Hear Better, Live Better

If you’ve ever said “I can hear you, I just can’t understand you,” you’re not alone and you’re not imagining it. We talk with Dr. Eneida Agolli, senior audiologist with AudioNova, about why hearing loss is often gradual, why families notice it first, and why waiting 6 to 7 years to get help can quietly raise the stakes for your health.

We get specific about the science and the lived reality: the connection between hearing loss and diabetes, cardiovascular disease, kidney disease, hospitalizations, and fall risk through the inner ear balance system. Then we dig into the topic many people are hearing about lately, the link between hearing loss and dementia risk. Dr. Rowley breaks down the “cognitive load” problem, how the brain works overtime to fill in missing sound, and why that constant effort can drain short-term memory and concentration over time.

We also cover what actually helps. Modern hearing aids are rechargeable, Bluetooth-ready mini computers that can stream calls, music, and podcasts, and they can be tuned to your exact hearing prescription. We discuss realistic expectations in background noise, tinnitus relief for many patients, and simple steps like checking for ear wax buildup and protecting your ears from loud noise exposure. If you’ve been putting off a hearing test, this conversation lays out a clear reason to start around age 50 and keep a yearly baseline.

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Transcript

Welcome And Why Hearing Matters

unknown 0:03

Thank you for coming up.

SPEAKER_03 0:18

I'm making a dedicated call. I'm so bad all of them. But this is Anita Agoli. I'm not going to have some. She Jim Brady is one of her patients, and he connected us with her to have her come and present to us why it's so important to make sure we pay attention to our hearing loss. So some of you may not have hearing loss, you may be much better than me. I'm not being I need it. So anyways, welcome. Thank you everybody.

SPEAKER_05 0:50

Thank you for having us.

Why Start Hearing Tests At 50

Common Causes Of Hearing Loss

Hearing Loss And Whole-Body Health

The Research Behind Dementia Risk

How The Brain Compensates For Loss

SPEAKER_07 0:53

Good morning, everyone. Thank you for your time. Thank you for having us. Thank you, Mr. Gray, for connecting us. We do this often around the Green Sparrow area. My name again is Dr. Nana Rowley. I am an audiologist with Audio Nova. I've been an audiologist with Audio Nova for about 11 years. We are located, we have a lot of offices across the area. We have an office in High Point, Asheboro, and all throughout North Carolina and the United States and Canada. I am in the Greensboro office. The Greensboro office is situated across from Wendley Long Hospital. Again, I've been there 11 years. I'm a senior audiologist. Not only do I see patients, but I also kind of go around other Audio Nova offices and I train new providers, existing providers, audiologists hearing aid dismiss. I uh finished my doctoral degree in the University, Montclair State University in New Jersey, and I've been in North Carolina for 11 years, and I've been with Audio Nova for 11 years. Again, thank you for having me. The best way to do this, I'm gonna do some, I have some slides here for you guys. You can read yourselves. From my experience doing this so many times, the best stuff comes up when we ask questions. So at any point, I'm gonna give you some space at the end to ask questions, but if throughout this presentation there's something there that catches your attention or something that you're like, hey, I heard of this, but I'm really not sure what it means or why this is important, please ask away. Raise your hand and I'll be glad to talk about it. Here we go. Okay. I said a little bit about our practice and all de Nova. Um here we are. We are gonna talk today a lot about hearing, hearing loss, why is it important to follow up, why is it important to start testing your hearing at the tender age of 50? Okay, so uh most of my patients I see about 15, 20 years later. Generally speaking, um, it takes about six to seven years for patients to actually get help after they've had hearing loss. Okay, we are working really hard to bring that number down, and you guys will find out why that is so important. But I'm just gonna continue here. Um, the prevalence of hearing loss, there's a lot of people that have hearing loss, okay? As people are living longer and longer, the prevalence of hearing loss is going higher. Um, about 50% of those over the age of 65 have some degree of hearing loss that can go anywhere between mild to moderate and then all the way to severe and profound, okay? Um, there's about 360 million people worldwide that have a significant amount of hearing loss. So lots, lots of people with hearing loss. I'm gonna put all of these here and I'm gonna mention a little bit about everything. There's several causes of hearing loss. Um, the natural aging process, I would say, is the most prevalent, okay, as we grow older. There's just a little bit of wear and tear on the body. Excessive hearing loss is something that also affects hearing quite a bit. That's why, generally speaking, men tend to have more hearing loss than women, in average, because generally speaking, men are exposed to excessive noise way more than women through work, through military service, um, hunting, other activities that are really damaging to the ears. Okay. Of course, genetics plays a role. There is a history, generally speaking, a family history of hearing loss. Um, if there is in the family hearing loss, it will kind of transmit through the ears to the to the next generations. Another hearing loss is medications. There are hundreds of medications that could cause hearing loss. Um, some cancer treatments are also well known to cause hearing loss. There are a variety of diseases that cause it: meningitis, palistiatoma, chronic ear infections. In fact, I have a lot of patients that would say back in the days where medicine was not as advanced, children would have repeated ear infections for years. And those would cause trauma to the middle ear, they would cause scarring to the campanic membrane, and that would lead to hearing loss that they've had for years that only gets worse as we age. Of course, there's birth defects, and there's trauma or injury to the ears and the head, and trauma could be either a lung force or even noise trauma, okay? Fireworks, hunting, loud music, uh, things of that nature. Even if they happened 40, 50 years ago. If there's significant noise exposure that would cause hearing loss that would follow you through the years. Any questions so far? Pretty good? Awesome. Hearing loss is connected to a lot of other health conditions, right? I'm sure no one is surprised by this. Everything in the body is connected. Um, one thing leads to another, one thing affects another. I'm gonna put this here and I'm gonna talk a little bit. You guys have do have some flyers in here that break it down pretty nicely. But um, hearing loss. Hearing loss is connected to diabetes. Okay, hearing loss is twice as likely for patients with diabetes. Diabetes affects the smallest veins and arteries in your body. The eyes and the ears both are well known to have very small vessels. That's why, generally speaking, those are the first two things that would be affected when it comes to the cranial nerves in terms of how diabetes affects your hearing loss. We have also followed people through the years, and we have found that your chances of hospitalizations increase by about 32% for patients with older hearing loss. This really can connect to what we have here, falling. Hearing loss is tied to an increased chance of falling. Why that is? Well, our ears and our balance system are anatomically related. Both our hearing and our ability to know where we are in the world and how to walk and how to kind of figure out where our body moves. It's situated in the inner ear and they share the same nerve. So if you have hearing loss, part of that nerve is working really hard to kind of overcome the effects of the hearing loss. That takes away from the ability of the same nerve to help you with your balance. That's why we see an increased number of falls and balance issues in people with hearing loss. In fact, I can tell you from my experience that when patients start wearing hearing devices, their balance also gets better. So that is that is a fact. Of course, smoking increases your chances just like everything else, makes your hearing loss worse. We talked about the medication. Chronic kidney disease. Chronic kidney disease is also related to hearing loss. Again, small vessels in the body, the kidneys, the eyes, the ears, they all kind of share that same reasoning. Cardiovascular disease, we have found more and more connection to cardiovascular and hearing loss that, in fact, we're now screening and having these discussions about patients that are they find first to have cardiovascular disease to get their ears checked, and the other way around. If you have hearing loss, maybe you want to check also to see if your diabetes, cardiovascular disease, any kind of risk factors that connect to hearing loss. And let's talk about the elephant in the room. What most people have kind of noticed, talked about in the past three, four years, we've had quite a bit of media attention about this longitudinal study that was done at John Hopkins. Okay? We have finally been able to connect hearing loss to dementia. Obviously, this doesn't mean hearing loss leads to dementia or dementia leads to hearing loss. But what we have found from our studies through 30, 40, 40 years is that people with hearing loss have higher chances of developing dementia than when they grow older. In fact, when we talk about dementia and Alzheimer's disease, there are about 12 factors that we can control. Okay? Good diet, healthy, stay active, don't smoke, don't drink, use your body, use your mind. But the most modifiable factor of them all when it comes to your ability to control dementia is hearing loss. The very most absolute modifiable factor connected to dementia is hearing loss. So I've had I've been in this profession, as I said, about 16 years. For many years, I've had patients say, Yeah, I don't hear so much, but you know, I can get by, it's okay. Um, I've had family members bring their spouses or their children or their parents in and say, hey, you know, I'm noticing they're not hearing as well. What can we do? And sometimes patients are reluctant to get help, right? Because again, you can get by. Well, I see some smiles here, and I see somebody looking at other people. We have a lot of that. I do a lot of marriage counseling in my practice. I say a lot of marriages. Okay. Now that patients are living longer, patients are generally speaking more in tune with what's happening. There's less stigma when it comes to hearing loss. There's more family doctors talking about hearing loss and the link to dementia. And because dementia is now becoming so prevalent because people are living longer and there's no cure for it yet. I have more and more patients coming in and saying, hey, I'm not sure if I have hearing loss, but I want to get checked because I read that it's related to dementia. I want to get checked because my mother had dementia. I want to get checked because my neighbor has dementia, and I would never ever want to live like that. So it's, as I said, one good thing that has come out of this is that it has made people a little more willing to get checked, to get checked early, and to embrace the fact that as we grow older, things change in our body, right? But if we can modify it or help it, why shouldn't we? Does that make sense to everybody? Do we have questions about that part? I'm gonna go a little deeper into the dementia and the hearing loss connection, okay? Because I get asked by a lot of patients. Well, how does hearing loss relate to dementia? When we have hearing loss, there's a lot of stimuli that we are missing.

unknown 12:17

Okay?

SPEAKER_07 12:18

So what the brain does, which is amazing, it tries to compensate. So if you can't hear really clearly, you lean in, you look at people's lips, you modify your body language, you get closer, you turn around, you stare at people to try to understand or put together the pieces that you are missing. When you're doing this, or if you're in background noise, I'm sure everybody can connect to this. When you're in background noise, it's much harder to hear, right? If you have a crowd, people talking from a distance, you have music going on, or a restaurant, think of a restaurant or cocktail hour, it becomes that much harder to hear. When the brain is trying to compensate so hard, because the ears are not working properly, you are taken away from your short-term memory. So the brain, instead of paying attention and remembering and kind of focusing on those things on a much deeper level, is actually working to do the job of the ears. That, through many months and through many years, affects our short-term memory, our cognitive decline, and in turn, if things don't get stored in short-term memory, they do not get stored in long-term memory. That's the connection between hearing loss and cognitive decline. We have literally measured people's brain in an MRI. We compare three groups: people with hearing loss, people with hearing loss that wear hearing devices, so they're treating their hearing loss, and people that have hearing loss but do not wear devices. We found out that literally the brain matter, the wide brain matter of the people with untreated hearing loss shrinks through the years up to 30%. Isn't that scary? Literally, your brain shrinks if it cannot hear. Which kind of makes sense because everything in the body, if you don't use, you're gonna lose, right? If you go to the gym and you work out one arm, but you never use the other arm, what's gonna happen six months down the road? You're gonna be strong and you're gonna use this arm really good, and it's gonna look all puffed up, and the other arm is kind of gonna fall behind. That's exactly what happens with our brain and our nerve hearing when we can't hear and we don't do anything about it. Does that make sense? Any questions so far? Yes? Good. So we talked about the cognition, the brain's ability to take an information and make use of it. I talked about this together. The ears and the brain are connected. If the ears that are the window to the brain of sound are not working properly, the brain is gonna work that much harder. Another thing that happens with hearing loss is the amount of effort. Yes, you can get by. Yes, you can read people's lips, yes, you can lean in, yes, you can bring your TV up. But that takes so much effort that through the years I've been doing this, fit like thousands of people with hearing devices across four states. People will come back and say to me when they start wearing devices, they say, I feel so much better at the end of the day. It is exhausting for the brain to try to pick in, pick the words and put them together. It's like you're constantly trying to fill in the puzzle just because your ears cannot do their job the way they used to. Okay, we talked about this. Okay, there is a 40% passive decline in cognitive health and mental health for those people that have hearing loss that don't treat it. And as it says, hearing loss might force a brain to devote too much of its energy and understanding the sound at the detriment of your short-term and long-term. Depression and hearing loss, I think this makes sense to everyone. If you can't hear, you isolate. If you can't hear, you fall back. If you can't hear and you're in a group and everybody's cracking jokes, and you just nod along and you have no idea what was said, next time you go out, maybe you don't want to go out anymore. Maybe you feel embarrassed, maybe you don't feel included. All these effects create that social isolation, that social withdrawal. And we have found more and more that social isolation and social withdrawal lead to higher chances of depression as we grow older. On top of the fact that as we grow older, chances of depression are higher because of the changes that happen in our mental capabilities, but also in our hormonal changes.

SPEAKER_06 17:19

Okay.

The Good News About Treatment

How Modern Hearing Aids Work

SPEAKER_07 17:21

And as I said, social isolation as a result of hearing loss, exhaustion, problems concentrating, and loss of interest in hobbies. But there is good news, right? That was the bad news. And now we're all gonna talk about good news. Um I say this all the time. I work with older patients, and I hear no, right? Oh, don't get old. And my favorite line for that is well, I'd rather get old than die young, right? So let's celebrate getting old. Um, there's a lot of things that happen to our bodies we grow older, right? We lose some control, we lose abilities, uh sickness, things follow. Hearing loss, in my book, maybe because I do it all day, every day, is very easy to treat. Thankfully, we live in a you know very developed country. We have the latest technology, technology of hearing devices has year after year after year is just increased in unimaginable levels, right? We have literally mini computers that we can put in people's ears to make them hear things that they haven't heard in 10 years, 20 years. So treating hearing loss in my book, it's easy. Okay? Other things don't come at me for falls, for knees, for hips. I can't help with that, but I can help with hearing loss. Um here we are. What does treating your hearing do? Right? All the things that we talked about. Reconnects to your loved ones, reconnects you with your group, with your community. It brings you back to being socially engaged. It literally improves your quality of life, it decreases your chances of dementia, it decreases your chances of cognitive decline, it decreases your chances of falling and balance issues, it increases your safety. Okay? Think of somebody that lives alone and cannot hear the door. Cannot hear the phone. I have so many older patients whose children bring them in and say, I want to make sure that mom can hear the phone. I want to make sure that mom can hear somebody coming at the door and knocking. I want to make sure that mom can hear my phone when I call her because when I call the TV is at 100 and the whole neighborhood is hearing it, right? Yeah. That happens every day. So that's why I say it's hearing loss can be fixed, can be treated, and you know, you can improve your life so much significantly for you and for your family. In fact, we have found that treating hearing loss improves your mental uh functions and overall wellness, it improves your safety, and um obviously it keeps cognitive decline away. Now let's talk about hearing loss. The vast majority of solutions for hearing loss for about 95% of people is hearing devices, right? There are certain surgeries for hearing loss, but those are generally for younger, um for younger people that might have some conductive components, something in the ears, either the bones of the middle ear don't work properly, or a disease like a cobisteatoma. In those scenarios, there are surgeries that could help with hearing loss, but for the vast majority of hearing loss, as we've already discussed, it's usually age-related and noise exposure related. The only solution is wearing hearing devices. Again, mini computers, super advanced. We basically test your hearing, find what your threshold of hearing is in different pitches and different frequencies, and then we prescribe the hearing loss ear by ear, pitch by pitch, so that you hear what you are missing. Just like a prescription glasses, but obviously way more advanced. There's different types of hearing aids behind the ears, they are generally the most advanced, the easiest to use. They are now rechargeable. I have a lot of patients that remember those old bananas, as we used to call them, that squealed all the time and took half your head and were only beige, there were no other colors, and then yep, I see heads nodding. And um, everybody kind of remembers those, making the noises, being unpleasant, all those. Well, we moved a long way from that. As I like to tell patients, we've gone from carriage and horses to a Tesla. That's how much. Differences, right? I have a test that's not bought for that. Um rechargeable healing aids, no more batteries, easy to use. You wear them all day, you put them in the charger at night, you wake up in the morning, you're ready to go. You never run out of batteries. Bluetooth compatible. Everybody is now into listening to Pandora or Spotify or audiobooks or podcasts or walking the dog and listening to music. Well, now you can do it through your hearing aids. You can get all your phone calls to go to your hearing aids. So you don't have to be on speaker anymore for everybody to hear what you're talking about, right? You can leave the phone down, you can chop veggies for dinner, and you can have a full-blown conversation with somebody over the phone without holding your phone to your mouth or to your ear or putting it on speaker.

SPEAKER_09 22:46

And starting in a month or two, you'll be able to do that here at the church too. The worship committee is just upgrading all of our audio capability of the sanctuary, and one of the things that we're adding is a hearing loop for exactly what she's talking about.

SPEAKER_06 23:04

Yeah.

SPEAKER_09 23:05

So you can turn off the sermon when you get bored at it.

Tinnitus What It Means And Helps

Q&A Insurance Noise Baselines Wax

SPEAKER_07 23:10

Well, there is a there is also an app to pick it back when you there is an app that you can connect to your hearing aids, right? That is literally like this a greenhouse. It's like a remote control for your ears. And there's a mute button there. Every time I show the patients a mute button, I have the wife saying, don't show him that. I don't know. I've been talking to Tonak about taking that off or hiding in the middle bit, but nothing has happened yet. So yes, you can have people that just mute you and they don't know what's happening. Um, this is our latest technology, as I said. I don't want to go too much into the latest. I want to kind of generally talk about how hearing devices work, how um how they improve your hearing and your health. Um generally, what we do when we see patients for the first time, we test their hearing. If they're candidates for hearing devices, um, we fit them with them, we make them accommodation based on the patient's lifestyle, based on the patient's preferences for the type behind or in the ear. And then we generally see patients every year because we would like to test your hearing every year. If you have hearing loss, we kind of want to keep an eye on how things progress. As I said, there could be other reasons, other diseases in your body that could affect hearing, getting worse sooner. Um, so we want to check on that. Generally speaking, though, when you start wearing hearing devices because you have hearing loss, what you're doing, you're not only helping yourself hear better and getting, you know, obviously involved and hearing and not isolating or withdrawing anymore, but it also affects your health of the hearing overall because you're activating your brain. You're keeping your nerve of hearing active. So as you grow older, of course, things will, you know, progress in a certain way where hearing loss will probably become worse. The good news is that with hearing devices, we generally see that that progression is slower because you are using your brain, because you are using your nerve of hearing. And your ears are only as good as your nerve of hearing, because I can bring sound to the ears all day, but if I have a nerve that's not working properly because of many, many years of not hearing well, it's gonna be much harder to help with speech clearly. Questions about this? Does this make sense to everybody? As I said, we talked about Bluetooth, reconnecting, hearing the ears on both ears, and tinnitus. Who here has tinnitus? Yeah, I see a hand, a couple of hands. I want to talk a little bit about tinnitus, okay? Tinnidus, or tinnitus, as some people say, or tendinitis. It's been called tendinitis about 50% of the time. So the correct way to say it is tinnitus, but that's okay, we all understand. Tinnitus comes in many forms. Yay. Ringing, buzzing, hissing, chirping. There's people that hear music in their ears. Okay? Generally speaking, tinnitus is a side effect of hearing loss. So I always tell patients if you have tinnitus, you want to get checked out because your body is trying to tell you something. Sometimes it could just be wax built up in your ears, right? So if your ears are fully blocked with wax, it's pretty much like having a hearing loss. The nerve cannot get the signal. Those nerve endings that used to respond to the signal keep firing because that's all they know what to do since the day you were born, but there's no sound coming in. Those nerve endings firing without sound coming in is what tinnitus is. That's why tinnitus is per it's in your brain. That's why tinnitus is one of the few medical conditions that we call totally subjective. Why? I can't measure it. I don't know how loud it is for you, how soft. I can't try to match it. If you have hearing loss and tinnitus, I will put you in the booth and I would play different sounds and try to ask you if this sounds similar or not similar, but we can't really measure it. Because again, it happens in the brain. One of the best ways to treat, there is no cure for tinnitus. So if you hear your family doctor unfortunately just telling people, oh well, you have it, just live with it, good luck. Terrible. It happens all the time. It makes people more depressed, it makes people more upset. There's people that react to it pretty badly, can't sleep, can't concentrate. It affects the way they can hear other people because they're hearing their ringing all the time. Hearing devices, generally speaking, about 80 to 85% of the time, is the answer. Why is hearing devices the answer? Well, when you put hearing devices on, you're bringing all the sounds of the world back to your ears, right? So when those nerve endings in the brain are actually responding to the sounds of the world, they're not just going to be firing at random, they're going to be firing doing the job they've been doing since the baby were born. And that's why, when generally speaking, we put hearing devices on people's ears, they'll say right away, oh my god. It either reduces significantly or it goes away. Here's the bad news. Once you take your hearing aids out, you're back to square one. But at least that tells you how well your hearing devices are working for your brain when you have them on 12, 13, 14, 15 hours a day, because now your brain is actually doing what it's supposed to be doing, which is listening to the sounds of the world and responding to those. Questions about tinnitus? Lots of medications cause tinnitus. Okay, you might not have ever had it before in your life, and then you start a new medication, and all of a sudden you have tinnitus. Again, generally speaking, we mask it by wearing hearing devices. Hearing devices themselves can be maskers. Like we can literally add sounds to the ears that kind of mask your tinnitus. So you listen to our sound instead of that sound that people find very annoying, or that have kind of made a negative connection to. And we try to take care of it that way. And we're not in this part. Now it's QA. Questions for me about hearing devices, about myths, about hearing loss. How do you go about it? How do you find out if you have hearing loss? What happens when you find out you have hearing loss? Does insurance offer help with hearing loss?

SPEAKER_03 30:11

Do most insurances cover it?

SPEAKER_07 30:14

So most insurances would cover an annual hearing test. When it comes to hearing devices, the vast majority of insurance, well, Medicare does not cover hearing devices in any capacity. Most secondary insurances or AARP plans do offer different benefits. Okay? It's mostly a discount program rather than insurances just covering your hearing devices like they would do your visit at your orthopedist. But there's different plans, there's different offers. I would say the vast majority of insurances offer some kind of discount. That's what happens, generally speaking, with hearing loss. Obviously, we're all trying and hoping and working hard to get insurance to pick up more of a benefit and cover hearing aids more because we find from our studies more and more how important your hearing is to your general health. So, yeah. Other questions?

SPEAKER_04 31:21

Can constant noise affect your hearing, such as I I grew up with Lair condition, so I had an offstand on a fan by my side.

SPEAKER_07 31:38

Is that a reason for noise exposure would only affect your hearing negatively if it's over 90, 85 to 90 dB decibels. If it's a low noise, I would say generally speaking would probably not affect your hearing or damage your hearing. That's why, in fact, now more and more we have OSHA, the federal agency that kind of protects for people that work in loud industries like pilots or you know military, all those. There's certain rules and regulations that you have to follow. But if people are in loud noises for more than 15 minutes at 90 decibels, they are required to wear ear protection to protect their hearing. And they get tested every year to make sure that there's no hearing loss that's related to your exposure to loud sounds. That's a good question. So I have a question. Yes.

SPEAKER_08 32:35

Oh, um, so I had a question about um the loud noises and hearing loss over time. So so if you um so if you're exposed to loud noises on a regular basis, say as a teenager, the hearing loss may not show up until like late middle age or something like that.

SPEAKER_07 32:59

Yes, so this is how it generally works. If you have noise exposure, I tell this to the patients all the time. In my questionnaire, I ask patient history of noise exposure, and somebody would say, Well, yeah, but I was a teenager working in a farm, you know. And I'm like, well, if the noise is really loud for an extended period of time, even if you were 16 years old, that would still damage your ear. Here's the trick it doesn't show up later, it's been there all along. But as we grow older, what did I say about the brain? It becomes much harder for the brain to fit in the pieces, and that's when people finally say, Oh wow, yes, I'm struggling. Something has happened that I'm not hearing well. So your loss has been there all along, but when you're young, your brain is much better equipped to kind of fill in and compensate for it, and then as we grow older and things kind of start to decline and slow down, that's when you really become more aware of the fact that hey, I'm not hearing as well, and you need so much more effort to be able to hear clearly. Does that answer your question? Yes. Sorry, yes.

SPEAKER_00 34:04

Um, I had an audio screen a couple of years ago. Uh huh. I don't even remember what audio company I went to for the screen. Uh-huh. The screening uh was very possible, just one sound. Okay. Yeah, so they didn't talk uh hearing. They said me on my wife said, you're fine, but they they said this is we're establishing a base. Correct, correct. Uh is is that something I can if I can find out who I went to, get that information.

SPEAKER_07 34:38

Yes, and bring it to us. Yes. So as it says in here, our um hearing tests are free. You make an appointment, we test your hearing. If you have a baseline from somewhere else, it would be great because now we can compare what your progression is. But if you can't find it, then tell patients it's okay. Because we can't really change what it was. We're gonna test you today, we're gonna start today, find out where you're at, what you're looking at. If you have hearing loss that's significant, then we'll get you help. If you're still good, we have a baseline with us, and then we kind of follow you every year from there. Absolutely. Other questions? You guys are quite much.

SPEAKER_04 35:26

Yes, sir. I have one question. Uh huh. If you're a heavy relaxer, do you recommend open counter medication for that heavy laxer?

Early Signs You Might Miss

SPEAKER_07 35:35

Yes. So um wax is a major, major enemy of good hearing. It's a it blocks your ears, it increases your chances of tinnitus because, again, it's a plug in the ear, it increases your chances of ear infections, it makes your ears itchy, it can affect your balance because again, it's just like a plug in your ear that causes hearing loss. Um, generally speaking, I tell every patient when you go to your family doctor, which most people go every year or every six months, have your family doctor check your ears and actually tell you if there's wax in there. Because I cannot tell you how many times I have patients that say, Well, yeah, the doctor took a peek in my ears and everything's fine, and then they come to me and I have to sit there half an hour and try to remove wax because they are fully impacted. Um, hydrogen peroxide, you don't really need medication. You can get over-the-counter drops at the pharmacy, um, or you can just use plain old hydrogen peroxide. Put it in the ear, leave a few drops. I tell patients that have a lot, do it every month, like pick the first of the month, do it for three, four nights, take a hot shower afterwards. Some of them come with those little pumps that you can kind of help it come out. But yes, wax is a major problem for both ear exhaust and for hearing devices because when you have you wear hearing devices and those are blocked with wax, they're pretty much not doing you any good. So, yeah, we spend about half of our day either cleaning wax out of ears or cleaning wax out of hearing. Yes. Perfect. Other questions? Any more questions? This is your time to shine. And away. Well, maybe I'll I'll give you guys some pointers to make you think about your own journey to hearing loss. Hearing loss. Very insidious, generally speaking. Very gradual. It comes on through the years. What does the brain do when you came here? It compensates, so you don't really notice it. You're like, eh. So it's always the other people that notice it first. I cannot tell you how many patients I have that come there because their family members have wanted them to get tested. In fact, if I had to pick to put statistics to the first question on the questionnaire is what motivated you to get tested today? Guess what's the number one statistical answer? My wife. My wife. I would be like, sir, what brought you in today? My wife. So um it is the family members that notice it. As I said, generally speaking, men have a higher prevalence of hearing loss than women. So um the women will pick up on it first, right? TV is loud. You say what? You lean in. You withdraw because if you can't hear in the group, after asking what a couple of times, most people kind of feel embarrassed. People want to kind of just let it go or just laugh along and nod along and not know exactly what happened. Um asking what? Asking for repetition, struggling in background noise. Background noise is generally speaking the first situation when most people, even the ones in denial, will notice a difference and will say, yeah, I mean I do fine in quiet, I can hear you, it's a quiet room, one-on-one. But if I'm in background noise, then I'm gonna be struggling. And that makes sense when it comes to the types of hearing loss. Most hearing loss, as we grow older, is generally speaking what we call the high frequency or high-pitched hearing loss. So what people miss the most is the higher pitches. Higher pitches are super important for speech. So when I explain hearing loss to patients, I tell them you can have a generally flat loss, so you just need volume to hear better. But most people have what we call this high-pitched loss, where what you lose is not necessarily volume, but you lose clarity. So people say, I hear it, but I just can't make out the words. So if I say fox, sox or box, you're supposed to hear that little small difference in the consonants to be able to tell what word I'm saying. Now, if there's background noise, if there's distance, if there's other people talking at the same time, and you have a little bit of hearing loss, it's gonna be much harder for you to make out that word. And that's what people say, I hear it, but I can't understand it. Does that anybody find themselves in a good position? Ever? No. Everybody has perfect hearing here.

Background Noise And Realistic Expectations

SPEAKER_02 40:26

Yes. And the new newer hearing aids, my friends that wear them, the biggest complaint they have is that if they're in a restaurant or somewhere there is background noise that they can't hear is right. Absolutely. So what the newer hearing aids and hearing devices, do they handle that?

SPEAKER_07 40:44

Yes. So that is an amazing question. Most people will tell you either I can't hear background noise when they don't have hearing aids, and then they get hearing aids and they say, I'm still struggling with background noise. So that is the hardest thing for a hearing aid to accomplish, right? To separate speech from background noise, because they've kind of share the same sound wave. So we're wanting a hearing aid to do this differentiation for you that normally happens in the brain. What our latest hearing aids do is they now have a two-chip technology. So before we used to have both the sounds of the background noise and of speech getting processed through one chip or one computer and kind of relying on the hearing aids microphones to pick up certain speech. So we would tell people when you're in background noise, try to turn around and look at the person you wanting to hear. Because we were relying on hearing aids to kind of turn the microphones and pick up speech more and still hear some of the background noise. What's happening with our latest technology that's been out for about two years and is the very first of this kind, it's the two-chip technology. So now we're not relying on directionality anymore. Now we're relying on one chip literally working on speech and the other one working on background noise. So for most of our patients with the newer technology, they see a significant difference. With that being said, hearing aids are not normal hearing. I tell this to patients. It's very important for me to present to the patients what improvements they can expect. But also let's talk about realistic expectations, right? If there's 30 people in a room and there's music going on and everybody's talking, I have perfectly normal hearing and I still struggle to some extent. So it's very important to have realistic expectations. Are we gonna hear better with hearing aids? 100%, 150%. Are we gonna hear perfect? It's never gonna happen. Just because no matter how much we beautify the sound and we fix the sound in the ear and we put it through these chips and we change it and we transform it, it still has to go to the brain. That's where understanding happens. And the older brain, or a brain that has lacked stimulation for many, many years, it's gonna be just much harder to make it work. That's why I say all the time, it's very important to catch it early, just like everything else. Any disease, you catch it early, you have better chances coming out. You've been without hearing aid for 10 years, you have a speech understanding score. What that means is we put you in the booth, we make the sounds loud enough for you to hear. So we're overcoming your hearing loss. And we want to see what your nerve can do with the sound when it's perfect. And I have patients that have a speech understanding score of 40%. That means that even when the sound is absolutely perfect in volume, in pitch, and everything, the brain is only processing at 40%. That's what long-term untreated hearing loss leads to. And as we are at this point, I don't know what will happen in 10-20 years. We still cannot fix the nerve. We can only fix the ears. But we can help the nerve along, especially if we start early. Does that answer your question? Thank you. Wonderful. Other questions? Very good questions.

SPEAKER_01 44:26

I'll just have a question about the you mentioned that alcohol use could affect your hearing and smoking as well. Have there been any studies to suggest or indicate how much alcohol you use or how much smoking I would take to damage your hearing?

SPEAKER_07 44:46

So I know for smoking for a fact that there are studies that have um that have related the smoking for many years to just overall health being decreased and also affecting your um literally your arteries and veins and the ears that are super small, the vessels. I don't know specifically about alcohol, what kind of amount of alcohol would cause hearing loss, but I do know for a fact that alcohol generally speaking affects all the pineal nerves. And the nerve of hearing is a cranial nerve. Other questions? We feel pretty educated about hearing loss. All the office if you want to get your ears.