This feature is intended to provide resources and information about hearing and ear protection but is not a substitute for advice or care provided by a licensed medical or health care professional.
Leading a musician’s lifestyle can take a toll on the body. Professional performers have a disproportionate amount of exposure to late nights, loud decibels, and open bars. We contort ourselves to squeeze between travel cases in vans and curl up on couches and La-Z-Boys when we’re crashing on the road. We eat whatever junk food is available at road stops, turn our ankles in heels, pull our backs lugging gear. We play late-night shows and decimate our circadian rhythms. And every time we justify it by saying, “Oh, it’s just for this gig” or “this tour” or “until my band takes off.” But the damage we do in our 20s determines how we wake in our 30s, and how we age in our 40s. Taking ownership of our health isn’t exactly easy in a society that commodifies artists and sees us as tools, but it can be the key to living a pain-free life down the road.
Last September, when I interviewed the eternally gigging drummer Simon Lott, we found ourselves speaking for hours about hearing protection. So I made an appointment to get my own ears checked. At that point, I’d played over 200 shows and had some anxiety about what the results might be, but I called Audibel Hearing Healthcare clinic and booked a free test. That’s when I met audiologist Dr. Monique Gallant, who gave me the information I needed in a clear and patient way. She has been seeing patients for over a decade, since receiving her audiology doctorate from LSU in 2014.
Dr. Gallant got on the phone with me again to follow up and answer my many questions about how we process sound and what we can do to protect that ability.
At the in-person appointment, Dr. Gallant began by saying, “When we test someone’s hearing, we’re testing low frequencies to high frequencies—basically, the frequencies that are most important to our speech understanding or speech intelligibility.”
She explained that being able to process low frequencies is important for bass and volume. High frequencies are more important for sharpness and clarity, so, “Together, the volume and the clarity create the speech signals that we recognize and understand. In order for someone to have ‘normal hearing’ they have to fall within a certain range in that level.”
Our first task was to manually check my ears to make sure there wasn’t any wax or other physical blockage impacting my perception. After the all-clear, Dr. Gallant had me enter a specialized, soundproof room and don headsets, which felt almost exactly like being in a vocal booth. She was on the God-mic, letting me know what I was listening for. But unlike having to nail a performance, my only job that day was to pay attention and respond honestly. Beeps and beats were played across the frequency range and I just had to push the button to let her know each time I heard a sound. “We’re looking for the softest sound you can detect of each pitch,” she said.
The next segment was speech testing, where she spoke a series of random words and I repeated what I heard. “It’s one of the easiest tests you’ll take and when you’re done, you get a good idea of where you stand, a baseline of your hearing sensitivity.”
The moment I stepped out of the booth, Dr. Gallant was able to show me where my results landed on the auditory range. It was reassuringly positive news. She was surprised to hear that I fronted a heavy rock band (WAR BUNNIES), having assumed I played softer music based on damage levels. Though, as expected, there was some loss in the high frequency range.
She drew a little spiral image for me and explained, “The way your inner ear is shaped is like a little snail. The cochlea has hair cells on the outside that are more exposed—those are the high frequency hair cells [that operate as receptors], so they tend to get damaged first. The low frequency hair cells are more protected on the inside of the cochlea, so most people who have had noise exposure have hearing loss in the high frequencies first.” Humans aren’t able to regenerate those hair cells, which is why this leads to permanent damage. However, there has been some promising gene therapy research in the area. Visualizing my hearing as a delicate little snail that I was protecting encouraged me to actually remember to wear ear plugs.
Dr. Gallant explained that when people say, “I hear you but I don’t understand you,” it’s often because of high frequency hair cell damage, which specifically affects sharpness and speech clarity. “You want to protect your hearing as much as you can, because, for the most part, once you lose it, it’s just gone.”
She spoke about how there are noise-level-monitoring apps available for your phone that are worth installing (such as Decibel X and NIOSH) to find out how much you’re actually exposing yourself to high volumes, because “anything over 85 decibels can do damage over time.”
When I asked what an example of that many decibels would be, she said, “Almost anything. Especially in New Orleans, with all the fun we have, it can get kinda noisy. If you’re used to it, 85 decibels doesn’t seem that loud. It doesn’t have to be a hard rock concert, it can be a bar or a parade, or, obviously, a Saints game. So you want to be aware and use protection as often as you can, ‘cause it can creep up on you.”
I splurged and ordered custom earplugs that day, so that I would have the ability to hear myself and stay on pitch well enough to sing while blocking out harmful venue sounds. But if you’re only interested in gathering information from the hearing test, there’s no requirement to purchase anything from Audibel. If you do get fitted for customs, the process involves cold, slimy medical-grade silicone being pressed into your ears to make a custom impression. It only takes about three minutes to dry, but feels like your inner ear snail is being introduced to a friend. Once the molds are made, you pick your attenuation level: The lowest option, 10 decibels, is more for socializing, to bring the volume down a little bit; the highest it goes up to is 33 decibels, which is more for loud impact noise—you’d want to get those if you were, say, a heavy metal drummer. The filters are interchangeable in the ear molds, so you can sub out different levels, depending on whether you’re performing or hanging out.
I asked Dr. Gallant what I could use to protect myself if I forgot my custom ear plugs at home and she said, “You can’t stick napkins in your ears and expect any help there, but you can go to a drugstore and get some non-custom little foam earplugs and those work pretty well when they’re inserted correctly. You really have to roll them down ‘til they’re pretty tiny and put them completely in, to where the end of the plug is flush with the opening of your ear canal—that’s the only way they really work. When you see them hanging out of someone’s ear, they’re not doing them a lick of good. You have to put them in so far that it feels wrong.”
I asked her to, very simply, explain how the mechanics of hearing works. She asked if I wanted the child version, which I absolutely did, so I got, “The way we hear is: Sound waves come into our ear canal. Those sound waves hit your eardrum. The eardrum vibrates much like a regular drum, and that vibration sets into motion the three smallest bones in your body that are called the ossicles [malleus, incus, and stapes]. The ossicles articulate in response to the vibration of your ear drums and that puts into motion all of the little hair cells in your cochlea. Different frequencies are activated, and then that sound goes up your auditory nerve. Each ear has an auditory nerve that leads up to the auditory system in your brain, where sound is processed. So it all starts out straightforward and mechanical and then becomes a little more intricate.”
I wondered if hearing loss could create headaches and confusion. She said “no” to headaches, “yes” to confusion, and that one of the biggest issues about hearing loss is that it affects cognition as we age. If you leave hearing loss untreated or don’t wear hearing aids or protection once loss has occurred, the auditory system in your brain won’t be properly stimulated, leading to rapid cognitive decline.
Dr. Gallant was diagnosed with hearing loss at a very young age, which was what piqued her interest in audiology. Hearing aids have allowed her to amplify and preserve her own aural perception, so she is a huge proponent of early detection and treatment.
I admitted to her that I had been scared to get my ears tested, assuming the damage was worse than what we discovered, but she explained that, “Everyone perceives sound differently… So someone might have completely normal hearing thresholds but really struggle to hear in noisy environments, and that could be a sign of an auditory processing problem, which isn’t mechanical.” I fit into that category, of someone who struggles to differentiate sounds but not because of actual damage. She said there aren’t a huge amount of resources for that kind of issue but that you can learn to compensate or just give yourself some grace. There are a few training videos online categorized as “LACE” (Listening and Communication Enhancement) and some home remedies like practicing music-based close listening.
My final question was about tinnitus, the strange ringing that can occur inside of your ears and is one of the only known sensations of sound that originates internally, inside of your own auditory system, instead of externally, from your environment.
“There are different theories as to what causes it but it still kind of remains a mystery,” she answered. “The most common links are noise exposure and hearing loss but changes in diet, stress, and anxiety can ramp it up too.”
I’ve had the occasional privilege of experiencing tinnitus, usually during a really severe sinus infection when my ears were blocked. Dr. Gallant said that made sense, because our brain creates the internal sound when it misses the stimulation of processing external sound, but then she assured me that while “it can be frustrating, because you can’t switch it off, it’s not actually harmful, it’s just a wild phenomenon in our auditory system.”
I didn’t necessarily intend to go down this journey, this (ear) canal of knowledge, but I’m grateful to have a better understanding of how the mechanisms work, how to minimize pain, and maximize comprehension. Below are a few options of affordable places to test your hearing, if you’d like to learn more. Happy Hearing!
AUDIOLOGY RESOURCES
Audibel Hearing Healthcare
audibelhearingneworleans.com
Audiology Program at Ochsner
ochsner.org/services/audiology
LCMC Health Neuroscience Institute
lcmchealth.org/our-services/neuroscience-institute-at-lcmc-health
LSU Health Audiology Clinic
alliedhealth.lsuhsc.edu/clinics/audiologyclinic.aspx
New Orleans Speech and Hearing Center
noshc.org/our-services/audiology
Illustrations by Kate Lacour
