Blindness cuts us off from things, but deafness cuts us off from people.” Helen Keller

 

 

 

Since I came back from Hawaii, I feel like this is me above constantly asking people to speak into the stethoscope,  ear trumpet, or speak into my good ear because my hearing has not been quite the same. I have been told by my family that I am speaking louder and yelling more than my usual customary “Mexican-ess” calls for. When a Mexican tells another Mexican that they are too loud than you know you are definitely in trouble! Plus, everyone in my family including me have found it terribly annoying having to ask for someone to repeat what they said and always seem to be two steps behind on the conversation. Over the last few years I have noticed that I have more trouble hearing and understanding what people are saying in crowed, noisy rooms as well as on the phone particularly with my right ear. But, things in the communication department seem to have gone south fairly quickly for no reasonable explanation.

Initially, since I came back from trip with a severe case of the flu, followed by pneumonia and then severe ear infections, causing the worst case of vertigo I have ever had in my life, I paid not much attention to it and assumed the problem was related to infections. However, once symptoms cleared I still have continued to experience this problem.

So I almost don’t like speaking on phone if a lot of ambience noise involved. Otherwise, I feel as if I were just guessing leading to some pretty funny and embarrassing assumptions and scenarios.

Of course being a doctor, I must research everything and find the root of the problem. The only new medication, I have added to my regimen is Rytary, thus I went in search of  possible side effects of this medication causing hearing deficits. What I found out is that in fact one of the side effects of Rytary is ear fluid build up which along with my history of chronic ear infections surely seemed like a plausible explanation for my acute and sudden worsening hearing. nevertheless, I went to have an audiology exam. Ears were intact with normal pressure and normal conduction but its the nerve that is not processing information properly- almost a delayed reaction. I am on no other medication which could harm the cochlear- aspirin use can do this on chronic basis but I take a baby aspirin about 2 times a week and this would produce bilateral problems. Doubt I have a brain tumor- aka a Schwannoma  of the eight nerve- I had normal MRI a year ago in so far as tumors but one never knows so will repeat just for peace of mind given my family history.

In the meantime, I began poring over articles on the subject and much to much chagrin I discovered several studies staying that Parkinson’s patients do in deed have hearing loss believed to be caused by the disease itself. Just like me some say not so much in loss of sound but rather slow processing and comprehension of spoken word…there seems to be a delayed reaction. now that I am aware of this when I don’t capture what is being said is I stop for a second and like a slow printer or processor that has to type one word at a time the words come to me slowly ..and I say AHH. Of course this only works if its quiet and not in active conversation because to overwhelming to have to intensely focus on what is being said.

In a study at the University of Naples, Italy  back in 2012, the researches discovered that out of 106/118 patients with Parkinson’s had age related hearing loss (presbycusis) in one or both ears. This was statistically significant finding since the a study of equal healthy counterparts did  not yield as high a figure. Another study in Taiwan revealed an increase in hearing loss of 1.5 times greater in those with Parkinson’s disease. Therefore it is speculated that a chemical specific to PD patients can cause noise-induced or age-related hearing loss or degeneration of various systems important in the integration of information from cochlear into Wernicke’s area could be another mayor problem.  Although, the actual cause of impaired hearing loss in PD’s still remains to be seen it appears that at least in my experience with PD in my own life this is a very real and potentially devastating problem leading to what I spoke of before impairment in communication causing greater isolation in those who have Parkinson’s disease that only worsens as we age and also if have a history of essential tremors for it is well known that most if not all patients with ET will develop hearing loss. This is because movement disorder specialists and neuroscientists believe that the  defect for tremors, hearing loss and longevity lie within the same gene.  

I also believe that perhaps Hispanics who  develop PD will be at an even higher risk for hearing loss since many in my observation have histories personally or in their family of essential tremors.

Once again the teacher has become the student in this ever evolving disease that seems to impact all aspects of our lives. Thus, we need to begin thinking about auditory loss as another non-motor symptom of the disease to which unfortunately I don’t have a solution for as of yet other than possible hearing aids. I don’t know if this will respond to increases of dopamine or not I suspect it might improve some since learning and understanding are higher cortical functions dependent on dopamine. So I will increase my medication and follow up with outcome. Hopefully, I won’t end up with my stethoscope or my daughter’s French horn wrapped around my head like princess Leia’s hair do…

In the meantime …. don’t be like these folks..

If hearing loss is one of your symptoms, ask your doctor for a referral to a hearing care professional for testing to determine the extent of your hearing loss and advice on treatment to restore as much of your hearing as possible. don’t forget to rule out medications and other organic causes- don’t just assume is PD.

Sources:

On Parkinson’s Disease & Hearing Loss

https://www.researchgate.net/profile/Gabriella_Santangelo/publication/231862911_Hearing_impairment_in_Parkinson%27s_disease_Expanding_the_nonmotor_phenotype/links/004635398b58fef8c9000000.pdf?origin=publication_detail