Deaf Free India Podcast with Dr. Shree Rao by Dr. Pal

Q: Are young people really experiencing more hearing loss than previous generations?

Absolutely yes. We are seeing a dramatic increase in hearing loss among younger patients. The myth that “hearing loss only affects elderly people” is completely false. With constant headphone use, attending loud concerts and events, working in noisy environments, and the normalization of high-volume audio, today’s youth are damaging their hearing at unprecedented rates. What used to be a condition primarily affecting seniors is now impacting people in their 20s, 30s, and 40s.

Q: What are three simple steps every Indian can take today for better hearing health?

Follow the 60-60 Rule: Keep headphone volume at 60% maximum and take breaks every 60 minutes. Invest in quality noise-cancelling headphones to avoid turning up the volume in noisy environments. Protect Your Hearing: Once hearing is lost due to noise damage, there is no medication to restore it. Prevention is the only solution. Use ear protection devices when exposed to loud environments (concerts, construction sites, etc.). Seek Early Intervention: If you or a loved one notices any hearing difficulty, don’t delay. When identified early, hearing loss is treatable. Regular hearing tests are important, especially for high-risk groups (IT workers, musicians, factory workers) and children showing signs of hearing problems.

what are the precautions like an IT

worker should do to prevent noise indued

hearing loss with headphones three

things they need to remember for sure

number one following the 6060 rule keep

the volume on your gadget on your

mobile number two creating an optimal

workp space that's very very important

which one do you prefer over thee

headphones or in thee headphones I

prefer do you see a lot of patients with

increased hearing loss these days

compared to before

many in elderly people the other big

thing is hypertension and diabetes can

lead to hearing GLS right yes sir

protection device your plugs your

Defenders they passively block and at

the same time they have this active

noise cancelling feature also in case if

you want to use them hearing loss only

affects elderly people it's a myth it

affects everybody everybody the hearing

which is gone the precious hair cells

that are gone once cannot be restore

hello guys this is Dr pal manikam

gastroenterologist focused on your gut

health welcome to another episode of gut

feeling with Dr pal in this episode

we're talking with Dr Shri she's one of

the reputed cckar implant surgeons that

are only a handful of surgeons in India

I had this opportunity of talking to her

about the most possible epidemic in

India right now which is noise induced

hearing loss noise pollution has been

going on throughout with the Advent of

newer headphones work from home culture

and a lot of you know computer meetings

and everything we being exposed to a lot

more debl than our years can handle so

she went through how we can identify

what are the treatment options available

how we can prevent it with simple simple

steps and more importantly she is such a

good soul that she works at Dr Ra

hospital at hyderbad where they are

placing implants in people who

cannot afford this and she's doing as a

wonderful cause for a part of a

non-governmental organization as well I

had a blast in this episode I'm sure you

will learn similar to how I did let's

dive deep into it so welcome Dr Shri uh

you are one of the most reputed

implant surgeon I'm so happy to have you

in my podcast um I uh really want to

drill down on this condition called

noise induced hearing loss which is I'm

going to explain that to my audience in

uh in a brief as well so since Co

everybody is on earphones

airport you name it okay and then you

know they I don't think they understand

the purpose of the zoom meet but they

will make sure that they mute the zoom

call so many people are on the earphones

and recently uh I came to know that um

you know Alka yagnik yes sir right and

then she raised a beautiful awareness

that you know uh noise induced hearing

loss of the frequent use of headphones

is one of the reasons as well um so tell

me why this is happening and tell walk

us through why frequent use of

headphones might be a

problem first things first sir noise in

used hearing loss as the name itself

suggest it's because of prolonged

exposure to noise which leads to hearing

loss this is how we tell it and why is

this exactly happening let me tell you

how actually the hearing functions our

ear is divided into three parts outer

middle and inner sound travels from the

external ear and it causes vibrations

and these

vibrations set the

eardrum we call it as Sanic membrane

cause vibrations and this vibrations are

transfer to the middle ear in the middle

ear they have some tiny bones three

bones from the middle ear because of the

vibration of the ear bones they travel

into the inner ear in the inner ear we

have a major organ called the engine the

ccka

cocka this ccka it has very tiny hair

cells and these hair cells the function

of this hair cells is to convert this

sound waves the mechanical vibrations

into electrical impulses and these

electrical impulses are sent to the

cckar nerve or the hearing nerve

auditory nerve and they are sent to the

brain and there it is perceived as

speech now what happens is noise induced

hearing cles let me let me boil it down

a little bit so that everybody can

understand so somebody is

speaking and that sound is going into

the ear or canal and then it goes inside

this CA which is the engine deep in the

ear yes sir which is the inner part of

the Year yes sir we call that as an

inner year inner okay so that sound

impulses what does this coar engine do

it converts that into an electrical imp

electrical impulses and it gets to your

brain yes sir through the nerve through

the nerve it's like a wiring through the

wiring through the wiring it is

conducted into the brain inside the

brain it is processed as peach peach so

somebody is talking to you yes yes so

then the brain interprets as a language

yes that you know or you may not yes

okay so what happens in this noise

induced hearing loss there is continuous

exposure of

sound so continuously the ear bones are

vibrating and continuously yeah ear drum

m e drum vibrating and from eardrum

vibrating the bones are also moving MH

and from there the hair cells as I told

you within the engine it's continuously

acting so they come to a stage where

they no longer work it's like using a

muzzle every day to train and all of a

sudden gives up so with this the sound

waves they are continuously triggering

the hair cells so they go into a state

of metabolic exhaustion and oxidative

stress due to prolonged exposure to

sounds causing the death of the hair

cells so hair cells are so tiny tetiny

right exactly sir and even the engine

itself is so small right yes sir what is

the size of it in general I mean if you

want to compare like a size of a like a

small button or of a golf ball extremely

tiny extremely tiny extremely tiny we

have to literally use a microscope to

see the turns of it it's in the form of

a snail snail

and then I know that there are multiple

semicircular canals yes yes within the

inner ear it has a cocka the anterior

part which is responsible for our

hearing and the posterior part has

semicircular can like the lord of rings

correct correct that is responsible for

balance so our ear is not just

responsible for hearing but also for the

balance I being a hearing restoration

surgeon my focus will be more on this

cocka the front part because the cells

once they are when they are died there

is no way that we going to get back no

how many cells will be there like

Millions sir millions of cells there

will be almost uh 3,000 to 4,000 of

inner hair cells and almost 12,000 to

13,000 of outer hair cells only these

many that's all it's like diamond

precious diamonds I see wow so everybody

is born with it yes sir everybody which

is more important inner or outer I mean

given an

option obviously the engine sir because

some people they do not have any ear at

all we call it atricia they don't have

but still they'll be able to hear

because they are hearing through the

engine so that's a very important point

atricia is few babies will not have year

at all yes when they are born they will

be born year less yes but in spite of

which they'll be able to hear correct

when the inner ear the hearing organ

develops correct there is a fascinating

thing which I can tell you because most

I think most of the Indians do know

about it in

Mahabharata abhimanu when he was in his

mother's wom subadra room he completely

overheard whatever Arjuna was narrating

about the Padma vuam to subadra even in

spite of subadra Dei she

slept in spite of which he was able to

hear inside the O and that is true

because the entire hearing organ the

cocka the engine hair cells everything

it develops within fifth month of

pregnancy it's not that after the baby

is born your hands are elongating your

legs are growing your neck is growing

it's not the size of the inner ear it

remains constant at the time of birth

till the time of death it's only the

hair cells as age progresses or because

of prolonged exposure to noise they are

dying but but they remain the same I

mean from the time of birth they remain

the same wow wow I still remember like

uh the abim menu story uh I used to tell

my uh kid when my wife was pregnant uh I

used to talk about gut health

intermittent fasting and that's why now

he is not talking to me at

all you're boring already he knows

everything he know everything but I

strongly believe that's true correct

true sir so people uh uh even as a baby

inside the

uterus they can hear what you talk

exactly that's why they recognize mom's

wise father's voice more and that's why

when they startle or cry loudly whenever

they hear to these voices which are

already familiar with them they tend to

calm down this is because they start

hearing as soon as they are in the

mother's Zoom from fifth month wow wow

you know the way that you are explaining

I could see how you are passionate about

this medicine thing I mean your your

your expertise but also at the same time

it kind of raises an alarm that we only

have 4,000

cells totally 12,000 plus 3,000 4,000

correct correct so somewhere around

177,000 cells 17,000 cells yes but the

more important thing the engine one yes

which is 3 to

4,000 so that raises an awareness where

you know we need to preserve it as much

as possible exactly so for example I'll

take it myself you know since Co I I

used to do like Zoom video consultations

for my patients in California where I

used to use my headphones yes so if I

understand right so the electronic

impulses take carry from the headphones

all the way into the O and all reach

this tiny teeny little thing at a

particular frequency correct what are

the precautions like an IT worker should

do to prevent noise induced hearing loss

with headphones for all the professional

headphone users and people who are

working remotely for all the software

engineers and as you it people three

things they need to remember for sure

number one following the 6060

rule keep the volume on your gadget on

your mobile to only 60% of the maximum

volume and limit it to only 60 minutes

and immediately after that take a break

for about 5 to 10 minutes this way we

can avoid noise and used hearing loss

number two creating an optimal workspace

that's very very important

make sure that you do not sit near a

window where there is so much of noise

or a door where there is so much of

noise and try to incorporate certain

curtains or rugs or carpets to absorb

the sound to absorb the sound creating

this optimal work space is very

important and most importantly number

three invest in a good efficient

headphones I would say active noise

cancelling

headphones and I prefer using of telling

them to use over the year rather than in

the year

headphones so which one do you prefer

over thee headphones or in thee

headphones I prefer over thee headphones

because there are very high chances when

you start using in thee headphones some

people may be having psorasis or eczema

dry skin and some of them may be having

wax and when you remove that in fact

when you start using any airpods you can

see after a couple of days wax getting

stuck there and unknowing those

microphones they get blocked so you tend

to increase the volume to compensate it

that's why we say especially I being a

surgeon after surgery they're not

supposed to use much of this one for

about 3 months and once they start using

this over the year they enjoy that I see

it snuggly fits around and the natural

way of hearing will be maintained wow so

you said 60 60 R like 60% of the maximum

volume and you listen for 60 seconds to

60 Minutes 60 Minutes 60 minutes

all right so you said 6060 rule which is

you 60% of the maximum volume up to 60

minutes and then you take a break for 5

10 minutes yes sir but how is it

practically

possible the reason is people are just

like blasting their ears with that's how

the music is as well correct exactly but

the hearing which is gone the precious

hair cells that are gone once cannot be

restored we need to remember that it's

like a precious diamond and we you're

losing at least diamonds we can buy but

this one later if you increase the

volume to more than normal also you'll

not be able to hear it's like if you

keep a louds speaker permanently in your

ear using a hearing aid rather than that

prevention is much much better wow I'm

going to be very honest with you you

know I grew up here I went to us uh for

my uh higher education um when the first

thing that I couldn't even adapt to the

US culture is the complete silence

there is no fan okay and there is no

honk car honks nothing

outside I thought I was in a haunted

house it looked very silent very silent

right so I'm there for like 15 16 years

now so now you know I'm traveling

frequently back and forth to India and

Us in India when I'm coming here the

roadside noise and in general the

utility of and other vehicles and other

things what is your take on noise

pollution here in India I can say our

country India is already in a kind of

hearing Health crisis because we are

constantly getting exposed to sounds

over 85 DB now let me put it this

way as per World Health Organization wh

the safe per permissible limits of

hearing is hearing about 85 DB of sound

until 8 hours in a day so what this 85

DBS corresponds

to the normal conversation that we have

in this silent environment will be

somewhere around 60 DB sound is measured

decb so this is 60 DB this is very

normal very good Pleasant for our ears

the sound that we are exposed in traffic

especially loud traffic between 85 to 90

and the sounds for a haird dryer which

every women uses nowadays is about 90 DB

M and the sound that corresponds to a

mixer blender every Homemaker uses it

that is also 90 DBS and the sounds with

that

we hear at concerts or loud IPL match

huh that hits over 100 DB above

100 and that amount of sound 100 or 110

the safe time of exposure for that is

only 15

minutes that's why it is not possible

for us practically to STI to stick to

this 85 DBS for about 8 hours in a

day you tend to put a blow dryer every

day correct you go for a saloon you get

your professional hair styling done you

have fruit juice every day with the help

of a blender all these are the loud

sounds so how to actually cut it down

now here comes the role of a three decb

rule so you're say so how to prevent

this hearing loss is that what you're

saying yes sir run a day in this hectic

noisy pollution areas so in the midst of

this active noise pollution what are the

steps that we can take to prevent this

loud exposure to

us here comes the 3 dbel rule what this

states that for every 3 D

increase in the intensity of sound the

safe time of exposure of sound is

hared for an 85 DB sound

the safe time of exposure limit is 8

hours and for 88 DB of sound it is only

4 hours for 91 DB it is only 2 hours and

imagine in concerts 100 DB the safe time

of exposure is only 15 minutes oh my God

so understanding this

crucial relationship between the sound

intensity and the safe time of exposure

is very important especially for people

of this generation where they are

exposed to noisy pollution every day do

you see a lot of patients with increased

hearing loss these days compared to

before many many and most of them you'll

be surprised to know are belonging to

the teenage group and young adults wow

what is the youngest age that you have

seen what is the youngest age that you

might have seen 12 years 12 years with

noise induced hearing loss wow 12 and

even they don't don't uh they don't even

have any symptoms they don't even tell

they say that I'm I'm hearing very

normally there's no problem with my

hearing the only complaint they say that

I can see something I can hear something

buzzing on and off in my ear that's all

and that ringing sound yes yes and that

to those kids they do not know that this

is not normal so their parents they just

get it for a hearing check and that is

when they come to know

how do the parents identify in that

12-year-old kid they complain some

ringing sounds ringing sounds very often

some mosquito is there inside my ear it

it is ringing um they usually complain

of some foreign body something is stuck

here it is ringing continuously see and

Parents try to look into that there'll

be nothing that is when they get okay

there should be some wax that's why we

got our child and we say no there is no

wax let us go for a hearing check and

it'll be a very classic dip in the

audiogram oh my god wow I mean the the

information that you're telling me is

like it's mind mind-blowing uh because

let's say I'm a average user I'm an

average headphones user

so easily anybody in an active work

environment you'll exposed to get 85 DBS

easily for 8 hours 84 DBS is very

minimal I mean not minimal it's a common

exposure you're talking about correct

yes sir yes sir so you're saying just me

and you talking itself around 65 70 here

this is a very quiet room 60 60 H 60 60

60 quiet room yes and uh so let's say

I'm in an active work for 8 hours and I

come back and then usually I do my in

the year airports and then go to the gym

and then

workout and the more louder it is the

better the workout is my suspicion

that's what many people do yes sir many

people just completely uh Max the

volume so then you are saying that when

you increase a decel then the time of

exposure should decrease so I have I

have also used maximal volume before

which means that I should not use this

more than like 15 20 minutes exactly sir

wow exactly in case if you are you know

if you really want to hit that dopamine

if you want to really work out that way

then you cut down the sounds that you

are hearing at the end of the day at the

end of the day we come home we chill

with our kids and they tend to increase

the volume in the TV and and we doctors

especially we think we are the safe

people I I definitely get exposed to

nearly 85

DB I very clearly know that because I

stay most of the time in the OT there'll

hedback there'll be laminar flow

there'll be suction machines correct

everything produces noise corre so I'm

literally placing myself there in that

zone over the top of it the drills that

I use it definitely corresponds to more

than 85 got it so how do we all the

professional people take care by

understanding this relationship

relationship wow so I have completely

used my safe amount of exposure there so

I have to cut down the sounds and there

will be some few unavoidable

circumstances as well where you know for

example there's a Temple function

outside and there's a huge loudspeaker

and the second example is you know

during

diali um and I'm I'm proud that actually

Tamil NAD government has imposed a ban

that you should not have firecrackers

after 700 p.m. I guess yes sir yes sir

does same in your state as well no sir

it's not uh way don't worry about it's

only impos but nobody is

practicing but all those firecrackers

that will be easily 100 Deb correct m

more than 100 110

120 but all these are unavoidable

circumstances how can we quit the family

functions how can we quit our own

festivals correct correct so there are

certain protection rules that we need to

follow so that we come under that safe

zone right if we follow this we'll be in

the safe zone or else we'll be having a

loud speaker at the end wow wow so let's

say that you know I hear hearing sound I

come to you what is the first step that

you do how do you diagnose that I have

hearing

loss when a person comes with hearing

loss or when when a person comes with

ringing sounds so let's say I I as a

patient come to Dr Ra's hospital and

then I say that I have a ringing sound

and then you assume you're suspecting

hearing loss so what do you do for the

first thing in in dr's hospital so when

a person visits to us complaining of

hearing law complaining of ringing

sounds in the ear these are the most

common things that we see every day in

our common practice we first do we first

take a very brief history whether there

was some noise

exposure is so you ask them whether you

use

headphones I'm asking you yes sir we

asked them or sometimes they would have

gone to the concert the previous day or

they would have gone to a birthday event

or some sports event so that's why

history tells us almost 50 to 60% of the

rough cost so tell me an interesting

case that you've seen with this kind of

history there are many interesting cases

but the one that is very closest uh to

my heart very

recently um is a adult he's uh 42 years

old he just had a history of

dingu that's all and how do we normally

treat it just we ask them to take

certain medications get admitted in a

hospital Dy fever check the platelets

everything was okay at the time when he

was about to get

discharged he they said that the values

were not there suddenly they were not

good that's why he was placed there and

suddenly he went into a syndrome called

dangu hemorragic shock syndrome and he

was placed on a ventilator all this was

completely medical and nothing related

to hearing right or end and all of a

sudden when he recovered from that

ventilator when he came back he realized

that both his ears were not

working he completely lost his hearing

and he is the one he's the spine of the

family he has his kids he took loans

many loans to pay and and suddenly he's

not hearing he lost his

job and he waited waited for a couple of

days and then he consulted an ENT

surgeon they gave hearing aids but which

were of no use and then he understood

that there is no way that I'm going to

get this back he Comm he wanted to

commit suicide and he committed suicide

twice for

this what happens with this denu is we

have a limited window of opportunity

where we need to intervene immediately

or else it lands up into acific the

entire inner year that was happening

inside him so many people were not even

attempting to go ahead with surgical

procedure because it's already set set

deification and that is when he visited

us I took him up for

surgery he was crying all the time

before surgery no I lost uh my hearing

now there is no one who is going to give

and the hearing losses because of the

Deni fever itself exactly so Deni can

cause menitis infections yes infection

of the brain so finally we did an

implant surgery and immediately at the

time of switch on he was extremely happy

extremely

happy that you know this is I can say

it's kind of bramastra these kind of

surgeries colear implants brahmastram on

the profound hearing loss where people

cannot even use a hearing aid they

losing their hearing completely wow

there are many kids that I do but this

person is the bread maker of the family

he is the who is the spine of the family

and without him earning nothing will be

there so this has a very profound impact

on the family but it is completely

hidden at least some physical

deformities like uh loss of hand or

limbs blindness they can be seen but

this is completely hidden and if it's

not understanding they call you dumb

fellow you do not understand but they

have to understand that he's deaf that's

why he's not able to

hear so this is uh one that is uh very

you know very closest to my heart of

course there are many kids who lost

their hearing over a period of time as I

told you earlier where there was a child

blunt trauma correct correct correct

correct so we talked about hearing it we

talked about implant anything else

that can be done there is something

called gene therapy which is quite

fascinating now gene therapy is an

advanced technique where doctors or

scientists are trying to fix or repair

the faulty genes that are responsible to

cause diseases so we are targeting the

diseases treatment of diseases at the

molecular level itself before they

manifest before they produce any

symptoms it's just very simply to put

this how the software Engineers they try

to fix a bug m or a glitch in the

software program to run a computer

smoothly similarly scientists are trying

to fix the glitches in the genes so that

the entire human body works normally and

this gene therapy was very recently

given in a uh toddler from UK in an

ear when she was born completely deaf

and after this infusion of gene therapy

giving in her ear she's able to here

absolutely normal wow wow available in

India it's still in the three phase

three of the clinical trials maybe a

decade or two decades it takes but it's

active research going yes yes so I want

to know about that coar implant a

littleit more because I know that there

are only like single digit surgeons are

doing this and you're one of them

actually our country should be very

proud to have surgeons like you because

this is a very very Niche area and uh I

want you to explain to your audience

what is clear implant

in terms of some figurative devices I

know it's a very very tiny teeny thing

previously for severe hearing loss we

had this option of using a hearing aid a

big device which has a microphone and a

pro and it has a speaker kind of thing

so that it just amplifies it's a

loudspeaker kind of thing but the

problem came where there is something

called profound hearing loss where the

engine the ccka that I was was talking

about there is no residual hearing at

all no hair cells which are there so

there is no way that this hearing it

started

working and for them this cckar implant

is a device it's like a brahmastram on

deaf what we call profoundly deaf

individuals it has two parts the

external part and an internal part

internal part is the part that we as

colear implant surgeons we place it

beneath the scal and Electrode array it

has an array electrode array which will

be threaded into the inner ear wow it's

like a wire that we are threading in the

inner

ear and the external part whatever it

has it has a microphone to grab the

sounds and a processor why a processor

is required here why can't just an

amplification device like hearing a work

there because

in normal ccka as I said earlier ccka

has hair cells these hair cells they

transform this sound waves into

electrical impulses that is a processing

unit we already have an inbuilt my

wonderful natural Processing Unit now

that is not there for this profoundly

deaf so scientists have invented in such

a way that there is a processing unit

which is outside so sound waves whatever

are being trapped are being converted

into electrical impulses within the

processing unit the speech processor and

from there I already placed inside a

device surgically from there the

impulses electrical impulses are

conducted into the ccka and there the

electrodes which I threaded into the

inner ear the wire that I threaded

inside it directly stimulates the

hearing nerve so literally we are

bypassing all the Parts in the we are

even bypassing the engine that is a

processing unit inside and directly into

the M it's like communicating directly

with your brain brain wow wow and the

success rate is tremendous tremendous

wow and what will be the first reaction

of a patient who can hear after a long

time this is mostly done in kids who are

completely born deaf so what will be the

first reaction of a child as soon as as

the baby is born he starts crying the

same thing will be there when we switch

on the implant they start hearing sounds

and they start

crying wow that I think there are very

few moments where parents also cry or

they feel happy when their kids are

crying one such moment is when we switch

on the implant kids will be crying but

this parents they have that Ananda

bashal they have that happiness oh my

God my kid is hearing for the first time

in his life

Wow and and of course the satisfaction

that you have from this

immense extraordinary extraordinary

right and so you're telling me that

anybody anyone with a hearing loss can

hear back again with this cular implant

there are certain criteria where we can

do implants but any age group from a

newborn baby to an elderly age group

there is no Edge restriction as I told

you the ccka develops as soon as the

inner ear it develops within the

mother's womb itself so there is no way

that is increasing or decreasing in size

so it's

Universal well it's a breakthrough

Research In Medical Practice exactly sir

how long this research has been how long

the practice has been going on almost

since 1980s 1980s 1980s they have

started it but um it was in 2000s when

2000 and after 20 2006 2010 that is when

it picked up its space they were slowly

transforming how the processor is going

to work getting a natural hearing they

Incorporated AI into that so that now in

the noisy in a sound normal this kind of

environment they can hear impulses but

once they get into the school there'll

be multiple noises which are there so to

incorporate that they have Incorporated

AI in the speech processor so it

immediately

transforms that wow that way wow it's

mind-blowing mindblowing and thank you

so much for doing this wonderful Noble

thing and um more important we talked

about the kids so tell me something

about deafness in kids and in

pons as I told you earlier

surprisingly 70 to

80% of the causes of newborn hearing

loss will be

genetic it is there is a very

significant role of genetics there and

genetic is you know if the uh family

history of deafness yes when there is a

consanguinous marriage so consanguinous

marriages or marriage between first

degree relatives which you are marrying

between uh uh sister's daughter or with

Mama that relative uh that angle where

there is increased risk of I know that

there's increased risk of both

complications so deafness is one of them

yes it's also one of them

so this consanguinous marriages as I

told you and a family history of hearing

loss they are all the highrisk category

and as I told you earlier once again

because within the pregnancy itself

fifth month of pregnancy itself the ca

is developing so any kind of infections

until fifth month or sixth month of

pregnancy the inner ear is not going to

develop maternal infections like torch

infections toxoplasmosis rubella

cytomegalo virus herpes in case if mom

is getting

the inner ear within the child is not

developing so that is also one of CA any

infection in the mother during pregnancy

during pregnancy maternal infections and

that's the reason we ask them to have a

very good healthy pregnancy and in case

if there is healthy pregnancy H but

immediately after the birth of the child

child is not crying because of hypoxia

hypoxia is aw state where enough amount

of oxygen is not delivered to the brain

and the hair hearing organ for few

minutes and that also causes hearing

loss and in case all the are okay but

child develops jaundice neonatal

jaundice parents very clearly say

everything was okay but child had

jaundice that's why he was kept in NIU

for one or two days days two days after

that everything is okay but that is a

triggering factor because jaes when the

Bel Rubin levels are high they cross the

blood brain barrier and that affects the

hearing organ so jaundice is the one

apart from genetics the ones which I

have seen for mother who had healthy

pregnancy non-c consanguinous marriage

jaundice is the leading cause for so as

as a mother how do we identify that

possible defers in M this is very very

important for all the expecting mothers

and parents to be because in India a

newborn here in screening is not

happening newborn hearing screening is

happening in all the developed countries

but it's not happening in our nation

because it's developing country so it is

very important for all the parents to

know certain milestones we call this as

hearing

Milestones number one as soon as the

birth of a baby until 0 to 3

months they start when they they start

to cry when they get responded to loud

sounds and when a mother or father they

shoes down the kid with their voice they

tend to calm down this is called startle

reflex this is number one test then

between 3 to 5 months of age when we

point at a particular sound some music

toy musical toy they tend to move their

eyes this side and that side that is how

this is other Milestone between 5 months

to 7 months because the head cing a past

everything coms though if there is a

music which is playing they tend to turn

their head this side or that side and

from 7th to 12th month or one year they

start responding to their name they

start speaking monosyllable words Mama

ATA MMA all this by one year they have

to get this words and between okay from

one year to 15 months of age they if we

ask them where is your nose they tend to

point at that get me the car

they go and get it so these are the

Milestones from 15 to 2 years of age 24

months they start speaking correct B

syllable words if this Milestones are

not met it is very important for parents

to immediately consult an end surgeon

any kind of early intervention is better

for the kids correct exactly early

intervention is very very

crucial and that awareness is not there

in our country yet because grandparents

they keep telling no you got your speech

late so your kid also gets speech late

don't worry about it they basically

consoling the parents but in this

generation where we have access to

Google access to doctors everywhere

parents are understanding that uh my

child is not responding Milestones are

not there but grandparents trying to

console them they delay and what happens

when they delay the child's brain is

like a super computer the hearing

neurons the neurons within the brain

they grow exponentially within 0 to 5

years of age think of a child's brain

like a clay when it is fresh we can mold

it in any direction the shape we want

but as it hardens up over a period of

time will not be able to mold it the

same thing holds good for the child's

brain the hearing neurons they and the

auditory Pathways they grow

exponentially between zero to one five

years of age we call this as neural

plasticity M and this neural plasticity

it tends to go down as the

age that's why this window of

opportunity I can say between 1 to 3

years is a very critical period if you

don't intervene a child who has hearing

loss sever hearing loss at least with

the help of hearing AGS during this

period there will be significant speech

delay he'll not be able to communicate

with his peers he'll not be able to go

to school and if a child who is born

with profound loss there is no hearing

at all this child will be left as deaf

and

mute throughout his life which has a

very significant impact on the

educational on the emotional status on

the socio economic status of the

family you know like we talked about the

young kids so Shifting the focus to the

elderly population right in my

experience at least because I don't do

ENT that much in a clinically most of

the times the elderly people come as a

main complaint of hearing loss and what

they do is they try to increase the

volume of the TV even to the maximum

right many people will say that you know

the TV is going to break right so that's

one of the sign that they are not able

to hear properly so but but the initial

thing is still hearing aids

correct yes

sir rather than just increasing the TV

volume see definitely they are

grandparents so they have grandkids and

we are there to look after them and we

tend to shout at them unknowingly we

raise our volume till now we were

obedient all this but because they are

not able to he hear well we tend to

shout and speak and that emotions will

be there on our face we cannot raise our

voice that is when we ask them to start

using hearing Adama start using an

amplifying device

but they don't agree elderly people they

still have the social stigma of not

using a hearing aid they feel that it's

odd to use but we need to remember

that as people become elderly they

become like kids so we have to console

them like kids like how we explain to

the kids no these are the things which

you are facing it's not just the TV

volume we are unable to talk to you and

we do not want to raise a voice against

you because of this you are isolating

yourself unknowingly you go into a state

of depression and finally leading to

memory loss we call this a dementia is

very commonly seen in them and we need

to educate them in fact the newer

hearing aids what we are seeing it's not

like something which is wor all the way

it's just like our Bluetooths they can

just play something here that's why

we'll ask them to take a hearing a trial

for about 3 to four days we give them

loner hearing aids at our Center M use

it you'll feel the difference that is

when you come and take it we have to

behave like kids wow so your hospital

gives a loner hearing age for 3 4 days

you try it out wow that's a wonderful

resource that's that's very nice so

could they can I can see that you know

if that works then they will be more

compliant in in in the hearing aids both

years or just one

year ideally when there is Blindness as

we tend to age will we use glasses is

only for one eye or both eyes both eyes

both same thing in hearing 1 + 1 is not

equal to 2 is equal to

three because it has a squishing effect

the localization of the sound if someone

starts speaking from the side they'll

not be able to hear properly from the

side that is how our p is built that's

why we have the squishing effect in the

brain to understand which side and all

this is possible when it is but of

course sometimes Financial issues

economic feasibility and the

compatibility of elderly people not

using hearing aids they may complain of

pain that's why we ask them to at least

use one at least one and then see how it

goes beautiful beautiful so I'm just

going to uh my most pressing question is

what is your take on airports which is

the most fascinating thing out there

now airpods I can say it's a kind of

revolutionary product right now from

Apple because

it's mainly solving two crucial aspects

one it is providing education about

hearing health and number two it is

removing the social stigma of using a

hearing

aid because with the help of airpods and

a phone we can literally do a hearing

assessment at comfort of our own home

you sitting on in our workplace you can

check you how good is your hearing

Health you've been to a concert

yesterday today and you feel there is

some muffling you can get your hearing

test done through the airpods through

the airpods and in case if you have some

hearing loss you visit a surgeon

especially it is very much useful in

elderly because they have this social

stigma of not using a hearing aid and

now because their grandkids are using

this airpods corre they don't hesitate

using this airpods as a hearing it so

basically the this airports they acting

as a bridge between the consumer

electronics and the Professional Medical

Electronics it's just we are giving them

an opportunity to get

in but of course there are certain cons

which are associated with this this is

only useful for mild to moderate hearing

loss in elderly people they have severe

hearing loss so mild M and most

importantly the treatable options of

hearing loss is not being addressed it

be it's being missed for example

situations like Autos sclerosis

the only presented the presenting

complaint will be hearing loss and a

person just gets his hearing and he

feels that oh I think the only option

which I have is a hearing aid but no

there is a surgical option it hardly

takes 20 minutes for surgery and

immediately on table if I do like this

patient will here tell me about the

Autos sclerosis for my audience I think

uh in layman terms in terms of how they

can understand this Autos sclerosis is a

condition where the smallest bone in our

body the stapis stapis is fixed ideally

the bones are supposed to

move I told you the three bones in the

middle year but what happens the stus is

not moving so the conductive apparatus

is not working because the stus is not

moving it cannot transfer the sounds to

the inner ear it is because of abnormal

bony deposition in the stapis now as a

surgical

procedure we place a small hole in the

uh we call it as

fenestra within the non-mobile stabus

and we place a piston there so that it

moves the Piston will be very tiny the

dimension will be uh 45

mm so you are you're dealing with like

so tiny teeny structures do you wear a

Vision Pro or something like that like a

big macroscopic thing my eyes will be

the microscope micos that is how we tend

to see that wow wow wow so this is

called uh hearing restoration complete

restoration complete restoration we need

not wear anything like hearing aades or

cckar implants wow it's completely you

can go in the rain you can walk normally

in fact this autoscar is something which

is hereditary I've operated for a son

for a 40-year old person because he's

not able to communicate properly in his

office and then because I operated on

both his years he's quite comfort

comfortable he got his

mother to get her evaluation and I

operated on them and

now his son son's son I operated on him

also all the three generations herit Tre

her Tre and this is such a fascinating

thing because we call it as magic

surgery immediately within 20 minutes

the patient will but it requires extreme

skill and

Equipment I'm making a hole of size4 mm

so any remers in the hand gone

completely deaf so that's why many

surgeons they don't do it they just go

for hearing it at least you have partial

hearing go ahead with that but we are

known for that hearing restoration nice

nice wow I know I could imagine the

difficulty in restoring such a tiny

teeny thing wow in elderly people the

other big thing is hypertension and

diabetes can lead to hearing gloss right

yes sir yes and what do you how do you

diagnose that same kind of evaluation

where they will not be able to hear

properly in diabetics the I always tell

them to get a screening evaluation done

at least once in two years because for

them this hearing loss is just like a

sunset they don't feel the dimming of

light minute by minute but all of a

sudden they feel it's

dark the same way they don't understand

that they are going through hearing loss

because initially it's only the high

high frequency loss what diabetic

individuals for normal people to

understand what this high frequency loss

is when a group of people are sitting

and they are conversating they'll be

able to understand they're talking

something but the clarity of speech will

be missing especially for sha if I say

Shri they can register only R sha sound

is gone

oh that is how it goes on especially for

and they have two times risk of

developing hearing laws when compared to

the normal ones it's mainly because of

multiple you being the gut Guru you know

how it works auditory neuropathy

diabetic neuropathy correct correct yeah

and nerves yeah just to summarize the we

have discussed in the past as well where

the diabetes complication the most

important complication is damaging the

nerves and the nerves applying

everything you know the stomach diabetic

gastropathy uh gastroparesis

uh you know the autonomic nervous system

every nervous that's why they check eyes

yes diabetic retinopathy so there

similarly you also check your years as

well once a year or once in two years um

ideally once in two years because if we

say once in an year also they don't

come I see at least once in two years

please get in case if they feel that

it's it's getting too muffled they only

come and visit us hearing is such a

humble organ it doesn't require much

attention just like us wives but if you

don't if you don't address that little

organ it makes sure that you don't even

sleep properly like the W like the

wives nice ni just a little attention

annual screening protection prote yeah

yeah that's all so as a very reputed

inner year coar implant surgeon which is

a very Niche how do you protect your

ears as a hearing restoration surgeon I

tend to spend most of my time in OT

operation theater so I'll be exposed to

various amounts of sounds laminar flow

which produces somewhere around this 50

to 60 Debs hitback the suctions the

mastoid drils so I know that I'm using

my precious time over there I'm losing

my precious time so I make sure I enter

into a calm Zone you're losing your

precious time of your hair cell safe

time exposure safe time exposure to

years safe time exposure to the years

and in the afternoon until evening only

a little bit of OPD and a normal

conversation that's all no loud

sounds and I exercise every day not so

long but at least 20 minutes without any

airpods nothing calm Zone once

again and yeah having very good foods I

tell foods are like volume controls so

if you have more of exposure into loud

sounds long

consumption of alcohol you're going to

lose your hearing so I make sure I do

not take them at all so this way I feel

most of the doctors they follow the same

routine and me especially into ENT I

have more of uh OT work yeah yeah so

safe time exposure I'll make sure do you

use headphones at

all very rarely because uh in the flight

I was looking at the your podcast Gutman

podcast so I had to use a proper noise

cancelling headphones so you invest in a

good noise cancellation headphones over

the Year yes yes and we also have some

ear protection devices like ear plugs

and ear defenders in fact when they are

buying certain things especially for

people who go for concerts or loud noise

exposure areas these year protection

devices when you flip the cover of it

there'll be something called nrr m noise

reduction rate M any nrr between 20 to

30 is very good so if you don't want to

listen to music or if you don't want to

invest in such make use of

the protection protection device your

plugs your Defenders they come they

passively block and at the same time

they have this active noise cancelling

feature also in case if you want to use

them so buy them at least they don't

cost much ear plugs hardly 1020 rupes

you're exposing yourself for a good

Festival just put that ear box 30 DB

you're getting exposed to 100 DB 30 DB

then and there it's cut so 70 it's more

or less okay less okay yeah so will that

be applied to the you know the movie

theaters the first day for

show

movie exactly right oh that's a good

thing H so your PL year Defender is a is

a device that goes over the year yeah

here this year Defenders we can also

call them as ear muffs but I

specifically didn't tell about ear muffs

because when I when I told this to my

patients they started buying this will

and ear mops and they said Madam I'm

putting this ear mops for my kid uh but

God oh God these are not the ear Ms ear

Ms are they just look like the

headphones headphones and for them to

understand I quoted an example of

Anushka Sharma and rir kapor where they

wear in a concert is Breakup Song they

wear that big chunky pieces right they

are the ear Defenders they passively

block and in case if they have active

noise cancelling so the noise will be

completely reduced and the song

whichever you want to listen you can

enjoy beautiful in case if you do not

want to use that ear protection take

breaks beautiful beautiful Anushka and R

are not talking to each other they're

doing dubbing that's

why wonderful wonderful so I'm going to

tell you a very interesting situation in

my one of my medical standup comedy

shows uh a person actually sent us an uh

uh message that um I absolutely love

what you're doing on your Channel I want

to come and see you do you have any sign

language because I am deaf that message

really moved me and um you know any

thoughts on that in terms of you know

how these people actually can have a

better

life I can say there is a

big deaf Community which is very vibrant

why am I stating this way because we

just have one mode of communication just

this way but they have different modes

of communication as you said sign

language interpreters through Indian

sign

language through Visual cues through lip

reading the community is quite

vibrant and there is a something uh an

article a research which um mentioned

that certain hearing losses when they

are not treated they lead into

dementia but there's a controversy in

this because it was done uh in John

Hopkins Institute where they researched

about 639 adults over a period of 12

years they stated that people who have

mild hearing loss they have chance of

developing dementia two times moderate

three times risk of developing dementia

that is I mean memory

loss and people who have severe hearing

ing loss they have a very high risk of

developing dementia almost five times

more but here the thing that we need to

remember it it's not just hearing loss

it's untreated hearing loss or lack of

communication because as you said that

young girl

Divya she is completely deaf she

required a sign language interpreter but

she's quite good she's able to remember

you all these years she was completely

deaf right so I can say they are already

leading their life there is nothing much

I can add to that but what we need to

remember that is communication is

crucial especially for the elderly

people they completely rely on this

speaking issue and if there is hearing

loss and it is completely untreated with

the help of hearing aids if they are not

using it and there is no one who going

and talking to them that social

isolation that develops into Dementia or

else this Vibrant Community you need not

even think about it they are extremely

good extremely intelligent and sincere

thanks to you

because you this de Community is

something which many people do not touch

but you you somehow you reach to a level

where even those people are very fond of

you and they want to attend the med yeah

really sincere thanks to you thank you

thank you thank you thank you that

really was emotional she came to the

show and then after the show we took

pictures and and uh was very nice it was

a very ni so nice of you uh I feel I'm a

part of that Community hearing Community

also of course of course you have made

beautiful changes to them as well so

wonderful wonderful super I'm going to

tell you a statement whether you need

you need to tell us whether it's a myth

or a fact okay so first question hearing

loss only affects elderly

people that's a myth it's a myth it

affects everybody everybody any age

group from the new want to holder age

group regular hearing test are not

required if you are able if you think

you're able to hear properly no even

that's a

myth because as I said earlier it's just

like a

sunset you don't feel that your hearing

is getting muffled until you completely

lose it even normal person should

undergo hearing test yes sir that's

mandatory especially we are noticing

this in uh age groups between 5 to 10

years old because they already had

hearing and now they are losing hearing

because they exposed to multiple sounds

it could be because of upper respir

recurrent upper respirat tract infection

very recently there was an outbreak of

Ms in India between age December to

March April and this moms when it was

going off it took off the hearing of

kids especially those age

groups that's why we say it is important

to get will those kids get better with

the implant yeah definely itely

definitely the only option is

because they go into profound loss and

thanks to the tech devices they were

stating Mama I'm able to hear only one

uh thing I'm not able to hear wow that

is how they are identifying and coming

to us wow wow beautiful all right can

oil drops cure ear

infections absolutely a myth oil drops

will never cure infections in fact they

worsen it in case if there is a breach

in ear drum those all drops they go

inside and that cause middle ear

infection chronic discharge heing loss

don't put anything in the ears M my

friend says don't use sunflower oil I

said that's good he said use

[Music]

safflower okay um hearing once lost

cannot be

restored I

think both

both because I myself be being a hearing

restoration surgeon there are two

components in this a conductive and a

sensory neural all the conductive Parts

they can completely be restored that

hearing part but the inner ear the hair

cell part that is the neural component

those cannot be restored like noise

induced hearing loss the ones which are

through viral infections the one which

alai AG had they cannot be restored they

have to be supplemented with a hearing a

or a cckar implant wow nice um ear

cleaning is necessary like a dental

cleaning

definitely

with there are only three times that we

need to do an ear cleaning one when your

hearing is muffled because of the ear

wax number two you start getting pain

because of the ear wax or number three a

hearing surgeon like me needs to look

into the eardrum what's happening inside

other than these three things there is

no need to clear

wax or clear your ears in fact that is

protective it prevents any

microorganisms entry because it has a

particular pH and it is designed in that

[Music]

way using earbuds is good for

you it's a

myth in fact when you flip the cover of

the earb s it is very clearly written on

that please do not use inside the ear

it's only for the outer crevices that's

all you're not supposed to stick

anything because once you start doing

that there's a conveyor belt mechanism

inside our ear it's inbuilt it always

makes sure that the dirt or wax

whichever is there it is shedded out

that is called shedding of epithelium

that's nothing but wax but in case if

you are using the Q-tips or earbuds you

are disrupting that and you creating

micro abration microscopically we can

see that and that causes infections in

and you are disrupting that conveyor

build mechanism the natural cleaning

mechanism is gone and your ear waxs get

stuck so people think that using earbuds

can actually clean your ear but can

actually increase the risk of ear

infections exactly so if you have a cold

and if you are uh taking a a flight that

will damage your hearing

permanently no myth that's a myth

because there'll be tube which connects

from nose to the ear that's called ustan

tube the main function of this tube is

to equalize the pressure outer

atmospheric pressure to the middle ear

pressure it equalizes what happens when

we take a flight travel because of rapid

changes in the cabin pressure it takes

time for this ustation tube to function

but it'll function like when you yawn or

when you take a sip of water when you

gulp but during upper respirat

infections like

cold the ustation DU gets blocked

because of this cold inflammation which

sets in that's why it will not be able

to equalize the pressure that's when

people start getting

pain because infection is spreading from

the nose to the

ear understand that is when they start

getting pain or muffled hearing all this

and most of the time we would have seen

in the flights as soon as there is

ascent and descent kids they start

crying yes rather than when it is flying

normally the reason is for kids this UST

station tube the tube it's much smaller

much narrower and the angulation is not

there it's horizontal like this as our

face expands this comes down this way so

it is like this the capacity to equalize

the pressure will not be there that and

that's when they start

cry nice nice I mean that's not nice for

the kid but I mean beautiful explanation

all right so rapid fire questions okay

the most dangerous myth you encounter

every day that you wish you can

change most of the great grandparents

they tend to console their kids stating

that don't worry if your child is not

getting his speech you took time to get

your speech you spoke after five or six

years wait and watch he starts speaking

that is a dangerous thing because neural

plasticity is gone he'll not be able to

hear properly throughout their life it's

better to have an early

diagnosis um one hearing Health habit

that you think everyone should adopt

stop using Q-tips or

earbuds biggest threat to hearing in

Modern India with all these devices

noise and used hearing loss headphones

headphones usage most promising

advancement in hearing loss coar

implants coar implants

beautiful so the last one is here is

three simple steps every Indian can take

today for better hearing Health

basically summarizing our

podcast for all the IT people for all

the software engineers make sure you

follow 6060 Rule and invest in good

quality headsets protect your hearing

because once your hearing is lost

through nois in you st there is no way

that we are going to restore there is no

medication there is no medication and we

are not able to restore for it please

spread the awareness that hearing loss

when identified early is

treatable treatable yeah yeah um and

also I wanted to bring it to my audience

the wonderful work that you're doing

where you are actually giving the cular

implants to underprivileged people where

they will not be able to afford this

much amount of an cost so that really

take I was I was pleasantly surprised

that you know there are hospitals who is

actually promoting this in a very good

way and you are one of the top surgeons

and if you are spending your time for

under privilege that is something that

is really really appreciative of what

you're doing and uh thank you so much

for doing that so can you tell us what

is a general cost involved and how a

person can actually reach out to Dr R's

Hospital in terms of if they ever find

any hearing loss in kids or anything

like that the cost of a cckar implant

ranges between 8 lakhs to 20 lakhs

[Music]

wow I myself as a cckar implant surgeon

as a hearing restoration surgeon I feel

privileged that I have performed the

maximum number of implants till L and

through our Rousey and declear implant

program we are

conducting these hearing surgeries free

of cost wow for kids who are born deaf

and the underprivileged kids under the

age of 5 years

so in case if your loved ones or people

who are working with

you if they do not know that early

intervention is required please create

the awareness that once they are

addressed with the help of this colear

implant surgery or hearing where we are

addressing their hearing your protecting

their life the child will be not the

child will come out from the zone of

being deaf mhm so in case if any of your

colleagues are there or any of the kids

that you know are there please let them

contact our hospital and thanks to the

NOS non-government organizations that

are helping us wow with the amount of

good work that do we are doing they

sponsoring us not just with the implant

but also the surgery of the implant is

also being covered nice nice I wish this

message reaches to many people because

you know sponsoring is a different thing

but the actual person to do it by giving

your time that is also uh very important

equally appreciable thing so the both

combined factors both the factors are

available in your hospital I I hope

everybody make use of this opportunity

and we could create a better India with

de free India as you say right that's

your mission yes sir right yes uh so I

hope Dr Shri makes that statement very

well and I I wish nothing but good luck

in all your endeavors and thank you so

much for your time thank you so much sir

thank you thank you that was a wonderful

episode I absolutely loved it she is an

absolutely amazing person you could see

that you know simple steps can prevent

our hearing loss and number two most

importantly if you know anybody with

hearing loss okay so tell them that

hearing aid is not the only option there

are other options available including

cckar implant which could potentially

change the way that they look and I'm

sure you will be conscious of how you're

using your headphones how much amount of

decibels that you are being exposed to

on a daily basis remember those 4,000

hair cells that she talked about in the

inner year is absolutely critical for

you to save for the rest of your life

all right as usual stay happy stay gutsy

May gut bless you

View full transcript

00:00:00 what are the precautions like an IT

00:00:01 worker should do to prevent noise indued

00:00:04 hearing loss with headphones three

00:00:05 things they need to remember for sure

00:00:07 number one following the 6060 rule keep

00:00:10 the volume on your gadget on your

00:00:13 mobile number two creating an optimal

00:00:16 workp space that's very very important

00:00:18 which one do you prefer over thee

00:00:20 headphones or in thee headphones I

00:00:22 prefer do you see a lot of patients with

00:00:24 increased hearing loss these days

00:00:26 compared to before

00:00:28 many in elderly people the other big

00:00:30 thing is hypertension and diabetes can

00:00:33 lead to hearing GLS right yes sir

00:00:35 protection device your plugs your

00:00:37 Defenders they passively block and at

00:00:39 the same time they have this active

00:00:41 noise cancelling feature also in case if

00:00:42 you want to use them hearing loss only

00:00:44 affects elderly people it's a myth it

00:00:46 affects everybody everybody the hearing

00:00:49 which is gone the precious hair cells

00:00:52 that are gone once cannot be restore

00:01:02 hello guys this is Dr pal manikam

00:01:03 gastroenterologist focused on your gut

00:01:05 health welcome to another episode of gut

00:01:07 feeling with Dr pal in this episode

00:01:09 we're talking with Dr Shri she's one of

00:01:12 the reputed cckar implant surgeons that

00:01:15 are only a handful of surgeons in India

00:01:17 I had this opportunity of talking to her

00:01:19 about the most possible epidemic in

00:01:23 India right now which is noise induced

00:01:25 hearing loss noise pollution has been

00:01:27 going on throughout with the Advent of

00:01:29 newer headphones work from home culture

00:01:32 and a lot of you know computer meetings

00:01:34 and everything we being exposed to a lot

00:01:37 more debl than our years can handle so

00:01:40 she went through how we can identify

00:01:42 what are the treatment options available

00:01:44 how we can prevent it with simple simple

00:01:47 steps and more importantly she is such a

00:01:49 good soul that she works at Dr Ra

00:01:51 hospital at hyderbad where they are

00:01:52 placing implants in people who

00:01:55 cannot afford this and she's doing as a

00:01:57 wonderful cause for a part of a

00:02:00 non-governmental organization as well I

00:02:02 had a blast in this episode I'm sure you

00:02:05 will learn similar to how I did let's

00:02:07 dive deep into it so welcome Dr Shri uh

00:02:10 you are one of the most reputed

00:02:12 implant surgeon I'm so happy to have you

00:02:13 in my podcast um I uh really want to

00:02:16 drill down on this condition called

00:02:19 noise induced hearing loss which is I'm

00:02:21 going to explain that to my audience in

00:02:23 uh in a brief as well so since Co

00:02:26 everybody is on earphones

00:02:30 airport you name it okay and then you

00:02:32 know they I don't think they understand

00:02:34 the purpose of the zoom meet but they

00:02:36 will make sure that they mute the zoom

00:02:39 call so many people are on the earphones

00:02:43 and recently uh I came to know that um

00:02:47 you know Alka yagnik yes sir right and

00:02:50 then she raised a beautiful awareness

00:02:52 that you know uh noise induced hearing

00:02:55 loss of the frequent use of headphones

00:02:57 is one of the reasons as well um so tell

00:03:00 me why this is happening and tell walk

00:03:03 us through why frequent use of

00:03:05 headphones might be a

00:03:07 problem first things first sir noise in

00:03:10 used hearing loss as the name itself

00:03:12 suggest it's because of prolonged

00:03:14 exposure to noise which leads to hearing

00:03:18 loss this is how we tell it and why is

00:03:22 this exactly happening let me tell you

00:03:24 how actually the hearing functions our

00:03:27 ear is divided into three parts outer

00:03:30 middle and inner sound travels from the

00:03:33 external ear and it causes vibrations

00:03:36 and these

00:03:37 vibrations set the

00:03:39 eardrum we call it as Sanic membrane

00:03:42 cause vibrations and this vibrations are

00:03:45 transfer to the middle ear in the middle

00:03:47 ear they have some tiny bones three

00:03:50 bones from the middle ear because of the

00:03:53 vibration of the ear bones they travel

00:03:55 into the inner ear in the inner ear we

00:03:58 have a major organ called the engine the

00:04:00 ccka

00:04:02 cocka this ccka it has very tiny hair

00:04:05 cells and these hair cells the function

00:04:08 of this hair cells is to convert this

00:04:12 sound waves the mechanical vibrations

00:04:14 into electrical impulses and these

00:04:17 electrical impulses are sent to the

00:04:18 cckar nerve or the hearing nerve

00:04:20 auditory nerve and they are sent to the

00:04:23 brain and there it is perceived as

00:04:25 speech now what happens is noise induced

00:04:29 hearing cles let me let me boil it down

00:04:31 a little bit so that everybody can

00:04:33 understand so somebody is

00:04:35 speaking and that sound is going into

00:04:38 the ear or canal and then it goes inside

00:04:41 this CA which is the engine deep in the

00:04:44 ear yes sir which is the inner part of

00:04:46 the Year yes sir we call that as an

00:04:47 inner year inner okay so that sound

00:04:49 impulses what does this coar engine do

00:04:52 it converts that into an electrical imp

00:04:54 electrical impulses and it gets to your

00:04:56 brain yes sir through the nerve through

00:04:58 the nerve it's like a wiring through the

00:05:00 wiring through the wiring it is

00:05:02 conducted into the brain inside the

00:05:05 brain it is processed as peach peach so

00:05:08 somebody is talking to you yes yes so

00:05:11 then the brain interprets as a language

00:05:14 yes that you know or you may not yes

00:05:17 okay so what happens in this noise

00:05:19 induced hearing loss there is continuous

00:05:22 exposure of

00:05:23 sound so continuously the ear bones are

00:05:26 vibrating and continuously yeah ear drum

00:05:29 m e drum vibrating and from eardrum

00:05:32 vibrating the bones are also moving MH

00:05:35 and from there the hair cells as I told

00:05:37 you within the engine it's continuously

00:05:41 acting so they come to a stage where

00:05:45 they no longer work it's like using a

00:05:47 muzzle every day to train and all of a

00:05:50 sudden gives up so with this the sound

00:05:53 waves they are continuously triggering

00:05:55 the hair cells so they go into a state

00:05:57 of metabolic exhaustion and oxidative

00:06:00 stress due to prolonged exposure to

00:06:02 sounds causing the death of the hair

00:06:05 cells so hair cells are so tiny tetiny

00:06:07 right exactly sir and even the engine

00:06:09 itself is so small right yes sir what is

00:06:11 the size of it in general I mean if you

00:06:14 want to compare like a size of a like a

00:06:17 small button or of a golf ball extremely

00:06:20 tiny extremely tiny extremely tiny we

00:06:22 have to literally use a microscope to

00:06:25 see the turns of it it's in the form of

00:06:28 a snail snail

00:06:30 and then I know that there are multiple

00:06:31 semicircular canals yes yes within the

00:06:34 inner ear it has a cocka the anterior

00:06:37 part which is responsible for our

00:06:39 hearing and the posterior part has

00:06:42 semicircular can like the lord of rings

00:06:44 correct correct that is responsible for

00:06:46 balance so our ear is not just

00:06:48 responsible for hearing but also for the

00:06:51 balance I being a hearing restoration

00:06:53 surgeon my focus will be more on this

00:06:56 cocka the front part because the cells

00:07:00 once they are when they are died there

00:07:04 is no way that we going to get back no

00:07:07 how many cells will be there like

00:07:09 Millions sir millions of cells there

00:07:12 will be almost uh 3,000 to 4,000 of

00:07:15 inner hair cells and almost 12,000 to

00:07:18 13,000 of outer hair cells only these

00:07:21 many that's all it's like diamond

00:07:23 precious diamonds I see wow so everybody

00:07:25 is born with it yes sir everybody which

00:07:28 is more important inner or outer I mean

00:07:31 given an

00:07:32 option obviously the engine sir because

00:07:35 some people they do not have any ear at

00:07:37 all we call it atricia they don't have

00:07:39 but still they'll be able to hear

00:07:41 because they are hearing through the

00:07:43 engine so that's a very important point

00:07:45 atricia is few babies will not have year

00:07:48 at all yes when they are born they will

00:07:49 be born year less yes but in spite of

00:07:53 which they'll be able to hear correct

00:07:55 when the inner ear the hearing organ

00:07:57 develops correct there is a fascinating

00:07:59 thing which I can tell you because most

00:08:02 I think most of the Indians do know

00:08:03 about it in

00:08:06 Mahabharata abhimanu when he was in his

00:08:09 mother's wom subadra room he completely

00:08:12 overheard whatever Arjuna was narrating

00:08:15 about the Padma vuam to subadra even in

00:08:19 spite of subadra Dei she

00:08:21 slept in spite of which he was able to

00:08:23 hear inside the O and that is true

00:08:27 because the entire hearing organ the

00:08:30 cocka the engine hair cells everything

00:08:32 it develops within fifth month of

00:08:35 pregnancy it's not that after the baby

00:08:37 is born your hands are elongating your

00:08:40 legs are growing your neck is growing

00:08:42 it's not the size of the inner ear it

00:08:46 remains constant at the time of birth

00:08:49 till the time of death it's only the

00:08:51 hair cells as age progresses or because

00:08:54 of prolonged exposure to noise they are

00:08:58 dying but but they remain the same I

00:09:01 mean from the time of birth they remain

00:09:03 the same wow wow I still remember like

00:09:07 uh the abim menu story uh I used to tell

00:09:10 my uh kid when my wife was pregnant uh I

00:09:13 used to talk about gut health

00:09:15 intermittent fasting and that's why now

00:09:17 he is not talking to me at

00:09:19 all you're boring already he knows

00:09:22 everything he know everything but I

00:09:24 strongly believe that's true correct

00:09:26 true sir so people uh uh even as a baby

00:09:30 inside the

00:09:31 uterus they can hear what you talk

00:09:34 exactly that's why they recognize mom's

00:09:36 wise father's voice more and that's why

00:09:39 when they startle or cry loudly whenever

00:09:41 they hear to these voices which are

00:09:43 already familiar with them they tend to

00:09:45 calm down this is because they start

00:09:48 hearing as soon as they are in the

00:09:49 mother's Zoom from fifth month wow wow

00:09:52 you know the way that you are explaining

00:09:54 I could see how you are passionate about

00:09:55 this medicine thing I mean your your

00:09:57 your expertise but also at the same time

00:10:01 it kind of raises an alarm that we only

00:10:02 have 4,000

00:10:04 cells totally 12,000 plus 3,000 4,000

00:10:09 correct correct so somewhere around

00:10:10 177,000 cells 17,000 cells yes but the

00:10:13 more important thing the engine one yes

00:10:15 which is 3 to

00:10:17 4,000 so that raises an awareness where

00:10:20 you know we need to preserve it as much

00:10:21 as possible exactly so for example I'll

00:10:23 take it myself you know since Co I I

00:10:25 used to do like Zoom video consultations

00:10:27 for my patients in California where I

00:10:30 used to use my headphones yes so if I

00:10:32 understand right so the electronic

00:10:34 impulses take carry from the headphones

00:10:37 all the way into the O and all reach

00:10:39 this tiny teeny little thing at a

00:10:42 particular frequency correct what are

00:10:45 the precautions like an IT worker should

00:10:47 do to prevent noise induced hearing loss

00:10:49 with headphones for all the professional

00:10:52 headphone users and people who are

00:10:54 working remotely for all the software

00:10:56 engineers and as you it people three

00:11:01 things they need to remember for sure

00:11:03 number one following the 6060

00:11:06 rule keep the volume on your gadget on

00:11:09 your mobile to only 60% of the maximum

00:11:12 volume and limit it to only 60 minutes

00:11:16 and immediately after that take a break

00:11:18 for about 5 to 10 minutes this way we

00:11:21 can avoid noise and used hearing loss

00:11:24 number two creating an optimal workspace

00:11:27 that's very very important

00:11:30 make sure that you do not sit near a

00:11:32 window where there is so much of noise

00:11:34 or a door where there is so much of

00:11:36 noise and try to incorporate certain

00:11:39 curtains or rugs or carpets to absorb

00:11:42 the sound to absorb the sound creating

00:11:44 this optimal work space is very

00:11:46 important and most importantly number

00:11:49 three invest in a good efficient

00:11:53 headphones I would say active noise

00:11:55 cancelling

00:11:56 headphones and I prefer using of telling

00:12:00 them to use over the year rather than in

00:12:02 the year

00:12:03 headphones so which one do you prefer

00:12:06 over thee headphones or in thee

00:12:07 headphones I prefer over thee headphones

00:12:11 because there are very high chances when

00:12:13 you start using in thee headphones some

00:12:15 people may be having psorasis or eczema

00:12:18 dry skin and some of them may be having

00:12:20 wax and when you remove that in fact

00:12:23 when you start using any airpods you can

00:12:25 see after a couple of days wax getting

00:12:27 stuck there and unknowing those

00:12:29 microphones they get blocked so you tend

00:12:31 to increase the volume to compensate it

00:12:34 that's why we say especially I being a

00:12:36 surgeon after surgery they're not

00:12:38 supposed to use much of this one for

00:12:39 about 3 months and once they start using

00:12:42 this over the year they enjoy that I see

00:12:46 it snuggly fits around and the natural

00:12:49 way of hearing will be maintained wow so

00:12:52 you said 60 60 R like 60% of the maximum

00:12:55 volume and you listen for 60 seconds to

00:12:57 60 Minutes 60 Minutes 60 minutes

00:12:59 all right so you said 6060 rule which is

00:13:01 you 60% of the maximum volume up to 60

00:13:04 minutes and then you take a break for 5

00:13:06 10 minutes yes sir but how is it

00:13:07 practically

00:13:09 possible the reason is people are just

00:13:12 like blasting their ears with that's how

00:13:14 the music is as well correct exactly but

00:13:19 the hearing which is gone the precious

00:13:21 hair cells that are gone once cannot be

00:13:24 restored we need to remember that it's

00:13:27 like a precious diamond and we you're

00:13:29 losing at least diamonds we can buy but

00:13:31 this one later if you increase the

00:13:34 volume to more than normal also you'll

00:13:36 not be able to hear it's like if you

00:13:39 keep a louds speaker permanently in your

00:13:41 ear using a hearing aid rather than that

00:13:44 prevention is much much better wow I'm

00:13:46 going to be very honest with you you

00:13:48 know I grew up here I went to us uh for

00:13:50 my uh higher education um when the first

00:13:54 thing that I couldn't even adapt to the

00:13:56 US culture is the complete silence

00:14:00 there is no fan okay and there is no

00:14:04 honk car honks nothing

00:14:06 outside I thought I was in a haunted

00:14:09 house it looked very silent very silent

00:14:12 right so I'm there for like 15 16 years

00:14:14 now so now you know I'm traveling

00:14:17 frequently back and forth to India and

00:14:18 Us in India when I'm coming here the

00:14:22 roadside noise and in general the

00:14:25 utility of and other vehicles and other

00:14:28 things what is your take on noise

00:14:31 pollution here in India I can say our

00:14:34 country India is already in a kind of

00:14:36 hearing Health crisis because we are

00:14:38 constantly getting exposed to sounds

00:14:41 over 85 DB now let me put it this

00:14:45 way as per World Health Organization wh

00:14:49 the safe per permissible limits of

00:14:52 hearing is hearing about 85 DB of sound

00:14:56 until 8 hours in a day so what this 85

00:15:00 DBS corresponds

00:15:02 to the normal conversation that we have

00:15:05 in this silent environment will be

00:15:06 somewhere around 60 DB sound is measured

00:15:09 in

00:15:10 decb so this is 60 DB this is very

00:15:14 normal very good Pleasant for our ears

00:15:17 the sound that we are exposed in traffic

00:15:20 especially loud traffic between 85 to 90

00:15:23 and the sounds for a haird dryer which

00:15:26 every women uses nowadays is about 90 DB

00:15:29 M and the sound that corresponds to a

00:15:32 mixer blender every Homemaker uses it

00:15:35 that is also 90 DBS and the sounds with

00:15:39 that

00:15:39 we hear at concerts or loud IPL match

00:15:44 huh that hits over 100 DB above

00:15:48 100 and that amount of sound 100 or 110

00:15:53 the safe time of exposure for that is

00:15:55 only 15

00:15:56 minutes that's why it is not possible

00:15:59 for us practically to STI to stick to

00:16:01 this 85 DBS for about 8 hours in a

00:16:06 day you tend to put a blow dryer every

00:16:09 day correct you go for a saloon you get

00:16:12 your professional hair styling done you

00:16:14 have fruit juice every day with the help

00:16:16 of a blender all these are the loud

00:16:17 sounds so how to actually cut it down

00:16:21 now here comes the role of a three decb

00:16:24 rule so you're say so how to prevent

00:16:28 this hearing loss is that what you're

00:16:30 saying yes sir run a day in this hectic

00:16:33 noisy pollution areas so in the midst of

00:16:36 this active noise pollution what are the

00:16:38 steps that we can take to prevent this

00:16:40 loud exposure to

00:16:41 us here comes the 3 dbel rule what this

00:16:46 states that for every 3 D

00:16:49 increase in the intensity of sound the

00:16:52 safe time of exposure of sound is

00:16:56 hared for an 85 DB sound

00:16:59 the safe time of exposure limit is 8

00:17:01 hours and for 88 DB of sound it is only

00:17:05 4 hours for 91 DB it is only 2 hours and

00:17:10 imagine in concerts 100 DB the safe time

00:17:14 of exposure is only 15 minutes oh my God

00:17:17 so understanding this

00:17:20 crucial relationship between the sound

00:17:24 intensity and the safe time of exposure

00:17:26 is very important especially for people

00:17:30 of this generation where they are

00:17:31 exposed to noisy pollution every day do

00:17:35 you see a lot of patients with increased

00:17:37 hearing loss these days compared to

00:17:39 before many many and most of them you'll

00:17:43 be surprised to know are belonging to

00:17:45 the teenage group and young adults wow

00:17:49 what is the youngest age that you have

00:17:51 seen what is the youngest age that you

00:17:52 might have seen 12 years 12 years with

00:17:55 noise induced hearing loss wow 12 and

00:17:58 even they don't don't uh they don't even

00:18:01 have any symptoms they don't even tell

00:18:02 they say that I'm I'm hearing very

00:18:05 normally there's no problem with my

00:18:07 hearing the only complaint they say that

00:18:10 I can see something I can hear something

00:18:11 buzzing on and off in my ear that's all

00:18:15 and that ringing sound yes yes and that

00:18:18 to those kids they do not know that this

00:18:21 is not normal so their parents they just

00:18:24 get it for a hearing check and that is

00:18:27 when they come to know

00:18:29 how do the parents identify in that

00:18:33 12-year-old kid they complain some

00:18:35 ringing sounds ringing sounds very often

00:18:37 some mosquito is there inside my ear it

00:18:40 it is ringing um they usually complain

00:18:44 of some foreign body something is stuck

00:18:46 here it is ringing continuously see and

00:18:49 Parents try to look into that there'll

00:18:51 be nothing that is when they get okay

00:18:53 there should be some wax that's why we

00:18:54 got our child and we say no there is no

00:18:57 wax let us go for a hearing check and

00:19:00 it'll be a very classic dip in the

00:19:03 audiogram oh my god wow I mean the the

00:19:07 information that you're telling me is

00:19:08 like it's mind mind-blowing uh because

00:19:11 let's say I'm a average user I'm an

00:19:14 average headphones user

00:19:17 so easily anybody in an active work

00:19:20 environment you'll exposed to get 85 DBS

00:19:22 easily for 8 hours 84 DBS is very

00:19:25 minimal I mean not minimal it's a common

00:19:27 exposure you're talking about correct

00:19:29 yes sir yes sir so you're saying just me

00:19:31 and you talking itself around 65 70 here

00:19:34 this is a very quiet room 60 60 H 60 60

00:19:39 60 quiet room yes and uh so let's say

00:19:43 I'm in an active work for 8 hours and I

00:19:44 come back and then usually I do my in

00:19:47 the year airports and then go to the gym

00:19:51 and then

00:19:52 workout and the more louder it is the

00:19:56 better the workout is my suspicion

00:20:00 that's what many people do yes sir many

00:20:02 people just completely uh Max the

00:20:04 volume so then you are saying that when

00:20:06 you increase a decel then the time of

00:20:08 exposure should decrease so I have I

00:20:11 have also used maximal volume before

00:20:13 which means that I should not use this

00:20:15 more than like 15 20 minutes exactly sir

00:20:18 wow exactly in case if you are you know

00:20:21 if you really want to hit that dopamine

00:20:24 if you want to really work out that way

00:20:27 then you cut down the sounds that you

00:20:28 are hearing at the end of the day at the

00:20:31 end of the day we come home we chill

00:20:33 with our kids and they tend to increase

00:20:36 the volume in the TV and and we doctors

00:20:40 especially we think we are the safe

00:20:42 people I I definitely get exposed to

00:20:47 nearly 85

00:20:48 DB I very clearly know that because I

00:20:51 stay most of the time in the OT there'll

00:20:53 be

00:20:54 hedback there'll be laminar flow

00:20:57 there'll be suction machines correct

00:20:59 everything produces noise corre so I'm

00:21:02 literally placing myself there in that

00:21:04 zone over the top of it the drills that

00:21:06 I use it definitely corresponds to more

00:21:09 than 85 got it so how do we all the

00:21:13 professional people take care by

00:21:16 understanding this relationship

00:21:17 relationship wow so I have completely

00:21:19 used my safe amount of exposure there so

00:21:23 I have to cut down the sounds and there

00:21:25 will be some few unavoidable

00:21:26 circumstances as well where you know for

00:21:28 example there's a Temple function

00:21:30 outside and there's a huge loudspeaker

00:21:32 and the second example is you know

00:21:34 during

00:21:35 diali um and I'm I'm proud that actually

00:21:38 Tamil NAD government has imposed a ban

00:21:39 that you should not have firecrackers

00:21:42 after 700 p.m. I guess yes sir yes sir

00:21:45 does same in your state as well no sir

00:21:48 it's not uh way don't worry about it's

00:21:51 only impos but nobody is

00:21:53 practicing but all those firecrackers

00:21:56 that will be easily 100 Deb correct m

00:21:58 more than 100 110

00:22:00 120 but all these are unavoidable

00:22:03 circumstances how can we quit the family

00:22:06 functions how can we quit our own

00:22:09 festivals correct correct so there are

00:22:12 certain protection rules that we need to

00:22:14 follow so that we come under that safe

00:22:17 zone right if we follow this we'll be in

00:22:20 the safe zone or else we'll be having a

00:22:23 loud speaker at the end wow wow so let's

00:22:26 say that you know I hear hearing sound I

00:22:29 come to you what is the first step that

00:22:31 you do how do you diagnose that I have

00:22:33 hearing

00:22:34 loss when a person comes with hearing

00:22:37 loss or when when a person comes with

00:22:39 ringing sounds so let's say I I as a

00:22:41 patient come to Dr Ra's hospital and

00:22:44 then I say that I have a ringing sound

00:22:46 and then you assume you're suspecting

00:22:49 hearing loss so what do you do for the

00:22:51 first thing in in dr's hospital so when

00:22:54 a person visits to us complaining of

00:22:57 hearing law complaining of ringing

00:23:00 sounds in the ear these are the most

00:23:03 common things that we see every day in

00:23:05 our common practice we first do we first

00:23:09 take a very brief history whether there

00:23:11 was some noise

00:23:13 exposure is so you ask them whether you

00:23:15 use

00:23:17 headphones I'm asking you yes sir we

00:23:20 asked them or sometimes they would have

00:23:22 gone to the concert the previous day or

00:23:25 they would have gone to a birthday event

00:23:28 or some sports event so that's why

00:23:30 history tells us almost 50 to 60% of the

00:23:34 rough cost so tell me an interesting

00:23:36 case that you've seen with this kind of

00:23:39 an

00:23:41 history there are many interesting cases

00:23:43 but the one that is very closest uh to

00:23:47 my heart very

00:23:49 recently um is a adult he's uh 42 years

00:23:56 old he just had a history of

00:23:59 dingu that's all and how do we normally

00:24:03 treat it just we ask them to take

00:24:06 certain medications get admitted in a

00:24:08 hospital Dy fever check the platelets

00:24:12 everything was okay at the time when he

00:24:14 was about to get

00:24:16 discharged he they said that the values

00:24:19 were not there suddenly they were not

00:24:22 good that's why he was placed there and

00:24:25 suddenly he went into a syndrome called

00:24:27 dangu hemorragic shock syndrome and he

00:24:30 was placed on a ventilator all this was

00:24:32 completely medical and nothing related

00:24:35 to hearing right or end and all of a

00:24:39 sudden when he recovered from that

00:24:41 ventilator when he came back he realized

00:24:43 that both his ears were not

00:24:46 working he completely lost his hearing

00:24:49 and he is the one he's the spine of the

00:24:51 family he has his kids he took loans

00:24:56 many loans to pay and and suddenly he's

00:25:00 not hearing he lost his

00:25:02 job and he waited waited for a couple of

00:25:05 days and then he consulted an ENT

00:25:07 surgeon they gave hearing aids but which

00:25:09 were of no use and then he understood

00:25:12 that there is no way that I'm going to

00:25:14 get this back he Comm he wanted to

00:25:16 commit suicide and he committed suicide

00:25:18 twice for

00:25:20 this what happens with this denu is we

00:25:23 have a limited window of opportunity

00:25:25 where we need to intervene immediately

00:25:27 or else it lands up into acific the

00:25:29 entire inner year that was happening

00:25:31 inside him so many people were not even

00:25:35 attempting to go ahead with surgical

00:25:37 procedure because it's already set set

00:25:39 in

00:25:41 deification and that is when he visited

00:25:44 us I took him up for

00:25:47 surgery he was crying all the time

00:25:50 before surgery no I lost uh my hearing

00:25:54 now there is no one who is going to give

00:25:57 and the hearing losses because of the

00:25:58 Deni fever itself exactly so Deni can

00:26:00 cause menitis infections yes infection

00:26:04 of the brain so finally we did an

00:26:08 implant surgery and immediately at the

00:26:10 time of switch on he was extremely happy

00:26:12 extremely

00:26:14 happy that you know this is I can say

00:26:17 it's kind of bramastra these kind of

00:26:20 surgeries colear implants brahmastram on

00:26:23 the profound hearing loss where people

00:26:25 cannot even use a hearing aid they

00:26:27 losing their hearing completely wow

00:26:30 there are many kids that I do but this

00:26:33 person is the bread maker of the family

00:26:35 he is the who is the spine of the family

00:26:37 and without him earning nothing will be

00:26:40 there so this has a very profound impact

00:26:44 on the family but it is completely

00:26:45 hidden at least some physical

00:26:47 deformities like uh loss of hand or

00:26:51 limbs blindness they can be seen but

00:26:54 this is completely hidden and if it's

00:26:56 not understanding they call you dumb

00:26:57 fellow you do not understand but they

00:26:59 have to understand that he's deaf that's

00:27:02 why he's not able to

00:27:04 hear so this is uh one that is uh very

00:27:09 you know very closest to my heart of

00:27:11 course there are many kids who lost

00:27:12 their hearing over a period of time as I

00:27:15 told you earlier where there was a child

00:27:18 blunt trauma correct correct correct

00:27:20 correct so we talked about hearing it we

00:27:21 talked about implant anything else

00:27:23 that can be done there is something

00:27:26 called gene therapy which is quite

00:27:28 fascinating now gene therapy is an

00:27:32 advanced technique where doctors or

00:27:35 scientists are trying to fix or repair

00:27:38 the faulty genes that are responsible to

00:27:41 cause diseases so we are targeting the

00:27:44 diseases treatment of diseases at the

00:27:46 molecular level itself before they

00:27:49 manifest before they produce any

00:27:51 symptoms it's just very simply to put

00:27:54 this how the software Engineers they try

00:27:56 to fix a bug m or a glitch in the

00:27:59 software program to run a computer

00:28:02 smoothly similarly scientists are trying

00:28:04 to fix the glitches in the genes so that

00:28:07 the entire human body works normally and

00:28:09 this gene therapy was very recently

00:28:11 given in a uh toddler from UK in an

00:28:15 ear when she was born completely deaf

00:28:19 and after this infusion of gene therapy

00:28:21 giving in her ear she's able to here

00:28:23 absolutely normal wow wow available in

00:28:26 India it's still in the three phase

00:28:30 three of the clinical trials maybe a

00:28:32 decade or two decades it takes but it's

00:28:35 active research going yes yes so I want

00:28:37 to know about that coar implant a

00:28:39 littleit more because I know that there

00:28:40 are only like single digit surgeons are

00:28:42 doing this and you're one of them

00:28:44 actually our country should be very

00:28:45 proud to have surgeons like you because

00:28:48 this is a very very Niche area and uh I

00:28:52 want you to explain to your audience

00:28:55 what is clear implant

00:28:58 in terms of some figurative devices I

00:28:59 know it's a very very tiny teeny thing

00:29:02 previously for severe hearing loss we

00:29:05 had this option of using a hearing aid a

00:29:08 big device which has a microphone and a

00:29:11 pro and it has a speaker kind of thing

00:29:15 so that it just amplifies it's a

00:29:17 loudspeaker kind of thing but the

00:29:20 problem came where there is something

00:29:23 called profound hearing loss where the

00:29:26 engine the ccka that I was was talking

00:29:28 about there is no residual hearing at

00:29:31 all no hair cells which are there so

00:29:34 there is no way that this hearing it

00:29:36 started

00:29:37 working and for them this cckar implant

00:29:41 is a device it's like a brahmastram on

00:29:44 deaf what we call profoundly deaf

00:29:48 individuals it has two parts the

00:29:50 external part and an internal part

00:29:53 internal part is the part that we as

00:29:56 colear implant surgeons we place it

00:29:59 beneath the scal and Electrode array it

00:30:02 has an array electrode array which will

00:30:04 be threaded into the inner ear wow it's

00:30:09 like a wire that we are threading in the

00:30:11 inner

00:30:12 ear and the external part whatever it

00:30:15 has it has a microphone to grab the

00:30:19 sounds and a processor why a processor

00:30:22 is required here why can't just an

00:30:24 amplification device like hearing a work

00:30:26 there because

00:30:28 in normal ccka as I said earlier ccka

00:30:32 has hair cells these hair cells they

00:30:35 transform this sound waves into

00:30:38 electrical impulses that is a processing

00:30:41 unit we already have an inbuilt my

00:30:45 wonderful natural Processing Unit now

00:30:48 that is not there for this profoundly

00:30:50 deaf so scientists have invented in such

00:30:54 a way that there is a processing unit

00:30:56 which is outside so sound waves whatever

00:30:59 are being trapped are being converted

00:31:02 into electrical impulses within the

00:31:04 processing unit the speech processor and

00:31:07 from there I already placed inside a

00:31:10 device surgically from there the

00:31:13 impulses electrical impulses are

00:31:14 conducted into the ccka and there the

00:31:18 electrodes which I threaded into the

00:31:20 inner ear the wire that I threaded

00:31:22 inside it directly stimulates the

00:31:25 hearing nerve so literally we are

00:31:26 bypassing all the Parts in the we are

00:31:29 even bypassing the engine that is a

00:31:32 processing unit inside and directly into

00:31:35 the M it's like communicating directly

00:31:37 with your brain brain wow wow and the

00:31:40 success rate is tremendous tremendous

00:31:43 wow and what will be the first reaction

00:31:46 of a patient who can hear after a long

00:31:48 time this is mostly done in kids who are

00:31:52 completely born deaf so what will be the

00:31:55 first reaction of a child as soon as as

00:31:58 the baby is born he starts crying the

00:32:00 same thing will be there when we switch

00:32:02 on the implant they start hearing sounds

00:32:04 and they start

00:32:06 crying wow that I think there are very

00:32:09 few moments where parents also cry or

00:32:12 they feel happy when their kids are

00:32:15 crying one such moment is when we switch

00:32:17 on the implant kids will be crying but

00:32:20 this parents they have that Ananda

00:32:23 bashal they have that happiness oh my

00:32:26 God my kid is hearing for the first time

00:32:28 in his life

00:32:30 Wow and and of course the satisfaction

00:32:33 that you have from this

00:32:34 immense extraordinary extraordinary

00:32:37 right and so you're telling me that

00:32:39 anybody anyone with a hearing loss can

00:32:43 hear back again with this cular implant

00:32:46 there are certain criteria where we can

00:32:49 do implants but any age group from a

00:32:53 newborn baby to an elderly age group

00:32:58 there is no Edge restriction as I told

00:33:00 you the ccka develops as soon as the

00:33:02 inner ear it develops within the

00:33:04 mother's womb itself so there is no way

00:33:07 that is increasing or decreasing in size

00:33:09 so it's

00:33:10 Universal well it's a breakthrough

00:33:12 Research In Medical Practice exactly sir

00:33:15 how long this research has been how long

00:33:16 the practice has been going on almost

00:33:18 since 1980s 1980s 1980s they have

00:33:21 started it but um it was in 2000s when

00:33:26 2000 and after 20 2006 2010 that is when

00:33:30 it picked up its space they were slowly

00:33:33 transforming how the processor is going

00:33:35 to work getting a natural hearing they

00:33:39 Incorporated AI into that so that now in

00:33:42 the noisy in a sound normal this kind of

00:33:45 environment they can hear impulses but

00:33:47 once they get into the school there'll

00:33:49 be multiple noises which are there so to

00:33:53 incorporate that they have Incorporated

00:33:54 AI in the speech processor so it

00:33:57 immediately

00:33:58 transforms that wow that way wow it's

00:34:00 mind-blowing mindblowing and thank you

00:34:02 so much for doing this wonderful Noble

00:34:04 thing and um more important we talked

00:34:07 about the kids so tell me something

00:34:09 about deafness in kids and in

00:34:13 pons as I told you earlier

00:34:19 surprisingly 70 to

00:34:21 80% of the causes of newborn hearing

00:34:24 loss will be

00:34:26 genetic it is there is a very

00:34:28 significant role of genetics there and

00:34:31 genetic is you know if the uh family

00:34:34 history of deafness yes when there is a

00:34:37 consanguinous marriage so consanguinous

00:34:39 marriages or marriage between first

00:34:40 degree relatives which you are marrying

00:34:42 between uh uh sister's daughter or with

00:34:45 Mama that relative uh that angle where

00:34:48 there is increased risk of I know that

00:34:50 there's increased risk of both

00:34:51 complications so deafness is one of them

00:34:54 yes it's also one of them

00:34:58 so this consanguinous marriages as I

00:35:00 told you and a family history of hearing

00:35:02 loss they are all the highrisk category

00:35:06 and as I told you earlier once again

00:35:09 because within the pregnancy itself

00:35:11 fifth month of pregnancy itself the ca

00:35:13 is developing so any kind of infections

00:35:15 until fifth month or sixth month of

00:35:17 pregnancy the inner ear is not going to

00:35:19 develop maternal infections like torch

00:35:21 infections toxoplasmosis rubella

00:35:24 cytomegalo virus herpes in case if mom

00:35:26 is getting

00:35:28 the inner ear within the child is not

00:35:30 developing so that is also one of CA any

00:35:33 infection in the mother during pregnancy

00:35:35 during pregnancy maternal infections and

00:35:38 that's the reason we ask them to have a

00:35:40 very good healthy pregnancy and in case

00:35:42 if there is healthy pregnancy H but

00:35:45 immediately after the birth of the child

00:35:47 child is not crying because of hypoxia

00:35:51 hypoxia is aw state where enough amount

00:35:54 of oxygen is not delivered to the brain

00:35:57 and the hair hearing organ for few

00:35:59 minutes and that also causes hearing

00:36:01 loss and in case all the are okay but

00:36:04 child develops jaundice neonatal

00:36:08 jaundice parents very clearly say

00:36:11 everything was okay but child had

00:36:14 jaundice that's why he was kept in NIU

00:36:17 for one or two days days two days after

00:36:19 that everything is okay but that is a

00:36:21 triggering factor because jaes when the

00:36:23 Bel Rubin levels are high they cross the

00:36:26 blood brain barrier and that affects the

00:36:30 hearing organ so jaundice is the one

00:36:33 apart from genetics the ones which I

00:36:35 have seen for mother who had healthy

00:36:38 pregnancy non-c consanguinous marriage

00:36:40 jaundice is the leading cause for so as

00:36:43 as a mother how do we identify that

00:36:46 possible defers in M this is very very

00:36:49 important for all the expecting mothers

00:36:52 and parents to be because in India a

00:36:56 newborn here in screening is not

00:36:59 happening newborn hearing screening is

00:37:01 happening in all the developed countries

00:37:03 but it's not happening in our nation

00:37:05 because it's developing country so it is

00:37:08 very important for all the parents to

00:37:10 know certain milestones we call this as

00:37:13 hearing

00:37:15 Milestones number one as soon as the

00:37:18 birth of a baby until 0 to 3

00:37:21 months they start when they they start

00:37:25 to cry when they get responded to loud

00:37:27 sounds and when a mother or father they

00:37:30 shoes down the kid with their voice they

00:37:33 tend to calm down this is called startle

00:37:35 reflex this is number one test then

00:37:38 between 3 to 5 months of age when we

00:37:41 point at a particular sound some music

00:37:44 toy musical toy they tend to move their

00:37:47 eyes this side and that side that is how

00:37:50 this is other Milestone between 5 months

00:37:53 to 7 months because the head cing a past

00:37:56 everything coms though if there is a

00:37:58 music which is playing they tend to turn

00:38:00 their head this side or that side and

00:38:02 from 7th to 12th month or one year they

00:38:06 start responding to their name they

00:38:08 start speaking monosyllable words Mama

00:38:11 ATA MMA all this by one year they have

00:38:14 to get this words and between okay from

00:38:19 one year to 15 months of age they if we

00:38:23 ask them where is your nose they tend to

00:38:25 point at that get me the car

00:38:28 they go and get it so these are the

00:38:30 Milestones from 15 to 2 years of age 24

00:38:34 months they start speaking correct B

00:38:36 syllable words if this Milestones are

00:38:39 not met it is very important for parents

00:38:43 to immediately consult an end surgeon

00:38:46 any kind of early intervention is better

00:38:48 for the kids correct exactly early

00:38:50 intervention is very very

00:38:53 crucial and that awareness is not there

00:38:56 in our country yet because grandparents

00:38:58 they keep telling no you got your speech

00:39:00 late so your kid also gets speech late

00:39:03 don't worry about it they basically

00:39:05 consoling the parents but in this

00:39:07 generation where we have access to

00:39:10 Google access to doctors everywhere

00:39:12 parents are understanding that uh my

00:39:14 child is not responding Milestones are

00:39:16 not there but grandparents trying to

00:39:18 console them they delay and what happens

00:39:21 when they delay the child's brain is

00:39:24 like a super computer the hearing

00:39:26 neurons the neurons within the brain

00:39:28 they grow exponentially within 0 to 5

00:39:31 years of age think of a child's brain

00:39:34 like a clay when it is fresh we can mold

00:39:37 it in any direction the shape we want

00:39:40 but as it hardens up over a period of

00:39:44 time will not be able to mold it the

00:39:47 same thing holds good for the child's

00:39:49 brain the hearing neurons they and the

00:39:52 auditory Pathways they grow

00:39:54 exponentially between zero to one five

00:39:56 years of age we call this as neural

00:39:59 plasticity M and this neural plasticity

00:40:02 it tends to go down as the

00:40:05 age that's why this window of

00:40:08 opportunity I can say between 1 to 3

00:40:10 years is a very critical period if you

00:40:13 don't intervene a child who has hearing

00:40:15 loss sever hearing loss at least with

00:40:17 the help of hearing AGS during this

00:40:19 period there will be significant speech

00:40:21 delay he'll not be able to communicate

00:40:23 with his peers he'll not be able to go

00:40:25 to school and if a child who is born

00:40:27 with profound loss there is no hearing

00:40:30 at all this child will be left as deaf

00:40:33 and

00:40:34 mute throughout his life which has a

00:40:38 very significant impact on the

00:40:40 educational on the emotional status on

00:40:44 the socio economic status of the

00:40:47 family you know like we talked about the

00:40:49 young kids so Shifting the focus to the

00:40:53 elderly population right in my

00:40:56 experience at least because I don't do

00:40:58 ENT that much in a clinically most of

00:41:00 the times the elderly people come as a

00:41:04 main complaint of hearing loss and what

00:41:06 they do is they try to increase the

00:41:08 volume of the TV even to the maximum

00:41:11 right many people will say that you know

00:41:13 the TV is going to break right so that's

00:41:16 one of the sign that they are not able

00:41:17 to hear properly so but but the initial

00:41:20 thing is still hearing aids

00:41:23 correct yes

00:41:25 sir rather than just increasing the TV

00:41:28 volume see definitely they are

00:41:31 grandparents so they have grandkids and

00:41:34 we are there to look after them and we

00:41:36 tend to shout at them unknowingly we

00:41:39 raise our volume till now we were

00:41:41 obedient all this but because they are

00:41:43 not able to he hear well we tend to

00:41:46 shout and speak and that emotions will

00:41:48 be there on our face we cannot raise our

00:41:50 voice that is when we ask them to start

00:41:53 using hearing Adama start using an

00:41:55 amplifying device

00:41:57 but they don't agree elderly people they

00:42:00 still have the social stigma of not

00:42:03 using a hearing aid they feel that it's

00:42:06 odd to use but we need to remember

00:42:10 that as people become elderly they

00:42:13 become like kids so we have to console

00:42:15 them like kids like how we explain to

00:42:17 the kids no these are the things which

00:42:21 you are facing it's not just the TV

00:42:23 volume we are unable to talk to you and

00:42:26 we do not want to raise a voice against

00:42:28 you because of this you are isolating

00:42:31 yourself unknowingly you go into a state

00:42:33 of depression and finally leading to

00:42:37 memory loss we call this a dementia is

00:42:40 very commonly seen in them and we need

00:42:42 to educate them in fact the newer

00:42:44 hearing aids what we are seeing it's not

00:42:46 like something which is wor all the way

00:42:47 it's just like our Bluetooths they can

00:42:49 just play something here that's why

00:42:51 we'll ask them to take a hearing a trial

00:42:53 for about 3 to four days we give them

00:42:55 loner hearing aids at our Center M use

00:42:58 it you'll feel the difference that is

00:43:01 when you come and take it we have to

00:43:03 behave like kids wow so your hospital

00:43:06 gives a loner hearing age for 3 4 days

00:43:08 you try it out wow that's a wonderful

00:43:10 resource that's that's very nice so

00:43:12 could they can I can see that you know

00:43:14 if that works then they will be more

00:43:15 compliant in in in the hearing aids both

00:43:19 years or just one

00:43:20 year ideally when there is Blindness as

00:43:24 we tend to age will we use glasses is

00:43:27 only for one eye or both eyes both eyes

00:43:29 both same thing in hearing 1 + 1 is not

00:43:32 equal to 2 is equal to

00:43:35 three because it has a squishing effect

00:43:38 the localization of the sound if someone

00:43:41 starts speaking from the side they'll

00:43:43 not be able to hear properly from the

00:43:45 side that is how our p is built that's

00:43:47 why we have the squishing effect in the

00:43:49 brain to understand which side and all

00:43:52 this is possible when it is but of

00:43:54 course sometimes Financial issues

00:43:56 economic feasibility and the

00:43:58 compatibility of elderly people not

00:44:01 using hearing aids they may complain of

00:44:03 pain that's why we ask them to at least

00:44:05 use one at least one and then see how it

00:44:07 goes beautiful beautiful so I'm just

00:44:10 going to uh my most pressing question is

00:44:14 what is your take on airports which is

00:44:17 the most fascinating thing out there

00:44:19 now airpods I can say it's a kind of

00:44:23 revolutionary product right now from

00:44:25 Apple because

00:44:28 it's mainly solving two crucial aspects

00:44:31 one it is providing education about

00:44:35 hearing health and number two it is

00:44:38 removing the social stigma of using a

00:44:41 hearing

00:44:41 aid because with the help of airpods and

00:44:45 a phone we can literally do a hearing

00:44:48 assessment at comfort of our own home

00:44:50 you sitting on in our workplace you can

00:44:53 check you how good is your hearing

00:44:55 Health you've been to a concert

00:44:56 yesterday today and you feel there is

00:44:58 some muffling you can get your hearing

00:45:01 test done through the airpods through

00:45:03 the airpods and in case if you have some

00:45:06 hearing loss you visit a surgeon

00:45:08 especially it is very much useful in

00:45:10 elderly because they have this social

00:45:12 stigma of not using a hearing aid and

00:45:14 now because their grandkids are using

00:45:16 this airpods corre they don't hesitate

00:45:19 using this airpods as a hearing it so

00:45:22 basically the this airports they acting

00:45:25 as a bridge between the consumer

00:45:27 electronics and the Professional Medical

00:45:30 Electronics it's just we are giving them

00:45:33 an opportunity to get

00:45:35 in but of course there are certain cons

00:45:38 which are associated with this this is

00:45:39 only useful for mild to moderate hearing

00:45:42 loss in elderly people they have severe

00:45:44 hearing loss so mild M and most

00:45:47 importantly the treatable options of

00:45:49 hearing loss is not being addressed it

00:45:51 be it's being missed for example

00:45:54 situations like Autos sclerosis

00:45:57 the only presented the presenting

00:45:59 complaint will be hearing loss and a

00:46:01 person just gets his hearing and he

00:46:03 feels that oh I think the only option

00:46:05 which I have is a hearing aid but no

00:46:08 there is a surgical option it hardly

00:46:09 takes 20 minutes for surgery and

00:46:12 immediately on table if I do like this

00:46:14 patient will here tell me about the

00:46:16 Autos sclerosis for my audience I think

00:46:19 uh in layman terms in terms of how they

00:46:21 can understand this Autos sclerosis is a

00:46:24 condition where the smallest bone in our

00:46:27 body the stapis stapis is fixed ideally

00:46:31 the bones are supposed to

00:46:33 move I told you the three bones in the

00:46:35 middle year but what happens the stus is

00:46:38 not moving so the conductive apparatus

00:46:42 is not working because the stus is not

00:46:44 moving it cannot transfer the sounds to

00:46:46 the inner ear it is because of abnormal

00:46:49 bony deposition in the stapis now as a

00:46:53 surgical

00:46:54 procedure we place a small hole in the

00:46:58 uh we call it as

00:47:00 fenestra within the non-mobile stabus

00:47:04 and we place a piston there so that it

00:47:06 moves the Piston will be very tiny the

00:47:10 dimension will be uh 45

00:47:13 mm so you are you're dealing with like

00:47:15 so tiny teeny structures do you wear a

00:47:18 Vision Pro or something like that like a

00:47:20 big macroscopic thing my eyes will be

00:47:22 the microscope micos that is how we tend

00:47:26 to see that wow wow wow so this is

00:47:28 called uh hearing restoration complete

00:47:31 restoration complete restoration we need

00:47:33 not wear anything like hearing aades or

00:47:35 cckar implants wow it's completely you

00:47:38 can go in the rain you can walk normally

00:47:41 in fact this autoscar is something which

00:47:43 is hereditary I've operated for a son

00:47:47 for a 40-year old person because he's

00:47:50 not able to communicate properly in his

00:47:52 office and then because I operated on

00:47:55 both his years he's quite comfort

00:47:56 comfortable he got his

00:47:58 mother to get her evaluation and I

00:48:01 operated on them and

00:48:03 now his son son's son I operated on him

00:48:07 also all the three generations herit Tre

00:48:09 her Tre and this is such a fascinating

00:48:12 thing because we call it as magic

00:48:14 surgery immediately within 20 minutes

00:48:16 the patient will but it requires extreme

00:48:19 skill and

00:48:22 Equipment I'm making a hole of size4 mm

00:48:26 so any remers in the hand gone

00:48:28 completely deaf so that's why many

00:48:32 surgeons they don't do it they just go

00:48:34 for hearing it at least you have partial

00:48:36 hearing go ahead with that but we are

00:48:39 known for that hearing restoration nice

00:48:42 nice wow I know I could imagine the

00:48:44 difficulty in restoring such a tiny

00:48:46 teeny thing wow in elderly people the

00:48:49 other big thing is hypertension and

00:48:52 diabetes can lead to hearing gloss right

00:48:54 yes sir yes and what do you how do you

00:48:57 diagnose that same kind of evaluation

00:48:59 where they will not be able to hear

00:49:01 properly in diabetics the I always tell

00:49:05 them to get a screening evaluation done

00:49:09 at least once in two years because for

00:49:11 them this hearing loss is just like a

00:49:13 sunset they don't feel the dimming of

00:49:16 light minute by minute but all of a

00:49:18 sudden they feel it's

00:49:20 dark the same way they don't understand

00:49:22 that they are going through hearing loss

00:49:24 because initially it's only the high

00:49:26 high frequency loss what diabetic

00:49:29 individuals for normal people to

00:49:32 understand what this high frequency loss

00:49:34 is when a group of people are sitting

00:49:37 and they are conversating they'll be

00:49:39 able to understand they're talking

00:49:40 something but the clarity of speech will

00:49:42 be missing especially for sha if I say

00:49:46 Shri they can register only R sha sound

00:49:49 is gone

00:49:50 oh that is how it goes on especially for

00:49:53 and they have two times risk of

00:49:55 developing hearing laws when compared to

00:49:58 the normal ones it's mainly because of

00:50:02 multiple you being the gut Guru you know

00:50:05 how it works auditory neuropathy

00:50:08 diabetic neuropathy correct correct yeah

00:50:10 and nerves yeah just to summarize the we

00:50:13 have discussed in the past as well where

00:50:14 the diabetes complication the most

00:50:17 important complication is damaging the

00:50:19 nerves and the nerves applying

00:50:21 everything you know the stomach diabetic

00:50:24 gastropathy uh gastroparesis

00:50:26 uh you know the autonomic nervous system

00:50:29 every nervous that's why they check eyes

00:50:32 yes diabetic retinopathy so there

00:50:34 similarly you also check your years as

00:50:36 well once a year or once in two years um

00:50:39 ideally once in two years because if we

00:50:41 say once in an year also they don't

00:50:44 come I see at least once in two years

00:50:47 please get in case if they feel that

00:50:49 it's it's getting too muffled they only

00:50:51 come and visit us hearing is such a

00:50:54 humble organ it doesn't require much

00:50:57 attention just like us wives but if you

00:51:00 don't if you don't address that little

00:51:04 organ it makes sure that you don't even

00:51:06 sleep properly like the W like the

00:51:10 wives nice ni just a little attention

00:51:13 annual screening protection prote yeah

00:51:15 yeah that's all so as a very reputed

00:51:18 inner year coar implant surgeon which is

00:51:20 a very Niche how do you protect your

00:51:23 ears as a hearing restoration surgeon I

00:51:26 tend to spend most of my time in OT

00:51:29 operation theater so I'll be exposed to

00:51:32 various amounts of sounds laminar flow

00:51:36 which produces somewhere around this 50

00:51:39 to 60 Debs hitback the suctions the

00:51:41 mastoid drils so I know that I'm using

00:51:44 my precious time over there I'm losing

00:51:46 my precious time so I make sure I enter

00:51:49 into a calm Zone you're losing your

00:51:51 precious time of your hair cell safe

00:51:53 time exposure safe time exposure to

00:51:55 years safe time exposure to the years

00:51:57 and in the afternoon until evening only

00:52:00 a little bit of OPD and a normal

00:52:02 conversation that's all no loud

00:52:05 sounds and I exercise every day not so

00:52:10 long but at least 20 minutes without any

00:52:12 airpods nothing calm Zone once

00:52:15 again and yeah having very good foods I

00:52:20 tell foods are like volume controls so

00:52:23 if you have more of exposure into loud

00:52:25 sounds long

00:52:27 consumption of alcohol you're going to

00:52:30 lose your hearing so I make sure I do

00:52:32 not take them at all so this way I feel

00:52:36 most of the doctors they follow the same

00:52:39 routine and me especially into ENT I

00:52:43 have more of uh OT work yeah yeah so

00:52:46 safe time exposure I'll make sure do you

00:52:48 use headphones at

00:52:49 all very rarely because uh in the flight

00:52:54 I was looking at the your podcast Gutman

00:52:57 podcast so I had to use a proper noise

00:53:00 cancelling headphones so you invest in a

00:53:03 good noise cancellation headphones over

00:53:05 the Year yes yes and we also have some

00:53:08 ear protection devices like ear plugs

00:53:11 and ear defenders in fact when they are

00:53:14 buying certain things especially for

00:53:16 people who go for concerts or loud noise

00:53:19 exposure areas these year protection

00:53:22 devices when you flip the cover of it

00:53:23 there'll be something called nrr m noise

00:53:26 reduction rate M any nrr between 20 to

00:53:31 30 is very good so if you don't want to

00:53:34 listen to music or if you don't want to

00:53:36 invest in such make use of

00:53:39 the protection protection device your

00:53:43 plugs your Defenders they come they

00:53:46 passively block and at the same time

00:53:48 they have this active noise cancelling

00:53:49 feature also in case if you want to use

00:53:51 them so buy them at least they don't

00:53:54 cost much ear plugs hardly 1020 rupes

00:53:57 you're exposing yourself for a good

00:53:59 Festival just put that ear box 30 DB

00:54:02 you're getting exposed to 100 DB 30 DB

00:54:05 then and there it's cut so 70 it's more

00:54:08 or less okay less okay yeah so will that

00:54:10 be applied to the you know the movie

00:54:12 theaters the first day for

00:54:14 show

00:54:16 movie exactly right oh that's a good

00:54:18 thing H so your PL year Defender is a is

00:54:21 a device that goes over the year yeah

00:54:24 here this year Defenders we can also

00:54:26 call them as ear muffs but I

00:54:27 specifically didn't tell about ear muffs

00:54:29 because when I when I told this to my

00:54:32 patients they started buying this will

00:54:34 and ear mops and they said Madam I'm

00:54:37 putting this ear mops for my kid uh but

00:54:41 God oh God these are not the ear Ms ear

00:54:43 Ms are they just look like the

00:54:45 headphones headphones and for them to

00:54:47 understand I quoted an example of

00:54:49 Anushka Sharma and rir kapor where they

00:54:51 wear in a concert is Breakup Song they

00:54:54 wear that big chunky pieces right they

00:54:57 are the ear Defenders they passively

00:54:59 block and in case if they have active

00:55:01 noise cancelling so the noise will be

00:55:04 completely reduced and the song

00:55:05 whichever you want to listen you can

00:55:07 enjoy beautiful in case if you do not

00:55:10 want to use that ear protection take

00:55:11 breaks beautiful beautiful Anushka and R

00:55:14 are not talking to each other they're

00:55:15 doing dubbing that's

00:55:17 why wonderful wonderful so I'm going to

00:55:20 tell you a very interesting situation in

00:55:21 my one of my medical standup comedy

00:55:23 shows uh a person actually sent us an uh

00:55:26 uh message that um I absolutely love

00:55:30 what you're doing on your Channel I want

00:55:31 to come and see you do you have any sign

00:55:33 language because I am deaf that message

00:55:36 really moved me and um you know any

00:55:40 thoughts on that in terms of you know

00:55:42 how these people actually can have a

00:55:45 better

00:55:47 life I can say there is a

00:55:51 big deaf Community which is very vibrant

00:55:57 why am I stating this way because we

00:55:59 just have one mode of communication just

00:56:02 this way but they have different modes

00:56:04 of communication as you said sign

00:56:06 language interpreters through Indian

00:56:09 sign

00:56:10 language through Visual cues through lip

00:56:13 reading the community is quite

00:56:16 vibrant and there is a something uh an

00:56:20 article a research which um mentioned

00:56:25 that certain hearing losses when they

00:56:27 are not treated they lead into

00:56:30 dementia but there's a controversy in

00:56:32 this because it was done uh in John

00:56:35 Hopkins Institute where they researched

00:56:38 about 639 adults over a period of 12

00:56:42 years they stated that people who have

00:56:45 mild hearing loss they have chance of

00:56:47 developing dementia two times moderate

00:56:50 three times risk of developing dementia

00:56:52 that is I mean memory

00:56:53 loss and people who have severe hearing

00:56:56 ing loss they have a very high risk of

00:56:58 developing dementia almost five times

00:57:01 more but here the thing that we need to

00:57:05 remember it it's not just hearing loss

00:57:07 it's untreated hearing loss or lack of

00:57:11 communication because as you said that

00:57:13 young girl

00:57:15 Divya she is completely deaf she

00:57:17 required a sign language interpreter but

00:57:20 she's quite good she's able to remember

00:57:22 you all these years she was completely

00:57:24 deaf right so I can say they are already

00:57:27 leading their life there is nothing much

00:57:30 I can add to that but what we need to

00:57:32 remember that is communication is

00:57:34 crucial especially for the elderly

00:57:36 people they completely rely on this

00:57:39 speaking issue and if there is hearing

00:57:42 loss and it is completely untreated with

00:57:45 the help of hearing aids if they are not

00:57:47 using it and there is no one who going

00:57:49 and talking to them that social

00:57:51 isolation that develops into Dementia or

00:57:54 else this Vibrant Community you need not

00:57:56 even think about it they are extremely

00:57:58 good extremely intelligent and sincere

00:58:01 thanks to you

00:58:02 because you this de Community is

00:58:05 something which many people do not touch

00:58:08 but you you somehow you reach to a level

00:58:12 where even those people are very fond of

00:58:14 you and they want to attend the med yeah

00:58:18 really sincere thanks to you thank you

00:58:20 thank you thank you thank you that

00:58:21 really was emotional she came to the

00:58:22 show and then after the show we took

00:58:25 pictures and and uh was very nice it was

00:58:27 a very ni so nice of you uh I feel I'm a

00:58:31 part of that Community hearing Community

00:58:34 also of course of course you have made

00:58:36 beautiful changes to them as well so

00:58:38 wonderful wonderful super I'm going to

00:58:39 tell you a statement whether you need

00:58:41 you need to tell us whether it's a myth

00:58:42 or a fact okay so first question hearing

00:58:45 loss only affects elderly

00:58:49 people that's a myth it's a myth it

00:58:52 affects everybody everybody any age

00:58:54 group from the new want to holder age

00:58:57 group regular hearing test are not

00:58:59 required if you are able if you think

00:59:02 you're able to hear properly no even

00:59:04 that's a

00:59:05 myth because as I said earlier it's just

00:59:08 like a

00:59:10 sunset you don't feel that your hearing

00:59:13 is getting muffled until you completely

00:59:15 lose it even normal person should

00:59:17 undergo hearing test yes sir that's

00:59:20 mandatory especially we are noticing

00:59:22 this in uh age groups between 5 to 10

00:59:25 years old because they already had

00:59:26 hearing and now they are losing hearing

00:59:28 because they exposed to multiple sounds

00:59:31 it could be because of upper respir

00:59:32 recurrent upper respirat tract infection

00:59:34 very recently there was an outbreak of

00:59:36 Ms in India between age December to

00:59:41 March April and this moms when it was

00:59:44 going off it took off the hearing of

00:59:46 kids especially those age

00:59:48 groups that's why we say it is important

00:59:51 to get will those kids get better with

00:59:53 the implant yeah definely itely

00:59:56 definitely the only option is

00:59:58 because they go into profound loss and

01:00:00 thanks to the tech devices they were

01:00:02 stating Mama I'm able to hear only one

01:00:05 uh thing I'm not able to hear wow that

01:00:08 is how they are identifying and coming

01:00:10 to us wow wow beautiful all right can

01:00:14 oil drops cure ear

01:00:17 infections absolutely a myth oil drops

01:00:21 will never cure infections in fact they

01:00:23 worsen it in case if there is a breach

01:00:25 in ear drum those all drops they go

01:00:28 inside and that cause middle ear

01:00:30 infection chronic discharge heing loss

01:00:32 don't put anything in the ears M my

01:00:35 friend says don't use sunflower oil I

01:00:37 said that's good he said use

01:00:39 [Music]

01:00:41 safflower okay um hearing once lost

01:00:46 cannot be

01:00:48 restored I

01:00:50 think both

01:00:53 both because I myself be being a hearing

01:00:56 restoration surgeon there are two

01:00:59 components in this a conductive and a

01:01:02 sensory neural all the conductive Parts

01:01:05 they can completely be restored that

01:01:07 hearing part but the inner ear the hair

01:01:10 cell part that is the neural component

01:01:13 those cannot be restored like noise

01:01:15 induced hearing loss the ones which are

01:01:17 through viral infections the one which

01:01:18 alai AG had they cannot be restored they

01:01:21 have to be supplemented with a hearing a

01:01:23 or a cckar implant wow nice um ear

01:01:28 cleaning is necessary like a dental

01:01:31 cleaning

01:01:33 definitely

01:01:35 with there are only three times that we

01:01:38 need to do an ear cleaning one when your

01:01:43 hearing is muffled because of the ear

01:01:46 wax number two you start getting pain

01:01:49 because of the ear wax or number three a

01:01:52 hearing surgeon like me needs to look

01:01:54 into the eardrum what's happening inside

01:01:58 other than these three things there is

01:02:00 no need to clear

01:02:02 wax or clear your ears in fact that is

01:02:07 protective it prevents any

01:02:09 microorganisms entry because it has a

01:02:10 particular pH and it is designed in that

01:02:13 [Music]

01:02:15 way using earbuds is good for

01:02:20 you it's a

01:02:22 myth in fact when you flip the cover of

01:02:25 the earb s it is very clearly written on

01:02:28 that please do not use inside the ear

01:02:31 it's only for the outer crevices that's

01:02:34 all you're not supposed to stick

01:02:35 anything because once you start doing

01:02:37 that there's a conveyor belt mechanism

01:02:41 inside our ear it's inbuilt it always

01:02:43 makes sure that the dirt or wax

01:02:45 whichever is there it is shedded out

01:02:48 that is called shedding of epithelium

01:02:49 that's nothing but wax but in case if

01:02:51 you are using the Q-tips or earbuds you

01:02:54 are disrupting that and you creating

01:02:57 micro abration microscopically we can

01:02:59 see that and that causes infections in

01:03:03 and you are disrupting that conveyor

01:03:05 build mechanism the natural cleaning

01:03:08 mechanism is gone and your ear waxs get

01:03:10 stuck so people think that using earbuds

01:03:12 can actually clean your ear but can

01:03:13 actually increase the risk of ear

01:03:15 infections exactly so if you have a cold

01:03:17 and if you are uh taking a a flight that

01:03:20 will damage your hearing

01:03:23 permanently no myth that's a myth

01:03:26 because there'll be tube which connects

01:03:28 from nose to the ear that's called ustan

01:03:31 tube the main function of this tube is

01:03:33 to equalize the pressure outer

01:03:35 atmospheric pressure to the middle ear

01:03:37 pressure it equalizes what happens when

01:03:40 we take a flight travel because of rapid

01:03:42 changes in the cabin pressure it takes

01:03:45 time for this ustation tube to function

01:03:48 but it'll function like when you yawn or

01:03:50 when you take a sip of water when you

01:03:52 gulp but during upper respirat

01:03:55 infections like

01:03:56 cold the ustation DU gets blocked

01:03:59 because of this cold inflammation which

01:04:01 sets in that's why it will not be able

01:04:03 to equalize the pressure that's when

01:04:06 people start getting

01:04:08 pain because infection is spreading from

01:04:11 the nose to the

01:04:12 ear understand that is when they start

01:04:14 getting pain or muffled hearing all this

01:04:17 and most of the time we would have seen

01:04:19 in the flights as soon as there is

01:04:21 ascent and descent kids they start

01:04:24 crying yes rather than when it is flying

01:04:27 normally the reason is for kids this UST

01:04:29 station tube the tube it's much smaller

01:04:32 much narrower and the angulation is not

01:04:35 there it's horizontal like this as our

01:04:37 face expands this comes down this way so

01:04:40 it is like this the capacity to equalize

01:04:42 the pressure will not be there that and

01:04:45 that's when they start

01:04:47 cry nice nice I mean that's not nice for

01:04:50 the kid but I mean beautiful explanation

01:04:53 all right so rapid fire questions okay

01:04:55 the most dangerous myth you encounter

01:04:58 every day that you wish you can

01:05:01 change most of the great grandparents

01:05:04 they tend to console their kids stating

01:05:07 that don't worry if your child is not

01:05:09 getting his speech you took time to get

01:05:12 your speech you spoke after five or six

01:05:14 years wait and watch he starts speaking

01:05:18 that is a dangerous thing because neural

01:05:20 plasticity is gone he'll not be able to

01:05:23 hear properly throughout their life it's

01:05:25 better to have an early

01:05:29 diagnosis um one hearing Health habit

01:05:33 that you think everyone should adopt

01:05:35 stop using Q-tips or

01:05:39 earbuds biggest threat to hearing in

01:05:42 Modern India with all these devices

01:05:45 noise and used hearing loss headphones

01:05:49 headphones usage most promising

01:05:51 advancement in hearing loss coar

01:05:54 implants coar implants

01:05:57 beautiful so the last one is here is

01:05:59 three simple steps every Indian can take

01:06:01 today for better hearing Health

01:06:03 basically summarizing our

01:06:05 podcast for all the IT people for all

01:06:08 the software engineers make sure you

01:06:10 follow 6060 Rule and invest in good

01:06:14 quality headsets protect your hearing

01:06:17 because once your hearing is lost

01:06:18 through nois in you st there is no way

01:06:21 that we are going to restore there is no

01:06:22 medication there is no medication and we

01:06:24 are not able to restore for it please

01:06:27 spread the awareness that hearing loss

01:06:30 when identified early is

01:06:33 treatable treatable yeah yeah um and

01:06:37 also I wanted to bring it to my audience

01:06:39 the wonderful work that you're doing

01:06:41 where you are actually giving the cular

01:06:43 implants to underprivileged people where

01:06:46 they will not be able to afford this

01:06:48 much amount of an cost so that really

01:06:51 take I was I was pleasantly surprised

01:06:53 that you know there are hospitals who is

01:06:56 actually promoting this in a very good

01:06:58 way and you are one of the top surgeons

01:07:00 and if you are spending your time for

01:07:02 under privilege that is something that

01:07:04 is really really appreciative of what

01:07:06 you're doing and uh thank you so much

01:07:07 for doing that so can you tell us what

01:07:10 is a general cost involved and how a

01:07:13 person can actually reach out to Dr R's

01:07:15 Hospital in terms of if they ever find

01:07:18 any hearing loss in kids or anything

01:07:19 like that the cost of a cckar implant

01:07:22 ranges between 8 lakhs to 20 lakhs

01:07:27 [Music]

01:07:28 wow I myself as a cckar implant surgeon

01:07:32 as a hearing restoration surgeon I feel

01:07:34 privileged that I have performed the

01:07:36 maximum number of implants till L and

01:07:39 through our Rousey and declear implant

01:07:42 program we are

01:07:44 conducting these hearing surgeries free

01:07:47 of cost wow for kids who are born deaf

01:07:51 and the underprivileged kids under the

01:07:54 age of 5 years

01:07:56 so in case if your loved ones or people

01:08:01 who are working with

01:08:02 you if they do not know that early

01:08:06 intervention is required please create

01:08:09 the awareness that once they are

01:08:12 addressed with the help of this colear

01:08:14 implant surgery or hearing where we are

01:08:17 addressing their hearing your protecting

01:08:19 their life the child will be not the

01:08:23 child will come out from the zone of

01:08:25 being deaf mhm so in case if any of your

01:08:29 colleagues are there or any of the kids

01:08:31 that you know are there please let them

01:08:32 contact our hospital and thanks to the

01:08:35 NOS non-government organizations that

01:08:37 are helping us wow with the amount of

01:08:39 good work that do we are doing they

01:08:41 sponsoring us not just with the implant

01:08:43 but also the surgery of the implant is

01:08:48 also being covered nice nice I wish this

01:08:51 message reaches to many people because

01:08:54 you know sponsoring is a different thing

01:08:56 but the actual person to do it by giving

01:08:59 your time that is also uh very important

01:09:02 equally appreciable thing so the both

01:09:04 combined factors both the factors are

01:09:06 available in your hospital I I hope

01:09:09 everybody make use of this opportunity

01:09:11 and we could create a better India with

01:09:14 de free India as you say right that's

01:09:16 your mission yes sir right yes uh so I

01:09:19 hope Dr Shri makes that statement very

01:09:23 well and I I wish nothing but good luck

01:09:25 in all your endeavors and thank you so

01:09:27 much for your time thank you so much sir

01:09:29 thank you thank you that was a wonderful

01:09:31 episode I absolutely loved it she is an

01:09:34 absolutely amazing person you could see

01:09:37 that you know simple steps can prevent

01:09:39 our hearing loss and number two most

01:09:41 importantly if you know anybody with

01:09:44 hearing loss okay so tell them that

01:09:46 hearing aid is not the only option there

01:09:49 are other options available including

01:09:51 cckar implant which could potentially

01:09:54 change the way that they look and I'm

01:09:56 sure you will be conscious of how you're

01:09:59 using your headphones how much amount of

01:10:01 decibels that you are being exposed to

01:10:02 on a daily basis remember those 4,000

01:10:05 hair cells that she talked about in the

01:10:07 inner year is absolutely critical for

01:10:09 you to save for the rest of your life

01:10:12 all right as usual stay happy stay gutsy

01:10:15 May gut bless you

About this Podcast

Dr. Shree Rao is one of India’s leading cochlear implant specialists with over 12 years of experience and 200+ successful cochlear implant surgeries. She completed specialized fellowship training under Padmashri Awardee Dr. Milind V. Kirtane and has trained at Singapore General Hospital for rhinoplasty and facial plastic surgery. As Director of Asia’s largest ENT Super Speciality Hospital, she leads teams across 7 OPDs, 3 operation theaters, and specialized units with a 99.9% success rate. Dr. Shree Rao is passionate about creating a “Deaf-Free India” and partners with NGOs to provide free cochlear implant surgeries to underprivileged children.

Dr. Pal Manickam is a renowned gastroenterologist and health educator with over 3.5 million subscribers on YouTube. Known for making complex medical topics accessible to the general public, Dr. Pal focuses on gut health and overall wellness. Through his podcast “Gut Feeling with Dr. Pal,” he brings India’s top medical experts to discuss critical health issues affecting millions of people.

Podcast Summary

In this eye-opening conversation, Dr. Shree Rao joins Dr. Pal to discuss the growing epidemic of noise-induced hearing loss in India. With the rise of work-from-home culture, increased headphone usage, and constant exposure to noise pollution, more Indians than ever are at risk of permanent hearing damage. Dr. Shree Rao breaks down the science of how we hear, explains why prolonged headphone use is dangerous, and shares practical prevention strategies like the crucial 60-60 rule. She also reveals the life-changing impact of cochlear implants and her mission to provide free surgeries to underprivileged children. This conversation is essential for anyone who uses headphones regularly, works in IT, or has loved ones with hearing concerns.

Need Expert Care?

If you or a loved one is experiencing hearing difficulties, don’t wait

Podcast Highlights

What is noise-induced hearing loss and why is it becoming an epidemic?

Noise-induced hearing loss occurs from prolonged exposure to loud sounds, which damages the delicate hair cells in the inner ear (cochlea). These precious hair cells convert sound vibrations into electrical signals that our brain interprets as sound. Once damaged, these hair cells cannot regenerate – making the hearing loss permanent with no medication available to restore it. With the post-COVID work-from-home culture, people are using headphones for 8-10 hours daily, exposing their ears to dangerous noise levels that our ears simply weren’t designed to handle.

What is the 60-60 rule and why is it critical for people hooked to earphones?

The 60-60 rule is recommended for anyone using headphones regularly:

Keep your volume at 60% of maximum and take breaks every 60 minutes.

This simple practice can significantly reduce your risk of noise-induced hearing loss. Additionally, she recommends creating an optimal workspace with reduced background noise, investing in quality headphones with noise-cancelling features, and preferring over-the-ear headphones instead of in-ear ones, as they sit farther from the eardrum and cause less direct damage.

Are young people really experiencing more hearing loss than previous generations?

Absolutely yes. We are seeing a dramatic increase in hearing loss among younger patients. The myth that “hearing loss only affects elderly people” is completely false. With constant headphone use, attending loud concerts and events, working in noisy environments, and the normalization of high-volume audio, today’s youth are damaging their hearing at unprecedented rates. What used to be a condition primarily affecting seniors is now impacting people in their 20s, 30s, and 40s.

Can medical conditions like diabetes and hypertension affect hearing?

Yes, hypertension and diabetes can significantly contribute to hearing loss. These conditions affect blood flow to the delicate structures of the inner ear, depriving the hair cells of oxygen and nutrients they need to function properly. This is why managing chronic health conditions is crucial not just for overall health, but also for preserving hearing ability as we age.

What treatment options are available for severe hearing loss?

For mild to moderate hearing loss, hearing aids can amplify sound effectively. However, for severe to profound hearing loss where hearing aids aren’t sufficient, cochlear implants are life-changing devices.

Unlike hearing aids that simply make sounds louder, cochlear implants bypass damaged hair cells and directly stimulate the hearing nerve. Early intervention is crucial, especially for children born deaf. With timely cochlear implant surgery (ideally before age 5), children can develop normal speech and language skills, transforming their educational and social futures.

What are three simple steps every Indian can take today for better hearing health?

Follow the 60-60 Rule: Keep headphone volume at 60% maximum and take breaks every 60 minutes. Invest in quality noise-cancelling headphones to avoid turning up the volume in noisy environments.
Protect Your Hearing: Once hearing is lost due to noise damage, there is no medication to restore it. Prevention is the only solution. Use ear protection devices when exposed to loud environments (concerts, construction sites, etc.).

Seek Early Intervention: If you or a loved one notices any hearing difficulty, don’t delay. When identified early, hearing loss is treatable. Regular hearing tests are important, especially for high-risk groups (IT workers, musicians, factory workers) and children showing signs of hearing problems.

Deaf Free India Podcast with Dr. Shree Rao by Dr. Pal

Deaf Free India Podcast with Dr. Shree Rao by Dr. Pal

About this Podcast

Dr. Shree Rao

Dr. Pal Manickam

Podcast Summary

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Podcast Highlights

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