Testing For Hearing Loss

The human ear is the envy of even the most sophisticated acoustic engineer. Without a moment's thought or the slightest pause, you can hear the difference between a violin and a clarinet; you can tell whether a sound is coming from your left or your right, and if it's distant or near; and you can discriminate between words as similar as hear and fear, sound and pound.

Nearly everyone experiences trouble hearing from time to time. Common causes include a buildup of earwax or fluid in the ear, ear infections, or the change in air pressure when taking off in an airplane. A mild degree of permanent hearing loss is an inevitable part of the aging process. Unfortunately, major hearing loss that makes communication difficult also becomes more common with increasing age, particularly after age 65.

Testing — 1, 2, 3

How do you know if you need a hearing test? If you answer yes to any of the questions below, talk with your doctor about having your hearing tested:

Are you always turning up the volume on your TV or radio?

Do you shy away from social situations or meeting new people because you're worried about understanding them?

Do you get confused or feel "out of it" at restaurants or dinner parties?

Do you ask people to repeat themselves?

Do you miss telephone calls — or have trouble hearing on the phone when you do pick up the receiver?

Do the people in your world complain that you never listen to them (even when you're really trying)?

You can also ask a friend to test you by whispering a series of words or numbers. After all this, if you think you have a hearing problem, you should have a test.

What does a hearing test involve?

Thorough hearing evaluations start with a medical history and examination of your ears, nose, and throat, followed by a few simple office hearing tests. An audiogram is the next step.

For an audiogram, you sit in a soundproof booth wearing earphones that allow each ear to be tested separately. A series of tones at various frequencies are piped to your ear. An audiologist will ask you to indicate the softest tone you can hear in the low-, mid-, and high-frequency ranges. People with excellent hearing can generally hear tones as soft as 20 decibels (dB) or less. If you can't hear sounds softer than 45 to 60 dB, you have moderate hearing loss, and if you don't hear sound until it's ramped up to 76 to 90 dB, you have severe hearing loss.

Hearing tones is nice, but hearing and understanding words is crucial too. For this reason, the audiologist will also play tape-recorded words at various volumes to find your speech reception threshold, or the lowest dB level at which you can hear and repeat half of the words. Finally, you'll be tested with a series of similar-sounding words to evaluate your speech discrimination.

Ringing In The Ear: Tinnitus And Hearing Loss

Many people with hearing loss also have tinnitus, commonly known as ringing in the ear. This phrase is misleading, however, because some people hear ringing while others hear whistles, chirping, or a combination of sounds. Regardless of the particular sound, the distinguishing feature is that it doesn't have an external cause. People with tinnitus hear sounds that people around them don't hear. This isn't to say that tinnitus isn't real—researchers at the National Institute on Deafness and Other Communication Disorders have detected changes in brain activity that occur with tinnitus.

If you think you might need a hearing checkup, you probably do. This Special Health Report contains in-depth information on the causes, diagnosis, and treatment of hearing loss. You'll learn how to prevent hearing loss and preserve the hearing you have now. You'll also learn about the latest advances in hearing aid technology and find out which kind of hearing device may be best for you.

Strategies that can help

Some people with hearing loss and tinnitus find that both problems improve after they get a hearing aid or have a cochlear implant. Others find that their tinnitus symptoms improve somewhat when they cut down on caffeine and alcohol, reduce the amount of fat in their diets, and quit smoking. The following techniques may also help reduce your tinnitus symptoms:

When you're in a quiet room, put on music or use a "white noise" machine. Background noise tends to drown out tinnitus sounds.

Use the "tinnitus masker" on your hearing aid. This is a separate feature that is embedded into most hearing aids that allows you to choose a sound to "mask" the tinnitus sound you are hearing. How effective they are varies from person to person, but they usually do provide some level of relief for most people. Depending on the hearing aid, sounds that you could choose from may include spa music, chimes, white noise, and more. You can choose the pitch and loudness of the sound to suit your needs, and you can choose to turn it on or off.

Tinnitus retraining therapy is an effective method for treating tinnitus, especially in people with tinnitus and oversensitive hearing. It is a lengthy, expensive process, and can take 18 to 24 months. It relies on the principle of habituation, which occurs when your brain is exposed to a background sound, such as white noise, for long periods of time. After a while, the brain starts to filter out that particular background noise. Retraining therapy involves listening to a tone that is similar to the tinnitus sound for hours at a time. Eventually, your brain ignores the tone along with the tinnitus sound.

Reduce stress by whatever methods work for you. Try mindfulness meditation, which helps you learn not to focus on irritations such as the sound of tinnitus. Also try yoga, visualization, or other relaxation techniques.

Consider biofeedback or hypnosis. Ask your doctor to recommend qualified practitioners.

Exercises For Pain Free Hands

Your hands perform countless small and large tasks each day — from pouring coffee, brushing teeth, and buttoning shirts to raking leaves or kneading bread.

But aching hands can transform the simplest task into a painful ordeal. Hands can hurt for a variety of reasons, from the mechanical to the neurological. Arthritis — which affects one in five American adults — and other persistent joint problems are by far the most common cause of hand pain and disability.

Beneath the skin, your hands are an intricate architecture of tendons, joints, ligaments, nerves, and bones. Each of these structures is vulnerable to damage from illness or injury. If your hands hurt, even simple tasks can become a painful ordeal. This report describes the causes and treatments for many conditions that can cause hand pain. It also features information on hand exercises, as well as handy tools and other gadgets that take strain off your hands.

There are many ways — including medications and surgery — to get hands back to work. One of the most important ways is through therapeutic exercises.

Some exercises help increase a joint's range of motion, while strengthening muscles around the joint. Some commonly recommended hand exercises follow. If you have a serious hand, wrist, or arm injury, consult your doctor before leaping into the routines below. All exercises should be done slowly and deliberately, to avoid pain and injury. If you feel numbness or pain during or after exercising, stop and consult a therapist.

Stretching exercises

Stretching helps lengthen muscles and tendons. Some repetitive tasks, such as typing on a computer or gripping gardening tools, can shorten muscles and leave them tight and painful. Do these stretches gently, until you feel the stretch, but without pain. Hold the positions for a count of 15 to 30 seconds to get the most benefit. These exercises are particularly helpful for tendinitis and tight forearm muscles, which are common in people who do a lot of computer work.

For each of these exercises, do a set of four repetitions, twice a day. Hold the stretch for 15 to 30 seconds and rest for 30 seconds between each repetition.

Wrist extensor stretches

Hold one hand at chest level with the elbow bent. 

With the other hand, grasp the thumb side of the hand and bend your wrist downward.

To increase the stretch, bend your wrist toward your little finger.

Repeat the same exercise with a straight arm.

Switch hands and repeat.

Wrist flexor stretches

Hold one hand at chest level with the elbow bent.

Grasp the fingers of that hand with the other.

Pull the hand back gently.

Repeat the same exercise with a straight arm.

Switch hands and repeat.

Resisted isometrics

These exercises work muscles against resistance. Hold each position for 10 seconds. Complete one set of 10 repetitions once or twice a day.

Isometric wrist extension

Hold one hand palm down on a table or other surface. Put your other hand on top of it.

Try to raise the lower hand, but don't allow it to move.

Switch hands and repeat.

Isometric wrist flexion

Follow the same steps as above, but with your palm facing up.

Living With Lactose Intolerance

Food intolerance and food allergies often produce similar symptoms, but they're not the same. If dairy products leave you feeling gassy and bloated or cause diarrhea or nausea, you may have either condition.

What's the difference? A dairy allergy is an immune system response to milk protein. In addition to feeling bloated or causing diarrhea, symptoms of a dairy allergy can include hives, wheezing, vomiting, cramps, and skin rashes. Dairy intolerance results from inadequate levels of lactase, the enzyme that breaks down milk sugar. While lactose intolerance can cause a lot of discomfort, it isn't life threatening, while a milk allergy can be.

The severity of lactose intolerance varies. For some people, consuming any dairy product causes their digestive tracts to rebel. Others can enjoy yogurt, ice cream, or even an occasional glass of milk.

The most successful approach to coping with lactose intolerance is to first avoid all dairy products. If you are lactose intolerant and love milk in all its forms, try experimenting with small amounts of dairy. In general, yogurt, cheese, and sour cream may be easier to tolerate because they contain less lactose than milk. However, several studies suggest that many people who are lactose intolerant can consume the equivalent of eight ounces of milk with no ill effects, and somewhat more when the lactose-containing food is part of a meal.

Supplements containing enzymes produced by lactose-digesting bacteria (Lactaid, Lactrase, others) can be taken as tablets or added to foods. Some milk products (Lactaid, Dairy Ease) to which lactase has been added may contain little or no lactose, and they may taste sweeter than untreated products, because the milk sugar has already been broken down. Probiotics (supplements of beneficial bacteria that normally inhabit the intestines) containing  Lactobacillus reuteri may reduce symptoms, but not quite as well as enzyme supplements.

The response to these products is highly individual. What works for your will depend on the amount of lactase your body produces, the type of intestinal bacteria that inhabit your colon, and the product itself. Finding the right approach for you can be a trial-and-error process. While this may take some time and expense, experimenting isn't likely to be harmful.

11 Stomach-Soothing Steps For Heartburn

Heartburn, that uncomfortable burning sensation that radiates up the middle of the chest, is the most common digestive malady. It's the result of a condition known as gastroesophageal reflux disease (GERD), often called acid reflux, in which stomach acid leaks upward from the stomach into the esophagus.

When your digestive system is running smoothly, you tend not to think about it. Once trouble begins, your gut — like a squeaky wheel — suddenly demands your attention. This Special Health Report covers the major sources of gastrointestinal distress: irritable bowel syndrome, gastric reflux, upset stomach, constipation, diarrhea, and excess gas. It also includes a special Bonus Section describing how emotional stress and anxiety can cause gastrointestinal distress.

While heartburn should not be ignored, there are many stomach-soothing steps you can try before going to a doctor. These can help cool your symptoms and prevent bigger problems later on. 

Eat smaller meals, but more often. A full stomach puts pressure on the lower esophageal sphincter (LES), a valve-like muscle that keeps stomach acid from backing up into the esophagus.

Eat in a slow, relaxed manner. Wolfing down your food fills your stomach faster, putting more pressure on the LES.

Remain upright after meals. Lying down increases pressure on the LES, which makes acid reflux more likely.

Avoid late-night eating. Eating a meal or snack within three hours of lying down to sleep can worsen reflux and heartburn symptoms. Leave enough time for the stomach to clear out.

Don't exercise immediately after meals. Give your stomach time to empty; wait a couple of hours after eating before exercising.

Tilt your torso with a bed wedge. Raising your torso up a bit with a wedge-shaped cushion reduces the pressure on the LES and may ease nighttime heartburn. Wedges are available from medical supply companies. Don't just prop your head and shoulders up with pillows, which can actually worsen reflux.

Stay away from carbonated beverages. They cause belching, which promotes reflux of stomach acid.

Find the foods that trigger your symptoms and avoid them. Some foods and drinks increase acid secretion, delay stomach emptying, or loosen the LES — conditions that set the stage for heartburn. Common offenders include fatty foods, spicy foods, tomatoes, garlic, milk, coffee, tea, cola, peppermint, and chocolate.

Chew sugarless gum after a meal. Chewing gum promotes salivation, which neutralizes acid, soothes the esophagus, and washes acid back down to the stomach. Avoid peppermint flavors, which may trigger heartburn.

Check your medications. Ask your doctor or pharmacist if any of the medications you take could worsen acid reflux or inflame the esophagus. For example, tricyclic antidepressants such as amitriptyline loosen the LES and tetracyclines such as doxycycline can cause esophageal inflammation.

Lose weight if you need to. Being overweight puts more pressure on the stomach (and the LES).

If changing your eating habits and other preventive steps don't get heartburn under control, talk with your doctor. He or she can advise you on which medications to try and recommend additional follow up if necessary.

Tips For Beating Anxiety To Get A Better Night’s Sleep

Many people with anxiety disorders have trouble sleeping. That's a problem. Too little sleep affects mood, contributing to irritability and sometimes depression. Vital functions occur during different stages of sleep that leave you feeling rested and energized or help you learn and forge memories. Sleep usually improves when an anxiety disorder is treated. Practicing good "sleep hygiene" helps, too. Here are some steps to take:

Everyone worries or gets scared sometimes. But if you feel extremely worried or afraid much of the time, or if you repeatedly feel panicky, you may have an anxiety disorder. Anxiety disorders are among the most common mental illnesses, affecting roughly 40 million American adults each year. This report discusses the latest and most effective treatment approaches, including cognitive behavioral therapies, psychotherapy, and medications. A special section delves into alternative treatments for anxiety, such as relaxation techniques, mindfulness meditation, and biofeedback.

Go to bed and wake up at the same time every day, even on weekends.

Daylight helps set sleep patterns, so try to be outdoors while it's light out for 30 minutes a day.

Exercise regularly (but not too close to bedtime). An afternoon workout is ideal.

Keep naps short — less than an hour — and forgo napping after 3 p.m.

Avoid caffeine (found in coffee, many teas, chocolate, and many soft drinks), which can take up to eight hours to wear off. You may need to avoid caffeine entirely if you have panic attacks; many people who experience panic attacks are extra-sensitive to caffeine.

Review your medications with a doctor to see if you are taking any stimulants, which are a common culprit in keeping people up at night. Sometimes it's possible to switch medicines.

Avoid alcohol, large meals, foods that induce heartburn, and drinking a lot of fluid for several hours before bedtime.

Tobacco is a stimulant. Quit smoking (or at least do not smoke for an hour or two before turning in for the night).

Keep your bedroom cool, dark, and quiet, without distractions like TV or a computer. Avoid using an electronic device to read in bed; the light from the screen can trick your brain into thinking it is daytime. If your mattress is uncomfortable, replace it.

Reading, listening to music, or relaxing before bed with a hot bath or deep breathing can help you get to sleep.

If you don't fall asleep within 20 minutes of turning in (or if you wake up and can't fall back to sleep in 20 minutes), get out of bed and do something relaxing until you feel sleepy.