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My WRS tanked. Why?

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I have conductive loss and had a stapedectomy about 30 years ago in one ear, and have left the other ear untreated. Over the years, I’ve always had excellent word discrimination scores, like routinely 100% in both ears. Three years ago, it was 96 (70db) in the right ear and 92 (103db) in the left.

I got a Costco hearing test the other day, and the hearing loss was about the same as my last one. However, my was 92 (65db) for my right ear (which is fine), but 72 (100db) for my left (untreated) ear. And when taking the test I could tell I was struggling.

I’ve heard all these warnings about how we need to wear our hearing aids regularly or our brain will “forget” how to hear. Could this WRS decline be a result of that? Ever since I first started using them, I’ve almost never worn them at home, but before Covid, that still meant I was wearing them at least every other day–I’d always use them when socializing, for example.

But with Covid, I went months without wearing them. And even now, the only time I wear them is when I go to the movies, or sometimes I wear them when I go to yoga and want to hear what the instructor is saying, or when I infrequently get together with friends. Basically, I use them only on an as-needed basis.

I do okay when using my hearing aids, and don’t have to adjust to them, like when you first get them and everything seems too loud. So I assumed that I wasn’t being affected by not wearing them, but this WRS has me wondering.

However, it was a fairly fraught hearing test. I think the girl wasn’t very experienced, and it’s been my impression that people at Costco don’t necessarily have experience with serious hearing loss (although I’ve had two VERY proficient Costo audiologists, so I know it’s a crapshoot). During the test, she had trouble getting the inserts in, she couldn’t get the bone conduction thingy to sit right and said she’d hurry before it started sliding again, and it took a LONG time for things to happen when she’d do something like say, “I’m going to play some wind noise.” It just didn’t seem very polished, which makes me question the technique.

Also, at one point she played a tone so loud that I literally jumped and said, “Oh god!” I have never had that happen in 35 years of hearing tests. And five or six other times, it was loud enough that I winced and said “Ow” or the like. Which makes me wonder if she was doing that part of the test correctly, whatever that means.

Plus, she talked very softly, which also points to inexperience, to me. FWIW, she was a hearing aid specialist and not an audiologist.

So I guess I’m asking if a decreased WRS is a symptom of the warnings about not using hearing aids regularly. And whether it is or not, what other symptoms are there? I’ve never really understood what they’re talking about.

I’m also wondering if the WRS part of the test can be poorly administered, resulting in a bogus result.

7 people in this conversation8 min readJump to latest

Uh oh. I have only the most rudimentary knowledge of how to read . What are these numbers called on the audiogram?

It may be the tester than tanked, not your . Get a retest from someone who knows how to do it. I’ve had some amazingly different , from totally unexpected drop of all low frequencies to amazing gain of highs. And the WRS varies. A failing connecter to the ear can wreck things.

You may want to be cautions about your conclusion. If it does turn out to be right, and you have concerns, check it out. Good luck getting the answers you seek.

If I’m understanding correctly your score in the left ear dropped from 92% to 72% and the presentation level dropped slightly from 103db to 100db. My understanding is that is not a dramatic change, but in the expected direction for an ear that is not wearing a hearing aid. Why aren’t you wearing a hearing aid in that ear? I’m not an audiologist, but I don’t think those test results are terribly significant. However I do think wearing hearing aids in both ears would be a good idea.

Ah, look at that, the presentation levels were included in the original post and my eyes just didn’t see them. I agree with MDB. I doubt the presentation level went from 103 to 100, rather it was likely 105 to 100. That’s a reasonably big difference in audibility for the left ear. is indeed variable, and unless you’re testing at 105 again you can’t really compare. Probably not a significant change.

In reply to @MDB

@MDB said:

However I do think wearing hearing aids in both ears would be a good idea.

I do wear hearing aids in both ears. I just don’t wear them all the time, like when sitting around at home.

And that was my secondary question, if my lowered could be an anomaly of testing and even if it’s correct, it isn’t that bad: Why are we told that it’s so important to wear our hearing aids all the time, and not just when we want to hear something, like going to a lecture? I’ve heard that the hearing sections of our brain will atrophy, but how does that present itself?

The only reason I had the test done was to see if I’d screwed myself by almost never wearing my hearing aids for the last two years, and even now wearing them for only a few hours a week. I wondered if I’d killed those portions of my brain.

But my is staying consistent, and my WRS went down but not that far, according to the comments here. It looks to me like I’m not suffering ill effects of not wearing them. Or is there some other measure of the hearing sections of my brain atrophying?

Or is the advice really for new users, which I haven’t been in decades.

@dove said:

I’ve heard all these warnings about how we need to wear our hearing aids regularly or our brain will “forget” how to hear. Could this WRS decline be a result of that?

YES. In fact, I had a pair of aids a few years ago, and unbeknownst to me, the speaker was dying in ONE of them. So I somehow limped along for months not knowing to attend to it! Got back in for my and that ear had dropped from 80+% down to mid-50s% in just about half a year. So I’m a firm believer that you have to wear FULLY-FUNCTIONING aids like every waking minute to keep your brain engaged and processing sounds: music, speech, ambient noise, etc. Don’t use it? You’ll DEAF-initely LOSE it.

You mentioned that the audi spoke softly during the word read-out? Well that ain’t supposed to be! They are supposed to either speak or play recorded words and ask, “Is that a COMFORTABLE level to hear?” before doing the test.

Edited

In reply to @dove

@dove said:

I wondered if I’d killed those portions of my brain.

It’s not really killing a portion of your brain. When the areas aren’t in use, other brain functions start to move in a take over and the auditory areas of your brain are re-purposed for other things. Then when you go back to stimulating the auditory cortex with sound, the normal organization is off (because it’s all connected up to other things) and while it recovers a bit over time there is evidence to suggest that it doesn’t return to normal. Assuming we work like cats. You’re right that the outcome is expected to be reduced speech clarity, speech in noise processing, or other more complex functions rather than a change in thresholds. I don’t think we have great evidence on how quickly those changes occur in humans, although it can be pretty quick in experimental animals.

There is evidence that in the visual system that you can maintain normal cortical organization in binocular areas with just 2 hours of normal visual exposure compared to 8 hours of monocular deprivation. That is, the brain “prefers” normal input and so a little bit of normal input protects against longer exposures to abnormal input. I haven’t seem similar work in the auditory system yet, but generally I think of the auditory system as a bit more flexible than the visual system so I would make a guess that it might need a higher ratio of normal exposure. But still, I would expect a big difference between not wearing the hearing aid at all and wearing it at least a few hours a day.

On the other end of things, hearing aid wear time is very strongly associated with better speech and language development in pediatric patients and one of our strongest messages to parents is that kids need to wear their hearing as as much as they possibly can.

While I can’t think of any wear time experiments in adults off hand (not to say that there aren’t any, I should perhaps have a look), if we’re talking about clinical experience rather than research I think clinicians would agree pretty unanimously that their patients who wear their hearing aids consistently are more successful, and certainly that people who wait longer before getting hearing aids struggle more. I’ve seen similar situations to what Bluejay mentions above, in which for some reason one hearing aid wasn’t worn for an extended period of time or was malfunctioning, and there appears to be a decline in the unaided ear which can sometimes be quite dramatic. Maybe six months to a couple of years? It’s variable, and the tests we are using are pretty gross level. I would expect that often the patients themselves might be more sensitive to changes in function. On the other hand, people will sometimes come in totally unaware that one hearing aid is broken, so maybe sensitivity to changes in auditory function varies a lot between individuals as well.

In reply to @1Bluejay

@1Bluejay said:

You mentioned that the audi spoke softly during the word read-out? Well that ain’t supposed to be! They are supposed to either speak or play recorded words and ask, “Is that a COMFORTABLE level to hear?” before doing the test.

Sorry, I guess I wasn’t clear. She spoke softly when just talking to me in conversation. She played recorded words for the test.

They tell you to wear your hearing aids all the time so that the brain can adjust. Many people have commented that after wearing their aids on a regular basis and then take them out it seems that their hearing is worse without the aids then they originally remember. That’s because the brain has adjusted to the to the additional input it gets from the aids. When you don’t wear your aids regularly you are not giving the aids a chance and you’re not allowing the brain to adapt. Wear your aids. It’s why most places give you a trial period. Most people don’t walk out wither new aids and that’s the end of the story. And I find most audiologist offices are the worst place to try a new pair of aids

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