We came across this article from 2012 in the Classical Music magazine about Cubex and our unique approach to musicians hearing care and hearing loss treatment more generally. We have developed our holistic approach further since this was written, with an even greater emphasis on cognitive function and mental health, aided by advances in research in this area.
Even though our approach has developed since this was written, it still has some prevalence today so we have written the article here for our friends and colleagues to enjoy.
With technological advances and joined-up thinking, Cubex has shown that hearing loss can be dealt with effectively, and needn’t threaten a musicians career, writes Andrew Stewart.
Medical science has progressed far since Beethoven wrote about the despair of deafness. Musicians, on the other hand, remain wedded to feelings so movingly expressed in the composers Heiligenstadt Testament. ‘Ah, how could I possible admit an infirmity in the one sense which ought to be more perfect in me than others?’ he asked. The question holds more than rhetorical force for anyone who’s livelihood depends on the ability to hear and react to sounds: common sense and the lore of the orchestral workpace, after all, suggest that it better to suffer in silence than admit to a career-threatening problem. Beethoven suspected that his condition was hopeless, beyond treatment. It was, two hundred years ago. But his progressive hearing loss could have been eased by modern audiology, its decline offset and managed by an increasingly sophisticated therapeutic toolkit of protection, aids and counselling.
Cubex is on a mission to change the way musicians think about hearing health. The independent team of hearing aid audiologists, based a short walk from London’s Harley street, has worked closely with classical performers over many years, fashioning individual solutions to the complex challenges of age or noise related hearing loss. Its audiologists offer strategies for hearing loss prevention, a three-year hearing healthcare plan and a range of diagnostic tests capable of isolating and analysing problems with forensic precision. They have also pioneered positive ways for clients to overcome the psychological and emotional barriers erected by the anxiety of hearing loss. Adam Shulberg, Hearing Aid Audiologist and Managing Director of Cubex since 1995, notes how his profession is constantly evolving forms of hearing loss therapy and prevention that promise serious benefits to musicians.
“I have worked with conductors, opera singers, composers and orchestral musicians”, he says. “Each category is different, has specific needs and can work in very different environments. Certain individuals will have tinnitus; others may experience hearing loss, while some will be more accepting of hearing problems than others. The young generation, for example, may be very motivated to prevent hearing problems, while the other generation can be deeply worried about their experience of hearing loss. There are many complex aspects of hearing that we are fully qualified to address”.
Shulberg recalls working closely with Yehudi Menuhin in the final years of his life and also helping the London Symphony Orchestra’s co-principal trumpet Rod Franks overcome the unilateral hearing loss that followed his surgery to remove a brain tumour. “He was unable to hear certain instruments within the orchestra, so we designed a system that would allow him to pick up specific instruments that he felt were most important to him”.
Cubex audiologists have harvested a rich collection of data and insights from professional musicians, which in turn has helped the company to refine its approach to the needs of individual performers. “There’s no single rehab formula, no ‘one way’ to address what musicians require from us”, comments Jerusha Shulberg, Senior Audiologist Scientist with Cubex. “Hearing management plans can help musicians come to terms with the natural deterioration of hearing that age delivers. “While age-related hearing loss is common, there’s still a stigma attached to hearing problems. We’ve noticed a change in attitudes over the last five years, though, and see more young adults coming to our practice voluntarily. We still struggle to reach those who believe there’s nothing that can be done about hearing loss”.
Orchestral musicians rank high on the chart of hearing management sceptics. Many bear the burden of conventional wisdom woven from strands of bandroom bravado, ignorance of hearing problems and their causes, and downright fear. Adam Shulberg suggests that reaching the older generation of players is among the biggest challenges facing audiologists. ‘People already have a certain mindset and are concerned about the way they might be perceived if, for example, we were to offer them a hearing aid solution.” He says. “Hearing aids are not designed for the needs of musicians; they’re designed for helping people to hear speech. But we’ve developed what we believe are clever ways of adapting hearing systems, not just to help musicians follow speech but to help them participate in their occupation. The younger generation of musicians is more open to the solutions we can offer.”
Cubex is committed to expanding its repertoire of prevention methods and hearing management strategies for musicians. Prevention and management, observes Jerusha Shulberg, demand strikingly different approaches. “Prevention is about awareness and an ongoing partnership with musicians. It takes their work environment and needs into consideration. We work with them to ensure that hearing loss, tinnitus and hyperacusis (over-sensitivity to certain frequency ranges) are prevented. Management is more difficult thanks to the complex nature of hearing loss and the fact that individuals and their needs are so varied. The longer a musician ignores hearing loss, the more difficult for us to reach the point where we can make that persons hearing feel normal again. We’re dealing here with two worlds. There are younger musicians who come to us early, having noticed signs of tinnitus. And there is an older generation of musicians who, unfortunately, come to us late to manage hearing loss’.
Leigh Martin, Cubex Audiologist and Audiology Services Coordinator, notes that each musician who comes to the practise is individually assessed. The first consultation begins by exploring an individuals perception of his or her hearing. We would do a series of different tests looking at all aspects of the auditory pathway, from simply looking in the ear to looking at measures of how the middle ear is operating and working”, he says. ‘Then we conduct a typical pure-tone audiogram, to judge sound attention thresholds, before conducting extended high-frequency and inter-frequency audiometry. It’s possible to register normal hearing on a pure-tone audiogram but for the person still to experience hearing difficulties. These are known as auditory processing disorders and we can employ very specific tests to look at these’.
In addition to analysing the measuring properties of their clients hearing, Cubex audiologists also address the psychodynamics of hearing loss. The company’s holistic approach touches on cognitive behavioural therapy and ideas developed in partnership with anthropologists at the IDA institute in Denmark. Its an area we’ve explored extensively over the last two years, notes Adam. “We look at the human dynamics of hearing loss and have become very good at reading those signs. We are developing strategies that go way beyond in-ear monitors, hearing aids and so on. Some people think this is fluffy stuff. But we’ve consistently proven the value of being able to motivate people and their family members in dealing with and managing hearing loss”.
Speak to a Cubex Audiologist
If you would like to speak with a Cubex Audiologist about your hearing or about our unique approach to musicians hearing care, please get in touch. We are able to carry out face-to-face appointments and assessments in our clinic where it is necessary to do so. You are always completely safe at Cubex.Contact Cubex