SSHL

You should know what this means. It's a medical emergency that few have "heard" about....

My right ear. I know. Yuck.

Lisa Owen's was the last voice I ever heard in my right ear.

It was Tuesday, 24th October 2023. I was preparing dinner. I remember listening to Checkpoint on Radio New Zealand on my kitchen's awful fuzzy FM radio.

My family hate the sound of that radio while I am cooking, but I love it.

Radio connects me with the world. Whether in the car or doing jobs around the house, the spirit of radio constantly enriches my environment.

On this night, the news from the Middle East was depressing. As I sadly pushed the ingredients of a stir fry around the pan, l listened to Lisa Owen. I remember wondering where our planet was heading and getting internally angry that humans were so stupid.

And then it happened.

There was a sudden pop and a crackle in my right ear. Weirdly, it took me back to my childhood as the "sound" I heard reminded me of what I used to hear when the valve radio I inherited from my granddad turned off.

That's odd, I thought.

Then, over about a minute, the hearing on my right side faded until I couldn't hear anything at all.

In all probability, a tiny blockage was happening in a minuscule artery in my right cochlea. Nobody knows actually what happened, but this is probably the best guess.

Notwithstanding the cause, I felt, for the first time, the absolute pressure of silence.

I had never felt this way before. On my left side I could still hear Lisa Owen chattering away. On my right… Nothing. A vast balloon of silence. It felt like a weight pressing inwards.

People with normal hearing don't think about the actual act of hearing. We just hear. On this night, for the first time in my life, I realized that hearing is a sense and that losing a sense completely changes your life.

In less than sixty seconds, how I interacted with the world around me changed, perhaps forever.

I didn't panic. While I had never lost hearing entirely before, I imagined I just had a blocked eustachian tube. I held my nose and swallowed. Nothing happened.

This is odd, I thought again.

But me, being me, I served dinner and then Maria (my wife) and I took the dog for a walk. I still couldn't hear a thing on my right side.

"I can't hear anything on my right-hand side," I told Maria. That was my first admission that something was wrong to anyone other than myself.

Upon getting home, I called my daughter Merope, who is a doctor. Her first instinct was "it's a blocked eustachian tube". I said, despite my best efforts, nah, it's not. I can't hear anything.

One of the benefits of a medically trained child is that they know how to find out stuff about the human body that you don’t.

They also have connections with real experts. About an hour after I called her, Merope, having spoken to a colleague who works in ENT (Ear, Nose and Throat) called back and said, "Get to the doctors as soon as you can and tell them you think you have Sudden Sensorineural Hearing Loss (SSHL). This is a medical emergency, you might lose your hearing if you don’t see a doctor soon."

By this time it was late, and I didn’t fancy waiting for hours at the local ER, so I went to bed, deciding to see a Dr. in the morning. My googling of SSHL suggested as long as I saw a Dr within a few days treatment might stand a chance of working.

Early the following day, when I woke up, my world had changed. I couldn't hear on the right, and my sense of balance disappeared. It was like someone had turned off the rules of the world and I had to relearn them all over again. I felt…different and strange and wobbled en route to my ablutions.

Fuck. What the hell is wrong with me?

Maria drove me to Urgent Doctors, and I wobbled my way to the waiting room. I felt weird and unsettled. I couldn’t determine from which direction sounds were coming and felt entirely lost and a bit scared.

A lovely young doctor examined me and said, "You probably have a blocked eustachian tube". I begged to differ. I told her about the hearing loss, shared Merope’s research and suggested she check me for SSHL. Even she had to look it up! So two, relatively young but experienced doctors hadn’t come across this thing that apparently is an emergency! It must be relatively rare I thought. (Actually it’s not that rare…. SSHL affects between 5 and 27 of every 100,000 people (1) so in a city the size of Dunedin between 5 and 27 people per year will get it each year!)

Luckily, despite I’m sure having corrected many patients who had used Dr. Google to diagnose themselves, the Doctor listened to me and ran a few more tests. About ten minutes later, I was heading away with a seven-day dose of steroids and a diagnosis to fear. I had SSHL. A hearing test later that morning revealed that I had more than 100dB of hearing loss in my right ear. Put another way, I was now profoundly deaf.

An audiogram taken on 25th October showing my left vs right ear: My left ear already has some hearing loss but my right is a disaster area!

So what is SSHL, and why hadn’t I heard about it before if it is supposed to be a medical emergency?

SSHL is a condition where a person experiences rapid hearing impairment, usually within 72 hours. SSHL generally affects one ear and can be accompanied by a sensation of fullness or ringing in the affected ear.

While the cause of SSHL is not known in many cases, it may be triggered by viral infections, autoimmune disorders, inner ear disorders, or vascular compromise. What is really important to know is that early medical attention is essential if you experience SSHL, as it may increase the chances of recovery.

Treatment options may include corticosteroids, antiviral medications, or other therapeutic interventions tailored to individual circumstances. It is imperative to seek immediate medical evaluation upon noticing sudden hearing loss symptoms for the best possible outcome. However, searching the literature it is quite clear that nobody quite knows how the treatment works, or whether the actual treatment is better than waiting for things to get better naturally. (2)

In my case, treatment included ten days of a high dose of steroids, followed by two steroid injections directly into the ear. By the way, in passing I note that having an injection in the ear is not nice. Particularly when the Doctor doing the injection tells you “Don’t swallow for the next twenty minutes”. I dare you to try not to swallow immediately when someone tells you not to swallow!

Unfortunately for me, the treatment didn’t really do much good, my hearing loss “improved” from profound to severe. My right ear was still unable to understand voices and, with my other ear suffering from age related hearing loss, unless I want to fund a $20,000 cochlear implant, I am going to need hearing aids for the rest of my life.

As for hopes of some new “miracle” cure, it seems the best hope, like for most medical problems these days might be stem cell treatment. (3)

By the way. HEARING AIDS ARE BLOODY EXPENSIVE… (that’s another story)

So, in conclusion, my world has changed. Despite nearly six months having passed since my SSHL event, I still find each day difficult. Parts of the Museum where I work (like the atrium and the cafe) have become awful hostile places, which I seek to avoid as much as possible. The cachophony of sound from every direction and no direction makes me want to leave them as soon as I can. Frankly architechts who design common spaces need to speak to those who can partially hear before unleashing these sound horrors on us!

On top of all that, I have lost some things I love. More than anything, I have concluded that monoaural music isn’t great. As a result, my daily commute to work is less cheerful and much less tuneful. Frankly, for a while after losing my hearing on one side I found myself in a bit of a funk.

And then, at about noon on 1st December 2023, my iPhone pinged an unexpectedly upbeat beep to my newfangled and very expensive hearing aid. A geomagnetic storm was forecast. I decided I needed cheering up, so I packed the car with cameras and, as the sun sank in the southwestern sky, headed up to Sandfly Bay on a cold, windy night.

For the next 8 hours I experienced a wondrous display of the aurora australis. I yelped and cheered in delight. The sky was aflame with stunningly bright auroral beams. I even saw an incredibly rare auroral corona, a breathtaking display of nature’s beauty. Auroral coronas are the convergence of the auroral rays overhead, creating a crown-like shape. They are only seen during the most powerful auroras.

Driving home after an epic night of Aurora chasing, my trusty iPhone playlist kicked in on my car stereo. I smiled for the first time in a month as Aurora Corona by the Chills filled my car with splendid sounds. Thank you, Mother Nature, for the aurora, and thank you, Martin Phillipps, for restoring my love for music—albeit now in mono!

References

1. Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013;34:1586‐1589. [PubMed] [Google Scholar]

2. https://www.nidcd.nih.gov/health/sudden-deafness

3. Coleman B, de Silva MG, Shepherd RK (2007) Concise review: the potential of stem cells for auditory neuron generation and replacement. Stem Cells 25:2685–94