Heroes with Hearing Loss

This Memorial Day, there will be very few parades to celebrate our veterans. But it’s a good time to remind ourselves of the toll that war takes on hearing.

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Photo by Tim Mossholder on Pexels.com

When we think about the injuries our servicemen and -women endure, we focus on major life-changing injuries like Traumatic Brain Injury and Post-Traumatic Stress Disorder. We worry about suicide in veterans. We see veterans struggling to learn to walk again with prosthetic limbs or learning to hug a child using a prosthetic arm. These are all horrifying consequences of war and no one would minimize them.

But there is a war wound we don’t see, and for the most part don’t think about. Hearing loss and tinnitus are the two largest categories of disability in the military, and have been for some time.

These are not comparable injuries in terms of the scale of destruction, and they are not life-threatening. They are often secondary to TBI or other debilitating injuries. But they’re permanent. And long after a veteran has begun to recover from these other wounds physically and emotionally, he (or she) begins to realize the hearing loss or tinnitus is not going away.

Hearing loss is even more an invisible disability in the military than it is elsewhere, but it is intertwined with other injuries both physically and emotionally — “as a trigger, a constant reminder or an everyday frustration. It is a very unique and personal challenge for many veterans,” one veteran told an audience at the Hearing Loss Association of America‘s (HLAA) annual convention in 2014 in a presentation by Heroes with Hearing Loss, who speak to veterans’ groups and others about the impact of hearing loss and tinnitus. I wrote about their 2014 presentation in “An Invisible War Wound,” published on November 11th, 2014, Veterans’ Day. (This post is an adaptation.)

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HLAA was founded in 1979 by Rocky Stone, who also suffered service-related hearing loss. It continues to honor and offer resources for veterans, on both the national and chapter level. Donald Doherty, a retired Marine and Vietnam veteran, is a former Chair of the Board of Directors of HLAA. He lost his hearing as a result of gunfire and artillery noise during a 1965-66 tour in Vietnam and has worn hearing aids since June 1970.  During his tenure as board chair, he established a virtual veterans chapter of HLAA, which offers many services to veterans. Here’s a link to the HLAA page. 

Doherty offers another explanation for the invisibility of hearing loss among veterans. “Marines — and anyone in the armed forces — have been instilled with a sense of pride, the need to act independently, to do it yourself. It’s a sign of weakness if you reach out for help,” he said. Eventually, he said, you realize it’s affecting “not only yourself but everyone around you.” Heroes with Hearing Loss helps veterans accept help.  If you’d like to read more about the Heroes with Hearing Loss presentation at HLAA, here’s a link to my earlier post, The Noise of War.

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For more about living with hearing loss, read my books at Amazon.com.

Smart Hearing is a guide to everything about hearing loss. Shouting Won’t Help is my personal story of loss and renewal. Both are available in paperback and on Kindle. Available only at Amazon.com unless you can persuade your local bookstore to order one for you.

 

 

 

 

Are Your Hearing Aids Surviving Social Distancing?

Mine are getting a workout. And the batteries are showing it.

I have an Oticon Made for iPhone hearing aid, which means that whatever I hear via the phone is channeled by Bluetooth to my hearing aid. This is wonderful!

I can hear phone conversations, I can listen to podcasts, I can watch and hear online classes, I can watch a YouTube video with sound. Recorded books go through the Bluetooth to my hearing aid. So does the audio of a meditation app, like Calm.

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It’s spring! Can you hear the birds?

I also use the phone and bluetooth when I am following an online exercise class. I use my laptop for visuals and phone for audibles. I connect to the class on both devices and then press “play” on both simultaneously. That way the video is on my laptop, the audio is in my ear.

The main problem is that all this use drains the battery at a significantly faster rate than a hearing aid battery without using Bluetooth. This is true with standard disposable batteries as well as rechargeable ones. Here’s a fairly technical discussion of battery capacity with both disposable and rechargeable batteries.

I actually have only one hearing aid, and it’s doing all the work. I have a cochlear implant in my other ear, so if I wanted to connect directly to the implant as well I’d need to stream through a second device like a Roger Pen. If anyone has tried this, I’d love to hear if it works. Do the two assistive devices sync properly? The four steps it would take to sign on to yoga class on both phone and laptop, using both Roger and Oticon bluetooth, does seem a little absurd. One ear is fine.

I also have a clip-on mini mike, useful for a socially distanced conversation with a masked person on a park bench, and this also drains the battery. I just ordered a ten-pack of batteries.

The hearing aid itself is suffering wear and tear for other reasons.

I always wear a mask when I go out, which is frequently  — because I live in an apartment (no back yard) and I have a dog. Dogs need to go out at least a couple of times a day. The mask loops fit over my ears. Unfortunately it’s already crowded behind my ears, with my hearing aid earpiece in one and c.i. earpiece in the other. I also wear glasses, which take up even more behind-the-ear space. The mask tends to dislodge the c.i. earpiece, so I have to wear a hat or a wide headband to keep it in place. Somehow the hearing aid manages to get tangled in the mask.

The second damaging element is dirt. I make sure the wax guards are clean but the vent – a tiny duct that lets in just enough air to make the aid more comfortable – is clogged with wax. I can’t remember how I used to keep it clean but now the audiologist says the only solution is denture floss. She’s mailing me some. If were able to go into her office, she told me, she could vacuum it out. I wonder if I can get a special hearing-aid attachment for my Electrolux.

I wasn’t sure how to reach the audiologist but I finally emailed her. It turns out she can do much of her work through telemedicine. And good news from the CMS: Medicare and Medicaid will now cover any tele-audiology visits that would ordinarily be covered by an office visit. I’ll write about this when I know more about how it works.

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For more about living with hearing loss, read my books at Amazon.com.

Smart Hearing is a guide to everything about hearing loss. Shouting Won’t Help is my personal story of loss and renewal. Both are available in paperback and on Kindle. Available only at Amazon.com unless you can persuade your local bookstore to order one for you.

Communicating in the Age of Covid: An Unexpected Benefit

There aren’t many bright spots when it comes to Covid 19. The death toll is enormous, the financial impact is potentially catastrophic, the fear of what lies ahead can be overwhelming. Still, for many with hearing loss, this period offers an insight into what it’s like to have equal access to spoken communication.

Many of us “manage” our hearing loss as best we can, through hearing aids and cochlear implants, through assistive listening devices, through speech reading and attention to communication strategies. I have a cochlear implant and a hearing aid. As grateful as I am for their superior technology, they’re not enough for me to participate fully in the hearing world. I employ these various devices and strategies with somewhat limited success.

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Giving a reading in Seattle. Behind me you can see CART captions projected on a screen.

But in the age of Covid, the playing field has been leveled. It is often said that we hear with our brains. It’s equally true that we hear with our eyes.

As an advocate for people with hearing loss, I attend a lot of meetings. Most have to do with disability access and most offer live CART captions as well as accommodations for other disabilities. I’m able to keep up fairly well, although the effort of reading captions during an in-person meeting gets exhausting.

These days, however, all our meetings are virtual, and many of them are captioned. See below for instructions for getting captions.  With a Zoom meeting or Google Meet or any other captioned forum, an extra element is added that makes all the difference for me. These apps allow the speaker’s face to be isolated on the screen. (Click on the icon on the upper right of the app’s screen and then choose “Speaker View.”) That means that in addition to hearing the voice and reading the captions it’s very easy to read lips as well.

A good CART captioner makes the captions seem to synchronize with the spoken word. With my ears alone (plus hearing aid and cochlear implant) I miss a lot. With CART captions, the speaker’s voice actually sounds clearer and easier to understand. Am I hearing the words or am I reading them? I often can’t tell.

Add the visual element of the speaker facing you on the screen, and you’ve got triple input. Researchers call this multiple the McGurk effect, named after one of the British scientists who discovered in the 1970s that people comprehend speech better if they hear it in multiple ways. The scientists called it “hearing lips and seeing voices.” That’s why we need to see the speaker’s face clearly. A friend of mine likes to say, “Don’t speak till you see the whites of my eyes.” That is, she needs to see your lips in order to hear your voice. Adding captions to eyes and ears is an important third element. In a live gathering, adding hearing assistance in the form of a hearing loop is another way of improving the hearing experience through multiple inputs.

FaceTime also turns out to be an invaluable tool, although it doesn’t use captions. I always thought FaceTime was basically for fun, for talking to your grandkids or your boyfriend. But the McGurk effect applies here too. FaceTime isolates the speaker’s face close up.  This vastly enhances the ability to speech read. So, just as with good CART captioning, if I’m on a FaceTime call, I’m not sure if I’m hearing the speaker or reading lips. The input from eyes and ears are inextricably entwined.

In this time of social distancing, masks, self-quarantine, living apart from one another – we may feel isolated. I did at first, and I wrote about it in my column Coronavirus Concerns for People with Hearing Loss. It’s not just the disease. (As we learned more, I updated that column: I Take It All Back.)

But as I’ve become more comfortable with technology, everything’s changed. Eyes, ears and brain working in sync make me feel more connected than ever.

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To access Zoom captions: The person who initiates the meeting can either hire a CART operator to provide live captioning or can offer automatic voice recognition captions (which are generally less accurate). You, the guest at the meeting, click on “Closed Captions” on the very bottom of the Zoom screen. The captions will run just above that. You can adjust the caption size by clicking on CC and scrolling down. Sometimes “chat” interferes with the captions. If that’s happening, click on “chat” and the box with chat messages will appear on the right. You can move your whole screen to the right to get them out of sight. I know this sounds complicated but once you try it, it gets easier.

For more on the kinds of technology that are useful for people with hearing loss, especially now, the websites of both the Hearing Loss Association of America and the Center for Hearing and Communication offer good tutorials, including webinars.

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For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

Here’s a link to my most recent book: Smart Hearing: Strategies, Skills and Resources for Living Better with Hearing Loss. 

 

 

 

 

 

 

 

 

 

 

Gratitude

I have my curmudgeonly side and I don’t always like being told to see the bright side of things. I enjoy a good wallow in misery. But the misery of the Covid pandemic is sustained and severe. We share funny things to lighten the day – jokes, cartoons, animal videos, kids doing kid things. We watch streaming performances of uplifting cultural events like opera and theater. We go on virtual museum tours. We listen to live streaming of religious services, particularly in this past week when many were celebrating Passover or Easter week.

Last week the Hearing Loss Association of America, #HLAA, offered a free webinar with Michael Harvey, a clinical psychologist in Framingham, Mass. and the author of  Listen with the Heart: Relationships and Hearing Loss and The Odyssey of Hearing Loss: Tales of Triumph.

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Photo by Giftpundits.com on Pexels.com

Dr. Harvey’s talk, titled “Coping with the Coronavirus (Part 2)”, was an interactive seminar on what ” Covid 19 has to Offer Beyond Hardship and Fear.” He began by discussing how some wise people like Nelson Mandela dealt with isolation. He quoted a veteran of the Bataan death march. And he also quoted some of the comments from listeners to Part 1, many of whom had their own wise observations to make.

Much of what we in the hearing loss community have focused on are the disadvantages specific to people with hearing loss: of isolation, of the difficulty of understanding people wearing masks, and so on. Dr. Harvey focused on the positives.

What Dr. Harvey was talking about, however, was a little different. He was asking us to see actual benefits from the experience of living through this pandemic. Some were predictable (though no less valuable for that): more time with family and friends, more time for books and culture. Some mentioned the particular intimacy of video chats and phone calls. One said that – as someone with hearing loss – her (or his) prior experience of isolation was preparation for this more dire isolation: “If the situation becomes more restricting, I’m prepared for it. I’m ahead of the curve.”

I live in New York City and one of the benefits for me is the quiet that has descended on my residential neighborhood. We hear a lot of sirens, but there is no plane or helicopter traffic overhead, very little car noise, not many trucks, no construction. Very few people are out and those who are out are social distancing. So it’s surprisingly peaceful.

At night, at 7 pm, the city opens its windows to cheer for our health care workers with clapping and song and banging pots and pans. In the quiet city, the sound seems to come up out of nowhere. You can’t see many other people, but because there’s no other noise the empty streets and buildings resound with the noise. Many people with hearing loss are sensitive to noise, I know I am. Being in a noisy place is exhausting. But this noise is different.  Make a joyful noise unto the Lord, the Psalm tells us. This is a joyful noise. We’re still here. Thank you, health care workers.

Some are juggling work from home while taking care of young children or supervising the remote-schooling of older kids. Some are taking care of sick or elderly relatives on their own, or worried about finances, or sick with the virus themselves, or grieving losses. And many, of course, are out doing those essential jobs, risking their health for the rest of us. But for many of us, especially people who are older, this is a time without distractions, without the daily activities that used to consume the day: without meetings, commuting, doctors’ appointments, exercising, playing and watching sports, shopping.

“We help ourselves by helping others,” Dr. Harvey said. “If we contribute to the betterment of other people’s lives, it feeds our soul as well.”

We do this by reaching out to friends and family to check on how they are. (Even more so if we reach out to the ones we dread calling for one reason or another.) We do this by sharing our experiences in webinars and Zoom meetings. We do this by observing the rules: by staying indoors, wearing a mask if we have to go out, staying well away from others, washing our hands. One friend of mine made masks by the dozens and distributed them to her neighbors. Others offer to shop for people who can’t go out. Pet adoptions are way up: let’s hope those adopters keep their commitments once the pandemic is over.

And don’t forget the power of a simple thank you. Thank your mail carrier. Thank your garbage collector. Thank the person checking you out at the supermarket. Thank your pharmacist for offering to make a delivery. Thank the bus driver. You can thank them by your actions as well: put your garbage out neatly, clear the junk mail out of your mailbox, have your money ready at the checkout counter so the checker can speed you on your way and shorten his or her own exposure to whatever germs you may be carrying.

If you have other examples of ways we can contribute to the betterment of others’ lives, please share them here. Check out HLAA’s other webinars, including Dr. Harvey’s Coronavirus Part 1.

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For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

 

 

 

 

Coronavirus Got You Stuck at Home? It’s a Good Time to Improve Your Hearing.

Social Isolation can get awfully boring. Many of us find ourselves with not much to do except anxiously watch TV. Here’s a suggestion: make the most of house arrest by tackling one the online auditory rehabilitation programs. virus-4835736_1920-1

Working on hearing better during this period has an added benefit. Since you are probably isolated and not talking to many people, it can help keep the hearing parts of your brain limber.

Essentially, rehab is a way to train your brain to recognize the signals coming via a hearing aid or cochlear implant as specific sounds: rehab focuses on speech sounds primarily, but also helps you to distinguish the sound of banging the lid on a trash can from the bark of a dog or a human shout. Here’s a good explanation from the HLAA website.)

Most of the online programs offer targeted training, like listening to music, as well as basic training that exposes the listener to speech in noise, gradually increasing the ratio of noise to speech. Training can teach you how to focus on one speaker when others are talking, how to retrieve the one word in a sentence you may have missed, how to improve speech-reading, and other general strategies for maximizing your hearing. These are all similar to clinician-based programs, but they are done at home.

After training, scientists can actually see differences in the way the brain responds to trained and untrained sounds, according to Kelly Tremblay, an audiologist and auditory neuroscientist, formerly on the faculty of the University of Washington and a member of the Board of Directors of the Hearing Loss Association of America. In her research, Dr. Tremblay has shown that it doesn’t really matter what specific type of training you do. There is no one-size-fits-all. Even passively listening to sound changes brain activity, including listening to recorded books.

Formal hearing rehabilitation programs are scarce. Fortunately, hearing rehab can be done at home on your own. Quite a few programs can be found online. Most are designed for recipients of cochlear implants, but they can also be useful for new and longtime hearing aid users.

One place to start is with the websites of the three companies licensed in the United States to provide cochlear implants. These programs are free: The Listening Room (Advanced Bionics), Soundscape (Med-El),  The Communication Corner (Cochlear).

Programs independent of the cochlear implant companies include Neurotone’s online LACE (Listening and Communication Enhancement) Listening Program, which was developed by two UCSF audiologists. LACE is available in three increasingly sophisticated levels, with programs for both PC and Mac, as well as DVD. The cost for the program varies but is generally less than $100.

Read My Quips (or RMQ ) is a kind of crossword puzzle. A man and a woman alternately recite lines that take an unexpected twist at the end. You listen as many times as necessary to fill in the crossword blanks. The idea is to be able to understand in louder and louder background noise. An article on the Starkey hearing-aid site is a useful guide to rehab and RMQ: Training the Brain: Hearing Aids and RMQ. (I’m including RMQ in this post because I enjoyed using it in the past, but I have been unable to sign on to their website, so it may no longer be available.)

For further reading, The website for Cochlear Americas also includes an excellent article, Cochlear Implant Rehabilitation: It’s Not Just for Kids! by Donna L. Sorkin and Nancy Caleffe-Schenk.  The Hearing Loss Association of America also offers a guide to listening training programs.

You can also read my 2018 post Learn How to Listen, which discusses some of these same technologies and a few others.

My two previous posts suggested ways for the deaf and hard of hearing to stay in touch  during this period: The first was Coronavirus Concerns for People with Hearing Loss: It’s Not Just the Disease).  The second, written as the pandemic worsened and rules for social isolation quickly changed, was I Take It All Back!

If you’d like to get email notifications of new posts, click on “Follow” on the right.

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For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

 

 

I Take It All Back!

 

Well, not all of it. But some of what I said last week — “Coronavirus Concerns for People with Hearing Loss. It’s not just the disease” — is already out of date. This is a very fast-moving story.

 

Resist isolation. Get outside. Take a walk, I said. Wrong.

A week later, it’s clear that’s not a good idea, especially for older people. Unless you live in a private home, to get outside you have to walk through a public space, a lobby perhaps, and maybe take an elevator. The coronavirus lasts a long time on dry surfaces and so just pushing an elevator button or opening a door can expose you. One solution is to wear gloves and make sure that you don’t touch the palms when you take them off. Nitrile or latex disposable gloves are the best, but they are probably in short supply by now. These are single use gloves and your conscience may rebel at the environmental impact. But it’s your life you’re talking about.

     Have a friend for lunch. Wrong.

“One of you is unlikely to infect the other if you both feel well,” I wrote. That was last week. This week we know that anyone can be an invisible and unaware carrier. It’s not worth it if you’re in a high-risk category. Learn to use FaceTime or Skype to keep in touch with family and friends. Here’s a very good article in The Atlantic on the subject.

     Videoconferencing. I was right about this one. 

Video or audio sessions, sometimes over FaceTime or Skype, quickly became the norm for psychotherapists and for anyone who conducts one on one counseling or informational sessions as part of their work. It happened practically overnight. With doctors, it’s called telemedicine. Telemedicine, incidentally, is a technology that is increasingly useful for people with hearing loss who live in areas where there aren’t many audiologists. Hearing aids can be programmed remotely these days. If coronavirus forces us to use telemedicine, it’s probably for the longterm good for hearing-aid users.

     The telephone. This is still a good choice.

But my recommendation to get a captioned landline from Captel or CaptionCall or one of the other companies may have to be put on hold. If you have a smart phone, definitely try Innocaption+. You can download it for free on the App store. The instructions that come with the app are clear and easy to follow. Innocaption+ support is available by email or by phone. I’ve always found them responsive.

     Chat electronically.

You can do this as email or text, or in various chat and message programs. If you’re not comfortable typing, dictate your messages. Just press the microphone icon below or to the left of the keyboard on either Apple or Android message/phone apps. There will be some garble but it’s much easier to go back and correct than it is to type the whole thing.

     Virtual Chapter meetings.

Most HLAA chapter meetings around the country have been canceled for the foreseeable future. HLAA already has a setup for virtual chapters, including one for veterans. Those of us who are #HLAA chapter leaders (I’m the President of the New York City Chapter) should put our heads together and figure out how to have an interactive meeting virtually. I’m sure HLAA can help us but I’d love suggestions from people with more tech expertise than I have about webinars and web-ex meetings.

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

 

 

Coronavirus Concerns for People with Hearing Loss. It’s not just the disease.

[This is a repost that contains new information on surgical masks.]

The new coronavirus COVID-19 is an equal opportunity infector, affecting rich and poor, young and old, healthy and sickly. Among the more prominent victims is an attendee at the annual Conservative Public Action Conference (CPAC), exposure to whom has led President Trump’s new chief of staff to self-quarantine. The head of New York’s Port Authority and his socialite wife, the head of the Central Park Conservancy, are infected. There’s been less focus on the poor, virus-4835736_1920-1although in the past day or so people have begun to realize that those in homeless shelters, where beds may be only two feet apart, are at risk.

The old are at higher risk but the young are not exempt. People with chronic conditions like diabetes, lung disease and immune-suppressing conditions are also at higher risk, but many victims so far have been healthy adults.

  • People with hearing loss may be affected in less obvious ways. What serves as protection to one individual acts as a barrier to communication to another.

Surgical masks. A lot of people are wearing surgical masks these days, and it makes communication difficult for the hard of hearing. Almost all of us instinctively supplement our hearing with speechreading. If we can’t read your lips, we can’t understand what you’re saying. There are several varieties of clear surgical masks on the market and some health professionals will wear them on request from a hard of hearing patient, but the majority of masks obscure everything except the eyes. (For more information about see-through masks, click here.)

The six-foot rule. Experts recommend staying at least six feet away from other people in public places. The problem is that many people with hearing loss can’t hear at that distance, especially in a public venue with other conversations going on. A request to step a little closer can result in a brushoff during these paranoid times.

Isolation. People with hearing loss need to stay socially involved. Otherwise their unused hearing deteriorates even further as the brain gets less accustomed to working with sounds. Staying home may seem like a wise move, but it’s good to go out, even if just to wave and say hello to your next door neighbor. Isolation leads to depression. Depression makes it harder to make yourself get up and out. It’s a vicious cycle.  Many members of our New York City Chapter of HLAA come to our monthly meetings at least in part to be with other people. Our next meeting isn’t for four weeks. I hope the virus will have come and gone by then, but if necessary we’ll cancel, reluctantly.

Being older. Youth is no protection against hearing loss, but it is true that the older you get the more severe the loss may become. We see a disproportionate number of older people at hearing-loss events. Unfortunately, these same people, especially if they have other coexisting conditions (coexisting with age, that is) are more vulnerable to coronavirus, not to mention the flu and other conditions that can be deadly in someone with compromised health.

  • What’s the solution?   With no end in sight, people with hearing loss need to come up with workable runarounds. Here are a few. 

Take a walk. Keep your distance from others but get out in the spring sunshine and communicate visually if not aurally.

Have a friend for lunch. One of you is unlikely to infect the other if you both feel well. Make sure guests wash their hands thoroughly the minute they arrive. If they have to take public transportation encourage portable hand sanitizers. I use nitrile gloves on public transit. They are a one-use product and environmentally wasteful, but if you’re going to visit an at-risk older or health-compromised person, the priorities seem clear to me. Wear the gloves, take them off and throw them away when you get there. Then wash your hands. Gloves have the added advantage of keeping you from touching your face: who wants to touch their face with dirty gloves that have been holding onto the subway pole.

Encourage videoconferencing. As an advocate for people with hearing loss, I attend many meetings on issues applicable to people with disabilities. In the past week or two, many have been cancelled but increasingly the organizers are setting up videoconferencing, with CART captioning. The week after next I’m going to be part of a conference in London in which people from many different countries will be attending by video. I’d love to have gone to London but I’m glad not to miss the meeting altogether.

The telephone. For years I avoided the telephone. It was just too difficult. Then captioned phones came on the market. At first I had a captioned phone on my home landline. Manufacturers like Captel and Caption Call offer these phones free to those with documented hearing loss. When I got my Caption Call phone, an installer came to the house to set it up. (You do need wi-fi, so this might be the time to get that as well.) These days, I use my cell phone more often than my captioned landline, thanks to Innocaption+, an iPhone and Android app that lets me receive and make calls (using my own telephone number) with near perfect captioning.

Nothing beats social interaction. But if doing it in person puts you at risk, think creatively about other ways to stay involved with others. These are just a few suggestions. If readers have others, I hope they’ll share. And wash your hands!  

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

Surgical Masks and Coronavirus – an Update

I heard from so many people today about my column on the extra-medical consequences of corona panic for people with hearing loss that I want to link to this excellent article from Johns Hopkins about see through surgical masks.

“Transparent Surgical Mask to Improve Communication with Patients.” 

Maybe this is something #HLAA should get behind. Any patient with communication difficulties would benefit from this patient-centered innovation.

I believe there may also be other brands. Please comment if you’ve tried them and found them successful.

Coronavirus and People with Hearing Loss

The new coronavirus COVID-19 is an equal opportunity infector, affecting rich and poor, young and old, healthy and sickly. Among the more prominent victims is an attendee at the annual Conservative Public Action Conference (CPAC), exposure to whom has led President Trump’s new chief of staff to self-quarantine. The head of New York’s Port Authority and his socialite wife, the head of the Central Park Conservancy, are infected. There’s been less focus on the poor, virus-4835736_1920-1although in the past day or so people have begun to realize that those in homeless shelters, where beds may be only two feet apart, are at risk.

The old are at higher risk but the young are not exempt. People with chronic conditions like diabetes, lung disease and immune-suppressing conditions are also at higher risk, but many victims so far have been healthy adults.

  • People with hearing loss may be affected in less obvious ways. What serves as protection to one individual acts as a barrier to communication to another.

Surgical masks. A lot of people are wearing surgical masks these days, and it makes communication difficult for the hard of hearing. Almost all of us instinctively supplement our hearing with speechreading. If we can’t read your lips, we can’t understand what you’re saying. There are several varieties of clear surgical masks on the market and some health professionals will wear them on request from a hard of hearing patient, but the majority of masks obscure everything except the eyes. (For more information about see-through masks, click here.)

The six-foot rule. Experts recommend staying at least six feet away from other people in public places. The problem is that many people with hearing loss can’t hear at that distance, especially in a public venue with other conversations going on. A request to step a little closer can result in a brushoff during these paranoid times.

Isolation. People with hearing loss need to stay socially involved. Otherwise their unused hearing deteriorates even further as the brain gets less accustomed to working with sounds. Staying home may seem like a wise move, but it’s good to go out, even if just to wave and say hello to your next door neighbor. Isolation leads to depression. Depression makes it harder to make yourself get up and out. It’s a vicious cycle.  Many members of our New York City Chapter of HLAA come to our monthly meetings at least in part to be with other people. Our next meeting isn’t for four weeks. I hope the virus will have come and gone by then, but if necessary we’ll cancel, reluctantly.

Being older. Youth is no protection against hearing loss, but it is true that the older you get the more severe the loss may become. We see a disproportionate number of older people at hearing-loss events. Unfortunately, these same people, especially if they have other coexisting conditions (coexisting with age, that is) are more vulnerable to coronavirus, not to mention the flu and other conditions that can be deadly in someone with compromised health.

  • What’s the solution?   With no end in sight, people with hearing loss need to come up with workable runarounds. Here are a few. 

Take a walk. Keep your distance from others but get out in the spring sunshine and communicate visually if not aurally.

Have a friend for lunch. One of you is unlikely to infect the other if you both feel well. Make sure guests wash their hands thoroughly the minute they arrive. If they have to take public transportation encourage portable hand sanitizers. I use nitrile gloves on public transit. They are a one-use product and environmentally wasteful, but if you’re going to visit an at-risk older or health-compromised person, the priorities seem clear to me. Wear the gloves, take them off and throw them away when you get there. Then wash your hands. Gloves have the added advantage of keeping you from touching your face: who wants to touch their face with dirty gloves that have been holding onto the subway pole.

Encourage videoconferencing. As an advocate for people with hearing loss, I attend many meetings on issues applicable to people with disabilities. In the past week or two, many have been cancelled but increasingly the organizers are setting up videoconferencing, with CART captioning. The week after next I’m going to be part of a conference in London in which people from many different countries will be attending by video. I’d love to have gone to London but I’m glad not to miss the meeting altogether.

The telephone. For years I avoided the telephone. It was just too difficult. Then captioned phones came on the market. At first I had a captioned phone on my home landline. Manufacturers like Captel and Caption Call offer these phones free to those with documented hearing loss. When I got my Caption Call phone, an installer came to the house to set it up. (You do need wi-fi, so this might be the time to get that as well.) These days, I use my cell phone more often than my captioned landline, thanks to Innocaption+, an iPhone and Android app that lets me receive and make calls (using my own telephone number) with near perfect captioning.

Nothing beats social interaction. But if doing it in person puts you at risk, think creatively about other ways to stay involved with others. These are just a few suggestions. If readers have others, I hope they’ll share. And wash your hands!  

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

How Fit is Your Hearing?

Recently, a prominent researcher in the field of hearing loss suggested a simple change in the way we talk about hearing loss. Rather than frame it as a disability, said Dr. Justin Golub of Columbia University Irving Medical Center, “I like the idea of hearing fitness.”

images“Hearing loss” is a negative term. For people who don’t want to admit they have hearing trouble, it invites the dismissive response: “I’m fine.”  But who wouldn’t want to be as fit as possible, especially if it takes little to no work on their part?

Dr. Golub is the lead author on a November 2019 paper in JAMA Otolaryngology-Head Neck Surgery, which found an association between cognitive impairment and what is generally considered “normal” hearing. In 2011, Johns Hopkins’ researchers led by Frank Lin, published the result of a longitudinal study on a large cohort of older adults showing that those with moderate or more severe hearing loss were at a greater risk of dementia. The greater the hearing deficit, that study found, the greater the risk of developing dementia. What Golub and his colleagues have now found is that even minor loss, within the so-called normal range  of 25 dB or less, is associated with lower cognition.

Using two major national databases as their source, the Golub team studied data on hearing and cognitive performance in 6451 people age 50 and over. This study, unlike previous studies of hearing loss and cognition, focused on people with hearing loss in the range usually considered normal. They considered all levels of hearing in that category, down to what would be considered “perfect” hearing, the ability to hear at zero decibels. (Dogs can hear at -5 to -15 decibels.)

After adjusting for demographics and cardiovascular disease, the study found that decreased hearing was independently associated with decreased cognition. The study did not look at whether hearing loss causes cognitive decline. Nor did it look at whether correcting hearing loss with hearing aids offsets the correlation.

“Can Hearing Aids Help Prevent Dementia?” That question was the title of the article in The New York Times Magazine where Golub’s hearing fitness quote appeared. We don’t have an answer yet but Frank Lin and colleagues will conclude what is expected to be the definitive study on hearing aids and their deterrent effect on cognitive decline in 2022. (For those who are interested in learning more about the study, Aging and Cognitive Health Evaluation in Elders (ACHIEVE), funded by the National Institute on Aging, here’s a link to an interview in AudiologyOnline on the study and other hearing-related public-health issues.)

Speaking to the Times Magazine, Golub mused, “We always frame [hearing loss] as a disability.” Telling college students that blasting their ears with loud noise is going to make them more susceptible to dementia 50 years later, he said, isn’t going to be much of a deterrent. “But if you say, ‘Hey, hearing is good for your brain, the more hearing you have the better,” that has immediate implications.”

“Hearing Fitness” is good for people at any age. Whatever it is about hearing loss that aligns it with an increased risk of dementia is of course of paramount interest. But poor hearing has a host of other physical and psychological ramifications, some of which themselves are a risk factor for cognitive decline.

Hearing fitness means taking care of the hearing that you have, whatever your age. And if it begins to decline, as it often does with age, correcting it. Cost has been a prohibitive factor for many up till now, but this year the FDA will announce guidelines for an over-the-counter hearing aid that will cost a fraction of existing FDA-approved hearing aids. Hearing aid companies and the consumer electronics industry are already offering products that are as good as some hearing aids at even cheaper prices. Costco is reportedly the nation’s largest hearing aid dealer (except for the VA), with volume permitting lower prices. Having hearing professionals on staff insures responsible service. Insurance companies are increasingly covering hearing aids, finally understanding their role in healthy aging. In some states, Medicaid covers hearing aids. Even that dinosaur Medicare may soon revise its hearing aid policies.

Tuesday March 3 is World Hearing Day. Although hearing fitness may be a distant goal for the half a billion people worldwide with disabling hearing loss, those of us in prosperous countries can make a start by taking care of our hearing, and by treating it promptly when problems develop. Hearing help comes in all price ranges. Keep your hearing fit!

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