Rob Brown, MD

A Physician's Unique Perspective on Wellness

Month: July 2016

Are You Slowly Going Deaf Exercising with Those Ear Buds?

Walk through any gym, and you’re likely to see people on the treadmill or working out, listening to music through a set of ear buds. Most people don’t realize it, but the combination of exercise and loud music can cause you to slowly go deaf.

We have been working out to music for decades. Years ago, music was a shared experience, played in the background. In fact, some based membership decisions on the type of music played at the gym.

MP3 players like the Walkman and then the iPod came around, and everything changed. These devices, when used with ear buds, block out extraneous noise while delivering music directly down the ear canal. Seems like a great idea, but ear buds have been shown to be able to wreak havoc on the inner ear.

When young, I mistakenly thought that when people became deaf, it was because their eardrum popped. Whereas this can happen with an extremely loud noise, such as an explosion, this “all or none” effect isn’t the typical way one loses their hearing. More commonly, it’s a slow, insidious process, called noise-induced hearing loss (NIHL). This form of deterioration can begin at any age from childhood through old age. This is a preventable form of hearing loss that occurs from repeated exposure to excessively loud sound.

NIHL is a common condition. The National Institutes of Health report that approximately one out of seven Americans (15%) aged 20 to 69 have hearing loss related to occupational or leisure activities, presumably from chronic exposure to loud noise and/or music. People with this form of hearing degeneration initially present with the inability to discriminate between different sounds or a hypersensitivity to certain sounds. Ringing in the ears, referred to as tinnitus, can also occur. Eventually, a hearing aid is needed.

Hearing requires more than just an intact eardrum.

The ear is the first part of an apparatus that first converts vibrational waves of energy into mechanical vibration and following, into electrical impulses which travel from the inner ear to the brain. The brain is where we interpret this information as something we call “sound”. The switch from mechanical vibration to electrical impulse occurs within a structure of the inner ear called the cochlea.

The cochlea is filled with fluid and contains a collection of cells with tiny protruding hairs called cilia. Mechanical vibrations transmitted within the fluid cause the cilia to vibrate. The cells housing the cilia change this mechanical information into an electrical nerve impulse which is then transmitted to the brain.

Each time we are exposed to excessively loud noise, tiny blood vessels that supply the cells in the cochlea constrict, diminishing its blood supply. If the blood supply is reduced too drastically, the cells sporting the cilia can die. Once they’re gone, they’re gone. They can’t grow back.

Where does exercise fit in?

During exercise, blood is diverted to the body’s active muscles that need oxygen and nutrients. This redirection of blood will cause a decrease in blood flow to the cochlea. By itself, this is not a problem for the cells in the cochlea. But mix loud music with exercise, and there is a compounding effect on the blood vessel constriction, doubling the risk for damage. More damage leads to more eventual hearing loss.

The maximum sound intensity that is safe under normal activity and health is 80 decibels. This equates to the noise level generated by running the vacuum cleaner or garbage disposal. Sounds over 85 dB can cause hearing loss. In general, if you are wearing ear buds and can’t hear when someone is talking to you in a normal tone voice, the volume is probably turned up to loud.

Listening to music while exercising can give an energy boost. We become entrained with the music and as a result, it motivates us to move and perform with the rhythm. The good news is that the music doesn’t need to be loud to receive this beneficial effect.

Be Cautious of Toxic Air Fresheners – At Home and on the Road

Clean indoor air is important. With non-fragrant cleaning materials, indoor plants and an air purifier, my home air is clean, even in the wintertime. I began to take this for granted, until a recent road trip.

I usually try to stay in a mid range motel or a bed and breakfast. On this past trip though, I had a two day drive and planned to spend the evening at a motel on the fly after hitting my driving limit. Upon exiting the highway, I pulled up to a roadside motel with a vacancy.

As I walked into the room, it was as if I had been placed into a sealed box filled with a sickly sweet, synthetic chemical odor of potpourri. The scent was overpowering and made me dizzy. I left the room door ajar to air out the room. Why the heck did they dispense so much air freshener in the room? What odor are they trying to conceal?

After washing up, I closed the door and prepared myself for sleep. Despite my dread at spending a night in that chemical laden room, I fell asleep instantly. In the early am, I awoke with a headache. I had planned to “sleep in”, but the odor was back in full force. I needed to get out of that room as quickly as possible.

Many new air fresheners either chemically inhibit receptors in your nose or actually coat the inside of the nose with a thin film of chemicals that work by initially stimulating and then deactivating your sense of smell. Isn’t this a form of poisoning? If one went to a public building that had a technology that temporarily blinded you, would this be acceptable? Why is it that we have allowed products in the marketplace that disrupt one of our important senses?

The ability to smell is important for many reasons. Aromas can attract or repel. Odors can alert us to danger such as fire, spoiled food or the presence of toxins. Pleasant smells can create a sense of calm and peace. Nerves travel directly from the nose and into the brain, stimulating memory centers, bringing to consciousness associations we have had with that scent in the past. We have all had recollections of loved ones and past experiences brought on by a particular scent, describable and indescribable.

Our sense of smell works in concert with our sense of taste.

Although the headache cleared after my escape from the motel room, after arriving to the beach, I was still marred by the air freshener.

I treated myself to a lobster dinner, but the food was tasteless. Because my sense of smell had been deactivated, I couldn’t smell or properly taste my food.

It took several days before my sense of smell returned and all was good. If I had continued exposure to that toxin, I would have lost my sense of smell for the whole week.

Many people purchase these carpet sanitizing and deodorizing products for use in their homes. Through daily exposure, these materials have inflicted a chemically induced anosmia on themselves and on their housemates/family.

If there is an offensive smell in your home, remove the source, don’t masque the odor with chemicals that take away your ability to smell. In addition to being able to “smell the roses”, you will enjoy an enhanced sense of taste.

Fireworks on July 4th – A Symbol of Entrainment

While sitting on the boat, waiting for the fireworks display to start, my mind drifted. Why was I destined to live a life of turbulence? Deep inside, I knew I became involved with people who mirrored different aspects of my own personality. My own complexity must be the source of my relational ups and downs. Was I destined to be alone? Yes, I became too introspective on this festive holiday.

The fireworks display started. Sheeewwwewww… Kaboom! One hundred tiny pink lights lit up the sky in an umbrella display. Boom! Boom! The lights were ordinary. I had seen them many times before. Yet, this year, they took on greater significance as I began to consider each light both individually and then as part of the whole. Sheewwww… boom!

I was mesmerized, looking at the lights as they fell from the sky, all turning color and then into glitter at the same time. All extinguishing at the same time. I reasoned that there must be the same amount of chemical in each particle falling from the sky, which then undergoes the same reaction at the same time. The result to the onlooker is coherence. A synchronized display. Yet, to me, it was a metaphor for entrainment, and a glimpse into the entanglement of relationships.

Entrainment is a phenomenon whereby physical objects in motion sync with each other over time. Entrainment is not chemical, physical or electrical. It’s an energetic, mysterious phenomenon that is very real. Think of a flock of birds moving synchronistically, all darting right or left at precisely the same time. Similarly, cuckoo clocks on display will all swing in perfect unison. In the garden, weeds all bloom and go to seed at the same time, regardless of how big the plant has become. Entrainment is universal.

Expressions like “Misery loves company”, “Laughter is contagious.” and “It takes one to know one” each hint to the concept of entrainment. While in the presence of someone who is heated and anxious, the companion too will become nervous. If one is in the presence of a calming energy, such as a trickling brook or a nurturing partner, the mind and body will relax. Living beings, including people, animals and even plants will entrain to the rhythms of music. Upbeat tempos will bring energy and higher metabolism, whereas slower rhythms will bring about lethargy and contemplation.

Entrainment occurs at many levels. Numerous internal processes are regulated by entrainment. For example, your heart rate entrains with your breathing rate. If your heart rate goes up, your breathing rate will increase. If you consciously slow your breath, your heart rate will drop.

Over time, we entrain with the company we keep. Women living in close proximity will cycle together. Couples who have been together for a long time will even physically resemble one another. Groups of people entrain to local politics, societal issues, even the weather. In a global sense, the human race is entrained with each other, as well as entrained with the position of the earth and its relationship with other planets, the sun and other celestial bodies. Perhaps this is where the origins of astrology lie.

As my mind drifted back to earth and to the boat, I began to cough and sputter. The smoke from the fireworks had formed a cloud on the water into which we had slowly drifted. Our captain backed up the vessel and we pulled away, leaving the toxic gas to dissipate. Approaching the shore, I came to the acknowledgment that we are all connected with each other. We have lovers, friends and adversaries. Regardless of the emotional hits we get from our relationships, we entrain with each other and our world, all of the time.

No one is alone.

Light at Night

How to Get Restful Sleep in a World that Never Shuts Down

Here we go again, another week of overnights. Another week of disturbed sleep.

I walked into the basement bedroom and placed the blackout liner over the ground level window and moved my toiletries to the downstairs bathroom. When I return home from work at 6:30 am tomorrow morning, I want to be certain there won’t be any light filtering into the room. I set out a pair of earplugs and a blindfold. It works some of the time. Sleep is important.

Many of us are saddled with having to work the graveyard shift. Service industries either outsource their night time coverage to the other side of the world, or delegate the onus of overnight work on the local work force. Sometimes the work is disseminated among the employees. At other times, a designated person or team is assigned this shift. Working overnights can take a toll on your health.

We are not nocturnal creatures. Systems in our body are designed around the rising and setting of the sun, called circadian rhythm. The brain’s production and secretion of melatonin provides the body with a biological clock discriminating between day and night.

To optimally produce and secrete melatonin, one needs exposure to periods of bright light, ideally sunlight, interrupted by complete or near complete darkness. Even for those who go to bed at a normal hour and sleep through the night, darkness in the bedroom isn’t easy to achieve. Sources of light in the bedroom can significantly affect your melatonin production. Who would have thought that light, particularly artificial sources of light could be toxic!

After learning this, I purchased a set of black out shades for the bedroom windows. But after the shades were installed, I noticed that every electrical device in the bedroom was supplied with an indicator lamp letting me know where it was located, just in case I wanted to use it in the middle of the night?! Those tiny lights cut the blackness of night with a faint glow of red, green or even blue light. One might think that closing the eyes is sufficient to block out ambient light, but that is not the case. Light will illuminate the retina, the back of the eye, even when the eyelid is closed. The eyelid will prevent you from “seeing”, of course, but there is a separate pathway from the eye that signals the brain whether it is light or dark. The brain then decides whether or not to produce melatonin. To avoid having to turn off all of these little appliances when I sleep, which some people do, I put on a pair of blinders. These eye covers prevent any light at all from entering my eye.

The proper timing and amount of melatonin produced is critical for proper health. Too much melatonin can cause depression. But the immune system will not function properly without enough melatonin. Melatonin also has hormonal effects on the body and has also been shown to kill off cancer cells. Unfortunately, studies have shown an increased cancer rate in people who do overnight shifts. I don’t have any idea how to trick the body into secreting the proper amount or concentration of melatonin, except to try and prepare for bed with appropriate lighting and then make the bedroom as dark as possible while I am sleeping, even at odd hours.

Preparation for bed is simple. Think of nature. The reddish color of the sun as it sets tells all living things, that the day has ended. To simulate this effect, use bedroom lamps that produce more reddish shades of light to get the brain geared up for sleep. Equally important, avoid blue lights before bedtime, particularly LED screens on electronic devices. Children especially will produce significantly less melatonin if exposed to a laptop or other LED display before bedtime.

Melatonin is produced in the absence of light, most intensely between 1 and 3 am. As I write this, it’s 3:30 am. My peak melatonin production is over for the night, yet I am still awake, looking at LED displays for work.

I just walked into the bathroom and looked in the mirror. Ugh. This shift is aging me.

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