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Why Identifying Unrecognized Hearing Loss Is So Important

Over 48 million Americans have hearing loss, with estimates of global numbers set to reach in the hundreds of millions in just a few short decades. Though hearing loss is an extremely prevalent condition, it often goes undiagnosed and untreated. Despite the high prevalence of age-related hearing loss, many adults still have hearing loss that never gets recognized, or they choose to forgo treatment options altogether. Older populations may miss the subtle changes in their hearing as they age because the onset is often gradual and slow, or possibly, they do not recognize the subtle changes they are making to compensate for their impaired hearing, such as increasing the volume on television sets or audio devices. To understand how some patients can have hearing loss without even realizing it, a study conducted by Wayne State University observed two groups of adults with and without hearing loss, had given them hearing screenings and had concluded with astounding results.

The Risks of Unrecognized Hearing Loss

Hearing loss can present serious risks for patients who do not seek treatment. Unfortunately, many struggling with hearing loss can wait up to 15 years to finally seek help. Research has shown a clear correlation between hearing loss and serious health complications such as depression, anxiety, a higher risk of suicide, and developing dementia. Communication difficulties are also common, as hearing loss causes higher rates of social isolation and a diminished quality of life. However, a majority of hearing aid users report satisfaction with their device, expressing a better quality of life while protecting their hearing for the long term.
Hearing loss is far more dangerous when unrecognized or undiagnosed. Early identification and intervention are critical for positive long-term outcomes when treating hearing loss. According to a 2012 study by Barbara Hutchinson of North Dakota State University, “In fact, adults who delay treatment until their hearing loss is severe do not respond to interventions as well as those who initiate interventions early in the course of their hearing loss.”

Wayne State University’s Conclusions and Recommendations

Self-defined as aiming “to explore characteristics that differentiate adults with unrecognized hearing loss from those with recognized hearing loss and adults with normal hearing”, researchers could determine how likely it was that a participant who described themselves as having no hearing issues, actually had unrecognized hearing loss. As part of the study, participants would complete a subjective and objective assessment of their physical health, various measures of cognition, and personality assessment of their traits for positive and negative affectivity (emotionality).
The results had proven researchers worry about unrecognized hearing loss to be true. “Participants who volunteered for the normal hearing group underwent hearing screens using a portable audiometer as part of the research study. Of the 69 adults who volunteered for that group, our hearing screens indicated that only 39 had hearing in the normal range. Unrecognized hearing loss was identified in 30 volunteers who had described themselves as having no hearing difficulty.”
The study’s research team had concluded that there is a sizeable subset of patients “who are likely to deny hearing difficulty upon questioning but have meaningful hearing loss.”, going as far as to recommend that new research should explore the best practices in psychoeducation about hearing screening that targets patients who do not endorse hearing loss.
If you believe you are suffering from signs of hearing loss but are not completely sure, it’s time to speak to a hearing health professional for a hearing evaluation. Unrecognized hearing loss should not go untreated.

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Why More People Should Be Wearing Hearing Aids (And Why They Choose Not To)

Hearing aid technology has seen miraculous advancements since their bulky predecessors of the 1970s, with new devices performing more like supercomputers than listening devices. Utilizing artificial intelligence, smartphone capability, and even reading your brain activity, some hearing aids are truly out of this world, helping millions across the globe bring sound back into their lives. Though the technology is impressive, studies continue to show that many choose to forgo hearing aids altogether, even when they can directly benefit. Whether you have obvious hearing loss or still aren’t sure, health experts are indicating that more Americans should be wearing hearing aids.

Hearing Loss is Extremely Common

Whether it is profound or mild, many Americans have hearing loss; 48 million in fact! Hearing loss is not an adult-only problem either, as every 2 to 3 children out of 1000 are born with a detectable level of hearing loss. Unfortunately, the estimates continue to grow. According to the World Health Organization (WHO), over 900 million people may suffer from hearing loss by 2050 across the globe. This is an alarming statistic, as hearing loss comes with many challenges, risks, and quality of life issues for those affected. Untreated hearing loss has been linked to increased risk of dementia, accidental falls, depression, and hospitalizations, making this common impairment a public health concern.

Why Some Decide Against Hearing Aids

Though technology and treatment options have become more advanced, a big percentage of hearing loss cases still go untreated. Various surveys have found that many struggling with hearing loss will wait years before purchasing hearing aids even though their hearing loss is known, some as long as 15 years! Why is this? Unfortunately, there is no simple answer.
Research indicates that stigma plays a large role in the decision-making process of whether to wear hearing aids. A 2009 study published by Dr. Margaret Wallhagen of the University of California San Francisco found that many patients associated hearing loss with aging or being handicapped. “Some people feared that wearing a hearing aid would make them appear unattractive.” explains Dr. Wallhagen, “They worried about the technology drawing attention to their ears and emphasizing their hearing loss.”
Cost is another worry for many. Though most indicate satisfaction with their device after purchasing, many patients believe they may not be worth the price before making the commitment.

What Experts Are Saying

Using hearing aids has been proven to minimize the risks involved with hearing loss and can truly improve the lives of patients. “Instead of worrying about ‘looking old,’ realize that hearing aids are a gift for you, your family, your friends, and everyone else you interact with,” says Dr. Steven Rauch, an otologist with Harvard-affiliated Massachusetts Eye and Ear, “They make everyone’s lives better.”
If you are struggling with hearing loss and have concerns, speak to a hearing health professional to learn about affordable and effective treatment options. Hearing aids will not only protect your health in the long term but will allow you to hear the things that matter to you today.

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Hearing Loss Could Put You at Risk for Accidental Injury

Hearing loss isn’t as benign or straightforward as we once thought it was. Not just a minor annoyance that you could choose to manage if you wanted to with a hearing aid.
No, hearing loss is a complex condition that can affect every aspect of our life from the way we communicate and our relationships to our total health and well-being. Study after study is finding that treating our hearing loss is no longer an option because untreated hearing loss can have devastating consequences.
New research is finding that it’s not just the cognitive decline and anxiety we should be aware of now, either. It’s something as simple as an increased risk of accidental injury.
Hearing loss and accidental injury
As experts realize the more significant impact of untreated hearing loss, they are digging into existing data as well as compiling new data through various studies to identify patterns related to hearing health. One of the most recent findings is linking hearing loss to an increased risk of accidental injury.
Analyzing data from the National Health Interview Survey gathered between 2007 and 2015, researchers determined that individuals who reported having “a lot of trouble” hearing were twice as likely to have an accidental injury as those who reported no trouble hearing. This fact was true both in work and leisure settings.
While more research is needed into exactly why this is the case, experts believe that the simple effects of sensory impairment may be behind it. This is concerning because accidental injuries are one of the leading causes of morbidity and mortality in America, according to the CDC’s National Health Report.
Reducing your risk for accidental injury could be as easy as scheduling an annual hearing evaluation to determine whether or not you have a hearing loss. This simple step could even help protect you from more than just accidental injury.
The importance of treating hearing loss
Hearing loss is one of the most common conditions, affecting an estimated one out of every five Americans and well over 450 million people around the world, yet it often goes untreated. As we learn more about the cost of untreated hearing loss, experts hope that the tide will change and the crucial role that hearing health plays in our lives will be taken more seriously.
While this study found that untreated hearing loss may increase the risk of accidental injury, this isn’t the only often unseen effect of untreated hearing loss. Others include:

Don’t let untreated hearing loss put you, your health and your well-being at risk. Whether it’s an accidental injury, falls, mental health or other concerns, you can take action now to reduce your risk.
Contact our office to schedule a hearing evaluation and discuss options to treat hearing loss, such as hearing aids. This could be the most powerful choice you make for your health.

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Newest American Girl Doll Doesn’t Let Hearing Loss Hold Her Back

Growing up, it can be a very special thing to find a toy that you relate to. That special toy that speaks to who you are. This can be especially true with dolls.
American Girl has long created dolls that reflect the children by whom they are loved. With stories, accessories, clothes, furniture and even physical features that speak to kids and parents alike. American Girl’s newest doll is doing it again, this time with kids with hearing loss in mind.
American Girl dolls
If you have kids in your life, chances are you’ve heard of the company American Girl. The company’s dolls are often a popular choice with backstories that help turn the dolls into almost living and breathing girls and so many options to customize the dolls that each one can become entirely unique. They are so popular that they even have entire stores across the country offering doll designs, salons, doll makeovers, dining and more.
It’s not hard to find a doll that’s seemingly made just for you. Joss Kendrick, the newest addition to the American Girl line, is making that especially true for kids with hearing loss.
Meet Joss Kendrick
In a recent announcement, American Girl introduced Joss Kendrick as the 2020 Girl of the Year. According to the announcement, Joss is “a fierce athlete born with hearing loss and a passion for surfing and competitive cheer.” While American Girl has long offered hearing aids as an accessory for their dolls, Joss is the first doll to include hearing loss as part of her story and identity.
American Girl did not take the creation of this newest character lightly. To create Joss, they teamed up with several experts including:

  • Crystal DaSilva—Women’s Deaf Shortboard champion and winner of national and world titles
  • Sara Jo Moen & Julie Peterson—Owners of Fury Athletics in Madison, WI, a training gym for competitive cheer teams
  • Sharon Pajka, Ph.D.—Professor of English at Gallaudet University and a specialist in portrayals of deaf characters in adolescent literature
  • Jennifer Richardson, Au.D.—Educational audiologist and founder of Hearing Milestones Foundation
  • Bianca Valenti—Professional big wave surfer and co-founder of the Committee for Equity in Women’s Surfing

This inspirational new doll, the company believes, will help demonstrate to kids the importance of trying new things and going beyond stereotypes, among other things.
To help bring it all to life, the company is also working with 17-year-old surfer Caroline Marks, who is currently preparing to be part of the first-ever U.S. Women’s Olympic surfing team next summer, on the launch of Joss.
“American Girl has a rich legacy of creating timeless characters who encourage girls to reach for new heights and discover who they’re meant to be,” said Jamie Cygielman, General Manager of American Girl. “We’re proud to welcome Joss Kendrick, whose stories are sure to instill confidence and character in girls who are learning to think about the possibilities in their own lives. Working with Olympic hopeful surfer Caroline Marks adds real-world inspiration about what can happen when you go ‘all in’ on your dreams.”
This newest doll from American Girl is a welcome addition to the line for families with hearing loss, bringing to life a child who doesn’t let hearing impairment hold her back in any way.

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How Clean is Too Clean? Cotton Swabs Can Be Harmful To Your Ears

Most would agree that good hygiene is an important aspect of your health, but how clean is too clean? When it comes to your ears, cleaning them with cotton swabs can actually damage your hearing and your eardrum. Despite their common usage in movies or at your local pharmacy, Q-Tips can be more harmful than helpful, leading the Scottish Parliament to ban plastic cotton buds this year in an effort to combat excessive litter and reduce their usage for inadvisable ear cleaning. Though it is admirable to try and maintain a healthy body, there is a wide consensus against cotton swabs for cleaning your ears. If you are experiencing a blockage, it is best to receive help from a medical professional, but when it comes to your day to day hygiene, let your ears handle it on their own. Your hearing will thank you.

How Can Cotton Swabs Damage My Ear?

Though they seem like the perfect length and shape to clean your ears, there is a consensus against cotton swabs for a reason. Puncturing your eardrum with a cotton swab due to going too far into the ear canal is more common than you might think, especially in children. This accidental puncture can not only damage your hearing but may also result in painful ear infections and an accumulation of fluid and bacteria. Not so hygienic, right?
Depending on the material your Q-Tip is made out of, it may also be abrasive to the sensitive skin within your ear. Some cotton swabs utilize a paper or plastic stick, which can scratch or puncture fragile areas of the ear resulting in infection, vertigo, and even permanent deafness.

Cleaning Your Ear Can Actually Be Counterproductive

Instead of removing ear wax, cotton swabs may actually push it deeper into the ear, compacting it and making your wax harder to remove. This misplaced wax can cause a whole host of problems, including ear fullness, hearing loss, and you guessed it: infection. If a blockage is created by your cotton swab, you may need to seek treatment from a doctor for removal, causing many more problems than they solve.

Your Ear Is Designed To Clean Itself

Earwax, also known as Cerumen, is an important part of your ear’s environment. Cerumen coats the inner ear protecting fragile cells and trapping dust and debris. Without this defense,  debris can travel to your inner ear and damage structures that we require to hear. Removing this natural part of the ear’s ecosystem can not only cause damage to your hearing but will actually make your ear less hygienic. Your body is designed to move earwax out of your ear through natural movements such as chewing, yawning, or skin cell growth inside the ear. Without this process, dust and debris may build up within the ear and cause infection, leading doctors to give simple advice when it comes to cleaning your ears: Don’t!
If you are experiencing ear pain, fullness, hearing loss, or suspect you may have an unnatural amount of earwax, it is best to consult a hearing health professional. You may be suffering from an infection that requires antibiotics or may need something as simple as proper cleaning.

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How Hearing Loss Can Change a Child’s Brain

Did you know that approximately 1.4 babies out of every 1000 have hearing loss, and according to the Centers for Disease Control and Prevention (CDC), 14.9% of children age 6 to 19 years have at least some hearing loss?  Whether it’s due to noise exposure, genetics and injury, or something else, early detection of hearing loss is critical.
Up until now, the focus has been on those children with deafness, but new research indicates that any level of hearing loss can affect a child’s brain and development.
The risk of hearing loss
Hearing loss in children can be a whole different ball game than hearing loss in adults. This is because children’s language and social development are so deeply rooted in hearing. Untreated hearing loss has been shown to impact social interaction and development, delay language and speech, and even leave children struggling academically. Early intervention is critical in avoiding these concerns.
But, do children with mild to moderate hearing loss face the same risks or just those with severe or profound hearing loss?
The research
New research led by Dr. Lorna Halliday, now at the MRC Cognition and Brain Sciences Unit, University of Cambridge, suggests that any level of hearing loss could lead to changes in how the brain processes sound. This, in turn, could pose developmental risks for the child.
The research team worked with 46 children diagnosed with mild to moderate hearing loss. An electroencephalogram (EEG) was used to measure their brain responses while they were listening to sounds. Dividing the children into two age groups (8-12 years old and 12-16 years old), researchers compared their results with those of children with normal hearing.
The results were not surprising. Those in the younger age group showed results similar to normal-hearing children their age, but those in the older group showed less response to sounds than those of normal-hearing children their age. The team repeated the test with the younger group several years later, finding consistent results. Their brain responses changed and were less than those of normal-hearing peers.
The team believes this is not due to a change in hearing loss but a change in how the brain works to hear sound with existing hearing loss.
“We know that children’s brains develop in response to exposure to sounds, so it should not be too surprising that even mild-to-moderate levels of hearing loss can lead to changes in the brain,” says Dr. Axelle Calcus, lead author of the paper, from PSL University, Paris. “However, this does suggest that we need to identify these problems at an earlier stage than is currently the case.”
The team believes that findings like these could help change how we diagnose children with hearing loss, and when hearing loss of any level is present, how we can better support them to foster strong language and social development.
If you believe your child has a hearing loss, contact our office to schedule a hearing evaluation today.
 
 

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The Structure Of A Hearing Aid And How It Works

A hearing loss can have a profound impact on your life, your career, and your relationships. If you choose the correct one, a hearing aid can make a significant difference in your ability to communicate while enhancing your enjoyment of life. Knowing what goes into the design of hearing aids will help you choose the most appropriate device for your hearing needs. Regardless of the style of hearing aid you have, all hearing aids share three essential components:

  • The hearing aid microphone picks up sounds and sends them to the amplifier. New technology distinguishes between speech and background noise, making it easier to understand a conversation.
  • Converting sounds from the microphone into an electrical signal and then sending the message to the receiver is the function of the amplifier. Amplification power is dependent upon the severity of the user’s hearing loss.
  • Power source. Batteries power the hearing device. Batteries may be either rechargeable or disposable, depending on the model.

These three components are in all hearing aids. Depending on the design and the severity of your hearing loss, a few other parts might be residing inside your hearing aid.

Buttons And Switches

Hearing aids that are of the receiver-in-the-ear (RITE) type come equipped with a button or a switch. A hearing healthcare professional programs the button or switch to perform different functions such as alternating between settings or increasing and decreasing volume. Make a point of knowing the purpose of your switch.

Wire

A hearing aid wire is typically thin and coated in plastic. The wire extends from the body of the hearing aid to the speaker, which resides in the ear. The transmission of power and signals takes place in the wire. Hearing aid wires feature conductor materials, shielding, and jacketing manufactured for custom hearing solutions.

Receiver/Speaker

Delivering the sound to the ear is the responsibility of the receiver, which is also known as the speaker. When the speaker receives an electrical signal from the amplifier, it converts it to sound. The speaker is inside the ear dome or earmold, depending on the severity of hearing loss and lifestyle.

Domes

A dome is a small piece of silicone that attaches to hearing aid tubing and fits deep in the ear canal. Domes come in an array of shapes and sizes to accommodate the unique anatomy of a person’s ear canal. A hearing healthcare professional can help you pick the appropriate size for a proper fit.

Earmold

Earmolds are plastic or acrylic and fit inside your ear canal to form an acoustic seal for the electronic sound coming in. The fit and the shape of your earmold will depend on the model of hearing aid you are utilizing and the severity of your hearing loss. Because they provide the highest amount of amplification, earmolds are for those with severe to profound hearing loss.
Hearing loss is a severe health issue, so do not ignore it. If you suspect that you may have a hearing loss, schedule a hearing screening with a hearing healthcare professional. Swift acting will significantly enhance the quality of your life.

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Have Hearing loss? Try This Home Technology

If you’ve been diagnosed with hearing loss, especially if it’s a recent diagnosis, you may be wondering how it will change your day-to-day life. The good news is that as the number of people diagnosed with hearing loss has grown and technology has advanced, the options available to support those with hearing loss have grown. This means, with the right tools on hand, especially at home, navigating your day may be easier than ever.
Hearing loss becomes more common
According to the Hearing Health Foundation, an estimated 48 million Americans of all ages report trouble hearing. When experts break that down, it means:

  • Almost 50% of people ages 75+
  • Nearly 33% of people between ages 65-74
  • Almost 15% of people between ages 45 and 64
  • 8 million people between ages 18 and 44

That means millions of Americans, many with previously normal hearing, now diagnosed with hearing loss and living in a world that is designed for the hearing.
Thankfully, simple changes in the home can help those with hearing loss adapt and thrive.
Home technology for hearing loss
While there are numerous options now to support individuals with hearing loss, including advanced hearing aids, assistive listening devices and even apps for everything under the sun, tools like these are an important consideration for the home:

  • Specialized alarm clocks – If you follow your hearing health care professional’s recommendations, you’ll remove and clean your hearing aids before bed, then leave them out and open to allow any built-up moisture to escape. That’s a smart strategy to maintain your hearing aid and hearing aid batteries, but if you need to hear an alarm clock to wake up in the morning, then what? Opt for a specialized alarm clock that uses light, a vibration of the bed or a watch on the wrist, extra loud sound or even a particularly strong smell to wake you up.
  • Smoke and carbon monoxide detectors for the hearing impaired – Similar to alarm clocks, these specialized detectors use alternative notifications to keep you safe. These include strobe light alerts, vibration, increased volume or varying tones. Many of these options can also be connected to in-home alert systems that notify you of emergencies such as severe weather as well as fire.
  • Doorbells that connect – Doorbell technology has moved well beyond the simple old buzzers. That’s true for everyone, not just those with hearing loss. There are now plenty of WiFi-connected options that connect to other devices in the home. They can notify with an extra loud sound, lights and even screens around the house showing that someone is at the door or approaching your home. Prefer something that’s not so connected? Simple doorbells that flash or use higher volume are also available for those with hearing loss.
  • Telephones – Whether it’s a traditional landline or your cellphone, consider options such a captioning phone or captioning app to help you maintain communication with hearing loss. Speech-to-text apps are another option. Many of today’s hearing aids also connect directly with phones via Bluetooth to make phone conversations more comfortable than ever.

Outfit your home to support your hearing loss with technology like this to make your everyday life easier.
If you have questions or believe you may need hearing aids to treat hearing loss, contact our office to schedule an appointment.

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Caption This: Closed Captioning Is Popular, Let’s Expand It

Whether you’re a member of the deaf and hard of hearing community or just want to make sure you never miss important dialogue in your favorite flick, closed captioning is incredibly popular with many. In fact, a recent survey by 3PlayMedia found that 98% of recipients watched movies with closed captioning turned on! By giving those with normal and damaged hearing alike the ability to read and experience sound and participate in healthy social interactions, it’s clear why closed captioning is such a hit. Thanks to laws such as the American with Disabilities Act (ADA) and the 21st Century Communications and Video Accessibility Act, official state and federal government videos, along with network TV programs, must have “accurate, synchronous, complete, and properly placed” captions, but what about online video? With new-age audiovisual media such as streaming services like Netflix, laws have yet to regulate captioning on the web. Ensuring access to closed captioning across all platforms is critical to avoiding barriers to auditory information, raising our quality of life, and decreasing social and emotional consequences.

The Numbers Are In, Closed Captions Are Used For More Than Hearing Loss

After discovering its popularity, 3PlayMedia’ survey dove even further into demographics, discovering who uses closed captions and why. What they found had further compounded the importance of universal access to these services. Captions were used by virtually everyone for a wide array of reasons, ranging from hearing loss to keeping focus. After crunching the numbers, 25% of respondents utilized captions for hearing loss purposes, while 75% of respondents used captions for other reasons unrelated to hearing damage, showing that captions do not only aid our hard of hearing community but the general public.

How Lack of Access Can Do Harm

For those suffering from hearing loss, there are social and emotional consequences that arise with a lack of access to auditory information. Participation in social interactions can plummet due to difficulty following along with conversations or fear of “being a bother” to friends and family, leading to depression, anxiety, and social isolation. Just like a conversation, watching movies or TV shows can be a social experience often done with friends and family. Without closed captioning, audiovisual information is withheld from those with hearing loss, excluding them from the social experience.
How does one participate in an equal society if they are excluded from social experiences? That’s what the National Association of the Deaf (NAD) argued after filing a lawsuit against streaming giant Netflix in 2011. Due to Netflix’s lack of closed captioning, the NAD argued they were not only violating the ADA, but treating the deaf community unequally. Thankfully, the district judge had ruled in favor of closed captioning marking serious progress for required captions, though many platforms such as Facebook and YouTube remain unregulated. With entertainment becoming increasingly digital, it is simply not enough to mandate captions for government programming or news alerts. Information will remain lost in translation until access to closed captioning is expanded to everyone, regardless of their hearing capabilities.

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It Is Time To Get That Annual Hearing Evaluation

We schedule yearly physical exams and dental exams, so why not schedule annual hearing testing? Hearing loss is gradual, and it affects not only your ability to hear but your physical and mental health too. Yearly hearing evaluations should be a part of your regular healthcare routine. If you are putting off a hearing evaluation, please consider some great reasons why you should schedule that test today!

Hearing Loss Is A Gradual Process

Hearing loss typically occurs at a slow pace over the course of many years. Because of this gradual process, it is difficult to detect when your hearing is not as good as it used to be. People with hearing loss typically wait 7 to 10 years before they address the hearing loss. An annual hearing evaluation by a hearing healthcare professional will detect any hearing loss so you can act before the problem exacerbates. You should monitor your hearing as well to identify hearing loss in your daily life. Indications include the following:

  • Trouble hearing phone
  • Difficulty hearing conversations
  • Ask people to repeat themselves
  • Sounds and voices seem muffled
  • Difficulty pinpointing the direction of a sound

Early Detection Is Critical

Putting off a hearing test for 7 to 10 years is not a good idea. An annual hearing evaluation will allow you the chance to address your hearing loss early before the problem worsens. It is essential to check your hearing annually after age 55, even if you experience no problems because this is the time most people begin to experience age-related hearing loss.

Dementia And Depression

Inquiry from the National Institute on Deafness and Other Communication Disorders (NICDC) states that depression is higher among U.S. adults with hearing loss than those without a hearing loss. Although the cause of this relationship is unknown, acting now can reduce your chances of experiencing mental health symptoms that often accompany hearing loss.

Hearing Loss And Happiness

People of all ages experience hearing loss, and the chances that you will experience change in your hearing over time are high. Here are a few statistics to consider:

  • 5% of American children have permanent hearing damage from exposure to loud noise.
  • 14% of American adults between the ages of 45 and 64 have some degree of hearing loss.
  • 30-40% of American adults over the age of 65 have hearing loss.
  • 50% of American adults over the age of 75 have some hearing loss.

It is essential to take hearing loss seriously. The longer you wait, the worse it gets. Heart disease, dementia, sleep apnea, and brain shrinkage all have a connection to hearing loss.

Schedule A Hearing Evaluation Today

Hearing loss will interfere with your life much quicker than you might realize. You may find yourself having trouble at work, not hearing your loved ones, or even enjoying the sounds of nature. Do something for your hearing today. Schedule an annual hearing evaluation with a hearing healthcare professional and protect your hearing before it is too late!