As baby boomers head into their 40s and 50s, the bill for their glory days is coming due.
Musicians and their fans are discovering that their ears don't work as well as they used to, and the loud rock music they reveled in is at least partly to blame.
It's a frightening prospect. Once you've battered some of the thousands of inner-ear hair cells that transmit sounds to the brain, they're lost forever. And the only remedy for most people is hearing aids.
Hearing aids generally cost from $600 to $2,400, although state-of-the-art digital aids can cost much more. Analog aids, using pre-digital technology, can cost as little as $300. In any case, the cost seldom is covered by health insurance.
An analog model "would do the minimal job of a hearing aid, which is to make things louder," said Jane Gilbert, an audiologist at Abbott Northwestern Hospital in Minneapolis. But busy people whose lives take them into a variety of settings need more flexibility and better sound than analog models can provide, she said.
Vanity, once an issue, shouldn't be one anymore. Today's custom-molded aids can be slipped into the ear canal where they can't be seen. Still, the prospect of wearing hearing aids is a big step, and many people procrastinate.
"The average person with a hearing loss will duck and hide for about seven years," said Bill Austin, president of Starkey Laboratories, a hearing aid company based in Eden Prairie, Minn.
Of the 28 million Americans with hearing loss, 10 million damaged their ears by loud noise, including music.
"Noise-induced hearing loss is entirely preventable, so that's a third of all hearing loss that didn't need to happen," said Julee Sylvester, a spokeswoman for the Sight and Hearing Association in St. Paul, Minn.
People who have ringing in their ears after concerts have damaged their inner ears, said Dr. Lisa Posey, who practices in Edina, Minn. "Often it's mild enough that the ears recuperate entirely," she said. "That's why the ringing goes away within 24 to 48 hours."
But with repeated exposure, the hearing loss can be permanent, she said. Loud noise also can cause tinnitus, a permanent ringing in the ears.
Posey said inexpensive foam earplugs, sold at pharmacies, hardware and sporting goods stores, can reduce the sound as much as 30 decibels without interfering with the enjoyment of the music.
Hearing loss is prevalent among baby-boomer musicians, said Dr. Rex Haberman, a Twin Cities ear, nose and throat doctor who also is a musician. "In fact, it's more unusual that I don't see it."
Haberman has no hearing loss himself but said he has "seen it in musicians in their 20s and 30s." He recommends that musicians who regularly play loud music get musicians' earplugs that "filter out sounds across the frequencies so they can still play."
Hearing loss starts in high tones above speech levels, where it may not have much impact. But with aging, the loss can drop into the speech frequencies, and the lack of hearing and understanding will become apparent.
Those considering hearing aids will find an increasing number of choices. Experts offer this advice.
See an ear, nose and throat doctor to rule out medical causes for your hearing loss.
Do some research. Hearing aids are made by many companies, including Siemens, Phonak, Oticon, Widex, Sonic, GN Resound and Starkey. Information on their products can be found at the companies' Web sites.
Choose a sample of hearing aids with features that appeal to you.
Take that information to an audiologist who carries models from several companies. The audiologist will test your hearing and help you decide what kind of a hearing aid is best for you.
Inquire about the warranty (generally one year) and try-out policy. In many cases, aids can be returned for a refund within 30 days.
When you've chosen your aids, molds will be made of your ears. Plastic shells will be made from the molds, and circuitry designed for your hearing loss will be placed in the shell. Professionals recommend aids in both ears for those who have hearing loss in both.
You may have to return to the audiologist for adjustments. Those visits generally are free.
Keep your aids clean; don't get them wet; don't drop them. Some aids last three to seven years, but treating them gently and repairing them when necessary can make them up to 10 years, said Jane Gilbert, an audiologist at Abbott Northwestern Hospital in Minneapolis.