Hearing test

[Dave2002]

I downloaded a copy of Dexed - https://www.audiopluginsforfree.com/dexed/

Part of the interface has a piano keyboard. I tried pressing keys, and each produced a series of tones - first the one corresponding to the key, then the one an octave above. Going up the keyboard I found I could hear the octave "note" at each level until I got to C7. I could hear the tone a semitone down at B, but not the one above C7.

However, when I turned the volume up on my MBP I could then hear the octave tone at C7 also - but I guess that's close to the limit of my hearing right now.

Going down to the bottom end of the virtual synthesiser keyboard I couldn't hear much at all, but that's most likely because an MBP not feeding into any loudspeakers doesn't generate any low notes at all worth considering.

I don't think I'm going to worry too much about my hearing for a little while longer.

[ardcarp]

If someone can explain how that complicated website works (i.e. how to get the hearing test) I'll give it a go.

[Dave2002]

On my MBP (Apple) I simply downloaded the program. When run it shows a complicated interface, but with a piano keyboard at the bottom. The keyboard is labelled with some keys marked as C1, C2, ... C7. Simply click on the keys on the screen and hold down and see what happens.

Might be different on Windows or Linux. Shouldn't take long to try - 5 minutes perhaps. The only issue if running on Macs is to override the security settings which block running it until you say you really do want to run it.

[BBMmk2]

I think if you are worried, make an appointment to see your GP.

[Dave2002]

I think if you are worried, make an appointment to see your GP.

Personally I'm not - at the moment - though I do get problems with wax build up periodically.

I was just interested to know if I could actually hear up to the top of the range of that synthesised keyboard, and it appears that I can go pretty much right to the top.

I am interested in reading this book - Sound: A story of hearing lost and found by Bella Bathurst. This was presented as an audio program a while back on Radio 4, but I missed quite a lot of that (not because of not being able to hear ....) - https://www.amazon.co.uk/Sound-Story...bathurst+sound

I have friends who have hearing aids who can hardly hear anything without them. A long time ago we had a friend who was almost completely deaf. I was very surprised at the degree of her deafness. I am hoping that my own hearing does not deteriorate that far - though it might - but I'm not expecting that for many years - if I live that long!

I am very wary of those commercial outfits that try to persuade people that they have a hearing problem, so that they can sell them some form of hearing "aid".
Obvously some people need that kind of assistance, but I suspect that for some - possibly many - people the hearing "aids" often exacerbate the problems. It will depend on the severity of their problems.

[Jonathan]

I had a hearing test for work a few weeks ago, I was very surprised to be told that I have the hearing of an 18 year old in one ear and 30 year old in the other (I'm 46).

[ardcarp]

On my MBP (Apple) I simply downloaded the program. When run it shows a complicated interface, but with a piano keyboard at the bottom. The keyboard is labelled with some keys marked as C1, C2, ... C7. Simply click on the keys on the screen and hold down and see what happens.

Might be different on Windows or Linux. Shouldn't take long to try - 5 minutes perhaps. The only issue if running on Macs is to override the security settings which block running it until you say you really do want to run it.

Thanks for that, Dave. I think I'll give it a miss, as knowing me I'll probably screw up the whole computer (steam-driven Microsoft). As it happens,
I'm not worried about my hearing at all. Hearing loss with age (presbycusis?) seems to affect some people much more than others. I and Mrs A. seem to be fine, but several friends of our age already have hearing aids. A couple have said that their pianos sound horrible when they first start wearing them, and I think they prefer to practise with hearing aids removed. I'm not sure if that applies to other instruments or to singing.

[rauschwerk]

I'm 73. I had a hearing test about 18 months ago and found that I had a 10 dB mid-range loss on both sides, and a high-frequency cutoff of around 5kHz. That's back to AM radio, though of course without the dreaded envelope detector distortion. I decided to pay lots of money for an aid which I control from my iPhone, and which has speech and music settings, as well as custom settings for various environments. Even on the music settings, it quite spoils piano sound, and I understand this is universal. The sound of a choir is fine, but when I'm singing in one, my own voice sounds a bit odd so I don't generally use it. For concerts, opera and social interaction it's invaluable.

My mid-range loss is now 20 dB (!) so when I play music at my preferred volume without the aids, my wife protests strongly. Wonderful to have good headphones! I am so very grateful that I don't suffer from tinnitus.

[Dave2002]

A couple have said that their pianos sound horrible when they first start wearing them, and I think they prefer to practise with hearing aids removed. I'm not sure if that applies to other instruments or to singing.

A family friend who lived to an advanced age tried several different hearing aids in his later years. Some were very expensive. He played the piano well, and he told me that the heading aids were seriously affecting the perceived pitches and harmonies which he heard, and were becoming unpleasant. Perhaps this is inevitable, but it did sound to me as though heating aid manufacturers perhaps don’t have good solutions for serious musicians and musical listeners.

[Serial_Apologist]

Tinnitus is strange. I first became aware I was suffering from it was in 1997, after completing an arduous degree course, when, on taking a quiet walk in the countryside, the continuous high-pitched whistle rendered it clear that I would not be able to enjoy the untrammelled sounds of the external world as I had long done when taking "Zen walks". And yet, sometimes the whistling sound is there, at other times not, or barely noticeably so, such as today; while at others it is loud to the point of being at the forefront of my consciousness. One associated effect is a clangy kind of reverberation experienced at certain frequencies at just above what I would perceive as the mid level of the frequency spectrum, which causes me to rush to the radio to turn down the volume in certain speech programmes; another is that the pitch level of the whistle - which is about the same as TV sets of old when no programmes are transmitting - can drown out sounds "in reality", including musical pitches, which are in the same register. I can no longer hear the very high sustained violin note that comes in the quiet passage that comes before the final massive climax in the third movement of "La mer" on any recording or performance.

At the beginning, the mere thought that I was now probably perrmanently to be at the mercy of this condition was a cause of considerable depression, especially when becoming conscious of it on going to bed; over time, however, I seem mostly to have got used to it, and only become fretful when the tinnitus is at its loudest, when I can also occasionally experience bodily tension and involuntary shaking around the midriff, and slight temporary feelings of nausea, so I have not bothered to visit the doctor or find means of counteracting it.

[ardcarp]

I'm very sorry to hear about the tinnitus SA. I am glad that your brain sometimes manages to give you some relief.

I was interested to hear of others' experiences of the piano+hearing aids. As I understand it, a note played on most instruments (flutes, violins, organ pipes) produces a set of harmonics as you would see in a physics book, i.e.

1st -fundamental note
2nd -octave higher
3rd -octave+ a fifth higher
4th -two octves higher
5th -two octaves + a major third higher

These are all 'harmonious' to the ear.

The piano, OTOH, where the string is struck by a hammer (as it is also on a cimbalom), that very act of striking produces an additional set of weird random high-up notes which are not part of the usual harmonic series. I think these are sometimes called 'transients'. As these are, as the name suggests, short-lived, people with 'normal' hearing either disregard them or at least regard them as part of a piano's tone. However, I gather that modern hearing aids work by boosting and even sustaining higher frequencies...probably ones you don't want to hear from a piano!

I have to declare that I have no specialised knowledge of hearing aids, and I'm sure there must be (or at least ought to be) some clever electronic wizardry whereby you can set your device to 'piano mode'. It probably isn't...and won't be...available on the NHS !

[ardcarp]

I've just found this article written by a 'Hearing Consultant' about hearing aids (or 'hearing instruments' as he chooses to call them) in relation to musicians. It may be of interest, though it doesn't mention the piano. I guess the writer is keen to promote his product!

There are now over 10 million people in the U.K who suffer with some form of hearing loss, the majority of which are of retirement age. In 20 years’ time, that figure could have risen above 16 million.

There are many causes of hearing loss including heredity, noise exposure, illness and physical trauma. However the greatest cause is presbyacusis – or quite simply, getting older! Arguably, from your mid-twenties onwards, your hearing could be getting worse, but certainly from your 50’s. This worsening happens very gradually and usually it isn’t until a family member complains the TV is too loud, or that people seem to start “mumbling” that it may be noticed. At that point most people will ignore the problem, blame other people’s diction and use coping strategies to try and compensate. The thought and stigma of possibly having to rely on a hearing aid would be positively abhorrent!! From now on, I shall refer to Hearing Instruments.

Things have moved on from the big boxes hung around the neck, granny putting a trumpet to her ear and that very annoying loud whistle from the big beige banana sitting on the back of the ear! Hearing Instruments nowadays are packed with the latest acoustic technology and can be very small and discreet. The aim of most Hearing Instruments on the market today is to generate much better speech understanding, especially when there is background noise. The latest Hearing Instruments are able to detect the acoustic environment they are in, automatically change program and apply varying amplification, speech-enhancement and noise-reduction to ensure the wearer gets the best listening experience possible. However, it is important to note that hearing loss is caused by the wearing away or breaking of tiny hair cells in the inner ear (cochlea), and as a result is none- reversible. Hearing Instruments attempt to compensate for this, but can never replace the ability or clarity of a fully functioning ear. But we can try to get close!

The best Instruments today are also able to detect music and adjust their functioning appropriately. However, music presents a particular challenge due to the dynamic range, intensity and complexity of the signal. Typically speech levels are around 65 – 70 dBSPL, with louder or “shouted” elements sitting around 80 dBSPL. But music, even at quieter instrumental levels, can be around 90 dBSPL and can more typically sustain a level of around 110dBSPL. If a Hearing Instrument processed and amplified music to the same criteria as a normal conversational environment, sound quality would be compromised. The instrument would try to focus on and amplify any speech frequencies (65 – 70 dBSPL), and it would try to reduce the intensity of the loud sounds and reduce overall amplification to prevent feedback. The result is a lack of sound quality and hence enjoyment for the user. Nevertheless, with the automatic music detection* this can be addressed.

When Hearing Instruments detect that music is the dominant input signal, they have the ability to switch to a specific music programme. As a result, the frequency responses, compression ratios noise-reduction, speech-enhancement and microphone functionality all change. Essentially all the complicated speech-processing is reduced in favour of more simple programme, allowing a more expansive, rounded and pleasant sound.



A dedicated music program can help, but listening to music can be difficult for both anatomical and technical reasons. As mentioned before, hearing loss is due to the breaking/flattening of hairs cells along the organ of Corti. As a result if there is a tone at the exact point where there is hair-cell damage, and if that sound is intense enough, it could actually excite the cells either side of that zone. This results in a sound being heard, but it is distorted. Additionally, a process called 'loudness recruitment' could be at play. This is where the ability of the inner ear to regulate loud sounds is reduced. As a result, a loud sound heard by a normally functioning ear is actually perceived as a very, very loud sound by an ear suffering with this....again affecting the quality of music. Furthermore, when a Hearing Instrument is placed in the ear, it changes all natural resonances of the ear canal. A Hearing Instrument will compensate for this, but it has to be fitted and tested well. The addition of a specific music programme can then help to overcome some of these problems.

Finally, in addition to the specific amplification and fitting changes required to enjoy music, a special High Frequency microphone* can replace the standard. This is specifically for individuals who are regularly exposed to music or for whom music is the most important requirement. In effect, this microphone is more sensitive to higher frequencies and ignores lower frequencies. As a result the high intensity low frequency signals pass the hearing instrument by and are heard naturally through the ear (in a non-occluding fitting). This prevents the chance of overloading the digital processing which in turn prevents the distortion caused by the sudden or irregular loud sound-events which often accompany music.

So to conclude, hearing loss affects millions of people and creates a number of challenges, not least music. Recently, technology has vastly improved, with automatic acoustic environment detection, automated programmes and fitting proceedures all designed to create the easiest listening experience possible for the patient. The specific problems with music have been addressed with targeted processing and fitting strategies and with the addition and development of a specific musicians' microphone modification. What the future holds – who knows! Improving quality of life is every audiologist's aim and having a suitable Hearing Instrument fitted expertly and regularly maintained can help to restore a patient's enjoyment of music.

Richard Jones BA (Hons), RHAA, MSHAA




Richard has worked as a dispenser diagnosing hearing loss, prescribing, fitting and adjusting hearing instruments. He currently works for Unitron, one of the worlds leading hearing instrument manufacturers.

*Automatic music detection is a feature of Unitron's Premium and Advanced instruments. The specialist musicians' microphone is an optional extra.

[Dave2002]

Tinnitus is strange. I first became aware I was suffering from it was in 1997, after completing an arduous degree course, when, on taking a quiet walk in the countryside, the continuous high-pitched whistle rendered it clear that I would not be able to enjoy the untrammelled sounds of the external world as I had long done when taking "Zen walks". And yet, sometimes the whistling sound is there, at other times not, or barely noticeably so, such as today; while at others it is loud to the point of being at the forefront of my consciousness. One associated effect is a clangy kind of reverberation experienced at certain frequencies at just above what I would perceive as the mid level of the frequency spectrum, which causes me to rush to the radio to turn down the volume in certain speech programmes; another is that the pitch level of the whistle - which is about the same as TV sets of old when no programmes are transmitting - can drown out sounds "in reality", including musical pitches, which are in the same register. I can no longer hear the very high sustained violin note that comes in the quiet passage that comes before the final massive climax in the third movement of "La mer" on any recording or performance.

At the beginning, the mere thought that I was now probably perrmanently to be at the mercy of this condition was a cause of considerable depression, especially when becoming conscious of it on going to bed; over time, however, I seem mostly to have got used to it, and only become fretful when the tinnitus is at its loudest, when I can also occasionally experience bodily tension and involuntary shaking around the midriff, and slight temporary feelings of nausea, so I have not bothered to visit the doctor or find means of counteracting it.

SA

I do wonder if you'd get anything useful out of the book Sound by Bella Bathurst which I mentioned in msg 5. I haven't read the book yet - but I have noted it. What interested me about hearing that on the R4 program (I wonder if the program is by any chance still available ...??) was that she seemed to become deaf, and was more or less completely deaf for a long while (years ...) but then somehow she must have decided to try to get her hearing back, and it seems that eventually she succeeded to the extent that she was able to go to a concert and listen and enjoy it without any artificial aids. I don't know all the details, but there are some hearing conditions which can be at least ameliorated with good and appropriate medical treatment. It does sound as though finding a medical practitioner who understands enough about these things to help is very difficult. Probably many will just fob one off with a hearing aid, or suggest that "it can't be helped", or "it's just old age".

Before my mother passed on at over 80 she became very deaf for a while, but she insisted that she'd be OK. Her GP said that she'd got wax, but she'd probably need a hearing aid anyway. I suspected that wax was going to be the problem, and I administered olive oil for a few days, before taking her back to the surgery to have her ears flushed out. As I thought, her hearing returned as soon as the gunk had gone.

Also, it is sometimes said that there can't be any recovery from deafness - which is probably the case from neural damage, or specific cell damage, but not all hearing problems are cause by such. Blocked eustachian tubes, or inner ear infections can be causes, and it is (sometimes - maybe often) possible to recover from such.
I think I occasionally have tinnitus, and using headphones makes that worse, but mostly it dissipates. I know that some people have it more or less permanently.

[ardcarp]

From what you say, Dave there seem to be 2 sorts of deafness, the first caused by mechanical things (wax, blocked tubes, damaged eardrums, otosclerosis...those little bones getting immobile), the second caused by problems with the nervous system. I guess the first is often curable, but I'm not so sure about the second. Again, I've no particular knowledge about it all.

I remember one of my daughters, when quite small, went partially deaf after a nasty viral infection. She was referred to a consultant (I mean a proper medical one) who struck a huge tuning fork and placed it on her skull, asking, "Can you hear that?"
"Yes" she said "it's a C" which impressed the Dr no end. He recommended having grommets fitted and she went on the waiting list. By the time her turn came, her hearing was perfectly normal again, so no grommets needed. This rather confirms what you say about self-healing, Dave.

[Old Grumpy]

Interesting feature on In Tune about, inter alia, cochlear implants [or cochlear earplants as SF insisted on calling them!] at about 28 minutes here. The feature was about an exhibition at the V and A by Tom Tlalim

OG