Convention 2016!

It’s not too late to register for the Hearing Loss Association of America’s annual convention, held this year in Washington DC. from June 23-26.

imgresDon’t miss innovative Hopkins otolaryngologist/epidemiologist Dr. Frank Lin, who will update members on the latest research.

Get a first hand report on the influential PCAST and IOM Reports, both of which signal the possibility of significant change in the hearing-aid marketplace.

An Experience Room, new this year, gives you the opportunity to try out hearing-assistive products from many different manufacturers.

Dozens of workshops and lectures cover everything related to hearing loss.

Meet interesting people with hearing loss from all over the globe . Share tips and information. This is especially true this year, when HLAA is hosting the International Federation of Hard of Hearing.

Best of all, spend two days in an environment where you can hear every word! CART captioning, looping, and ASL interpreters are available at every event.

I hate conventions but I love this one. For more information go to HLAA’s website.

What Would Helen Keller Do?

 

“Blindness cuts us off from things, but deafness cuts us off from people.”

Bouton: What Would Helen Keller Do?

                                                                       Helen Keller — Pictorial Press Ltd / Alamy Stock Photo

Did Helen Keller actually say this? No one knows.

She did express the idea in different ways. In one letter she wrote, “The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus — the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man.”

Helen Keller lost her vision and her hearing when she was 19 months old, from an infection that was probably scarlet fever or meningitis. Like many toddlers at that age, she had some spoken language, which was presumably lost in the trauma of her illness.

Today Helen Keller’s parents would be offered the option of cochlear implants and speech therapy. Because she was also blind, conventional sign language would not be an option. The Deaf-Blind today use a form of sign language called fingerspelling,  or tactile sign language, which Keller herself used. She also learned to speak, although her speech was labored and difficult to follow.

Those with serious hearing loss often cite this quote. Although cochlear implants and hearing aids restore hearing, it may be to limited degree. Even with additional assistive devices and good lip-reading, a person with severe to profound hearing loss may still have trouble following speech in any but ideal circumstances. I know, because I’m one of them.

Nevertheless, I am certain that, given her blindness, Helen Keller would have embraced today’s cochlear implant technology. In a remarkable historic video, Keller speaks about the loss not of sight or hearing but fluid speech:

“It is not blindness or deafness that bring me my darkest hours. It is the acute disappointment in not being able to speak normally. Longingly I feel how much more good I may have done, if I had only acquired normal speech. But out of this sorrowful experience I understand more clearly all human striving, wanted ambitions, and infinite capacity of hope.”

When she died in 1968, at 87, the New York Times cited her many accomplishments: “she was graduated from Radcliffe; she became an artful and subtle writer; she led a vigorous life; she developed into a crusading humanitarian who espoused Socialism; and she energized movements that revolutionized help for the blind and the deaf.” She was a “symbol of the indomitable human spirit.”

It is hard to imagine that she could have “done more good” with the ability to speak. But her quotes suggest that she would have embraced the chance to hear “the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man” — and to respond with speech.

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.

This essay first appeared in a slightly different form on AARP Health.

Scholarship Opportunities

Two scholarship opportunities:

The HearStrong Foundation is offering scholarships to two college-bound student athletes with hearing loss. For information, click on their  website. This is a national scholarship program.

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Hearing Loss Association of AmericaHLAA New York City Chapter

2016 ANNUAL SCHOLARSHIP AWARD

FOR NYC HIGH SCHOOL SENIORS WITH HEARING LOSS

Applications are time-sensitive. Late submission of materials will disqualify the applicant. Please act on this information as soon as you receive it.

The Hearing Loss Association of America—New York City Chapter is pleased to announce four $1,000 scholarships for high school seniors with hearing loss, to be used toward the pursuit of a college degree or vocational training.

Applicants must have applied to a college or vocational education program, be between the ages of 17 and 20, wear a hearing aid or cochlear implant, and have a grade point average of 3.0 or better. The scholarship is a one-time award given in recognition of academic achievement, leadership qualities, community service, and work experience. Financial need is not a consideration.

To apply for the scholarship, complete all parts of the 2016 SCHOLARSHIP APPLICATION FORM and send by email to borough supervisor, Karen A. Edwards, Manhattan.

DEADLINE FOR RECEIPT OF APPLICATIONS: May 10, 2016

Please write to Karen Edwards for an application: KEdwards9@schools.nyc.gov.

Driving and Listening When You’re Hard of Hearing

                            Tips for the best ways to enjoy recorded music and books.

Hearing Blog: Driving and Listening

The average American drives 13,746 miles a year, according to the Federal Highway Administration. What is the safest activity to fill those hours? Listening. Listening to recorded books, music, the radio – they all help while away the hours behind the wheel.

Unfortunately, for many people with hearing loss, that is not an easy accomplishment.

Even if you’re not a driver, listening can divert you while taking a power walk, working out on a treadmill or exercise bike, riding on a train or bus, even lying in bed. And summertime means long vacation car, plane or bus trips for many.

One caveat: if you’re not a confident driver — someone with years of experience driving with your eyes rather than your ears, with the instinctive habit of constantly checking the rear and side view mirrors —  don’t listen to anything! Just concentrate on driving. 

Here are some tips:

  • Use Bluetooth. If you have mild to moderate hearing loss, you may have trouble hearing through earbuds or your smartphone over the noise of the car. Most new cars come with Bluetooth. A simple solution is to link your blue-tooth equipped device to the car’s sound system. You can listen to music or books through the sound system, and get and send phone calls.
  • Try a Bluetooth streamer. If your hearing loss is more serious, you may need to stream books, music or phone calls on these devices through a Bluetooth streamer connected wirelessly to your hearing aid or implant. All major hearing aid manufacturers make Bluetooth streamers. The one I use is a ComPilot, which streams to my Phonak hearing aid and my Advanced Bionics cochlear implant (both are made by the same company, Sonova). The Oticon Streamer Pro is also a popular brand. Made for iPhone hearing aids (including those made by ReSound and Starkey), it connects to an iPhone without the need for the intermediary streamer. Ask your audiologist for information about Bluetooth streamers for your brand of hearing aid.
  • Choose music or books wisely. It can make a big difference in comprehensibility and enjoyment. Recorded books can be borrowed from your library or by subscribing to a service like Recorded Books and played on your car’s CD player. If you can’t hear clearly enough through the car’s sound system, however, you’ll have to switch to a service like Audible, which downloads books to your smartphone or iPod, which you can then access through a Bluetooth streamer. These are subscription services, with new credits for books available monthly.
  • Listen to a free audio sample first. We all have our favorite literary genres, but genres that are good for reading are not always good for listening, especially with hearing loss. Listen to the free audio sample of a recorded book before you order, to see if you can hear and understand the reader’s voice. If you find a reader whose voice you like, you can search for other books featuring the same reader.
  • A professional reader is preferable. I have found that a plot-driven novel, with a single professional reader, not too many place names or proper names, and no background music or sound effects is easiest to understand. Sorry, authors, but a professional reader is often more understandable than the writer reading his or her own work.
  • Multiple readers can be confusing. I try to avoid books read by more than one reader (an increasing trend) because I get lost trying to understand who is who. I also need time to adjust to a voice. Sometimes I even start a book over again once I’ve figured out the reader’s voice.
  • Need a really long story? The first recorded book I ever listened to was Moby-Dick, read by Frank Muller, which had me enthralled for almost all 21 hours and 20 minutes. Anna Karenina, read by either Davina Porter or David Horovitch, is also a spellbinder at 38 hours and 5 minutes (Horovitch) or 36 hours and 8 minutes (Porter). Is the difference in time because Porter reads faster? That might make Horovitch better for the hard of hearing. You can also slow down the recording, but that sometimes distorts the sound.
  • For nonfiction fans, how-to and advice books, self-help, history and biography are all popular car listening material. If you Google “best recorded books,” you’ll find a variety of lists, but always listen before you buy. Otherwise you may find you can’t understand a word.
  • Music is also according to personal taste, but I find that complicated orchestral music is almost impossible to listen to via streamer. I also love opera, but for listening in the car, I go for music with a strong beat or a strong solo voice, like rock or blues songs that don’t obscure my hearing with too much background music.
  • For podcasts, you want a professionally recorded, clear-spoken narrator. Once you get two or three guys joking around, or environmental sounds in the background, or laughter interrupting the spoken words, you — or I, anyway — are going to be lost.
  • What about the good old-fashioned radio? All of the above advice applies: a clear professional speaker, no background sound effects or music, no multiple speakers joking around and interrupting each other. Unfortunately for me, that limits my listening to traffic and the occasional baseball game.
  • Talking on the phone? No. Avoid using even a hands-free phone. Talking on a hands-free phone is legal in most states, but I don’t recommend it for people with hearing loss. The concentration required to follow a phone conversation may distract you from the road. Also, unless you have a very good voice recognition system, you may have to futz around looking for the phone number — even if it’s on speed dial. Don’t do it. It’s amazing how few milliseconds it takes for a car to swerve when you take your eyes off the road.

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

 

First published on AARP, April 28, 2016.  Photo: Getty Images

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

It May Be Later Than You Think

Two Good Reasons to Get Your Hearing Checked Now

The negative health effects of hearing loss may affect people at a younger age than was previously believed.

“Higher Health Care Costs in Middle-Aged US Adults With Hearing Loss,” published online April 7 in the journal JAMA Otolaryngology-Head & Neck Surgery, found significantly greater health costs in middle-aged adults 55 to 64 years old who had hearing loss than in their peers with healthy hearing.images-2

The research examined the records of 562,000 adults, drawn from the Truven Health MarketScan national health care billing database. They were matched in terms of age, employment, the presence of a variety of chronic health conditions, as well as other factors. All had private low-deductible health insurance with at least 18 months of coverage.

Over 18 months, those with diagnosed hearing loss had 33 percent higher health care costs than those without hearing loss. The dollar amount was $14,165 for those with hearing loss, $10,629 for those without. This should not be read as suggesting a cause and effect relationship between hearing loss and higher health costs. It is a statistical association.

Of the 280,882 study subjects with hearing loss, just 36,323, or 12 percent, had received hearing services. The study adjusted for the cost of hearing services in this group. A study subject was identified as having hearing loss using a set of billing-related diagnosis codes that indicate age-related hearing loss.

The study’s lead author, Annie N. Simpson PhD, an assistant professor in the departments of Otolaryngology-Head & Neck Surgery and Healthcare Leadership and Management at the Medical University of South Carolina, emphasized in a journal news release that the important finding was that the patient cohort was not elderly. The finding, she said, shows 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.”

This and other studies may make you think hearing loss is bad for your health. Based on another study published last fall in the same journal, you might even think it’s fatal.

Hearing loss is associated with a higher risk of health problems and with an increased risk of death. But it’s not a cause and effect relationship. Hearing loss does not cause physical and cognitive decline, and it does not kill you.

But it does have a strong correlation with these negative outcomes, and one explanation may be the very low use of hearing aids among those who could benefit from them. Fewer than 20 percent of those who could benefit from hearing aids have them. The Simpson study found that only 12 percent in her age cohort had received any hearing services.

Simpson offered some possible explanations for the negative correlation: “Patients with hearing loss may avoid seeking timely medical care because of their hearing difficulties,” she wrote in an email, and “patients with HL may be less effective participants in their care because of communication barriers that affect adherence to medication regimens, and/or recognition of symptoms that signal the need to seek care.”

Hearing loss often results in isolation, she went on, and it may also “reduce necessary communications about health problems to health care providers and family members.” It can also affect understanding of the proper use of medications.

Even going to the doctor may be affected by hearing loss. “Patients may avoid or delay visits to doctors” because their hearing loss makes it a stressful experience. All of these can lead to health-related problems becoming exacerbated, resulting in a sicker patient who needs more care.

And what about that study on hearing loss and death?

Kevin J. Contrera, Frank Lin and colleagues at Johns Hopkins University School of Medicine, studied associations between death and hearing loss. “Association of Hearing Impairment and Mortality in the National Health and Nutrition Examination Survey” was published online in the same journal as the Simpson study a few months earlier. It found that moderate or severe hearing loss in adults 70 or older is associated with a 54 percent increased risk of death, using an age-adjusted model.

The NHANES database, used in this study, identifies those with hearing loss based on audiometric testing. In a news release, Contrera noted that the most important unknown in their study is whether treatment helps offset the negative effect. “The big question is, do hearing aids and other therapies have an impact?” he said.

Does hearing loss cause death? No. But untreated hearing loss negatively affects cognitive and physical health. It is associated with a greater risk of falls in the elderly, with reduced walking speed and physical functioning and with decreased driving ability. It is also associated with greater risk of hospitalization.

The evidence for the benefits of treating hearing loss continues to mount. Simpson’s study is yet another wake-up call.

People with hearing loss – as well as insurers, including Medicare, and the hearing industry – need to pay attention to the negative health consequences of untreated hearing loss. The cost of treatment is likely to be far less than the cost of the consequences of not treating.

This is One Big Ear

I’m traveling in Sicily. Many wonderful things including fabulous food, wine, Greek and Roman ruins, Sicilians, olives. These photos are from archeological park near Siracusa.

This cave is called Dionysius’s Ear, Orecchio di Dionisio. It was carved out of limestone in Greek/Roman times as a place to store water. The digging technique was ingenious and also labor intensive. Like many big projects in ancient times, it was accomplished using slave labor.

The painter Caravaggio coined the term Orrechio de Dionisio. The name refers not to the Greek god but to a legendary tyrant named Dionysus's earDionisio 1 of Siracusa. He supposedly built the cave and used it to imprison enemies. Because of the perfect acoustics he could eavesdrop on their plans from an opening near the top. Oreccio di Dionysio

A flexible ear trumpet was named after the cave, and The Ear of Dionysius is also sometimes used as a reference to spying.

If you know of other legendary sites that feature the ear, please let me know about them using the comment section.