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 Hearing loss
Author: Simon 
Date:   2003-10-21 05:23

I have been diagnised to have hearing loss in both ears up to 40%. I have constant ringing in both ears.
The deficiency is described as hearing loss in the mid frequency. Apparently hearing in the low and high frequency is O.K.
As strange as it may sound I haven't been aware of this for a long time.

Can any one help/advise how this may affect my clarinet playing and what is meant by mid frequency. I have read some articles but still confused.

Would this mean that I have been playing really loud?

Any information is most appreciated.

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 Re: Hearing loss
Author: sfalexi 
Date:   2003-10-21 07:34

Well, mid frequency I believe you answered yourself. And you may want to ask your doctor about specifically what range you're having trouble hearing.

As for the clarinet playing, you may have been playing loudly. Of course, you may not have been able to tell. I think you're gonna have to fine tune some other senses and start playing by feel.

For clarinet, I've somewhat developed some sort of feeling as to where I am in volume and tone whether I was able to hear it or not. I'm sure you have it, but maybe you haven't really focused on it and paid attention to it.

Of course, it may not be necessary. Best judge would be to have someone ELSE listen to you play. Have someone knowledgable in music listen to you play a piece. They'll tell you how dramatic of a difference there was between fortes and pianos and, with a few fingers crossed, maybe you don't have to worry about it at all. But I'm sure you'll manage no matter what.

Alexi

US Army Japan Band

Post Edited (2003-10-21 07:59)

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 Re: Hearing loss
Author: Ralph Katz 
Date:   2003-10-21 11:57

Everyone's pattern of total noise exposure is different, but everyone should take the same precautions.

In my case, it could have been clarinet playing. It could have been sitting in front of the trumpets. It could have been the motorcycles. It could have been that Stones concert in 1972 after which I couldn't hear the traffic in downtown Manhattan and the next two weeks of worry about whether I would be able to hear well ever again. It could have been the last 30 years of sitting around computer cooling fans or driving 600,000 miles in autos.

Then there is genetic makeup. I am lucky to hear and see better than my father did at my age, but that may not be saying much. I was wearing hearing protection in computer rooms 25 years ago, and everyone looked at me as being crazy. Better to be uncool and keep your hearing.

Where do you practice? Is it a live or dead space? Adding sound absorbing material, even a rug, will change things. How large is it? A larger space might allow you to hear yourself better.

I use hearing protectors, usually the foam ear plugs, when I am around any loud or continuous noise: at work, when driving on the freeway, mowing the lawn, using woodworking equipment, etc. If things are really loud, I may double up the plugs with muffs. At home or in the car, I turn the radio/stereo to what I think is a comforable level, then I turn it down a couple of notches. I may turn it up for the traffic reports, but turn it right down again afterwards,

There have been other threads hear about noise exposure here. I think one recently mentioned the Chicago Symphony. I have been trying to find out what brand of hearing protectors orchestral players use, with no luck yet. Playing clarinet with the plugs in has not been a positive experience for me. If you use a single-lip embouchure, a rubber mouthpiece patch will probably help hear with the plugs in by reducing transmitted sound through your upper teeth.

E.A.R. makes a compressible foam plug that a lot of people like for about $1 a pair. Etymotic makes a baffle-type plug for musicians that they claim has a flat response, for about $13 a pair. In a factory setting, I once tried out an active sound cancellation system built into earmuffs (about $250). It was really amazing how it knocked out all the low frequency sounds when you turned it on, but I still needed plugs to knock out the highs. There are plenty of other makers of hearing protection equipment.

Regards

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 Re: Hearing loss
Author: William 
Date:   2003-10-21 15:06

The earplugs that I use are were made by Westone Laboratories (Inc) and were custom fitted by a local hearing clinic. They work a little better than the cheap foam plugs and do not make you sound so much like a kazzoo, but it is still difficult to evaluate tone quality and balance in the orchestral setting. Using ear plugs, however, is better than eventual hearing loss and I use them whenever the brass and percussion section is too loud--which usually seems to be "all the time". My plugs came with two decible reducing inserts--15 & 25, I think--and cost around $130.00, ten years ago. They are inconspictuous--ulike the foam yellow thingies sticking out of your ears--and I often wear them undetected in loud social settings like bars with loud sound systems. In fact, I wore them last evening at a 3.5 hr long Eagles concert--even the loudest guitar licks were tolerable and nobody noticed them in my ears.

Hearing is a precious luxury that should be protected at all costs and I highly recommend the use of any device that will prevent the cumulative damage of a lifetime of "too loud sounds". My hearing loss is (so far) only in the upper frequencies making some parts of speech difficult to hear. There is also a constant tenitus (mild ringing) all the time, but one learns to just live with it. I use my ears plugs to hopefully prevent more serious hearing loss in the future--but I wish that I had begun prevention many years ago as a young musician and band director.

So my "bottom line" advice is always: to prevent damage and eventual hearing loss, Use Ear Plugs, even if it doesn't seem too loud--CAN YOU HEAR ME!!!

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 Re: Hearing loss
Author: Synonymous Botch 
Date:   2003-10-21 15:32

Age also has some effect on hearing... I've been careful, but the topmost notes of an orchestra are beginning to escape me.

The clearest indication of hearing loss is when in a crowd, or while there are ambient noises competing, if you can't understand someone speaking to you directly.

Mid-frequency loss probably refers to the range of hearing that would detect the output of your loudspeaker's middle driver... between the Bass and the Tweeter (2000 Hz to 10,000 Hz, for example).

If you have a decent hearing aid installed, you should be able to play finely.

********

It's not all bad, you know...
My favorite local old-timers band is the "Mostly Deaf Orchestra" composed of retired school band directors.

They considered the erosion of their hearing a mixed bag; caused by the high and loud style of the kids, but sparing them from same.

They know the charts so well that they really only need to see the first downbeat. The problem is stopping the drummer, after he winds up!


******

Best of luck to you, it's a manageable, if lamentable problem.

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 Re: Hearing loss
Author: Bob A 
Date:   2003-10-21 17:36

SB, you added: "If you have a decent hearing aid installed, you should be able to play finely."

I got two of the best and I can't play worth a poop.
Bob A

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 Re: Hearing loss
Author: Don Berger 
Date:   2003-10-21 19:04

Well said, all of you "What did you say?" folks. The term Age-Related as applied to my [and other's?] EARLY! Macular Degeneration [the drusen kind] says it all. Thats just one of several drawbacks in getting older [NOT OLD, please understand]. I haven't found significant problems in playing, tho I suggest to our conductor to shush me if I get out of hand [bass/alto cl], of course he has H A's in both ears!! which I haven't gone to yet! My principal problem is the distinguishing of none-too-loud speaking. Must listen more carefully and ask for repeats. Don

Thanx, Mark, Don

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 Re: Hearing loss
Author: sdr 
Date:   2003-10-22 18:28

Hearing Factoids:

A routine audiogram (hearing test) measures hearing threshold at each octave from 250 Hz to 8 kHz. When you double the frequency, you go up one octave. Thus the standard audiogram measures from approximately one octave below middle C (512 Hz) to four octaves above middle C. "Midrange" hearing loss typically refers to hearing in the 500-3000 Hz range. Isolated hearing loss in this range is typically congenital (you were born with it) but often progresses over time.

"Normal" hearing shows thresholds of 0-25 dB at all test frequencies. Most audiometers can deliver signal intensity up to 100 dB. The dB scale used for audiometry is normalized specifically for testing human hearing and is not an absolute value of dB. When midrange hearing gets down to about 30-35 dB you have entered "hearing aid land." Although there are complex formulas to calculate "percentage hearing loss," these are only used routinely for medicolegal purposes such as damage awards in workmen's compensation cases. It is more correct to refer to the actual dB of hearing threshold. Often this is reported as the "puretone average " or PTA (thresholds at 500, 1000, 2000, and 4000 Hz added together and divided by 4). Since the range of acoustic stimuli of the audiometer is 0-100 dB, many careless ear docs and uninformed patients mistakenly report their 40 dB PTA as a "40% hearing loss."

Most speech has its acoustic energy in the 500-2000 Hz range (a.k.a. "the speech frequencies"). Vowel sounds have energy in the lower end of this frequency range, consonants in the higher (especially unvoiced sibilants and fricatives: "s", "th", "f").

Acoustic trauma (a.k.a. noise-induced hearing loss or NIHL) is a "dose effect." The louder the sound, the less time it takes to do damage. Below about 80 dB, even chronic exposure does not seem to have a deleterious impact. However, from 90 dB up, there is a big problem. OSHA, the Occupational Safety and Health Administration has published guidelines for noise exposure in the workplace. At 90 dB, you are allowed 8 hrs exposure daily. For each increase of 5 dB, you cut the time in half. Thus, 4 hrs @ 95 dB, 2 hrs @ 100 dB, etc. For "impulse noise" such as a gunshot or hammer on a steel plate, the intensity can exceed 140 dB and create instantaneous permanent hearing damage. If the noise is "broadband" (spread over a wide frequency domain, such as machinery noise, chainsaw, etc), acoustical features of the ear canal and middle ear preferentially admit energy in the 3000-6000 Hz range and hearing is damaged in those frequencies. The audiogram shows a deep "V"-shaped notch centered around 4000 Hz. If the noise is narrowband or a pure tone (e.g. the ring tone on early cellphones), it only damages hearing in that frequency range.

The quality of ear plugs as noise protection varies WIDELY. Simple foam or silicone plugs sold at the hardware store preferentially block low-mid frequency sounds and still admit a fair amount of higher frequencies. This is an acoustical effect of ear canal occlusion somewhat independent of the material the plugs are made of. "Musician's plugs," available from hearing aid dealers and better music stores, have a flat frequency response. There is a good analogy to sunglasses: hardware store earplugs are analogous to green, red, or amber sunglasses -- they reduce the intensity of incoming light but distort the color balance. Musician's plugs are analogous to neutral gray sunglasses that dim the light without distorting color balance.

For more information about hearing and hearing loss, visit the National Institutes of Health: National Institute of Deafness and Other Communication Disorders (NIDCD) at http://www.nidcd.nih.gov and see your tax dollars at work.

-steve rauch
============
Steven D. Rauch, MD
Dept. of Otolaryngology
Harvard Medical School
Massachusetts Eye & Ear Infirmary
Boston, MA

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 Re: Hearing loss
Author: Don Berger 
Date:   2003-10-22 20:08

Many thanx, SDR, for definitive discussion, will copy for reference. Don

Thanx, Mark, Don

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