How I Learned to Love My Cochlear Implant.

In 2013 in my first book, “Shouting Won’t Help,” I wrote about the difficult experience I had adjusting to a cochlear implant I received in 2009. That section was excerpted in Bloomberg View and it is still easily available online.shoutingwonthelp

I often get letters from people who have seen the article and are worried by the information in it. They write to ask if they should get a cochlear implant. (Needless to say, this is a question only they and their medical professionals can answer.) Part of the concern stems from the Bloomberg title, “Cochlear Implants Are Miraculous and Maddening.” If you read the article carefully, as I just did, you won’t see me damning cochlear implants. But you will see me raising some caveats.

I am 100 percent in favor of getting a cochlear implant if you qualify for one, and if your hearing aid no longer works for you. I am also 100 percent in favor of aural rehabilitation after the implant. If your implant center doesn’t offer aural training, look for it elsewhere. A speech language-pathologist is one possible provider. There are many online training programs, the best known of which is L.A.C.E. This is a graduated program that starts with speech at a decibel level you can hear (this is determined before you start the program) and gradually increases the noise level in the background. I have written about aural rehabilitation previously on this blog, and you can find other suggestions there.

So how did I come to love my cochlear implant after my initial tepid embrace?

The first answer is practice. I have taken formal and online aural rehabilitation courses. I’ve worked one on one with a speech language pathologist. I listen to recorded books and then read the text to make sure I’ve gotten it right.

The second answer is consistent use. I wear the implant all day every day.

The third answer is technology. The cochlear implant I got in 2009 was not nearly as sophisticated as the replacement implant I got in 2014. (Most implant companies upgrade the external processor every five years.)

The fourth answer is support. I am active member of the Hearing Loss Association of America. We meet regularly and we share tips and experiences. I am always learning new things about hearing.

The fifth is to have reasonable expectations. Is my hearing perfect? Far from it. I need assistive listening devices and captions to hear in a group. I use captions to watch TV. I use captions at movie theaters. I say “What?” a lot. But I live an active daily life in the hearing world, and rarely feel disabled.

But without my cochlear implant I would hear almost nothing. My hearing loss is progressive and the hearing in my hearing-aid ear continues to drop. I am already planning for a second cochlear implant. I qualify now (many times over) but my hearing aid is adequate and this is one area where I follow my own advice: If you can still hear with a hearing aid, hold off on a cochlear implant.

If your hearing aid is no longer adequate, start your research. I have written a great deal about cochlear implants and with every writing my optimism grows. The paperback version of “Shouting Won’t Help” is more upbeat on cochlear implants than the hardcover was. My 2015 book “Living Better with Hearing Loss” offers more updated information than the earlier books, and also reflects my comfort and satisfaction – and gratitude! – for having a cochlear implant.

 

For more information on living with hearing loss, see my books on Amazon.com.

Good News About Hearing Loss, With Qualifications

Hearing loss is declining, according to a study published on December 15 by researchers at Johns Hopkins School of Medicine.

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At the top of Mt. Etna, April 2016, with Damian Croft of Esplora.co.uk. What does this have to do with hearing loss? Nothing! It’s a New Year’s treat.

This is good news.

But before you put back in those earbuds and conclude that all those reports of an “epidemic” of hearing loss were wildly exaggerated, read a little closer.

The study of almost 4000 adults 20 to 69 years old found that the overall prevalence of hearing loss (as measured in the speech frequencies) dropped from 16 to 14 percent in the years between 1999-2004 and 2011-12.  (Among adults 60 to 69, however, a whopping 39.3 percent still had hearing loss.)

The decline among working age adults was slight but statistically significant. Despite the fact that there was a greater number of older adults, “the estimated number of adults aged 20 to 69 years with hearing loss declined absolutely, from an estimate of 28.0 million in the 1999-2004 cycles to 27.7 million in the 2011-2012 cycle.”

“Our findings show a promising trend of better hearing among adults that spans more than half a century,” said Howard J. Hoffman, M.A., first author on the paper and director of the NIDCD’s Epidemiology and Statistics Program. “The decline in hearing loss rates among adults under age 70 suggests that age-related hearing loss may be delayed until later in life.”

The researchers attributed the decline to a decrease in noisy manufacturing jobs, to increased use of hearing protection (OSHA requirements for hearing protection have helped), to a drop in smoking and to better medical care.

A greater awareness of the dangers of noise may also have helped. It’s no longer unusual to see someone at a sporting event or loud concert wearing protective headphones. It’s the norm for people with ride-on lawn mowers or those doing other kinds of noisy yard work to wear headphones.

But before we celebrate and abandon advocacy for equal access for people with hearing loss, remember that the age group studied is getting older every day. In the coming years we can expect that normal age-related hearing loss will have its usual effects. “Despite the benefit of delayed onset of HI,” the paper concluded, “hearing health care needs will increase as the US population grows and ages.”

We’re still going to need cheaper and more accessible hearing aids. We’re still going to have to defeat the stigma of hearing loss so that people will wear those hearing aids – and help offset or prevent the negative health effects of untreated hearing loss.

We’re making progress against hearing loss, and that’s cause for celebration. But don’t give up the good habits that have allowed us to get to this point. The world is still noisy. We still need to protect our ears. There is still a lot of hearing loss. We need to treat it.

 

This post appeared in a slightly different form on AARP Health on Dec. 22, 2016.

Hearing Loss? Don’t Neglect Your Eyes

Take care of your eyes and ears
For people with hearing loss, even a small decrease in vision can affect the ability to lip-read and understand better what they hear. — Getty Images/Hero Images

 

Those of us with more than just moderate hearing loss tend to take care of our hearing.

We make sure our hearing aids are in good working order, and any new symptoms — dizziness, ringing in the ear, a drop in hearing — result in a prompt visit to the ear doctor.

Unfortunately, the eyes, like much of the rest of the body, become more susceptible to disease and other issues as we get older. Some problems are serious and can lead to blindness, if left untreated. But for people with hearing loss, even a small decrease in vision can affect the ability to lip-read and thus understand better what they hear.

The combination of vision and hearing problems can also decrease the ability to socialize, which has been linked to a greater risk of dementia.

A 2014 study of nearly 900 European adults age 75-plus with hearing problems and more than 27,000 Europeans age 50-plus with vision problems found that people with vision or hearing problems were less socially active than those without sensory problems, and those with both vision and hearing problems were the least socially active.

  • Age-related macular degeneration, a deterioration of the portion of the retina responsible for central vision, is the leading cause of vision loss in the U.S. According to the American Academy of Opthalmology, the risk of getting macular degeneration jumps from about 2 percent of people in their 50s to nearly 30 percent in people over age 75.
  • Cataracts, a clouding of the eye’s lens, can affect one or both eyes and are very common — by age 80, more than half of Americans either have it or have had cataract surgery, according to the National Eye Institute.
  • Retinal problems affect people with diabetes disproportionately, but can occur in anyone and can cause blindness if not treated.
  • Glaucoma, the leading cause of blindness, can develop without symptoms, so regular eye checkups are important.
  • Dry eyes may not sound like a problem, but million of Americans suffer from this painful, irritating condition that can affect vision. Some 20 million to 30 million older Americans have a mild condition, while 9 million suffer a moderate to severe case. “In patients over 50, dry eye is the most prevalent — and under-recognized and under-treated — condition out there,” Alan Carlson, M.D., professor of ophthalmology at Duke University School of Medicine, told AARP. “Virtually everyone over 55 has some degree of dryness.” There are treatments, generally over-the-counter eye drops, but don’t ignore the problem. It can result in a deterioration of vision.

Recently I started having painful itching in my right eye and the vision in that eye was blurry. I dismissed this as allergies, but a few weeks ago I began waking up in the middle of the night with stabbing headaches. I knew I should see my ophthalmologist — especially when I realized it had been almost two years since I’d had a checkup.

I regarded these new symptoms as bizarre, but not really worrisome. But when I mentioned them to a physician, she said I should go straight to the eye doctor.

I got some eye drops and made an appointment. In the meantime, I wanted to share the lesson learned. My physician friend put the fear of blindness in me, and I’ll never be so casual about my vision again.

This post first appeared on AARP Health on 10/25/2016.
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Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

Hiding Your Hearing Loss? Not Worth It

New York’s second annual Disability Pride Parade on July 10 included representatives of various national hearing loss associations. They marched because hearing loss is a disability, but more importantly, because hearing loss is a hidden disability. We can never remind people too often that people with hearing loss need accommodations as much as someone in a wheelchair.

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HLAA-NYC member Ruth Bernstein at the Disability Pride Parade, with an HLAA umbrella.

 

Like most hidden disabilities, hearing loss comes with baggage that contributes to people’s reluctance to be open about the condition. Historically, hearing loss has been considered a sign of old age, impairment and declining mental capacities. Those with mental conditions, even when those conditions are controlled with medication, face similar worries about revealing their hidden health issues.

But this secrecy can have a deleterious effect on professional and personal relationships, affecting job performance and mental and physical health. I wrote about this in 2013 in a New York Times article headlined, “Quandary of Hidden Disabilities: Conceal or Reveal.”

Keeping a secret like this, living every day pretending you’re something you’re not, is debilitating. It undermines your confidence. You wonder if the disability is affecting your job performance and, if it is, if you’re the only one who doesn’t know it. You worry your employer or your colleagues will find out and you’ll lose your job. Firing someone for a disability is forbidden by the Americans with Disabilities Act, but employers find ways around it.

There is also the stress of having a condition that may get worse. With hearing loss, the progression is often unpredictable. I first lost my hearing in one ear when I was 30. I never dreamed that by the age of 60 I’d be profoundly deaf in that ear and close to it in the other. Because the cause of my hearing loss is undiagnosed, I also live with the worry that it may be a symptom of an as-yet-undiagnosed larger medical condition.

Those with disabilities bear the responsibility to speak out, but others should be sensitive to the fact that they may not feel confident enough to do so.

There are ways professionals can avoid inadvertently discriminating against people with hidden disabilities. Medical professionals need to recognize that complaints about depression and anxiety, as well as memory loss, may reflect an underlying, unacknowledged hearing loss.  Psychotherapists need to recognize the symptoms of a hidden disability with new patients, draw them out about it, and then confront the issues that the disability contributes to.

Finally, those who work with the elderly have a special responsibility to recognize hearing loss. Fully 50 to 80 percent of their clients will have hearing loss. It’s easy to mistake unrecognized — or even acknowledged — hearing loss for cognitive decline or even dementia.

 

This post first appeared on AARP Health on June 27, 2016.

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 5o Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

 

Higher Medical Bills for Those Who Don’t Treat Hearing Loss

The cost of hearing loss treatment is far less than the cost of not treating.

Higher Medical Bills for Those Who Don’t Treat Hearing Loss

Two new studies point out the serious consequences of untreated hearing loss.

In one, researchers at the Medical University of South Carolina found that middle-aged adults with untreated hearing loss had substantially higher medical bills compared with those without hearing loss. A second study from Johns Hopkins University found that moderate to severe hearing loss in those age 70+ was associated with a 54 percent higher risk of death.

The South Carolina study, published online April 7 in the journal JAMA Otolaryngology — Head & Neck Surgery, examined some 562,000 adults ages 55 to 64 drawn from a national health care claims database. They were matched in terms of age, employment, the presence of a variety of chronic health conditions and other factors. Most had private, low-deductible health insurance with at least 18 months of coverage.

SIGNIFICANTLY HIGHER MEDICAL BILLS.    The study found that over 18 months, those with diagnosed hearing loss had 33 percent higher health care costs than those without hearing loss. Those with untreated hearing loss spent $14,165, while those without hearing loss spent $10,629. The study did not suggest a cause-and-effect relationship between hearing loss and higher health costs, merely a statistical association.

The study also found that of the 280,882 study subjects with hearing loss, just 36,323, or 13 percent, had received hearing services. That’s even lower than the federal estimate that only 20 percent of those who could benefit from a hearing aid actually use one.

The study’s lead author, Annie N. Simpson, an assistant professor of Health Care Leadership and Management at the Medical University of South Carolina, emphasized that the important finding was that the patients in the study were middle-aged, not 50+. The study shows, she said in a statement, that the negative health-related effect of hearing loss “may manifest earlier than is generally recognized and may affect use of health care across the continuum of care.”

The reason for the higher bills, said Simpson in an email to AARP, could be because hearing difficulties cause some patients to avoid seeking timely medical care due to the stress of “trying to communicate with medical providers.” Putting off going to the doctor could lead to problems becoming worse, she said, resulting in “a sicker patient who needs more care.”

In addition, communication barriers could also affect how well those with hearing problems followed directions for taking medication or recognized “symptoms that signal the need to seek care.” The isolation that often results from hearing loss may “reduce necessary communications about health problems to health care providers and family members,” she added.

EARLIER STUDY SHOWED INCREASED MORTALITY.     Hearing loss expert Frank Lin, M.D., and colleagues at the Johns Hopkins University School of Medicine found a 54 percent higher risk of death among those age 70+ with moderate to severe hearing loss in another study published in JAMA Otolaryngology — Head & Neck Surgery.

Co-author Kevin Contrera, a medical student, said in a statement that the findings don’t answer “the big question” — whether hearing aids and other therapies could offset this negative effect.

Both of these studies are wake-up calls about the health (and financial) consequences of untreated hearing loss.

People with hearing loss — as well as insurers, including Medicare, and the hearing industry — need to pay attention to the consequences of doing nothing about hearing problems. The cost of treatment is likely to be far less than the cost of the consequences of not treating.

For more information about hearing loss read my books “Shouting Won’t Help” and “Living Better With Hearing Loss,” both available at Amazon.com. 

 

Photo: IStock

Reflections on Hearing Loss

KB in Seattle copyInterview with Stu Nunnery, After hearing loss, Katherine Bouton finds new purpose in life. This paragraph about HLAA is just one part. Click on the link to read the whole interview.

Stu: Hearing loss has many side effects short and long term and most troubling to many of us is the isolation, depression, and other long term health issues.

Katherine: This is why I advocate for HLAA. Joining your local chapter of HLAA is the best way you can find others like you. It doesn’t mean you give up your hearing friends or your hearing life, but you meet new friends. And because many HLAA meetings have Communication Access Real Time (CART) capability, you can actually comfortably “hear” in these meetings.  I’ve learned a huge amount in casual conversation with my HLAA friends, and even more from the structured programs we sponsor. That said, in contrast to the very culturally vibrant deaf community, outside of HLAA (and maybe ALDA) there isn’t a hearing-loss community at all, much less a vibrant one. I think active HLAA members do have a vibrant community, but it’s hard to get people interested.

 

Source: After hearing loss, Katherine Bouton finds new purpose in life

Talking About Hearing Loss With Someone Who Doesn’t Want to Listen

The one question I am asked more than any other is: “How do I talk to my spouse about hearing loss?”

Older couple enjoying a cup of tea together Every time I try to bring the subject up, they say, the spouse brushes it off. “I can hear fine,” is the impatient reply. Or, “It’s because you mumble.” Or, “It’s too loud in this restaurant.” Or —and this is the most frustrating — “Maybe I do, but it doesn’t bother me.”

“Well, it bothers me,” you may be tempted to reply. Not a good idea.

What might work is to turn the discussion around. “Honey,” you say, “have you noticed that I’m missing things people say? I think I might be losing some of my hearing.”

Honey may look at you suspiciously.

“There’s a free clinic at the university where they do hearing tests,” you go on. “I’m going to go down there. There are so many new devices to help you hear better these days.”

“Hearing aids,” Honey says.

“Yeah, hearing aids. But also these things that work like hearing aids but cost about a tenth as much. I hear they’re great for mild hearing loss. I’m missing a lot of what they’re saying on TV, and also when we eat out I can never hear the specials.”

“Like I said,” Honey says. “Restaurants are too loud.”

“Anyway,” you continue. “It might just be earwax and it would be good to get that out.”

No response.

“I read the other day that you can use a smartphone as a hearing aid. I can turn my iPhone into a microphone — I read about it on Giz Mag. There’s another thing you can use with an IPhone or an Android that looks great. I read about it in the Times. You’ve gotten me hooked on this tech stuff.”

No response.

“There’s also this cool device that works kind of like a hearing aid but it looks just like a Bluetooth — called theSoundhawk. In fact there are all sorts of things that aren’t hearing aids but sound pretty great.”

Honey: “Hmft.”

“I’m going to go down to the clinic tomorrow and maybe stop off at the Apple store and check out the new stuff. Can you drive me, in case I can’t park?”

Honey agrees to drive you. You find a parking spot. No point in sitting in the hot car, Honey thinks. Might as well have the hearing test. I’m here anyway.

If you can get Honey to the hearing test, that’s a big first step. If the visit results in a halfway solution like thesmartphone app or the Soundhawk, that’s not a bad second step.

Turns out you have some hearing loss, too. The audiologist suggests the Bean, since you don’t really want to look like a Wall Street trader wearing the Soundhawk. It’s invisible. Then, maybe down the road, hearing aids.

Honey goes for the Soundhawk. The power look. The average wait between discovering you need a hearing aid and actually getting one is seven years, so get started now.

Photo: annebaek/iStock

Katherine Bouton is the author of Shouting Won’t Help, a memoir of adult-onset hearing loss. She has had progressive bilateral hearing loss since she was 30 and blogs about healthy living — and healthy aging — at Hear Better With Hearing Loss. She is a member of the Board of Trustees of the Hearing Loss Association of America.

This post first appeared on the AARP website: Healthy Hearing, by Katherine Bouton.