In-Ear Monitors: Expert Insights with Dr. Melissa E. Heche

Ever wondered if in-ear monitors (IEMs) can truly safeguard a musician’s hearing? This episode promises to uncover that truth. Join us as we welcome Dr. Melissa Heche, an eminent audiologist, musician, and sound engineer, who dispels the myths surrounding IEMs. Dr. Heche, who has trained with Mike Santucci at Sensaphonics, provides an expert perspective on why IEMs are not standalone hearing protection devices and highlights the essential tools and practices for effective hearing conservation among musicians.

Transitioning from traditional floor wedges to IEMs can be a daunting experience for many musicians, often leading to feelings of isolation. Dr. Heche and Dr. Beck tackle this issue head-on, discussing personalized mixes, ambient microphones, and the benefits of click tracks, all aimed at creating a more comfortable and safe auditory environment. Drawing from Dr. Heches' experiences performing in New York, we delve into the practical benefits of IEMs for musicians at all levels, from students to seasoned professionals, emphasizing how these devices can help prevent hearing damage even in the loudest of stage environments.

Choosing the right IEMs is pivotal, and Dr. Heche walks us through the process, from detailed audiological evaluations to the setup and management of these devices. For those just starting out, we provide tips and recommendations for selecting the best IEMs to meet their needs. Don’t miss this comprehensive guide packed with expert advice and valuable resources to enhance your auditory health and performance.

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Chapters

• 0:00 In-Ear Monitors
• 5:24 Dispelling Myths About in-Ear Monitors
• 13:23 Choosing in-Ear Monitors Wisely
• 24:54 Expert Advice on in-Ear Monitors

Transcript

Dr. Melissa E. Heche:

And the take home, if there is no other take home from our talk is that in-ear monitors by themselves are not hearing protection devices. A lot of people think they are and a lot of musicians think they are. But they are not, by themselves, a hearing protection device.

Blaise Delfino, M.S. - HIS:

You're tuned into the Hearing Matters podcast, the show that discusses hearing technology, best practices, and a global epidemic hearing loss. Before we kick this episode off, a special thank you to our partners. Redux, faster drier, smarter, verified. Cycle, built for the entire hearing care practice. Fader Plugs, the world's first custom adjustable earplug. Welcome back to another episode of The Hearing Matters podcast. I'm your founder and host, Blaise Delfino, and as a friendly reminder, this podcast is separate from my work at Starkey.

Dr. Douglas L. Beck:

Good afternoon. This is Dr. Douglas Beck with the Hearing Matters podcast. And today my guest is Dr. Melissa Heche. And Melissa is a clinical audiologist. She's been in hearing healthcare, hearing conservation, hearing aids, amplification, oral rehab. She does a little of everything. She is a musician's hearing specialist, which means that she works with a lot of musicians. She herself is a musician. We'll talk a little bit about that. Musical products, fitting in-the-ear monitors, monitor mixing, onsite audio consultations. She is a voice pathologist, which I'm not sure, we have to talk about that, with regard to vocal use and abuse for professional voice users, singers, vocalists, things like that. She is a sound engineer. She specializes in live music events. She's a public speaker, she's a writer. She does voiceovers. And she's a performer. And she is most often compared to Bette Midler and Bernadette Peters, which is pretty good company to keep. Hi Melissa, how are you today?

Dr. Melissa E. Heche:

I'm well. How are you?

Dr. Douglas L. Beck:

I'm doing great. I'm doing great.

Dr. Melissa E. Heche:

Thank you for having me.

Dr. Douglas L. Beck:

I'm delighted to have you. And I should say, you and I performed together about nine years ago at a AAA function in San Antonio. And as best I recall, we were an amazing band.

Dr. Melissa E. Heche:

We were. We were. We kicked butt. We kicked audiology butt.

Dr. Douglas L. Beck:

Absolutely. All right, well I want to start with, so where did you get your audiology education? Just in a few words. Where'd you get your AUD and your master's and stuff like that?

Dr. Melissa E. Heche:

I have a dual master's in audiology and speech pathology, which I got...

Dr. Douglas L. Beck:

There you go.

Dr. Melissa E. Heche:

Yes, which I got at Hofstra University out on Long Island. And then I did my doctorate of audiology at what is now Salus University, although I think they are now Drexel.

Dr. Douglas L. Beck:

Yeah, they've undergone some changes in the last six months, last year, yes.

Dr. Melissa E. Heche:

Yeah. But that organization is where I did my AUD.

Dr. Douglas L. Beck:

So you became a speech language pathologist and an audiologist. You got your Cs in both and became licensed.

Dr. Melissa E. Heche:

Exactly, at the same time.

Dr. Douglas L. Beck:

All right. You started clinically and then you moved into becoming a sound engineer. So most of our audience knows how we become audiologists and SLPs, but how do you become a sound engineer? What's that about?

Dr. Melissa E. Heche:

So when I really felt there was a void in my education and how I could help people, I went through a program in New York City that led to a certificate in sound engineering. And it went through the basics and then intermediary and then more advanced components of sound engineering, both from a live and a recording aspect. And we had exams and we had the equivalent of clinicals, projects to demonstrate our aptitude. And then the next part of sound engineering is really being on-site and learning it as you're going.

Dr. Douglas L. Beck:

And that gets me to the essence of today's talk, which is in-ear monitors. And I'm very curious because I know you studied with my friend Mike Santucci a couple of years back. And as far as I'm concerned, Mike is one of the leaders in in-ear monitors and, of course, his company Sensaphonics is very, very clever, very brilliant. And you went and studied up there for a while, right?

Dr. Melissa E. Heche:

I did. I met Mike at an industry event where I was speaking actually about musicians and musician tools. And he invited me to come to Sensaphonics to take a tour and to really do a quick and dirty component of his Gold Star audiologist course. I was already a sound engineer. I was already a musician, so it didn't really make sense for me to go through the whole program. But it is an excellent program for people that don't have that background and who don't have the knowledge base. And Dr. Santucci is amazing at truly making front and center, not just the musician's tools, but how to utilize them to protect your hearing.

Dr. Douglas L. Beck:

So let's talk about that. What are the number one, two, or three myths that musicians have with regard to in-ear monitors and how to avail a better sound to themselves while performing?

Dr. Melissa E. Heche:

Well, it depends on the musician and what their background is. A lot of the older musicians feel like they rely on the floor wedges and what they hear acoustically. And they feel like if they are using monitors in their ear that there's a disconnect. And to some extent they're not wrong. There's a disconnect. There's definitely a sense of isolation. The positive is that you get your mix in your ear. The negative is this sense of isolation. But there are ways to go around that, whether it be how the sound is mixed or the type of in-ear monitor that you choose. So that's one myth.

Dr. Douglas L. Beck:

Yeah. Well, go ahead. I'm sorry. I didn't mean to interrupt.

Dr. Melissa E. Heche:

No, no, no, you didn't.

Dr. Douglas L. Beck:

Okay. So when I performed on stage, I was in, probably the largest most significant band I was in was the Jeff Keith Band in 2010 through 2013, something like that. We did one event that was incredibly large. It was the Walk For The Cure, the Walk Run For The Cure, the Susan G Komen race. And there were 25, 30,000 people there. And we used wedge monitors around us because that... And it's interesting because the audience has no idea, but the band on stage, we're hearing it at 90 to 100 db with the wedge monitors pointing at us. Even though, to the audience behind those huge giant stadium speakers, it could be 120, 125 db. But I never really liked having the monitor in my ear because exactly what you said, it feels isolated and secluded. So what do you do about that?

Dr. Melissa E. Heche:

There's a lot of things you can do. And just to go back. That setup where you have the floor wedge and then there's the monitors that go out to the audience. That offers the perfect storm of a situation, a geographic situation that is too loud and too and bleeds in and over itself so that nobody really hears the right mix and everybody is really exposed to loud music that could impair their hearing.

Dr. Douglas L. Beck:

Sure.

Dr. Melissa E. Heche:

What do you do for that?

Dr. Douglas L. Beck:

Yeah.

Dr. Melissa E. Heche:

That feeling of isolation can be hard to overcome, especially with people that are used to the physical component of it. But there are ways around it.

Dr. Douglas L. Beck:

So how do you mix that so that the musician, supposing you're playing lead guitar and you want to prominently hear your guitar so you know you're not making mistakes, or if you make a mistake, you correct it. How would you mix that into the in-ear monitors so that you're aware of all the other musicians and what they're doing?

Dr. Melissa E. Heche:

So you get your own personalized mix. So when I'm on stage, I like to hear the keys, the guitar, maybe a bit of the drums and that's it. I don't need to hear anybody else. You may want to hear other things. Some vocalists just want to hear themselves and some people just play to a click track, by the way, just so that they can keep their time. Your mix is personalized to you. So if you like to hear yourself and maybe the keys or yourself and maybe the bass, then you would mix that in your ears. If you like to hear environmentals, you want to hear the audience, you want to hear more of the spatial, get more of the spatial awareness of what's on stage, you can put mics around. You can put what are called shotgun mics around in the audience or on stage so that you can hear your fellow musicians and the stage response.

Dr. Douglas L. Beck:

And you mentioned click tracks. So many people won't know what that is. So a click track is, quite literally, in your ear, you're getting a regular rhythm like that so that you stay within the beat. And it's very important, particularly when you're isolating your sound and you're not necessarily hearing the bass or the drummer as prominently as you might open ear, open air environment, that click track becomes really critical because when somebody screws up and goes off-time the rest of the band, it's a disaster on stage.

Dr. Melissa E. Heche:

Exactly. Exactly.

Dr. Douglas L. Beck:

And so you are still performing, as best I know. So you perform in and around New York. Tell me a little about that.

Dr. Melissa E. Heche:

So what's really cool about New York and some of the other big cities is that you can still pursue your dream while you have a regular job because there are stages everywhere. There's opportunities in every corner. And because of that, I've been afforded the, I have a great deal of gratitude for the people who have afforded me opportunities to get on stage, to play with bands, to develop my own shows, my own jukebox musicals, theater pieces where I'm really able to still get my hands dirty in the performance space. And what that also offers me is this crossover. So I have a good idea of what some of the musicians are dealing with. I become my own patient sometimes. I pull out my own ears. I play my music too loud. But this is sort of the tap dance that we play both as performers and as performers that are also audiologists.

Dr. Douglas L. Beck:

Tell me about, so supposing a local band comes to see you and they say, "Dr. Heche, we'd like to get in-ear monitors." What's the protocol? What do you do with them? What do you recommend?

Dr. Melissa E. Heche:

So the cool thing about in-ear monitors and the trajectory and journey that they have taken over the course of the last 40 years is that, initially, it was really, when it really broke in the '90s, it was really the professional performing musicians that could both afford them and really wear them. And now there are so many different cost options for the average musician or the new musician, the music student, to really break in and use something that's appropriate for them. And that's what's really great about it. When I was learning both drums, when I was learning my instruments and as a vocalist, nobody taught me that I needed to protect my ears or anything about these music tools. And the truth of the matter is, in a lot of music education today, they're still not teaching them. And I think one of the biggest assets about in-ear monitors today is that there is a product for everybody at every age and every stage of their career.

So I ascertain where they are in their career and what they're playing and in what kind of venues. What their trajectory will be. And, of course, I do a full audiogram, a full complete audiological evaluation, a musician's audiological evaluation. So that includes the extra high frequency testing through 20,000 hertz so that I can see what their upper harmonics look like. And based on that and based on where they are professionally and where they hope to be professionally in the next number of years, we make decisions as to which music tools would be best suited for them.

Dr. Douglas L. Beck:

I like that a lot.

Dr. Melissa E. Heche:

And then we do some sound demos. Because we do sound demos because the truth of the matter is you may love Metallica, but it sounds like noise to me. And I make a joke about that because I love the guys from Metallica and I appreciate their music, but metal isn't my thing. Adult contemporary and musical theater is my thing. And that may not be your thing. So everybody has a different sound that they veer to. Some people like a punchy bass. Some people like a crystal high. Some people need and like something that's a little flatter. And we won't necessarily know until we start listening to it.

Dr. Douglas L. Beck:

So you get a complete audiogram, musicians audiometric evaluation so that you know where their hearing thresholds are, what their auditory abilities are. And then you set them up. And are you with them as the sound engineer is tweaking and setting things because each musician could have a totally different musical profile.

Dr. Melissa E. Heche:

And has a totally different sound engineer that's working with them with different skill sets also. The answer-

Dr. Douglas L. Beck:

Yeah, go ahead. I'm sorry.

Dr. Melissa E. Heche:

Sometimes, sometimes I am and I'm on onsite and I will facilitate that process and sometimes I'm not. Sometimes it's feasible and sometimes it just isn't because they go back on tour and they're someplace else.

Dr. Douglas L. Beck:

So when they're on tour, who is running the sound to make sure the IEMs are placed and that the SPL, the sound pressure coming out of the in-ear monitor is appropriate for that musician?

Dr. Melissa E. Heche:

That's a great question. And really the answer to that question is the construct of what the band is. So for a professional band there is the band, the musicians, and then there is a monitor engineer that focuses on the monitors and the mix that goes to the musicians. Then there is a separate engineer, a front-of-house engineer that works with the audience mix.

Dr. Douglas L. Beck:

Sure.

Dr. Melissa E. Heche:

That's really the most ideal setup. Of course, that's for a professional band. And the bands that have more of a budget or are not quite at that level may have one engineer or may not. They may engineer their own monitors.

Dr. Douglas L. Beck:

And if they do that, is that like having a whole separate mixing board for each individual? What does that look like pragmatically to the musicians performing?

Dr. Melissa E. Heche:

Each individual musician has a set of in-ear monitors and they look like this. I'm wearing my set of in-ear monitors. They look like these. And then they plug into a belt pack using an eighth inch regular TRS kind of connector. And that belt pack is wireless. That belt pack communicates to the soundboard. Now the system, the wireless monitoring system, can be unilateral, meaning it's for one musician, or you can buy a system that's more complex that has multiple belt packs, that for multiple band members. And that's an individual band choice. The belt pack then communicates to the sound board through a transmitter. The transmitter is hardwired to the soundboard and it's connected through one of the aux out connectors. And then the sound engineer can choose a mix that is specific to each musician. So each musician does not need their own soundboard.

Dr. Douglas L. Beck:

Right. And now supposing that it's a touring band and they're just getting started, they've been at it a couple of years, they've got gigs all over the country. How often do they get their hearing checked?

Dr. Melissa E. Heche:

How often do they or how often should they?

Dr. Douglas L. Beck:

Yeah, really.

Dr. Melissa E. Heche:

Depending on the level of tour and how often they tour, I like to see them before and after the tour. And if they're ongoing tour, then once a year.

Dr. Douglas L. Beck:

And do the professionally fit IEMs offer attenuation for overall SPL or is it just happenstance?

Dr. Melissa E. Heche:

That is a great question. And the take home, if there is no other take home from our talk, is that in-ear monitors by themselves are not hearing protection devices. A lot of people think they are and a lot of musicians think they are. But they are not, by themselves, a hearing protection device. In fact, you can, depending on the in-ear monitor, put them in your ear and if you tend to like loud sounds, you can still blast the loud sound in your ear.

There is research out there that has shown that people that tend to like a certain level of sound still veer towards that level of sound. So they still choose to turn it up to whatever it is, 95 decibels, 100 decibels. And the truth of the matter is that the musician themselves still need to learn to use them properly and then go through the proper channels to continuously monitor their hearing. They're in a better position of protecting their hearing when they have something in their ear that's isolating them from all of the bleed over from the environmental sounds. They're in a better position. But is it possible to still do damage? Absolutely.

Dr. Douglas L. Beck:

Yeah. And I think that is a good take home message that in-ear monitors don't necessarily protect you from noise induced hearing loss. And for performing bands, it's a likely outcome for many people. Tell me about garage bands, not professional bands, but perhaps one day they will be and they're interested in getting IEMs. Who would you recommend? Who would you look at maybe on Amazon or other popular venues? What should they look at, maybe which products? And what are the features that they want to make sure they have?

Dr. Melissa E. Heche:

So I would never look at an in-ear monitor on Amazon. The answer to that is never. Not for a garage band, not for a new musician. Never. Because the in-ear monitors that you can purchase on Amazon are cheap for a reason. They're not built well. They break down. The sound is not great. You can get a really solid good device from any of the major manufacturers, from the major vendors, at a decent price point.

Dr. Douglas L. Beck:

Give some examples.

Dr. Melissa E. Heche:

And depending on what your price point is, you can still get a good custom device. There's a low-end Ultimate Ears, there's a low-end JH Audio, there's a low-end FiR audio. Actually, FiR Audio has another sister brand, Bellos Audio that has entry level devices. But the cool part about Ultimate Ears is they also have, and actually all the manufacturers have universals in addition to the custom product. So you can get a professional level universal product. The Ultimate Ears product, you can get a professional level universal for $200.

Dr. Douglas L. Beck:

That's pretty reasonable.

Dr. Melissa E. Heche:

And you can add a custom sleeve that's made by Westone that will attach to that universal, that can make it sort of like a custom unit for another 100$, $150 if you wanted to.

Dr. Douglas L. Beck:

And do you recommend that musicians go directly to the companies you've mentioned or should they go through an audiologist? Or what's the best way to approach that?

Dr. Melissa E. Heche:

I always recommend going through an audiologist because the audiologist will be able to help you choose which device is best suited for you. And will also help you utilize that device in a way that is safe and easy and effective.

Dr. Douglas L. Beck:

And these are specialty areas within audiology. Every audiologist is not familiar with music and/or entertainment and/or different sound systems. How do you find somebody who is well versed in all of these issues we've been discussing?

Dr. Melissa E. Heche:

There are a few ways you can go ahead and look into that there. If you go to your pro audio Listservs and ask around, a lot of the real well-established music industry audiologists are well known by other musicians. So word of mouth is a really good way. Sensaphonics has a Gold Circle audiologist group where, if you go to their website, you can see anybody who's on that list has been through a program or has the knowledge base. Going through any of the other manufacturers, JH Audio, Ultimate Ears, anybody who is listed as a dealer has some level of understanding. But if you want somebody who really has a good understanding of what your needs are as a musician, as a performer, and the real intricacies of how the in-ear monitor is built, I would turn to your colleagues in sound engineering and in music because the likelihood is they've spoken to somebody already.

Dr. Douglas L. Beck:

All right, well that's great. That's very useful information. It's very pragmatic. I want point out that you have a Les Paul behind you over your right shoulder. And it makes me wonder, are you performing locally right now? Where would people go to see you if they want to see you sometime in the fall of 2024?

Dr. Melissa E. Heche:

I am always performing. I think once a month, I'm always on a stage somewhere. So I will be on a stage sometime in September and then again in October. But I am actually in the process of building a jukebox musical that I'm very excited about that will span the trajectory of some real important topics that will touch us all. So I'm really excited about that.

Dr. Douglas L. Beck:

You have to tell me when that happens.

Dr. Melissa E. Heche:

I definitely will.

Dr. Douglas L. Beck:

Maybe we'll come to New York and have a look see. Do you have a website for people who want to get more information on in-ear monitors and how to go about purchasing and using them?

Dr. Melissa E. Heche:

Yes. You can reach me at New York Speech and Hearing or New York Sound and Hearing. My website is ny-sh.com. You can also find me at musicaudiologist.com.

Dr. Douglas L. Beck:

All right. Well Melissa, it's a joy to speak to you. You're a wealth of knowledge. And I really, I've learned a lot about the better ways to go about IEMs and I appreciate your time and your expertise.

Dr. Melissa E. Heche:

Thank you so much for having me. This was a joy. I really appreciate it.

Dr. Douglas L. Beck:

Thank you so much.