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Hack My Hearing

Broadcast on BBC Radio 4 - 6 January 2014

(The programme is available via the BBC website(external link, opens in new window))

Announcer

In hack My Hearing, Frank Swain shares his experience of early hearing loss and looks at what the future might hold for hearing technology.

Frank Swain

My name is Frank Swain. I’m 32 years old and I’m slowly going deaf. Nobody knows for certain why I’m losing my hearing. The first doctor I visited blamed the countless nights spent at ear splitting gigs and clubs during my 20’s. The second doctor thought it was more to do with an unfavourable draw in the genetic lottery; what they do agree on is that it’s irreversible. If you want to enter my world then my hearing loss started here in the vocal band and so I live in a world where the voices of my friends, my family and everyone else are faded into the background and are lost against the noise of day-to-day life.

Today I’m visiting a clinic in Camden, North London to meet with the NHS audiologist. They’ll be running some tests so I can find out just how bad my hearing has become.

I’ve got an appointment, my name’s Frank Swain.

Reception

Do you know who your appointment’s with today?

Frank

Er, it’s with the audiologist, that’s all I know.

Reception

Cheers. He’s coming out now, if you just take a seat here.

Frank

Excellent. Thank you.

Turning down a maze of white corridors, he shows me into a small room tucked away in the heart of the clinic, insulated from the noise outside.

Audiologist

Come in. Come in and make yourself comfortable.

Frank

Thank you.

There are posters on the wall showing the labyrinth themed twists of the inner ear and the whole corner of the room is taken up by a large isolation booth.

Audiologist

My name’s Shahed, I’m the audiologist here today.

Frank

Good to meet you.

Audiologist

Good to meet you too Mr Swain. Before we start can you just confirm your date of birth for me please?

Frank

The 21 February 1982.

Audiologist

Okay, before I start the actual hearing test, there’s just one test I want to do, it’s called a tuning fork test, it just helps me establish if there’s any middle ear problems okay? This tuning fork’s gonna establish a sound and all I need you to do is tell me if it sounds louder to you in front of your ear or behind your ear.

Frank

No problem.

Audiologist

So I’ll put it in the front first. Okay, here we go.

(ringing sound)

Frank

Definitely louder in front.

Audiologist

Good. And now the right ear.

(ringing sound)

Frank

Same again, louder in the front.

Audiologist

Excellent. Good. What we’re now gonna do is perform the hearing test, this test is very simple. The aim of this test is to measure the quietest sounds that you can hear. So I’ll ask you to sit in a booth and I’ll put a set of headphones on you and very simply, every time you hear a sound, even if it’s really quiet or if you think you heard it, just press and let go of the button for me. Okay?

Frank

No problem.

Audiologist

Mind your step as you go in.

Frank

Sitting inside the booth is a bit of an uncanny experience. Even for those of us who are losing their hearing it’s rare to ever experience absolute silence and at this level it almost feels like a physical force pressing in on you.

(ringing sound)

That is until the bleeps start.

(variation of bleep sounds)

As the tones become higher and quieter, it becomes harder to know whether I’ve really heard something or whether it was just my imagination and there’s that frustration of knowing for certain that there are beeps being played that I can’t hear which other people would.

Audiologist

If you’d like to take your headphones off.

Frank

Thank you.

Audiologist

Thank you, all done.

Frank

It’s like waiting for my test score isn’t it!

Audiologist

This is what we call an audiogram, I’ll describe it to you; so at the side here is the volume of sound and we measure in decibels, the quite sounds are at the top and as you go down it gets louder. This here, the X-axis, we measure it in frequencies but these frequencies represent the hair cells in our ear and the way we hear is via the vibration of hair cells. What we classify as normal hearing is anything above 20 decibels is normal hearing...

Frank

I’ve only got one point...

Audiologist

…and anything below is a hearing loss. It starts of good as you can see it’s very border line at 20. As you go across the hair cells it dips down a bit. So you start off within the mild range and then you dip down just into the moderate section. The lower frequencies, so a certain type of hair cells, represents the volume of sound and the higher frequencies represent the clarity in sound, so the volume in sound is quite okay for you even though it’s mild but you’re probably struggling with clarity of speech. So by your results it’s telling me that maybe one-to-one situations you’re fine but if there’s a crowded situation you may struggle a little bit. I don’t know if that ties in with your...

Frank

That’s about right yeah.

Audiologist

Yeah? Also men’s voices are located at a more low pitch, so you’re more likely to hear a male than a female. So that’s where your weakness is at the moment. You’ll probably find that if somebody’s facing away from you, you’ll probably hear them speaking but to understand what they’re saying is a bit of a challenge, do you find that happens?

Frank

Yeah. Is there anything I could do to...

Audiologist

Prevent it?

Frank

To avoid it getting any worse?

Audiologist

That’s a good question. To be honest with you there isn’t. Obviously if exposed to loud sounds it will aggravate your hearing loss even more, yeah, other than monitoring your hearing there’s not much you can do.

Frank

For all I know my hearing may have declined no matter what I do. But I can’t help thinking that all of those hours spent in front of towering speaker stacks probably didn’t help.

Increased levels of noise however may just be a symptom of modern life, says Brian Moore, Professor of Auditory Perception at the University of Cambridge.

Professor Brian Moore

Nowadays it’s mostly leisure noise, previously there was a lot of noise exposure at work but then it was realised that noise could damage hearing. So sound levels in factories have either been reduced directly or people working there are given hearing protection, ear defenders or ear plugs. But in parallel with that, sound levels coming from leisure activities, particularly live concerts, have been  going up dramatically and that’s partly because amplifiers have got more powerful, loud speakers have got more efficient and so the bands are simply playing much louder than they used to and so the effects are potentially more damaging.

Frank

Professor Moore carried out a study looking at how young people’s hearing was affected by exposure to loud noises, in this case from MP3 players. He found that their audiograms were still within the normal range but then he tested their ability to discriminate different notes.

Brian

In one interval they’d hear, bup bup bup and in the other interval they’d here bup, bup, bup, bup and they had to say in which interval the sounds were changing in pitch or in frequency. And we found that the group who were habitually using these personal music players were actually worse at that task, significantly worse than the people who didn’t use personal music players at higher sound levels.

Frank

The real shock came when they recorded levels of noise that young people were exposed to by live music, going to gigs, playing in a band, or visiting night clubs. 

Brian

We actually fitted them with what are called noise dose meters which record the sound level they’ve been exposed to during a two hour period or so. We found that those people were getting exposed to really very high sound levels, sometimes up to 120 decibels. There are some animal studies on this and in animals that are exposed to intense sounds often just after the exposure they show a temporary hearing loss, so their ability to detect weak sounds is decreased, but then it recovers over a period of a few hours or a few days and the same sort of thing happens in people. But in those animals it’s been shown that the nerves in the auditory nerve that are carrying signals from the ear to the brain, slowly degenerate following the noise exposure. So after six months there’s a significant degeneration of neurones and it doesn’t necessarily show up in the ability to detect weak sounds but it can show up in the ability to discriminate sounds. That’s what prevents people from noticing it, it’s not like having a sudden change in your hearing, it creeps up on you gradually.

Tre Lowe

My name’s Tre Lowe and I’m a music producer.

Always was a noise addict, like massive, I loved it the louder the better for me. I mean stupid levels of loudness, sat in my car cranked up, or headphones cranked up like wanting more and more noise.

(Music Plays)

Frank

Tre’s hearing problems began following an operation for Appendicitis when he suffered an adverse reaction to his medication and was left with a quiet but noticeable tone ringing in his ears. But it was music, listening to it, making it, playing it that made it worse.

Tre

The specific DJ episode I remember clearly was five years ago, the club system had died and they’d hired stacks and stacks of speakers. Stupidly they placed it right behind the DJs, I’m talking massive stacks that you see at a gig. So I remember going into the toilets during my set and trying to stuff my ears with tissue and the next day I had massive hearing loss, I was literally pretty much deaf. I think it’s called temporary threshold shift and it was since that day that my tinnitus jumped from, on a scale of 1-10 of bothering me from a three to a nine overnight. So it was about five years ago that I think the tinnitus has really introduced itself to me,  like hello it’s me, you’ve been ignoring me for years, here I am.

For me it’s just a sea of noise, it’s the only way I can describe it. Also being joined by a low pitch rumbling.

It’s no longer just one sound.

I avoid silence at all costs, because obviously if I'm in a silent room, even in this interview room, I can hear my tinnitus as loud as you speaking. But I'm really aware that I might not ever hear silence again in my life and I may have to always take measures to avoid silence. On the flip side of that, I then have to take measures to avoid loud noise. So I now exist in a 40-70db world, where everything is alright. The minute is goes either side of those two db readings, I have to either introduce noise or to limit the noise. So that’s been a bit challenging. So I've got ear plugs with me all the time so if I go to a loud club or whatever, I stick them in. normally when I'm at home I have the white noise generator on my phone which masks my tinnitus. Sometimes I have some sort of sound effect coming out of my Mac speakers. It kind of helps me to chill out and gives your ear something else to think on. So it’s been a bit of a lifestyle change for me.

Frank

Tre Lowe now volunteers for the charity Action on Hearing Loss. If you're worried about your own hearing they offer free tests on their website. They can be taken by phone, online or even as an app. But let’s go back to what’s going on inside the ear when it’s exposed to loud noises.

Brian

It sets up a whole chain of reactions and there are processes where some cells that have become damaged actually undergo a sort of programme suicide. It’s called apoptosis, where cells actually kill themselves and degenerate after they’ve been damaged. Interestingly there’s a slight correlation of susceptibility to noise damage and colouration of the skin and hair. So generally blond, blue-eyed people are slightly more susceptible to noise damage than dark-skinned, dark-haired people. More and more genes are being discovered that influence how the hearing system ages and how susceptible it is to noise damage. There’s a lot that we don’t yet understand.

Frank

Hi there!

Audiologist

Hi! Good afternoon. I'm Natesh. Take a seat.

Frank

I’ve returned to the clinic in Camden because for me the next step is to get some amplification.

Audiologist

Today’s appointment, we are just going to fit your hearing aids today. We are then going to set them up. Once they are set up, you can switch them on and make sure you are comfortable with how things sound. It is going to sound a little bit different compared to what you are used to and it is a case of going away and trying them. Any questions so far?

Frank

None so far.

Audiologist

No, so I'm just going to out these hearing aids in your ears now. The significance on the red and the blue; red is right and blue is left. So we’re going to set these hearing aids up and that should begin in the next couple of seconds, alright?

Frank

The audiologist has placed a small plastic bud in each of my ears about the size of a kidney bean and these are connected to a nearby computer by a pair of fine wires. There’s a strange sense of feeling part man, part machine as I prepare to give control of my hearing over to a computer.

Audiologist

So I'm just going to switch the hearing aids on and as I keep on speaking to you, hopefully you will notice a change in my voice now that both hearing aids are on. Compared to when you came in earlier this afternoon how does my voice sound now?

Frank

Very tinny, it’s like we’re inside a tin can.

Audiologist

So it’s sounds a bit echoey and a bit unnatural. That usually does fade away. Does my voice sound a little bit clearer, sharper, are the words coming out a bit more crisper?

Frank

A lot crisper.

Audiologist

Brilliant. Is my voice comfortable?

Frank

Absolutely.

Audiologist

So it’s not like I'm yelling at you?

Frank

No.

Audiologist

Ok so this is how we want you to hear from today onwards. And if I switch both hearing aids off how does everything sound now?

Frank

Er, like we’re underwater.

Audiologist

Ok so how the volume and the clarity of my voice also reduced?

Frank

That’s right, yes.

Audiologist

Okay so this is what you’re used to, or shall we say what your brain is used to and as I said from now on we want you to start hearing at this level here. But this is the transition and this is what takes a few weeks. Just be aware in a room like this it’s reasonably quiet. I'm sitting literally right in front of you, very little background noise and to a certain degree this is an ideal situation but in the real world it’s a little bit different. For example if you’re going on the bus, you're going to hear the traffic, the bell going, people talking, kids screaming, all these other noises. Something that we all can hear but for somebody who has hearing loss over a period of time and has not had hearing aids fitted, those sounds are a little bit alien.

Frank

As I walk out of the clinic I'm aware that the boundaries of my world have spread about a lot further than I'm used to.

(Background noise)

Frank

I can pick up on sounds the other side of the waiting room that normally would have been lost to me.

(Background noise)

Frank

So I'm outside now and the world is a bit of a different place I think. The taxi that is idling over by the pavement, I probably wouldn’t have heard so it bothered me so much. I think I can hear some people with a dog at the end of the street. The whole world is happening out here. It’s difficult to describe but normally by having a certain amount of hearing loss you feel like you’re swaddled up in this blanket. So getting your hearing back can be a little bit frightening. It certainly does make you feel a little bit more exposed than you were before.

(Noise in street)

Professor Kevin Monroe

Unlike a vision problem where you can give someone a pair of glasses and for most people the benefit is pretty much instant, when you provide someone with a hearing instrument it can take some time to adjust to hearing the high pitched sounds that people haven’t heard for a while. It you don’t hear high pitched sounds, it’s as if you’ve gone through life with the treble turned down on your hi-fi system. If someone increases the treble it suddenly sounds high pitched and tinny and somewhat unpleasant.

Frank

Kevin Monroe is professor of audiology at the University of Manchester. He accepts that wearing a hearing aid is something that is often needed but not necessarily wanted. On average people suffering from hearing loss will wait about ten years from needing a hearing aid to actually getting one. And that’s in large part due to the stigma surrounding them. They’re ugly, beige and definitely for old people. Unlike prescription glasses, there’s nothing at all glamorous about wearing hearing aids.

Kevin

Currently there are about 6 million adults in the UK who could benefit from using a hearing instrument. But only something like 2 million actually have a hearing instrument. So the uptake is low, it’s also low because people sometimes don’t recognise they have a hearing problem or because of the stigma associated with them they delay seeking help. So only about one in three people who could benefit from using a hearing instrument have one and probably about 20% of them are not making maximum use of their hearing instrument.

Frank

Why is that? What is driving this stigma of wearing a hearing instrument?

Kevin

I think the reasons for this stigma and the low uptake are rather complex. One of them is that we have these outdated attitude that if something goes wrong with your hearing that’s hearing loss, that means you have to accept that there is something wrong, that you have an illness, that you have to go along to your GP. Your GP will send you along to the hospital and that reinforces you know, I've got a loss, I'm impaired, I need an aid and they feel a bit infirm. That doesn’t happen for if you want a pair of glasses Frank, you go along to the high street and if you need dentist, you go to see the dentist. So actually the provision of hearing aid services is somewhat different. You know that’s only one example, it’s a very complex issue but I think if I could break down these barriers that would be a good start.

Frank

I notice you use the word hearing instrument there, is there a reason you prefer that over what most people would commonly call a hearing aid.

Kevin

Well traditionally we refer to it as a hearing aid, but historically is probably referred to as a deaf aid. But that conjures up this image if you need an aid it’s like using a crutch or a walking stick and that contributes to outdated attitudes to words, changes in hearing, though a hearing instrument avoids that stigma. The other important point is we’re probably getting to the stage where hearing instruments could potentially benefit people with normal hearing. There are devices that hopefully will become available during my career that will help people with normal hearing to give them super human hearing and that will help even normal hearing individuals and that would be an important step.

Frank

I wonder might my hearing loss be a blessing in disguise because I don’t have to be content with simply reaching the level of an average person. With these devices there is no reason I can’t push beyond the limits of human ability to become sensitive to things that other people can’t hear.

(Crackling)

This is the sound of a geomagnetic storm reaching high above Earth…

...created by art duo Semicoductor using data from radio telescopes.

Why shouldn’t I be able to tune in my ears to listen in on these stratospheric tempests? Or sense the crackle of the sun’s radiation?

(Crackle)

Or eavesdrop on the ebb and flow of nearby WiFi traffic?

(Low electronic rumble)

That’s a lot to ask from a device that could happily fit inside a thimble but there is a solution at hand. Michael Bjergby from GN Store Nord, one of the industry giants of hearing technology, told me about their latest piece of kit – a hearing device that’s wirelessly coupled with a smart phone.

Michael Bjergby

This would be the world’s first made for iPhone hearing aid. And a direct link can create significant benefits for hearing aid users because you can use the iPhone as a remote control, you can have the sound streamed directly when you are doing a phone call, you can have the sound streamed directly up to the hearing aids. You can also do other cool things because what you actually do is connect the new hearing aids to the internet via the phone so you have the possibilities to use the GPS in the phone so you can go into airport and have flight information directly into the hearing aids. And that is one important step, I think, in that direction.

Frank

Now I’m quite excited about the idea of viewing these things rather than ‘prosthetic’ as being a piece of ‘wearable computing’ and obviously that’s a big trend right now. Do you think that young people, or even people of all ages, will ever come to see these as ‘life-style gadgets’ more than something that you only need if you want to improve your hearing?

Michael

I really hope so and that is probably our mission; that one day it will be cool to have a hearing aid. It’s like the same transition you have seen with glasses, to some extent, now you see people wearing glasses even though they don’t have a vision impairment. I think the first step is to make them useful.

Frank

Now one of the things I have been really interested in doing is adding in additional layers of information into that hearing device, so sonifying data about local WiFi traffic or weather patterns that other people might not be able to sense and in that way create a kind of ‘super sense’. Is this something that I would be able to do with your device?

Michael

I think that hearing aid users will be able to do that, yes. You really connect to the internet directly via the hearing aid so I think you have access to a lot of information. You can get that quite easily via APP development. Now you start to be able to do things people without a hearing aid cannot do.

Frank

Already there are people using technology to push their bodies beyond normal human abilities – what you might call Cyborgs. Artist Neil Harbisson was born with achromatopsia and can only see in shades of black and white. He developed a unique hearing device to overcome this.

Neil Harbisson

Well, I have an antenna attached to my head that allows me to hear colours. It detects the light frequency in front of me and it sends this light frequency to a chip that is installed at the back of my head and then this chip just slides down the light frequencies to sound frequencies until I can hear the colours through both conductions. So instead of using my ears to hear colour I use my bone.

Frank

So when this device changes colour into sound and is heard through your bone conduction what do you actually hear?

Neil

Well it’s like an electronic sound is a sound wave. Each colour has a different note. This is, for example, the sound of...

(HIGH PITCHED SOUND)

Frank

So that’s the sound of purple walls in our studio.

Neil

Yeah. Then if I point something else...

(NOTE GETS HIGHER THEN DROPS)

Frank

Your blue shoes are making that sound?

Neil

Yeah. (laughs)

Frank

So what does my face, for example, sound like?

Neil

Let’s see

(Low note)

You sound...

Frank

A kind of mournful. I have a mournful sounding face.

Neil

That is the sound of your face.

Frank

You can actually sense colours that normal people can’t see, can’t you?

Neil

Yeah exactly. The exciting thing about having a cybernetic organ is you can actually keep extending it. When I was able to perceive all of the visual colours I didn’t see why I should stop so I included infra-red perception and ultra-violet. This is useful because ultra-violet is a dangerous colour so if I hear ultra-violet it means it’s not a very good day to sunbathe, for example.

Frank

And how does that change the way that you perceive your environment? I mean, do you find yourself interacting with the world in a different way?

Neil

Yeah hearing colour has changed many things because there is colour everywhere – there is music everywhere now, I live in a music composition. Wherever I look I hear music, so my experience of walking around a supermarket is like going to a nightclub! It’s electronic music everywhere I look.

(Rhythmic Pulses)

Neil

Art museums have changed because now I can listen to a Picasso, I can listen to an Andy Warhol. So painters have become composers.

(Faster Pulses)

Neil

In my dreams I dream in colour so my brain recreates the sound of oranges, the sound of the sky. It’s not the chip giving me the sound of colour, it’s my brain. So if I dream of a blue sky, or a clear sky then I hear C#.

(Fast Pulses)

Frank

In terms of you using cybernetic equipment to push the envelope of what humans can see and sense and experience – how have other people reacted to what you are doing?

Neil

Well there are all sorts of reactions. Some people find it unnatural, unsafe, unhealthy and then I just try to convince them that I think it is extremely natural to do this. We are humans, humans have this natural wish to extend themselves. Not only through knowledge – extend their knowledge or extend our spirituality - but also to extend our perception of reality. By applying cybernetics to the body we can actually extend our senses. The exciting thing is the field is very open and you can experiment in many different ways.

Frank

In needing a hearing aid, or rather a hearing instrument, I’ve actually entered a select group of people lucky enough to have a cybernetic organ. As well as being a curse, losing my hearing could also prove to be an opportunity. Music producer, Tre Lowe, agrees.

Tre

I actually wouldn’t change a thing and it’s weird to say that because sometimes tinnitus is like my biggest foe and if it was a person I would strangle the soul out of it! But at the same time, when I look at the positives it has given me I would hug tinnitus if I could. So, I now wear earplugs, so whereas I might have been destined to lose my hearing anyway – like all my friends who don’t have tinnitus and think it’s great that they get to listen to loud noises, who then might be unable to hear at 50 - I protect my hearing. So for me that has been a gift that tinnitus has given me, and that’s fine if I have to listen to this out of tune symphony for the rest of my life, so be it.

Frank

Most people will experience a decline in their hearing over the course of their lives. But perhaps I can count myself among the few of them who will also experience the opposite too – endlessly expanding the repertoire of what my ears can detect from storms to stock markets. Instead of saddling me with a disability losing my hearing may be my first step toward becoming superhuman.

Man

Ultimately we can get to a stage where hearing instruments are implanted within the ear so there may be nothing to see at all and some of that technology is already available.

Frank

Fascinating, I didn’t know that. That sounds cool. (LAUGHS)

Man2

I’d certainly volunteer, that sounds like a blast. 

Announcer

Hack my Hearing was presented by Frank Swain and the producer was Michelle Martin. There are links to more information on hearing loss on the programme’s webpage which you can find via the Radio4 website. Let’s find out what’s on ‘You and Yours’ this lunchtime – here’s Winifred Robinson.

Find out more

Hack My Hearing is available via the BBC website(external link, opens in new window)

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