Fact or Deception?
I recently had a conversation with a hearing aid dispenser whom I highly respect, and whose opinion I often seek when I have hearing aid fitting problems. So, I was somewhat surprised when he presented me with a “difficult” case for which he had no solution and asked if I could share it with other dispensers to see if they had any thoughts to share.
Hearing Status
The patient (HJ) is a 63-year-old male who has the hearing levels shown in the audiogram and who has been reporting hearing loss symptoms for several years. Hearing thresholds are fairly similar, showing moderate to moderately-severe hearing levels, but showing very good word recognition scores of 80% for the right ear, 90% for the left ear, and 100% at MCLs of 70 dB HTL. UCLs were 110 dB for each ear to speech. His hearing and medical status has not changed over the last twelve months.
HJ is an outside farm supplies representative who also maintains a family farm. He trialed CIC digital hearing instruments approximately three years ago, but rejected them because of his own voice (occlusion effect), physical plugged-up sensation, and their failure to address his primary related complaint – that of understanding speech in noise.
Current Trial
His primary reason for seeking hearing aid assistance now is to satisfy his girlfriend’s expressed frustration of having to repeat herself during their conversations. He is very conscience of cosmetics and believes that something in the ear would be best for him. Therefore, premium CICs with maximum venting were ordered for him. The trial that ensued was to determine if the aids ordered would satisfy his expressed hearing needs.
After three weeks without any success in solving his hearing problems with two CIC (completely-in-the-canal) instruments, the dispenser loaned the patient a pair of completely open-fit RIC (receiver-in-the-canal) instruments, which HJ preferred to the CICs. The occlusion effect issues were greatly reduced and listening was enhanced. However, during this entire fitting period (starting with the CIC instruments), the patient complained of sinus-type headaches following short-time hearing aid use (within 5 and no longer than 15 minutes), and showed extreme sensitivity to prescriptive amplification. To satisfy the latter concern, the instruments were fitted 8-10 dB under target (gain and output) – even for a first-time user just to be able to provide an amplified listening experience.
Now, For the Weird Part
When the hearing aids were muted,or the batteries removed, the patient did not experience the headaches. Out of curiosity, and wondering if there might be a zinc reaction, a zinc cell was taped behind his ear for 20 minutes. There was no adverse reaction (no headache). He has seen a physician about the headaches, but no explanation for cause was advanced.
Many of us might be thinking that this patient is doing and saying just about anything to not wear hearing aids. That is entirely possible. Or, might there be a reaction to the plastic of the housing? One was acrylic (CIC) and the other reported to be ABS (Acrylonitrile butadiene styrene) in the RIC instruments. But, this would not explain the absence of headaches when there was no amplification. Could it be the amplified sound? Serious measures were made to reduce the amount of amplification, but even low levels resulted in the patient headache complaint.
In spite of this, and even though he rejected the CIC instruments outright, the patient claimed to be motivated to wear the open RIC instruments, but could not tolerate the headaches. What do you think is going on?
I wonder if removing all gain from the transition from by-pass (vented) to amplified sound might reduce the problem – maybe he reacts to the phase confusion around this point.
I have one patient with this complaint and was never able to resolve it with the instruments we were using. I did try another brand so sound was handled differently and it helped but did not stop it altogether. Have always wondered at the cause but have never even talked to anyone that has had this happen with their patients.
We did try not only reducing gain but eliminating certain frequencies and the only ones that made any difference at all were in the mid freqs where they were needed for understanding.
If you find out cause would love to know.
I know it’s a long shot but could this be some unusual nocebo effect? Perhaps the first headache was a sheer coincidence but he erroneously assigned the RIC amplification as the cause thus creating a cause and effect relationship between the two in his head. Again, I know it’s a stretch.
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0404.2008.01035.x/abstract;jsessionid=88F706457D888FABDA899C5F1136AFBC.f03t04?deniedAccessCustomisedMessage=&userIsAuthenticated=false
I have been trying to use RIC hearing aids for 3 months. I really want to hear better and understand conversations when out socially. My problem is the headaches! Within a minute of putting them in, I am slammed with a headache. The Audi doesn’t believe me. He even had me go to the Dr. to see if I had an ear infection. I do not believe it is the sound, as much as something (tiny) in my ear. It is indeed like a sinus headache, and takes hours to go away after removing them. I have tried everything and just can’t wear them.
My husband is a retired engineer who worked with digital audio and video for many years in the television industry. All digital processing requires extremely fast digital clocking rates in turning the analogue sound signal into a digital one. We believe this has rather like the effect of using wireless- and mobile- phones, neither of which I can use because of similar effects, but this includes the heating effect on the particular ear that the phone is held next to – this is a known heating effect from the UHF radiating back to the base station – a bit like using a microwave. We are not saying that digital hearing aids are “cooking” the ear because there is no UHF in the hearing aid, BUT there is a similar digital coding going on at high frequencies. We believe that some people are sensitive to this radiation, small though it might be. But no-one seems to be investigating such a possibility, either by the manufacturers or suppliers looking after hearing loss.
Like others I have tried putting the aids in without batteries, but this doesn’t cause any discomfort, thus the problem isn’t due to plastic or pressure in the ear canal. My husband is convinced it is due to the digital processes in the aid itself.
I just got hearing aids about 2 months ago. I have been getting severe headaches but did not associate them with the hearing aids until I removed them and did not put them in for 2 days, no headaches. I have to go back to audiologist.
Had my aids a few months and could not bear both in at same time as advised so have been using just one at a time. People say I speak quieter when they’re in and this is because I sound as if I’m shouting. I am also experiencing a headache in my temple and pain behind the eye of whichever hearing aid I have in that day. Have tried leaving them out for couple of day and the pains go. I have never liked the idea of having batteries so near to my head and brains and feel sure this is the cause. It needs investigating.
There is some research suggesting that some individuals might be more satisfactorily fit (not necessarily better fit) with a single, rather than two hearing aids. If you feel as if you are shouting, it may be that the aid’s gain is set too high, or that you might be experiencing what is called an occlusion effect. On the other hand, it is not uncommon for a person to speak more quietly when wearing amplification. Realize that we monitor our voices by what we hear (our servo mechanism). We speak more loudly with a hearing loss in order to monitor our own voice level. If you have a hearing loss, you will speak more loudly to monitor your own voice level. With a hearing aid, you hear yourself more loudly, and therefore, reduce your speaking level. The same occurs for people talking in noisy environment. They do not speak more loudly in order to be heard, but in order to monitor their own voices. They do not hear themselves well due to the noise around them, and therefore speak more loudly to monitory/adjust their own voice level.
Related to the headaches, you are not the first to comment on this . In almost 45 years, I have had this presented to me a number of times. We asked in an earlier post how individuals treated this and there were some suggestions to try, but no solutions. You might have the audiologist look closely at the contact points of the hearing aid to investigate whether anything might be causing pressure, and if so, try another type aid, earpiece, etc. It is a known fact that the ear canal can be very sensitive to some people when objects are placed in the ears. I often fit soft earplugs into an ear canal to determine if they have a similar effect. If the hearing aid has a link that fits over the ear, some individuals have an experience that sometimes occurs when wearing ill-fitted glasses. Glasses that are too narrow or tight create pressure on the temples, the bridge of the nose, and above the ears, which can result in frequent headaches.
I can’t believe I stumbled across this forum. I just started using BTE hearing aids. The 2nd day I wore them I got the most severe migraine headache I have ever experienced in my life. It felt like a severe sinus headache and migraine all in one. My entire head and face hurt. I’ve never experienced anything so severe until I wore hearing aids. I’m afraid to put them on again.
I searched for this forum because I experience headaches when I put my hearing aids in. The headache goes away almost immediately when I remove them. I really need help hearing…so there doesn’t seem to be an answer except to stay home where I don’t have to ask others to repeat themselves.
I get a different kind of pain caused by a Phonak over-the-ear aid being trapped between the glasses temple tip and the head, particularly on the right side. There is no immediate pain, but some time later a terrific pain develops in the ear. The pain takes hours to go away, even with aspirin. There is no infection involved. The pain comes from physical pressure against the head, in the temporal-bone area. The area is very sensitive to touch once the pain develops. What is the mechanism of this pain? Larger plastic sleeves over the tips has not helped.
I cannot tell you how happy I am to hear this I have been suffering with this for over five years I have a wonderful audiologist I work with I am right now trying to pair of Oticon OPN‘s but what’s funny is that when I were Oticon delta 4000 hearing aids I had no pain I do believe maybe it has some kind a game on my brain can’t handle the fast processing but I have neck pain job pain headache I’ve taken out my hearing aids and we’ll see what happens The sad part is easy to help me to hear everything that’s if I wanna walk around with a migraine all the time which I can’t I will see my audiologist again on Thursday if anyone has any new information or has a name for this syndrome please tell me I would really appreciate it thank you Shanie
I recognize this is an old thread, but I found it by searching “Headache with hearing aid.” I recently started wearing them and within about a half an hour of putting them in I have a massive tension headache at the base of my head into my neck. I have no idea why this is happening, but it’s directly related to to the hearing aids. It’s not that I haven’t had this type of headache before – I have. The difference is that I’m now having them daily, and only after I put in the hearing aids. When I take them out at night it takes 15-20 minutes, but the headache diminishes. I have it for the entire time they are in though.
This is difference from the sinus headache some are describing, but I know what they’re talking about too! I tried Phonak hearing aids on a trial basis, but they just about immediately gave me a nasty sinus headache. I thought I was crazy. I tried them three separate times in the office, but it happened every time! It was the oddest thing, and my audiologist said she’d never heard anything like it. I went with ReSound instead, which were fine in the office, but now that I am using them in my daily life I’m having to pound ibuprofen to manage pain at the base of my skull that extends into my neck.
I hope someone does definitively look into this. I can’t trade off the fact that I can hear just to avoid headaches. My loss is moderate. I can more or less function at home without the hearing aids, but my ability to do my job really depends on my being able to hear.
I ‘ve worn my new behind the ear for one day and the worst headache of my life. It was on the left side and throbbing towards the front and behind the left eye seemed to be coming from the back of my head. I fell asleep with the left one still in. They have a constant high pitched whistling. Maybe that’s the problem for all of us is perhaps a reflective sound going in that we don’t hear like a dog could hear it and would drive them crazy. This is my possible theory. They are both ringing today also. I did not have this with my former behind the ear Resound. So I’m using that today. The headache went away significantly although still there. It was so painful I thought I would pass out or throw up. The new one is a bit fatter behind the ear and the earpiece is bigger that goes into the ear. So this could have some bearing but I don’t think so. I think it’s an increase in that digital processing and increase in higher frequency sound waves perhaps overexciting the brains receptors. I haven’t experienced much if any tinnitus, I have it today. I know they can be adjusted, but never once in 10 years did I have this. Also, during initial testing, I felt extremely nauseous and was sick to my stomach when they were both inserted. i have severe loss in both ears, I’ve been wearing only one in my left ear for 4 years so I can hear natural sounds coming in and talk on the phone in my right ear which has worked. I’m a professional singer, actor and dancer and playing the lead for the musical Big Fish which opens Aug. 1st. I was so looking forward to the newest technology to help me. Im back to wearing the old Resound in my left ear only for now whuch is narrower and much more comfortable around the ear and in the canal and doesnt whistle as much and doesnt have the occlusion which occured with that sinitis reaction during a 3 week trial of oticon and the wax soft tips which plugged up my ears and made it feel like I had a headcold. My earpiece with Resound made 5 years ago has good airflow through a hole in the earpiece whuch prevents the occlusion. Im 52. Been wearing aids since I was 35. As to the above on the worry of batteries near the brain and radioactivity, i do believe there absolutely is truth to this. Mercury has been taken out of heaing aid batteries nowdays, which was and is a poisonous mineral to our bodies just as filling in teeth. So that was a good discovery and elimination, but what was it replaced with.? What is the active charging elements in our hearing aid batteries? I will say this, they are expensive and sometimes only last a day or two. In 2003 the batteries lasted a full week with my Starkey ITC and they were awesome hearing aids. That was 2004-2005. I need more power now so my fear is for all of us the BTE is going to come with side effects we have yet to fully understand. And even if discovered would be kept from the public because of the billion dollar industry. Ellen Duguld and Tina O’ Leary Some comments above I’m in agreement of at least the possibilities. But I must admit I’m thankful to so many who have put their skills to work in helping us all. A true and real life necessity.