you put it back, it will stick again.
Anna But you need a magnet (K: Yes, the magnet is here), and it requires surgical implantation (K: Yes, surgery is needed; the ENT specialist will assist).
Anna It's similar to when they implant something for irregular heartbeats. The principle is the same, right
Kelvin Yes, the principle is the same, just that this part will be inserted into the cochlea, and that's how it works.
Anna Let me ask Kelvin a question. Many people wonder if they can use Medisave to get some subsidies for these hearing aids.
Kelvin The government does provide some subsidies, but you need to undergo some assessments with a social worker. You might be eligible for these subsidies.
Usually, if there are no subsidies, private purchases cannot be made with Medisave. (A: Understood.) But for cochlear implants, if you need one, you can go to the hospital, submit an application, and they should be able to help you get significant subsidies.
Anna And if you need hearing aids but choose not to wear them, what would be the consequences?
Kelvin OK, the biggest issue currently, according to specialist, is that if you have hearing problems and don't wear hearing aids, your chances of developing dementia and depression will double.
Anna Understood. But I also read a report saying that some people wear two hearing aids. Why is that?
Kelvin Usually, if you have age-related hearing loss affecting both ears, you should use hearing aids for both the left and right sides because your hearing loss is occurring in both ears. If you use only one side, your hearing will be unbalanced, and you might perceive sounds from the left as coming from the right. So, the direction of the sound would be problematic. If a car is coming from the left, you might hear it as coming from the right, leading to accidents when crossing the road.
Anna However, many people feel that they are expensive, so they choose to wear only one.
Kelvin In terms of eyesight, if both eyes have different prescriptions, and you wear glasses for one eye, you would find the other one expensive. It's not possible. So, it's the same for ears, but people might feel that ears are not as important as eyes.
Anna Alright, understood. Anything else to remind today?
Kelvin The most important thing is if people around you keep asking why you're not responding, why your volume for TV, music is so loud – that's the first few symptoms. Go for a hearing test.
From there, you'll know the results and what the next steps should be. If it's normal or doesn't require immediate attention, like Anna, who can't hear 14 KHz, there's no immediate need to address it. Still, at least you know and can start observing.
Anna How about this. As there were many questions on WhatsApp, can we attend to some of the questions and do a quick Q&A? Now, let’s go back to our seats and I will go through the questions directly from the chat box from our livestream.
Crew Please go back to your seats.
Anna So, I don't remember their questions. The camera is right here. For example, just now, a listener sent a message saying his eardrum is ruptured. He has undergone several surgeries, right? And there's no way to recover; the eardrum remains ruptured. How to deal with this?
Kelvin Here’s the thing, we are not doctors; we can only provide some general explanations. Regarding the listener who mentioned a ruptured eardrum and multiple surgeries, it's important to note that surgeries do not guarantee 100% success, and outcomes can vary. In such cases, consulting with a doctor to explore alternative options or seeking a second opinion may be necessary.
Anna Many people ask about tinnitus. Tinnitus can result from various factors, so if you experience tinnitus, it's advisable to see a doctor, undergo examinations, and then determine the cause. Is that right?
Kelvin For those experiencing tinnitus (ringing in the ears), it can result from various factors. It is recommended to consult with a doctor, undergo an examination, and conduct a hearing test to identify the underlying cause.
Tinnitus is often associated with hearing loss, and hearing aids can provide compensation for the lost sounds, but they won't "cure" tinnitus.
Jenny Sorry to interrup, I would also want to add that many people may think that wearing hearing aids can improve their hearing. This is impossible because the main purpose of wearing hearing aids is to provide hearing compensation only, bringing the hearing closer to the normal level. Once the hearing aids are removed, the hearing will return to its original state. Therefore, it is recommended to wear hearing aids every day, at least for more than eight hours.
Anna Wow, dear. However, hearing aids, like electronic devices, will also wear out over time, right? So, a hearing aid cannot be used for a lifetime.
Kelvin Usually, hearing aids can last for about five years with regular use. Some hearing aids used in daily life can last up to ten years. The reason for wanting to change them is that technology has improved, similar to upgrading a mobile phone, or some parts may be damaged after a long time. If a part is missing, you may need to replace the whole pair with a new one.
Anna Okay, I have a question that I don't know if you can answer. It comes from a listener in Kuala Lumpur, Malaysia.
He has oily ears, but his sister has dry ears. In such a situation, he inherited it from his father, and both he and his father have significant hearing loss. He wants to know about this.
Kelvin As for myself, my brother has oily ears, and I have dry ears. So it’s not necessarily it’s genetic.
Oily ears mean that there are many oil cells in the ear canal, and the person tends to sweat a lot. When sweat mixes with earwax, it becomes a kind of mud. Ear mud can easily block the ear canal, reducing the amount of sound heard. Therefore, people with oily ears usually need to clean their ears frequently.
How to clean them? It seems that in our pharmacy, sometimes you can find instruments for cleaning. You can buy them or ask your family doctor to do some relatively simple procedures.
Dry ears don't have this problem. The ears will automatically clean themselves. The skin of the eardrum will push the earwax away on its own. You just need to wipe the outside with toilet paper after bathing. There is no need to use cotton swabs to dig.
Anna Our ears have the auditory nerve. If there is a problem with the auditory nerve, is it helpful to wear hearing aids?
Jenny It can help unless the person is completely deaf. Hearing aids won't help because the intensity is not enough. (A: Then, as you mentioned, the artificial) cochlea.
Anna Wow, okay. Thank you, Kelvin and Jenny, the audiologist from Listening Lab, for sharing your knowledge.