Mark S. Brigham D.O., Inc.

10/28/2025

Most people don't seem to realize that difficulty with hearing-more than any other sense-tends to impact everybody ELSE more than the person with the hearing loss. Hearing almost always takes a back seat to pretty much everything, so by the time that it IS addressed, there has been a great deal of life that has passed by.

We frequently hear from frustrated family members that cannot stand to be in the same room as a spouse or parent because the TV is painfully loud, but to the relative, it is just the right volume. It doesn't sound too loud to them, but like the person that doesn't notice that they are shouting over their headphones' volume, it is bothering everybody else in the room.

The cartoon is a lighthearted poke at a very stressful way of living. It is exhausting to live with somebody with hearing loss! To have to constantly repeat themselves and to often do it at a louder volume than their natural voice, wears down your family and friends and to be in a room where the TV is twice as loud as comfortable is a miserable experience.

With hearing loss, your private conversations aren't as private as you think, that video you're watching quietly on your phone is annoying people 15 feet away, and you can't even begin to imagine what all you're missing out on because the hearing loss sneaks up on you so slowly that you didn't notice those sounds slipping away.

Because of our ear's anatomy, most people will start to show some decline in the high frequencies long before you notice it in the low frequencies, but it occurs over years and at a rate that is imperceptible until it is quite significant. The high frequency range of your hearing includes subtle sounds that are crucial for your ability to understand WHAT people are saying. You can hear the talking, but the clarity is easily lost when you have a high frequency hearing loss. This can lead to misunderstandings, not realizing that people are even speaking at all, and missing out on things like rustling leaves, bird chirps, and a laughing 2 year old.

When people are properly fit with hearing aids, they are often amazed at the things that they hadn't realized had slipped away in their lives, but it is appreciated even more by their loved ones that no longer have to shout.

Hearing aid candidacy is determined by a comprehensive hearing evaluation from a licensed hearing heath practitioner AND the patient's openness to their benefit. If you refuse to accept that you'll benefit and if you refuse to give them the opportunity to help you, then you are not a candidate at this time. This is an unfortunate situation because through it all, the people around you are the ones that may be suffering the most.

10/08/2025

A few patients have inquired about at what point might they want to start looking at cochlear implants as an option. The candidacy for the implants is more complicated than just where on the chart your hearing lies, and we refer possible candidates to a cochlear implant specialist that works directly with University Hospitals to help determine if the person is a good candidate. UH works with all three manufacturers of the implants and through this process will determine which one is the best for your needs.

If you or somebody that you know is curious about cochlear implants, what they do, and how they differ from hearing aids, there will be a virtual event to discuss them next week on October 14th at 7pm. They are vastly different from hearing and are for when hearing aids are no longer sufficient. There is a significantly more involved adjustment period utilizing several different disciplines in the healthcare industry. Videos can be found on YouTube that replicate what something would sound like through an implant.

This is not meant to deter people that would benefit because for the right candidate, a cochlear implant can be a miracle. However, just like with first time hearing aid users, we want to be sure that your expectations are not too lofty.

If you are interested in attending this virtual event, please register at:

https://webapp.spotme.com/login/sonova/journey-to-sound-ohio-valley

09/08/2025

A recent study of over 7 MILLION Veterans has discovered possible connections between untreated hearing loss and Parkinson's Disease. SO many patients come in for their first hearing evaluation when they're in their 70s or 80s because hearing health is not prioritized by most people, although more and more examples of how hearing loss can impact other aspects of our health continue to surface.

A comprehensive hearing evaluation looks at the entire auditory system from your ear lobe to your brain and can detect serious medical conditions such as a tumor on the auditory/vestibular nerve. A baseline evaluation-the sooner, the better-can catch problems before they escalate.

"Results showed that those with hearing loss have a much higher risk of developing PD later in life. Research also showed that those who have the worst hearing loss seemed to have the highest risk of developing PD.

The study also looked at any link between the use of hearing aids and lowering the risk of developing PD. Researchers found that as long as people got a hearing aid within two years of having an abnormal hearing test, their risk of developing PD later in life was lowered substantially."

A new study from a database of millions of veterans nationwide reveals a possible connection between hearing loss and Parkinson’s disease.

07/10/2025

Traveling with allergies?
Some extra planning can help for a comfortable vacation.

Be mindful of airplanes and dry cabin air, which can irritate nasal passages. Bring saline spray or gel with you. If you know your ears struggle with changes in altitude (particularly ascent and descent), despite normal measures such as chewing gum or drinking water, consider using Afrin nasal spray or taking a decongestant one hour prior to flight. Other pressure reducing devices such as earplanes or mack’s flight guard may also help with pressure. ✈️

With hotels and Airbnb‘s don’t be afraid to ask for accommodations such as pet free and smoke free rooms. Some places might also offer dust mite covers for bedding. Consider bringing your own hypoallergenic pillowcase or a portable air purifier.

If traveling to a different climate, check pollen counts and forecasts ahead of time. If spending time outdoors, make sure to shower after and change clothes. If traveling by car, keep the windows up and use air conditioning. Remember to check & change your car cabin filter routinely.

Bring all necessary medications, supply of as needed meds, EpiPens, and nasal saline rinses like Nettie pots (please use distilled water).

If you’ve made it this far with reading my post, I’d like to know where you have been or plan to go this year?

05/23/2025

Sadly, the market is flooded with fake miracle pills and bizarre procedures that claim to fix tinnitus, however there really are legitimate attempts to tackle ringing/buzzing/choosing etc in the ears.

04/09/2025

In celebration of Cherish an Antique Day, here is the antique audiometer that is enjoying it's golden years in our testing room.

This model of Maico audiometer was manufactured between 1949 and 1953, however that was all of the information that the company was able to provide.

It still lights up, and it still plays tones!

03/03/2025

Coming soon to our office, medical ear piercings. 💎 what better place to provide ear piercings than a sterile, medical environment performed by ENT experts. This jewelry is QUALITY.
Pricing will be announced soon, along with special discounts to first 10 customers! Stay tuned for more info!
-Natalie Topp FNP-C

02/21/2025

It is fairly often that we have a patient that mentions a spouse or parent that they wish would get their hearing tested, but the other person is in denial. What that other person fails to realize, is that hearing loss is THE most difficult sense impairment...for those around you. If your vision is waning, you can sit closer to the TV. If your hearing is declining and you turn the TV up to where it sounds fine to you, you are likely to make things very unpleasant for those around you that do not have hearing loss. If your sense of taste declines, dinner won't be disrupted for others at your table, but your dinnertime conversation may be frustrating if your hearing isn't as good as you think that it is.

This video is a very quick approximation of what the same scene would sound like from the perspective of different kinds of hearing loss. Everybody's hearing configuration is different, but this represents the typical decline of high frequency hearing that we see most often.

This simulation is for those of you that may be exhausted from dealing with a loved one's declining hearing. It is an opportunity to glimpse into their world and experience the immense challenge that communication may be for them. The hearing loss occurs VERY gradually over many, many years. You may wonder how these examples would not be obvious to the person with the hearing loss, but remember that you are not taking it in in real time. It is like looking at a photo of the summer sky at 6 pm, then 8 pm, then 9:30, then 10:00. If you are outdoors from 6 to 10, the sunset happens so gradually that you wouldn't notice until it was getting pretty dark. Spread that over years (maybe decades) and that is closer to what a severe hearing loss is like.

This is not an effort to excuse their denial! It is just a way to hopefully understand how incredibly difficult it is to hear and listen with a hearing loss. If your spouse "ignores you" when they're watching TV, it is likely because listening can take so much effort and attention that they just are not aware that you are speaking. Getting somebody's attention BEFORE speaking is critical in these situations and remember that if they can see your face, communication is much easier. Remember how tricky it was to understand people when masks were everywhere? Yeah, it's like that all of the time for some people with hearing loss.

Oh, one last thing. Nobody does well when you're trying to talk to them from another room! Many frustrated patients bring this up. If you suspect hearing loss, try to remember that walls are not your friend during communication!

An example of what hearing loss sounds like using a clip from the Flintstones. This is a tool to help those with normal hearing relate to those suffering fro...

02/14/2025

Hearing protection is all too often overlooked.

When our ears are inundated with decibels, we may have a ringing or "fuzzy" feeling afterwards. That is called "temporary threshold shift", and that is your hearing thresholds (the softest volume that you can hear) being changed. Your ability to hear quiet sounds actually gets worse for a period of time. In other words, you experience a temporary hearing loss...or IS it temporary? There have been studies that suggest that on a very small level, a part of your auditory system may actually experience permanent damage.

If you experience enough of these temporary threshold shifts, it will become a permanent threshold shift-in other words, a detectable hearing loss. We tend to naturally lose high frequency hearing just from living. Add to that extreme volume levels, and you are asking a heck of a lot of a very tiny anatomical system.

You cannot shut your ears off. The mechanisms that allow us to process waves in the air into impulses of sound to the brain are on 100% of the time and the fluid in your inner ear is always moving which in turn is constantly causing motion of the hair cells in our inner ears. These hair cells are extremely durable, but they were never intended to process the abuse that our modern life presents. Once they are displaced, there is no recovering the hearing that is controlled by those hair cells.

Many of our patients report noise exposure that came at a time when ear protection was just not a thing that people did. The hazards of high levels of noise are well documented today and the options for hearing protection are vast, yet hearing protection is still not on the radar of many of the people that need it the most.

Without going into much detail about decibel levels and exposure time, let's just say that if you have to shout to be heard, the environment is likely too loud to be safe. Hearing loss usually manifests very slowly and is focused on a small section of our hearing at first. This small notch in our hearing is very easily overlooked since the rest of your hearing may be pretty good. As the assault to your ears continues, you can expect that notch in your hearing to worsen and spread. I have seen MANY patients with fantastic low frequency hearing that plummets in the high frequencies, and this very often makes it hard to detect the hearing loss for that person. They can hear so well in low and maybe middle frequencies that they don't notice the high frequency loss. These high frequencies are where the clarity of speech is, so you can hear people talking but may struggle to understand them or follow conversations. This is especially the case when there's some background noise.

If nothing else, foam ear plugs from any drug store will help. If you require something more, there are many options of filtered earplugs sold as "one size fits all" and beyond that, custom earplugs can be a game changer. There are specialty plugs for shooters, for musicians, for swimming, or even custom plugs just for a quieter environment (sleeping, studying, etc). We offer all of these options and work with a few different manufactures that pretty much just do earplugs or earmolds for hearing aids.

If you only want to keep really loud stuff out, foam plugs and/or earmuff hearing protection is fine. For shooters, it is recommended to use BOTH at the range. If specialty plugs are needed, we take ear impressions to ensure that the ear plugs will fit your specific ears, and then they are made in whatever color combination you'd like. Swimmer's plugs float just in case they do pop out, shooter's plugs have electronic components that allow you to hear and activate only when sounds above a certain decibel level are presented, and musician plugs are specially filtered to allow the sound to be at a reduced volume without compromising the frequency response. You can even get custom tips for your earbuds or communication earpieces.

Whatever method you use, use it consistently. FYI, a small pill carrier on a keychain can be repurposed to carry a set of earplugs everywhere. Protect what hearing you still have so that you don't need to come and see us down the road

For fun, here's a photo of the hair cells in a healthy ear and one that has experienced a great deal of damage:

01/15/2025

Tinnitus is the presence of sounds without any external source. Lots of us experience this, but not everyone is able to block it out. Here is a great bit of information to help understand what it is.

Travel into the auditory system to explore the constant ringing sensation of tinnitus, why it happens and how to treat it. --Tinnitus has been bothering huma...

12/31/2024

Just a reminder that if your New Year's celebration involves fireworks, keep every part of yourself safe. We don't want to see anybody on Friday for acoustic trauma.

Also keep in mind that hearing aids are tricky to put in your ears if you are missing some of your fingers. Not impossible, but let's keep it safe, shall we?

12/04/2024

HEARING LOSS PT 2:

"Everybody mumbles."

"My hearing is fine."

These are common phrases to hear in an audiology clinic and sometimes, they ARE true. However, they are often more of a denial of an existing hearing loss.

But IS it really denial? Studies show that from the time that somebody starts to recognize an issue with their hearing to the time that they make their first step toward doing something about it, an average of 7 YEARS has elapsed. This may seem like denial or stubbornness (and sometimes it totally is), but there is a good chance that it could be something else.

To understand how somebody can be so resistant to the hearing loss that is so obvious to a spouse, coworker, friend, family member (and sometimes neighbor, if the TV is cranked), we need to have an understanding of how hearing loss tends to occur, and how it is so very different from something like vision loss. This is a key point to understand, especially if you are in frequent contact with a hearing impaired person.

I suspect that many people feel that hearing loss would be like somebody turning down a volume k**b on life, but it is almost never like that. I sometimes try to explain what vision loss would be like if we lost our vision the way that many people lose their hearing. If our vision declines, often everything loses sharpness relatively uniformly (if there isn't an underlying factor contributing). Imagine that instead of that, the color yellow started to fade very slowly, followed by orange at a slower rate. After that, maybe pinks would start to lose their vibrancy. Red may be impacted slightly, but let's say that blues, greens, browns, etc are still as full as they've always been. You could go years without ever noticing that things were changing because so much of what you see is "normal" and only certain lighter colors are impacted. Maybe you start to wonder why people are gushing over a spectacular sunset when it just seems "okay" to you. It could take several years of this before you happen to notice that that picture, an azalea in the yard, or some object that you've had for 25 years is looking duller than it used to.

This is how hearing loss sneaks up on many people. In the Ear, Nose, and Throat (ENT) world, we see a huge variety of hearing loss configurations, but by far the most common is a loss of hearing in the high frequencies which very often occurs with normal or near normal hearing in the low or middle frequencies. If you picture a piano keyboard, the people in these cases would not hear the keys on the right side as well as they hear the ones in the middle or to the left, and some won't hear them at all. These people may hear the left hand notes as well as they ever did, and this is what can cause confusion. If they were listening to a piano performance, they would hear many of the notes just fine-well enough to not even notice that the others weren't balanced. Likewise, they can hear people talking and may understand them pretty well, but sometimes struggle with certain voices, sounds, or situations.

"Selective hearing" is a rather common diagnosis-most often made by a significant other! They laugh about it, but IS it somebody just not listening? Many people will come in for a hearing test insisting that they can hear fine, but then the test shows something very different. They may hear MOST of the frequencies used in speech, but these high frequency losses tend to impact the subtle consonants like "sh, f, th" etc. These help us understand what we're hearing and these sounds are very easily covered by background noise, making conversations difficult to understand, even if they are audible. This is frustrating to the listener as well as those that are constantly being asked to repeat themselves.

There are many factors that may contribute to this high frequency hearing loss. Some medications or medical procedures can bring it on (chemotherapy can be very rough on your auditory system), noise exposure impacts a certain range of those high frequencies, but high frequency hearing loss is very often just a side effect of living life. The way that our anatomy is set-up, the microscopic hair cells in our inner ears that are responsible for translating sound waves into impulses to our brain take a substantial beating in the high frequencies first. They get worn down from use. It is usually impossible to pinpoint just what has caused your hearing loss, because it is almost always an amalgamation of factors that occur over years

This type of hearing loss can easily cause us to mishear certain words-especially if somebody is speaking quickly or facing a different direction. If the listener is engaged in something (watching TV, reading, scrolling on a phone, etc), that could make it even more difficult to pick up that somebody is speaking to them. Television can be difficult to watch even with decent hearing, so somebody that is hearing impaired will need to concentrate even harder to hear, and this may take some concentration away from hearing somebody that is trying to talk to them. Rather than getting annoyed because they have not responded to what you said, maybe find a way to get their attention BEFORE talking. It isn't (necessarily) that they aren't paying attention, but hearing can take a surprising amount of effort. It also doesn't help AT ALL if the speaker is in another room! We hear this counter-argument fairly often from people that are defending themselves from accusations of hearing loss. Heck, we even do it here amongst ourselves with two audiologists talking from adjacent rooms, and if ANYbody should really know better, you'd think it would be us!

Communicating with somebody with hearing loss can be exhausting, but these steps could possibly help ease the experience a bit.

Sometimes, these seemingly normal high frequency hearing losses may suggest a more serious problem, as was touched upon in Part 1. Your audiologist should be on the lookout for signs that your hearing loss may be something more, and a referral to ENT out of an abundance of caution is a good idea.

Up next, the different types of hearing losses and how they are treated....