It’s an innocent enough question: Are you experiencing a loss of
hearing? But answering it can be complicated, says Brett Levine, MD, an
otolaryngologist, also known as an ear, nose and throat surgeon (ENTS)
at Torrance Memorial and a member of the Torrance Health Independent Physicians’
Association (THIPA).
“This is one of those things people often deny,” he confirms.
“Everyone has a different reaction when they start noticing a loss
of hearing, and a range of how long they might go before they address
the issue.” Reaction time often is based on one’s experience
and whether they have seen family members go through hearing loss.
“The other real factor is one’s age,” Levine points out.
“The generation born after the year 2000 has no problem with having
things in their ears. There is not a stigma, which is in stark contrast
to older generations for whom a hearing aid labeled you as a senior citizen.
I think it will be a different paradigm for those who have hearing loss
in 30 years or so.”
Levine considers it his job to be an educator and someone to offer options.
He refers to a poster he has in his office that asks these questions:
- Do you miss a lot of conversations?
- Is it hard to understand people on the phone?
- Do people complain that your TV is too loud?
- Do you have difficulty hearing conversations at a restaurant or where there
is background noise?
- Do friends or family get frustrated with you saying, “What?”
after every sentence?
- Do you nod in agreement to someone you don’t hear?
- Does it seem like everyone mumbles?
- Do you need to see a person’s face or lips to “hear”
them well?
- Do you hear ringing or noises in your ear that prevent you from hearing
what you want to hear?
If you answer yes to most of these questions, you should get a hearing
evaluation. “I’m not a salesman,” Levine explains, “but
if I had a family member who seemed to be experiencing hearing loss, I
would very compassionately point out to them what they might be missing.
The obvious thing is it’s annoying to others, but from the patient’s
standpoint, hearing loss can be very isolating and can lead to depression—even
cognitive decline and dementia.
“Just as muscles you don’t use will atrophy,” Levine
continues, “if you end up sitting in silence and checking out, your
hearing gets worse and you are not as intellectually stimulated or connected.
That leads to decline.”
Causes of Hearing Loss and Solutions within Reach
For people over 50, most hearing loss is age-related and can also be due
to environment and genetics. “Noise exposure is an absolute factor,”
he says, “which can be due to loud music or machinery or even traumatic
situations such as military settings, gunshots and explosions.”
Other less common causes include inner ear infections or viruses. Then
there are easy things like wax impaction or fluid behind the eardrum.
“Some of the fixes are easy and can be treated medically, and some
require surgery such as a cochlear implant,” says Levine. “But
most hearing loss due to age or a noise origin will benefit from hearing
aids.”
There is a wide range of hearing aids now available: old-fashioned, big,
very visible aids, and now smaller rechargeable models that can be placed
way inside the ear canal and that interact with your cell phone to adjust
according to noise level and other situations, like exercise.
And there are health plans that cover them. “It’s very reasonable
to check with an insurance company or your human resources department
to see what plans offer benefits you know you will need,” Levine
advises. “Getting hearing aids is not like buying a hat at Target
or Costco. You need to be able to try them and get used to them, which
may take some adjusting so you get something customized to your loss.
It’s best to work with your audiologist or hearing aid dispenser
over time. Be patient; it can take several weeks or months to maximize
the potential of hearing aids.”
In California, all hearing aids are refundable within 45 days, so you can
exchange or even return something that’s not working for you. “It’s
very tempting to order something inexpensive online, and if your loss
is minimal they might just work. But you aren’t going to get the
service you might need. The plans offered within THIPA often include coverage
for hearing aids and glasses. Call THIPA member services at 866-568-4472
for information.
Brett Levine, MD, otolaryngologist, member of Torrance Health IPA (THIPA),
THIPA.org