Dr. Beck: Good Morning General. Meeting you is an honor and a privilege. I thank you for taking the time out of your busy schedule to meet with me. You must hear this all the time, but you have clearly shown that one person with conviction can make an enormous difference. I am grateful for your bravery, your leadership and your service to our nation.
Schwarzkopf: Thank you Dr. Beck. Its my pleasure. Nice to meet you too.
Dr. Beck: General, I believe you know that for 28 million Americans, hearing loss is a reality. Hearing loss impacts quality of life, communication abilities, and in many respects impacts physical health too. Therefore, the fact that you, an American hero, are exploring and managing your hearing loss, is certainly going to be inspirational to many people. Would you please tell us a little about your hearing loss, and perhaps how that came about?
Schwarzkopf: Sure. Years ago in the military, we didnt really think much about hearing loss. When we went out to the rifle range we didnt use, and in fact, didnt even have ear plugs. You just went out and practiced and you listened to a lot of explosions and loud weapons. You just gritted your teeth and fired. Not so great for your ears!
Dr. Beck: Weapons certainly can be a major contributor to noise induced hearing loss. Have you had other noise exposure in your military career beyond weapons fire?
Schwarzkopf: Yes. Probably one of the noisiest things we did was way back when I was a paratrooper. I can distinctly remember when high decibel aircraft came around, such as turbojets like the C-130, that was loud! We used to hang out around the aircraft waiting for our assignments with our parachutes on while the engines were cranking at full blast. All the high decibel sounds coming out of those engines really took their toll. I can also recall a specific noise injury to my right ear while I was standing on a tank range and the tank next to me shot off a blast unexpectedly -- sounded like it was almost directly into my right ear!
Dr. Beck: Could you tell immediately that damage had been done?
Schwarzkopf: Oh absolutely, yes. I was in terrible pain, and it didnt get better very quickly. I think most of the time when an injury like that occurs, we all expect itll get better as time goes on, but it took a really long time to recuperate, and then even after the pain went away, I knew there was additional hearing loss. Of course in the military, protecting your ears can be a dilemma. In actual combat you dont have the time or the thought process to protect your ears. You do your job, and you do it quickly and unfortunately, you need to hear everything thats going on around you on the battlefield while shooting your weapon, so it really is a dilemma. Hearing the battlefield sounds versus protecting your ears, not a great choice! Anyway, I think all of these incidents combined to cause my hearing loss, and similar incidents undoubtedly contributed to the hearing loss of many of my colleagues from my generation.
Dr. Beck: General, is it OK if we speak specifically about your hearing loss?
Dr. Beck: I noticed from your audiogram that you have an asymmetric loss, meaning the two ears are not the same. I suppose the cannon fire you mentioned a moment or two ago contributed to that. Is there any other reason you are aware of that may have contributed to the asymmetry?
Schwarzkopf: I am left handed, and I shoot left-handed, and that means the right ear gets more noise exposure from the barrel end of the weapon. So between the left handed shooting and the cannon explosion on the right, that probably took out lots of the hearing on the right side.
Dr. Beck: In the right ear you have what we describe as a precipitous, or ski-slope, high frequency, sensorineural hearing loss. The left ear also has a sensorineural hearing loss, but the degree of hearing loss in the left ear is not as severe as is the right.
Schwarzkopf: Yes, thats interesting to me because as weve experimented with different hearing aids, weve decided to just fit the left ear for now. Previously I thought it made more sense to fit the worse ear. But I can see that in my situation, wearing the left hearing aid by itself seems to be pretty good.
Dr. Beck: Sometimes in a situation where the two ears are different, the decision regarding which ear to fit depends on the type and degree of hearing loss. Sometimes we fit the worse ear, depending on how bad the worse ear is, sometimes we fit the best ear, but typically, both ears are fit. Again, it depends on the type and degree of hearing loss, and certainly the personal preferences of the patient, and the specifics of the situation.
Schwarzkopf: So both ears have a high frequency hearing loss?
Dr. Beck: Yes, thats correct. Your hearing in the low frequencies is quite normal, but you do have high frequency hearing loss, and that is the most common type of hearing loss. If you think of speech sounds as divided into low frequencies and high frequencies, the low frequencies contain most of the vowel sounds, and the vowel sounds are the loudest, but they carry the least information. The high frequency sounds are the consonant sounds, and they are the quietest sounds. Some 85 to 90 percent of the intelligibility, or the clarity of speech -- comes from the high frequencies. So with high frequency hearing loss, you know people are speaking, but its tough to tell exactly what theyre saying because the high frequency sounds are the ones that identify the words and carry the bulk of the speech information.
For example, typical complaints of a high frequency hearing loss include everyone mumbles, or people dont speak clearly anymore. The reason patients make those statements is they cannot identify the quiet sounds of speech such as the consonants, and so to the patient, it truly seems like everyone mumbles.
For example, patients often confuse the words shoe and true because even though the vowel sound oo is the same, its the high frequencies that tell us the shh or the tr sounds, and if the patient cannot hear those sounds, the words cannot be correctly identified! This is even worse in a noisy situation. Most cocktail party noises are low frequency sounds and those sounds cover up the consonants and high frequency sounds, and then everything just sounds like noise particularly when you wear hearing aids in a noisy situation. There are noise suppression circuits that work quite well, and there are FM systems, which do an excellent job managing background noise.
Schwarzkopf: Yes. I know the technology has really become spectacular, and I am impressed by whats available.
Dr. Beck: General, when youre not wearing your hearing aid, can you tell a difference in your ears, and can you tell that the hearing aid makes a difference?
Schwarzkopf: Oh certainly. The one that really comes to mind easily and really drives home the point you were just making is that when Im sitting at the dinner table, next to a woman on my right, and she is soft-spoken to begin with, it becomes almost impossible to hear what shes saying. Also, I know that while listening to television sometimes its really hard to tell what theyre saying unless its really loud. So absolutely, the hearing loss impacts the way I manage personal and professional situations, and managing it effectively and efficiently is very important to me.
Dr. Beck: Thanks so much for your thoughts on these topics General, and thanks for sharing a little about your personal hearing issues.
Schwarzkopf: Youre welcome Dr. Beck. I hope my story is helpful for some of the readers.
Dr. Beck: Im sure it will be General. Thanks so much for participating.
Schwarzkopf: My pleasure.