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DEAR DR. ROACH: I have worked in a loud facility for 35 years and have always worn protection and had my hearing tested annually. Several years ago, I had a threshold shift (a loss in my hearing range), and the plant nurse sent me to a hearing specialist. He said that my hearing loss is not due to noise exposure. I asked how he could tell, but I didn’t get a satisfactory answer. I later asked my primary care physician, and he didn’t know.
How do you determine from the result of a test whether hearing loss is caused by noise exposure or other factors, such as illness or injury? Would a hearing aid be effective? – J.G.
ANSWER: A comprehensive exam and hearing testing can show whether the hearing loss is likely due to loud noise exposure, based on the pattern of hearing loss across different frequencies. However, I don’t think that there is 100 percent certainty about making or excluding noise exposure as the cause of the hearing loss from the pattern.
I would think that an independent evaluation, by a certified audiologist and your own ENT doctor, might give you additional information, including a discussion about how much benefit you might get from a hearing aid. The Hearing Loss Association of America (on the Web at www.hearingloss.org) can provide you some support and guidance through this process.
DEAR DR. ROACH: My father suffers from GERD and takes medication for it. After returning from a recent holiday, I asked him about his symptoms. He replied that he was not bothered by heartburn for the 10 days he was away.
You see, my father takes all his meals sitting on the couch, eating off of a low coffee table. Taking a bite, sitting back to chew, bending forward toward the table, over and over. It almost looks like he’s doing sit-ups while seated, and I think this must contribute to stomach acid pushing up. During the 10 days that he was away, he was sitting at a proper-height table when eating all his meals.
What are your thoughts? He won’t listen to me, because I’m not a doctor! – A.C.
ANSWER: Believe me, being a doctor doesn’t mean people always listen to you. However, I do hope your father listens to you, because I agree with you that his eating position may contribute to mechanical acid reflux: The increased pressure from his bent-over position may be forcing acid up into his esophagus.
However, being on holiday may lead to other reasons he was not bothered. Maybe he was avoiding foods that cause symptoms. Maybe he was feeling less stressed. It’s possible he ate earlier and went to bed a longer time after eating, which allows the stomach to empty so there is less acid at night, when more damage to the esophagus can occur due to the loss of gravity and swallowing.
Sometimes several lifestyle choices are needed to address GERD. I always prefer to work on those before prescribing medication treatments, especially because the proton pump inhibitors like omeprazole have long-term side effects that are best avoided, if possible.
Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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