We鈥檙e seemingly bombarded with reminders of health aspects that need to be tended to regularly, especially as we get older: our hearts, our lungs, our 鈥� um, digestive tracts. But there鈥檚 one widespread health problem that doesn鈥檛 get nearly as much attention.
鈥淲e鈥檙e told 鈥楪et your teeth checked every six months鈥� and 鈥楪et your vision screened annually,鈥� but I don鈥檛 think there鈥檚 much out there about hearing,鈥� said Nicole Jordan, an audiologist at the Speech and Hearing Center at George Washington University.
Jordan said that about 1 in 3 people 65 and over has hearing loss. By the time you鈥檝e noticed a hearing loss, Jordan said, you should probably have already had a test.
鈥淚 encourage people to start getting their hearing tested at age 50,鈥� and earlier if you have a family history of hearing loss, or have had one of the conditions that can bring on hearing loss, such as head trauma, tinnitus, vertigo, some autoimmune disorders, cancer that requires chemotherapy, and more.
It鈥檚 important to get tested because hearing loss comes on slowly.
鈥淚t is usually so slow-progressing that [patients] don鈥檛 notice it until they realize that they鈥檙e turning the TV up a little bit louder, or they鈥檙e missing things in background noise that they didn鈥檛 usually miss, or more often than not, family members are saying 鈥榊ou know, you鈥檙e asking 鈥渨hat?鈥� and 鈥渉uh?鈥� a lot more often.鈥�
And of course, hearing loss can symbolize old age, which many people don鈥檛 want to acknowledge.
鈥淚t鈥檚 that combination of not wanting to admit to anything, and then of course it being so slowly progressive that you don鈥檛 notice it.鈥�
Screenings and tests
The first step, Jordan said, is a hearing screening. Many primary care doctors can do them, though not all.
A screening is a pass-fail sort of test held in a non-soundproof environment. They鈥檙e also done at health fairs in noisy areas such as schools. It can be a good first step 鈥� you might get a referral for a full hearing test 鈥� but it鈥檚 no substitute for a full examination.
A complete hearing test is performed by an audiologist, who looks at a much wider range of pitches 鈥� frequencies that the same sound can emit, and that you may or may not hear.
Hearing a beep is only part of the test, Jordan said. A hearing test also measures 鈥渢he lowest level of speech you鈥檙e able to hear. When the speech is loud enough, can you successfully hear it, repeat it, understand it? When you鈥檙e listening in noise, how well are you doing when you鈥檙e listening in different degrees of background noise? 鈥� It鈥檚 complex.鈥�
A lot of people who get referred for a test don鈥檛 go.
Jordan said that studies find the average time span between when someone notices a problem with his hearing and he walks in the door of an audiologist is seven years.
Your insurance may or may not cover hearing tests and hearing aids 鈥� that鈥檚 indicative of the American health care market鈥檚 aversion to preventative care, Jordan said. Medicare will cover evaluations, but only if there鈥檚 a there鈥檚 a medical reason 鈥� a regular test won鈥檛 be covered.
That may seem unusual, given that Medicare is for older people, and taking care of your hearing as you age can pay off in a lot of ways: Human beings are social beings, and hearing has a lot to do with how social you can be.
Staying connected
鈥淗earing and communication is so tightly connected to things like how social you鈥檙e going to be, and how long you鈥檙e going to be an independent individual,鈥� Jordan said. 鈥淗ow active you鈥檙e going to be in the community, how long you鈥檙e going to hold a job for, how emotionally and socially happy you鈥檙e going to be.鈥�
Another of the reasons people tend not to get their hearing checked is that they鈥檝e been told for years that there really isn鈥檛 anything you can do about hearing loss. It鈥檚 true, Jordan said, that the cilia 鈥� the tiny hairs inside your ear that pick up sound vibrations and send them to your can鈥檛 grow back or become re-sensitized to sound, but there are still steps people can take.
鈥淧reventatively, the best thing to do is to live a healthy lifestyle,鈥� Jordan said.
Diet and exercise can have an effect on hearing, because high cholesterol and high blood pressure tie into it. Quitting smoking also helps.
Of course, protecting your ears against loud noises is key 鈥� wearing musician鈥檚 earplugs if you鈥檙e going to be around or playing) loud music, and wearing hearing protection for outdoor work such as lawn-mowing or snow-blowing, are important steps.
What you can do
Jordan said there are plenty of non-mechanical options for someone with a mild hearing loss: speech reading, lip reading, hearing rehabilitation and background noise practice are some options.
If you do need some kind of hearing correction, there are more options than ever, and that can be daunting. Many people are deluged with advertisements about hearing aids that they start to think it鈥檚 a racket: Not just audiologists, but online marketers and independents. Soon there will be over-the-counter hearing aid companies.
鈥淚f 鈥� I didn鈥檛 work in the field, I would think it was a racket,鈥� Jordan said.
The latest hearing aids are iPhone-compatible: You can run your phone through hearing aid, control the hearing aid from your phone and, of course, send your audiobooks or podcasts through your phone.
They can be custom-fit with ear impressions and measurement; you can pick a color to match your hair and/or glasses, and they鈥檙e smaller than they鈥檝e ever been.
But the most important thing patients need to do is notice what鈥檚 happening to their hearing and speak up. Primary-care doctors will often ask about any vision or dental problems, but won鈥檛 ask how your hearing is holding up.
Patients, Jordan said, 鈥渘eed to get in the door and they need to be self-advocates.鈥�
