Listen Up!

After returning from my “baby” brother’s surprise 50th birthday party, I began to think about hearing loss. For years, he had grumbled about the difficulty he had hearing. We assumed it was a combination of a genetic predisposition (hearing loss was experienced by both our father and uncle), his work as a young heavy-duty mechanic and his later exposure to gunfire and other occupational noises as a fish and wildlife officer. Now in an administrative position, he recognized that he was not able to hear all of the conversations and comments in complex planning meetings. At the party, he was delighted to show off his new hearing aids and discuss the world of hearing that he had re-entered.

My younger sister had, from time to time, also commented that she had increasing difficulty hearing conversations – especially in crowded, noisy environments. Whenever I asked her why she had not had her hearing tested, she replied with “Well, you can get used to reading lips” and “I just avoid really noisy settings.” She never mentioned one of the most frequently unstated reasons for avoiding exploration of hearing loss: “I don’t want to look old.”

These family interactions led me to an interview with Harry Lam, a registered audiologist in Vancouver. He noted that it is not easy for people to deal with hearing loss. It takes most people seven to 10 years after they realize they are losing their hearing acuity to arrive for an assessment. Even then, it is not the concessions they were making in their lives that forced recognition of the need for an appointment, but because their spouses or relatives were annoyed by having to repeat information and insisted on an examination.

“The concern about looking old because of wearing hearing aids is often there in the background,” says Henry. “But there is nothing that makes a person look older than having to ask for information to be repeated, responding inappropriately or appearing confused because of misunderstanding words, becoming socially isolated because of avoiding noisy settings and living with a nagging family member related to hearing loss.”

Other significant consequences that result from unattended hearing loss include depression and mental health issues. Safety issues when driving, being a pedestrian or within paid work situations are also areas of concern.

Hearing loss may occur at any age and results from a number of causes. For individuals who were born with normal hearing and experience hearing loss in adulthood, it may be because of illness, (e.g. Bell’s Palsy) or infections, tumours, drugs, disease processes, interruption of the blood supply to the inner ear or noise/work-related causes. Some hearing loss inevitably occurs with aging.

Sadly, hearing loss is expected to become more prevalent in the future. Today’s children and teens who are exposed to loud music, an increase in urban noise pollution and the constant boom of a plugged-in audio world may arrive in their 40s for assessment of significant hearing loss.

Once a person acknowledges that he or she has hearing difficulties, there are a number of ways to obtain an assessment. Following an examination by either a family physician or an ear-nose-and-throat specialist, a referral to an audiologist or a hearing aid dealer/consultant will generally be made.

Audiologists have a master’s degree and specific skills in defining hearing loss, hearing testing, test interpretation, hearing aid fitting, hearing rehabilitation and counselling clients who range in age from infants to seniors. They are trained to manage situations such as seniors with dementia or blindness and those with other medical conditions. The Hearing Aid Consultant/Hearing Instrument Specialist is trained to test hearing, to fit hearing aids and to help individuals accept and learn to wear their aids.

The price ranges from $1,800 to $4,000 per hearing aid, so it is essential to select a reputable resource for the assessment, possible purchases and follow-up. Many clinics offer free initial assessments, but it is important to ask questions before arranging an appointment to avoid any “hard sell” of expensive or unnecessary aids during the assessment.

With the above in mind, and after visiting and talking with the audiologist, I made an appointment with a well-established company for their free assessment. I didn’t really think I had hearing loss (although I was recently finding the sounds of sirens and fire engines increasingly loud) but I approached the assessment with mild anxiety. What if I really did have hearing loss and they suggested hearing aids? Could I face my own and possibly others’ perceptions that wearing hearing aids meant that I was “old”?

Response to a client medical history preceded a visual exam of my ears. Next, as I sat in a soundproof room, I was asked to press a button each time I heard a beep or to repeat a word spoken with varying loudness. The ability to identify speech sounds with interfering noise is another part of the assessment, but was not used in my case. The consultant tested both my external hearing as well as bone conduction hearing. Throughout the test, I worried. “Was I hearing the sounds correctly?”

At the end of the assessment, the consultant showed me the graph related to my responses. Although the majority of responses were accurate, the errors I made were with soft sounds such as f, sh, ph. This indicated mild hearing loss suggesting a need for yearly monitoring – although there is no way to determine how quickly my hearing might deteriorate.

After entering my hearing profile into a computer program, customized hearing aids were placed in my ears. The amplification meant soft sounds that had become somewhat fuzzy for me were back to their original clarity.

A variety of hearing aid styles are available. They range from open canal aids to ones custom fitted to the ear canal. Some interconnect to cellphones and the TV. The smaller aids may be less powerful and those that go directly inside the ear tend to break down more quickly, although on average an aid should last about four to six years.

Hearing loss will be a reality for most at some time in their lives. However, today’s seniors and those in the future may not be as concerned about the stigma of a hearing device. The earplugs of an iPod or cellphone appear similar but are often larger and more obvious than many of the hearing devices. “No one thinks wearing glasses makes you look older – and that is what we hope will happen with hearing aids,” says Harry.

In the meantime, as those plugged-in young people say, “Listen up.” If you have to continually ask for verbal information to be repeated, need to lip-read, avoid social situations, miss the sounds of nature or become the recipient of angry comments about your lack of response to requests or in conversation, it may be time to have your hearing assessed. And it won’t hurt a bit!