It is true that some commonly used over-the-counter pain relief medications are associated with sensorineural hearing loss or in medical terms ototoxicity (damage to the ear by a toxin). These medications have been associated with hearing loss, tinnitus and balance disturbances – symptoms all due to disturbance of inner ear function. This is particularly so for medications belonging to the aspirin group and closely related non- steroidal anti-inflammatory drugs (NSAIDs) – aspirin (eg Disprin, Aspro), ibuprofen (eg Advil, Nurofen) and naproxen (eg Naprogesic) are the most commonly used. Codeine is another common pain medication (and codeine/paracetamol combinations like Panadeine, Panadeine Extra and Forte)associated with hearing loss. However in clinical practice it is extremely uncommon to see a permanent or even measurable hearing loss related to the aspirin group as the hearing loss seems to be dose and duration related. There have been reports of hearing loss in young adults who have taken one or more of the NSAIDs or aspirin-containing analgesics in high dosage continuously for years. At the recommended dosages for short durations (days to a few weeks) it is highly unlikely to cause hearing loss. If patients on regular dosages of aspirin or NSAIDs do have a hearing loss it is often due to another cause, most commonly ageing or a hereditary cause.

The hearing loss associated with codeine-containing painkillers has only just been described. It does seem to be associated with prolonged usage of moderate to high doses of codeine and can present as a sudden hearing decline in both ears. Prolonged use of any medication for chronic pain may have serious consequences. Paracetamol containing medications may cause liver damage. Aspirin and related medications may cause excessive fluid retention or precipitate an asthma attack. Fortunately from the hearing point of view, hearing loss is exceedingly uncommon, and when it occurs, it is often associated with a dramatic increase in tinnitus, so the ototoxic effect may be recognised early. It may be reversible by reducing the dosage of the medication or ceasing it completely. If you do suspect that your pain relief medication is causing you harm, consult your doctor and discuss its continuing usage as a matter of urgency. 

The decision to get a cochlear implant can be quite daunting and asking your surgeon some questions can help you to move forward with more confidence. The first step is to find out if a cochlear implant is the best choice for you. To determine this ask: Am I likely to obtain more benefit from a cochlear implant compared with my hearing aids? If you are likely to benefit and you feel it is the right time for you, there are some specific questions about the surgery you might want to ask. Will I lose the hearing I currently have? Are some implants better for keeping my remaining hearing? What does the surgery involve? Is there anything I can’t do after surgery? Will the surgery affect my balance or tinnitus (sounds in the ear)? How long will I be in the hospital? How long does it take until I can hear with the cochlear implant?

The answers to these questions will help you prepare for the surgery and understand what to expect. If you have decided to go ahead, you will also need to decide which cochlear implant is the right one for you and your lifestyle. You could ask:
What implants are available and what are their differences? If you are receiving only one implant, ask if there is an implant compatible with your other hearing aid so that they can work together post-surgery.

It is also important to consider what you enjoy in life and compare your needs to the options that each implant can provide. If hearing in water is important, you might ask about the options for swimming and bathing. Consider asking about phone use, connecting to your television or music and the ability of the implant to be upgraded for use with future technologies. It can also be important to ask about how the implants themselves work on the inside to replicate hearing. If choosing for your child, ask about wearing options, ease of use and monitoring and availability of accessories for listening in school. These questions will help you make a decision as to which implant might be best for you and why. It will also give you some information as to where to start if you want to do further research into your options. The choice of implant is a very personal decision. Explore all the options and choose what is right for you and your family. Whatever you decide, you will open up a whole new world of hearing. 

You are not alone. A lot of people complain about the level of the sound track in the cinema. There are limits to the levels of all types of sounds - most speakers have limiters on them for the output of the sound available. Determining when sounds become dangerous is a combination of the level of the sound and how long you are exposed to it . Anything over about 80dB can be dangerous if you are exposed to it for long enough (and sounds less than 80dB can certainly be very annoying). If it is uncomfortable for you then I would advise next time you are at the cinema (or go to see a band or engage in a noisy activity such as using power tools) then you should use hearing protection - earplugs can be slipped in quite easily - you should still be able to hear the movie soundtrack (often better) but at a lower level and cutting out some of the background noise. For power tools, earplugs or earmuffs can be used to reduce the sound pressure at the eardrum. You do need to be careful about how they are worn – hanging the earmuffs around the neck doesn’t help! The National Acoustics Laboratory website also has some great information on noise exposure at www.nal.gov.au.

There are no laws in Australia regarding hearing aid disposal. Up to 97% of hearing aid button cell batteries end up in household waste potentially causing damage to our health and the environment. Adding to this, the processes used to create and distribute batteries are not eco-friendly. Hearing aid batteries are typically made of zinc, mercury and steel and are called zinc air batteries. A typical hearing aid battery lasts a week. So if you are wearing two hearing aids, you will be using around 104 disposable hearing aid batteries a year.If you are using disposable batteries with your cochlear implant processor, which has greater power requirements, you would be using around 312 batteries for each processor. Many audiology clinics collect used batteries and forward them to the council for recycling. Unfortunately, Australia can only recycle car (lead-acid) batteries and all other types including hearing aid batteries are sent overseas for recycling.Some battery companies such as Hearing Aid Batteries Express have invested in a recycling bin from French utility company Suez Environnement. Used batteries can be forwarded to Habex (preferably by road mail) and they fund shipping to Suez Environnement for recycling. Adding to these sustainable projects, a European Union ban on mercury as a stabilizer in button cell batteries became effective from October 2015. Following the same ban in many US states, the EU ruling sends out a clear international message that mercury-containing batteries should not be manufactured or offered for sale. Where possible, look at rechargeable battery options. Not only are they cheaper for you, they are substantially less harmful for the environment.

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