Shark Tank Host Discusses His Hearing Lossby Brenden Gilewski, Hearing Healthcare Liasion

Instantly recognizable from ABC's "Shark Tank," Daymond John is an entrepreneur extraordinaire. But did you know that Daymond  (@thesharkdaymond) suffers from hearing loss and wears Starkey's Hearing Technologies' Halo 2 hearing aids?

In a recent Instagram post, Daymond set out to combat hearing aid stigma and help others live life to the fullest, overcoming what is a common but often hidden issue.  Daymond is not a paid sponsor of Starkey, but wanted to share his experience and reach out to those that may literally be suffering in silence.

Here is Daymond John's recent Instagram post:

“I love music!  I have been partying, attending concerts and wearing headphones while listening to music way too loud ever since I was a child. So like many of us, my hearing is not what it should be. 3 years ago I started wearing @StarkeyHearing Halos because they not only amplify my hearing, but I can also connect them to my iPhone and listen to my music, audio books and anything else quietly.

Once I started wearing them, I was shocked at how many people approached me about them. Many of the people clearly knew that they or a loved one had a loss of hearing but were too embarrassed to wear a hearing device because they were afraid of what people would think. That makes absolutely no sense to me. Why would you ever miss all the beautiful sounds of life because of what somebody else thinks? I decided that I want to be somebody that helps break the stigma that only seniors need these type of devices. Especially when today's technology allows you to do so much more with them by connecting to your smartphone. So I asked Starkey to hook me up with a special pop color pair that didn't blend in with my skin like my brown pair did. I want to make sure people noticed them when they see me.

Today my brand new red Halos came in and I'm ready to rock!! So if you have somebody in your life that is afraid of what people think if they wear hearing devices, then use me as an example. When you see them on me, tell them to get with the times.

To be clear, I have a great relationship with Starkey, but I have absolutely no ownership and I am not getting paid for this post. If you choose not to buy a Starkey product, that's ok. The point here is to share with the people you love with hearing loss that life is way too short to not enjoy all the beautiful aspects of it to the fullest. Push them to get their hearing checked and let them know that what other people think should be the last thing they should ever listen to! Pun intended:-) DJ”

This world renowned entrepreneur has built brands into global powerhouses including a six billion dollar brand in FUBU, which he founded.  In addition to being the Presidential Ambassador of Global Entrepreneurship and a co-star on "Shark Tank," Daymond is also a celebrated pioneer in the fashion industry, a best-selling author, and a highly sought after motivational speaker.

Daymond recently spoke at the Starkey Hearing Innovation Expo to talk about the "power of people" with Starkey's research and development team. He reminded the team why they are dedicated to investing in their people and their purpose.

The Hearing Innovation Expo is a global event hosted by Starkey Hearing Technologies, America's premier provider of hearing healthcare.

Use and Optimize your Awesome Hearing Resource

The things we don’t think about!  This week the New York Times reported on Lee Duck-hee.  He is an 18 year old who is ranked 143rd in the world in tennis, a sport in which listening to the ball is crucial.  Lee is the best player in South Korea, and he is also deaf.  In tennis, seeing the ball is thought to be insufficient at the top level of play.  Hearing the ball enables the quickest responses.  Even milliseconds make a difference in a game with super-fast serves and powerful groundstrokes.

Each spin has a slightly different sound as it comes off the racket.  Martina Navratilova explains that “You first hear the ball. Then you respond to the speed and spin according to the sound.” Studies have shown that people react more quickly to auditory stimuli than visual ones. At this level of play, every fraction of a second is significant.  Andy Roddick noted that at Wimbledon his first reaction to the shot comes from hearing. He explains “I think you need to hear the ball pretty clearly to play at your highest level.”

Hearing is so important that some players struggle with crowd cacophony – at this year’s U.S. Open even the pounding rain caused some players to find it hard to hear the cues that informed them about their opponents’ strokes.

In his book “The Inner Game of Tennis” W. Timothy Gallwey preached attention to the sounds of the sport, and described a feedback loop created by close attention to the sounds of one’s strokes in order to replicate the “crack” of a successful shot. The body learns to repeat the movements that produce that wonderful sound.

So – how remarkable it is that Mr. Lee, a deaf player, could do so well without the benefit of critical auditory information!  Paige Stringer, founder of the Global Foundation for Children with Hearing Loss, suggested that people born deaf may have a stronger sense of intuition in general, and are more tuned in to the subtle clues in face and body language than people with normal hearing.

This led me to thinking:  We know that hearing loss is a risk factor for falls; we suspect contributions of the inner ear balance system, medications and other health issues, and perhaps decreased awareness of the environment.  I thought this article raised a related issue: that auditory cues are quicker than visual cues – for the tennis player this may mean quicker access to information about where the ball is coming from.  Likewise ordinary people deprived of acoustic feedback in the form of footsteps, maybe even echoes, may be at a disadvantage in keeping their balance.

I shared this with Dr. Frank Lin, a Johns Hopkins otologist with expertise in the field of hearing and cognition, and he offered this thought:

“Yes—I fully agree with you about the role of subtle environmental cues in helping maintain balance. Importantly, for many older adults, balance is dictated by lots of things—strength, vision, cardiovascular output, proprioception, etc. I don’t think hearing is one of the dominant risk factors but for an older adult who already has multiple ‘hits’ affecting their balance (e.g., diabetes and peripheral neuropathy, poor eyesight, etc.), hearing could be a key additional ‘hit’ that may in fact be modifiable/treatable unlike the other risk factors.”

My conclusion: use and optimize your awesome hearing resource! Whether for your best possible tennis game….or treasured everyday communication with your friends, coworkers, and family.

Borrowed Time

Borrowed time, we hold it now…..  
I want to sit under the stars and watch the night unfold
I want to stay here with you now and whisper really close
Remember what I said as you lay down your head
The only thing that stays with us is love.
From the song "Borrowed Time," by Antigone Rising
(with permission of Nini Camps, Antigone Rising)

As we approach the Thanksgiving and holiday season, my heart seeks what really matters.   We are living in a time of constant visual images.  Our smart phones let us document every occasion for all to see.  But the sound track of our lives is usually more fleeting.   Each day, all day, we hear sound bites - snatches of conversation, the environmental soundscape around us, streams of music…they come, and then they are gone.

In this stream of sounds are a series of moments…and embedded in them are bits of beauty, what I think of as “everyday wisdom.”   I am not thinking of profound wisdom from great teachers, but the simple moments we catch every day.  A whispered “I love you.”  A child’s insight…my grandson, turning 5, asked his mom if he could wish everyone good health as he blew out his birthday candles. Yes, replied my daughter.  Because, he continued, that is a very important wish.

One patient I saw today was amazed she heard birds again with her new hearing aids.  The daughter of another lady said “My mom is so much more engaged.  She and my sister enjoyed a movie together – it was the first time in ages they could do that.”

So, you can see these are not earth-shattering moments.  They are little memories of the past few days. They are the moments that add up to our days and nights, and that’s what there is!  Here is a long-ago bit of everyday wisdom that has stayed with me:  I was a little girl and was at a birthday party. The children were playing a game.  I was shy, hanging back, and my mom encouraged me to play.  "I'll play later," I said. My mom replied that the game was on now, if I waited till later, I'd miss out.   If you have concerns about your hearing, address it now – don’t let those precious moments slip away.

Happy Thanksgiving.  I wish us all gratitude for our blessings.  In the words of this song:

So make the most of it
Like a wave crashes the shore
Make the most of it
‘Cause we can’t come back for more
Make the most of every minute as it turns into a day
Before it slips away…

We Would Love to See Our Family Physicians Incorporate Hearing Screening into Routine Primary Care

When new Medicare recipients see their doctor for their Welcome to Medicare visit, the doctor may or may not ask about hearing. So far, hearing health has not been given an "A" rating, which is a flat-out recommendation to provide service. The doctor may be speaking loudly in a small room one-to-one setting, and so a hearing issue may not be on his/her radar.

But, the evidence is mounting to support early intervention for hearing loss. Early detection and appropriate intervention holds the key in reducing disability and maintaining independence. Last year's PCAST (President's Council of Advisors on Science and Technology) endorsed access to appropriate hearing technology especially for people with mild to moderate hearing loss. Research finds that hearing aids, when indicated, boost social engagement, reduced caregiver and family stress, and reduced symptoms of depression, all factors important in positive health outcomes and quality of life.

As we have reported in the past, there are independent associations between hearing loss and an array of broader health issues, including cognitive decline, functional dependence, falls, social isolation, diabetes, cardiac problems and patient-physician communication.
Physicians, asked to be experts in so many health areas, may not be aware of the array of current treatment options available for hearing help.

So, if you or a loved one has concern about ease of hearing:

• Difficulty understanding family members
• Difficulty understanding health care providers
• Difficulty with group conversation
• Difficulty hearing in noise
• Difficulty hearing on the phone
• Communication is tiring or hearing loss interferes with easy flow of conversation…

Ask your doctor for a referral for a diagnostic hearing evaluation. We will make some measurements with you, and then educate and inform you about the results. We always send a clear report to your physician to explain the results.

Remember that communication is key to a full and joyous life at any age. Never say "at my age….…" I thought of this recently at holiday services when a 102 year old lady – a choreographer by training – led the congregation in beautiful body movements to accompany a prayer. 102! And still reaching up and out, and living strong. Remember: at the end of the day – what we have is connection and communication.

Tweaking! Whether it's a Concert Sound System, Cochlear Implants, or Your Hearing Aids, Sometimes a Little Adjustment Can Make All the Difference.

A few weeks ago I had the pleasure of sitting on Sea Cliff beach and watching a favorite band set up the sound system before their concert. It was fascinating for me to watch the sound engineers add a drop of bass here and a bit of treble there till the musicians were pleased that the mix was just right.

Shortly after that, I heard a captivating story on NPR, so interesting that I am sharing the link here so you can hear it too. It is the story of a pediatric audiologist, a long-time hearing aid user, who then lost her hearing all together following a car accident. She went from being the provider of hearing services to the recipient.

Hearing aids no longer helped her very profound hearing loss, and she had surgery to obtain cochlear implants. Cochlear implants bypass the outer and middle ear, and the electrode array stimulates the auditory nerve fibers from within the cochlea. The device receives acoustic stimuli from the external processor that's worn outside the ear. This new sound took some work to get used to, even for a knowledgeable and seasoned audiologist.

As the research audiologist who worked with the patient explained, sometimes there is too much sound, as the sound from the incoming frequencies may "spread" and the sound may be blurry. In this case "more" stimulation could actually be "less" hearing. To clean up the sounds for this patient, they turned off a few of the electrodes, and suddenly the sound was perceived as cleaner and easier to hear.
Please listen to this story – even if you don't know much about cochlear implants I think you will find it interesting.

http://www.sciencefriday.com/videos/breakthrough-portraits-of-women-in-science-a-re-sounding-remedy/

And even if you do not have CI's or know anyone who does, remember that sometimes a little tweaking will make a real difference in the comfort and clarity of the sound quality. Hearing aids are works in progress as your brain accommodates to sound, and as we make little tweaks as we go along.

So the World May Hear…

Last month I wrote about Starkey’s Hear Now program that recycles used hearing aids so that new hearing aids can be built for people in need in the U.S. and around the world.

Now I want to share an amazing story of caring and sharing. The Starkey Hearing Foundation actively changes lives through the delivery of hearing care all around the globe. The Foundation conducts Missions at home and all over the world to connect hearing impaired children and adults with the amplification they need. And that is only the first step. Hearing is a tool to open up our world. Bridges of trust and understanding are built. People are empowered so they can best contribute to their communities. One step drives the next…hearing is the vehicle that drives projects in health, housing, education, clean water, and agriculture.

From Afghanistan through Zambia...and over 100 countries in between Starkey offers Missions that effectively deliver and support hearing. Here is how it works: Patients are screened by trained community-based health workers and potential hearing aid candidates are identified. Primary ear care services are offered and custom ear molds are created.

The hearing aids are fit and the recipients and teachers are counseled on care and operation of the hearing aids. My favorite part of this program is after-care. It is not enough to simply fit the hearing aids. Local teams are created to offer ongoing support to care for the hearing aids, and learn to use amplification for better communication, and in the case of children, speech and language development.

Ongoing after-care provides further counseling, batteries, and maintenance services. Education is provided both to the hearing aid recipients and the team of teachers and community healthcare workers. Having great technology only works if it is used effectively and maintained.

When I was at a conference in Minneapolis I was privileged to hear Starkey founder Bill Austin and his wife Tami Austin talk about their hands-on, effective, and caring work, person-to-person, with passion and humility. I was moved beyond words. Hearing aids through the Starkey Hearing Foundation are truly the gift that keeps on giving. To my mind, it is compassion leveraged to real and meaningful change to countless lives.

Smiles abound in Afghanistan.

MLB Hall of Famer Paul Molitor (right) assists
a patient in the Dominican Republic

Dancing in Portugal while musician Alice Cooper (second from left)
looks on with approval.

Starkey is recognized for their efforts in Kenya.

The Journey of a Recycled Hearing Aid

Renew Reuse Recycle is a mantra in my family.  Toys and clothes get passed along to anyone who might enjoy them.   Often my hearing aid patients ask what can be done with hearing aids that are no longer being used.  We mention the “Donate Now” button on our website that connects them to Hear Now, a program run by the Starkey Hearing Foundation.

Here is what happens when you send your hearing aids to Hear Now. 

Your hearing aid goes on a journey that results in providing hearing help for a person in need.  Here is how your hearing aid goes from you to someone in need:

1. The original owner ships to hearing aid to Starkey Hearing Foundation, ATTN: hearing aid recycling, 6700 Washington Avenue South, Eden Prairie, MN 55344
2. The donation is received and documented, and a letter of acknowledgement is sent to you.
3. Aids are sorted by make and model.
4. Everything gets used: components are removed and salvaged for rebuilding.
5. Hearing aids are rebuilt to specification – both custom (in the ear) and behind the ear models.
6. Custom shells are cleaned and buffed. Ear hooks are fitted for over the ear styles.
7. Each aid goes through the Quality Assurance process so the new owner is assured of accurate and appropriate amplification.
8. Aids are packaged and made ready for missions.
9. A person in need is fit with hearing aids.   The Starkey Hearing Foundation is changing lives, one at a time.

This is not a new program – Starkey has been doing this work for many years.  But only recently did I realize that each and every hearing aid can be put to use for the benefit of people in need. I’m proud that we work with Starkey/Audibel, a company that has a core belief in changing lives in the U.S. and around the world. To date, more than 560,000 hearing aids have been recycled – AMAZING!

Lunch and Learn Series Hosted by the Hearing Center

Join us for a FREE LUNCH where nationally known hearing expert, Patrick Gilmartin will be discussing the latest and most innovative advances in the hearing industry and answer any questions you may have about hearing loss and tinnitus.

• We’ll clear up the confusion about hearing aids.
• If you or a loved one are experiencing symptoms of hearing loss, don’t miss this opportunity!

Leave your checkbook at home nothing will be sold during this educational seminar.

Two Seminars:

Piatto Grill

90 Triangle Center, Yorktown Heights [MAP]

Tuesday, August 16th at 12 noon

RSVP: (914) 245-6618

Tombolino Ristorante

356 Kimball Ave, Yonkers [MAP]

Wednesday, August 17th at 12 noon

RSVP: (914) 968-7555

Please Come In!

When we fit you with hearing aids we ask you to come back for follow-up.  We schedule the first follow-up visit a week or two following the fitting. This is a very important visit as it allows us to answer your questions, confirm comfort of fit and sound, and review the many details that we covered during the fit.  We will ask you where you see improvement, and what still needs work.  Virtually all of the hearing aids that we fit can be modified right in the office.  Your observations will guide us in fine tuning the hearing aids to best meet your needs and preferences.

It may take a few visits in the beginning to be sure your hearing aids are optimally set for you, and you are confident in using them successfully.  Once we have you “on track” we still want to see you for routine clean and check visits (usually every three months).  We do not charge you for these visits during the warranty period, which may vary from one to three years. 

Here is why we ask you to come in for “Clean and Check” appointments, even if you’re not having a problem:

• As you learn to listen with hearing aids your listening demands may change, and we may modify your settings to give you the best results possible.
• You may – or may not – want additional control of your hearing aids through program options – you are in charge of how automatic your hearing aids are.
• We find many patients benefit from a review of care and cleaning from time to time.
• We will check that the microphones and receivers are clear of debris and working at their best. Sometimes simply cleaning the hearing aids and changing the filters that protect the microphones and receivers will brighten the sound quality – even if you had not perceived a problem.
• Many hearing aids “log” your hearing aid usage, the types of environments you are in, and how you are using your volume controls or program buttons. By monitoring your usage we are guided to make adjustments that will enhance your experience.
• We will check your ear canals to be sure they are free of any wax that might compromise the function of your hearing aids.
• We will review with you the routine care you should do daily to keep those instruments at peak performance. Your hearing aids live in a warm and moist environment, and the earwax with which they come in contact (salty and acidic) can harm the electronics. But a little care can often prevent problems before they happen.
• Frank conversations about your goals will let us determine if they are being met, or if you need additional support (perhaps with a streamer or remote control) to help you further. A reminder about good communication strategies can also fill the gap between help from the hearing aids and maximal benefit.

If you have a concern, please call right away so we can help.  Do not wait for that scheduled appointment.  If we do not hear from you, we cannot address your concern.  We are here to help you.

So, please come in!  By keeping your scheduled appointments you are helping us do the job we want to do for you.

The Road to Change

I’ve lived in the same house since 1978, and I’ve had the same job since 1985, so you can see that I don’t make changes lightly! Making decisions and implementing change can be tough. I have surely found myself thinking: “On one hand….but on the other hand…” I get it!!!

Yet, changing habits is fundamental in hearing health care. When we recommend something to you, we are asking you to change some habits. Implementing change is often a journey. When people change habits psychologists have found they follow a well-recognized pattern. Let’s look at this pattern and see how we can use these stages to describe the journey to better hearing health:

Pre-contemplation: At this stage the person does not realize or believe that there is need for change. Someone else may have initiated the appointment such as a physician or family member. The person may be surprised by the perceptions of others, and may make excuses for missing conversation, such as “other people mumble” or “I wasn’t paying attention.” The audiologist listens and offers information, but he or she may not be ready for intervention.

Contemplation: There may be ambivalence at this stage. The person may still be comfortable with the status quo, but may be beginning to explore the consequences of doing nothing. At this point, we acknowledge ambivalence, and start to explore the person’s experiences with communication and hearing. We begin to offer advice about options for improving the situation.

Preparation: As the person moves on to the preparation stage, they reach a tipping point and decide to act on the hearing loss. Now the person is motivated, and is looking for information on the best path forward. We are here to offer advice about what it takes to facilitate communication. There are always a variety of options and so it’s important that both the person, the family, and the professional are open to listening and exchanging ideas that make the most sense for this particular situation.

Action: A person in the action phase is moving ahead. Having resolved the initial ambivalence, the person feels positive. This is the point where the decision that had seemed daunting now feels less difficult than anticipated. This is the time to focus on the anticipated benefits of improved hearing and communication. As in any decision we make, it’s so much easier once we are on the path to action.

Maintenance: This is the stage that moves from a place of stress to a place of contentment. The person is now taking advantage of amplification and better communication strategies. The goal of this stage is to feel successful and comfortable with the new behavior (amplification and communication strategies). These new habits are fully integrated into his or her lifestyle. The person is now using amplification confidently…and we continue to be there for support and assistance as needed.

Of course, not every decision is a step-be-step process for every person. Sometimes it’s a journey, and sometimes it’s a slam dunk. Either way, change involves a little adjustment. But before you know it, you’ll have a “new normal” - you’ll be in a better place, wondering why you didn’t get there sooner.

Patients and their Families are the Real Experts

Hearing loss impacts everyone involved in the life of someone with hearing challenges, especially family and loved ones. In healthcare overall, and in hearing healthcare in particular, we are learning that treatment outcomes are better when families are involved, increasing overall patient satisfaction.

We support a holistic approach to healthcare - one that considers the person receiving services and his/her family to be active partners in the planning, executing, and monitoring of treatment.  The Institute of Medicine offers the following description:

Family-centered care provides care to patients and family members that is respectful of and responsive to individual patient and family preferences, needs, and values, and ensures that patient and family values guide all clinical decisions.

Sure, we perform our tests and make our measurements to quantify hearing ability and determine what areas of the auditory system are involved. But these measures offer a starting point, and do not dictate how we proceed.  

We have learned that each person is unique, and not every hearing loss can be treated the same way. I am a guide, so that we may explore options based on lifestyle, perceptions and preferences of the individual.

We encourage our patients to invite a family member along to the audiology appointment. The family member is great for support, encouragement, and "reality check".  Sometimes the patient has one perception of his communication abilities, but his significant other may see things a bit differently. Interestingly, both views may be aspects of the same story!

We welcome active participation by family members.  Familiar voices help to assess how a hearing aid is perceived, and helps us tweak the settings to best serve the patient.  

We consider the individual patient and his family to be the experts. They (not we) live with that hearing loss every day. Nobody knows you as well as your family! Everyone in the family has a role in setting goals. We get the best picture when we see it from all sides.  The patient may say: "I want to hear TV more comfortably." A son or daughter may have another concern: "I need to know he will hear the phone when I call so I don't worry." Likewise, both the patient and the family members contribute to assessing success and/or need for adjustment.

Finally, another pair of hands and set of eyes can make things easier so any problems can be addressed quickly by the "team" and the family can get on with good, stress-free communication. When you hear better, you (all of you) live better.

Ear Infections

This is happy news!

Ear infections are uncomfortable for both the babies who have them and their parents whose nights are disrupted, but new research shows that fewer American babies are getting ear infections compared to 20 years ago.

The researchers followed 300 newborns through their first year. Almost half of them had at least one infection during that year. This is a big drop since the 1980s and 90s. The number of babies with ear infections during the first three months of life dropped by two thirds. Good news indeed.

This decline did not surprise lead researcher Dr. Tasnee Chonmaitree. Here’s why:

VACCINES: There is a vaccine that’s been available for a few years (the pneumococcal conjugate vaccine) that protects against several strains of bacteria which can cause serious illness such pneumonia and meningitis. These bacteria are also major causes of children’s middle ear infections.

Also, annual flu shots are now recommended for babies and children. These may help too, as ear infections may arise following a viral infection like the flu or common cold.

So it may be that these recommended vaccines have an additional benefit of driving down the rate of ear infections in babies and children.

BREAST FEEDING: Exclusive breast feeding during the first six months helps lower the rate of ear infections. There are a few reasons: Breast milk contains antibodies that can protect the babies against infections. Also, breast fed babies spend less time feeding from a bottle while on their backs. That position may make some babies more vulnerable to infections. The author said “breast feeding is good and should be encouraged to do it if they can.”

CIGARETTE SMOKING: Smoking cigarettes is down, and although the number of babies in the study is too small to clearly implicate second hand smoke, the researchers believe that the impressive reduction in smoking in the last few decades has had a positive effect on reducing the incidence of ear infections in young children.

Mild Hearing Loss

A few weeks ago I had a bout of garden-variety external otitis, or “swimmer’s ear.”  I ignored it for about a week, and when my home remedies did not help, I sought treatment by an otologist.   It resolved quickly after that, and now I’m back in the pool and hearing fine.  But I learned a lesson during the time that my hearing was muffled.  While my hearing was off I had perfectly normal hearing in my left ear, and a mild conductive (plugged-up) hearing loss in my right ear.  That doesn’t sound bad, does it?  But, it was more tiring than I would have anticipated.

These are some of the problems I noticed:

I had trouble telling where sounds were coming from, as the hearing symmetry was off-kilter.

I was missing some of the soft high frequency consonant sounds that define words – I found myself almost reflexively asking “what?”

When the pace of the conversation was fast, I had even more trouble.

As an audiologist I speak with different people all day long – it is important to me that I hear my patients accurately so that communication is accurate, and I don’t need to interrupt the conversation to ask for clarification.  Even with this little degree of hearing loss I was guessing and straining.  I found my brow was wrinkling up as I worked to hear.

Soft and distant sounds were challenging to hear.  By the end of the work day I was ready for the quiet of my home.

If you doubt this degree of difficulty, you can try this at home.  Insert one (or two) foam ear plugs, and ask someone to recite a list of short words: fish, dish, six, fist, fifth, sits, sit, etc.  How did you do? Try it again with the radio or TV on. More challenging?  Next, try it without the visual help you get from looking at the speaker.  Now with another speaker also reading some words… this can be really difficult. 

Imagine you are listening like this all day long, every day.  It can be done, but you would be using effort better spent on enjoying and responding to what you are hearing.

My lesson is that even what I think of as a mild hearing loss can significantly interfere with ease of communication.  Some patients with mild hearing loss may not perceive day-to-day challenges. But many do, as I did,  and they are real.  Each patient is unique, and for many people with even mild hearing loss, there is a simple appropriate solution to make every day communication easier, more accurate, and fun.  

Normal Audiogram, but…

From time to time, a patient comes to the office noticing they are struggling with conversations, especially in challenging listening environments.  Sometimes they come in after a big birthday – maybe 40, maybe 50.  They ask, “Is it me?”  They want a baseline, and an explanation of why they are have difficulties when other folks seem to be following the conversation or getting the joke.  So I perform our standard audiometric measures, and often find myself saying “Good news – your audiogram is normal, you understand words clearly in quiet, your middle ear is functioning properly, even the inner ear response is fine – in fact, if you were a baby you’d pass the newborn hearing screening.”

And yet, and yet….   They are still not hearing well in noisy environments.  What is going on?  Perhaps my “Good news” is not so reassuring, as it raises the question of “Well, then, why can’t I hear like I used to?”  This was addressed nicely in a recent article in the ASHA Leader (Koehnke, Lister, and Wambacq).  

Although undetectable with audiometric testing, changes in hearing ability begin in our 40’s and 50’s.  A growing body of research suggests that while hearing acuity may be normal, complex auditory processing at the central (brainstem and brain) level is not what it was in our 20’s and 30’s.  

Remember, there is so much more to accurate hearing than raising the volume.  There is a set of skills we use in listening that are complex and quite amazing:

• Temporal processing is the ability to follow rapid changes in speech and music, and affects our ability to discern the consonants and vowels that define a word.  Temporal processing declines with age.
• Information from speech rhythm and emphasis is also clearly affected by age, and affects ease of communication.
• Separating out one stream of conversation from another (at a restaurant or party) becomes more challenging with age – to me, it is a miracle that we can do this at all!
• Subtle changes in hearing may interact with changes in memory, attention, and processing speed.  One study found that speech “babble” (background speech) adversely affects middle aged people’s ability to retrieve words from working memory.

So – there are “normal” changes in the auditory system as we age that may interfere with listening, especially in background noise.  Hearing thresholds may be normal, so hearing aids are not called for.  Here are some strategies (mostly common sense) for easier listening if normal age-related changes in auditory processing are impacting on daily communication:

• Turn off the radio or TV that interfere with your understanding another’s speech.
• Position yourself and your conversation partners to best see and hear each other.
• Ask conversation partners to speak more loudly, slowly, clearly (whatever would help).
• If other conversations are happening simultaneously, try to relocate.   Separating will help you focus your attention on the conversation of interest.

We may not know exactly which of the many age-related changes may affect our individual auditory systems.  We do know that there are normal changes that occur.  They may affect each of us differently, but if you are not hearing quite as easily as you used to, I hope it is reassuring to know that you are not alone! 

Helping Single Sided Deafness

Some people have little or no usable hearing in one ear, and either normal hearing in the other ear, or a hearing loss that can be helped with amplification. There is a solution for this situation, and current technology makes it better than ever!

Single sided deafness (SSD) involves significant damage to hearing in one ear. People with SSD can have trouble understanding speech because they can’t separate background noise from the sounds they want to hear, and they can’t hear from one side – making it difficult to locate sounds.

In addition, these people need to strategize when they are in a car, walking in the street, or sitting at a meeting, in each case being sure that the speaker they are trying to hear is on the “good” side. This is not easy.

The technology that addresses single sided deafness is called CROS (when the better ear is normal) and BICROS (when the better ear has an aidable hearing loss.) Here is what happens:

CROS hearing aid systems wirelessly transmit sound from the deaf side to the better ear via a small sleek transmitter, which is placed behind the deaf ear. The transmitter picks up sound and wirelessly transmits it to a receiver hearing aid on the normal-hearing ear. This solution is discreet and highly effective.

BiCROS is similar to CROS, but is made for those who are deaf in one ear and hearing impaired in the other ear. Here, the receiver hearing aid also amplifies sound on the better ear.

People who have lost their hearing in one ear and begin to use a CROS or BICROS system often light up with delight as they realize they are picking up sounds from the “bad” side. It is truly an “oh, wow!” moment.

Today’s CROS/BICROS instruments use the latest fashionable wireless instruments. They not only look good, but take advantage of the newest sound processing.  Battery life is surprisingly good.  Some units have a volume control so the sound from both sides can be adjusted.

Finally, patients with tinnitus (ringing in the ear) often get relief because of the additional sound enrichment.

If you or someone you know has single sided deafness, we would we happy to discuss this option with you.

CaptionCall - a Free Service to Assist With Phone Calls

If you have trouble hearing easily on the phone there is a technology that can help you.   Even with hearing aids, sometimes it is difficult to hear soft or high-pitched voices. Sometimes names or numbers are hard to hear, and sometimes the phone connection is simply not good.

CaptionCall is similar to captioned TV, but it is only available to people with hearing loss.  It displays written, almost instant easy-to-see captions so that you can listen and read the captions simultaneously.   Twice the information allows you to communicate with better understanding and less stress.

Moreover, it is FREE!  Captioned Telephone Service is a federally funded program administered by the FCC as a benefit of the Americans with Disabilities Act.  There are no costs associated with this service.  The telephone itself is provided by CaptionCall at no cost.

In the words of one of my patients – a dynamic professional woman with a tough hearing loss and a wonderful way with words:  “Thanks to CaptionCall there’s no more ‘processing’ time interrupting my conversation.  I can answer spontaneously.  Without the help of CaptionCall it takes a pause to get the contextual meaning.  But now I can have a true dialogue.  It provides another layer of ability, not disability!”

To qualify for a CaptionCall service you must have a hearing loss, and a signed form from a qualified health professional affirming that you need a captioned phone because of your hearing loss.  Once you submit your form by FAX to 1-888-778-5838 a CaptionCall representative will contact you and arrange for: free phone, free delivery, free installation, free in-home training, and free captioning service.

You will be able to communicate with confidence!  Caption Call is familiar – calls are dialed and answered like any regular phone.  The phone is hearing aid compatible if the hearing aids have telecoils available.  The sound of the phone can be customized - the ringer, handset volume and frequency balance can be optimized to meet your hearing configuration.

Three things are needed to get started:

• hearing loss that requires the help of a captioned phone service
• high-speed internet connection 
• standard home phone connection

Be empowered!  Accurate and easy telephone use is important for staying in touch with family and friends, obtaining needed information, knowing you are communicating with accuracy, and staying well-networked.  My patients who have obtained this service are delighted with the help.