Dear Doctor,
I must start this letter by saying I am exceedingly grateful to have had the opportunity to be treated by you. I recognize that you have studied Meniere's disease ad nauseum, published hundreds of articles about it, and traveled the world to attend and present at conferences on the subject. When I read about the struggle other sufferers have just in getting a diagnosis, much less appropriate treatment, I feel a bit guilty to have had the sheer luck of living close enough to be cared for by someone as competent as you.
But, as the person living with the frustrations of this disease, I feel compelled to tell you that I wish there was one more thing you would have encouraged me to do a long time ago: get a hearing aid.
Shortly after getting my last gent injection, it became apparent that my hearing had reached a new low, to the point that I now fell into the "severe hearing loss" category in that ear. I don't fault the gent, it gave me my life back by stopping the relentless vertigo I was experiencing. My hearing stunk before the gent anyway. So, at my follow-up appointment with you, I asked if I qualified for a hearing aid. You winced. I think you felt badly about the possibility that the gent may have stolen a little more sound from my world. I appreciate your compassion. You stated that some of your patients found that hearing aids made them feel dizzy. Considering what I had just been through, Lord knows I didn't want to do anything to make me feel dizzy. You also went on to say that hearing aids don't always help people with Meniere's disease due to the fluctuating nature of our hearing loss. All that being said, you kindly referred me to the audiologist in your office anyway. I must have looked pretty pathetic.
I met with the audiologist. A stoic woman, very matter-of-fact, but pleasant enough. She confirmed that my hearing loss was significant and proceeded to discuss a couple of models of hearing aids that might benefit me. After asking some technical questions, I asked about cost. I already knew my health insurance did not cover the expense of these little devices. She took a deep breath and said, "$1800 to $2000 - for one." Fortunately, I only needed one, but at that point I abruptly said I needed to think about it and walked out of her office, disgusted.
Three stikes: potential for dizziness, questionable benefit, and cost. So I groped for sound for the next two years. I kept a stiff upper lip while experiencing exhaustion, brain fog, hyperacusis, and further progression of my hearing loss. Somehow I managed.
Then last summer I had a new job opportunity handed to me on a silver platter. It was all but my dream job, working for a well-respected company and putting my years of professional experience to good use for the common good. This meant a new office with new coworkers. My previous employer and colleagues had lived my Meniere's journey with me and had been very accomodating. Coincidentally, my desk had been positioned such that my hearing environment was almost ideal and although I still had some difficulty hearing, I got by well enough. I had made the decision not to tell my new employer about my diagnosis. My interviewer informed me of the company's stringent physical exam requirements and an off-handed comment was made about a candidate who was once turned down for employment due to a heart murmur. As my current employer was going through some major changes at the time, which put into question my long-term job security, I felt I needed to do everything I could to secure this new job, so I didn't mention my hearing loss.
Two months into my new position, I was struggling terribly. Not only was I frequently asking people to repeat themselves, but I couldn't ask for any accomodations for my condition. Eventually, I did lightheartedly mention to a few people that I had some trouble hearing out of my right ear and could they please get my attention before speaking to me, but they quickly forgot and continued to talk to me with their head turned away from me or from behind my back. When I worked in the clinic with patients or taught group classes, I couldn't understand what was being said. I couldn't ignore my hearing loss anymore.
I'll skip the details of being evaluated and shopping for my hearing aid, but I eventually took the $1800 plunge and here's what I learned after getting this little beauty that I wish someone had told me sooner:
1. Stimulating the brain with sound improves hyperacusis, the condition of being hypersensitive to sound. It was hard the first few weeks, but I was persistent. Rarely did I take the hearing aid out, despite sound grating on my nerves at first. Eventually, the sensation virtually disappeared. Only recently did I read that avoiding sound actually makes hyperacusis worse. The brain becomes super sensitive to noise when it is deprived of sound stimulation.
2. Correcting single-sided hearing loss makes the brain feel more balanced. This is hard to understand until you experience it. Basically, I was always favoring my good ear, tilting, twisting, and relying on it to understand what and where sounds were.
3. A hearing aid helps drown out some of the annoyance of incessant tinnitus.
4. The cost of a hearing aid takes into account the multiple appointments with the audiologist usually required for adjusting the hearing aid, not only in the beginning, but for the life of the device. I have probably used up half the cost of the HA already with visits for fine tuning, excessive feedback, and questions that have arisen with day to day use. Considering this and the huge improvement in my quality of life that I've experienced, it feels like a bargain.
5. Hearing aids can most certainly help at least some patients with Meniere's disease, such as yours truly. My hearing isn't perfect, nor is my hearing aid ideal in all environments, but I most definitely hear better than I used to. I can sense where a sound is coming from more so than before. I ask people to repeat themselves far less often than I used to (a real plus for my family!). I can understand conversations better, even in noisy environments.
6. I did not experience any increase in dizziness. In fact, I felt more balanced and much less fatigued at the end of the day.
So, in hindsight, Doctor, I wish you had encouraged me from the very beginning to get a hearing aid. It seems you might have read an article or two along the way about the effects of hearing loss on the brain, as well as on the quality of life of people who are living with it. I understand, though, that you are in the trenches of this disease in your own way. You have focused your career on treating the worst this condition has to offer: vertigo, balance disorder, and extreme physical discomfort. I don't really fault you. But I hope in the future when the next patient asks you about the pros and cons of getting a hearing aid, you might have a more balanced discussion with them about some very real benefits that can be achieved by wearing a hearing aid. Most major manufacturers of hearing aids have a 30- to 90-day return policy. So what does your patient have to lose? What do they have to gain?
Respectfully,
Someone who lives with Meniere's disease
Wednesday, March 20, 2013
Wednesday, February 20, 2013
The Science Behind Addictive Junk Food
This post is not directly related to Meniere's but I think everyone can agree that following a healthy diet can only be good for us. However, making the decision to eat better can be difficult without enough motivation to do so. Being healthy is certainly one motivation, but for many of us it can wax and wane. Another motivator is to consider where we spend our money. Would you rather support farmers and industries that produce foods that are good for us or an industry whose sole goal is profit at any expense? If you need that kind of motivation, this article may do it for you. I am not going to copy and paste the whole thing here since it is so long, but I encourage everyone to read and share it.
The Extraordinary Science of Addictive Junk Food
By MICHAEL MOSS
Published: February 20, 2013 94 Comments
On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America’s largest food companies. Nestlé was in attendance, as were Kraft and Nabisco, General Mills and Procter & Gamble, Coca-Cola and Mars. Rivals any other day, the C.E.O.’s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it. While the atmosphere was cordial, the men assembled were hardly friends. Their stature was defined by their skill in fighting one another for what they called “stomach share” — the amount of digestive space that any one company’s brand can grab from the competition.
James Behnke, a 55-year-old executive at Pillsbury, greeted the men as they arrived. He was anxious but also hopeful about the plan that he and a few other food-company executives had devised to engage the C.E.O.’s on America’s growing weight problem. “We were very concerned, and rightfully so, that obesity was becoming a major issue,” Behnke recalled. “People were starting to talk about sugar taxes, and there was a lot of pressure on food companies.” Getting the company chiefs in the same room to talk about anything, much less a sensitive issue like this, was a tricky business, so Behnke and his fellow organizers had scripted the meeting carefully, honing the message to its barest essentials. “C.E.O.’s in the food industry are typically not technical guys, and they’re uncomfortable going to meetings where technical people talk in technical terms about technical things,” Behnke said. “They don’t want to be embarrassed. They don’t want to make commitments. They want to maintain their aloofness and autonomy.”
A chemist by training with a doctoral degree in food science, Behnke became Pillsbury’s chief technical officer in 1979 and was instrumental in creating a long line of hit products, including microwaveable popcorn. He deeply admired Pillsbury but in recent years had grown troubled by pictures of obese children suffering from diabetes and the earliest signs of hypertension and heart disease. In the months leading up to the C.E.O. meeting, he was engaged in conversation with a group of food-science experts who were painting an increasingly grim picture of the public’s ability to cope with the industry’s formulations — from the body’s fragile controls on overeating to the hidden power of some processed foods to make people feel hungrier still. It was time, he and a handful of others felt, to warn the C.E.O.’s that their companies may have gone too far in creating and marketing products that posed the greatest health concerns.
In This Article:
• ‘In This Field, I’m a Game Changer.’
• ‘Lunchtime Is All Yours’
• ‘It’s Called Vanishing Caloric Density.’
• ‘These People Need a Lot of Things, but They Don’t Need a Coke.’
The discussion took place in Pillsbury’s auditorium. The first speaker was a vice president of Kraft named Michael Mudd. “I very much appreciate this opportunity to talk to you about childhood obesity and the growing challenge it presents for us all,” Mudd began. “Let me say right at the start, this is not an easy subject. There are no easy answers — for what the public health community must do to bring this problem under control or for what the industry should do as others seek to hold it accountable for what has happened. But this much is clear: For those of us who’ve looked hard at this issue, whether they’re public health professionals or staff specialists in your own companies, we feel sure that the one thing we shouldn’t do is nothing.”
As he spoke, Mudd clicked through a deck of slides — 114 in all — projected on a large screen behind him. The figures were staggering. More than half of American adults were now considered overweight, with nearly one-quarter of the adult population — 40 million people — clinically defined as obese. Among children, the rates had more than doubled since 1980, and the number of kids considered obese had shot past 12 million. (This was still only 1999; the nation’s obesity rates would climb much higher.) Food manufacturers were now being blamed for the problem from all sides — academia, the Centers for Disease Control and Prevention, the American Heart Association and the American Cancer Society. The secretary of agriculture, over whom the industry had long held sway, had recently called obesity a “national epidemic.” Read more...
The Extraordinary Science of Addictive Junk Food
By MICHAEL MOSS
Published: February 20, 2013 94 Comments
On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America’s largest food companies. Nestlé was in attendance, as were Kraft and Nabisco, General Mills and Procter & Gamble, Coca-Cola and Mars. Rivals any other day, the C.E.O.’s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it. While the atmosphere was cordial, the men assembled were hardly friends. Their stature was defined by their skill in fighting one another for what they called “stomach share” — the amount of digestive space that any one company’s brand can grab from the competition.
James Behnke, a 55-year-old executive at Pillsbury, greeted the men as they arrived. He was anxious but also hopeful about the plan that he and a few other food-company executives had devised to engage the C.E.O.’s on America’s growing weight problem. “We were very concerned, and rightfully so, that obesity was becoming a major issue,” Behnke recalled. “People were starting to talk about sugar taxes, and there was a lot of pressure on food companies.” Getting the company chiefs in the same room to talk about anything, much less a sensitive issue like this, was a tricky business, so Behnke and his fellow organizers had scripted the meeting carefully, honing the message to its barest essentials. “C.E.O.’s in the food industry are typically not technical guys, and they’re uncomfortable going to meetings where technical people talk in technical terms about technical things,” Behnke said. “They don’t want to be embarrassed. They don’t want to make commitments. They want to maintain their aloofness and autonomy.”
A chemist by training with a doctoral degree in food science, Behnke became Pillsbury’s chief technical officer in 1979 and was instrumental in creating a long line of hit products, including microwaveable popcorn. He deeply admired Pillsbury but in recent years had grown troubled by pictures of obese children suffering from diabetes and the earliest signs of hypertension and heart disease. In the months leading up to the C.E.O. meeting, he was engaged in conversation with a group of food-science experts who were painting an increasingly grim picture of the public’s ability to cope with the industry’s formulations — from the body’s fragile controls on overeating to the hidden power of some processed foods to make people feel hungrier still. It was time, he and a handful of others felt, to warn the C.E.O.’s that their companies may have gone too far in creating and marketing products that posed the greatest health concerns.
In This Article:
• ‘In This Field, I’m a Game Changer.’
• ‘Lunchtime Is All Yours’
• ‘It’s Called Vanishing Caloric Density.’
• ‘These People Need a Lot of Things, but They Don’t Need a Coke.’
The discussion took place in Pillsbury’s auditorium. The first speaker was a vice president of Kraft named Michael Mudd. “I very much appreciate this opportunity to talk to you about childhood obesity and the growing challenge it presents for us all,” Mudd began. “Let me say right at the start, this is not an easy subject. There are no easy answers — for what the public health community must do to bring this problem under control or for what the industry should do as others seek to hold it accountable for what has happened. But this much is clear: For those of us who’ve looked hard at this issue, whether they’re public health professionals or staff specialists in your own companies, we feel sure that the one thing we shouldn’t do is nothing.”
As he spoke, Mudd clicked through a deck of slides — 114 in all — projected on a large screen behind him. The figures were staggering. More than half of American adults were now considered overweight, with nearly one-quarter of the adult population — 40 million people — clinically defined as obese. Among children, the rates had more than doubled since 1980, and the number of kids considered obese had shot past 12 million. (This was still only 1999; the nation’s obesity rates would climb much higher.) Food manufacturers were now being blamed for the problem from all sides — academia, the Centers for Disease Control and Prevention, the American Heart Association and the American Cancer Society. The secretary of agriculture, over whom the industry had long held sway, had recently called obesity a “national epidemic.” Read more...
Friday, February 15, 2013
More on Hearing Loss and Dementia
I posted recently about hearing loss and mental decline. Today I discovered author Katherine Bouton whose book, Shouting Won't Help, will be published on February 17th. While reading a little more about her, I came across the following article which goes a long way to validate what many of us with hearing loss, and Meniere's disease specifically, affectionately call brain fog. Though it is what I imagine dementia might feel like.
Could Hearing Loss and Dementia Be Connected?
Interview by PAM BELLUCK
Published: February 11, 2013
This interview has been edited and condensed for space.
PAM BELLUCK: I’m Pam Belluck, I’m a health and science writer for The New York Times. And this week, I am interviewing Katherine Bouton, who has been a long time editor for The New York Times and it now a contributing writer to our science section. And she has written a book called, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” And it’s a look into her own personal journey with hearing loss and a look into the research behind hearing loss. Katherine has written a piece that looks at a very interesting and surprising connection that some scientists have found between hearing loss and dementia. Katherine, first of all, welcome to the podcast, thank you for joining us.
KATHERINE BOUTON: Thank you very much.
MS. BELLUCK: And why don’t you tell us a little bit about what the scientists have found here.
MS. BOUTON: In studies over about the past…beginning in 2011 and continuing now—a new study was just published last month—is that there seems to be a strong association between hearing loss and both the earlier onset and more serious degree of dementia even with milder hearing loss, but especially with very severe hearing loss. For somebody like me who has a hearing aid and a cochlear implant but I still don’t hear very , this is alarming news.
MS. BELLUCK: All they have found at the moment is what’s called an association. So we don’t have any kind of causal connection—either that dementia either causing hearing loss or vice versa. But they do have three interesting theories about what could be happening. Could you lay those out for us?
MS. BOUTON: Okay, I should mention that the primary researcher on this is Frank Lin, who is at Hopkins and his database are two or three different long-term epidemiological studies. The first was based on the Baltimore Longitudinal Study of Aging. I went to see him after that first study was published and he had three things to offer.
The first made a lot of sense. It was that people with hearing loss tend to isolate themselves and isolation is a risk factor for dementia whether you’re hearing or hearing-impaired.
The second is something that he calls cognitive load — and which I call cognitive overload. What happens is that when you aren’t hearing very well, even with corrected hearing you’re trying so hard to hear the person that it makes it very hard to actually listen to what the person is saying. It’s very hard to absorb the information. When I did my interviews for this book – and I did a lot — I taped all of my interviews and I had someone else transcribe them because I couldn’t hear the tapes. I went and I got my transcriptions back I was constantly surprised by what I had asked, what I had heard, what they had answered. Every interview was like doing the whole thing fresh twice over.
The third possible explanation is the one that is most alarming and it’s the one that scientists like Dr. Lin and others are beginning to look at, and that’s that there’s an underlying pathological mechanism that has an influence on both hearing loss and dementia. It could be something environmental. It could be something genetic. They just don’t know.
These studies so far have relied on self-reported use of hearing aids. The next study that Dr. Lin is doing — he’s submitted a grant application now — is to specifically study how hearings aids are used, how often they are used, how carefully they were fitted, how much continual contact with the audiologist there is, whether the hearing-impaired person uses any assistive technology in addition to the hearing aids or the cochlear implant.
MS. BELLUCK: I’m interested in what you’re saying about corrected hearing. You are somebody wearing a hearing aid and a cochlear implant and according to the research that would not necessarily make a difference here. According to his research so far, people who are wearing hearing aids — it didn’t protect them from getting dementia. So does that tend to suggest some support for this idea that there being this underlying biological mechanism that might cause both?
MS. BOUTON: First they have to determine what the real relationship is between correcting hearing and the development of early or serious dementia. So far, the questions about the uses of hearing aids have been answered anecdotally by the participants in the study. What Frank Lin and his colleagues are going to do now is a serious prospective study about how people use their hearing aids, how often they use them, how well they were fitted, how often they go back and have them reprogrammed, where or not they use assistive devices like FM systems and looping, which in effect augment the use of hearing aids and implants — until they can really determine the role of hearing aids and the development of dementia the underlying causative factor remains a sort of outlying explanation.
MS. BELLUCK: An unanswered question. You open your piece with a kind of anecdote about your own sense of cognitive overload, as you call it.
MS. BOUTON: What happens is that you can’t really hear what the other person is saying and so you’re grasping for straws and basically trying to direct conversation in a way where you’ll be able to predict the answers.
I was at a party with my husband who is a literary editor and he was talking to a writer who I recognized and who I’ve met before, but who I figured didn’t remember me. And suddenly I found the two of us standing side by side. And this writer has had best-selling books and he’s very highly regarded and I have read his books and I wanted to talk to him about them. And I had a question about the second book — how it referred back to the first book.
And as I started the sentence I realized that I couldn’t remember the name of the second book and as I got half way through the sentence I realized I couldn’t remember the name of the first book either. So I stumbled through the sentence and said, ‘your first book, umm, umm, ummm…’ and he said — he gave me two choices. One of them I’d never heard of and of them was the book I was actually thinking of.
Last year, even, I would not have put myself in that situation. I would have just stayed home. I wouldn’t have gone to the party and that’s where isolation comes into this association with dementia as well because it’s very typical behavior just to say, this is too hard, it’s too embarrassing, I’d rather stay home and read a book.
MS. BELLUCK: Now, did you explain to him upfront that you have hearing loss and wouldn’t be able to hear him?
MS. BOUTON: I did, but I don’t have any visible signs of hearing loss and I tell people but I think they simply can’t comprehend what I’m saying. And this is one reason I wrote the book. It’s because I think people do not understand what so many people in the United States, and around the world for that matter, what their life is like on a daily basis. Serious hearing loss — it’s something you can’t just try it out for yourself. You can’t put earmuffs on and go outside and see what it’s like because it’s not just that you can’t hear, it’s that what you do hear is distorted. You hear every single thing that’s going on in the room, in addition to whatever you can grasp of the speaker’s voice. You hear some kinds of sounds louder than other sounds. In my case I mostly hear the things — like a glass being put down on the table is like an assault. So, going out is difficult.
Even now, I have a dog that I walk in the park a lot and somebody will say to me, ‘What’s your dog’s name?’ and I’ll say, ‘He’s three years old.’ [Laughter.] It’s windy in the park. It’s hard to hear when it’s windy because it makes noise on your hearing aid. But, I usually just guess what it is: ‘What’s your dog’s name?’ ‘How old is your dog?’ ‘What kind of dog is that?’ They all sound about the same to me. And I take a chance on getting it right — one out of three times.
MS. BELLUCK: Well, you’re doing a great job with this interview, which we are doing across a table probably separated by about four feet.
MS. BOUTON: Well, I’m looking directly at you. And being able to read lips and hear at the same time is the optimal way to hear. There’s a term for it, it’s called the McGurk-MacDonald effect. It means that you hear bi-modally, so that if you can hear, and see and even better, hear and see and read, as you would do in captions on a TV, your hearing is optimized.
MS. BELLUCK: So, just to circle back to the subject of this piece, which is dementia, I would imagine that that’s something of great concern to you, you’re 65 now. What are your thoughts about whether you have increased risk for yourself?
MS. BOUTON: Yes, I do worry about it. My mother, who has perfect hearing at 88, has very severe dementia. So I would worry about dementia anyway from a genetic perspective, but these studies have given me additional reason to worry about it.
MS. BELLUCK: Is there anything else you would like to add?
MS. BOUTON: First of all, the number of people with hearing loss in this country is astonishing. Approximately 48 million people in this country have hearing loss. Of these 48 million people in this country with hearing loss, from mild to profound, by far the majority have sensorineural hearing loss, which is the hair cells are damaged in your inner ear. And that causes eventual deafness. By far the majority of this kind of hearing loss can be avoided. It’s all noise-related hearing loss.
And one of the things I do in the book is talk about how noisy our society is. We have a real love affair with noise. If you’ve gone into any restaurant recently you’ll know how loud it is. If you were at the Super Bowl and you weren’t wearing earmuffs, you were probably deafened. Stadiums deliberately amp up the noise. Restaurants deliberately amp up the noise. It’s a very dangerous environment and unless we do something to control the amount of noise we’re exposed to on a daily basis, this rate of hearing loss is going to go on. And if these studies between hearing loss and dementia turn out to be accurate, as we get older that means a really considerable number of people having earlier and more serious dementia, which is — it’s bad for them, but it’s a huge cost factor in terms of public health.
MS. BELLUCK: Absolutely. Well, Katherine Bouton, thank you so much for joining us, for writing this article, which is fascinating and worrisome. Katherine Bouton is a former New York Times editor and currently a contributing writer to the science section. She’s author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” Thanks so much.
MS. BOUTON: Thank you.
Could Hearing Loss and Dementia Be Connected?
Interview by PAM BELLUCK
Published: February 11, 2013
This interview has been edited and condensed for space.
PAM BELLUCK: I’m Pam Belluck, I’m a health and science writer for The New York Times. And this week, I am interviewing Katherine Bouton, who has been a long time editor for The New York Times and it now a contributing writer to our science section. And she has written a book called, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” And it’s a look into her own personal journey with hearing loss and a look into the research behind hearing loss. Katherine has written a piece that looks at a very interesting and surprising connection that some scientists have found between hearing loss and dementia. Katherine, first of all, welcome to the podcast, thank you for joining us.
KATHERINE BOUTON: Thank you very much.
MS. BELLUCK: And why don’t you tell us a little bit about what the scientists have found here.
MS. BOUTON: In studies over about the past…beginning in 2011 and continuing now—a new study was just published last month—is that there seems to be a strong association between hearing loss and both the earlier onset and more serious degree of dementia even with milder hearing loss, but especially with very severe hearing loss. For somebody like me who has a hearing aid and a cochlear implant but I still don’t hear very , this is alarming news.
MS. BELLUCK: All they have found at the moment is what’s called an association. So we don’t have any kind of causal connection—either that dementia either causing hearing loss or vice versa. But they do have three interesting theories about what could be happening. Could you lay those out for us?
MS. BOUTON: Okay, I should mention that the primary researcher on this is Frank Lin, who is at Hopkins and his database are two or three different long-term epidemiological studies. The first was based on the Baltimore Longitudinal Study of Aging. I went to see him after that first study was published and he had three things to offer.
The first made a lot of sense. It was that people with hearing loss tend to isolate themselves and isolation is a risk factor for dementia whether you’re hearing or hearing-impaired.
The second is something that he calls cognitive load — and which I call cognitive overload. What happens is that when you aren’t hearing very well, even with corrected hearing you’re trying so hard to hear the person that it makes it very hard to actually listen to what the person is saying. It’s very hard to absorb the information. When I did my interviews for this book – and I did a lot — I taped all of my interviews and I had someone else transcribe them because I couldn’t hear the tapes. I went and I got my transcriptions back I was constantly surprised by what I had asked, what I had heard, what they had answered. Every interview was like doing the whole thing fresh twice over.
The third possible explanation is the one that is most alarming and it’s the one that scientists like Dr. Lin and others are beginning to look at, and that’s that there’s an underlying pathological mechanism that has an influence on both hearing loss and dementia. It could be something environmental. It could be something genetic. They just don’t know.
These studies so far have relied on self-reported use of hearing aids. The next study that Dr. Lin is doing — he’s submitted a grant application now — is to specifically study how hearings aids are used, how often they are used, how carefully they were fitted, how much continual contact with the audiologist there is, whether the hearing-impaired person uses any assistive technology in addition to the hearing aids or the cochlear implant.
MS. BELLUCK: I’m interested in what you’re saying about corrected hearing. You are somebody wearing a hearing aid and a cochlear implant and according to the research that would not necessarily make a difference here. According to his research so far, people who are wearing hearing aids — it didn’t protect them from getting dementia. So does that tend to suggest some support for this idea that there being this underlying biological mechanism that might cause both?
MS. BOUTON: First they have to determine what the real relationship is between correcting hearing and the development of early or serious dementia. So far, the questions about the uses of hearing aids have been answered anecdotally by the participants in the study. What Frank Lin and his colleagues are going to do now is a serious prospective study about how people use their hearing aids, how often they use them, how well they were fitted, how often they go back and have them reprogrammed, where or not they use assistive devices like FM systems and looping, which in effect augment the use of hearing aids and implants — until they can really determine the role of hearing aids and the development of dementia the underlying causative factor remains a sort of outlying explanation.
MS. BELLUCK: An unanswered question. You open your piece with a kind of anecdote about your own sense of cognitive overload, as you call it.
MS. BOUTON: What happens is that you can’t really hear what the other person is saying and so you’re grasping for straws and basically trying to direct conversation in a way where you’ll be able to predict the answers.
I was at a party with my husband who is a literary editor and he was talking to a writer who I recognized and who I’ve met before, but who I figured didn’t remember me. And suddenly I found the two of us standing side by side. And this writer has had best-selling books and he’s very highly regarded and I have read his books and I wanted to talk to him about them. And I had a question about the second book — how it referred back to the first book.
And as I started the sentence I realized that I couldn’t remember the name of the second book and as I got half way through the sentence I realized I couldn’t remember the name of the first book either. So I stumbled through the sentence and said, ‘your first book, umm, umm, ummm…’ and he said — he gave me two choices. One of them I’d never heard of and of them was the book I was actually thinking of.
Last year, even, I would not have put myself in that situation. I would have just stayed home. I wouldn’t have gone to the party and that’s where isolation comes into this association with dementia as well because it’s very typical behavior just to say, this is too hard, it’s too embarrassing, I’d rather stay home and read a book.
MS. BELLUCK: Now, did you explain to him upfront that you have hearing loss and wouldn’t be able to hear him?
MS. BOUTON: I did, but I don’t have any visible signs of hearing loss and I tell people but I think they simply can’t comprehend what I’m saying. And this is one reason I wrote the book. It’s because I think people do not understand what so many people in the United States, and around the world for that matter, what their life is like on a daily basis. Serious hearing loss — it’s something you can’t just try it out for yourself. You can’t put earmuffs on and go outside and see what it’s like because it’s not just that you can’t hear, it’s that what you do hear is distorted. You hear every single thing that’s going on in the room, in addition to whatever you can grasp of the speaker’s voice. You hear some kinds of sounds louder than other sounds. In my case I mostly hear the things — like a glass being put down on the table is like an assault. So, going out is difficult.
Even now, I have a dog that I walk in the park a lot and somebody will say to me, ‘What’s your dog’s name?’ and I’ll say, ‘He’s three years old.’ [Laughter.] It’s windy in the park. It’s hard to hear when it’s windy because it makes noise on your hearing aid. But, I usually just guess what it is: ‘What’s your dog’s name?’ ‘How old is your dog?’ ‘What kind of dog is that?’ They all sound about the same to me. And I take a chance on getting it right — one out of three times.
MS. BELLUCK: Well, you’re doing a great job with this interview, which we are doing across a table probably separated by about four feet.
MS. BOUTON: Well, I’m looking directly at you. And being able to read lips and hear at the same time is the optimal way to hear. There’s a term for it, it’s called the McGurk-MacDonald effect. It means that you hear bi-modally, so that if you can hear, and see and even better, hear and see and read, as you would do in captions on a TV, your hearing is optimized.
MS. BELLUCK: So, just to circle back to the subject of this piece, which is dementia, I would imagine that that’s something of great concern to you, you’re 65 now. What are your thoughts about whether you have increased risk for yourself?
MS. BOUTON: Yes, I do worry about it. My mother, who has perfect hearing at 88, has very severe dementia. So I would worry about dementia anyway from a genetic perspective, but these studies have given me additional reason to worry about it.
MS. BELLUCK: Is there anything else you would like to add?
MS. BOUTON: First of all, the number of people with hearing loss in this country is astonishing. Approximately 48 million people in this country have hearing loss. Of these 48 million people in this country with hearing loss, from mild to profound, by far the majority have sensorineural hearing loss, which is the hair cells are damaged in your inner ear. And that causes eventual deafness. By far the majority of this kind of hearing loss can be avoided. It’s all noise-related hearing loss.
And one of the things I do in the book is talk about how noisy our society is. We have a real love affair with noise. If you’ve gone into any restaurant recently you’ll know how loud it is. If you were at the Super Bowl and you weren’t wearing earmuffs, you were probably deafened. Stadiums deliberately amp up the noise. Restaurants deliberately amp up the noise. It’s a very dangerous environment and unless we do something to control the amount of noise we’re exposed to on a daily basis, this rate of hearing loss is going to go on. And if these studies between hearing loss and dementia turn out to be accurate, as we get older that means a really considerable number of people having earlier and more serious dementia, which is — it’s bad for them, but it’s a huge cost factor in terms of public health.
MS. BELLUCK: Absolutely. Well, Katherine Bouton, thank you so much for joining us, for writing this article, which is fascinating and worrisome. Katherine Bouton is a former New York Times editor and currently a contributing writer to the science section. She’s author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You.” Thanks so much.
MS. BOUTON: Thank you.
Shouting Won't Help by Katherine Bouton
Here's a link to a new book coming out in 2 days called Shouting Won't Help, by Katherine Bouton. I just listened to this interview with her on NPR. Very fascinating, I can't wait to read the book.
Here is also a link and some excerpts to a NY Times article written by Bouton in August, 2012.
Excellent description of what those of us with hearing loss actually hear everywhere we go:
In a noisy environment like a restaurant, a person with normal hearing will still be able to hear his companion. But in that same environment, a hearing-impaired person will hear chairs scraping, dishes clanking, waiters shouting, all of it bouncing off the high ceilings, the bare walls, the chic metallic tables and chairs — an anxiety-provoking wall of noise. Worst of all is the restaurant’s background music, sometimes competing with a different sound track throbbing in the kitchen.
Earlier this week I had dinner with my husband and sister (both with normal hearing) and my daughter, son and niece, all 20-somethings, in a popular Brooklyn restaurant. It was my birthday and I had a great time, enjoying my family and the good food, but I didn’t hear one word said at the table.
Frustrating and exhausting...
Here is also a link and some excerpts to a NY Times article written by Bouton in August, 2012.
Excellent description of what those of us with hearing loss actually hear everywhere we go:
In a noisy environment like a restaurant, a person with normal hearing will still be able to hear his companion. But in that same environment, a hearing-impaired person will hear chairs scraping, dishes clanking, waiters shouting, all of it bouncing off the high ceilings, the bare walls, the chic metallic tables and chairs — an anxiety-provoking wall of noise. Worst of all is the restaurant’s background music, sometimes competing with a different sound track throbbing in the kitchen.
Earlier this week I had dinner with my husband and sister (both with normal hearing) and my daughter, son and niece, all 20-somethings, in a popular Brooklyn restaurant. It was my birthday and I had a great time, enjoying my family and the good food, but I didn’t hear one word said at the table.
Frustrating and exhausting...
Subscribe to:
Posts (Atom)