Author Tracy Markley on Why Hearing Care is Brain Care

Tracy Markley — acclaimed author, hearing aid wearer and fitness trainer who focuses on stroke survivors — joins Dave to discuss the many connections between stroke treatment and hearing loss treatment, the importance of shortening the time between diagnosis and treatment, smart uses for our Table Mic accessory, and the inspiration for her new book, “I’m Not Stupid, I Have Hearing Loss.”

Link to full transcript

Transcript

SPEAKER_03 0:02

Welcome to Starkey Soundbites. I'm your host, Dave Fabry, Starkey's Chief Innovation Officer. Our guest today is Tracy Markley. Not only is she an advocate for people with hearing loss and a longtime user of Starkey Hearing Aids, she's also an award-winning fitness specialist, author, and educator specializing in restorative and functional fitness. She joins us from her Pilates and Yoga studio in Long Beach, California via Zoom. Tracy, thank you for joining us on Starkey Sound Bites.

SPEAKER_00 0:32

Hi, thank you for having me.

SPEAKER_03 0:34

Yeah, it's great. I I I can see some of the equipment in the in the background. My wife is trying to make me an advocate for Pilates. She's been a longtime uh beneficiary of Pilates due to uh some uh neck fusions. She's had a couple uh uh fused uh discs, and and Pilates are about the only thing that she can do uh and really stick to and improve her flexibility and mobility.

SPEAKER_00 0:56

Yeah, Pilates you have to train deeper. Yeah, not just a weekend certificate. You have to get more education and knowledge. And so you get it's almost like physical therapy. So listen to her, you should go.

SPEAKER_03 1:07

I I am I'm I'm trying, so I'm I'm working on it. But uh well, first things first, let's talk a little bit about yourself in terms of what interested you in becoming a fitness specialist. And then also was there a specific catalyst? Um a lot of times on this on this podcast, we'll talk about what got people interested in hearing or balance or the areas that that we as a profession uh are are passionate about. What what made you passionate about a fitness specialist? And was there a catalyst that sent you in that direction?

SPEAKER_00 1:42

Well, when I was I I always liked to exercise, but I wasn't like I wasn't a gym goer. I just I I thought exercising felt good. And whenever I went through a hard time or I was sad or I felt like I was getting blue, exercise made me feel better. And then um I used to always do Tamilly Webb and Kathy Smith videos and some other ones too, but they're like the big ones I did, and that made me want to do it. So I wanted to become a fitness per professional, and but at that time you buy a manual about this thick. I put my finger to it. You read it and go take a test. I'm like, I can't learn to do that. So there's a local college that had a two-year fitness specialist program. So I took that and um right before I graduated, I got a call from someone who wanted to sell her business. She was running a space from a chiropractor, so I just kind of got into it. Some of her clients stayed with me. But when I was, but I was also working full-time in a pediatric office. I did that both for a while. But anyway, so her clients had stayed with me, and then the new clients I started getting, they had arthritis, mouth issues, back issues, fibromyalgia, all these diseases half of them I never heard of lupus and things I didn't know at the time. So I started studying deeper because I thought, well, how can I train someone if I don't know this stuff?

SPEAKER_02 2:55

Right.

SPEAKER_00 2:55

So I started just advancing out. Um so I got certificates and osteoporosis and fibromyalgia, arthritis, and just furthering things. And that just got me to be kind of known as a physical therapist type trainer. Then as time went along, I was in California for like 17 years, moved to Oregon, and I was in a senior community. I went there to live with my mom and stepdad. And um I started getting more seniors and stroke survivors, and the knowledge and work I did worked perfect for them. And so I started getting in just being known as strokes, you know, recovery and everything. And I've written some books on it, and um, and that leads into balance, stability, fall prevention, which also the hearing goes into that too.

SPEAKER_03 3:42

Exactly. A lot of those things that you mentioned where you're specializing in your occupation also have high comorbidity with hearing loss. Uh, many of those conditions also come along. Hearing loss doesn't occur in a vacuum, and uh and as you know, and and in many of those conditions, there are also increased risk of hearing loss if you have one or more of those conditions. And let's talk a little bit about that segue into your hearing loss and your hearing loss journey. When when did you acquire a hearing loss? And talk a little bit about um that if you don't mind sharing.

SPEAKER_00 4:19

Oh, I don't mind at all. So I didn't really realize I had a hearing loss till I was in my 20s or 30s. Um but when when I was younger, I did have hearing infections ear infections a lot. I remember that. And in the old days of the 70s, they always put like drops in your ears and all that kind of stuff. I don't think they do that anymore. And um, but I remember when I was three, I had to get my adeno out.

SPEAKER_01 4:42

Okay.

SPEAKER_00 4:43

And when and I learned as I got older, most kids you had the adenoids. I could be wrong, but this is my knowledge. The adenoids sits on the tonsils, so they took them both out. Well, they didn't with me, they took out the adenoids and I had to go to speech school and learn to talk again. I never understood why. And then about a year or so later, I got my tonsils out. And all I was just teased by my brothers and stuff, saying, I say words wrong. They would say, I instead of saying my brother Stephen, they said I said the O. Instead of saying the word yes, they said I said a bad word. And they just laugh when I asked them. So I don't really know the truth of it all. And I remember in third grade, I was having a hard time comprehending and reading. Like the teacher would read something, and then she'd give us questions and answered, and then like she didn't say any of that. So when the teachers talked to me, she would just say, Oh, honey, it's because your parents are divorced. Then I went into tutors and I called it dummy reading in English. And then I was always kind of having a hard time in English and reading. And um, but if I had a really good teacher, it wasn't as hard. She was a good teacher, but as I got older, I realized she might she might have been speaking in all the tones. And my hearing loss and nobody was paying attention. I had a hearing loss. So um as time moves on, here I am married, I have step kids, and they're like, You need hearing aids. So I got my hearing check and um I needed hearing aid. And then I pretty much warm ever since I I faded off of them for about a year and a half when one wasn't working.

SPEAKER_01 6:09

Okay.

SPEAKER_00 6:10

And then I had a kind of go through the phase of what you go through and you get new hearing aids again. But each time I get a new pair of hearing aids, they're still more advanced. So and my last pair before these I have now, are the Starkey of all AI now. I've got another pair of Starkey.

SPEAKER_02 6:25

Okay.

SPEAKER_00 6:26

That hearing aid the professional I was in Oregon thinks that was the first time I ever started hearing the letter F. It was like F.

SPEAKER_03 6:36

That's awesome.

SPEAKER_00 6:36

He thinks I they've all just thought I've been really good at reading lips. So for like the first two weeks, it sounded like everyone was going when they talked, but they really weren't. But that's what my brain could your brain adjust to it? Yes. The neuroplasticity and stuff. So my brain kept hearing long S's, but nobody was saying that. Then it then it sounded normal and yeah.

SPEAKER_03 6:55

Yeah, I mean, not unlike uh physical activity, it takes a while to uh climatize to hearing those sounds differently. And even after you've worn hearing aids for a long time, if these latest pair, the Evolve AIs, have been providing more high frequencies uh to audibility, um, it takes a little while to adjust to it.

SPEAKER_00 7:16

It does. And when I was learning that, but my the audiologist person that helped me in organ, I learned so much from I got fascinated with it. So I started thinking, God, my brain never hurt this down. It's adjusting, and I get dizzy a little bit and just adjusting, and I like was real aware of it all. But also, I work with it so much with my clients, I'm aware of their neuro issues because of structural covering and everything. But I was, you know, well, first of feeling it myself.

SPEAKER_03 7:41

Yeah, and and one thing I have to ask, given that you raised that you you uh uh clearly you you exercise every day and you're working with your clients, do you use the physical activity feature on the Evolve AI devices in the user app, in the Thrive app?

SPEAKER_00 7:58

I did sometimes, but no, not all the time.

SPEAKER_03 8:00

Yeah, I guess you probably know um when you're getting enough activity programmed throughout the day, you know, in terms of the steps and that whether you're standing for a requisite number of minutes every hour and whether you're exercising, you probably blow those out of the water. But one of the things you know, maybe, but but in light of the issues that we talked about with comorbidity with other health conditions, we know cardiovascular fitness and car um and hearing loss are very closely aligned. People with uh hearing loss in many cases have associated elevated risk of stroke, of uh high blood pressure, uh, of uh a number of diabetes, elevated risk and comorbidity. And so that's where we find that by incorporating sensors in Evolve AI, which was a continuation of what we began back with Livio in 2018, um, encourage people to be more physically active because we say hear better, live better. And that really does sort of segue into some of the clients that you've worked with, um, maybe recovering from some of the conditions that they had, or as you're working with them that also had associated hearing loss. Can you talk a little bit about that? Or are there any specific clients that have given you permission to sort of talk about um their journey with you?

SPEAKER_00 9:20

Yeah, they're they're fine with that. Um so I've had well, the visual too, you know, the visual makes the difference and how the brain works at all.

SPEAKER_02 9:28

Huge.

SPEAKER_00 9:28

But I've had clients, you know, many of my clients are stroke recovery or stroke survivors and stroke recovery, they do have a hearing loss. They're hearing whether their visual visions affected, you know, all these different things. And um, but and like when I'm working with people that are seniors, well, some people have mini stroke, some people have big strokes, but either way, it does affect their brain and it affects their balance. And my clients who don't wear hearing aids, they have a harder time if they're in that condition, they have a harder time with their balance. And the ones that wear hearing aid that forget them sometimes, they have a hard time balancing when I'm with them. So I have this one man who's 80. I don't have an or he's an organ client. We trained about eight years together, he was eighty-three or eighty-two, I think. He would walk across posing balls, he was very good in shape. Um so he'd some days he'd kind of stay on the post ball, they wouldn't be balancing so well. Did you forget your hearing aid? Yeah. But it took me a few times to put that together. And I had this other man who um, you know, because not wearing hearing aids as I'm I assumed I'm right. Um, my studies have shown you can be more prone to getting dementia if you don't wear your hearing aids as you they're aging. So some of my male clients who are older, their wives tell them to get hearing aids, and they are like, don't want to wear them. Once they train with me and I tell them that, they go get their hearing aids, and their wives are like, How'd you get them to get them? I've been telling them for five years. I'm like, I just mentioned dementia, and they go out and get them quickly.

SPEAKER_03 11:01

You know, that's really uh an important point. And we think, you know, my parents who were uh more from the traditional generation were concerned about cancer and cardiovascular disease, but among baby boomers in particular, we're seeing, but but even among those traditional generations, the 80-year-olds that you're mentioning, I mean, we've all um had family members uh who've suffered from dementia and cognitive decline, or we uh maybe are seeing a little bit of that in ourselves as we get older. Um and there's nothing that really will get a baby boomer uh uh attention faster than start talking about the impact of untreated hearing loss and those delays. And we know it's often a five to seven year period of time from the time someone thinks they may have a hearing loss until they act on it. Uh and it's often the case that um primary care physicians will say, don't worry about it. You know, hearing often is a aging is often accompanied by hearing loss. And just your nor your hearing uh is normal for your age uh is uh a statement I frequently uh uh have heard from patients when they inquired about hearing aids with uh a physician in in that routine care. And and we really think that it's so essential to hear better, live better, to shorten that delay from the time that um you think you have a loss until you move into action. But I think the other point you raise is uh the statement has been said, you're never a prophet in your own land. And spouses, I think, um often are frustrated in that they may say the same thing and they've been saying it for years, but until someone else sort of points it out and and brings it into the discussion whether it's hearing and hearing and balance and and the use of of hearing aids uh and that link to really keeping as sharp mentally as possible is so important.

SPEAKER_00 12:55

Yeah. Another thing I noticed with hearing aids that I I like my hearing aids and batteries. I don't want to charge them, I like changing my batteries and wherever I can be. But now that they have hearing aid that can be recharged, that's good because that really helps people who are older or maybe one of their hands don't work well, arthritis or something, because they don't have to do things with the batteries, they just have to put them in. And I thought that was really good. That helps when I say something to some of the older people about that, that helps too.

SPEAKER_03 13:24

For sure. You know, anything that helps the ease of use, with they have arthritis or neuropathy, or and especially stroke victims, uh people with stroke who've let me think that again. Especially those individuals who've had a stroke may often have neuropathies associated with it or manual dexterity issues and complications after their stroke that uh the rechargeable batteries really do serve as an important component uh for ease of use.

SPEAKER_00 13:53

Yeah, when I had a client, he did pass away, though. My very first book was Um Dear Stroke You Suck, A Journey of a Fitness Center and Strokes Whatever. He wanted his story shared. And so but he passed away before the story came out. He had to get a heart surgery, and there was actually an error was made. He he was something he should have came through, so it was kind of sad. I trained him for almost four years. Anyway, he had he couldn't feel cold or hot on his hand. But he never told me that. But he was very aware, he was very aware of um spatial awareness and stuff. I'll have to tell you one of those stories. But anyway, so he was using he was way way advanced now. I met him at a walker, but this was a year or so later. He's doing like a plank position with a bosom ball upside down, holding the plastic, you know, the side of the bosom ball. And he goes, Oh my god, I can feel the ball. I'm like, what are you talking about? He goes, Well, I never felt it before. He goes, I knew my hand was on it, but I never felt it. So he got up, went to the refrigerator, I gave him cold water, and he felt the cold water. So right in front of me, he got his senses back of his cloth and cotton cold in his hand. He was amazing to train, get all kinds of things like that.

SPEAKER_03 14:58

Well, I'm sorry that he passed before you got to see his uh story published. I mean, yeah. Talking a little bit about um the the patients that you've worked with who have had strokes, um, I think a lot of maybe, you know, a lot of the people that are going to be listening to this podcast are audiologists and hearing instant specialists. And maybe let's segue a little bit into some guidance that you might have for them in terms of thinking about the hearing as one component of the overall patient, particularly those who've suffered a stroke. And and one thing that some professionals may or may not be aware of in the literature is that um people who have a sudden onset of their hearing loss are at an elevated risk of stroke, partly due to the concern over restricted blood flow that can cause a sudden drop in their hearing, but it elevates the risk of a stroke by 1.6, 1.7 times. So nearly double the risk. Yeah, and and it's particularly those who have a sudden drop in their hearing. So one risk factor, according to the literature, should be that that sudden onset hearing loss uh might it might be important for them to seek help from their physician, from their cardiologist or their primary care physician to see if there are any risks associated with that uh causality, if you will, between the drop in hearing and the potential risk of a stroke.

SPEAKER_00 16:23

But um, could that also mean they had a mini stroke and didn't know it?

SPEAKER_03 16:27

You know, it's entirely possible. I haven't found any studies that have suggested that, that it might have been a precursor, a mini stroke or a precursor to the larger stroke. But um but certainly we've seen raised awareness in the literature for that importance, in particular for individuals who suffer either a one-sided or or bilateral uh sudden onset hearing loss, that uh that it is accompanied by an elevated risk by uh 1.64 times over those individuals who haven't had that sudden drop in hearing of a stroke.

SPEAKER_00 17:02

Well, that's good for me to learn that. I always know the other side of it, what happens after.

SPEAKER_03 17:06

Yeah, and so let's talk a little bit about that in terms of some of the differences between expressive and receptive communication and how uh that impacts uh the individual.

SPEAKER_00 17:18

Well, you know, excuse me, some of them get aphasia and they can't speak well. I had a client who it was they came from New Jersey in their 80s to Florence, Oregon, 3,000 miles away to train with me because they actually were getting um professionals that didn't have education. That's what made me write some of my books. I'm like, how are they pretending? So anyway, they actually flew, they lived for a month in a small town to train me. I was just I can't even say it was like excited, sad for them. It was like amazing, you know, all this stuff. Anyway, well, he had aphasia and he couldn't speak words, he could say yes or no, but he said them backwards. But I could tell after a day or two being around him by his eyeballs what he meant. So he might say yes, he meant no. But if we sang a song, he could sing all the words. So he can sing the happy birthday song like nothing. My dog used to train with us, he used to sing happy birthday. So we would sing, he would sing. Your dog saying happy birthday, or he sang happy birthday to the dog.

SPEAKER_03 18:19

Okay, oh, that's hilarious.

SPEAKER_00 18:20

But the person would sing the words completely clear. Yeah, my dog was very special. He used to work with me in past two. Um anyway, so that's one communication thing that happens after stroke. He I I don't know how that affects his his hearing because I couldn't really discuss it with him. I don't know how aphasia affects hearing, but I know verbally they can't get it out.

SPEAKER_01 18:41

Right.

SPEAKER_00 18:42

But it was interesting how the brain works and it can sing, but it can't speak.

SPEAKER_03 18:46

Yeah, that that temporal pattern, the rhythm from singing often is an assist. I mean, one of one of my best friends and longest friends, my uh from freshman year in college, unfortunately suffered a stroke at the age of 47. It's now 15 years later. Um, you know, a lot of times people think this is only an affliction of the elderly, but uh out of the blue, um he suffered this stroke. And he talked about the fact that uh while he saw recovery quickly within the first couple weeks to what he guessed was about 80% of where he was before he had the stroke, then it took another six months before he got up to 95%. And that was really through working with oral rehabilitation, working with both an audiologist who um was ensuring that um hearing uh was uh up to snuff, and it was, and then a speech language pathologist working in collaboration uh to provide the oral rehabilitation.

SPEAKER_00 19:47

So he had good care.

SPEAKER_03 19:48

He had really good care, but a lot of them don't. You know, and but even in the good care that he had, and he got up after about a year, he got up to about 95 percent of where he wanted to be, but then his insurance benefit ran out. And so he said subsequently he has seen some regression um back to maybe 80, 85 percent. And and so it would be interesting to see if from an insurance benefit staying with it, you he often wonders you know, uh how we could get back up to that level again. And obviously, uh you can go through the training and uh but but the insurance to really raise awareness for the importance of that oral rehabilitative component and working on expressive and receptive, because like you said, the expressive and the receptive are both critical. That uh person with aphasia, um, he he said, my friend said that you know he could understand what was being said to him, but he couldn't come up with the words to be able to uh get the language out and to get the words out to to let people know um uh what he was uh able to comprehend during those early stages.

SPEAKER_00 20:54

And plus well, two things. One, well, my second book is Stroke Recovery What Now. Okay when you cover when you recovery your when you insure what's the name of it, your insurance ends that your recovery continues. Because basically they only give you so much insurance benefit.

SPEAKER_02 21:08

Right.

SPEAKER_00 21:09

And a lot of stroke well, this is a lot of diseases too, but a lot of stroke survivors just feel, oh my therapy's over. They say they can't help me anymore, therefore there's no more advancement to make. Well, that's not true. Right. I mean, in some cases, possibly it depends on their brain, but in most cases, if they keep going, you know, they may eight months have something happen, and you're I mean, I've trained people three, four years after and they're still making progress. You know, the brain has a lot to do with it, but it also having someone with a knowledge around them because some like in any in in any profession, you take your basic stuff. Like you can, you know, I used to do hair. You get your license, but if you want to do better at hair and perms, you go take advanced color, you take advanced stuff. Well, just like a personal trainer or doctors or physical therapists, if you just get the basic, you have to go specialize in something. So there's a lot of physical therapists that don't go to the specialty, so They just do the same things with every stroke survivor, and it doesn't work for all of them. So they're not like a pa it's not a cookie cutter healing.

SPEAKER_03 22:08

Yeah, I mean, we really that'll resonate, I think, with a lot of the audiologists and hearing instant specialists listening here is that it's not simply a matter, every hearing loss isn't the same because you're not just testing two ears, you're testing an entire person and evaluating what sorts of fears and concerns and expectations that they have for where they're going to benefit. And I think that's whether it's physical therapy or whether it's uh audiology, um, you're still trying to understand the person and their unique uh uh combination of lifestyle and hearing loss and symptoms and family support that factors in, and you can't treat it like a cookie cutter method.

SPEAKER_00 22:46

Not at all. Plus the other thing I was I brought up spatial awareness. So you have pro-preception of spatial awareness and and you know they work work together, but they're a little different. Basically, it's your your your brain and body awareness of your surroundings and what's coming up in here. And so my one client that was in my first book, he he was he was just I learned so much with him, he was just aware of everything. So I never actually explained to him what spatial awareness was, but he was sp standing on a balance disc, which um I things happen on the balance disc. When your your central nervous system is stimulated, I saw people they can speak quicker, they can read better, they were able to see the colors better. I held in front of them. And always wanted an audiologist to test somebody's hearing on a balance disc and see if it's different. I haven't got anybody to do it yet. Anyway, so we were he was standing on the balance and he goes, Oh, I gotta tell you something. So he got off, and this is what he said. He goes, Okay. I know there, I know there's cars on the street, I know someone's working out in the gym next to me, but I don't feel them in my space. So he basically just says, I don't have spatial wearing. And he did have a little bit of peripheral loss on one side, whatever side he was on. And and I know his hearing was affected because he didn't know someone was in this space until they showed up right here. He didn't he didn't hear them, he didn't feel them in his space. Then maybe about a year working with them, he goes, you know what? I feel like my whole world just went out to hear.

SPEAKER_02 24:21

Wow.

SPEAKER_00 24:21

Like he got it all back. So you can the further people keep working, it's a you don't know what's coming back next. It's not like step one to six in order. It's like that your finger may come back, your hearing, you don't know what's happening. So you just keep doing stuff.

SPEAKER_03 24:38

Right. I mean, the brain is such a remarkable engine and and the most um comprehensive computer that exists on the planet. And when you think about with a stroke, with damage to one or more regions in the brain, as you say, it can manifest itself in terms of hearing damage and associated vision and then balance and proprioception and spatial awareness, and you don't know they more they may all recover at different rates and respond to different forms of treatment. As you said, again, that cookie-cutter method doesn't apply uh the same for everybody, and and you have to be willing and able to adapt as the patient is starting to recover. One thing we find, you know, with with the importance of involving an audiologist to ensure that hearing thresholds are, you know, where they are, how impaired they are after a stroke, in some cases with there's uh blood interruption or the specific region in the brain that's been damaged can affect the hearing, and then, as you already alluded, can cause aphasia or it can cause receptive or expressive communication difficulties. But then that spatial awareness is really an important one and one that we focus on with non-stroke patients to just ensure that when we're putting hearing aids on both ears, that they're serving as sensors to the brain, and that they're preserving that ability to not only detect when a sound occurs and where it occurs, so that they can use that information and feed that to the brain for those other uh overall system benefits such as balance and spatial awareness.

SPEAKER_00 26:18

And it's full-on fall prevention. Yeah. It's safety and fall prevention for people, especially seniors, that they, yeah, if they can't calculate how high to lift a foot or how far to reach an arm, or if this sounds here or there, it they're gonna fall down.

SPEAKER_03 26:32

Such an important point. And we know that even a mild degree of hearing loss without a stroke, that a mild degree of hearing loss elevates your risk of falling by about three times versus somebody who is the same age group but doesn't have a mild hearing loss. And then as you get more hearing loss, sort of the the cognitive load, as you say, all of the systems that are going into place to keep you from falling become challenged more. And uh and so working when you think about even uh independent of the stroke risk, just working with anyone with a hearing loss and aging to preserve that balance function is essential. And when you add a stroke into that, it makes it even more important. And the the training that you're uh providing them uh is essential to preventing a fall from occurring because as we know, the emotional and economic costs of falling are significant.

SPEAKER_00 27:30

Exactly. And plus quick reaction time. If when you're you know you you're a little cautious and you're hearing what you hear and your movements and you're and you're slower, or you see older people start shuffling, they're not doing the natural rotation of the spine where they walk, they start shuffling. Well, now things aren't lined up for good movement, and so the reaction time. So if they need to grab something and not fall, they're behind time. They can't do it quick enough.

SPEAKER_03 27:59

Absolutely.

SPEAKER_00 28:00

So it plays into all that as well.

SPEAKER_03 28:02

Yeah, and and and so working hand in hand with improving, and again, yeah, I'll go back to again that one of those features in Evolve AI that um you mentioned and and I mentioned uh of looking at physical activity, standing, and exercising can assist if there are patients you're working with who are recovering from stroke, getting them to uh uh adapt and and modify their targets every day from maybe they start out with 2,000 steps a day and then get to 5,000, then to 10,000. That's adaptable in the user application, the Thrive app, to encourage them to be more physically active as they're undergoing their recovery, trying to stand more. And then we even have a feature which you may or may not be aware of in your Evolve AI devices that can uh alert up to three contacts if you're wearing your devices. It'll send them a text if you suffer a fall while you're wearing your hearing aids.

SPEAKER_00 29:01

Yes, they did know that one.

SPEAKER_03 29:02

Yeah, and you know, so important. We often think again, in the same way that uh some people think, well, strokes are only for older people, falls are only for older people.

SPEAKER_00 29:11

And and again that's exactly what my hearing professional told me because don't think because you're in your age that that part doesn't fall in.

SPEAKER_03 29:18

Yeah, I mean, any age, we've heard many, many stories among professionals and patients alike that didn't fall right in the traditional um spectrum, if you will, of what preconceived notions are for fall risks. They had a hearing loss and they suffered a fall. And and having that peace of mind to know that family members or friends or colleagues or professionals can be alerted in the event that they uh they suffer a fall because we want uh, and I think this is comes back again with the physical therapy aspect of this, really having a fall detection feature is great, but the long view is to really try to work to prevent a fall from occurring before it does.

SPEAKER_00 29:57

And also posture. Posture. I know people say core. Well, I've been working with core before, like core became a fad because that's for spine and spine rotation and you know preventing back injuries. And then it you know came out further. But when your posture's poor, you're rounded over. One, you're gonna fall more because you're leaning forward, you're not lined up, your joints won't work as well, your arms and your hips, and you can't have quick reaction time. But also, my studies have shown the more you're in proper posture, the better the brain can communicate to the spinal column because you're not all rounded over, which that plays into everything.

SPEAKER_03 30:34

And I guarantee you, everyone listening to this podcast or watching you right now is trying to straighten up a little bit more and uh and they're probably trying to straighten up by throwing their shoulders back, not by engaging their core and holding their self up their center.

SPEAKER_00 30:47

So the centers I always describe it like the tree, the tree trunk. If the tree trunk is hollow and kind of weak, if it's an apple tree, when it starts growing apples, they're gonna fall off, the branches are break, the tree can blow over from the wind. But if your core is strong, the branches stay strong and the wind can blow, it's not gonna blow you over. So the core is essential. That's like the the trunk of the body, the trunk of the tree. And and when I work with stroke survivors, the ones that can get their posture better, they're the ones that can get their arms moving better, they can fix their drop foot better because you have to balance the shoulders and the hips, and it's all and then the brain, I think works better if it's not trying so hard to send messages in poor posture. I know they don't put that out there, but that's what I see.

SPEAKER_03 31:32

Well, it is, and they talk about the cognitive load in terms of if you can get your posture under control so that it you can sort of not have to be so conscious of thinking about it, and you just are working with that core uh or or that that that core strength to keep your posture um uh to prevent that risk of falling, then you have more cognitive reserve left over for some of the other essential functions.

SPEAKER_00 31:57

So you think of when when you see a baby trying to learn to stand up, it doesn't just stand up and start walking, it stands, but it's building its core and the spatial awareness and the skills of the brain, stabilizing before the limbs move. And that's kind of like when people start getting default prevention mode, you know, seniors need default prevention care or stroke survivors or MS or whatever people are struggling with. If the center of the body almost retrains like it did as a kid, because that's what it knows. A lot of people start making them do things and like you can't squat 50 times and train your core for balance. That's you're going backwards. It's it's you know, you have to start from the way the brain the that's how I train, the way the brain knows, the natural sense of how it developed. Kind of go back to that mode, and you know, and it seems, I mean, in most cases I work, it works that way. And yeah, I think kind of common sense logically.

SPEAKER_03 32:54

For sure. And and and I think you provided some important tips in terms of working with stroke patients and the recovery and the need for physical, uh, expressive and and receptive language, um, and uh that recovery that can't be a cookie-cutter method are all really important reminders that serve well for the audiologist, and then thinking about the whole patient. Now let's come back to your experience with hearing loss a little bit before we close. And I see already the time has just flown by here, but um the one of the things um we've seen with the transition from hearing aids as standalone devices to those that now use Bluetooth that can be connected directly to a phone also enables a connection to accessories like uh a remote microphone. And have you used any of the remote microphones or the table mic or any of the other features beyond the hearing aids alone? And tell us a little bit about your experience with the table mic.

SPEAKER_00 33:54

Can you I don't know if you can see my balance bar on the wall. I can. There's a ballet bar. Okay. Well, they're up on a by a rack that's metal.

SPEAKER_01 34:02

Yep.

SPEAKER_00 34:03

Metal rack. Okay. Well, I have one girl I trained who's a stroke survivor, just a little bit of aphasia. And when she faces the wall, I can't hear her.

SPEAKER_01 34:10

Sure.

SPEAKER_00 34:11

I mean, I can't hear her. Her mom's with there to help too, but it's kind of hard to hear. So I took, I don't have it with me, but it's round. I don't know. I I tried to get mine to have with me, but I think it's at home right now. Anyway, I stuck it on there one day, and I don't know if it's actually very magnetic, but it stuck up like a magnetic. No, it is.

SPEAKER_03 34:26

There's a magnet on it, yes.

SPEAKER_00 34:28

Okay, well, it stayed there. And it made me hear her more, and I thought, well, that's kind of cool. So you can use it not just at a table and meeting. So I used it more here because when I've been at um conference type things, it wasn't really environment for me to use it.

SPEAKER_03 34:46

Well, well, explain that. I mean, uh as long as you can either put it in a restaurant and put it in the middle of a table, or you could use it, you could hang it around your neck. There is there is a neck loop, that accessory that comes with it that has the magnet that then affixes the table mic to the magnet. So the the the accessory is the magnet, and then the table mic attaches to it, or if that board behind you has a magnet on it, it will do the same. And you can use it in uh a classroom where you could put it up on the podium uh or in a place of worship or something like that. You could put it up near the lectern um to hear that person speaking clearly. But um I would encourage you to try it even in more situations than you have. The the one you gave, the example of the patient with aphasia who's hanging on to your balance board, but then limiting your ability to lip read them and hear them as clearly, can really help. And they could even um wear it uh easily around their their neck during your session as well, so that you could hear them the entire time.

SPEAKER_00 35:49

And one reason I didn't use it at some of the things I was at because the hearing aids were working so good I didn't need it.

SPEAKER_03 35:56

Well, even better.

SPEAKER_00 35:57

Because I could do the audio. I was able to change these. I couldn't do that in my older ones. But these I could like click at the auditorium or you know, you do the tap tap and it goes up. So but I I don't I so when I was in college, I always sat towards the front of the room, slightly left. I knew I didn't hear well in the left ear, wouldn't think much about it. So I thought it was just quirky because I did really well in classes there. So whenever I go someplace, I'm always there. So I was at a conference in San Francisco in the front row, listening to the speaker, slightly left right there, and I heard everything he said, even when he was facing the other direction, because sometimes they pace back and forth, they put their head down, I don't hear all the words. I didn't miss anything with him. So I didn't need the thing. I had it with me because they heard him so well, so I didn't even take it out.

SPEAKER_03 36:43

Well, yeah, if the hearing aids work alone without the need for the accessory, that's the best case scenario. But then still having that capability in addition for those times that are really challenging is great.

SPEAKER_00 36:55

But I'm and these people had very clear voices. There's still those people that you know like what? No matter how good you have, they still mumble or they're or they're speaking in time. I can't understand you. I would pull that up. If the speaker was like that, it probably would have been a good time to pull it out.

SPEAKER_03 37:11

Yeah. Well, I'm glad that your experience has been so positive with this. Now let's talk uh in the closing time here. Let's talk about your latest book. What's that one called?

SPEAKER_00 37:19

My latest book is called I'm Not Stupid. I have hearing loss, a story of hearing loss and hearing aid, including hearing and brain care tips. Because I always tell my people, hearing care is brain care.

SPEAKER_03 37:33

Absolutely. Your ears are sensors and your brain is doing where the work is. And so um uh what's one key take-home message from your book, and then that can serve as a catalyst for people to go out and buy it too.

SPEAKER_00 37:47

I would say one of the things is don't be afraid to wear hearing aids. People don't see them. I mean, randomly people see them. But anyone who noticed my hearing aids are people that know someone with them when they are aware of them. Most people don't notice. So if you need hearing aid, don't not get in because you think someone's gonna make fun of you or something. I mean, I don't think most people even notice. And the things you can hear. I mean, you if you don't wear your hearing aids when you need them, you'll start staying home more, you'll get isolated, you won't go to certain events. And then also, um, it's good brain care because of what I've been learning and studying and all my experiences and what the audiologist I talk to teach me all these years is because I'm 50 I just turned 57 last week. If I wouldn't have got hearing aids in my early 40s or late 30s, or if I got them, thank you. Um and I didn't get them to now, I would probably have some social issues right now. And I may not get some of them back if I got hearing aids right now. I went I would have gone too long without them.

unknown 38:51

Yes.

SPEAKER_00 38:52

You know what I'm talking about. You can try to explain that better.

SPEAKER_03 38:55

And and the in and the shortening of that delay from that five to seven years or longer, think about all of the auditory moments you would have missed if you hadn't uh been able to hear with your hearing aids over that last decade or so.

SPEAKER_00 39:10

And I and I I feel like I'm I can read and write better. That's uh I share that in the book too. So I like I said, but I'm I couldn't comprehend very well unless the teacher's really good and loud and they're in my face.

SPEAKER_01 39:22

Yeah.

SPEAKER_00 39:22

Um so I feel like I'm a faster reader, a better reader. And since I've worked more hearing aids, I became an author.

SPEAKER_01 39:31

Yeah.

SPEAKER_00 39:31

Because when you hear the reading, reading skills play into your hearing skills.

SPEAKER_03 39:37

No question. No question.

SPEAKER_00 39:38

As children and everything, yeah. So it's helped me all around.

SPEAKER_03 39:43

Well, we thank you very much for sharing. I am gonna touch on that last point in terms of the hearing moments that you might have missed in the last decade. One tradition that we have on the Soundbites podcast, given that we are focused on auditory moments and how they enhance your life. What are some of your favorite sounds that you enjoy listening to? Whether it's music or whether it's nature or other human beings, what are your some of the favorite auditors?

SPEAKER_00 40:11

I like hearing birds outside the window. Okay. I like hearing birds in the morning. Um, when I first got my hearing aids, I felt I heard the leaves crunching under my feet, which you're loud again, like more nature thing. Um a couple weeks ago, it was about a month ago, I did, and this is my social media, I made a video on it. I was in my car and 80s songs is on. I graduated in a class of 83. Anyway, so I'm in the car and I'm like, what is that banging noise? It's kind of going to the beat of the music. And then I realized it was the tone in the song that I've never heard before. So I hear music now, and it's like, that's what the words are. I've been singing them wrong. So you hear I hear music better, the words better. But the funniest story was when I first got my first hearing aid, I'm driving home and I put on my blinker and I heard the blinker.

SPEAKER_03 40:59

Oh, yeah. That's such a common one that people will say, for the first time, I heard the blinker in the car.

SPEAKER_00 41:04

Well, I just thought any cars newer than what my parents had when I was a little girl, they didn't make blinker sounds anymore. I just thought it was something the cars didn't have. And I'm like, my car makes that noise. Oh, I thought it was like something they made in cars in the 70s and they stopped.

SPEAKER_03 41:20

But that's funny. Nope, they were still there. Your hearing was just changing. And, you know, there's uh the hearing loss association group has used uh uh the modification of this saying for for many years, and they say your hearing loss is more conspicuous than your hearing aids. And I think you really embody the generation of hearing aid users now who say, like you said, people don't notice, but even if they do, who cares? I mean, when you think about all of the the things that you're able to hear and that can enhance your life in so many ways that you'd be missing otherwise, that I think you know maybe that's a good place for us to end. And um, I'm really appreciative of your sharing the way it is that you're working with um uh stroke patients, uh, your personal journey with hearing loss, um, the way that you've shared on social media, and also uh through authoring numerous books that you've mentioned, I encourage people to uh go and look for um uh the latest book, which again you can uh can you say one more time is your latest book?

SPEAKER_00 42:22

I'm not stupid, I have hearing loss. Because if you don't talk well, sometimes people or sometimes we pause longer to process. I think people think we're dumb. It's like we're not dumb. We just give us a second. Slow down.

SPEAKER_03 42:33

Yeah, slow down, speak clearly and uh and enunciate. So well, Tracy Mark leads to it.

SPEAKER_00 42:38

And let us process it.

SPEAKER_03 42:40

Yeah, it's been an absolute pleasure to speak with you here today. And to our listeners, thanks for listening to this latest episode of Starkey Soundbites. If you enjoyed it, please tell your friends about it uh and tell them they can find it wherever it is on their favorite podcast platform. Um, subscribe so that they're sure not to miss a single episode. And I thank you again for uh sharing your knowledge with us today.

SPEAKER_00 43:05

Thank you for having me. I loved it.

SPEAKER_03 43:06

It's my pleasure.