5 days ago
I didn't realise how bad my hearing was until I had my ear wax removed
There's a crackling, like someone tuning an old radio, then a violent pop as if a champagne cork exploded near my head. And all of a sudden I can hear. The hum of the air conditioning, a shout from the street outside, distant traffic; the world which had been a dull and distant fog to me comes rushing in.
The process of restoring my hearing has taken a while. Three weeks ago, the Telegraph Health editor asked if I'd be willing to be videoed getting my ears cleaned out.
'What?' I responded, wondering why my editor might want a video of beer-weaned trout.
When I told my partner about this assignment, he was delighted, reeling off all the times I'd accused him of mumbling when, he claimed, his volume was normal. 'I'm sure it's not that bad,' I demurred. Later, as we ate our blackened dinner – I hadn't heard the oven timer going off – I conceded that he may have a point.
In 2019, earwax removal services, formerly free to access at GPs practices, were removed from the roster of 'core services' GPs were obliged to provide. Six years later, the Royal National Institute for Deaf People (RNID) says it's a postcode lottery as to whether those who need the treatment can get it.
According to the RNID, 2.3 million Britons suffer with excess wax requiring professional removal every year, leaving many people vulnerable to reduced hearing.
Just as in my case, hearing loss is often detected by family or friends rather than the person experiencing it, says Mitan Katelia, the pharmacist who first checked my ears. 'Our busiest time for hearing checks is after Christmas,' he explains. 'It becomes evident which forces people to act.'
It's partly down to the stigma around hearing, thinks Dr Krishan Ramdoo, a former ENT surgeon who founded TympaHealth, the UK's largest provider of hearing assessment technology. 'If you woke up and you couldn't see, you would seek medical attention,' he says. 'But when people experience hearing loss, they muddle on and find ways to get around it.'
That's me. I've always had intermittent hearing loss. If I ever go swimming, I'll be near-deaf in at least one ear for a week or so. Similarly if I get a cold I sometimes wake up with a blocked ear for a few days. It's annoying but I remind myself to say 'I beg your pardon?' instead of 'what?', and hope it'll sort itself out.
This is not the course of action recommended by Dr Ramdoo.
'Hearing is hugely important to our health. Hearing loss is the single biggest modifiable risk factor in the prevention of dementia,' he tells me. 'When you lose your hearing you automatically feel disengaged with your environment so it leads to social isolation. If you have untreated hearing loss you're also three times more likely to have a fall.'
I've seen all of these issues personally. My grandmother refused hearing aids and soon began complaining that she couldn't follow conversations. She became reclusive and, after a fall landed her in hospital, she was diagnosed with dementia.
But I'm 31, not 81, surely this shouldn't matter so much to me? 'Maybe not yet, but the World Health Organisation thinks that by 2030 hearing loss will overtake diabetes and cataracts in the top 10 burdens on global health,' says Dr Ramdoo. 'We're wearing headphones all the time, going to loud concerts, sitting beside busy roads – our ears didn't evolve to cope with these constant micro-traumas.'
Soon Katelia had his camera and suction tube in my ear. 'Hmm,' he said. 'You have a lot of wax in there.'
'What?' I replied.
'A lot of wax!' he bellowed.
My other ear was the same. Katelia showed me the videos he had taken (click to watch below). In each of my ear canals sat a hard ball of wax, both so old that they'd had lost their golden hue and morphed into a pair of pitch black clumps.
Part of the problem is that I have the tightest ear canals Katelia has ever seen among the thousands of patients he has worked on (I'm slightly proud of this superlative.)
I was dispatched with a bottle of olive oil and told to put a few drops into my dainty little ears every morning and night to help soften the wax.
Given that cotton buds are strictly forbidden (they just push the wax further back into the ear and can damage the ear drum which can lead to permanent deafness) olive oil is usually the first port of call for home remedies. For most people it'll soften the wax enough for it to come out on its own.
A week later I was back in his clinic; 'a lot has come out,' Katelia advised. But the black clumps were still firmly in post, if a little frayed around the edges. I was sent away again, this time with the next step up from olive oil: sodium bicarbonate drops to soften the lumps. I left thinking about a scene from Dreamworks's 2001 film Shrek where the ogre extracts a glob of wax from his ear so big he can make a candle from it.
The following week I was visited by Katelia's colleague, the Pearl Pharmacy Group's brightest talent when it comes to removing earwax.
After a quick inspection, we were off again: the microsuction machine at full whack. My pharmacist glaring into my ear with intense concentration, sweat beading across her brow. The machine was emitting a high pitched whine.
'Keep going,' I demanded. 'I can feel it moving.'
'I'm giving it all she's got, Captain!' the pharmacist snapped back.
For one brief, golden moment, it felt like she'd got it – my hearing suddenly clicked into high-definition. I could hear like never before. But then the microsuction hose retracted and it was blocked again. The pharmacist was able to open up a small hole between my ear drum and the canal, but the wax soon slipped back. It shifted, but remained unextractable.
'I really believe I can do it,' the pharmacist said with determination. 'I don't want to use too much force because your ear canals are so tight I can't see around the wax. For all I know it's adhered to your ear drum. If I turn the suction up too much it could rip a hole in it.'
When I returned in three days time it was the same story: a glimmer of success, but no cigar.
With nothing more to be done, I'm referred upwards. Dr Ramdoo's friend, a fellow ENT specialist, Joseph Manjaly sees me at his private clinic. When I arrive he's already seen my file and the videos that the pharmacy had sent.
'Are my ear canals the tightest you've seen?' I demand.
'Definitely in the top 10, I'd say,' Manjaly says. I am mollified. 'But it's not the worst case I've ever dealt with.'
The end being in sight now, I wonder how big a difference to my hearing I should expect. One thing I find most annoying is that when I'm in a noisy environment – a busy restaurant for instance – my ears tend to lock onto whatever the loudest sound is (invariably an American having a personal conversation) and then tune out everything else.
'That happens because your hearing isn't great and your brain gets worn out by trying to sort through all the different sounds, so it just fixates on whatever is easiest for it to hear,' Manjaly explains. 'Once the wax is out that shouldn't be a problem any more.'
Then we're away, there's the crackling as the last of the olive oil gets slurped out and then the pop of the wax plug springing forth. The globules of black grime aren't as big as I expected – each is about the size of my little fingertip – but are satisfyingly disgusting.
After he's finished, Manjaly gives me a hearing test. The results? 'Perfectly average.'
Since my ears have been cleaned, I no longer have to lean in close to hear someone in a crowded room, I can hear approaching cars, I've never missed the oven timer. The world suddenly feels crisp and defined; it's the equivalent of having spent the past few years watching a flickering old TV then upgrading to a high-definition 4K cinema screen.
What I'm surprised by is how much I'd been compensating. A few weeks ago, I'd have said my hearing was basically fine. I'm just discovering how much I couldn't hear.
For most of us, hearing gradually declines from the age of 35. Given we know how badly hearing loss affects us, it's worth a check up, isn't it? Take my experiences as proof that just because you think you can hear doesn't mean you can and if you're always complaining about your partner mumbling, maybe the problem lies in your ears.
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