Podcast Summary: "How To Prevent Hearing Loss"
Am I Doing It Wrong?
Hosts: Raj Panjabi Johnson & Noah Michelson
Guest: Dr. Craig Casper, Audiologist and Founder of New York Hearing Doctors
Release Date: January 9, 2025

Introduction

In the episode titled "How To Prevent Hearing Loss," hosts Raj Panjabi Johnson and Noah Michelson delve into the often-overlooked topic of hearing health. Joined by Dr. Craig Casper, a seasoned audiologist with nearly three decades of experience, the discussion aims to educate listeners on the causes, effects, and preventive measures related to hearing loss. The episode seeks to empower individuals with the knowledge to preserve their auditory well-being amidst modern lifestyle challenges.

Understanding Hearing Loss

Causes of Hearing Loss

Dr. Casper begins by outlining the multifaceted causes of hearing loss, emphasizing that it isn't solely a result of external factors.

• Genetic Factors: "Genetics play a role in everything from a health perspective for us. ... babies that are born with severe, profound hearing loss..." (04:00)

• Noise Exposure: Identified as the number one preventable cause, Dr. Casper highlights everyday sources such as concerts, power tools, and urban noise. "Noise exposure, which is really the number one preventable cause of hearing loss." (04:30)

• Medications: Certain medications, including some chemotherapeutic drugs and high doses of aspirin, can be ototoxic, meaning they are toxic to the ears. "There are certain medications that can cause some damage to our hearing system." (05:00)

• Chronic Illnesses: Conditions like high blood pressure, high cholesterol, and diabetes increase the risk of hearing loss. "Chronic illnesses such as high blood pressure ... put us at a higher risk for hearing loss." (05:20)

• Occupational Hazards: Exposure to solvents and other industrial chemicals can contribute to auditory damage. "Certain solvents can cause hearing loss as well." (05:40)

Types of Hearing Loss

Dr. Casper categorizes hearing loss into two primary types:

1. Conductive Hearing Loss:

   • Mechanism: Problems in the ear canal, eardrum, or middle ear bones (hammer, anvil, stirrup) impede sound conduction.
   • Examples: Earwax blockage, scar tissue on the eardrum.
   • Treatability: "Typically results in what's called a conductive hearing loss. It's usually medically treatable." (08:00)

2. Sensorineural Hearing Loss:

   • Mechanism: Damage to the inner ear (cochlea) or auditory nerves impairs sound transmission to the brain.
   • Causes: Noise overexposure, genetics, medications, viral infections like COVID-19.
   • Treatability: "That's not something that's typically medically treatable." (09:57)

The Role of Stress and Tinnitus

Impact of Stress on Hearing

Raj and Dr. Casper explore how stress doesn't directly cause hearing loss but affects auditory processing.

• Auditory Processing: "If we're in a noisy environment, I have to pick up the person I'm listening to from all the nonsense that's going on. ... stress can impact totally." (11:08)

Tinnitus: The Hidden Symptom

Tinnitus, or ringing in the ears, is discussed as a common symptom associated with hearing loss exacerbated by stress.

• Mechanism: "The brain realizes that it's not getting input from the auditory system, it literally jacks up its internal amplifier... creates this phantom auditory perception." (14:30)

• Stress Connection: "All of a sudden, we start paying attention to the tinnitus... becomes a problem for us." (15:47)

Living in a Noisy Environment

Urban Noise Exposure

The hosts discuss the challenges of residing in loud cities and its implications for hearing health.

• Sound Levels: "There's noise all over the place. But just because there's noise doesn't mean it's dangerous for our hearing." (17:57)

• Safe Exposure Levels: Utilizing OSHA standards, Dr. Casper explains that exposure to noises below 85 decibels for up to eight hours is generally safe. "For every five decibel increase, we literally reduce our safe time in half." (17:58)

• Practical Tips: "Stick your fingers in your ears for that period of time" during high-noise events like passing sirens or subway trains. (18:36)

Protective Measures for Hearing Health

Using Earplugs

Dr. Casper advocates for the consistent use of earplugs, especially in environments with potential loud exposures.

• Types of Earplugs:

  • Foam Earplugs: "Great if you're using power tools or something where you don't need to hear clearly." (29:21)
  • Filtered Earplugs: Allow for clear sound transmission while reducing volume. "They're like less than 20 bucks. They're called ER20s Etymotic Research." (29:53)
  • Custom Molded Earplugs: "Custom versions... super nice and comfy." (30:00)

• Occupational Use: Even professionals like dentists wear earplugs to prevent hearing loss from prolonged noise exposure. "Dentists wear these types of plugs as well." (30:10)

Headphone Usage and Volume Control

The discussion shifts to modern audio consumption habits and their impact on hearing.

• Volume Recommendations:

  • Stay Below 65% Volume: "If you're at 65% of your volume and lower, you're pretty much good all day long." (28:04)
  • Avoid Prolonged High Volumes: Listening at higher volumes for extended periods can be detrimental. "Once you start listening for hours at that level, then you're going to encounter some issues." (28:15)

• Noise-Canceling Headphones:

  • Benefits: Reduce the need to increase volume by electronically canceling out external low-frequency sounds.
  • Cautions: "Be aware of your surroundings" to ensure personal safety while using them. (26:34)

Alternative Hearing Protection

• Sound-Isolating vs. Noise-Reducing:
  • Sound-Isolating: Blocks external noise entirely, ideal for environments like concerts.
  • Noise-Reducing: Less restrictive, allowing some ambient sounds to remain.
  • Quote: "The noise cancellation headphones are really interesting because ... allowing you to drop your volume." (26:46)

Hearing Tests and Technological Advances

Importance of Regular Hearing Tests

Dr. Casper emphasizes the necessity of baseline and periodic hearing assessments to detect and address hearing loss early.

• Baseline Tests: "Get a baseline hearing test, regardless of what age you are." (39:56)

• Frequency Based on Health Conditions: Individuals with diabetes, hypertension, or cardiovascular diseases should undergo annual hearing tests. "If you're somebody who has diabetes ... get your hearing tested every year." (40:11)

Emerging Technologies: Apple Hearing Test

The introduction of Apple’s hearing test feature is discussed as a preliminary step towards hearing health awareness.

• Functionality: Utilizes AirPods to perform basic hearing assessments.

• Reliability: "It's a really good estimate and understanding of what your hearing pattern looks like. It's not a perfect diagnostic." (42:00)

• Recommendation: Use as a first step and consult a professional if anomalies are detected. "Use that test. If anything seems a little off schedule, ... see someone like you." (42:13)

Proper Ear Cleaning Practices

Debunking the Q-Tip Myth

The hosts address common misconceptions about ear cleaning and provide expert advice.

• Why Q-Tips Are Harmful:

  • Risk of Earwax Pushback: "If you just stick that in your ear, all you're doing is plunging the wax further down into the ear canal." (43:24)
  • Potential for Eardrum Damage: "Start brushing their teeth, the Q tips still sticking in their ear, and then ... conductive hearing loss because you punctured the eardrum." (44:10)

• Recommended Cleaning Methods:

  • External Cleaning: Gently wipe the outer ear with a damp cloth.
  • Ear Drops: Use hydrogen peroxide or similar solutions to soften wax before flushing. "The drops soften up the wax and then it'll flush out." (46:26)
  • Professional Assistance: Seek professional help for excessive wax buildup. "Have them look in your ears. There's easy, simple ways to get it out that are safe." (45:55)

• Expert Advice: "You can use a soapy finger ... just put a soapy finger in there and that should be fine." (44:45)

• Warning Against Dangerous Practices: "Don't use Q tips ... nothing in there that says it's used for cleaning ears." (43:05)

Addressing Stigma and Promoting Hearing Health

Changing Perceptions

The conversation shifts to the stigma associated with hearing loss and the importance of normalization.

• Historical Stigma: Traditionally, hearing loss was seen as a sign of aging and associated with negative perceptions. "Why is there so much stigma against hearing loss ... it's a sign of aging." (34:07)

• Evolving Attitudes: Modern hearing aids are discreet and technologically advanced, reducing stigma. "They're tiny. They're computers. They've got AI elements in them now." (35:24)

• Youth and Hearing Loss: Increasing awareness among younger populations about hearing health challenges. "We're seeing more younger people actually do something to treat their hearing now." (35:24)

Personal Testimonials

• Impact on Quality of Life: Dr. Casper shares stories of how untreated hearing loss leads to social isolation, anxiety, and depression. "You have somebody who has untreated hearing loss and their life is very different..." (36:08)

• Listener Stories: Raj mentions a narrative about a woman whose anxiety and depression improved after using a hearing aid, underscoring the profound effects of addressing hearing issues. "There's an essay edited about a woman ... got a hearing aid and felt better immediately." (36:25)

Key Takeaways: Better in Five

1. Hearing loss can occur at any age.
   "Hearing loss can happen at any age, so get your ears checked."
   (49:37)

2. Living in a loud city isn't inherently harmful.
   "Living in a loud city actually shouldn't be too much of a problem. It's how long you're exposed to the noise that matters."
   (49:42)

3. Maintain headphone volume below 65%.
   "Keep your headphone volume at about 65% or less."
   (49:50)

4. Use ear protection to prevent hearing loss.
   "Wearing ear protection can prevent hearing loss. So get out those earplugs."
   (49:57)

5. Stop using cotton swabs for ear cleaning.
   "Stop using cotton swabs to clean your ears."
   (50:03)

Conclusion

The episode concludes with a reaffirmation of the importance of proactive hearing health management. Both hosts express their newfound commitment to better hearing practices, inspired by Dr. Casper's expertise. Listeners are encouraged to get regular hearing tests, use protective gear in loud environments, and adopt safe ear cleaning habits to preserve their auditory health for the future.

Notable Quotes

• Dr. Craig Casper [04:30]: "Noise exposure, which is really the number one preventable cause of hearing loss."

• Dr. Craig Casper [08:00]: "That's just once you've lost some hearing, you're just stuck in a way."

• Dr. Craig Casper [14:30]: "Your brain turns up the internal amplifiers, creates this phantom auditory perception..."

• Dr. Craig Casper [26:34]: "Anything that's going to allow you to drop your volume, not compete, is going to give you longer time under headphones and also save your ears at that point too."

• Dr. Craig Casper [42:00]: "It's a really good estimate and understanding of what your hearing pattern looks like."

• Dr. Craig Casper [35:24]: "They're tiny. They're computers. They've got AI elements in them now."

Final Thoughts

"How To Prevent Hearing Loss" serves as an essential guide for anyone looking to safeguard their hearing amidst the hustle and bustle of modern life. By addressing common misconceptions, providing practical solutions, and reducing the stigma associated with hearing loss, the episode equips listeners with the tools needed to maintain their auditory health effectively.

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