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James GallagherÌý 00:01

Hello there. I hope you can hear me loudly and clearly as I'm walking down a busy street. There's plenty of traffic as I'm on my way to my first interview. Now we're going to be talking about hearing loss, because it affects 18 million people in the UK. That is a huge number of people, and yet it's something that all of us kind of ignore a little bit. Even when we know that we can benefit from hearing aids, we often delay getting treatment for years. So we're going to tackle some of these issues today, and it's all been inspired by a question from listener John. Here's what he had to say.

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John (Listener)Ìý 00:36

Hello, I'm John. I am a musician and a sound engineer, and I also test websites part time for their accessibility, because I'm totally blind.

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James GallagherÌý 00:47

And John, you got in touch with Inside Health? Yes, I did. I emailed you a little while ago. I have been thinking for many years that hearing tests don't have the complexity of the sort of tests you get for sight and my hearing is absolutely essential, probably because I'm a musician and a sound engineer, but also for my own navigation day to day and generally keeping me alive. Really, I've had a few hearing tests over the years, and what I've found is that you either get offered the opportunity to have your ears syringedÌý if there is a gathering of wax in them, or you get a hearing test, which I think is incredibly rudimentary. And if there's an issue according to this hearing test, you get offered a hearing aid. Now, if there's no issue, they just say, your hearing's great and send you off on your way. Because if we're talking about glasses or sights, there's loads of different conditions, and we have a specific treatment for each of them. You can correct short or long sightedness, you can correct a stigmatism. Whereas, are you saying you think it's not as nuanced? Absolutely, if you go to an optician for sort of full test, you get tests of your vision depth, you get tests of the colors you can see. You get tests of, you know, how good your peripheral vision is, how good your central vision is. Hearing they just put some headphones on me, and they do some beeps, and if I can hear the beeps at different volumes, they think I'm marvelous. Now, what they don't do is they don't test, or I never have had tested specific frequencies or anything to do with how I perceive my sort of stereo environment, which is kind of what keeps me alive on the roads, and no one talks about any of this stuff or how it might be corrected.Ìý How old are you, John?

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John (Listener)Ìý 02:31

I'm 60. Now, I know my hearing is not as good as it was. I have no idea why this is. Everyone just says oh, it just happens as you gets older and, maybe it does, but why and what can be done about it, if anything?

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James GallagherÌý 02:44

W as there any point in your life where you started to notice this isn't what it was like when I was 20.

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John (Listener)Ìý 02:50

In the last 10 years, perhaps I've started noticing deterioration to the point where it makes me a little more cautious when I'm out and about.

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James GallagherÌý 03:00

And when you're out and about doing your thing, where does it crop up? What are the things that you're, like, that would have been easier before?

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John (Listener)Ìý 03:07

The whole issue of moving about and sort of being outdoors as a blind person completely depends on your ears and obviously a white cane for me, and if you get into any kind of environment, that's not optimal. So if it's loud, if there's a lot of wind, say, all those sounds around you are more difficult to discern. And obviously, if your ears are not in tip top condition, as it were, they get even harder to discern. Hearing is all I've got in terms of sort of distance senses. And if that doesn't work so well, I haven't got anything else to sort of use to go with it.

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James GallagherÌý 03:43

ÌýAnd have you had any treatment?

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John (Listener)Ìý 03:45

No, because I've sort of given up on the hearing thing, because I've never had anybody really react to me in a way that makes me think they're actually that interested once I've passed their test.

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James GallagherÌý 03:56

John, you're a musician. Favorite music? What's your style?

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John (Listener)Ìý 04:00

Oh, crikey. Well, I'm a drummer by trade, but I also sing...

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James GallagherÌý 04:03

Okay, I'll do you a trade. I'll go investigate this. If you give me a little sing

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John (Listener)Ìý 04:07

(Laughs) You've got to be kidding. I'm not going to do that. Am I going to do that? I don't know how sweet it is to be loved by you, not you in particular. You understand.

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James GallagherÌý 04:18

Oh, I thought that was just for me!

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John (Listener)Ìý 04:22

[Laughs] Of course it was!

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James GallagherÌý 04:23

Oh, John, that was so cruel. I wasn't actually expecting you to do it, but beautiful voice

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John (Listener)Ìý 04:26

Give me an opportunity, and I always do that sort of thing

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James GallagherÌý 04:28

Well, John, let me see what I can do.

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John (Listener)Ìý 04:30

ÌýI look forward to that.

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James GallagherÌý 04:33

Don't put too much faith in me Hearing from John made me think, well, how do we actually hear? Because if we can get to grips with how our ears and our brain understand the world of sound all around us, then we can start to figure out what's going wrong. Show us your pass, hello (enters building) We've come to a hearing clinic at UCL to meet ear nose and throat surgeon, Nish Mehta. James Nish, thanks so much for having us in pleasure. Can you give me a really easy explanation of how we hear? Walk me through it sound wave hits the outside of my face.

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Nish MehtaÌý 05:21

Yes, hearing is an amazing sense. It's a special sense and the ear is really the hearing organ. So the ear is split up into three main parts. It's the outer ear, the middle ear and the inner ear. The outer ear is the bit that you see. It's on the side of your head. We call that the pinna. Think of that as the satellite dish. It collects the sounds and it funnels them in towards the sense organ that then gets transmitted to the middle ear. The middle ear's main job is to amplify those sounds. That's done by having an eardrum, which catches it and then vibrates sympathetically to the vibration of the noise that you heard, and then that's passed on to the three smallest bones in the body, the hammer, the anvil and the stirrup.

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James GallagherÌý 06:01

Everyone's favorite pub quiz answer - where is the smallest bone in the human body?

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Nish MehtaÌý 06:04

Exactly, exactly, and if you think stirrup is so small that it's about the size of the letter E on a one penny piece. It's absolutely tiny and that vibrates and now all of a sudden you're hitting the inner ear. Now this is the real sense organ. The inner ear is called a cochlea. The cochlea is the one that looks like a seashell, and it's filled up with fluid, and inside it's got 1000s and 1000s of these hair cells. And as the fluid vibrates and moves past the hair cells, it activates them. Now the hair cells are programmed so that they activate most sounds that are specific to a tone. So some are for high pitch, some are for low pitch. Once they vibrate, they start off an electrical current that gets sent to your brain. So your ear is able to tell the brain that it heard a sound, that it was of high pitch, and what its volume was based on how much reflection it has of the inner ear. So that's how earring works.

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James GallagherÌý 06:53

So you got that whole process. Can it go wrong at any point?

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Nish MehtaÌý 06:57

Yes it can go wrong at nearly every single point that we've talked about. So in terms of the outer ear, as sound is made into the ear canal itself, it can get blocked. And so that can happen from things such as having lots of wax impacted in your ear. And when that happens, you can have a simple procedure where the wax is removed to restore your hearing. It can also occur from the middle ear. Now this happens when you can have a hole in your eardrum, or if the bones of hearing aren't moving as nicely as they should do, and that is fixed with surgery, where we do operations to fix the hole in the eardrum or to restore the communication through the bones of hearing. And then finally, the hair cells of the inner ear can degrade over time or with infections, and they become less efficient at sending signals. So the first way that we would deal with that is to increase the amount of sound signal getting to your ear. And that's done by things like hearing aids. They amplify the sounds that you hear, so you get more vibrations getting to the hair cells. And the few hair cells that are left are still working, but you may get to a point where there is not enough hair cells left to really pick up that change in noise, and for those patients, we'd consider a surgical hearing aid option called a cochlear implant. And what we do here is we implant a beautifully engineered electrode into the inner ear that uses electricity to directly transmit to the nerve, which then sends information to the brain, so it bypasses that whole ear system.

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James GallagherÌý 08:19

We're going to spend a lot of today Nish thinking about age related hearing loss. When does that start?

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Nish MehtaÌý 08:25

Wear and tear of your hearing starts from around the age of eight.

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James GallagherÌý 08:29

Okay so we're doomed already.

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Nish MehtaÌý 08:30

We're already on a downward spiral, but we've got a lot of redundancy on the system, and the speed at which our hearing declines is partly based on the genetics that you're born with, and then partly based on the environment that you're exposed to. So someone who has really strong genetics to protect them from hearing but spends their life on a pneumatic drill may have a much faster decline than someone in the other side.

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James GallagherÌý 08:52

So it's the meeting of the two.

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Nish MehtaÌý 08:54

Exactly

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James GallagherÌý 08:54

When do we start to notice because we don't notice it when we're eight?

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Nish MehtaÌý 08:58

So normally what happens is that you create memories of sounds, shadows of what the sounds are. And when you hear parts of the signal, your brain kind of attaches it to that

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James GallagherÌý 09:07

Is your brain doing guesswork?

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Nish MehtaÌý 09:08

It's filling in the gaps. Yeah, it's doing guessworks. And this is how you can have optical illusions and also auditory illusions. And you can imagine that your brain is doing so much computation behind the scenes just to listen to someone speaking and understand the words that are saying, let alone when there is another conversation that's going on behind them, and they've got to take that information and exclude it from their attention. So there's lots and lots of computation that's going on. So whilst hearing is going the brain tends to increase its listening effort, its computation, and so often it's a very slow process for you to realize that you're struggling with hearing, but then there seems to be a cut off area where all of a sudden, people drop off, and they realize that actually, I'm really struggling with my hearing. And I don't know how this happened.

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James GallagherÌý 09:51

So that sudden moment, is that when the quality of the signal is degraded so much that the brain can't compensate it?

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Nish MehtaÌý 09:57

Exactly. So you've got a combination of the two. Where you've slowly been having up regulation on the brain side, and it just can't cope anymore because it's not receiving enough signal for it to kind of fill in the gaps of what's going on.

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James GallagherÌý 10:08

Do we have the same tools in treating hearing loss that we have, like the equivalents for in sight, because I need glasses. You're wearing glasses now, but my vision is as good as somebody who's not wearing glasses, as long as I'm wearing them. But we don't have the same in hearing. Do we?

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Nish MehtaÌý 10:23

No, we don't have something that immediately completes it. We have something that approximates it. We have a few problems with hearing, which is that, unlike your eyes, the hearing organ is actually deeply embedded in your skull, quite far away from the surface, and to even approach it requires quite complex surgery.

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James GallagherÌý 10:42

Well, I've come now to the Ear Institute at UCL, and as we approach, you can see a picture of the outer ear, the eardrum, the middle ear, and gigantic, oversized hair cells that are inside the inner ear. So, definitely in the right place. Let's go in there. (Enters building)

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Hannah CooperÌý 11:00

Welcome. Hello (low level sound of her saying 'I'll put the heating on). My name is Dr Hannah Cooper, and I'm a lecturer at the UCL Ear Institute.

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James GallagherÌý 11:10

So Hannah, are you going to walk me through today what a hearing test looks like or 'sounds like' should be the probably the appropriate word?

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Hannah CooperÌý 11:15

Yes. First thing we'll do is have a look in your ears if that's okay?

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James GallagherÌý 11:18

You're more than welcome.

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Hannah CooperÌý 11:19

Yeah, great. So you can see your own ears on the screen, if you want to go, okay, so I have this camera here. It's called a video otoscope, so I can just stick it in your ear, if that's okay. So if you just stay reasonably

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James GallagherÌý 11:33

Okay, in we go

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Hannah CooperÌý 11:34

In we go. So a few hairs, little bit of wax, but right at the bottom there, you can see your ear drum you see

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James GallagherÌý 11:41

Is it a healthy looking ear drum?

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Hannah CooperÌý 11:43

It is a healthy looking ear drum, and there's a healthy amount of wax in there. So we want a little bit of wax, right? Because that's going to protect our ear, make sure that dust and bugs and things like that don't go down there.

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James GallagherÌý 11:54

But that's the only bit of the ear that you can see directly?

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Hannah CooperÌý 11:56

Yeah, exactly. So the rest of the ear is going to be behind the ear drum, but we can test that with something called pure tone audiometry, which is sort of a classic hearing test. Should we go for that? So this is a button that I'm going to give you here, and I'm going to test your hearing by measuring the very quietest sounds that you're able to hear. So what I want you to do is listen really carefully. When I've put the headphones on, when you hear a sound, press the button, keep the button held down for as long as the sound is there, and then when you think the sound has gone away, release the button. Do that no matter how quiet the sounds are, and no matter which ear you hear them in.

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James GallagherÌý 12:06

Okay This is fairly standard. This is what most people who come to the NHS saying, I've got problems with my hearing. This is what you would go through?

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Hannah CooperÌý 12:34

Anyone that goes to any audiology appointment will have their ears looked into and will almost certainly have this test Okay are these nice noises?Ìý You're gonna find

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James GallagherÌý 12:43

Are you going to play ocean sounds to me?

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Hannah CooperÌý 12:44

I'm not gonna play you ocean sounds. No, sorry, it's gonna be some pure tones, which is like a sine wave. So, very, very simple tone, all right.

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James GallagherÌý 12:52

(Beep sound) Oh, that sounds like the beeps on radio four. Okay, that was loud and clear.Ìý (Lower pitched beep sound) Okay, I can still hear that only my right ear, but quite faint. (Higher pitched sound) Oh, I think I just about heard something there. (Beep sound) Oh, that's a really unpleasant squeak. (Beep sound) Oh, that is the faintest of faint noises. I'm pretty certain I reached the point of phantom hearing soundsnow.

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Hannah CooperÌý 13:14

Do you know I think that's really normal. So we're looking for the quietest sounds that you're able to hear. That's like the threshold between when you can hear it and when you can't hear it.

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James GallagherÌý 13:21

You're not going to give me a full me a full diagnosis, because we only did the short version of the test?

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Hannah CooperÌý 13:25

We did a very short version of the test, but so far from what we've got today, your hearing is normal or within the normal range

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James GallagherÌý 13:31

What does normal mean?

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Hannah CooperÌý 13:31

Yeah, that's a great question

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James GallagherÌý 13:32

Because surely normal for, like, a 20 year old is different to normal for somebody who's just turned 40, versus my parents.

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Hannah CooperÌý 13:38

So there are different levels of sound that you heard, right? And we can say that a certain level. So we take 20 decibels as being the normal range of hearing. So you can take 20 decibels...

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James GallagherÌý 13:50

Can you convert 20 decibels into a normal sound for me? Yeah so quieter than a whisper, so maybe leaves rustling, something like that. We're probably talking around 60 to 70 decibels, so it's much quieter than the normal volume of somebody speaking. What we're essentially doing when we're talking about that 20 decibel level is comparing the individual's hearing to a group of normal hearing young listeners, which is how that scale was derived. So your hearing is within the same range as some normal hearing young listeners. I take normal and young to words that aren't normally associated with me (laughter).

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Hannah CooperÌý 14:27

You said about sort of if you compare your hearing to your parents hearing, for example. So as you get older, you tend to lose high frequencies of hearing. So you might have normal low frequencies and mid frequencies, and then we might have to make the high frequencies a bit louder for you to be able to hear them.

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James GallagherÌý 14:43

Okay, so what would be a low a medium and a high frequency sound?

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Hannah CooperÌý 14:46

You can think about it a little bit around speech sounds. So a low frequency speech sound might be mmm, those kinds of sounds. And then high frequency speech sounds are often things like so. Yeah. So the issue there is that you lose the consonant sounds so you can hear that somebody is speaking, but you might not be able to understand what they're saying. So even within normal speech, you're losing sounds and syllables Exactly and potentially the ones that really affect your speech intelligibility, so understanding what somebody is actually saying. When does that all kick in? It's different for different people, right? But I think when you're in your 60s, approximately, we would say that that starts to happen, although some people in their 60s 70s have completely normal hearing. Other people, it might happen a bit earlier for.

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James GallagherÌý 15:29

And the way it works in the NHS at the moment is you have to come in. There's no screening program for every person in their 60s or 70s. So when should you go get one of these tests?

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Hannah CooperÌý 15:39

I think you should go whenever you think you have a problem with your hearing. There's some evidence to suggest that people wait a really long time to seek help with hearing, so much longer than with vision. So as soon as you notice a problem with your hearing, I think it's worth going and having it checked out.

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James GallagherÌý 15:53

I'm going to ask what sounds like a really dumb question, but how do you know that you can't hear very well? Because one of the things you can just do is turn radio four a little bit louder, or crank up the television, or just say pardon and someone will repeat what they said to you. There are so many ways of compensating for sound in a way you can't compensate for sight.

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Hannah CooperÌý 16:11

Absolutely. Sometimes people tell you, maybe they might say, Oh, your TV is really loud. You might find that you're missing what people are saying a bit more. Some people say that it feels like other people are mumbling and that they should speak more clearly. Think if you're asking for repetition a lot, then potentially that's an indicator.

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James GallagherÌý 16:28

So our listener, John, is convinced that his hearing is starting to decline. What should he be doing?

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Hannah CooperÌý 16:34

John should go and see an audiologist. I think that it's not necessarily that he would immediately be given some hearing aids, although he might be if he was having difficulties in everyday life. It might be that there could be other options available for him, potentially something for the telephone. There are apps that you can use now as well. So the first thing he should do is go to an audiologist, get a hearing test and talk about the options.

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James GallagherÌý 16:36

But if you were like John, can you start very early. At the moment, he's first noticing?

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Hannah CooperÌý 16:44

I think what we don't want to do in audiology is provide amplified sound where you don't have any hearing problems. So if your hearing is within the normal range, then you won't get some hearing aids, because we could do damage to your auditory system. But once there's a hearing difficulty or hearing loss, then we can definitely provide some kind of technology, some amplification, particularly with helping you to hear speech, which is what hearing aids are really set up for.

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James GallagherÌý 17:29

Is there anything you can do to avoid having to have an appointment like this or need hearing aids later in life? Or is it just an inevitable part of ageing?

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Hannah CooperÌý 17:38

So two things. First thing is to remember that your ears are self cleaning, so you don't need to put any cotton buds or anything like that in your ears. In fact, the rule is, don't put anything in your ear smaller than your elbow. The second thing is, noise induced hearing loss takes ages to happen. I think the main thing that you can do is take lots of breaks from listening to music. Try not to stand next to a giant speaker when it's blaring out music. So yeah, trying to prevent any noise damage.

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James GallagherÌý 18:06

Hannah thank you so much, and I think you're going to take me to one of your colleagues now on you who's looking at the future of testing

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Hannah CooperÌý 18:12

I am. Let's go. So James, I brought you upstairs at the Ear Institute to meet Professor Maria Chait, and she's going to tell you about some tests that are in development.

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James GallagherÌý 18:27

Hi Maria

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Maria ChaitÌý 18:28

Hi James

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James GallagherÌý 18:28

So what have you got to show me?

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Maria ChaitÌý 18:30

What we're going to show you is an eye tracking test that we're developing to try to address the problem about what happens when somebody's audiogram appears normal, but they're still reporting difficulties listening. So one way to objectively assess these difficulties is to measure something that's related to the effort that you're putting in while listening. So often it manifests in feeling very, very tired after going out to the pub with friends, so after having to listen in noisy environments, to concentrate a lot more, because you have to focus, yeah. And as a consequence, people tend to retreat, actually, from these sorts of situations. And this is sort of one under reported consequence of hearing loss. And what we're trying to do is we're trying to develop tests that would enable us to measure this objectively. So how hard is listening for a given person? And we do that by looking at the eyes.

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James GallagherÌý 19:22

Oh, the eyes are the windows to the ears

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Maria ChaitÌý 19:24

Exactly and that is because, in addition to the pupils, responsivity to light, the pupil has also been shown to dilate when we are experiencing cognitive effort, for example, when we are trying to solve a difficult math problem, or when we're trying to listen in noisy environments

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James GallagherÌý 19:43

Let's have a go

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Maria ChaitÌý 19:44

So I will ask you to sit on this chair. You can put your chin on the chin, right, yeah, adjust it so that it's comfortable. So the idea is that we have you listen to relatively simple sentences, and we progress. Make the sentences softer, so the noise louder, and we'll look at how this affects your pupil response in a way that enables us to say at which point you begin to experience difficulty. So the first thing...

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James GallagherÌý 20:14

So I'm staring at a computer screen with my chin on a chin rest while there is a strange device staring at me. Is this the... this is what's measuring my eyes?

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Maria ChaitÌý 20:24

This is the camera. So now, yeah, you can press the space key. You'll hear a sound. Listen out for the words,

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James GallagherÌý 20:29

here we go Show the dog where the black one is. (Female voice is muffled by white noise) Show the dog where the black one is. So just click on the black square and then the number one (Muffled voice says show the dog where pink three is)Ìý Show the dog where the pink three is, but it was like, almost like being at a railway station or in a very windy environment, so you're kind of listening for it against all of that background noise.Ìý ('Show the dog where the pink three is' plays again) It's not hard to imagine how if that voice was a little bit quieter, this would be really hard to do. So Maria, why do we need better hearing tests?

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Maria ChaitÌý 21:06

I guess the most important one is that there is increasing understanding that pure tone audiometry, which is the standard tests administered in clinics, is not predictive of the difficulties that a listener might face in real life environments, and so a test like this can provide extra evidence for the audiologist to decide for and against a hearing aid or any other kind of treatment.

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James GallagherÌý 21:29

How far off?

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Maria ChaitÌý 21:30

ÌýI would say, five years

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James GallagherÌý 21:32

ÌýAh, I've got time then. Perfect (laughter) What I found really hard about Maria's tests, there was the noise in the background, but I suppose the simple reality is that is life, even if you're just going out to buy a cup of tea. It's why I'm here in this noisy, echoey cafe to discuss the future of hearing aid technology.

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Kevin MunroÌý 21:52

So hello. My name is Kevin Munro. I'm a Professor of Audiology and a consultant clinical scientist in Manchester

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James GallagherÌý 22:00

And Kevin, we've decided to meet up in a noisy cafe. I think my hearing is fine, and I'm having to concentrate in here, I can feel the difference.

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Kevin MunroÌý 22:06

Yeah, and I have a hearing loss, so it's making it a bit harder for me. So I was born with no hearing in one year, and in the last year or two, I've started to develop high frequency hearing loss in my good ear, so I only have the one ear, and it's not working perfectly, and it causes no end of problems.

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James GallagherÌý 22:23

Are you working quite hard to have this conversation?

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Kevin MunroÌý 22:25

ÌýI am. And I've got this little extra bit of technology, this remote microphone lying in front of you

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James GallagherÌý 22:30

I've got my microphone in my hand, but you've also got this tiny little one you've popped on the table.

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Kevin MunroÌý 22:34

So this is a fantastic bit of technology because it uses Bluetooth. So I have this little microphone, and I can place it in front of you. I can put it on a table, I can take it with me, and it really means the microphone is really my ear and it's lot closer to your mouth, but there's so much noise in a place like this that it's still effortful, but it would be a lot harder without this little remote microphone.

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James GallagherÌý 22:54

Give me the history of hearing aid technology, then, because this seems quite swanky, what you've got out in front of you, but take me back to the early days of hearing aids and walk me through it

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Kevin MunroÌý 23:03

So in Victorian times people used your trumpets, didn't they? And I suppose the benefit is they don't need a battery, and they don't whistle, but they're limited in terms of the amplification you're getting through on your trumpet. To come forward to current times, you go to the NHS to get a hearing aid, you will get a digital hearing aid. So the way they process sound, they can collect information about the level of sound coming into the hearing aid, and then they can amplify it accordingly. So if it's a quiet speaker, their voice will be amplified more. If there's a lot of loud sound, the hearing aid will realize, I don't need to amplify this very much, but they do come with extra features, for example, a directional microphone. So all hearing aids assume that if you're listening to someone, you'll be facing them, so the microphone will be more sensitive to sounds coming from in front. But actually, even here, James, directly behind your head, there's a coffee machine going on there. So into my hearing aid, I'm getting you a voice, but I'm getting the coffee machine. So it's not perfect, but it's good. They have other things like digital noise reduction, where the hearing aid will analyse the sound coming in, and if it thinks this is not speech, it will turn the level down a bit. So they are able to do quite sophisticated things. But it doesn't cure a hearing loss. It helps you, and they still have the limitations, as I find, not only as a professional work in the area, but now wearing a hearing aid.

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James GallagherÌý 24:23

I mean there's all that kind of like chat around AI solving everything you get AI inside the hearing aid to sort this thing the hearing aid itself?

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Kevin MunroÌý 24:30

Absolutely. So some of the big international hearing aid companies are now using machine learning and artificial intelligence. So it processes all the sound that goes into the hearing aid. It removes the noise, builds the speech back together, puts it into your ear. So in theory, that should definitely be an improvement and better than what people have right now. I think there's a lot more independent studies have to be done to demonstrate that, but I think that probably is the future.

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James GallagherÌý 24:54

Some headphones we've been marketed as actually being like hearing aids, aren't they now?

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Kevin MunroÌý 24:57

That's right, not completely new. That technology has been available in some ear phones for some time. I guess what is new is they're allowed to call it hearing aids, and your smartphone can be used to test your hearing and then the results of your own hearing test you've done at home can be fed into your earphones so they compensate appropriately for your hearing. Think the good thing is probably remove some of the stigma associated with wearing hearing aids. So I think it might start to break down barriers. I think it might introduce people to the idea of, well, let's just try these. If I get some benefit, then maybe I need to go to the NHS, wherever I'm getting hearing aid

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James GallagherÌý 25:33

Your hearing aid looks very discreet in comparison to one that I remember my granddad having, which was very visible all the time

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Kevin MunroÌý 25:40

Yeah they're getting smaller all the time. And the part that goes into the ear, you almost can't see, right? They're very small. It's very discreet.

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James GallagherÌý 25:47

Kevin, how's this interview been for you? Are you tired now?

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Kevin MunroÌý 25:50

Well, there's a bit of adrenaline because I'm talking to you and you're recording me. I'll be glad to get on the train and go home where I can just sit back and relax. I don't have to concentrate and listen.

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James GallagherÌý 25:59

We've not exhausted you doing it in the cafe. That's what I was worried about

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Kevin MunroÌý 26:02

Not quite

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James GallagherÌý 26:05

Well, I'm glad to be back in the Inside Health studio for a moment of calm and quiet. What struck me while making this program, though, is the acknowledgement from pretty much everyone we've spoken to that we need both better hearing tests and hearing aids, and some of that work is underway, but I wonder if that's enough for our listener, John. He's on the line. So John, you sent us on this quest. What did you make of any of the answers?

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John (Listener)Ìý 26:30

Unfortunately I feel pretty much as though what I brought you is actually the case. So I'm very much still feeling that there are nothing like the corrective measures or interventions available for hearing problems, as there are for visual problems, and even the tests coming in the future won't work for me because I've got false eyes so my eyes don't change, regardless of what you do.

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James GallagherÌý 26:53

So overall, John, have we left you in a more or less happy place?

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John (Listener)Ìý 26:58

I think you've left me kind of where I started, really, with a little bit more information. So that was useful, but I don't know how things can be improved if they can

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James GallagherÌý 27:08

John, I think that just tells us that you were such a switched on listener in the first place

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John (Listener)Ìý 27:12

(Laughs) I do my best

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James GallagherÌý 27:14

Well, a big thank you to John for inspiring this program, and you can get in touch with us by emailing insidehealth@bbc.co.uk hopefully all of your questions won't end with such disappointing answers, but until our next episode, you can explore an interactive guide of health issues that people can find uncomfortable discussing. Just go to bbc.co.uk/insidehealth and follow the links to the Open University. And when you're there, you'll also find a guide on how to make dining out safer if you have an allergy, see you next time.