I've grumbled about my ears enough to attract the attention of hearing aid vendors, who are relentless in their sales efforts. They do not affect what is described here, nor do I think they even knew the issue exists. Hearing is not just a matter of loudness, but rather getting accurate code from the first responding structure's code to the brain stem for interpretation into words. The shape of the pharynx, the openness of the Eustachian tubes, and the efficacy of tiny bones and muscles are crucial to proper hearing, which is one access to each other.
When my tonsils and adenoids were removed -- I was about eight years old and it was conventional -- the neighborhood doc did the operation in his little home clinic a few blocks from home. There were few complications, or so it seemed, though I've hated ether ever since and felt totally betrayed by my mother's story about mountain air. I was cocooned in a blanket, arms at my sides, in an additional trauma: bondage. My mother was there.
I have suspected that too much tissue was taken, but I don't know if a person could really that check that in old age. As an adult, I told the doc my idea, and he as angry as well as skeptical. When I talk on the phone to order something or make an inquiry, the person on the line is often speaking English as a learned language and kept their accent. Or they are young and speak too quickly for me to process their sounds. If I tell them I'm very old and ask them to speak more slowly, they try to help me, but do not KNOW how to speak slowly. When I watch even BBC films, I keep the closed captions on.
My mother, who was deaf in old age, wore a hearing aid and often took it out to fiddle with it. The pink plastic appliance looked like a baby mouse and squealed. My mother prided herself on her ear canal being narrow, though the doctor had to remove the wax that the "aid" packed into it. I guess that my ear canals, both the one in my exterior ear and the one inside, the eustachian tube, are a little narrow. Even driving down into the local coulees and up the other side will make my ears pop so I have to yawn to equalize the pressure.
The other factor was much more recent: the ear ache I couldn't get anyone to help me with, not even the local clinic. It seems to be the source of unsteadiness that caused a series of falls until the shoulder dislocation. I knew about the cochlea, the eardrum and even the stapes, but not about the two little muscles that can tighten or loosen the drum. These are the smallest bone and muscle complexes in the body and vulnerable to wind, temperature, and trauma. Far too many people's reflex when striking out in anger is to hit the side of the head, where the ear is. You know what too-loud ear buds will do.
(Wiki) "There are two muscles which serve a protective function in the middle ear; the tensor tympani and stapedius. They contract in response to loud noise, inhibiting the vibrations of the malleus, incus and stapes, and reducing the transmission of sound to the inner ear."
"The primary function of the middle ear is to offset the decrease in acoustic energy that would occur if the low impedance ear canal air directly contacted the high-impedance cochlear fluid. When a sound wave is transferred from a low-impedance medium (eg, air) to one of high impedance (eg, water), a considerable amount of its energy is reflected and fails to enter the liquid. If no middle ear were present, only 0.1% of the acoustic wave energy traveling through air would enter the fluid of the cochlea and 99.9% would be reflected."
"For physiologic hearing to occur, a precochlear amplification system must be present to address the impedance mismatch that exists between air and water. Proper impedance matching requires the normal anatomy and functioning of an external ear and a middle ear with an intact tympanic membrane, a normal ossicular chain, and a well-ventilated tympanic cavity."
When I was teaching, I would notice that students who were struggling scholastically would go impassive, flat-faced, frozen. I thought it might be petit mal epilepsy and I still think that's possible. My step-granddaughter would do that and sometimes it seemed related to being dumb or defiantly not listening. If I put hands on her (she was possibly eight) or got in her face, she reacting by gasping as though being suddenly wakened, startled. Porges would suggest that since she was recently traumatized by her parents' divorced, a move two states away to a very different place, and then her mother's death. She was zoning out for relief. I was stupid about it.
The inability to really hear in an effective, well-interpreted way can be helped by physical contact. If one of the step-grandsons, who were primary school age, got into trouble, my instinct was to hold them close. I think this was right, but only a beginning. The same thing happened in the marriage.
When I briefly tried to return to teaching about 2003, taking on a set of rambunctious boys, I remembered a defiant kid from decades earlier whose root problem turned out to be increasing deafness, so I asked for an audiologist to test the whole class and -- to show solidarity -- tested myself as well. These were football players who had suffered concussions and other bodily traumas. Their coach was described as a "red-meat coach" who would not tolerate weakness or drama. There was a bit of deafness that showed up, including in myself, but I suspect that what was really happening was self-protective dulling of interpretation and understanding. I left. By that time it had become a dangerous place to be. The boys had to stay.
It wasn't a matter of being more understanding, but rather finding a way to be safe, both for the students and myself. The only boy who was never attacked by anyone was the son of a motorcycle gang captain. When I found out, I realized his father was a former pupil who had a horse in those days. Laughter over that gave me a little more security.
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