"I hear fine. My spouse just mumbles," is a common refrain.
Hearing loss affects one in three people over 60, and by age 85 more than half will experience it, according to the National Institute on Deafness and Other Communication Disorders.
Beyond the frustration and embarrassment it can cause when talking to friends and family, hearing loss can be dangerous when a person can't hear warnings and alarms.
"You hear speech with the low frequencies, but you understand speech with the high (frequencies)," said Joe Kane, a hearing systems consultant for Miracle Ear.
Frequency measures tone.
"High frequency sounds are where we get our understanding of speech," Kane said. "Those are the consonants ... high frequencies are the first to get damaged if you have over-exposure to loud noise. Vowel sounds exist in the low frequencies."
Someone can hear fine on the phone, but have poor hearing in a crowd, or just the opposite.
"Your lifestyle dictates how you hear and it is what we have to base our assessment on. Everyone is not the same," said Kane. "If you have the same type of hearing loss that I have, but all you do is sit around and watch the television and hear your daughter on the telephone, my needs are a lot less than yours if I am a supervisor attending a lot of meetings."
Decibels measure loudness. Sounds between 0-25 decibels are considered normal.
Everyone has his or her own perception of what is "too loud."
In the 21st century, more professions than ever have occupational noise. Thirty million people a year are exposed to hazardous noise, including those in construction, roadwork, the military and operators of heavy machinery.
Loud music is problematic for teens who often believe hearing loss can't happen to them.
Sally Culwell, owner and dispensing audiologist of Rim Country Audiology, said she saw a teenager with hearing that falls off in the high frequencies. His mother told Culwell that he listens to his music so loud through his earphones that she can hear it in the other room.
"My son is in a rock ‘n' roll band," Kane said. "He asked me to make him some earplugs because he knows he would be a client of mine in 20 years if he didn't."
People today are savvier about using earplugs and ear phones to help reduce noise.
Off-the-shelf earplugs cost a few dollars, while custom ones can cost between $45 and $150 each. They allow the spoken word to come though.
Noise-canceling earphones start at $50.
Not hearing properly could simply be a buildup of earwax, which is correctable by a nurse or doctor, or it could be more serious.
"One of the big symptoms (of hearing loss) is if a person has ringing or buzzing in the ear," Culwell said. "That shows that the nerve has been damaged."
The buzzing doesn't have to be constant and usually starts out as light and intermittent.
Vertigo can be another symptom of disease or vascular swelling.
"The organ of balance is in the inner ear," Culwell said. "The auditory nerve divides into two portions as it enters the inner ear. One goes to the cochlea ... the other to the semi-circular canals or the organ of balance.
"I want to determine the hearing profile by finding out first: Is there a hearing loss? How bad is it and what kind of loss? Can it be medically corrected or is it a nerve loss which is permanent?"
Based on this kind of testing, patients are sent to a doctor or shown a hearing aid.
According to Culwell, about 200 percent of school-age children will get an infection behind the ear drum, that is a buildup of fluid interrupting the movement of the three little bones and causes as much as a 25-decibel loss.
"We really worry about the kids educationally," Culwell said. "They need to hear."
Parents who have a baby who pulls at his ear a lot or who notice their child is not developing appropriate speech and language skills should seek medical attention.
Testing takes between 40 minutes to an hour. Medicare covers a portion of the cost and some insurance companies pay for a portion of the hearing aid itself if needed.
A trained professional will use equipment such as an audiometer, an impedance bridge and an otoscope to look at the ear and test hearing.
Analog hearing aids have been replaced by digital ones that range in price from $400 to $2,400 dollars and have from one to 16 channels.
Patients are taught how to wear the hearing aids and adjustments are made to them as necessary.
"Hearing aids are basically little computers now," Kane said. "The more technologically advanced hearing aids have more ability to understand in more complicated environments."
The longer you wait to get a hearing aid, the harder it is for your brain to get used to hearing in a new way, Culwell said.
Kane said a punctured eardrum, signs of otosclerosis (arthritis in the three bones of the inner ear) or weakening ligaments and muscles are "conductive hearing loss." Patients are generally referred to a specialist for such conditions.
Culwell has her master's from Tulsa University and has been an audiologist since 1970, working in conjunction with ear, nose and throat doctors. Kane was trained by and apprenticed with Miracle Ear and has been a hearing systems consultant for three years. Both have passed the State Boards.
Each recommended that an adult have a baseline-hearing test while they are healthy and before any problems arise.
For more information, contact Rim Country Audiology at (928) 468-6023 or Miracle Ear at (928) 474-5158.
To clean the ear, Culwell recommends using a piece of bathroom tissue or the end of a washcloth so there is no danger of poking a hole in the eardrum with a Q-tip or pushing the wax in toward the eardrum, where it will harden instead of protecting the thin skin from dirt.