Your Hearing. Your Choice.

Choice Audiology

938 Mulberry Street

Loudon, TN US 37774




Three statements that indicate you need a hearing test.

This month’s blog is going to be a little different! I have broken down some of the most common statements that individuals with untreated hearing loss report. Often when someone is suffering from untreated hearing loss they state that they don’t know if the problem is due to hearing loss, their spouses' voices, or their environment.

Statement 1:

Eventually, I got tired of asking and just smiled politely.

I think we have all experienced this once or twice. The background noise in the restaurant is so overpowering that it’s hard to concentrate on the words being spoken. After asking to repeat once, then twice, it’s common for some people to give up on the conversation and just smile politely. 

This patient knew that they needed help because it wasn’t only happening in restaurants. It was also happening at home, in grocery stores, and at work in quiet settings. 

When situations like this occur, those with hearing loss will stop participating in conversations due to the level of difficulty and frustration. It is not uncommon for individuals to blame the other person for mumbling or talking to quietly. 

Statement 2:

It’s frustrating because I have to continuously ask her what she’s saying. So, I eventually just stop doing it and I just guess, which usually results in embarrassment or an argument.

Untreated hearing loss may result in embarrassment? Yes, you read that right! In an effort to continue the natural flow of the conversation many of my patients have confessed to me that they guessed what the other person was telling them, just so they didn’t have to ask for clarification. 

For example, “It’s windy today” may sound a lot like “It’s Wednesday today.”

It is not uncommon for patients with untreated hearing loss to also report that they constantly bicker with their loved ones because they thought they heard one thing but really their family was trying to tell them something else. This is one example how anxiety, depression, and social isolation can start to creep into the lives of those suffering from untreated hearing loss.

Statement 3:

Eventually we just stopped going. It’s not interesting anymore. I don’t enjoy it.

This one, personally, is hard for me to hear. I’ve had patients who quit attending things like Bible Study or choir rehearsal because they found it more frustrating than enjoyable due to their untreated hearing loss.

You may ask yourself, "Why do people wait so long to get treated or even tested for hearing loss?" The reality is it goes unnoticed, sometimes for years. It’s usually their loved one or friends who notice the difficulty in communication their untreated hearing loss is causing. This is because the most common type of hearing loss is only in the high frequencies, leaving the low frequencies normal. So, for most people if their low frequencies sound normal they will pass the blame to others for not speaking clearly or the environment they are in for being too noisy.

If these statements above sound familiar, please contact us for more information. It is easy to contact us from this website, or even take our online hearing screen to see if you need a diagnostic hearing evaluation. If you know you are ready for an evaluation, you can also make an appointment directly through our website. The first step is to have a routine hearing evaluation. We pride ourselves on counseling our patients regarding their hearing evaluation in a way that is easy to understand in a pressure free environment.

Everyone deserves a first choice in hearing healthcare. Choice Audiology wants to be yours. 


Three Habits for Better Hearing in the New Year

Your habits may be sabotaging your hearing. In this article, discover how implementing exercise, hearing protection, and social interaction can help maintain your hearing even as you age.

1) Exercise

The pandemic has caused several of us to forsake the gym this year. Have you heard of the “quarantine 15?” Obviously, several factors contribute to gaining 15 pounds during quarantine, but the greatest of these is lack of exercise. In 2021, let’s purpose to improve our habits and, in doing so, lessen our risk of hearing loss.

Data on risk factors related to hearing loss are limited, but several reputable studies suggest that changing our daily habits can affect our hearing. One of those studies, published by the American Journal of Medicine, states that people who participate in physical activity reduce their risk of developing hearing loss. According to the article, this reduced risk is especially true of women who walk more than 2 hours per week.

Interestingly, hearing loss is not caused by strenuous exercise, but exercise can help maintain healthy hearing despite one’s age. As an audiologist, I counsel patients regarding the common stigmas associated with hearing loss, such as aging. These studies affirm that hearing loss isn’t always directly caused by age. 

2) Hearing Protection

Last year, a record number of people made improvements to their homes. Did you hear all the power tools running in your neighborhood? 

Everything from in-home offices to backyard decks were and still are being constructed as the pandemic sparks various home-improvement projects.

Tools such as table saws, drills, and sanders can cause hearing loss, especially if the sounds they make are long, repeated, or reach at or above 85 dBA. Before you start that new home improvement project, make sure to purchase over-the-counter hearing protection such as earplugs or earmuffs. 

If the over-the-counter options are not suitable, visit us to obtain custom hearing protection. You will be surprised by the functionality and durability of professionally made hearing protection. You can call our office at 865-229-6230 or shoot an email to drtripp@choiceaudiology to request an appointment for custom hearing protection.

Interesting Facts

  • A handheld belt sander can reach up to 103 dBA, depending on the quality and condition of the tool.
  • An average table saw can reach up to 100 dBA.
  • The normal handheld drill produces between 90 and 94 dBA, and hammer drills produce in excess of 100 dBA.

3)Social Interaction 

During this pandemic, you have personally experienced social isolation. My patients have told me they haven’t interacted in-person with loved ones or friends for weeks, if not months. 

As humans, we thrive on healthy social interactions. Without them, your physical, mental, and cognitive health can suffer. According to a 2019 study led by Kassandra Alcaraz, Ph.D., MPH, a public health researcher with the American Cancer Society: “Our research really shows that the magnitude of risk presented by social isolation is very similar in magnitude to that of obesity, smoking, lack of access to care and physical inactivity.”

You might be thinking, “How can a lack of social interaction worsen my hearing?” While social isolation may not affect the level at which you can hear, it can affect your brain’s ability to process the information. Hearing is not just about your ears. Your brain plays a big role in how you process and understand sound.

As we age, our cognition can be affected by decreased social interaction. As our cognitive function declines, so does our ability to process information. For many, this change may seem like hearing loss, but what is actually happening is the loss of the ability to process the information while the function of hearing remains the same. 

Although safely interacting face to face in Loudon County may not be advisable right now, make use of virtual communication methods this year such as Facetime or Zoom to keep your brain active and social.

Diabetes: How It Impacts Hearing

If you or someone you love has diabetes you are probably aware that diabetes causes small blood vessel disease. What happens is blood vessels weaken and slow the flow of blood through the body which can lead to diabetic neuropathy or organ and tissue damage.

Since I am an audiologist I am particularly interested in what diabetes does to our inner ears. Both of our inner ears are made up of a cochlea and vestibular system.

Did you know that the same cranial nerve (8th nerve) innervates both the cochlea and the vestibular system? That is why I sometimes see patients with both hearing loss and balance issues. Since diabetes affects the entire neural system it is not uncommon for patients to report a disruption in the perception of hearing and balance as a whole.

Hearing Loss, How It Happens

Just like high blood glucose can damage organs such as eyes and kidneys it can also damage the inner ear. Our inner ears are extremely sensitive to blood flow and even our eardrums include a network of small blood vessels.

I often tell my patients a hearing evaluation is one of the easiest ways to identify if there has been any damage in the cochlea, the organ of hearing. Unlike a vision test where an optometrist can look into the back of your eye for signs of diabetic retinopathy we cannot look into your ears and visualize the inner ear, your eardrum is blocking our view!

If damage has occurred in the cochlea it will show up as a sensori-neural hearing loss. This type of hearing loss is referred to as nerve damage that can not be regained through surgery or medication.

Balance, How It Happens

As I mentioned above diabetes also affects balance. When there is too much sugar in the blood it can affect our balance in more ways than one:

It affects the connective tissues inside the vestibular system making one feel off-balance.

The myelin sheath that covers the vestibular nerves are damaged which doesn’t allow our inner ear to send messages properly to our brain.

It can degenerate the hair cells inside the vestibular system just like it damages the hair cells inside the cochlea resulting in hearing loss.

As you can probably imagine we use several sensory inputs to remain balanced on our feet. One of the main inputs is our vision, can you see what is in front of you as you take a step? How about proprioceptive inputs like what your feet are telling you? If someone has a hard time feeling their feet they may be stepping on a surface that isn’t level, which will cause them to fall. Remember, diabetes affects the whole body so there are multiple systems at play when balance is an issue.


My Role As An Audiologist


Baseline Hearing Test

I tell anyone who is suffering from diabetes that a baseline hearing test is an important starting point. It is important to have a complete picture of hearing at the time of diagnosis! Therefore if any issues arise in the future we have something to compare to. Here is a link to our online hearing screen to determine if you need a full hearing evaluation:



Another recommendation I commonly make may be diabetes education. Did you know that it is covered by Medicare? If you were recently diagnosed with diabetes you can get up to 10 hours of diabetes education when you’re first diagnosed.


Balance Screening

Another recommendation may be a balance screening. We perform balance screenings here at Choice Audiology and if there are any concerns we can refer you for further testing.

I commonly will refer any of my patients to a local Ear, Nose and Throat physician for a full balance evaluation.


Vision Health

I will commonly ask my patients who their eyesight is if they are diabetic and having issues with balance. Make sure that you or your loved one is getting their eye exam with dilation at least once a year. As mentioned above, vision health plays an important role in balance.



Dowd, K. (2020). Audiology: diabetes in hearing & balance care. AudiologyOnline, Article 27259. Retrieved from


Causes of Noise-Induced Hearing Loss and How to Protect Your Hearing


“Are your hobbies noisy?”

“Yes, I do a lot of yard work, and I also enjoy woodworking. Will that affect my hearing?”

As an audiologist with 7 years of experience, I have tend to notice patterns in my audiograms. Noise-induced hearing loss is one of them. As you can see on the audiogram below, there is a dip near 4000 Hz. Audiologists refer to this type of hearing loss as a 4000 Hz notch. The noise-induced audiogram is at the side for reference.

You might have noise-induced hearing loss and not realize it.

Because noise-induced hearing loss develops slowly after many years of prolonged noise exposure, many people might not notice the change.

Many of my patients’ hearing loss began at a frequencies where they could still hear some speech sounds. Because of this, they might not have had difficulty understanding conversations at first. However, as exposure to noise continued over the years, their hearing worsened, severely lessening their ability to understand speech.

Common Types of Noise Exposure

The CDC provides a list of common sounds that will damage the inner ear when they are loud and prolonged. Here are a few: 

  • Gas-powered lawnmowers and leaf blowers. They range about 80-85 decibels and can damage your hearing after 2 hours of constant exposure. 
  • Motorcycles. They range about 95 decibels and damage your hearing after about 50 minutes of exposure.
  • Sporting events. Events such as hockey playoffs or football games can reach about 100 decibels and damage your hearing within 15 minutes of exposure. When we do return to some normalcy and we are able to attend sporting events keep this in mind!
  • Personal listening devices. The maximum volume of a personal listening device can reach 105-110 and cause hearing loss in less than 5 minutes.

I’m sure you’ve participated in at least one item on the list without using hearing protection. Remember, if healthy hearing habits are not practiced on a routine basis, hearing loss can happen over time.

How To Prevent Noise-Induced Hearing Loss

Hearing loss resulting from noise is often preventable. The best ways to protect your hearing from noise damage are to:

  • Lower the volume on any personal listening devices.
  • Wear over-the-counter hearing protection such as earplugs or earmuffs. Make sure you are inserting your foam earplugs correctly by watching this tutorial:
  • Contact our office to obtain a pair of custom hearing protection devices. You will be surprised by the functionality and durability of professionally made hearing protection. 
  • Obtain a baseline audiogram yearly from Dr. Tripp to identify shifts in your hearing that you may otherwise not notice. Having these checks done will also give you the opportunity to discuss more about your specific noise exposure and receive recommendations for your occupation or hobby. 

Why protecting your hearing is important 

The reason I wrote this article is to show you that loud environments endanger your hearing. Don’t be the person who disregards the warning, thinking; “It will be fine. It will not happen to me.” 

Despite your doubts, hearing protection is needed to preserve your hearing in noisy environments. Research has proven that wearing hearing protection will also: 

  • Decrease your chances of cognitive decline.
  • Decrease your chances of tinnitus.
  • Decrease your risk of social isolation and depression.


Tinnitus and Anxiety – How They Affect Each Other

During these challenging times, my patients’ overall mood has been somber. I see fewer smiles and more frustration. Many of you have expressed how the COVID-19 pandemic has affected your quality of life. Some of my patients have had to reschedule important procedures, others have lost insurance (making paying for medication difficult), and others are struggling to put food on the table.

Unfortunately, the ramifications of this pandemic will be long-lasting. It has caused a great deal of uncertainty and continues to cause unrest and anxiety. I know I am feeling it. Routines that used to bring comfort have seemed more monotonous or even like a burden. I know many people are feeling stressors from all sides, and stress can manifest itself in different ways.

During this pandemic, I have taken the role of educator in my community. I want to teach people about the added stress exacerbating your tinnitus (ringing in the ears). I have noticed many of my patients reporting a recent increase in tinnitus. Unfortunately, I’m not surprised. Stress can cause many problems and exacerbate others.

Tinnitus, a known side effect of hearing loss, can be dealt with daily until stress levels rise and tinnitus becomes significantly worse. Besides hearing loss, stress and anxiety can also cause tinnitus.

If the patient is not considered a candidate for amplification after a thorough health history review and hearing evaluation, I counsel them regarding the snowball effect.


The Snowball Effect 

Tinnitus, if caused mostly by stress or anxiety, can become never-ending as the body reacts physically in other ways, causing additional problems such as insomnia, anxiety, and even depression. These other problems only intensify the tinnitus, trapping patients in a vicious cycle. To avoid this cycle, patients must find a way to relax and manage their symptoms instead of stressing and exacerbating them. Fortunately, individuals with tinnitus can follow the tips below to learn to control their stress before it causes worse problems.


Where Do We Start? During these times, we need to be creative! 

 1.  Schedule A Hearing Evaluation

Tinnitus and hearing loss usually go hand in hand. About 90% of my patients who are diagnosed with hearing loss also suffer from tinnitus. For some of them, the tinnitus is not bothersome. For others, it is debilitating. As a doctor of audiology, I am well versed in tinnitus and tinnitus treatment.


2.  Reevaluate Your Social Media Time

Check how much social media you are consuming. Ask yourself, “Am I using this to create meaningful connections and relax or is this causing my stress levels to rise?”


3.  Reach Out

If you’re feeling anxious, depressed, or alone, reach out to a friend or family member. Chances are, they are feeling lonely too—especially during this time! Although expressing your feelings can seem scary, it is the first step to releasing your negative emotions. Reaching out to a mental health professional or your primary care physician is also a good idea since anxiety is sometimes associated with other mental health disorders.


4.  Exercise

One way to reduce stress is to simply exercise. Exercise has been proven to help individuals relax, forget about what is bothering them, and simply enjoy life. Another good option for reducing stress is to participate in yoga and meditation sessions or get a massage on a regular basis. 


In Summary 

Nobody wants to have tinnitus and those who have it already certainly don’t want their symptoms to worsen. If you or someone you know suffers from tinnitus, your first step should be to find a local audiologist. Dr. Tripp is a doctor of audiology who has 10 years of experience diagnosing and treating tinnitus. For more information or to schedule a consultation, please call 865-229-6230.

How to Save Money on Hearing Aids

Two of the biggest misconceptions about hearing aids that people have is that they are all the same and that you should search for the best bargain you can find. These misconceptions are dangerous because they can guide you to devices that are cheaply made and can be less effective.

Even with a smaller budget, you can still afford reliable hearing aids—it is possible! Rather than letting misinformation discourage you, take the advice of a professional. My name is Rebekah Tripp, and I have my doctorate in audiology. Here are my tips for saving money on hearing aids.

Buy from a Trusted Source

Many patients have come to my office disappointed by a device they purchased from a large retailer or from a discounted service their insurance provided. Many times, patients do not familiarize themselves with the seller, and this leads them to trust products that may not be best for them.

For you to have success with your purchase, first learn about the company and the people who will be fitting you. At Choice Audiology, we always counsel patients about their hearing loss and whether hearing aids would benefit them.

You want to work with an audiologist that you and others trust—one who will focus on your needs rather than on making a sale. The last thing I want for you or your loved one is to purchase a hearing aid that is a waste of money.

“Don't buy off the TV or the internet,” says Laurel Christensen, chief audiology officer at GN Hearing, a hearing aid manufacturer. “This is a health issue, and you do need to see a professional.”

Maximize Your Benefits

You wouldn’t believe how many people have hearing aid benefits and don’t know about them. The amount of hearing aid benefits that go unused each year is monumental. As with most benefits, hearing aid insurance benefits don’t roll over even though you've paid the premiums on your insurance all year long. If you don’t use them by the end of the calendar year, they expire.

At Choice Audiology, we have a dedicated team of experts who will help you know and understand your benefits. Just give us a call!

Use HSA, FSA, and Financing Options

Not all insurance plans or providers offer hearing aid insurance, but if you have any HSA or FSA dollars set aside, we can help you use them efficiently with no out-of-pocket cost. At Choice Audiology, we also offer CareCredit and Allegro Leasing options to make the purchase of hearing aids easier to afford.

These options can save you some serious money since traditional loans or credit cards charge a high-interest rate!

Actively Care for Your Ears

Any audiologist will tell you that the best way to save money on hearing aids is to stay vigilant about your hearing health. Many people have noise-induced hearing loss and do not realize it because it develops slowly over time. Many of my patients’ hearing loss began at a frequency where they could still hear some speech sounds. Because of this, they might not have had difficulty understanding conversations at first. However, as exposure to noise continued over the years, their hearing worsened, severely lessening their ability to understand speech.

A hearing test is very affordable and is a great way to stay on top of your health and well-being. These tests may help us to catch hearing problems early. Even if you do not have hearing loss, obtaining a hearing evaluation can still benefit you because it gives you the opportunity to discuss your likelihood of needing hearing aids in the future, especially if you are a borderline hearing aid candidate.

Is it time for your next hearing test? Call us at 865-229-6230 to set up an appointment, or schedule it yourself right now on our website! I can’t wait to meet you!


Is My Hearing Good For My Age?

Myth: Hearing loss is a direct result of the aging process.

By far, this is one of the most common myths my patients believe. They ask me, "Is my hearing normal for my age?" I reply, "Whether you're 5 or 105, you need to hear above 25 dB to hear all the sounds in normal speech. That standard does not change with age."

When patients ask those types of questions, they're sometimes implying that they don't need amplification because hearing loss is a normal part of life. Since others their age do not wear amplification, they assume that they, too, can go without it. "My hearing does not bother me," they say.

In my opinion, the excuse "It does not bother me" is something we tell ourselves to avoid the problem at hand. Rather than addressing the issue, we normalize hearing loss and file the problem away until it becomes a bigger issue—an issue that's too big and problematic to fix through amplification.

The truth is that any hearing loss that impedes your ability to understand speech is a BIG problem. The longer your hearing loss goes untreated, the harder adjusting to hearing using amplification will be.

Is AGE the only reason hearing loss occurs?

Cardiovascular Disease

An interesting study by Friedland and colleagues suggested that about 85% of diagnosed strokes were associated with individuals who had a certain type of hearing loss. As we know, our inner ears are extremely sensitive to blood flow. This study shows that vascular issues may affect both hearing and cardiovascular structures.


Another interesting study conducted by Horikawa et al showed that people with diabetes were two times more likely to develop hearing loss and that the association between hearing loss and diabetes was stronger among people younger than 60. Many researchers believe that high blood glucose levels may damage the vessels in the inner ear, resulting in hearing loss.

Ototoxic Medications

Over 200 prescriptions and over the counter medications that are known to be ototoxic (literally meaning "poisonous to the ears") are being sold on the market today. Some well-known ototoxic drugs include aspirin, quinine, loop diuretics, certain antibiotics, some anti-cancer drugs, and some anesthetics.

Point in Case: When people are diagnosed with cardiovascular disease or diabetes, do they think, "Oh, well. This is normal for my age" and avoid treatment? Probably not. No matter your age, when any cardiovascular disease or diabetes is diagnosed, it should be treated, and so should your hearing loss.

How to ensure proper hearing health?

Since age isn't a direct link to hearing loss, you should put certain habits in place today to ensure healthy hearing in the future.

Healthy hearing is a lifelong commitment, similar to dental and ocular care. Most of us carry sunglasses and floss in our cars or purses and get our teeth and eyes checked routinely. However, many of us overlook using hearing protection and ignore hearing screenings. Here's how you can change your habits to protect your hearing:

Have your hearing screened. A hearing screening performed by someone like me, a doctor of audiology, is a great place to start.

Wear hearing protection. Hearing loss can be caused by loud noises over time when healthy hearing habits are not practiced on a routine basis.

Wear hearing aids, if needed. Hearing aids have improved drastically while I've been in practice. When fitted by a professional, the direct effects of hearing aids can be amazing. For example, I have witnessed patients with amplification become more socially active and less depressed.

Form healthy habits. Participating in routine checkups with your primary care physician and heeding their recommendations will lower your risk of developing comorbidities associated with hearing loss.

Surprising Stats

  • 1 in 5 teenagers have some type of hearing loss.
  • 1 in 14 generation Xers (ages 37-48) already have hearing loss
  • 1 in 6 baby boomers (ages 49-68) have hearing loss
  • 1 in 3 people over the age of 60 have hearing loss

Finishing Thoughts

Overall, I hope this article helps you better understand that age is not always directly associated with hearing loss. I also hope that you never settle for a lesser quality of life based on your age.

Hearing loss is a treatable and sometimes preventable health condition. No matter your age, you should be able to hear and participate in conversations.

Through conversations like these, we are decreasing the stigmas associated with age and reducing cognitive decline, social isolation, and depression.

Don't ignore hearing loss; reach out to Dr. Rebekah Tripp for a complete picture of your hearing.

Friedland DR, Cederberg C, Tarima S. Audiometric pattern as a predictor of cardiovascular status: Development of a model for assessment of risk. Laryngoscope. March 2009;119(3):473-486.

Horikawa C, Kodama S, Tanaka S, et al. Diabetes and risk of hearing impairment in adults: A meta-analysis. J Clin Endocrinol Metab. January 2013;98(1):51-58.

Bisht, M., & Bist, S. S. (2011). Ototoxicity: the hidden menace. Indian journal of otolaryngology and head and neck surgery: official publication of the Association of Otolaryngologists of India, 63(3), 255-259.

The National Institutes of Health (NIH) :

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