July 27, 2025 • 40 mins
Hearing loss is one of those thing that just kind of sneaks up on you, and most people never think to get it checked until you reach a certain age.
Hearing loss affects 1 in every 5 kiwis, and it's projected to get far worse over the coming decades.
Dr Michel Neeff is a leading ENT surgeon and he joins Tim Beveridge on the Health Hub.
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
Bicky, there's a please go come that's where you are.
Speaker 3 (00:45):
Anyway, Welcome God. A little bit of beach Boys to
ease us into the health Hub. Tim Beverage, this is
the Weekend Collective and now this, as I said, it's
a health hub and we're going to be having a
chat about hearing loss and and well lots of things
around that whole topic. Because one of those things that
I think it's actually a bit of a I wouldn't
say it's a peeve of mine at all, but it's
(01:06):
something that I think we are very you know, we
worry about all sorts of things like obesity and looking
after diabetes and all sorts of obvious things and alcohol.
And I always have felt that one thing society is
quite ambivalent or a little bit maybe the words blase
is about hearing loss and how it can sneak up
on you and how you need to protect it more.
And of course you never think about getting it checked
(01:27):
until more not necessary until you reach a certain age.
But maybe your wife or your husband has said I
just said that three times. Do you don't just hear me?
But it affects one in five kiwis, and it's projected
to get far worse over the coming decades. We all
know that, you know, you should avoid turning the car
radio up loud people in radio, take the headphones off,
turn them down. But anyway, how does it affect the
rest of our bodies. We're going to talk about everything
(01:48):
to do with well, it's a few issues as well
to do with hearing loss and joining us as a
new guest on the show. He's a leading E and
T surgeon and his name is doctor Michelle Neif. Michelle,
Good afternoon, Good.
Speaker 4 (02:01):
After luntin, Thanks for having me, Thanks.
Speaker 3 (02:03):
For coming on. How long have you been involved in
this area? Because E and T is obviously Ian osen throat.
Speaker 4 (02:13):
Training is five years long. So I finished my training
in two thousand and six and then did another fellowship
training and came back in two thousand and seven, and
since then have only dealt with hearing loss, hearing, hearing
restoration and that sort of thing. So I've sub specialized
in hearing disorders.
Speaker 3 (02:32):
Actually, because there have been a lot of innovations, I
guess constantly science is evolving, and when it comes to
hearing loss, it's just been a I don't want to
use the word exciting time. It's such a cliche, but
has it been an interesting time in the last sort
of five ten years with some of the innovations.
Speaker 4 (02:51):
Yeah, I mean, obviously there are technological innovations, and I
guess you are referring to some of the cochlear implant technology,
in particular, more recently the new neccess system from Cochlear,
which enables us now to program the device, the internal
device of a cochlear implant, for example, without having to
(03:14):
wait for innovation for seven or eight years. So that's
that's that's the latest exciting thing. But it's the research
behind all the hearing loss and what we've learned, you know,
in in my time since I've come back from my fellowship,
we've introduced new nature hearing screening, which is very important. Obviously,
(03:38):
there's more awareness about noise induced hearing loss in children,
you know, using ear pods, as well as occupational noise
induced hearing loss, and most recently the association between hearing
loss and dementia. So interesting and some exciting progress. But
(04:01):
we've learned a lot over the last ten fifteen years.
Speaker 3 (04:05):
So you might have heard my brief comments which are
just informed on you know, obviously a lay person's approach.
And I've been a musician as well, and I've always
been constantly aware and especially the headphones because the background is.
I did a show years and years ago which was
using the latest in technology where all the cast it
(04:26):
was Jesus Christ Superstar is about. Oh, I don't want
to say how long ago it was, but it was
about thirty years ago, and we all had ear monitors
to monitor our voices. And I think the best thing
that the producers ever did for us was they said,
we're going to set your level now where you can
hear what you need to hear. And here's a warning
for you all. We're not changing that level. You're not
(04:47):
going to come to us in two or three weeks
and say, can you please give me a bit more
of this and a bit more of that. But they said,
because it's insidious, you won't think that, you ain't realize,
but you keep turning your headphones up. That's is that
a real thing, A real problem?
Speaker 4 (05:05):
Yeah, that's a real problem. Yeah. I mean airbs are
a very good example. You know, I think everybody's got airports.
I've got AirPods, for this interview now. And you know,
hearing damage starts at eighty five decibels if you expose
yourself over eight hours, and that means if you have
a hair dryer, vacuum cleaner, that can be loud enough
(05:26):
if you do it for long enough to cause hearing damage,
hair cell damage, So you're damaging the inner ear hearing
organ And you know, if you listen to enough music
and loud enough, then you can cause in your hearing
damage and unfortunately the manufacturers don't control that. So an
AirPod can be turned up to in some cases one
hundred and ten decibels, So we're talking about significant noise exposure,
(05:51):
like power tools.
Speaker 3 (05:52):
Is there something about the way we perceive sounds? So,
for instance, if I had my stereo on and it
was producing one hundred decibels, do I, by virtue of
sticking headphones on, have a different tolerance where I might
listen to it louder than I realize?
Speaker 4 (06:08):
Potentially it depends a bit on the background noise. You know,
if you're in a noisy environment and want to hear
the music better, then obviously you turn it louder, and
that's where noise cancelation can be useful. So if you
use that, you don't have to overcome the background noise,
and therefore you keep the sound down. But some people
just like to listen to very loud music, and I
(06:31):
think nothing helps there.
Speaker 3 (06:33):
How come from a why are shorter exposures? Okay? What
is it about the length of time? And what's the
what's the you know, the physiological reaction that happens with
the long long exposure noise?
Speaker 4 (06:46):
Yeah, so you're talking about intensity. So the it's it's
the length of exposure and the loudness of exposure. You know.
So as I mentioned before, eighty five decibels for an
eight hour day is loud enough to cause damage. Ninety
decibels for four hours is loud enough to cause damage.
(07:08):
So it's the accumulation sort of the you know, the
product of time and loudness that causes the problem.
Speaker 3 (07:15):
So what I mean is why do short, shorter bursts
not cause damage?
Speaker 4 (07:24):
They don't. I think they can, you know, if you
turn it loud enough, they can.
Speaker 3 (07:28):
Okay, what what's with cocula? Sorry? Cochlear implants?
Speaker 4 (07:35):
Mhm?
Speaker 3 (07:37):
How do they work? Because you know, we're there and
we see people will see on YouTube videos of people
hearing sound for the first time, and what an emotional
experience it is. How how much of it is a
mechanical thing to do with the ears and the way
we perceive sound versus a neurological I don't know, but
I mean, how on earth does it work? It still
blows my mind.
Speaker 4 (07:57):
But I think you sort of have to step bigger.
How does hearing work? You know? You have you transmits
through the ear canal, ear drum, hearing bones to the
inner ear, which is the hearing organ. And it's often
the hearing organ itself that gets damaged or is not
working at birth that you have to overcome. So that
comes a time where a hearing aid, which really just
turns the sound up, doesn't work anymore, doesn't give you
(08:20):
the benefit it's supposed to do. And that's where cochlear
implants come in. So a cochlear implant has got two
components to it. An internal device, which is the cochlear
implant itself, and that is essentially an electrode that gets
wrapped around the hearing nerve, and then an external device
that sits on the outside, which is the hearing aid
(08:42):
part if you wish, and that transmits to the implanted part.
The sound gets transmitted to the electrode and that stimulates
the nerve, and from there it goes up to the
brain and stimulates the hearing cortex.
Speaker 3 (08:55):
And how do we confidently know that what someone with
cochlear implants here is is comparable, similar, exactly the same.
I don't know to what you and I hear before
we damage a hearing well.
Speaker 4 (09:11):
It's obviously half for a child who was born deaf
or severe profoundly deaf to know what normal sounds are.
But we have a lot of adults who could hear
normally and then lose their hearing, And in fact, initially
they some of those adults feel like crying when they
first turn hearing at the cocklear implant on, not because
(09:32):
they're so emotional that they can hear again, but because
it sounds so terrible. And then with time, the brain
associated the sounds that they hear to their memory from
the hearing memory, and over six to twelve months, everything
sounds normal again. So if you ask somebody who an
adult to receive the cochlear implant what it sounded like
(09:52):
at the beginning and what it sounds like now after
the year, they would say look, after a year, everything
sounds normal again.
Speaker 3 (09:59):
How how do they manage that? Then? Would they have
times where they turn it down or off or not
speaking to a complete light person? So I might ask
some dumb questions here.
Speaker 4 (10:09):
No, no, no, I think the the idea is to
wear it all the time, but not at a nigh
to get the brain used to the sound. And yeah,
that's how they learn. The cochlear implant programs each to
hear again, So you have to completely learn to hear
with the device again. But after some time, after a year,
(10:31):
it just becomes normality. Passions put it on and leave
it on so that they can hear normally. Otherwise without
the implant, they're still profoundly deaf, and so it is
sort of it brings them back to their normal working life,
normal social like when before they couldn't take part anymore.
Speaker 3 (10:48):
Another dumb question potentially, so if a cochlear implant is
more around the well it does. How much of the
cochlear implant involves surgery actually to do with anything to
do with your ear?
Speaker 4 (11:02):
Yeah, well I'm in the first step is surgery. You
know they've you go through an assessment process first, or
you all just determine that you're hearing aids don't work
as well anymore as they should and a cochlear implant
might be a better solution. And then the first that
is surgery, So you have one and a half up
to two hour surgery on one ear, so one cochlear
(11:23):
implant is funded for adults in New Zealand, and a
healing period of a few days. And then we can
usually do the switch on, which means you put the
device on and get the patient used to the cochlear
implants sound very slowly and then over time you turn
it louder and louder according to what the patient perceives
(11:44):
and he is.
Speaker 3 (11:45):
So that was going to be in My next question
was just around eligibility and funding and things. So you
say that one you get one funded, and if you want,
if you want stereo, I guess you get two. Is
that right?
Speaker 4 (11:57):
Yeah, yeah, that's right. Yeah. So children, all children up
to the age of eighteen get bilateral coclear implants funded
by the government and that is sustainable funding, and adults
only get one implanted. If the funding runs out, then
obviously your patients might have to wait longer. At the
(12:17):
moment the funding is fairly.
Speaker 3 (12:18):
Good, right, we'd love your cause if you've got any
questions for doctor Michelle Nef he's an E and T
surgeon specializing in ears hearing, any questions for him. I've
had a few texts coming already on a bunch of things,
and I'm sure you're happy to take calls from people,
Michelle on any questions they might have to do with
hearing of your if you've got a relative or something
(12:39):
you're concerned about their hearing loss. And because sometimes a
lot of the calls we get maybe asking for a friend,
you can give us a call. We'd love to hear
from you on eight hundred and eighty ten eighty you
can text nine to nine two. We've got a few
texts that have come on as well about a few
questions around hearing as well, and we're going to dig
into other questions that Michelle raised at the start of
our chat with the app, with the connection with hearing
(13:02):
loss and dementia, which I'm sure is something you would
probably all like to know a bit more about, which
we'll dig into in just a moment. But we'll take
your cause eight hundred and eighty ten eighty text nine
two nine two. It's nineteen and a half past four.
News Talk said, b Yes, welcome back to the Weekend Collective.
This is the Health Hub. My guest is doctor Michelle Neath.
(13:24):
He's an E and T surgeon specializing and hearing loss,
coccoli and plants. And well, I'm not going to try
and sum up his his his expertise, but he's an
E and T guy and an ears or his thing,
if I could put it that way. Now, let's text
some calls. We've got lots of lots of texts and
some really interesting questions. So if you want to jump
the queue, you can jump on the blower on eight
hundred eighty ten eighty John.
Speaker 5 (13:44):
Hello, Oh goody, how's it going good?
Speaker 4 (13:47):
Thanks?
Speaker 5 (13:48):
That's up, it's great. So I'm just wondering what the
surgeon's thoughts are on the induction. Yeah, phone, so like
the shocks brand which go over your ear and they
work on phone conduction, and yeah, are.
Speaker 3 (14:02):
They the ones that don't actually stick into your ear?
They of.
Speaker 5 (14:07):
Ear so there grading for running so you can hear
what's going on around here. But yeah, I can't just
imp the thoughts.
Speaker 3 (14:15):
Thank you, Yeah, thanks, I guess Michelle, what is that
technology and what are you what can you tell us
about it?
Speaker 4 (14:21):
Well, are you talking about a bond bond conduction hearing
it or bond conduction headphones? And in terms of in
terms of hearing, that two components. That one is the
conductive component. That's where the sort of that's the ear
drum and the little hearing bones the osccles working to
transmit the sound. And then you've got the inner ear
hearing and speaking generally, if you have a conductive hearing loss,
(14:45):
then a bone conduction hearing it, which works similarly behind
the ear can over can byplass the middle ear that
is the ear drum and the hearing oscacles and stimulate
the hearing organ directly. And the bond conduction headphones for
running their work exactly this same and they can work
(15:05):
very well. Some people work then are used them for
their for their phones as well work extremely well.
Speaker 3 (15:11):
So there's there's the there's the retail sort of version
for consumers who want to just use it, but there's
also a medical application for people who have hearing losses
that correct correct. Yeah, yeah, and yeah, any follow up, John.
Speaker 5 (15:25):
I think that covers it. That's all I've got. I've
got to follow up with.
Speaker 3 (15:31):
I've got to follow up for you. Are there any
safety issues with because people think are I mean, do
you still have to be careful with volume with bone
bone conduction? Is it conduction or induction?
Speaker 4 (15:41):
Mister conduction conduction? Yeah? Yeah, yeah, we talked about before.
Is it exactly the same if you turn it too loud?
But you're still cause in your hearing damage.
Speaker 3 (15:50):
You know, Okay, I've had a lot of texts asking
about tinatus or tonight is tinatus? And where are we
at with the causes and the treatments for tentatives?
Speaker 4 (16:04):
Mhmatives, You need to listen to tinatus. Sorry about the pun,
but I think it can be an early warning sign
of hearing loss. And if you have tentatives, I think
it's important to see an audiologist and get a hearing
test to make sure there's no underlying hearing loss. And
a lot of the patients who get referred to see
(16:25):
me for tinatus have an underlying inner ear hearing loss
and that explains it. And then you talk about management
and investigations separately. There's no good one cause you know,
there's sort of other factors that can influence tentatives, make
it louder and quieter, but overall there it's an early
(16:47):
warning sign for hearing loss and therefore get a hearing
test if you have bad tinatus, and the audiologists can
also help you manage the tentatives to make it more comfortable.
Speaker 3 (16:56):
Again, I'm distilling a few texts here, but the question
is around hearing aids and if they are boosting part
of this hearing that you've lost, is the cure also
a cause of further hearing loss because you're having to
boost and play something louder, So it is it layering
on louder noise, in which case it's going to contribute
to your losing your hearing because you're turning you're essentially
(17:18):
turning certain frequencies up.
Speaker 4 (17:21):
I think that's one of those myths. That's not the case.
So hearing aids are set in a way that they
do not cause a hearing loss. You know, they adjust
to the hearing that you've got, and yeah, they will
not cause hearing loss. So don't do not not buy
a hearing age just because you were to make the
hearing worse. They will not make it worse and make
you hear better.
Speaker 3 (17:41):
Yeah, I'm not sure if I should read this one
from Mars. This is asking for a friend to my
wife's voice. I sometimes struggle to hear as the decibel
reaching reading reaches unsafe levels. What should I do? I
think that's just a syoterical text. But just read it.
You got to have as little bit of mischief at
the cause of the show. What is tim one of
(18:02):
the This person has offered a comment rather than a question.
I'll put it into a question, but said, one of
the things that causes the biggest hearing loss for the
older person. This is as a statement says it's high
blood pressure kills your hearing. I'm going to turn it
into a question. Is that true?
Speaker 4 (18:19):
Not? Not really? Not really? You know, I think there's
you know that with age, hearing gets worse. So the
older you are, the more likely you are to have
hearing loss, and the more likely you are to have
hypertension high blood pressure. But blood pressure doesn't cause a hearing.
Speaker 3 (18:36):
Is it about? It just happens that that's something that
happens when you get older and don't like the two together.
Speaker 4 (18:41):
Yeah, is there?
Speaker 3 (18:44):
So back to my question about hearing aids, so people,
if you don't get them, is the risk to your
hearing that you will turn sounds up and then cause
further damage to your hearing. I mean, if you don't
get a hearing aid and you cope, doesn't matter, it does.
Speaker 4 (19:00):
I mean, it's sort of two parcels or yes, it
doesn't matter. It doesn't matter if you don't get hearing aids,
you know, And again it depends on what music you're
listening to, you know, and how strong your amplifier is.
You know, So if you turn really loud rock music
to a volume where you can hear it really loudly,
(19:20):
then it causes damage. Again, But if you listen to
classical music just at a normal, you perceived normal volume,
it will not cause additional damage. But not treating hearing loss,
not wearing hearing aids as a sort of significant factor
in social isolation. And there's also an association, like I
mentioned before, between dementia and hearing loss, and so the
(19:43):
earlier you treat it, the better.
Speaker 3 (19:45):
Well let's take into that little just another follow up
question on the hearing loss then, because some people might
be well, I don't really want to go and pay
to have a hearing test, and how much of our
own judgment can we rely on when it comes to
assessing our hearing, We're.
Speaker 4 (20:00):
Overall not very good, you know. I think we need
to get better in judging that. I think if you
missing out on conversation, if you have problems hearing in
background noise in restaurants slightly noisy environments, or if you
have tinatus ringing in your ears, then I think it's
time to maybe get a hearing taste. If you don't
(20:22):
want to spend money on it, there are a lot
of free hearing tests that get offered by a lot
of audiologists, or you can use an app or your
iPhone and do your own hearing tests and just see
where you are and then go and seeing audiologies.
Speaker 3 (20:36):
If it's bad enough, Okay, I've got one more follow
up and then we'll take some more calls. The other
follow up question is why is it that background noise
can be a nuisance when clearly you can hear the
background noise but you can't hear the conversation. What is
it about the sounds that means that's a hearing loss problem.
Speaker 4 (20:54):
I mean it's at the brain level. When we get born,
we're just much better cutting our background noise, and it's
in some way related to the high frequency hearing and
the high frequency hearing to hearing. We lose the earliest,
and if you start losing some high frequency hearing loss,
you're not as good anymore. Cutting out of the back
end noise.
Speaker 3 (21:13):
Okay, let's take some more calls. We're talking with doctor
Michelle nephi's leading E n T surgeon specializing in and
all things to do with your hearing in your ears.
Let's take some more calls. Andrew, Hello, yeah, hi, Hi.
Speaker 1 (21:30):
What would you do if I injected a nicotope into
your say, right here, just hypothetically.
Speaker 3 (21:43):
What are you talking about?
Speaker 1 (21:45):
What's that?
Speaker 3 (21:45):
What are you talking about? Injecting?
Speaker 1 (21:48):
Injecting that made your ear ring constantly?
Speaker 3 (21:56):
I have no idea, Andrew. I don't know if Michelle
has any idea what that's about, either of Michelle. Is
there something I'm missing there?
Speaker 4 (22:05):
No, I don't. I don't know. What do you mean?
Can you elaborate?
Speaker 3 (22:09):
No? No, he's gone. That's on me that one, thanks, Andrew.
I don't know what that was about a company.
Speaker 4 (22:19):
This is that.
Speaker 3 (22:19):
We've got a few texts here. In fact matter, before
we get onto those, I want to find out a
bit more about the connection between hearing loss and dementia.
Speaker 4 (22:29):
Mm hmm. Yeah, there've been studies about sort of dementia,
cognitive decline, dementia, Alzheimer's and factors that can be addressed
to stop the progression of dementia. And one of the
factors that was identified is hearing loss, and the earlier
(22:50):
you treat hearing loss, it's hoped the more you can
slow down the cognitive decline and dementia. Potentially. There's still
lots of studies. I mean, the we're talking about association
still that means that we don't quite know that whether
using a hearing aid or cochlear implant then means that
(23:13):
we will stop that particular person getting cognitive decline or dementia.
But the fact is that if we start wearing hearing
aids early, the patient gets used to it better and
it has a whole lot of other benefits in terms
of work and social life and social isolation that will
be addressed. So there's still a lot of studies that
(23:37):
finds show that there is that is a true risk factor,
But there's definitely an association. Is that.
Speaker 3 (23:46):
Is that mean that I mean this is I mean
everything overlaps in the end, doesn't it I wonder actually
how much work you have to do as a E
and T with in the in the areas of I
don't know, psychiatry, psychology, and neurology. How much of an
overlap is there once you start getting into this these
other overlaps and medicine, dementia, Alzheimer's, hearing loss, et cetera.
Speaker 4 (24:09):
I mean, we're pretty subspecialized when it comes to other things,
you know. I mean I deal with the hearing. But
you know, I think if you if you have a
patient who already has had cognitive decline or has got dementia,
it's probably too late. But if you have a patient,
or if you have somebody or know somebody who's got
(24:30):
a mild hearing loss, you know, there's there's so many
benefits to having a hearing aid and potentially also preventing
cognitive cognitive decline, that it's best to address it early
rather than later.
Speaker 3 (24:44):
So so in terms of I don't you want to
use a crud analogy check what came first, the chicken
or the egg? So it's it seems to be that
what's contributing to cognitive decline is hearing, So address that
early and reduce your risks of early or dementia or
is that right? So, yes, there definitely is a correlation
(25:06):
there rather than just sort of like a vague sort
of theory.
Speaker 5 (25:09):
Yes.
Speaker 3 (25:10):
Yes, by the way, don't forget you can give us
a call and join in on the conversation. Fascinating stuff
from doctor Michelle neath the other question you mentioned at
the start about screening, because I want to dig into
how prevalent hearing losses just in broadly in society. But
you were talking about screening and neonatal screening. Is this
a new thing where I don't know, these tests done
(25:33):
by midwife in the early stages of a child's life
or how does that all work?
Speaker 4 (25:40):
Yeah, I mean it's new natal screening. So all our
newborns get screened in the hospital before they leave hospital
shortly afterwards. And it's a device where there's a little
prob by left food on the forehead, you stimulate the
hearing path where the ears, and then you can measure
whether this child can hear and so and if the
(26:01):
you know, if they're for some reason they don't pass
that test, it gets repeated and then if they still
don't pass that test, they get referred on to an audiologist,
And the idea here is that it's very important to
pick up children as soon as possible. If you don't
diagnose severe profound hearing loss, it leads it, you know,
(26:24):
leads to well, children don't develop speech language unless they
can hear. And so that's how we pick up here.
Speaker 3 (26:31):
How what has that screening been going for.
Speaker 4 (26:35):
I can't tell you exactly, but shortly after I came back,
probably two thousand and eight or nine, I think it
was introduced, and so it's been around for a long time.
And all our kids get screened.
Speaker 3 (26:46):
Were they before that? Did midwives used to do certain
tests with newborns instead of making noises and see if
they responded them and stuff. Because I've got a vague
recollection of that, but I think it might be just
my imagination being a bit creative.
Speaker 4 (26:58):
Probably clapping, you know that's.
Speaker 3 (26:59):
Yeah, yeah, clapping and things.
Speaker 4 (27:02):
Yeah, and the pieces that it And I think a
lot of the messages used to be that you can't
test children or neonates come back when they just go
to school. And that's the sad thing, you know, we
in the past, when we didn't have the neonatal hearing screening,
a lot of the profoundly deaf kids who needed cochlear
implants weren't picked up until they were four years old,
and now we aim to implant them at six months
(27:23):
so that they can actually learn speech and language.
Speaker 3 (27:26):
That must be quite profound to see that the changes
you've made, you can make in people's lives with that technology.
Speaker 4 (27:32):
Yeah, I mean it's I mean it's it's a huge
shock for the families when they first hear it. But
then the next step they go through the cochlear implant
programs and hopes hope sets and you know, and our
kids go to mainstream, mainstream schools, they get our normal jobs,
and so yeah, you make a huge difference doing that.
Speaker 3 (27:54):
Just before we go to the break, can I ask
you what drew you to the area of hearing. Was
there something in terms of your own You have to
be passionate for anything and meet some really to stick
with it and keep pursuing things. What was it for
you that drives you in the area of medicine.
Speaker 4 (28:07):
It was Cockler implantation, And I think it's just sort
of the godfathers of Cockla implant in plantation in New Zealand,
Ron Goody and Bill Baber. They were you know, leaders
in their field, and they brought it to NIS very early,
and they went through all the funding hurdles, and they
(28:28):
had VHS videos. A lot of the younger listeners might
not know what that is, but of and I watched
those videos and I thought that's quite amazing, just that technology.
And I went back to do my elective overseasoned in
Europe and they still felt it wasn't useful and didn't work,
but we were already doing it here then, and that
(28:51):
sort of got me started.
Speaker 3 (28:53):
Did you start? I mean, you do have a French
name and a mild mild French accent. Did you where?
Did you where did you do your early days of study?
Speaker 4 (29:02):
Well, the French name is actually Southern German.
Speaker 3 (29:05):
I'm German, okay, plan, sorry.
Speaker 4 (29:12):
That's all right. And I did my first year in
medicine in Italy. But then I finished my medical school
in New Zealand and all my subspecial and my specialty
here in subspecialty in the UK, and I came back
to stay.
Speaker 3 (29:24):
Here actually right. I mean, I don't know why I
thought it was a friend checking because it clearly isn't.
Speaker 4 (29:29):
It's the name.
Speaker 3 (29:31):
It was the name through me because somebody said, what
is this guy called Michelle? I was like, and I
went back and I said, it's a it's a French name,
and I was like, Oh, let's not get into the
into the tricky topics anyway. If you've got any questions
for doctor Michelle Neaf on hearing or questions around your
own concerns, then give us a call on No. Eight
hundred and eighty teen eight and we'll dig into a
(29:51):
few more things. Just after the break. It's twenty to
five news Talks. It'd be Yes News Talks, it'd be
My guest is doctor Michelle Neef. He's an E and
T switch surgeon specializing in hearing. And let's got a
bunch of calls to get into. You've left your run
to late people, but let's get into it. Greg, Hello,
Yes today.
Speaker 6 (30:07):
Look I've got I've got a few problems with it.
But so I've lost my hearing from our music and
i've got bad tonight. But I'm also a surfer for
thirty years and I'm dure to have the surf. Well,
I'm on the waiting list for the serve the operation,
and I was just wondering with the drill and everything
(30:27):
going in my ear. Will that help more tonight just
down the trail or will actually make it worse?
Speaker 3 (30:36):
Michelle?
Speaker 4 (30:37):
Yeah, so surface there is a condition where you formed
your bone as a result of cold water exposure in
the ear canal, and the tatus can get louder if
the ear canal blocks off completely, because we get a
conductive hearing loss, so all the sounds inside they had
get louder. But you may have got tenatus because of
(30:58):
an inner hearing loss on top of that, like you mentioned,
as a result of a lot of music or noise exposure.
In terms of the.
Speaker 6 (31:07):
I do we're hearing its So I have have got
quite bad hearing loss, and I knew that tonightus was
from that. But I'm just wondering if my ear, if
the gaps in my ears are so small, could that
be made the slightest worse? And if I get it clear,
will it maybe help it?
Speaker 4 (31:26):
Yeah, I wouldn't. I wouldn't expect it to be helped.
I think you don't need a large opening for hearing.
So the hearing the operation is not necessarily to improve
your hearing. It is to improve the block feeling you
might get after swimming. The idea of the procedures to
widen the ear canal to sort of give you a healthy,
(31:48):
healthy canal that doesn't get infected. And one of the
complications of the procedure, even though it's rare and it's
a good operation, don't get me wrong, but one of
the complications is additional in your hearing loss, and some
patients can get worsening tenders from it as well, And
so just sort of makes or that you sort of
are fully aware of that.
Speaker 6 (32:08):
Okay, okay, and thank you.
Speaker 3 (32:10):
And thanks Greg. We better keep moving' got lots of
people trying to get through now. Joy. Hello, Hi, yeah, Hi,
there you go.
Speaker 5 (32:19):
Good.
Speaker 7 (32:22):
I was going to ask I work in the MRI environment.
We obviously can't be hearing as I'm completely different money
in losing hearing in the other Is there any advances
on the cochlear implants that you can wear them inside
an MRI skinning room?
Speaker 5 (32:40):
Oh?
Speaker 4 (32:40):
Okay, unfortunately not. You know, I think the all the
hearing devices, including cochlear implants, they would be sucked up
by the magnet in the MRI scanner. And so yeah,
there's nothing, nothing good for you.
Speaker 6 (32:55):
Okay, that's all right.
Speaker 3 (32:56):
Thanks Joy. Thanks gosh, gosh, that really is. I guess
so that's you out of that particular part of the job,
isn't it.
Speaker 5 (33:04):
Yeah.
Speaker 3 (33:04):
Yeah. By the way, Judy says, I my husband white,
where as my husband white where as hearing aids? Can
I have them tuned in for me? Judy?
Speaker 4 (33:16):
It depends, I mean the tuned in the tunes and
is the key here? You know, so you can't as
where your husband's But it depends on the degree of
your hearing loss and how older hearing aids are. You know,
the technology changes every five to seven years, and if
the hearing aids are already that old, then they can
probably not be retuned. But just talk to the audiologists
are in the corner and they should be able to
(33:37):
help you.
Speaker 3 (33:38):
Great, right, another call Abe, Hello, Hi.
Speaker 8 (33:42):
I just wanted to ask the doctor about again tinatus.
I have had tinatus my whole life. I'm still fairly young,
under thirty, and it's not from hearing damage as I've
done a few tests with audiologists and whatnot to try
and work out the source. But yeah, I don't know.
(34:04):
I've had a bit of a history with having grammars
and things of that sort. Is it possible that that
could have caused tinetus in a young child, or is
there a different kind of tenetus that's not from very damage?
Speaker 4 (34:20):
Yeah, I think if you ask, most people would have
had tints at some stage in their lives. It's rare
that it's constant, like in your case from birth, if
you've had grammats. It is possible that there was some
hearing damage in frequencies that we don't normally test for.
You could potentially test your hearing up to sixteen thousand herds.
(34:44):
Normally in a normal hearing test we test up to
eight thousand herds. And therefore, if you get the very
high frequency hearing tests, you might find that that there
was some damage done early on. You know, as you
age you lose the very high frequency hearing anyway, So
it would have been good to do that very early
(35:04):
on in life if you want wanted to determine it,
to determine whether damage was done. But yeah, it is
possible that the gromat insertions contributed to the tentatives.
Speaker 8 (35:16):
Okay, right, So that would be more expected than something
like just by by genetics.
Speaker 3 (35:23):
Or something to do with you.
Speaker 4 (35:24):
Yeah, I mean it could, I mean, and I think
it could be genetics. You know, maybe we're born with
some HESL damage, you know, HESL loss in the very
high frequencies hard to say now in retrospect, and you
can't test for it. There's no skin that you can
do to test for it.
Speaker 3 (35:40):
Thanks. Hey, what percentage of hearing losses genetic versus environmental? Michelle?
Speaker 4 (35:46):
Well, the profound hearing is that we've been talking about
is sort of about one percent. So those patients get
born with the hearing loss requiring cochlear implants. And you know,
I think you mentioned the number. I think it's about
twenty Yeah, twenty percent have a hearing loss and it's
only a fraction of those that actually have a noise
(36:08):
induced hearing loss.
Speaker 3 (36:09):
Yeah, okay, I tell you what. We will take a
quick break, come back. We'll see if we squeeze and
a couple more calls before you wrap it up. It's
eleven minutes to five new stalks, you'd be. It's Tim
beverage with doctor Michelle Nafeez and E E and T
hearing ear specialist. Just quickly before we're going to try
and squeeze a couple of calls. But I've got one
quick text. I think you can answer. Cotton buds cleaning
the inner ear advice caution please.
Speaker 4 (36:33):
Yeah, don't use cotton buds. I think the rule of
thumbers don't put anything into your ear that's bigger than
your elbow, and so yeah, don't use cotton bud, not
even your finger. No, no, just leave it. The ear
cannot just beats all the ear wax and old skin
out by itself. If you clean on the outset, all
you're doing is pushing earwax inwards, which somebody then has
(36:55):
to remove.
Speaker 3 (36:55):
I bet you that saved a lot of people some problems.
Very short piece of advice, that's why I read it.
I read that one out on where's the next caller?
Stand by? I just have to lead something here and Marie, Hello.
Speaker 9 (37:08):
Hello Tim, and hello doctor Michelle. I recently went to
have a free hearing test and hearing aids on trial
for about a month I think it was, and it
was all very good and she was very thorough. But
(37:30):
afterwards she said, no, no, no, I can't give your
hearing aids. You must go and see it ear nos
and thoat specialists. So that's what I've done. I have
very limited hearing in my left ear, but I just
wonder why I walked away with no free trial or
(37:50):
hearing aids.
Speaker 4 (37:52):
Yes, there are conditions, you know. Normally hearing loss is symmetrical.
That means the hearing loss on the right side is
the same as on the left side, you know, which
makes sense. We get born with normally here in both ears,
and then over time, the way we're programmed and damaging
in our ear hearing, it gets worse and worse. So
if there's a difference between the ears, it needs to
(38:14):
be investigated. There could be something wrong in the ear, canal,
something wrong in the middle ear, in the inner ear,
or even on the hearing pathway all the way up
to the brain, and an E and T surgeon will
investigate that by examining and maybe even doing a brain
scan to make sure everything looks fine there. So it's
quite an important advice before considering a hearing aid. So
(38:35):
I think the audiologists will still consider hearing aid but
wishes an a medical appointment first.
Speaker 3 (38:42):
Yeah, thank you, Maury, thank you for your call. Just
a quick one from a Peter. I find that screeching
voices and laughter painful. Does this indicaate hearing loss?
Speaker 4 (38:53):
It can? Yeah, So that's hyperaccurses. Hyperaccurses at the brain level,
so it's a little bit learned behavior as well, but
it's often associated with hearing loss and definitely a hearing
test maybe in some work with a hearing therapist or
audiologists to try and to address that.
Speaker 3 (39:10):
Because there is a thing such as mesophoni or isn't
it which is more of a psychological thing where you
find certain sounds irritating that that's different.
Speaker 5 (39:17):
Isn't it?
Speaker 4 (39:18):
Yeah, But I mean it's hyper causes the sort of
generic term of that, and I think it's sort of
similar to that.
Speaker 3 (39:25):
Look, we've got about a minute to go, so really
just sort of actually we've had a truckload of people
try and call. They left it a bit late because
I guess they wanted to get to know you first
by listening to Michelle. Michelle, I hope we can get
you on again sometime to have a chat about this
this stuff. But is there anything in particular with about
fifty seconds to go, just that you think you'd like
(39:48):
to leave people with in terms of considering the safety
of their only hearing and all that.
Speaker 4 (39:53):
Yeah, I mean the safety sort of loud sounds, loud noise,
occupational noise, and address hearing loss early. Because of the
beneficial effects of normal hearing with hearing aids. But also,
you know, if you start wearing hearing aids early, when
you're thirty forty, you're much it's much easier to get
(40:13):
used to technology. And I think some of the negative
things you hear about hearing it is when you left
it till late. You know, when you're seventy eighty, it's
harder to deal with technology.
Speaker 3 (40:24):
Hey, thank you so much for your time, and you
can go and listen back. If you missed any of
this on our podcast on iHeartRadio News Talks, you'd be
doctor Michelle Nate. Thanks so much for your time, pleasure,
thanks for having me. We'll be back to Smart Money Nick.
Speaker 4 (40:38):
For more from the weekend collective.
Speaker 3 (40:40):
Listen live to News Talks it'd be weekends from three pm,
or follow the podcast on iHeartRadio
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
Bicky, there's a please go come that's where you are.
Speaker 3 (00:45):
Anyway, Welcome God. A little bit of beach Boys to
ease us into the health Hub. Tim Beverage, this is
the Weekend Collective and now this, as I said, it's
a health hub and we're going to be having a
chat about hearing loss and and well lots of things
around that whole topic. Because one of those things that
I think it's actually a bit of a I wouldn't
say it's a peeve of mine at all, but it's
(01:06):
something that I think we are very you know, we
worry about all sorts of things like obesity and looking
after diabetes and all sorts of obvious things and alcohol.
And I always have felt that one thing society is
quite ambivalent or a little bit maybe the words blase
is about hearing loss and how it can sneak up
on you and how you need to protect it more.
And of course you never think about getting it checked
(01:27):
until more not necessary until you reach a certain age.
But maybe your wife or your husband has said I
just said that three times. Do you don't just hear me?
But it affects one in five kiwis, and it's projected
to get far worse over the coming decades. We all
know that, you know, you should avoid turning the car
radio up loud people in radio, take the headphones off,
turn them down. But anyway, how does it affect the
rest of our bodies. We're going to talk about everything
(01:48):
to do with well, it's a few issues as well
to do with hearing loss and joining us as a
new guest on the show. He's a leading E and
T surgeon and his name is doctor Michelle Neif. Michelle,
Good afternoon, Good.
Speaker 4 (02:01):
After luntin, Thanks for having me, Thanks.
Speaker 3 (02:03):
For coming on. How long have you been involved in
this area? Because E and T is obviously Ian osen throat.
Speaker 4 (02:13):
Training is five years long. So I finished my training
in two thousand and six and then did another fellowship
training and came back in two thousand and seven, and
since then have only dealt with hearing loss, hearing, hearing
restoration and that sort of thing. So I've sub specialized
in hearing disorders.
Speaker 3 (02:32):
Actually, because there have been a lot of innovations, I
guess constantly science is evolving, and when it comes to
hearing loss, it's just been a I don't want to
use the word exciting time. It's such a cliche, but
has it been an interesting time in the last sort
of five ten years with some of the innovations.
Speaker 4 (02:51):
Yeah, I mean, obviously there are technological innovations, and I
guess you are referring to some of the cochlear implant technology,
in particular, more recently the new neccess system from Cochlear,
which enables us now to program the device, the internal
device of a cochlear implant, for example, without having to
(03:14):
wait for innovation for seven or eight years. So that's
that's that's the latest exciting thing. But it's the research
behind all the hearing loss and what we've learned, you know,
in in my time since I've come back from my fellowship,
we've introduced new nature hearing screening, which is very important. Obviously,
(03:38):
there's more awareness about noise induced hearing loss in children,
you know, using ear pods, as well as occupational noise
induced hearing loss, and most recently the association between hearing
loss and dementia. So interesting and some exciting progress. But
(04:01):
we've learned a lot over the last ten fifteen years.
Speaker 3 (04:05):
So you might have heard my brief comments which are
just informed on you know, obviously a lay person's approach.
And I've been a musician as well, and I've always
been constantly aware and especially the headphones because the background is.
I did a show years and years ago which was
using the latest in technology where all the cast it
(04:26):
was Jesus Christ Superstar is about. Oh, I don't want
to say how long ago it was, but it was
about thirty years ago, and we all had ear monitors
to monitor our voices. And I think the best thing
that the producers ever did for us was they said,
we're going to set your level now where you can
hear what you need to hear. And here's a warning
for you all. We're not changing that level. You're not
(04:47):
going to come to us in two or three weeks
and say, can you please give me a bit more
of this and a bit more of that. But they said,
because it's insidious, you won't think that, you ain't realize,
but you keep turning your headphones up. That's is that
a real thing, A real problem?
Speaker 4 (05:05):
Yeah, that's a real problem. Yeah. I mean airbs are
a very good example. You know, I think everybody's got airports.
I've got AirPods, for this interview now. And you know,
hearing damage starts at eighty five decibels if you expose
yourself over eight hours, and that means if you have
a hair dryer, vacuum cleaner, that can be loud enough
(05:26):
if you do it for long enough to cause hearing damage,
hair cell damage, So you're damaging the inner ear hearing
organ And you know, if you listen to enough music
and loud enough, then you can cause in your hearing
damage and unfortunately the manufacturers don't control that. So an
AirPod can be turned up to in some cases one
hundred and ten decibels, So we're talking about significant noise exposure,
(05:51):
like power tools.
Speaker 3 (05:52):
Is there something about the way we perceive sounds? So,
for instance, if I had my stereo on and it
was producing one hundred decibels, do I, by virtue of
sticking headphones on, have a different tolerance where I might
listen to it louder than I realize?
Speaker 4 (06:08):
Potentially it depends a bit on the background noise. You know,
if you're in a noisy environment and want to hear
the music better, then obviously you turn it louder, and
that's where noise cancelation can be useful. So if you
use that, you don't have to overcome the background noise,
and therefore you keep the sound down. But some people
just like to listen to very loud music, and I
(06:31):
think nothing helps there.
Speaker 3 (06:33):
How come from a why are shorter exposures? Okay? What
is it about the length of time? And what's the
what's the you know, the physiological reaction that happens with
the long long exposure noise?
Speaker 4 (06:46):
Yeah, so you're talking about intensity. So the it's it's
the length of exposure and the loudness of exposure. You know.
So as I mentioned before, eighty five decibels for an
eight hour day is loud enough to cause damage. Ninety
decibels for four hours is loud enough to cause damage.
(07:08):
So it's the accumulation sort of the you know, the
product of time and loudness that causes the problem.
Speaker 3 (07:15):
So what I mean is why do short, shorter bursts
not cause damage?
Speaker 4 (07:24):
They don't. I think they can, you know, if you
turn it loud enough, they can.
Speaker 3 (07:28):
Okay, what what's with cocula? Sorry? Cochlear implants?
Speaker 4 (07:35):
Mhm?
Speaker 3 (07:37):
How do they work? Because you know, we're there and
we see people will see on YouTube videos of people
hearing sound for the first time, and what an emotional
experience it is. How how much of it is a
mechanical thing to do with the ears and the way
we perceive sound versus a neurological I don't know, but
I mean, how on earth does it work? It still
blows my mind.
Speaker 4 (07:57):
But I think you sort of have to step bigger.
How does hearing work? You know? You have you transmits
through the ear canal, ear drum, hearing bones to the
inner ear, which is the hearing organ. And it's often
the hearing organ itself that gets damaged or is not
working at birth that you have to overcome. So that
comes a time where a hearing aid, which really just
turns the sound up, doesn't work anymore, doesn't give you
(08:20):
the benefit it's supposed to do. And that's where cochlear
implants come in. So a cochlear implant has got two
components to it. An internal device, which is the cochlear
implant itself, and that is essentially an electrode that gets
wrapped around the hearing nerve, and then an external device
that sits on the outside, which is the hearing aid
(08:42):
part if you wish, and that transmits to the implanted part.
The sound gets transmitted to the electrode and that stimulates
the nerve, and from there it goes up to the
brain and stimulates the hearing cortex.
Speaker 3 (08:55):
And how do we confidently know that what someone with
cochlear implants here is is comparable, similar, exactly the same.
I don't know to what you and I hear before
we damage a hearing well.
Speaker 4 (09:11):
It's obviously half for a child who was born deaf
or severe profoundly deaf to know what normal sounds are.
But we have a lot of adults who could hear
normally and then lose their hearing, And in fact, initially
they some of those adults feel like crying when they
first turn hearing at the cocklear implant on, not because
(09:32):
they're so emotional that they can hear again, but because
it sounds so terrible. And then with time, the brain
associated the sounds that they hear to their memory from
the hearing memory, and over six to twelve months, everything
sounds normal again. So if you ask somebody who an
adult to receive the cochlear implant what it sounded like
(09:52):
at the beginning and what it sounds like now after
the year, they would say look, after a year, everything
sounds normal again.
Speaker 3 (09:59):
How how do they manage that? Then? Would they have
times where they turn it down or off or not
speaking to a complete light person? So I might ask
some dumb questions here.
Speaker 4 (10:09):
No, no, no, I think the the idea is to
wear it all the time, but not at a nigh
to get the brain used to the sound. And yeah,
that's how they learn. The cochlear implant programs each to
hear again, So you have to completely learn to hear
with the device again. But after some time, after a year,
(10:31):
it just becomes normality. Passions put it on and leave
it on so that they can hear normally. Otherwise without
the implant, they're still profoundly deaf, and so it is
sort of it brings them back to their normal working life,
normal social like when before they couldn't take part anymore.
Speaker 3 (10:48):
Another dumb question potentially, so if a cochlear implant is
more around the well it does. How much of the
cochlear implant involves surgery actually to do with anything to
do with your ear?
Speaker 4 (11:02):
Yeah, well I'm in the first step is surgery. You
know they've you go through an assessment process first, or
you all just determine that you're hearing aids don't work
as well anymore as they should and a cochlear implant
might be a better solution. And then the first that
is surgery, So you have one and a half up
to two hour surgery on one ear, so one cochlear
(11:23):
implant is funded for adults in New Zealand, and a
healing period of a few days. And then we can
usually do the switch on, which means you put the
device on and get the patient used to the cochlear
implants sound very slowly and then over time you turn
it louder and louder according to what the patient perceives
(11:44):
and he is.
Speaker 3 (11:45):
So that was going to be in My next question
was just around eligibility and funding and things. So you
say that one you get one funded, and if you want,
if you want stereo, I guess you get two. Is
that right?
Speaker 4 (11:57):
Yeah, yeah, that's right. Yeah. So children, all children up
to the age of eighteen get bilateral coclear implants funded
by the government and that is sustainable funding, and adults
only get one implanted. If the funding runs out, then
obviously your patients might have to wait longer. At the
(12:17):
moment the funding is fairly.
Speaker 3 (12:18):
Good, right, we'd love your cause if you've got any
questions for doctor Michelle Nef he's an E and T
surgeon specializing in ears hearing, any questions for him. I've
had a few texts coming already on a bunch of things,
and I'm sure you're happy to take calls from people,
Michelle on any questions they might have to do with
hearing of your if you've got a relative or something
(12:39):
you're concerned about their hearing loss. And because sometimes a
lot of the calls we get maybe asking for a friend,
you can give us a call. We'd love to hear
from you on eight hundred and eighty ten eighty you
can text nine to nine two. We've got a few
texts that have come on as well about a few
questions around hearing as well, and we're going to dig
into other questions that Michelle raised at the start of
our chat with the app, with the connection with hearing
(13:02):
loss and dementia, which I'm sure is something you would
probably all like to know a bit more about, which
we'll dig into in just a moment. But we'll take
your cause eight hundred and eighty ten eighty text nine
two nine two. It's nineteen and a half past four.
News Talk said, b Yes, welcome back to the Weekend Collective.
This is the Health Hub. My guest is doctor Michelle Neath.
(13:24):
He's an E and T surgeon specializing and hearing loss,
coccoli and plants. And well, I'm not going to try
and sum up his his his expertise, but he's an
E and T guy and an ears or his thing,
if I could put it that way. Now, let's text
some calls. We've got lots of lots of texts and
some really interesting questions. So if you want to jump
the queue, you can jump on the blower on eight
hundred eighty ten eighty John.
Speaker 5 (13:44):
Hello, Oh goody, how's it going good?
Speaker 4 (13:47):
Thanks?
Speaker 5 (13:48):
That's up, it's great. So I'm just wondering what the
surgeon's thoughts are on the induction. Yeah, phone, so like
the shocks brand which go over your ear and they
work on phone conduction, and yeah, are.
Speaker 3 (14:02):
They the ones that don't actually stick into your ear?
They of.
Speaker 5 (14:07):
Ear so there grading for running so you can hear
what's going on around here. But yeah, I can't just
imp the thoughts.
Speaker 3 (14:15):
Thank you, Yeah, thanks, I guess Michelle, what is that
technology and what are you what can you tell us
about it?
Speaker 4 (14:21):
Well, are you talking about a bond bond conduction hearing
it or bond conduction headphones? And in terms of in
terms of hearing, that two components. That one is the
conductive component. That's where the sort of that's the ear
drum and the little hearing bones the osccles working to
transmit the sound. And then you've got the inner ear
hearing and speaking generally, if you have a conductive hearing loss,
(14:45):
then a bone conduction hearing it, which works similarly behind
the ear can over can byplass the middle ear that
is the ear drum and the hearing oscacles and stimulate
the hearing organ directly. And the bond conduction headphones for
running their work exactly this same and they can work
(15:05):
very well. Some people work then are used them for
their for their phones as well work extremely well.
Speaker 3 (15:11):
So there's there's the there's the retail sort of version
for consumers who want to just use it, but there's
also a medical application for people who have hearing losses
that correct correct. Yeah, yeah, and yeah, any follow up, John.
Speaker 5 (15:25):
I think that covers it. That's all I've got. I've
got to follow up with.
Speaker 3 (15:31):
I've got to follow up for you. Are there any
safety issues with because people think are I mean, do
you still have to be careful with volume with bone
bone conduction? Is it conduction or induction?
Speaker 4 (15:41):
Mister conduction conduction? Yeah? Yeah, yeah, we talked about before.
Is it exactly the same if you turn it too loud?
But you're still cause in your hearing damage.
Speaker 3 (15:50):
You know, Okay, I've had a lot of texts asking
about tinatus or tonight is tinatus? And where are we
at with the causes and the treatments for tentatives?
Speaker 4 (16:04):
Mhmatives, You need to listen to tinatus. Sorry about the pun,
but I think it can be an early warning sign
of hearing loss. And if you have tentatives, I think
it's important to see an audiologist and get a hearing
test to make sure there's no underlying hearing loss. And
a lot of the patients who get referred to see
(16:25):
me for tinatus have an underlying inner ear hearing loss
and that explains it. And then you talk about management
and investigations separately. There's no good one cause you know,
there's sort of other factors that can influence tentatives, make
it louder and quieter, but overall there it's an early
(16:47):
warning sign for hearing loss and therefore get a hearing
test if you have bad tinatus, and the audiologists can
also help you manage the tentatives to make it more comfortable.
Speaker 3 (16:56):
Again, I'm distilling a few texts here, but the question
is around hearing aids and if they are boosting part
of this hearing that you've lost, is the cure also
a cause of further hearing loss because you're having to
boost and play something louder, So it is it layering
on louder noise, in which case it's going to contribute
to your losing your hearing because you're turning you're essentially
(17:18):
turning certain frequencies up.
Speaker 4 (17:21):
I think that's one of those myths. That's not the case.
So hearing aids are set in a way that they
do not cause a hearing loss. You know, they adjust
to the hearing that you've got, and yeah, they will
not cause hearing loss. So don't do not not buy
a hearing age just because you were to make the
hearing worse. They will not make it worse and make
you hear better.
Speaker 3 (17:41):
Yeah, I'm not sure if I should read this one
from Mars. This is asking for a friend to my
wife's voice. I sometimes struggle to hear as the decibel
reaching reading reaches unsafe levels. What should I do? I
think that's just a syoterical text. But just read it.
You got to have as little bit of mischief at
the cause of the show. What is tim one of
(18:02):
the This person has offered a comment rather than a question.
I'll put it into a question, but said, one of
the things that causes the biggest hearing loss for the
older person. This is as a statement says it's high
blood pressure kills your hearing. I'm going to turn it
into a question. Is that true?
Speaker 4 (18:19):
Not? Not really? Not really? You know, I think there's
you know that with age, hearing gets worse. So the
older you are, the more likely you are to have
hearing loss, and the more likely you are to have
hypertension high blood pressure. But blood pressure doesn't cause a hearing.
Speaker 3 (18:36):
Is it about? It just happens that that's something that
happens when you get older and don't like the two together.
Speaker 4 (18:41):
Yeah, is there?
Speaker 3 (18:44):
So back to my question about hearing aids, so people,
if you don't get them, is the risk to your
hearing that you will turn sounds up and then cause
further damage to your hearing. I mean, if you don't
get a hearing aid and you cope, doesn't matter, it does.
Speaker 4 (19:00):
I mean, it's sort of two parcels or yes, it
doesn't matter. It doesn't matter if you don't get hearing aids,
you know, And again it depends on what music you're
listening to, you know, and how strong your amplifier is.
You know, So if you turn really loud rock music
to a volume where you can hear it really loudly,
(19:20):
then it causes damage. Again, But if you listen to
classical music just at a normal, you perceived normal volume,
it will not cause additional damage. But not treating hearing loss,
not wearing hearing aids as a sort of significant factor
in social isolation. And there's also an association, like I
mentioned before, between dementia and hearing loss, and so the
(19:43):
earlier you treat it, the better.
Speaker 3 (19:45):
Well let's take into that little just another follow up
question on the hearing loss then, because some people might
be well, I don't really want to go and pay
to have a hearing test, and how much of our
own judgment can we rely on when it comes to
assessing our hearing, We're.
Speaker 4 (20:00):
Overall not very good, you know. I think we need
to get better in judging that. I think if you
missing out on conversation, if you have problems hearing in
background noise in restaurants slightly noisy environments, or if you
have tinatus ringing in your ears, then I think it's
time to maybe get a hearing taste. If you don't
(20:22):
want to spend money on it, there are a lot
of free hearing tests that get offered by a lot
of audiologists, or you can use an app or your
iPhone and do your own hearing tests and just see
where you are and then go and seeing audiologies.
Speaker 3 (20:36):
If it's bad enough, Okay, I've got one more follow
up and then we'll take some more calls. The other
follow up question is why is it that background noise
can be a nuisance when clearly you can hear the
background noise but you can't hear the conversation. What is
it about the sounds that means that's a hearing loss problem.
Speaker 4 (20:54):
I mean it's at the brain level. When we get born,
we're just much better cutting our background noise, and it's
in some way related to the high frequency hearing and
the high frequency hearing to hearing. We lose the earliest,
and if you start losing some high frequency hearing loss,
you're not as good anymore. Cutting out of the back
end noise.
Speaker 3 (21:13):
Okay, let's take some more calls. We're talking with doctor
Michelle nephi's leading E n T surgeon specializing in and
all things to do with your hearing in your ears.
Let's take some more calls. Andrew, Hello, yeah, hi, Hi.
Speaker 1 (21:30):
What would you do if I injected a nicotope into
your say, right here, just hypothetically.
Speaker 3 (21:43):
What are you talking about?
Speaker 1 (21:45):
What's that?
Speaker 3 (21:45):
What are you talking about? Injecting?
Speaker 1 (21:48):
Injecting that made your ear ring constantly?
Speaker 3 (21:56):
I have no idea, Andrew. I don't know if Michelle
has any idea what that's about, either of Michelle. Is
there something I'm missing there?
Speaker 4 (22:05):
No, I don't. I don't know. What do you mean?
Can you elaborate?
Speaker 3 (22:09):
No? No, he's gone. That's on me that one, thanks, Andrew.
I don't know what that was about a company.
Speaker 4 (22:19):
This is that.
Speaker 3 (22:19):
We've got a few texts here. In fact matter, before
we get onto those, I want to find out a
bit more about the connection between hearing loss and dementia.
Speaker 4 (22:29):
Mm hmm. Yeah, there've been studies about sort of dementia,
cognitive decline, dementia, Alzheimer's and factors that can be addressed
to stop the progression of dementia. And one of the
factors that was identified is hearing loss, and the earlier
(22:50):
you treat hearing loss, it's hoped the more you can
slow down the cognitive decline and dementia. Potentially. There's still
lots of studies. I mean, the we're talking about association
still that means that we don't quite know that whether
using a hearing aid or cochlear implant then means that
(23:13):
we will stop that particular person getting cognitive decline or dementia.
But the fact is that if we start wearing hearing
aids early, the patient gets used to it better and
it has a whole lot of other benefits in terms
of work and social life and social isolation that will
be addressed. So there's still a lot of studies that
(23:37):
finds show that there is that is a true risk factor,
But there's definitely an association. Is that.
Speaker 3 (23:46):
Is that mean that I mean this is I mean
everything overlaps in the end, doesn't it I wonder actually
how much work you have to do as a E
and T with in the in the areas of I
don't know, psychiatry, psychology, and neurology. How much of an
overlap is there once you start getting into this these
other overlaps and medicine, dementia, Alzheimer's, hearing loss, et cetera.
Speaker 4 (24:09):
I mean, we're pretty subspecialized when it comes to other things,
you know. I mean I deal with the hearing. But
you know, I think if you if you have a
patient who already has had cognitive decline or has got dementia,
it's probably too late. But if you have a patient,
or if you have somebody or know somebody who's got
(24:30):
a mild hearing loss, you know, there's there's so many
benefits to having a hearing aid and potentially also preventing
cognitive cognitive decline, that it's best to address it early
rather than later.
Speaker 3 (24:44):
So so in terms of I don't you want to
use a crud analogy check what came first, the chicken
or the egg? So it's it seems to be that
what's contributing to cognitive decline is hearing, So address that
early and reduce your risks of early or dementia or
is that right? So, yes, there definitely is a correlation
(25:06):
there rather than just sort of like a vague sort
of theory.
Speaker 5 (25:09):
Yes.
Speaker 3 (25:10):
Yes, by the way, don't forget you can give us
a call and join in on the conversation. Fascinating stuff
from doctor Michelle neath the other question you mentioned at
the start about screening, because I want to dig into
how prevalent hearing losses just in broadly in society. But
you were talking about screening and neonatal screening. Is this
a new thing where I don't know, these tests done
(25:33):
by midwife in the early stages of a child's life
or how does that all work?
Speaker 4 (25:40):
Yeah, I mean it's new natal screening. So all our
newborns get screened in the hospital before they leave hospital
shortly afterwards. And it's a device where there's a little
prob by left food on the forehead, you stimulate the
hearing path where the ears, and then you can measure
whether this child can hear and so and if the
(26:01):
you know, if they're for some reason they don't pass
that test, it gets repeated and then if they still
don't pass that test, they get referred on to an audiologist,
And the idea here is that it's very important to
pick up children as soon as possible. If you don't
diagnose severe profound hearing loss, it leads it, you know,
(26:24):
leads to well, children don't develop speech language unless they
can hear. And so that's how we pick up here.
Speaker 3 (26:31):
How what has that screening been going for.
Speaker 4 (26:35):
I can't tell you exactly, but shortly after I came back,
probably two thousand and eight or nine, I think it
was introduced, and so it's been around for a long time.
And all our kids get screened.
Speaker 3 (26:46):
Were they before that? Did midwives used to do certain
tests with newborns instead of making noises and see if
they responded them and stuff. Because I've got a vague
recollection of that, but I think it might be just
my imagination being a bit creative.
Speaker 4 (26:58):
Probably clapping, you know that's.
Speaker 3 (26:59):
Yeah, yeah, clapping and things.
Speaker 4 (27:02):
Yeah, and the pieces that it And I think a
lot of the messages used to be that you can't
test children or neonates come back when they just go
to school. And that's the sad thing, you know, we
in the past, when we didn't have the neonatal hearing screening,
a lot of the profoundly deaf kids who needed cochlear
implants weren't picked up until they were four years old,
and now we aim to implant them at six months
(27:23):
so that they can actually learn speech and language.
Speaker 3 (27:26):
That must be quite profound to see that the changes
you've made, you can make in people's lives with that technology.
Speaker 4 (27:32):
Yeah, I mean it's I mean it's it's a huge
shock for the families when they first hear it. But
then the next step they go through the cochlear implant
programs and hopes hope sets and you know, and our
kids go to mainstream, mainstream schools, they get our normal jobs,
and so yeah, you make a huge difference doing that.
Speaker 3 (27:54):
Just before we go to the break, can I ask
you what drew you to the area of hearing. Was
there something in terms of your own You have to
be passionate for anything and meet some really to stick
with it and keep pursuing things. What was it for
you that drives you in the area of medicine.
Speaker 4 (28:07):
It was Cockler implantation, And I think it's just sort
of the godfathers of Cockla implant in plantation in New Zealand,
Ron Goody and Bill Baber. They were you know, leaders
in their field, and they brought it to NIS very early,
and they went through all the funding hurdles, and they
(28:28):
had VHS videos. A lot of the younger listeners might
not know what that is, but of and I watched
those videos and I thought that's quite amazing, just that technology.
And I went back to do my elective overseasoned in
Europe and they still felt it wasn't useful and didn't work,
but we were already doing it here then, and that
(28:51):
sort of got me started.
Speaker 3 (28:53):
Did you start? I mean, you do have a French
name and a mild mild French accent. Did you where?
Did you where did you do your early days of study?
Speaker 4 (29:02):
Well, the French name is actually Southern German.
Speaker 3 (29:05):
I'm German, okay, plan, sorry.
Speaker 4 (29:12):
That's all right. And I did my first year in
medicine in Italy. But then I finished my medical school
in New Zealand and all my subspecial and my specialty
here in subspecialty in the UK, and I came back
to stay.
Speaker 3 (29:24):
Here actually right. I mean, I don't know why I
thought it was a friend checking because it clearly isn't.
Speaker 4 (29:29):
It's the name.
Speaker 3 (29:31):
It was the name through me because somebody said, what
is this guy called Michelle? I was like, and I
went back and I said, it's a it's a French name,
and I was like, Oh, let's not get into the
into the tricky topics anyway. If you've got any questions
for doctor Michelle Neaf on hearing or questions around your
own concerns, then give us a call on No. Eight
hundred and eighty teen eight and we'll dig into a
(29:51):
few more things. Just after the break. It's twenty to
five news Talks. It'd be Yes News Talks, it'd be
My guest is doctor Michelle Neef. He's an E and
T switch surgeon specializing in hearing. And let's got a
bunch of calls to get into. You've left your run
to late people, but let's get into it. Greg, Hello,
Yes today.
Speaker 6 (30:07):
Look I've got I've got a few problems with it.
But so I've lost my hearing from our music and
i've got bad tonight. But I'm also a surfer for
thirty years and I'm dure to have the surf. Well,
I'm on the waiting list for the serve the operation,
and I was just wondering with the drill and everything
(30:27):
going in my ear. Will that help more tonight just
down the trail or will actually make it worse?
Speaker 3 (30:36):
Michelle?
Speaker 4 (30:37):
Yeah, so surface there is a condition where you formed
your bone as a result of cold water exposure in
the ear canal, and the tatus can get louder if
the ear canal blocks off completely, because we get a
conductive hearing loss, so all the sounds inside they had
get louder. But you may have got tenatus because of
(30:58):
an inner hearing loss on top of that, like you mentioned,
as a result of a lot of music or noise exposure.
In terms of the.
Speaker 6 (31:07):
I do we're hearing its So I have have got
quite bad hearing loss, and I knew that tonightus was
from that. But I'm just wondering if my ear, if
the gaps in my ears are so small, could that
be made the slightest worse? And if I get it clear,
will it maybe help it?
Speaker 4 (31:26):
Yeah, I wouldn't. I wouldn't expect it to be helped.
I think you don't need a large opening for hearing.
So the hearing the operation is not necessarily to improve
your hearing. It is to improve the block feeling you
might get after swimming. The idea of the procedures to
widen the ear canal to sort of give you a healthy,
(31:48):
healthy canal that doesn't get infected. And one of the
complications of the procedure, even though it's rare and it's
a good operation, don't get me wrong, but one of
the complications is additional in your hearing loss, and some
patients can get worsening tenders from it as well, And
so just sort of makes or that you sort of
are fully aware of that.
Speaker 6 (32:08):
Okay, okay, and thank you.
Speaker 3 (32:10):
And thanks Greg. We better keep moving' got lots of
people trying to get through now. Joy. Hello, Hi, yeah, Hi,
there you go.
Speaker 5 (32:19):
Good.
Speaker 7 (32:22):
I was going to ask I work in the MRI environment.
We obviously can't be hearing as I'm completely different money
in losing hearing in the other Is there any advances
on the cochlear implants that you can wear them inside
an MRI skinning room?
Speaker 5 (32:40):
Oh?
Speaker 4 (32:40):
Okay, unfortunately not. You know, I think the all the
hearing devices, including cochlear implants, they would be sucked up
by the magnet in the MRI scanner. And so yeah,
there's nothing, nothing good for you.
Speaker 6 (32:55):
Okay, that's all right.
Speaker 3 (32:56):
Thanks Joy. Thanks gosh, gosh, that really is. I guess
so that's you out of that particular part of the job,
isn't it.
Speaker 5 (33:04):
Yeah.
Speaker 3 (33:04):
Yeah. By the way, Judy says, I my husband white,
where as my husband white where as hearing aids? Can
I have them tuned in for me? Judy?
Speaker 4 (33:16):
It depends, I mean the tuned in the tunes and
is the key here? You know, so you can't as
where your husband's But it depends on the degree of
your hearing loss and how older hearing aids are. You know,
the technology changes every five to seven years, and if
the hearing aids are already that old, then they can
probably not be retuned. But just talk to the audiologists
are in the corner and they should be able to
(33:37):
help you.
Speaker 3 (33:38):
Great, right, another call Abe, Hello, Hi.
Speaker 8 (33:42):
I just wanted to ask the doctor about again tinatus.
I have had tinatus my whole life. I'm still fairly young,
under thirty, and it's not from hearing damage as I've
done a few tests with audiologists and whatnot to try
and work out the source. But yeah, I don't know.
(34:04):
I've had a bit of a history with having grammars
and things of that sort. Is it possible that that
could have caused tinetus in a young child, or is
there a different kind of tenetus that's not from very damage?
Speaker 4 (34:20):
Yeah, I think if you ask, most people would have
had tints at some stage in their lives. It's rare
that it's constant, like in your case from birth, if
you've had grammats. It is possible that there was some
hearing damage in frequencies that we don't normally test for.
You could potentially test your hearing up to sixteen thousand herds.
(34:44):
Normally in a normal hearing test we test up to
eight thousand herds. And therefore, if you get the very
high frequency hearing tests, you might find that that there
was some damage done early on. You know, as you
age you lose the very high frequency hearing anyway, So
it would have been good to do that very early
(35:04):
on in life if you want wanted to determine it,
to determine whether damage was done. But yeah, it is
possible that the gromat insertions contributed to the tentatives.
Speaker 8 (35:16):
Okay, right, So that would be more expected than something
like just by by genetics.
Speaker 3 (35:23):
Or something to do with you.
Speaker 4 (35:24):
Yeah, I mean it could, I mean, and I think
it could be genetics. You know, maybe we're born with
some HESL damage, you know, HESL loss in the very
high frequencies hard to say now in retrospect, and you
can't test for it. There's no skin that you can
do to test for it.
Speaker 3 (35:40):
Thanks. Hey, what percentage of hearing losses genetic versus environmental? Michelle?
Speaker 4 (35:46):
Well, the profound hearing is that we've been talking about
is sort of about one percent. So those patients get
born with the hearing loss requiring cochlear implants. And you know,
I think you mentioned the number. I think it's about
twenty Yeah, twenty percent have a hearing loss and it's
only a fraction of those that actually have a noise
(36:08):
induced hearing loss.
Speaker 3 (36:09):
Yeah, okay, I tell you what. We will take a
quick break, come back. We'll see if we squeeze and
a couple more calls before you wrap it up. It's
eleven minutes to five new stalks, you'd be. It's Tim
beverage with doctor Michelle Nafeez and E E and T
hearing ear specialist. Just quickly before we're going to try
and squeeze a couple of calls. But I've got one
quick text. I think you can answer. Cotton buds cleaning
the inner ear advice caution please.
Speaker 4 (36:33):
Yeah, don't use cotton buds. I think the rule of
thumbers don't put anything into your ear that's bigger than
your elbow, and so yeah, don't use cotton bud, not
even your finger. No, no, just leave it. The ear
cannot just beats all the ear wax and old skin
out by itself. If you clean on the outset, all
you're doing is pushing earwax inwards, which somebody then has
(36:55):
to remove.
Speaker 3 (36:55):
I bet you that saved a lot of people some problems.
Very short piece of advice, that's why I read it.
I read that one out on where's the next caller?
Stand by? I just have to lead something here and Marie, Hello.
Speaker 9 (37:08):
Hello Tim, and hello doctor Michelle. I recently went to
have a free hearing test and hearing aids on trial
for about a month I think it was, and it
was all very good and she was very thorough. But
(37:30):
afterwards she said, no, no, no, I can't give your
hearing aids. You must go and see it ear nos
and thoat specialists. So that's what I've done. I have
very limited hearing in my left ear, but I just
wonder why I walked away with no free trial or
(37:50):
hearing aids.
Speaker 4 (37:52):
Yes, there are conditions, you know. Normally hearing loss is symmetrical.
That means the hearing loss on the right side is
the same as on the left side, you know, which
makes sense. We get born with normally here in both ears,
and then over time, the way we're programmed and damaging
in our ear hearing, it gets worse and worse. So
if there's a difference between the ears, it needs to
(38:14):
be investigated. There could be something wrong in the ear, canal,
something wrong in the middle ear, in the inner ear,
or even on the hearing pathway all the way up
to the brain, and an E and T surgeon will
investigate that by examining and maybe even doing a brain
scan to make sure everything looks fine there. So it's
quite an important advice before considering a hearing aid. So
(38:35):
I think the audiologists will still consider hearing aid but
wishes an a medical appointment first.
Speaker 3 (38:42):
Yeah, thank you, Maury, thank you for your call. Just
a quick one from a Peter. I find that screeching
voices and laughter painful. Does this indicaate hearing loss?
Speaker 4 (38:53):
It can? Yeah, So that's hyperaccurses. Hyperaccurses at the brain level,
so it's a little bit learned behavior as well, but
it's often associated with hearing loss and definitely a hearing
test maybe in some work with a hearing therapist or
audiologists to try and to address that.
Speaker 3 (39:10):
Because there is a thing such as mesophoni or isn't
it which is more of a psychological thing where you
find certain sounds irritating that that's different.
Speaker 5 (39:17):
Isn't it?
Speaker 4 (39:18):
Yeah, But I mean it's hyper causes the sort of
generic term of that, and I think it's sort of
similar to that.
Speaker 3 (39:25):
Look, we've got about a minute to go, so really
just sort of actually we've had a truckload of people
try and call. They left it a bit late because
I guess they wanted to get to know you first
by listening to Michelle. Michelle, I hope we can get
you on again sometime to have a chat about this
this stuff. But is there anything in particular with about
fifty seconds to go, just that you think you'd like
(39:48):
to leave people with in terms of considering the safety
of their only hearing and all that.
Speaker 4 (39:53):
Yeah, I mean the safety sort of loud sounds, loud noise,
occupational noise, and address hearing loss early. Because of the
beneficial effects of normal hearing with hearing aids. But also,
you know, if you start wearing hearing aids early, when
you're thirty forty, you're much it's much easier to get
(40:13):
used to technology. And I think some of the negative
things you hear about hearing it is when you left
it till late. You know, when you're seventy eighty, it's
harder to deal with technology.
Speaker 3 (40:24):
Hey, thank you so much for your time, and you
can go and listen back. If you missed any of
this on our podcast on iHeartRadio News Talks, you'd be
doctor Michelle Nate. Thanks so much for your time, pleasure,
thanks for having me. We'll be back to Smart Money Nick.
Speaker 4 (40:38):
For more from the weekend collective.
Speaker 3 (40:40):
Listen live to News Talks it'd be weekends from three pm,
or follow the podcast on iHeartRadio
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