War is hell — on your hearing - Marine Corps News | News from Afghanistan & Iraq - Marine Corps Times

War is hell — on your hearing

Army Capt. Mark Brogan lay motionless, bleeding out of both ears, one arm nearly torn from his body. An Iraqi suicide bomber, dashing from behind a corner, had just detonated next to him.

Four years later, Brogan’s still trying to recover.

Doctors had to open his skull to insert an acrylic plate, and most of his tricep is gone, but after many long months of hard work, he has relearned how to walk, talk and live.

Yet, of all his injuries, he told a recent gathering in Washington, his hearing loss remains among his most troubling problems.

“I knew that I couldn’t hear well, but we had no idea just how bad it was,” he said.

He’s not alone. Defective hearing and tinnitus are the most common service-connected conditions diagnosed among veterans, according to Veterans Affairs Department data examined by the Institute of Medicine.

Some 50,000 veterans from Iraq and Afghanistan have reported hearing loss. For many, the damage is permanent — and not just from incidents like Brogan’s.

Long doses of anything louder than 85 decibels, say a lawn mower or a hair dryer, can do damage. A single burst of anything tipping 140 decibels — a jet engine, for example — can be just as bad, according to the ear specialists as the Rochester Institute of Technology. Reality check: A rifle produces 160 decibels of sound.

Once damage occurs, it can be for life. For many, the only option is to turn up the volume with hearing aids.

That’s the only thing that has made a difference for Brogan.

“The difference between having them and not having them in my ears was amazing,” he said. “I had taken my hearing for granted before this. I had excellent hearing. I was a musician, and it just was incredible to realize that wow, you know, not hearing is such a challenge.”

But there is hope. Researchers and doctors are working on breakthrough technologies such as cognitive therapy, implants and even regenerating cells from within a bird’s ear.

It could happen to you

More than 58,000 people have reported ringing in their ears after returning from deployment to Iraq or Afghanistan, and VA says hearing loss will affect 800,000 veterans by 2011.

Modern hearing protection clearly makes a difference.

There’s less hearing loss now due to flight-deck or generator noise compared with 40 years ago, when service members didn’t wear any hearing protection.

The ubiquitous improvised explosive devices troops face in Iraq and Afghanistan create a whole new scenario. Rather than losing their hearing purely to noise, service members also may suffer brain injuries that damage the way they hear and process sound.

Often, the eardrums rupture from a loud noise — a tympanic membrane perforation. Symptoms include pain and bleeding from the ears. That type of hearing loss may repair itself, though troops should still see a doctor.

Diagnosis and treatment

Sometimes it’s nearly impossible to determine what kind of a hearing injury a person has. In fact, people often don’t realize they have hearing loss until their eyesight starts to go — those extra visual clues made up for the hearing loss — or they begin to miss the high-pitched sounds of a child.

Fortunately, the treatment won’t cause more damage: Try a hearing aid. If that doesn’t work, try cognitive therapy.

If the brain can process sound — and parts of the ear just aren’t working — then doctors prescribe hearing aids or cochlear implants. If it’s a processing issue, they use forms of cognitive therapy, including work on memory.

Kenneth Grant, a senior research audiologist at the Army Auditory-Visual Speech Recognition Laboratory at Walter Reed Army Medical Center, said hearing aids have proven effective for people of all ages.

One solution

“Communication is one of the most prevalently human things that we do,” Grant said. “Every part of your life is challenged if you can’t communicate.”

And that’s a big part of the problem: Ear protection often means lessening the ability to hear.

“For the big explosions, if [troops are] wearing their protection, there’s a lot of help in that,” Grant said. “The problem is, if you’re really protecting [your] hearing, you can’t hear. If you can’t hear, you can’t do your job, and you could put yourself in more serious danger.”

To combat the problem, the military recently has developed a “combat arms earplug.” If you insert the yellow end of the plug into your ear, you should still be able to hear between firings and have normal-voiced conversations. That’s for weapons or explosions. If you insert the olive drab end into the ear canal, it protects from other kinds of noise, such as aircraft, generators or watercraft.

George Gates, medical director of the Deafness Research Foundation, said that though the military does a good job teaching troops about hearing loss, it’s often not the priority when they’re outside the wire.

“When you’re in battle, hearing loss is not on your list,” Gates said.

A possible cure

Compounding the problem, researchers say, is that continued exposure to noise can worsen the hearing loss that occurred while you were in the military.

When a person experiences hearing loss or tinnitus in the field, audiologists say he should be removed from high-noise environments and given two to three weeks to recover — not only for his own safety, but for his teammates’.

Gates believes a cure is not far away. He said he has worked with the military’s Center of Excellence for Hearing in San Antonio about the possibility of hearing regeneration, but that possibility comes with a huge price tag.

If birds or fish lose their hearing — say if something knocks out their inner ears — those cells grow back within about 30 days. Researchers discovered these regenerative abilities in 1987 and have been working on applying them to humans ever since. They have already grown the cells in mammal ears in laboratories.

“We believe we can figure this out,” Gates said. “If birds can do it, why can’t people?”

Who knew birds had ears?

Gates said if researchers continue with current funding, it could take 25 to 50 years to figure out how to regrow cells to recover lost hearing. With a grant of $50 million, he believes it could happen much faster.

“I’m old and impatient,” Gates said. “And DoD is very interested.”

Right now, there is no cure for tinnitus, though there are cognitive treatments that can help a person deal with it.

He added that the new hearing aids and devices are “really slick.”

“The cochlear implants help when a hearing aid won’t,” Gates said. “It allows sound to reach your brain.”

Related reading

• Check, protect, adjust your hearing