One veteran speaks out about his struggle with the most common service-connected disability, hearing loss
The word “disability” conjures different images in the mind, but by far the most prevalent service-connected disability among veterans isn’t even visible to the naked eye. In 2017, more than 1.7 million veterans received compensation from the Department of Veterans Affairs for tinnitus, and more than 1.1 million veterans received compensation for hearing loss—representing the top 2 service-connected disabilities among veterans.
“It is a significant problem in the veteran community, and one that flies a little too far under the radar,” said National Service Director Jim Marszalek. “It can have such a far-reaching and devastating impact on someone’s quality of life.”
And indeed, for individuals like DAV life member Dr. Bruce Douglas, the impact of suffering from hearing loss can oftentimes be crippling in their daily lives.
“Unfortunately, my experiences in the Navy caused an acoustic traumatic event that eventually led to my hearing disability,” said Douglas, a World War II and Korean War veteran. “Because of my hearing situation, there were some aspects of life that I had to adjust. I started to stare at people when they talked to me, as I was subconsciously learning to read lips. Lord knows how many times in my life that my hearing impairment affected my relationships with the outside world.”
According to Dr. Rachel McArdle, national director of audiology and speech pathology for the VA, the most common type of hearing loss among veterans is high-frequency sensorineural hearing loss—generally caused by noise exposure, age or both—which results in difficulty distinguishing sounds or understanding speech. And, she says, it’s critical when veterans believe they are experiencing hearing loss or tinnitus to get a proper assessment and the right care for their problems.
“When hearing loss is untreated, psychological effects can include low self-confidence, frustration, embarrassment and depression,” said McArdle. “Adults with hearing loss have difficulty participating fully in conversations at work, at home and may withdraw from social situations.”
Military occupations, from flight lines to firearms, put veterans at particular risk. Because this disability can be particularly damaging to a sufferer’s career, it can exacerbate other problems that affect nearly every aspect of daily living and basic human interaction, which is why getting the proper care and treatment is so vital.
The most common treatments for high-frequency sensorineural hearing loss are hearing aids—which provide amplification mainly in the frequency region where the user has a hearing loss—and cochlear implants.
In 2018, the VA issued 786,741 hearing aids to veterans, but it is the cochlear implant that helped Douglas the most.
“Cochlear implant devices have two primary parts: the internal implant and the external sound processor,” said Nancy Cambron, chair of the Veterans Health Administration’s Cochlear Implant Advisory Board. “The implant is placed in the ear by a surgeon who specializes in ear surgery. Surgery is typically an outpatient procedure done under general anesthesia and lasts two to three hours. Patients are given two to four weeks to heal, during which time they will not hear anything from the implant. After the site has healed, they return to an audiologist who programs the external sound processor.”
Most sound processors look like a behind-the-ear hearing aid with a cable attached to a coil and magnet. Sound enters the microphones where it is processed and converted to electrical pulses, which are then transmitted to the internal implant via the coil that attaches to the head by a magnet. The electrical pulses stimulate the hearing nerve, the signal travels to the brain, and the patient can hear.
“Cochlear implants can greatly improve hearing for people who have hearing losses ranging from moderate to profound, poor ability to understand speech, and who obtain limited benefit from hearing aids,” said Cambron. “It may take three to 12 months for a new implant user to obtain maximum benefit from a cochlear implant. It is critical that implant recipients use the sound processor consistently to allow their brains to become accustomed to the new sounds.”
Douglas, who got his first set of hearing aids in 1980, thought he may have missed his opportunity to try cochlear implants.
“I found my way to a VA hospital’s audiology department, where I started to get appropriate care,” said Douglas. “At the time, I thought my hearing aids were working relatively well. I knew about cochlear implants but was convinced that, at age 90, it was too late for me. I cannot even begin to express my appreciation to the two audiologists at the VA hospital for their support in encouraging me to have cochlear implant surgery on my almost-deaf right ear.”
Douglas said that the VA remained by his side while his brain worked overtime to teach his right and left ears to “talk” to each other, enabling him to remain active in his academic and professional life.
“I returned to the real world of hearing,” said Douglas. “My hearing aid and cochlear implant are working amazingly well together, but it was the implant that introduced me to a world of sound that I could not have known existed if I had not had the implant surgery done. I strongly encourage any and all veterans who are suffering from hearing loss to take it seriously and seek an appointment with their local VA audiologists.”
With his hearing improving, Douglas has been able to stay active and continue his career as a professor of health and aging at the University of Illinois at Chicago School of Public Health.
“Assuming that the future will bring more miracles, I am hoping that most of them happen before the year 2025, when I reach my 100th birthday,” Douglas said with a laugh.
The VA offers comprehensive care services to veterans with hearing loss, tinnitus or both. Veterans experiencing hearing loss or tinnitus should contact their local VA audiology department for assistance in obtaining a comprehensive audiology evaluation.