The often-forgotten health condition impacting veterans on World Hearing Day

What are some of the health conditions that most commonly affect veterans and how might they be linked to hearing loss?

Two of the most prominent conditions affecting veterans are noise-induced hearing loss (NIHL) and post-traumatic stress disorder (PTSD). While prevalent in the general public, each is a uniquely common health problem for veterans based on the important jobs they’re asked to perform.

Also common is tinnitus, a ringing in the ears that afflicts about 10 percent of Americans but disproportionately affects veterans. By the nature of their military work, many were exposed to excessive noise—machinery, engine noise, artillery fire, more— putting them at increased risk of tinnitus. All three of these health conditions can lead to social isolation, loneliness, and depression, which are commonly associated with untreated hearing loss.

Additionally, according to a recent study of injured military personnel, hearing loss and PTSD may be linked. The study’s authors found that the risk of PTSD in veterans was about three times higher in individuals with hearing loss in both ears, in comparison to those without hearing loss. The reason, at least in part, is that hearing loss—even partial—can affect a veteran’s ability to listen and communicate, which decreases their quality of life and exacerbates mental health conditions, such as PTSD.

It seems that hearing-related health issues often tend to be overlooked. Why do you think that is?

There are several misconceptions about hearing loss, which contribute to hearing loss being misunderstood and overlooked. Hearing loss can sometimes be difficult to interpret, especially when veterans in a younger age group aren’t expecting and looking for symptoms. Although most people who decide they need hearing aids are in their 60s and 70s, about half of all military veterans are below the age of 55. In other words, many Americans address the effects of hearing loss later in life, but veterans often grapple with symptoms, such as tinnitus, earlier. www.signia.net/en-us

Especially for those in a younger age group, hearing loss may go unaddressed because of the social stigma associated with it. Modern hearing technology is more efficiently combating this stigma with sleek, modern designs that are more attractive to younger users.

What are the risks of letting noise-induced hearing loss (NIHL) or other hearing-related conditions go untreated?

Noise-induced hearing loss leads to difficulty discerning high-pitched sounds (other forms of hearing loss impact lower frequencies). When a veteran has problems hearing high frequencies, it impacts communication and their ability to understand voices, and can present secondary symptoms such as fatigue and difficulty concentrating.

In the case of tinnitus, because it often co-occurs with NIHL, it is associated with higher rates of PTSD. In some cases, tinnitus may also impact traumatic flashbacks. Although tinnitus is not hearing loss, research indicates that it can be a sign of hearing loss to come, and therefore requires early identification and treatment.

Generally, over time when hearing loss is unaddressed it gradually worsens. When sufferers constantly strain to hear and have trouble communicating, they may be more likely to withdraw from social situations, which adversely affects their mental health. A significant delay in treatment could have a serious impact on quality of life.

What options are available to veterans who want to manage their hearing loss and prevent any further damage?

A first step for veterans is to get a baseline hearing test to assess hearing health and hearing risks. Fortunately for veterans, the Department of Veterans Affairs recognizes the heightened risk of NIHL and tinnitus from military service and covers diagnostic audiology from the moment a veteran exits the service. In fact, it’s VA policy that once a veteran is enrolled in VA health care, he or she is automatically eligible for diagnostic audiology. It is in veterans’ best interest to avail themselves of these services because hearing loss, diagnosed early, is eminently and conveniently aided through modern technology.

Being equipped with the right hearing solutions will also help greatly. Modern hearing technology can dramatically improve a veterans’ ability to hear and communicate in various settings. For example, hearing aids with split processing technology make it so NIHL sufferers can listen and socialize with ease in all environments—quiet, noisy, or normal.

Advanced hearing aids can also treat tinnitus. Specialized hearing aids made available through the VA incorporate a technology called notch therapy, which can eliminate or suppress tinnitus after being fitted to the patient.

How can new hearing health technology help veterans care for their total mental and physical wellbeing and why is it essential to take a holistic approach to hearing care?

Taking a holistic approach to hearing care will ultimately improve a veteran’s general mental and physical fitness. As discussed above, untreated hearing loss and tinnitus put veterans at increased risk of social isolation, PTSD, and other mental health struggles. Simply put, better hearing equates to better living.

Veterans should feel encouraged to bolster themselves with the solutions that will help them care for their hearing, and technology is rapidly evolving to meet veterans’ needs. Today’s hearing technology devices aren’t bulky, and they’re capable of more, bringing increased benefits to veterans.

The gap is closing between hearing aids and traditional modern wearables, and the most current hearing aid models can help veterans track their daily movement and activity, social engagement, and hearing aid wear time, to help ensure that they look after not only their hearing, but all connecting aspects of their health as well.

Brian Taylor, AuD is a Doctor of Audiology and Senior Director of Audiology for Signia. He is also the editor of Audiology Practices, a quarterly journal of the Academy of Doctors of Audiology, editor-at-large for Hearing Health and Technology Matters and adjunct instructor at the University of Wisconsin. Dr. Taylor has authored several peer reviewed articles and textbooks and is a highly sought out lecturer. Brian has nearly 30 years of experience as both a clinician, business manager and university instructor.

By Kie Copenhaver CSA, RHIA, SHSS, RCFE www.agingwellpartners.com

March is Brain Injury Awareness

Month so let’s talk about your brain.

The brain is approximately 3-4 pounds of soft tissue floating in cerebrospinal fluid (CSF), surrounded by multiple layers of membranes that serve to protect and cover it. Beyond the membranes is the skull, the dense bony structure that protects our brains from the bumps, jolts, bangs and falls of everyday life. Brain injuries occur when we sustain an injury to the head; the severity of the injury will determine the level of brain injury sustained. Brain injuries can range from mild, such as a concussion sustained while playing in a sporting event, to moderate/severe which can result from a car accident, gunshot to the head or being near an explosion.

A brain injury occurs when a sudden jolt to the head causes the brain to hit against the inside of the skull, causing bruising of the brain tissue. Depending upon the outside forces causing the brain injury, the brain can actually rotate inside the skull causing tearing of tissues, blood vessels and nerves in addition to bruising. This severity of injury can cause what is known as a Traumatic Brain Injury or TBI. Most brain injuries are considered closed head injuries meaning the brain and supportive membranes were not exposed to the external world. An open head injury, on the other hand is when the injury is severe enough to cause the brain to be exposed to outside air and other elements.

The brain is essential to our survival. It can process up to 11 million bits of information per second. Don’t ask me to do the math for what that looks like over the course of a “normal” day but suffice to say, the brain does a lot of work, much of which we aren’t even aware. So, when the brain sustains even a minor injury, it can affect our whole being. Brain injuries result in changes to one’s physical, cognitive, and emotional/behavioral functioning and these changes can be temporary, in the case of a mild brain injury, to long-term, in the case of moderate to severe brain injury. People who have sustained a brain injury may experience a wide array of symptoms which can make diagnosing a brain injury difficult.

The Model Systems Knowledge Translation Center (MSKTC) has done in-depth research and study on brain and spinal cord injuries. Their website contains a plethora of information on brain injury issues such as alcohol and TBI, driving and TBI, voting tips for those with TBI, sleep and TBI plus many more. “Understanding TBI Factsheet” is a four-part series covering the following topics: What Happens During Injury & In Early Stages of Recovery, Brain Injury Impact on Individuals’ Functioning, The Recovery Process for Traumatic Brain Injury, and The Impact on Family & How They Can Help. These resources are for the patient AND the caregiver/spouse/ loved one and can help individuals and families navigate the TBI journey.

Check out www.msktc.org for more information and protect your brain - talk to your doctor if you think you have sustained a brain injury.