As he says? Tips to prevent deafness and hearing problems

Successful but isolated from the world, Ludwig Van Beethoven spent his last winters, suicide constantly brooding in the back of his mind. One of the most important composers and musical geniuses of all time had to endure some kind of hell before ascending Olympus, on March 26, 1827, when death found him at the age of 56 .

The origin of his ailments would have been, mainly, in a growing deafness, which began to manifest itself when the German was still in his twenties, an apprentice composer based in Vienna, where he would spend most of his life. A deaf musician, an embarrassing size that overwhelmed him and drove him to the brink of despair, but who knew how to remain stoic during his youth and with whom he managed to deal secretly in adulthood.

But old age compounded his problem, as he was only able to maintain a relationship with a few relatives through conversation notebooks. He was unable to complete his Tenth Symphony, but managed to present the terrible Ninth, before cirrhosis of the liver put an end to his work.

His work is immortal, connoisseurs say, but Beethoven’s ears proved as deadly as any. Like 30% of the elderly population, at least, who, according to the World Health Organization, suffer from deafness and hearing loss. And as in most of these cases, the German knew the consequences of this evil: social isolation, loneliness, frustration, depression.

The big difference between today and yesterday is that today there are both prevention methods and tools to deal with deafness and to remain socially active when sounds are no longer perceived.

According to WHO records, more than 466 million people worldwide, or about 5% of the population, suffer from hearing loss or deafness to a disabling degree. And the prognosis is not good: it is expected that by 2050 the cases will expand to more than 900 million.

Suspicion of hearing loss begins when a person has a hearing threshold below 20 decibels (dB), which is the unit used to measure sound intensity. If you have difficulty following the flow of a conversation, especially in noisy environments, if you have difficulty distinguishing between high-pitched sounds, if you hear louder sounds in one ear than the other, or if you experience annoying ringing in one or both ears, your hearing may be impaired. risk. The same is true for boys and girls who are delayed in speech and language development.

A few hours of television will be enough to come across an advertisement for toothpaste, with a dentist lecturing on the importance of maintaining good oral hygiene. A lesson that begins to take hold as soon as the first milk tooth appears.

They also teach you that the eyes are extremely sensitive organs and the same is happening lately with the skin. About the ears? There are no advertisements or lessons repeated ad nauseam warning of its delicacy. The only thing we learned about the ears was that they could be pulled if you misbehaved, a kind of institution of punishment that thankfully is in decline.

It is possible that this lack of empathy towards our ears stems from this old relationship based on abuse. A little proof of this: Álvaro Romero, neurologist at the Indisa Clinic, says that one of the most common ways we injure our ears is, paradoxically, when we clean them.

“Using cotton swabs, we push the wax out and plug the ear canal. So, little by little, you can lose your hearing,” he comments. What should be done, instead, is to consult an otolaryngologist with a certain frequency – every two or four years – even in the absence of discomfort or loss of hearing, to wash safely, without risking acoustic trauma. , as could happen if a water syringe is used by mistake, for example.

Being frequently exposed to noisy environments, above the levels that the human ear can tolerate and without the corresponding protection, greatly increases the risk of suffering acoustic trauma which leads to the development of hearing loss. Romero says that in noisy work environments — above 50 db — workers should wear hearing protection.

But how many decibels is a lot of decibels? In the following table you will find examples of each range, with 0 db being the minimum hearing threshold and 140 db being the hearing pain caused by a lot of noise.

Being constantly exposed to high decibels can lead to acoustic trauma such as the infamous tinnitus, a condition that counts among its victims musicians like Pete Townshend —of The Who— or Phil Collins. Decades of touring and performing have caused hearing damage that manifests as a constant ringing in one or both ears. The situation is as unpleasant as it is disabling: both the guitarist and the former singer of Genesis have announced their retirement on several occasions. Only stubbornness brings them back.

These types of conditions threaten not only those who make music, but also those who listen to it at higher than tolerable volumes, especially through headphones. Alejandro Paredes, an otolaryngologist at the German clinic, argues that this negative effect is cumulative, although “exposures at very high intensity for a short period are also capable of causing damage due to acoustic trauma”.

What is a safe volume for listening to music? According to the specialist – and for reference – it is the one that “allows you to hear ambient sounds with headphones on”.

As if that weren’t enough to lose hearing, the risks of this damage go more or less beyond hearing. This was recently established by the Mayo Clinic Alzheimer’s Disease Research Center. According to its director, neurologist Ronald Petersen, presbycusis – age-related hearing loss – may be linked to greater cognitive decline, which increases the risk of developing dementia or other neurodegenerative diseases such as Alzheimer’s disease. Alzheimers.

Petersen even recommends that people who “have difficulty following a conversation or develop memory problems have their hearing checked.”

Chilean specialists support this thesis. Álvaro Romero observed that patients with hearing impairment “start with an earlier memory deficit”. Patricio Sandoval, a neurologist at UC CHRISTUS Health Network, says there is national research to the same effect, but confounding factors must be taken into account, “such as rurality, low schooling and low status. socio-economic, any known risk factors for dementia.These, moreover, “influence by not correcting presbycusis in a timely manner”.

Why could hearing loss be linked to neurodegenerative diseases or mental disorders such as dementia? The causes seem multiple. To better understand it, we must consider that the five senses of the human being (hearing, smell, taste, sight and touch) converge in the brain into “sensory inputs” —as Sandoval conceptualizes—, which are integrated into our experience. and our emotions. , making it possible to give cognitive and affective meaning to what is perceived.

“The sound perceived by the ear not only ‘turns on’ the auditory cortex, the place where the brain ‘hears’ that word, but also stimulates and connects with other areas of the brain, allowing us to understand and to connect what is perceived aurally,” he adds. .

Thus, illustrates Álvaro Romero, patients suffering from memory loss seem to have hearing problems, when in reality they have difficulty understanding what is said to them. Likewise, the deterioration of hearing could involve damage to the temporal lobe of the brain, which is also responsible for participating in the process of memory and language.

Like Beethoven, the problems caused by hearing loss increase as old age approaches. In young people, the situation is more variable, because brain plasticity and cognitive reserve are greater.

In the elderly, meanwhile, deafness tends towards social isolation, feelings of loneliness and mood disorders such as depression, further increasing the risk of developing dementia. And with the lack of communication and oral language practice, the inability to understand what others are saying is compounded, causing greater isolation. It is a vicious and silent circle.

“Given the social implication of this problem, Clínica Alemana has launched a support program for the North Health Service, carrying out assessments of Colina patients on the waiting list for evaluation, diagnosis and installation of hearing aids”, comments Alejandro Paredes.

Hearing loss can be irreparable, so the focus should be on prevention. According to the WHO, the earlier the problem is detected, the more likely it is to be treated. “The incidence of hearing loss could be reduced through screening – diagnostic tests for healthy people – and early interventions in childhood, particularly with the use of assistive or surgical options. On the other hand, screening can help prevent the use of harmful drugs in high-risk cases,” they say from the global body.

Better treatment of the ear is also a means of prevention. It is essential to avoid noisy environments and use adequate protection. In the case of listening to music, it is recommended not to do so at an exaggerated volume. Are some hearing aids more convenient than others? Paredes says circumaural headphones allow for a good listening experience without having to turn up the volume so much.

It is important to consult an otolaryngologist every two or three years for an ear wash: hearing problems are often due to the accumulation of earwax and only cleaning is enough to solve it. Diseases or infections that affect the ear should also not be minimized, especially in people with a family history of deafness.

Cardiovascular disease is also a risk factor, so a healthy lifestyle means taking care of yourself on both fronts. Paredes, meanwhile, argues that the role of family is highly relevant, given the social implications that hearing loss could have. In this sense, it is essential “the recognition of the problem by the patient and the support of the family before it generates emotional consequences or a deterioration of its functionality”.

That can’t say you haven’t heard it.

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