Air Travel and Ear Pain

With the summer holiday season fast approaching, more and more of us will be jetting off to far flung destinations around the world. Whilst traveling by plane many of us will experience issues with our ears due to pressure.  In rare cases these problems can lead to severe pain and hearing loss, so it is best to take precautions, before, during and after a flight. 

As an Audiologist, I thought it would be good to explain what happens to our ears when we fly…

It really comes down to air pressure. Normally the air pressure inside the inner ear and the air pressure outside are essentially the same, or at least not different enough to cause any trouble. Even if you were to hike to the top of a tall mountain, the slow speed of your ascent would allow time for the pressure to equalise along the way. A problem only occurs when the change in altitude is so rapid that the pressure inside the inner ear and the air pressure outside don’t have time to equalise, as occurs in air travel. 

When your flight takes off, and begins its ascent, the air pressure inside the inner ear quickly surpasses that of the pressure outside. The eardrum swells outward. Picture a loaf of bread baking, and you get the idea. Conversely if air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane (the eardrum) will be sucked inward, almost like a vacuum effect. What has happened is that the Eustachian tube (which links our ears with our throat) has flattened and needs a bit of extra help from you in order to continue to do its job of bringing air into the inner ear. Whether ascending or descending, that stretching not only causes the eardrum not to vibrate (thus the muffled sounds) but also causes the pain you feel. 

Everyone who has flown in a plane has felt the effects of a change in altitude on ears; a feeling of fullness and popping is commonplace. You need to equalise the pressure by introducing as much air as possible via the Eustachian tube and there are a number of ways to do that. 

The easiest way to equalise the pressure is to swallow. When you swallow, that clicking or popping sound you may hear is actually a tiny bubble of air that has moved from the back of the nose into the middle ear, via the Eustachian tube. The Eustachian tube ensures that the air in the middle ear is constantly being re-supplied. That air is then absorbed into the membranes of the inner ear, and the cycle starts over again. This constant cycle of air ensures that the air pressure on both sides stays equal. When you fly, the trick is to ensure that the Eustachian tubes work overtime and open more frequently to accommodate the change in air pressure. 

Chewing gum or sucking on a hard boiled sweet will help; for infants, whose Eustachian tubes are much narrower than an adult’s, the change in air pressure can be even more excruciating, so a bottle or dummy is recommended to increase swallowing. 

Other ways of equalising the pressure include:

• Avoid sleeping during ascent or descent
• Drink lots of fluids in-flight to stay hydrated
• Yawn
• EarPlanes: Specially designed ear plugs that have a filter to equalise pressure
• Nasal spray: Take only when needed as overuse of nasal sprays can end up causing more congestion

Karen Finch is the Managing Director and lead audiologist at The Hearing Care Centre.
The multi-award winning, family-run company has 20 centres across Suffolk and Norfolk.
For more information visit www.hearingcarecentre.co.uk or call 01473 230330.

FREE BEER!* By HCC patient, Geoffrey Holdcroft

"Right now that I've got your attention, I want to discuss men and hearing loss.

Ask any medical professional and they will tell you that we men are very bad at seeking help when it comes to health issues. Hearing loss is just such an issue. Hearing loss is a problem which will creep up on you. Whereas the ladies will deal with the issue when they know they have a problem us men just ignore the problem and put off dealing with it. How do I know this? Well, I've lost count of the number of ladies who tell me their male partner has a hearing problem and refuses to deal with it!

Why does it matter, I hear you ask? The posh term the professionals use is “auditory deprivation”. Eh?? In a nutshell the mechanism of hearing is a complex system involving the ears and the brain. If you fail to deal with a hearing problem when you or your family notice you have a problem, the system gets into a vicious circle and you lose the ability to hear. Having a hearing test and getting the right aids for you will prevent the system “forgetting” how to hear and becoming a degenerative downward spiral. Modern hearing aids are a wonder of miniature high tech engineering. I wear hearing aids myself and I can tell you that the aids themselves and the connecting wires are so small, nobody notices them.

My own experience is quite interesting. I suspected I had a hearing problem so I went for a hearing test at HCC. Quite properly I was told, yes I did have hearing loss but I wasn't in need of aids immediately. I decided to go ahead anyway because I had come across an article giving pointers that socially I did need aids. For me the ones that resonated were:

1. Do people appear to be mumbling?       

 Yes especially female check-out assistants.

2. Do you find it difficult to hear when a lot of other people are talking?

Yes our family gatherings are nothing short of riotous!

3. Do you get a very bad headache after attending an event as described above?

Yes this is the killer reason I decided to get hearing aids. I was getting really bad headaches when I had been straining to hear in difficult conditions.

There are lot of other pointers which might apply to you. For example: Do you say pardon a lot? Does your family complain that you have the TV or radio far too loud? Everyone is an individual and there are lots of other pointers.

*Sorry, I'm not giving away free beer I lied - but I do urge anyone, especially the men amongst us to book a hearing test if you suspect you have a problem."

Geoffrey

The Emotional Stages of Hearing Loss

Experiencing a myriad of emotions from denial, sadness and fear to eventually acceptance, is normal and a natural part of the emotional stages of hearing loss.

Here are the stages that one with hearing loss goes through, as I see it...

STAGE ONE | DENIAL

When normal hearing begins to decline, a natural reaction is for the person to compensate by trying to alter their environment to suit their loss. They may turn up the volume on the TV or radio disregarding complaints from their family members. They may ask their partners to answer the phone thereby avoiding the embarrassment of not being able to understand whoever is on the other end. They may blame others instead of acknowledging their hearing loss  i.e. “If people didn’t mumble, I would be able to hear them!”

STAGE TWO | WITHDRAWL

Hearing loss causes a person psychological hurt and grief. Over time, it also causes intolerance to social interactions, and reduced stimulation to the auditory system can result in a rapid decline of speech recognition. A way to deal with this is to avoid embarrassing situations, such as social occasions where there are likely to be lots of people or background noise.

STAGE THREE | ANGER

A hearing loss left untreated can cause the person suffering to become bad-tempered and the family may say he/she has become difficult to live with.

The person becomes less tolerant of others because of the frustrations and comments focused upon them.

STAGE FOUR | DEPRESSION

All these factors can eventually lead to the person becoming depressed. Low self-esteem, the loss of social interaction, suspicion of others, the inability to do easily what used to be problem free, isolation and loneliness become a part of daily life that wears the person down. It’s really tiring!

STAGE FIVE | ACCEPTANCE

When a person finally reaches this stage, they can then make the transition to seeking treatment with hearing aids, and auditory rehabilitation. A visit to a qualified audiologist will be the first stage on the road to hearing well again and ‘getting their life back’. A thorough test will be performed and hearing instruments prescribed where suitable. It can take up to ten years for someone to reach this stage.

Does any of this sound familiar to you? Which stage are you or your loved one at? How long did the process take you? Please let me know your experiences by posting in the comments box below.

For more information on hearing loss please visit www.hearingcarecentre.co.uk