For Veterans Some of the Deepest Wounds Are Invisible

Saturday, May 28, 2016

GoLocalWorcester Health Team and Beltone

Sixty percent of veterans returning home suffer from hearing loss, tinnitus, or auditory disorders – now considered the most prevalent injury among returning veterans. This is according to the Hearing Health Foundation. Historically, hearing loss was common in soldiers exposed to active fire, with weapons powered by gunpowder, but when the use of improvised explosive devices (IEDs) and other modern weapons, came into the equation, wartime service has taken an unprecedented toll on combatants’ hearing.

While we think of the maiming war injuries that veterans live with, and the stress on the healthcare system that strives to address them, we don’t often think of tinnitus and hearing loss as one of those injuries – but just ask a veteran who suffers from them. The life changing toll of the service experience that is compounded by hearing loss is very real, and constant, impacting on one’s personal life, physical and psychological wellbeing, ability to continue to serve in the military, and impacting on one’s future work.

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In 2009, the US Congress directed the establishment of the Hearing Center of Excellence, within the US Department of Defense, and partnered with the Department of Veterans Affairs (VA). The mission includes development of a data registry to track hearing loss and auditory injuries across the armed forces, hearing research, developing best practices and clinical education, and ensuring the coordination and delivery of VA rehabilitation services to veterans with hearing loss.

While in active service, the Hearing Center of Excellence, conducts a wide variety of awareness programs, designed to prevent hearing loss. Campaigns bring across messages such as “You are not fit for duty…unless your ears are” – and - “Only fear what you cannot hear” – and - “Don’t be the weak link.” These messages stress the value of ear protection as well as provide encouragement for auditory testing and treatment.

Double-edged Sword

Veterans who suffer from PTSD and/or Traumatic Brain Injury (TBI) often have these conditions combined with hearing loss, tinnitus and other auditory processing injuries such as dizziness and balance. In multi-trauma cases, hearing issues can often be overlooked by conditions which overshadow what might be the causative or contributing factor. That’s where education for clinicians and accurate diagnoses and treatment comes in.

The Battle Plan

Treatments can range from removal of packed ear wax to adjusting medications that may be causing hearing loss or ringing in the ears. Hearing aids might be the most popular treatment for those losses that are permanent. Other treatments include middle-ear implants, bone conductor implants, and cochlear implants. Adaptive equipment such as infrared systems for listening to television, personal amplifiers for closed areas such as traveling in the car, or outdoors can be used. These systems involve sound being transmitted to a personal receiver worn by the individual. There are also visual systems that provide alerts when the phone or doorbell rings.

Hearing aids and batteries, especially devices with newer technologies can be costly. Not all veterans will be eligible for all types of hearing aid assistance. According to the DOD, veterans who enroll for VA medical benefits are placed in one of several eligibility categories based on service-related disabilities, income level, and other factors. The good news is that all veterans with a service-connected disability for hearing loss or ear-related conditions (including tinnitus) are eligible for hearing aid services. Veterans usually require referral from their VA medical provider (e.g. primary care, mental health, etc.), and there are many regulations about different types of coverage. To find out more about what is covered, go to Military.com. In addition to services provided by the VA, veterans can also access private audiology and hearing aid centers. Many centers are willing to provide creative financial plans for veterans or discounts.

The VA Audiology Clinic

Through the Providence VA Medical Center, this clinic provides services aimed at improving quality of life, while also providing research, education, and advocacy. The clinic encourages family participation to aid rehabilitation. They have two centers, one on Atwells Avenue in Providence, and one in New Bedford. Audiology services can be accessed through most state VA Hospitals.

Hearing Dogs

There are several organizations that provide guide dogs and guide dog training programs to veterans with significant hearing loss, usually determined as 30% hearing loss in both ears, or who have complete hearing loss. The national Guide Dog Foundation (GuideDog.org) and America’s VET Dogs (VetDogs.org) are two resources. There are usually significant wait times in programs providing these services.

Later in Life

Veterans with mild or even no hearing loss, when they first come out of the service, may find that hearing loss will develop as time goes by. If loss is suspected, veterans should request a hearing test from an audiologist and pursue hearing rehabilitation such as hearing aids or assistive devices.

For veterans with multiple disabilities, correcting hearing issues will only help successful transition into civilian life. In addition, communities across the country will start to see an influx of newly hearing-impaired vets in public venues such as churches, movie theaters, etc. as they begin to get the hearing help they need. Hearing testing and services, may be introduced more upon physical and psychological assessments of veterans, even if problems in hearing aren’t first mentioned or apparent in the returning veteran.

For all veterans suffering hearing loss as a result of their service, it is important that they know hearing help is available to them. Its important to identify any hearing difficulties and address them. Hearing loss may not be a visible wound, but can have a large impact on communication and interaction with others. It may also be related to other medical conditions. For all of these reasons it is important that hearing loss in our veterans is not overlooked.

This story is part of an ongoing series between GoLocal and Beltone - a sponsored content series.