Dr. Ajay Kothadiya

Ageing is not the only factor that brings hearing impairment. The causes are many. Certain medications, continuous exposure to loud noise, genetic involvement, injury and some medical conditions may cause hearing loss.

But if you think that you are facing hearing issues, then these symptoms should raise an alarm for you to see an ENT specialist:

1. You find it hard to hear phone conversations: Do you find yourself asking the person on the other end of the phone line to 'repeat' themselves, or find yourself pressing the phone instrument right into your ear? If you are trying so hard to hear, you might find yourself missing out on bits of the conversation as focussing to clearly hear the conversation is exhausting work. Getting a hearing test might be a good option if this sounds like you.
2. Your TV is blaring: Do you often find people around you shouting above the TV sound complaining that it's too loud? When you find it hard to hear the TV at the average volume and find yourself turning up the sound, this could signify a hearing loss. Doctors are seeing a growing number of patients visiting them after prolonged exposure to loud music and sounds.
3. You have trouble hearing in noisy environments: When you are out dining with friends or family at a busy restaurant or accompanying a friend shopping in a busy street, all that background noise makes it difficult to hear what the people are saying. People with hearing loss often have problems masking out background noise. 
4. You find yourself leaning closer to people to follow the conversation or staring at their lips trying to lip-read what's being said.
5. Family members telling 'you're going deaf'?: Trust the views of the people closest to you, they never lie about your health. Family members often are the first to sense signs of hearing loss as they find themselves repeating things to you or calling out louder to get your 'attention'.

Did you know your earphones are making you deaf? Here's how.

Fact - Roughly 1.1 billion people worldwide within the age group of 12-35 have been found to be at an increased risk of developing hearing problems.

Listening to loud music on handheld devices using earphones has become a common trend among youngsters these days. You might find it very relaxing to plug in your earphones and escape into your own world of music, but you need to know that this can cause serious damage to your ears.

The worst part - You won't realise your ears are being damaged until it's too late.

So, exactly how is loud music damaging your ears?

Continuous exposure to loud music from earphones or other sources results in a medical condition known as Noise-Induced Hearing Loss (NIHL), which can be associated with irreversible damage to the ears resulting in deafness.

When you hear loud music for a considerable amount of time every day, it affects your hair cells (nerve cells responsible for sending sound signals to the brain) negatively, so that their ability to respond to sound decreases. If this keeps on happening for many months, eventually the hair cells are damaged beyond repair. These cells cannot be regenerated, thus making you permanently deaf.

How loud is too loud?

If your ears are exposed to sounds at 95, 100, 105, 110 and 115 dB (decibel, the unit used for measuring sound) for 4 hours, 2 hours, 1 hour, 30 minutes and 15 minutes each day respectively, your ears are at risk of getting severely damaged. Also, playing music at 120 dB or above can damage your ears instantly. You can have a realistic idea about the relation between decibels and sounds you commonly hear by referring to this list:

- 30 dB: soft whisper
- 75 dB: busy traffic
- 90 dB: noise of a motorcycle at 25 feet
- 100 dB: noise of a farm tractor
- 140 dB: jet plane taking off

Moreover, if you experience the following symptoms regularly, there's a high chance that you need to get your ears treated soon:

- A ringing sound in your ears when you are at a quiet place, which vanishes after a few minutes
- You need to raise the volume of TV or music to the fullest to hear it properly
- You have difficulty in hearing people talking at a distance of just 3 feet

How can you prevent the risk of hearing impairment?

When you're using earphones, keep the volume low. Also, using in-ear headsets or noise reduction/cancellation earphones also helps as it lets you hear the music distinctly at lower volumes by cutting out background noise.

CHECK - You need to lower the volume of your music if the person sitting or standing beside you can hear the sound coming out of your earphones.

Though nosebleeds are usually not a cause for serious concern, it can sometimes be a scary experience and cause a lot of anxiety. The nose is home to a lot of blood vessels and being fragile they bleed easily. Nosebleeds, however, can be a cause of concern if they happen regularly. While a few factors can be taken care of easily, there are a few rare cases that are actually alarming.

1. Injury or blow to the nose: Any injury or sudden blow may cause the nose to bleed. The severity of bleeding depends on the intensity and nature of blow/ injury.
2. Sinusitis: Bleeding is seen in a moderate number of cases of sinusitis. Not every person with sinusitis experiences nose bleeds though.
3. Hypertension/ high blood pressure: People, who have high blood pressure and one or more of other predisposing factors, might experience nosebleed in some cases. High blood pressure basically increases your chances of experiencing nosebleed.
4. Liver infection: This condition can be one of the rare causes of nosebleed.
5. Conditions hampering blood clot formation: There are certain medical conditions in which the blood clot formation does not take place effectively and thus the bleeding incidents can happen with minor causes as well.
6. Blood-thinning medication: People having blood-thinning medicines are more prone to experiencing an episode of nosebleed for obvious reasons.
7. Excessive scratching or sneezing: This might cause the nasal wall to rupture, causing minor bleeding.
8. Excessive alcohol consumption: In people who consume alcohol in an excessive amount, nose bleeding might occur as an after effect.
9. Blood cancer/ leukemia: In some cases of leukemia, the patient might experience nosebleed along with other complications.

While some causes can be self-cured at home, a few others need proper treatment from a medical practitioner. In case you have a concern or query you can always consult an expert & get answers to your questions!

Cochlear implant is a medical device that provides direct electrical stimulation to the hearing nerve in the inner ear. Children and adults with a severe hearing loss may be helped with cochlear implants. A cochlear implant is a prosthetic substitute directly stimulating the cochlea and it does not cure deafness or hearing impairment.

A cochlear implant completely by-passes the normal hearing mechanism and stimulates the auditory nerve directly by means of an internally implanted electrode assembly. The implant consists of an external portion that located behind the ear and an interior portion which is surgically implanted under the skin. An implant has a microphone, a speech processor, a transmitter and an electrode array. The sound from the environment is picked by microphone and transmitter and receiver/stimulator sends them to speech processor to convert them into electric impulses. The speech processor placed with the microphone behind the ear, or it is a small box-like unit worn in a chest pocket. The speech processor digitizes the sound signals and sends them to a transmitter just behind the ear. The electrode array collects the impulses from the stimulator and sends those to different regions of the auditory nerve. The electrodes stimulate the fibers of the auditory nerve, and sound sensations are perceived.

A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so that they can be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Hearing via a cochlear implant is different from normal hearing and takes time to adjust. However, it enables many people to understand other sounds in the environment, recognize warning signals, , and understand speech in person or over the telephone.

Once a person is referred for cochlear implant, more testing is done which includes audio logic testing, psychological testing, medical examination, and tests performed by the surgeon. It is done to ensure that the candidate will benefit from a cochlear implant and will have the motivation to participate in the process. Once the decision is made to go ahead, the surgery is done. Sometimes it involves an overnight stay in the clinic, and sometimes it is done on an outpatient basis. Six weeks post-surgery, patient is fitted with the external microphone and speech processor and implant is activated and programmed.

The best candidates are those having severe hearing loss in both ears, limited benefit from hearing aids, medical condition that makes surgery risky. Children can be considered for cochlear implants if they have the similar conditions as adults and in addition have support from their educational institutions to development of auditory skills.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Do you snore too much while you sleep? Does your snoring give others a hard time? Snoring is caused because of the vibration of soft tissues and muscles that make up your upper airways. Working out these muscles help in the management of snoring. These soft tissues and muscles stay floppy when you are snoring. The tightening of these muscles helps in reducing the level of floppiness, which results in reduced snoring. There are several simple mouth exercises that are considered to be effective in dealing with snoring. Several researches and experiments have been carried out in order to prove the effectiveness of these exercises in controlling snoring.

The most important and common mouth exercises that help stop your snoring are as follows:

1. The tongue slide
   • You have to push the tip of your tongue against the roof of your mouth, or the hard palate.
   • After this, you simply should slide your tongue backwards. You should repeat this around 20 times.
2. The roof smash
   • In order to practice this exercise, you need to turn your tongue in the upwards directions, and press the whole tongue against flush with the hard palate.
   • This should be repeated 20 times.
3. Tongue carpet
   • You have to force the underside of your tongue against the floor of your mouth.
   • Along with this, you need to keep the tip of your tongue in contact with the bottom part of your front teeth.
4. Say aah!
   • You need to lift your soft palate, at the back of your mouth’s roof and uvula, similar to how you open your mouth during a throat inspection.
5. The cheek push
   • You need to insert your right index finger into the mouth, while pressing the inside of your finger against your left cheek’s length.
   • You should engage your cheek muscle and try to return the pressure back on your finger.
   • This should be repeated 10 times on each side.
6. Even chewing
   • It is important for you to chew evenly even you eat any form of food.
   • You should alternate both sides of your mouth while chewing and swallowing food.

Similar to any form of exercise, you need to practice these mouth exercises on a regular basis to gain benefits and observe positive results. Unless you practice them strictly and continuously, you may not experience any change in your snoring patterns and intensity. You should try incorporating these exercises into your daily schedule. You may do a set after brushing your teeth, or during evening commutes. In case you have a concern or query you can always consult an expert & get answers to your questions!

Dizziness is now a very common problem among the adults. Maybe people do not take this to be a serious problem in many of the cases, but repeated feeling of dizziness may lead them to visit a doctor. When in the case of such situation, you visit a general physician, not knowing the causes of such problem; often the doctor will refer you to an ENT. There have been some reasons of why you should visit an ENT for dizziness.

Symptoms of Dizziness

Often dizziness occurs along with some other symptoms too. Some of the symptoms that are accompanied by dizziness are:

• Anxiety
• Nausea
• Buzzing noise in the ears
• Pressure in the ears and the head
• Hearing issues

Some Important Reasons for Dizziness
If you are facing dizziness on regular grounds, then it may happen that it is due to some very serious health complications that you are suffering from. Some of the problems that may cause dizziness are:
Inner ear issues,

• Issues in the central nervous system,
• Issues related to the cardiovascular system,
• Bacterial or viral infection,
• Side effects of any medicine.

Diagnosis of The Problem
Diagnosis of the problem is the most important step in case of dizziness. It is because the diagnosis is not about whether you are feeling dizzy or not, it is the diagnosis about why you are feeling dizzy. There are some tests related to balance to diagnose the cause of dizziness. To get the tests done related to balance, you need to visit an ENT because the balance system of the human body is there located in the inner ear.

Treatment of The Problem
After several tests of various sensory organs, when the ENT expert reaches a particular result, then the treatment starts depending upon the diagnosis. Today treatment for such balance disorder or dizziness has become common. Some problems can get solved by a changed diet only while other may need the help of medicines. Again, some of the problems may get cured by doing exercises while for some; you may need the help of a physiotherapist too.

When it is about dizziness, it is surely about balance disorder due to some major problems. Balance is controlled from with the inner eye and other sensory organs also, hence it is important to visit the ENT in this case.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Swimmer's ear is a medical condition, which involves inflammation, irritation or infection of the ear. It may affect the outer ear and also the ear canal. Swimmer's ear is called Otitis externa in medical terms. The condition may be acute to chronic in nature.

Causes:
Swimmer's ear is an infection that's usually caused by bacteria commonly found in water and soil. Infections caused by a fungus or a virus are less common. This condition is more common in teenagers and young adults. It may occur due to a middle ear infection or because of a respiratory infection such as cold.
Swimmer's ear can occur as a result of swimming in unclean or contaminated water. These waters contain pseudomonas and other harmful bacteria, which can lead to such ear infections. The infections are rarely caused by fungus.

Swimmer's ear may also result due to other reasons. They can be:

1. Scratching the inside or outside of the ear.
2. Having something stuck in the ear. When you clean ear wax with cotton swabs or small objects, damage may occur. Using headphone or ear plugs for a long period of time may also cause swimmer's ear.
3. Allergic reaction to some object or anything placed in the ear may also cause Swimmer's ear. These may be hair products or jewelry.
4. Some chronic skin conditions like eczema and psoriasis may also lead to this infection.

Risk factors:
There are several factors, which may enhance the risk of getting swimmer's ear. They are as follows:

1. Swimming in water, which has got elevated levels of bacteria. This includes lakes and ponds.
2. People having narrow ear canals are at a more risk of swimmer's ear.
3. Aggressive cleaning and scratching of the ear canal.

Symptoms:
The symptoms which indicate swimmer's ear are:

1. Itching of the ear canal. This becomes intense as the condition progresses.
2. Redness on the inside parts of the ear, which get more extensive in later stages.
3. Discomfort which worsens by pulling on the outer ear or pushing on the tragus of the front part of the ear.
4. Drainage of a fluid which is clear and odorless. As the condition worsens, there is excessive drainage of fluid along with the discharge of pus.
5. A fullness feeling in the ear and a partial blockage of the ear canal because of swelling and fluids.
6. In advanced stages, fever and swelling of lymph nodes in the neck is indicated. Hearing impairment may occur.

Swimmer's ear is a health condition, which involves the ear. The ear gets inflamed because of a certain bacterial infection. Although it is not a very severe condition, in some cases it can do significant harm. In case you have a concern or query you can always consult an expert & get answers to your questions!

A nosebleed also called epistaxis medically is normally not dangerous, but if you are old nosebleeds come with a number of risks. Treating a bloody nose incorrectly can only make it more dangerous, because of prolonged bleeding. Before we explain the ways to stop nosebleeds, let’s take a look at its causes:

Nosebleeds usually start from just inside the entrance of the nostril. But, why? Because the blood vessels here are quite fragile and are also prone to rupture easily. This is the reason why children suffer from nosebleeds so easily. Other common reasons are

1. A blocked nose due to colds
2. Picking one's nose roughly
3. Blowing one's nose
4. Injuries
5. Use of cocaine

A nosebleed usually lasts for about 10-20 minutes and is usually easy to treat. But in some conditions, this bleeding can be profuse and last longer like in cases of 

1. Heart failure
2. Blood clotting disorders
3. Due to 'blood thinning' medicines
4. Hypertension

Bleeding can sometimes also happen in areas further back in the nose due mostly to injuries and disorders of the nose.

Treatment
Usually, nosebleeds can be stopped using simple first aid.

1. Sitting up straight helps, especially along with tipping your head forward. It is vital that you don’t tip your head backwards as this can allow the blood to go down your throat and cause vomiting. And this can make your nosebleed worse. So, take care to spit out the blood in your mouth and not to swallow it.
2. To stop a nosebleed, pinch the soft, cartilaginous part of your nose using your thumb and forefinger. Spraying your nose with a medicated nasal spray before pinching it can help the bleeding to stop faster. Apply pressure for 10 minutes to get results. Check if your nosebleed has stopped after 10 minutes if it’s not; apply pressure for another 10 minutes. Nosebleeds usually stop after 10 to 20 minutes of pressure.
3. Use an ice pack to your nose and cheeks. This will constrict the blood vessels in the nose and stop the nosebleed.
4. Use a saline- or water-based nasal gel inside your nose to stop bleeding.
5. Remember not to blow your nose or insert anything into your nose for at least 12 hours after your nosebleed is over.
6. If the bleeding doesn’t stop even after 20 minutes of applying direct pressure, it’s prudent to rush to a doctor. He will treat your nose to stop the bleeding.
7. In a few rare cases, the bleeding is so severe that a blood transfusion is needed, and surgery may be needed to stop it.

In case you have a concern or query you can always consult an expert & get answers to your questions!