Science & Medicine

The Empowered Patient — June 2012

Hearing is Empowering

by Michael Goldstein, M.D.

I gave in. After years of avoiding doing anything about my progressive hearing loss, I finally followed through with hearing assessment and remediation. On the first Friday in May, I received my new high tech hearing aids, and I am totally amazed at the difference it is already making in my life.
So, what do hearing problems have to do with MPNs? And, why did it take me so long to get help for my hearing loss? I will address both these questions in this month’s column, starting with the second one.

Like most folks with hearing loss, I minimized my dysfunction. The author of a March 21, 2012 editorial in the Journal of the American Medical Association (JAMA) noted that, “although 26.7 million US adults aged 50 years or older have a clinically significant hearing loss, fewer than 15% use hearing aids”.

Unlike many with age-related hearing loss (ARHL), I have been aware of my deficits for quite some time. An audiology assessment indicated moderate hearing loss in 2007, though I had noticed changes in my hearing well before then. It started with trouble hearing my companions or waitstaff when dining in a busy or noisy restaurant. I also began to have difficulty discerning dialogue when viewing a movie, especially when background music was playing, and as time went on, I frequently had bad phone connections or believed that whoever I was talking with was mumbling.

My experience is quite common. As noted in the JAMA editorial, “ARHL begins and proceeds insidiously and is often characterizedby the inability to understand words rather than the inability to hear, leading to the refrains of ‘I can hear you but I can’t understand you’ or perhaps more commonly, ‘My hearing is fine. You’re just mumbling.’

Though I intended to pursue obtaining a hearing aid after my 2007 assessment, I avoided following through despite my increasing frustration, and my family’s growing annoyance. My work was impacted as well, as I was unable to hear all the speakers on phone conferences or hear the comments of participants when I was leading trainings.
In hindsight, a number of factors contributed to my avoidance. Despite awareness that advances have been made in hearing aid technology, I couldn’t stop recalling images of the bulky hearing aids worn by my relatives that always seemed to be malfunctioning or emiting high pitched screeches that made everyone cringe.

Also, I didn’t like admitting that I had age-related loss of function, despite all the obvious signs. Afterall, at 60, I am not old, just middle-aged!

Living with a MPN also influenced my response to hearing loss. As a result of having PV, I have have tried to do all I can to live a “normal life”. It is hard work to manage a MPN, which perhaps distracted me from focusing on my hearing loss. I have attributed my most distressing symptoms, fatigue and cognitive slowing, to my PV and my treatment with phlebotomies and cytoreductive medications (especially interferon). Till recently, I wasn’t aware that hearing loss has been linked to impaired cognitive functioning and even the development of dementia.

As noted in the JAMA editorial, compared with individuals with normal hearing, those with hearing loss had a 2 to 5-fold increased risk of developing dementia. The reasons for this increased risk of dementia is not clear, though experts believe that hearing loss negatively impacts brain functioning and memory. Hearing loss can also induce embarassment and shame, causing many to shun interaction. The resulting social isolation is also associated with increased dementia risk, perhaps because of reduced brain strimulation.

The good news is that hearing aids are not only effective at boosting sound levels, they also improve our ability to understand speech, and thereby restore the quality of our interactions. I am enjoying not having to work so hard to listen. My wife was very pleased that I could hear her during dinner, despite being at a loud Cinco de Mayo celebration. And, the sound on our TV no longer has to be turned up to levels that are painful to those with normal hearing. And, I can again hear birds chirping, as well as the timer on our microwave. There are so many benefits to wearing my hearing aids. They are indeed truly empowering!

Take me back to the Contents
© Michael Goldstein and, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited.Excerpts and links may be used, provided that full and clear credit is given to Michael Goldstein and with appropriate and specific direction to the original content.

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