These are signs of gradual, age-related hearing loss called presbycusis. High pitched sounds are the ones to go first. Hearing loss from presbycusis cannot be restored, but hearing aids, along with the Self-Care Tips listed on page 61 can be helpful.

Hearing loss can also result from other things:

• Acoustic trauma - This may be caused by a blow to the ear or from excessive noise. Excessive noise includes that heard from low-flying airplanes when living near an airport, when flying in an airplane, or when working with heavy, loud machinery.
• Blood vessel disorders including high blood pressure.
• A blood clot that travels to nerves in the ear.
• Ear wax that blocks the ear canal.
• Chronic middle ear infections, or an infection of the inner ear.
• Meniere's disease (a disease marked by excess fluid in canals of the inner ear which help maintain balance).
• Multiple sclerosis.
• Syphilis.
• Brain tumor.

• Ask people to speak clearly, distinctly, and in a normal tone.
• Look at people when they are talking to you. Watch their expressions to help you understand what they are saying. Ask them to face you.
• Try to limit background noise when having a conversation.
• In a church or theater, sit up front.
• To rely on sight instead of sound, install a buzzer, flasher, or amplifier on your telephone, door chime, and alarm clock. Also, an audiologist (hearing therapist) may be able to show you other techniques for "training" yourself to hear better.

• Lie on your side. Using a syringe or medicine dropper, carefully squeeze a few drops of lukewarm water into your ear (or have someone else do this). Let the water remain there for 10-15 minutes and then shake it out. Do this again, but use a few drops of hydrogen peroxide, mineral oil or an over-the-counter cleaner such as Murine Ear Drops or Debrox. Let the excess fluid flow out of the ear.
• After several minutes, follow the same procedure using warm water again, letting it remain there for 10-15 minutes. Tilt the head to allow it to drain out of the ear.

To prevent hearing loss:

• Don't put cotton-tipped swabs, fingers, bobby pins, etc. in your ear.
• Don't blow your nose with too much force. It is better to do so "gently" with a tissue or handkerchief held loosely over the nostrils.
• Avoid places that have loud noises (airports, construction sites, etc.). Protect your ears with earplugs.
• Keep the volume on "Walkmans", car stereos, etc., on low. If someone else can hear the music when you have earphones on your head, the volume is too loud.
• Follow your doctor's advice for disorders that can cause hearing loss (Example: High blood pressure, Meniere's disease, etc.).
• Avoid prolonged use of medicines that cause hearing loss or overdosing on such medications. (Example: Heavy use of aspirin, streptomycin, quinine).

• Hearing aids (See your doctor).
• Devices made to assist in hearing sounds from the TV and radio.
• Special equipment that can be installed in your telephone by the telephone company.
• Portable devices made especially to amplify sounds. (These can be used for movies, classes, meetings, etc.).

In a child: Does the child not respond to any sound, even a whistle or loud clap? (Did the child's mother have German measles when pregnant with the child)? Does the child not respond to sounds after experiencing any of these things? Recent earache or upper respiratory infection Airplane travel
In a child or adult: Do you have any of the following with the hearing loss? Discharge from the ear Earache Dizziness or feeling that things are spinning around you Recent ear or upper respiratory infection Feeling that the ears are blocked or filled with wax
Can you not hear a regular (non-digital) watch ticking when held next to the ear?
Do you hear a ringing sound in one or both ears all of the time?
Did you lose your hearing after being exposed to loud noises such as those associated with airplanes, work or hobby related loud noises (i.e., heavy machinery, power tools, firearms, etc.) and has this not gotten better?