Would You Cure Your Hearing Loss?

Katherine Bouton Healthy Hearing

Would you cure your hearing loss?

At the moment, that’s a hypothetical question. A cure for hearing loss does not exist. But as Dr. Tom Friedman of the National Institutes of Health told an audience at the Hearing Loss Association of America’s annual convention in June, a cure for at least one type of hearing loss may be around the corner.

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Genetic, or hereditary, hearing loss is responsible for about 60 percent of hearing loss present at birth or developing in early childhood. It is also responsible for some adult-onset hearing loss, either on its own or in combination with exposure to noise or other toxins, including some medications like streptomycin or aminoglycoside antibiotics.

Hereditary hearing loss is caused by one or more mutations on a specific gene or genes. As of May 2019, scientists have identified 129 different genes causally associated with hearing loss. (“Causally” is the important word here.) Others are still being investigated. Gene sequencing can show which specific genes carry a mutation.

Hela Azaiez, PhD at the University of Iowa, who also spoke, noted that there are over 7000 possible mutations in those genes. She also said that an expert can sometimes predict which gene is responsible for the loss by the pattern on an audiogram. The more a person knows about the pattern of loss in the family, the easier it is to find the defective genes that are causing the loss, so a large family tree is helpful.

Autosomal recessive genes are the cause of hearing loss in 59 percent of cases. When the gene is recessive, the effect — in this case hearing loss — may skip generations and a pattern may not be apparent. Thirty-six percent of the genes that cause hearing loss are autosomal dominant, which means they always cause hearing loss. That leaves five percent, of which four percent are linked on the x chromosome and 1 percent in mitrochondrial DNA.

Two-thirds of those with hereditary hearing loss have no other related symptoms. But the remaining third have what is called syndromic deafness, with symptoms in addition to hearing loss. These include Usher syndrome (the disorder that Rebecca Alexander, subject of my previous post, has), Alport syndrome, and Perrault syndrome.

The next step for researchers is developing a way to correct those mutations. Several laboratories are moving ahead quickly with research.

Dr. Friedman is chief of the Laboratory of Molecular Genetics at the National Institute on Deafness and Other Communication. Dr. Hela Azaiez focuses on autosomal dominant genes at the Molecular Otolaryngology and Renal Laboratory at the University of Iowa. In the afternoon Dr. Azaiez gave a workshop with former HLAA Executive Director Brenda Battat and her family, who have hereditary hearing loss. Brenda Battat wrote about her family’s genetic search in an article for the January-February issue of Hearing Life Magazine called “Caught Up in a Whirlwind of Genetic Hearing Loss . They have been working with Dr. Azaiez.

To return to the question in my title: Would You Cure Your Hearing Loss? Many in the culturally Deaf community would answer with an emphatic No. Hearing loss/deafness/sign language are what makes them a community. As for me, with many years of hearing loss behind me, I would also probably say no, because the speech pathways in my brain are attuned to the way I hear now with a hearing aid and a cochlear implant.

But there are good reasons for determining the cause of hereditary hearing loss even if you don’t plan to treat it. Families may decide to correct the mutation in future generations. If it is too late to correct in younger family members, or if the family does not want to correct it, finding out what the mutation is and which family members have it allows them to plan ahead for future health care and other decisions.

The research symposium at Convention is always fascinating. This year’s panel included other researchers and much more information than I have room for here. Don’t miss next year’s symposium at the HLAA Convention in New Orleans.

For more about living with hearing loss, read my books, available at Amazon.com and Barnes and Noble, and maybe at your favorite bookstore or library. If it’s not there, ask for it!

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Resilience

Katherine Bouton #HLAA., Cochlear Implants, Hearing Loss Association of America, Usher Syndrome

Whenever I am with a group of people with hearing loss, as I was last week at the annual convention of the Hearing Loss Association of America, I am impressed by the hurdles so many have overcome. Sudden or severe hearing loss is an ever-present challenge all on its own. So many at Convention, however, also have complicating factors: vision loss or blindness, tinnitus, vertigo or dizziness. Many have hearing dogs to assist them, some use motorized wheelchairs. All of them, if they have made it to Convention, also have strength and resilience. They wouldn’t be there unless they did. Many also have another crucial asset: a sense of humor.images

This year’s keynote speaker was Rebecca Alexander, author of “Not Fade Away: A Memoir of Senses Lost and Found.” She has Usher Syndrome Type 3, which results in blindness and deafness. I first came upon Rebecca when I reviewed her book in the New York Times in February 2014. She is an inspiring speaker (with a sense of humor) and if you have a chance to hear her speak, don’t miss it. In the meantime, read her book. And soon you’ll be able to see the movie, starring Emily Blunt. Here’s a link to her website. 

Rebecca began to lose her vision at age 12. By the time she was 19, her deafness had been diagnosed. Her trials seem, in retrospect, Biblical. She developed a severe eating disorder. Her twin brother, Daniel, was diagnosed with bipolar disorder that was resistant to treatment. Her boyfriend got cancer. She had tinnitus, with auditory hallucinations: a woman screaming at night, a jackhammer.

In spite of all this — or maybe because of it — she was driven to succeed. As a teenager at summer camp, she set off at 3 a.m. for a five-mile swim across a lake. In her early 20s, (by then well into deafness and blindness) she trained for a weeklong AIDS-benefit bike ride from San Francisco to Los Angeles. She ran extreme-athlete events and taught spin classes. She swam from Alcatraz to shore. She climbed Mt. Kilimanjaro with her sister. She climbed the treacherous Inca Trail at Machu Picchu: “My lack of peripheral vision made it easy to block out the deadly fall that you could take on either side,” she dryly comments in the book.

She pushed herself professionally as well. She has a double M.A. from Columbia in psychology and public health and has a successful private psychotherapy practice. As one friend wrote in an interview about Rebecca, “I think she keeps going 100 miles an hour to not have to process it all.”

Maybe, but as Rebecca wrote in her memoir: “If there’s one thing you absolutely need with a disability like mine, it’s resilience. I’m not talking about strong will and zest for life, either — but pure physical resilience. When you are going blind and deaf you are basically an accident waiting to happen.”

And happen they did. Just before she left for college, she fell out of her second-story bedroom window, mistaking it in the dark — and a drunken stupor — for the door to the bathroom. She broke virtually every bone in her body in the 27-foot fall onto a flagstone terrace, except for her neck and her head. The accident — and her recovery, which left her with a limp — taught her “something integral to who I am today,” she writes, “the perseverance I would need every day of my life.”

Today she has some vision and can focus on a speaker well enough to read lips. She has two cochlear implants and hears well with them. The Rebecca of the 2014 book was an astonishing person, but I worried that it all might come crashing down on her. Seeing her strong and beautiful and telling her story at Convention was clear evidence that she has overcome adversity that most of us can barely imagine. But her audience too was made up of people who have overcome adversity that many of us can barely imagine.

As Rebecca says in her book, what choice is there? “People often tell me I’m an inspiration. I’m never sure what to say.” She short-changes herself. She is an inspiration, as are so many with disabilities.

 

This post is partly adapted from my review in The New York Times: “Young, Stricken and Determined to Fight.”

For more about living with hearing loss, read my books, available and Amazon.com and Barnes and Noble, and maybe at your favorite bookstore or library. Smart Hearing Cover final

 

 

 

 

 

 

Captions Wherever You Go

Katherine Bouton Captions for hearing loss, Healthy Hearing , ,

It’s rare that a new app or product comes on the hearing device market that seems revolutionary. But Google has come out with a voice to text app that is potentially game-changing for those of us with severe hearing loss.

Although I have an excellent hearing aid and a state of the art cochlear implant, I still have trouble understanding speech in a group or in a noisy environment. Existing voice to text apps like AVA and Dragon Dictation help in those situations, but Google Transcribe far out performs them.

Google Transcribe is a free app that is currently available only for Android devices. I’ve been using it for the past month or so and didn’t want to write about it till I understood the pros and cons.

There are cons, as a glance at the photo illustrates. It starts out fine and then deteriorates.Google Transcribe IMG_0495

This transcript was made during a discussion with three other people. Looking at the transcript now, a day after the conversation took place, the text seems pretty garbled. It seemed perfectly clear at the time, probably because I can also hear enough to provide context. My book club was discussing Geraldine Brooks’ novel “March,” which imagines Louisa May Alcott’s “Little Women” from the perspective of the father who goes off to the Civil War. “Marmion” in this text refers to Marmee. I’m not sure what the word “Reversible” was supposed to be, but the rest of it seems clear enough.

Using the device at my book club, the discussion at first appeared in Spanish. Google Transcribe is also a translation app and has dozens of languages to choose from. I must have clicked on Spanish by mistake.

If you have an Android phone, all you need to do is download the Google Transcribe app. If, like me, you are a loyal Apple user, you’re out of luck unless you buy an Android device. Fellow blogger Shari Eberts, who wrote about Google Transcribe a few weeks ago, suggested buying an inexpensive Android device and not registering for phone service.

I bought this device. Since I’m not an Android user it took me a few tries to figure how to turn it on and navigate around it. I should have had the sales person show me how it works. It’s a nice slim phone and it charges quickly. As long as it’s connected to WiFi, it gets Internet access. I recently used this phone for GalaPro (see earlier post), because the type is clearer and larger than that on my iPhone. It even has a nice camera.

Live Transcribe also provides live captioning for any video, including podcasts, Skype calls and others. You can read more about this on Hearingtracker.com in an article by David Copithorne.

Live Transcribe is an artificial-intelligence based technology, which means that it learns how to hear speech. Your own voice will quickly be the most accurate, because it’s the one the app is most often exposed to. Other speakers will also transcribe more or less accurately depending on background noise, how clearly the speaker articulates and so on. It may take longer for Live Transcribe to recognize and accurately translate heavily accented speech.

Copithorne also wrote about Google’s Project Euphonia, which learns to recognize diverse speech patterns, for instance speech impediments. In partnership with the ALS Therapy Development Institute, Google Transcribe’s algorithms will enable it to learn to follow the speech patterns of people with ALS.

I haven’t tried Google Transcribe yet in a restaurant but I have successfully used it in environments that were previously very difficult. One is at our HLAA New York City chapter monthly meeting. The presentations are looped and captions are provided by CART. But I’ve always found it difficult to hear people who want to talk to me before or after the program. I used it this past week and it changed the whole experience. I could actually understand what people were saying. (CART, at least for now, is a superior caption provider, but since you can’t take your CART provider with you most of the time, Google Transcribe is a good substitute.)

Last week Apple stores were holding workshops for people with disabilities to demonstrate ways that Apple products could be of help. I had asked for CART captioning for the workshop, but Apple was unable to provide it. The workshop was held in a typically loud Apple Store. Apple had provided a portable hearing loop, which helped. But the only way I followed the presentation was on my Android phone using Google Translate.

It seems like heresy to use an Android phone in an Apple Store, but the presenters were impressed. Let’s hope Apple follows Google’s lead in this promising new technology.

 

UPDATE, MONDAY May 27:

Android’s Live Transcribe will let you save transcriptions and show ‘sound events’.

Click to read the article.

 

 

 

 

 

 

Hearing Mom

Katherine Bouton Healthy Hearing

Sunday is Mother’s Day. I miss my mom. But I especially miss all the things I didn’t hear her say.Mom and me 2013

In her 80s, my mother’s mind and body succumbed to aging. She developed dementia, she had frequent falls and she often needed a wheelchair. But her hearing remained acute. Mine did not.

After my father died, when Mom was 85, she wanted to stay in the house they’d lived in together. It was far away from any of her children, and she had 24-hour-a-day nurses’ aides. Despite this attention, she often fell or had other physical issues that would send her to the hospital, then into rehab to recover, then home again with an aide, only to fall or suffer heart problems or infections once again, and start the cycle over.

Eventually, against her wishes, my siblings and I decided she would be better in the long-term nursing care facility at the community where they lived. She ended up thriving there.

But while she was still living at home, my hearing was a significant obstacle. It was difficult for me to hear her on the phone — and frustrating for us both — so I visited as often as I could. Even when I visited her, though, her soft voice and increasing dementia made it hard for me to understand her. My hearing loss also created some potentially dangerous situations. If I had to call her doctor or even 911, I couldn’t hear their responses. I’d hand the phone to my mother to listen for me and hope she was correctly repeating whatever the doctor said. I didn’t know about captioned phones then, or I’d surely have ordered one. If Text 911 had existed, that would have removed another barrier to communication.

Once she was in the nursing facility, there were fewer crises. But as she became less clear mentally, and as her voice weakened, I not only couldn’t understand what she was saying, but I was never sure she was saying what I thought she was saying. It’s hard enough for a fully hearing person to converse with someone with dementia. Imagine what it’s like when you aren’t sure you’ve understood correctly.

My mother died in 2014. Every mother’s Day I think about all that I missed in those last years of her life. Despite hearing aids and a cochlear implant, and hearing-assistive devices galore, my hearing and her dementia still created an enormous gap. The only way across it was with smiles and hugs and just being there — for her and for me.

Most people’s hearing problems are not as severe as mine. But if you’re having trouble hearing an elderly parent with a whispery voice — or if the parent is having trouble hearing you — don’t let that happen. If you are not ready for hearing aids, buy yourself a handheld device such as a pocket talker.

But whatever solution you come up with, don’t let those words be lost forever.

(A version of this post was first published in 2015 in AARP online.)

Photo courtesy of Katherine Bouton

For more about hearing health, my book “Smart Hearing.” will tell you everything I know about hearing loss, hearing aids, and hearing health.Smart Hearing_Cover_highres

You can get it online at Amazon or Barnes & Noble, in paperback or ebook for Kindle or Nook. You can also ask your library or favorite independent bookstore to order it.

Theatre for All

Katherine Bouton lipreading , , ,

Theatre is one of the world’s oldest forms of entertainment, but in recent years I’d stopped going. My hearing loss was too big a barrier to enjoyment. Now, thanks to technology, I once again have access to theatre, and I’m loving it,

On Easter Sunday afternoon my husband and I went to see The Ferryman, the much acclaimed play by Jez Butterworth that takes place during the Troubles in Ireland. It’s a big cast with many voices. As recently as two years ago the only way I could have seen the play was if the Theater Development Fund had offered an open captioned performance through its Theater Access Program. iStock_000002637313Medium

This Sunday performance was not open captioned. But it was fully accessible to me, for two reasons.

The first is that the theater is owned by the Shubert Organization, which has installed a hearing loop. (For a list of other looped theaters, check out audiologist Louise Levy’s website.) If you have a hearing aid or cochlear implant with a telecoil, all you have to do is change the program to telecoil mode (usually by pushing a button on the earpiece) and the sound will go directly into your ear. If you don’t have a hearing aid with a telecoil, you can use the theater’s headset, which you get at the concierge desk. But really, just go back to your audiologist and ask for a telecoil. It costs almost nothing.

The second reason is captions. My hearing loss is severe enough that the enhanced sound delivered by a hearing loop is sometimes not enough especially in a multi-character play (with Irish accents). Understanding that the loop won’t help everyone, including the signing Deaf, many theaters usually also offer a handheld captioning device called I-Caption. Captions are also availably for your own phone or tablet from GalaPro. For I-Caption, you pick up the device at the concierge desk and drop it off when you leave.  It’s important to remember that captions are not available on I-Caption or GalaPro until four weeks after the show’s opening.

For the second act, I switched to GalaPro. This time I methodically set the captions up during the intermission, so they were ready to go as the curtain rose. The captions were almost perfectly synced to the dialogue and I barely missed a word from that point on.  Given the fast dialogue, Irish accents, and the need for sheer listening stamina (the play is three-plus hours), my guess is that I heard, and retained, more than most of the people in the theater. The combination of sound via the loop and sight via the captions may have made me the best hearing person in the theater.

The GalaPro app is free and available for iPhone or Android. You need to be sure you know the correct steps to activate the captions – before the play begins. It’s not difficult to set up, and the concierge desk can help, but don’t wait till the last minute to get started.

You begin by putting your phone into airplane mode and then sign onto the theater’s wifi system. Scroll down the list of shows to the show you’re attending, and fill in the password. This last step is the one that stumped me. What IS my GalaPro password? Turns out you don’t need one. The site actually tells you the password (GalaPro1). But if you wait till the curtain is about to go up before completing the setup, you’ll find yourself literally in the dark and caption-less until intermission. Yes, this has happened to me, more than once.

You can check whether GalaPro is available at the show you want to see by going on TheaterAccessNYC, another useful tool offered by the Theater Development Fund, in this case in partnership with the Broadway League. The website is just one of many TDF services that make Broadway theater accessible to almost all. In addition to open-captioned performances, TDF-TAP also offers ASL-interpretation, accessibility for the blind and for people with disabilities like autism. The TKTS booths (at Lincoln Center, in Times Square, and at the South Street Seaport) sell same-day half-price tickets. TDF also offers special pricing for students, the elderly and many other groups. See here to find out if you qualify for membership.

GalaPro does have limitations, especially in a play with very fast dialogue. I saw Theresa Rebeck’s Bernhardt/Hamlet last fall, with the magnificent Janet McTeer playing Sarah Bernhardt. The play itself is intricately layered with McTeer playing Bernhardt playing Hamlet. It’s also very very fast. Everyone once in a while GalaPro seemed to take a breather, so I did miss some lines.

I haven’t tried GalaPro at a musical but I imagine the captions have an easier time keeping up, especially with the songs, which inevitably repeat many phrases. I’m seeing Kiss Me Kate later this month, with open captions via TDF-TAP. I’ll keep an eye on GalaPro for comparison.

Meanwhile, the loop can work very well on its own for me. Last week I saw What the Constitution Means to Me, Heidi Schreck’s autobiographical play. I had good seats, with a good sightline to the actors, and thanks to the loop I understood every word.

I’m very lucky to live in New York, where I have easy access to the theater. Until recently, I didn’t go much because it was too hard to hear. Gala Pro, I-Caption, and looping have given me back the theater again.

Meanwhile, here’s a list of looped venues across the country, with thanks to David Myers and Jerry Bergman.

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For more about hearing health, my book “Smart Hearing.” will tell you everything I know about hearing loss, hearing aids, and hearing health. Smart Hearing_Cover_highres You can get it online at Amazon or Barnes & Noble, in paperback or ebook for Kindle or Nook. You can also ask your library or favorite independent bookstore to order it.

It’s About Attitude

Katherine Bouton Smart Hearing

Ten years ago when my hearing dropped suddenly and severely, I despaired of ever living a hearing life again. Despite a cochlear implant and a sophisticated hearing aid, that despair seemed justified. I could hear, but I could not function in a hearing world

Some terrible times are burned into my memory.

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Taking my daughter and some of her friends to a restaurant for her 21st birthday. My daughter sat next to me and helped with handwritten notes and clearly enunciated explanations, but that wasn’t enough. I was never even sure of her friends’ names, although I do know three of them were named Sarah.

Going to a college friend’s funeral in Cambridge in a beautiful Harvard chapel with terrible acoustics. Several old classmates were there but I didn’t recognize them and I couldn’t hear names clearly enough to know who I was talking to.

My children’s college graduations – both lovely occasions, of which I heard nothing, from start to finish. But even the milder hearing loss I had from age 30 on meant that I never really heard any school event, pre-k to graduate school.

The daily morning meeting of editors in my department at The New York Times. 15 to 20 people planning a daily section, of which about a fifth would be content I was responsible for. I delivered my information but I never heard the responses, or questions about it. I cringe at the memory.

Most of the 2008-2010 theater seasons. As theater editor I was expected to see as much as possible. No one said anything about hearing it. I remember going to a play with Ben Brantley, the theater critic. Not only could I not hear a word of the play but I couldn’t hear him in the intermission either. Did I tell him? Vaguely. Maybe. At that point in my career the stigma of hearing loss and aging was terrifying. (Readers of my memoir, Shouting Won’t Help, know that that strategy did not work!)

Now a mere a decade later, technology has delivered the tools I need to function in a hearing world. Over the next few weeks, I’ll discuss some that I personally use. Some allow me to hear at the theater, some at the movies, some over dinner in a noisy restaurant, some in a gym class, some to hear music again. I can go hiking and hear my companion ten feet ahead of me. I can hear everyone at my book club (as long as they speak one at a time). I can communicate with friends who are even deafer than me, friends I used to “talk” to over our computers sitting side by side. I can understand on a windy cold morning when someone asks me my dog’s name. (Oliver.)

Ollie on bed
Oliver

But it’s not just technology that allows me to hear better now. It’s attitude. I ask for CART captions. I ask for a seat in the front. I ask people to repeat themselves slowly and clearly. I ask my Pilates teacher to wear my clip-on mic so I can hear her. I make myself tell everyone that I have hearing loss, and explain to them over and over again how to talk so that I can understand them. I credit my friends at the Hearing Loss Association of America, #HLAA, for showing me the way.

In addition, instead of giving in to my hearing loss, I make myself hear better. I make myself listen. I did auditory rehabilitation – that is, I practiced listening — in both informal and formal programs, and part of what I learned was how to listen.

I accept my hearing loss – I use my devices, flawed as they sometimes seem, I ask for help. Most of all, I demand respect. It’s surprising how successful that is.

Next week I’ll write about how technology has allowed me to  love theater again. The week after, I’ll write about the new live captioning devices that me possible conversation in a noisy place. And the week after that I’ll write about how a new hearing aid can completely change the way you hear, even if the one you already had was top of the line and cost more than you’ve ever spent on any one thing except maybe a car or a house.

 

For more about hearing health, my book “Smart Hearing.” will tell you everything I know about hearing loss, hearing aids, and hearing health.

Smart Hearing_Cover_highres

You can get it online at Amazon or Barnes & Noble, in paperback or ebook for Kindle or Nook. You can also ask your library or favorite independent bookstore to order it.

 

 

 

 

 

Crowdsourcing Hearing Info

Katherine Bouton Healthy Hearing

The Mayo Clinic, in collaboration with the Hearing Loss Association of America (#HLAA) and the Ida Institute, an independent non-profit organization that promotes hearing health, has established an online forum where you can find support, answers to specific questions, share experiences and even gripe if you feel like it.

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Photo by Pixabay on Pexels.com

The forum is monitored by Mayo Clinic staff as well as volunteer mentors, and this oversight should help keep the discussions civil and the information credible. I’ve been following it for the past couple of weeks and I’ve found a lot of interesting information, and a lot of people whose hearing-loss experiences help put my own in perspective.

To join the group:

Go to https://connect.mayoclinic.org/group/hearing-loss/.Click on the “Join” button at the top, create a user name (you can use a nickname or a first name plus @ — for instance Katherine@), enter your email address and follow the prompts.

Anyone can read the discussions, whether or not you join, but if you want to initiate a topic or comment on an existing discussion, you’ll need to fill in information in the section titled “Introduce Yourself.”

An online forum is not a substitute for an in-person support group. Whether you are new to hearing loss or a veteran of hearing loss, you might benefit from joining an HLAA or ALDA (Association of Late Deafened Adults) chapter near you. But I also recommend joining this forum. You can learn from the discussions and also contribute to others’ knowledge.

(If you think you’ve already read this post, you’re right! It was published in a longer form a few weeks ago. Now that I’ve had a chance to read the discussions over a few weeks, I thought it was worth another post. Please share your experiences.)