Interviewer: Christian Bullas
Interviewee: Brian Field
C: Welcome to the Savvy Senior Show. I’m your host, Christian Bullas, Owner and director of Senior Homecare by Angels. And this week I’m joined by Brian Field, Doctor of Audiology, from Meridian Hearing Centre’s.
B: Hi Christian, Good to see you today.
C: Good, how are you doing today Brian?
B: I’m doing well thank you.
C: Excellent. Good to have you back on the show. It’s been a little while.
B: It has been a while.
C: Yea, we talked about tinnitus last time.
B: Yes, I think we probably did. It’s a common topic because so many people are bothered by it.
B: Well you know what, it can be pronounced ‘tinnitus’ or ‘tinnitus’ either way is acceptable. So I jump back and forth as to not show preference to one or the other.
C: There we go, there we go. Equal opportunity. Okay great, well we can get into that a little bit later.
C: So let’s talk, obviously you’re here, why is hearing health important?
B: Great question. Hearing is you know, from a social stand point, it’s our primary way of interacting with other people. Hearing what’s happening with your family, hearing happening with your friends, going out to social gatherings. Most of what we do is interacting by listening, talking. And when that gets interrupted, or we are unable to hear clearly. When we go to a social gathering and we can’t follow a conversation then we are very likely to start not going to those social gatherings any more. And so it can really lead to isolation where you decided to stop going to bridge, or you stop going to church, or you stop going to family gatherings because you’re a wallflower when you go there because you can’t join in on the conversation. So one of the things we are beginning to learn from that isolation all sorts of negative health effects can come from a result of that.
C: Okay. Absolutely. I remember in one of our pervious interviews, you mention something about, that has always stuck with me, about when people leave their hearing issues too long that you had mentioned that when they do get hearing aids that they become overwhelmed, because they become, as you mentioned, most cases, not all, but most cases people gradually lose their hearing unless there is a big event of course.
B: You’re right.
C: And then, so you have gradually over years and then you become accustom almost to that. So then you hear the full world again it becomes overwhelming.
B: Yea, that’s absolutely right. And that’s one of the points I always make to people. The time to do something about your hearing is when you first begin to notice it. Because you are right, for most people it is a gradual process. Either through just the aging process, or the noise damage over the years. And we gradually lose our hearing and gradually become accustom to the way the world sounds around us. And when you take a big step that always hard to take, taking a little step is a little bit easier. So starting with hearing aids when it first begins to interfere with your life. When you first start to notice you’re asking people to repeat. Or when you first think ‘Boy, people seem to be mumbling more than they use to’. That’s the time to do something about it.
C: Okay, yea, that’s interesting. Now, I’m going to go off topic a little bit. Is there a certain, so we all generally think of hearing aid, hearing loss, we always associate it with a lot of cases of age. Is that true? And is there a certain age potentially? Or maybe, I’m asking all the questions here, is maybe, it happening earlier now? I’m just thinking of myself and my age, I’m in my mid 40s now and I’m the first Walkman generation.
B: Yea, it’s probably not much earlier. Although there is some evidence to show that that’s the case. But a lot of what’s happened is we’ve replaced industrial workplace noise with recreational noise. So we’ve become much better at protecting our hearing on the job. So we are using hearing protection, job sites are much quieter then they use to be, quieter equipment, better isolation of the equipment. But we are becoming much, much worse at subjecting ourselves to recreational noise through Walkman’s, iPods, ATVs, dirt bikes, and all that kind of things. And the other thing that I’m also concerned when I see it, is when people are out cutting the grass on their riding lawn mower and instead of wearing hearing protection, they’re listening to music with their earbuds in.
C: Which you know that they have to have at full blast in order to hear.
B: Above the level of the lawn mower. So not only is the lawnmower too loud, but then they are listening to music up louder than that. It’s sort of a double whammy for them. That’s concerning and yet, they are not bothering anybody, no one else is bothered by the music when you’re listening with earbuds. So you don’t notice it’s that loud.
C: Okay. So here’s a warning if you have a riding lawnmower, don’t listen to music.
B: Not a good choice to make.
C: Yea that’s true, I never thought of that. Because you know, you do see people doing that.
B: Oh yea, I see it, I see it quite frequently.
C: But you know the interesting thing you say about how we protect people at work better. Because if you see a landscape company they all wear hearing protection because they are mandated to do it because it’s on the job safety. But yet, I haven’t seen anyone mowing their lawn wearing hearing protection.
B: It’s becoming a little more common. But you’re right, most home owners don’t think about it, it’s just not thought about, people don’t think about it. Now, are lawn mowers a little quieter than they use to be? For the most part, yes. And you know, if you have a 10 minute lawn to do, it’s not an issue. But if you have a 2 hour lawn to do, then that is an issue. Noise damage is a combination of how loud and how long. So we need to monitor both of those thing.
C: So time and length.
B: So the longer you’re going to be exposed the less intensity you can be exposed to and still be safe.
C: Okay, that certainly makes sense. So other than, you mentioned already isolation, what are some other consequences of having poor hearing.
B: There has been a lot of recent research into relationships between cognitive decline and hearing loss. Its ground breaking, well researched articles showing that adults with untreated hearing loss experience a 30-40% faster decline in cognitive abilities. Now, the question is why is that happening? One of the reasons may be the isolation. Because you start withdrawing from playing bridge, or doing those things.
C: And you’re not doing those social, and isn’t that one of those things that they say to combat dementia is social interactions.
B: Yea, absolutely. Staying engaged, staying up to date with the local news, and talking with people, and being engaged playing bridge or going to other social activities.
C: Isolation can lead to depression as well.
B: Absolutely. Depression is one of the same things. Depression and anxiety even. Anxiety about someone’s calling me on the phone and I’m don’t who it is, and do I need to be worried about that phone call. And they can’t hear well on the phone. So people can be anxious they can be depressed because they don’t have that social interaction. So much of it involves that lack of integration with our family and community. So yea, cognitive decline, absolutely, the other research is dementia, which you just mentioned. Adults with untreated hearing loss are more likely to develop dementia. Now, it’s not that hearing loss causes dementia.
C: It could be other factors like you mention with the social withdrawal.
B: Absolutely. The other factor that’s getting a lot of research attention is something called cognitive load. And what that means is, for people with normal hearing, listening requires no effort. When you’re having a conversation you don’t think about what you’re hearing, it’s automatic. You hear it, your brain processes it.
C: But if you’re having a harder time, you’re working at it.
B: You’re working at it, exactly.
C: so you’re spending energy trying to listening trying to figure out what did they say was it this, was it that, processing what words they may have said.
B: You’re exactly right. You’ve hit right on. You’re using cognitive resources to figure out what likely was a good guess about what was said. And using those resources in that way means you have less cognitive resources to put towards remembering the person’s name or other cognitive issues. So it can appear to people like ‘Jeepers, grandpa’s losing his memory, he’s getting dementia’. It’s just because they’re not hearing well. So, firstly it can mask one another, one can be masked by the other. So people can be labeled as having dementia or Alzheimer’s and really they are just having troubles hearing. But the other things is that again that isolation, that lack of connection with their community really leads to that progression of cognitive decline.
C: So let’s talk a little about, what should we do, what should someone do if they suspect that they’re having some hearing issues and aren’t hearing well.
B: Well the first thing to do is find out. If you think you are having an issue, come and have an assessment. It’s easy to do, it doesn’t take long. What we do at our office, is take a history. Find out any important issues your family history, because we are looking at any genetic factors that may be there. Family history, what kind of work…
C: Is hearing potentially genetic?
B: Yea, there are certainly genetic factors, sudden, early, or age related hearing loss can happen earlier in some families than others and there can be hereditary hearing loss as well that’s presents from birth or progressive losses that are genetic and their origins. So, we are looking at all of those things. Those are the rarer things. The common things are just the aging process which affects all of us and noise exposure. Those are the 2 big factors. But yea, if you think ‘Boy, I don’t seem to be hearing the way I did 5 years ago.’ Let’s find out. It takes all of 15 mins to do an assessment. At our office there’s no charge for that. We’ll do the assessment, if you’re hearing is normal, that’s great, now we have a baseline for the future, we know where it is at this point. If there is some hearing loss present, it may be just be mild and we recommend some strategies to help with listening. Or it may be at the point where you require hearing aids and if that’s the case then we will talk about what’s possible and what options are available with hearing aids and what we would recommend for you. We’re always going to make a recommendation in terms of helping you with your hearing health. And in that same light, if it turns out to be something that can be corrected from a medical/surgical stand point, then we will make that recommendation. So a report will go back to your family doctor saying that this is the issue with this persons hearing and is something that can be medical treatable and refer back to that medical treatment so that those things get looked after as well. We don’t want to miss, you know there are certain issues and concerns with the ear that are rare but some are potentially life threatening. Where you may have growth that’s pushing on the auditory nerve that can grow and cause other problem, you may have chronic infection in the middle ear spaces that can cause problems. So, we want to pick those things up if they are there. So of course that is the importance of having actually having a proper assessment done. You are see a lot of places that sell hearing aids that are saying ‘Come in for a free test and get a hearing aid’ well they are wanting to just sell that hearing aid. And so the test is really just you need a hearing aid as opposed as to taking a look at what is the underlying reason for the hearing loss and making sure it’s not something that really requires treatment.
C: So, should they be looking for someone that has a certain type of certification or credentials to be able to do that?
B: Yea. In Ontario, audiologist are a licensed body, we have a college, just like the college for physicians and surgeons, and we have the college of audiologist and speech language pathologist of Ontario. So we have a regulating college. And what that means is we all operate under standards, and if we don’t we can lose our license. So there is some teeth in that, so if you see somebody who’s an audiologist, to use that name, audiologist, you must be registered with the college. It means you have the minimum education in Ontario of a master’s degree, and you are seeing more and more audiologist with a Doctor of Audiology degree now. But that’s a minimum, and then we have a standards of practice too. The way we do things is all written down, it’s standardize and it’s important.
C: Okay, great. Now, before you even get to that test, what are some of the signs that may indicate that you should go for that test?
B: I think that is a great question. Because we tend to, as you were saying before, it’s happens gradually, so we tend to not be that aware of it, it’s hard to remember the way you use to hear. But the kinds of things that we begin to see and it usually is the family members saying ‘Dad, you should get your hearing checked cause you are missing stuff.’ It’s usually our family members or our friends who notice that we are missing things more than we do. And the way they notice that is they saying something and you respond inappropriately, you answer the wrong question. Or you say ‘Dad, I told you that last week.’ And you say ‘Oh, I don’t remember you saying that.’ And that’s the kind of thing that people start to… so it’s usually coming from family members and on the part of the individual. It’s usually ‘Well, I can hear fine if people look at me when they’re talking to me.’ Or ‘I can hear fine if people don’t mumble.’ Or ‘The new TV, me new TV isn’t as clear and sharp as the old ones.’ So we always come up with these eternal reasons why we aren’t hearing well. And so, if you start, if in your mind your saying I’m not hearing the way I use to, the TV’s not clear, people mumble, people talk too fast, people don’t look at me anymore when they are talking. Those are all signs that you’re beginning to miss things.
C: Okay, so those are signs coming from you more so then from other people necessarily.
B: Yea, that’s what you’re going to be noticing. You’re explaining away why you’re missing things. But, the first clue is often other people noticing things. Or it may be things like, you’re in another room and you children say ‘oh the microwave just beeped’ and you didn’t hear it beep. Or the current washer and dryers make that little sound song when they are finished, everybody else hears it but you didn’t hear it. And the reason I’m picking those sounds is that they are fairly high pitched. And typically we lose our hearing in the high pitches. And so you hear stuff but it’s not clear and you start missing those high pitched tones.
C: I may have to come see you. My family is always saying to me, but I think its cause I’m not paying attention, I’m on the phone all the time. That’s what I think, but who knows. Because I can still hear the dyer when it goes.
B: Yea, there you go, that’s good. But it can seem like I’m not paying attention anymore, or others can think ‘oh George doesn’t paying attention anymore.’ But it can be that you’re just not hearing as well as you use to. That’s a factor.
C: That may be an issue.
C: When we come back I’m going to ask you all about the hearing aid. Just get right into that because I know there is some crazy new technology you have. And we can’t cover that in 30 secs.
C: In the last segment we just left off talking about hearing aids. So now we are at the point where we need a hearing aid. I know that you have some, we have talked before about some really interesting technologies. So let’s just get right into that right now.
B: Okay, great. Yes, absolutely the technology is getting better. And what’s driving it at getting better is smaller, faster computers. Every hearing aid that’s out there today is digital. That use to be, 10 years ago, so these hearing aids are digital, and that was a big deal. Everything is digital now. You’d have a hard time to find a hearing aid that’s not digital now. So what happens is the sound comes through the microphone, it’s digitized, and it’s played around with by the computer inside the hearing aid, and then turn back into a sound and in our ears. That process has to happen very fast, within 2-3 milliseconds. If it took longer than that, then people lips would be out of sync with what you were hearing. And so the processor has to happen, that processing is called digital-signal-processing that goes on. And that’s what help the hearing aid detect – are you in a noisy place or a quiet place. Do I need to do a noise reduction to help the speech come through, or are you in a big auditorium with echo and reverberation. So it’s detecting and then trying to modify the speech signal to help you understand speech in those difficult listening environments. If you have a faster, more powerful processor, it can do more processing in that time limit we have. So the more expensive hearing aids have better processors in them. It use to be that the size was the thing that determined how expensive the hearing aid was. Smaller hearing aids were more expensive than bigger hearing aids. Size really is not a factor in cost anymore, it all has to do the processor inside.
C: Okay, now does faster processor are they bigger?
B: Nope. No, and that’s what I’m saying. That’s what’s driving the technology improvement. Faster, smaller computers that can run them. So typically from the smallest to the largest hearing aids the processor inside it is the same. And it’s amazing what they can do. The other thing that’s happened, so digital-signal-processing is a really big factor that allows the hearing aids detect and determine. And not only that we have wireless communication now with the hearing aids so your hearing aids can talk to each other from one side to the other. So the processors can work in conjunction with each other, so they are making joint decisions as opposed to one deciding one thing and one thing deciding another thing. That helps them to work as a pair, just like our own ears do. And also allows communication with outside devices. So for example, there are a couple manufacturers who have devices that they did proprietary work with Apple. So if you have an iPhone 5s or above your hearing aid can hook up directly to your iPhone, without having to wear any external device. Once it’s paired with your phone, when you take a phone call the sound will come right out in your hearing aids. Your GPS instructions, you’ll hear them in your hearing aids, the phone becomes the remote control for your hearing aids, and you can make volume adjustments. You can, what’s call geo-tagging, you can maybe setup your hearing aids up a certain way at a certain restaurant that you like to go to. Next time you go to that physical location the phone will put it back to that setting for you all automatically.
C: Oh, because it’s a noise restaurant so you change the setting.
B: Yup, and your phone will track that GSP location. The phone will also keep track of where you’ve left your hearing aids. So if you’ve put them down somewhere or left them at somebodies house ‘Oh, where did I put my hearing aids?’ Your phone will know where it was last in touch with them. So that’s what’s happening in terms wireless capability with hearing aids. Where the future is leading, to the hearing aids doing a lot more than just helping with your hearing. Things like tracker heart rate, tracking whether you’ve fallen down. So we envision in a not too distant future your hearing aid will detect that you’ve fallen down and place a phone call for you to 911. So all sorts of things are going to start happening with the sensors that are built into our ears.
C: Oh, interesting, great.
B: And people say ‘Oh, how much is that going to cost?’ The thing with hearing aids is the price really hasn’t changed over the last 10 years. The technology has gotten better…
C: Is cheaper so they are adding more so it’s keeping the price the same.
B: And there are hearing aids for all budgets. It’s very, very, very rare that someone says ‘I can’t do this because I can’t afford it.’ The government still provides the grant that they did in the past, that hasn’t changed. Workers compensation, WSIB has coverage if you’ve worked in noise. Veteran Affair’s still covers things. So there are all sorts of funding mechanisms. And it’s very rare that somebody just doesn’t do it because they don’t have the money for it.
C: Okay, great. That’s excellent, lots of news. And of course if somebody wants to hear more they should come and see you at Meridian Hearing.
C: We wanted to talk a little bit before we are finished here about May. May is…
B: May is speech and hearing month! Has been for years. When I first was in school doing my degree in audiology back in the late 70’s, that seems like an awful number to put out there now, but it’s always been. May is speech and hearing month. It ends up now that each month is more than one thing because there is so many good causes out there. But May is speech and hearing month has always been that way, and not that there is anything special other than it’s a time to focus on, pay attention to hearing and what can be done to improve people’s hearing.
C: Now let’s just quickly, if anyone has any questions for you at all, where is it best to reach you at?
B: In terms of a phone number to reach me at is 519-657-2094 or our website www.meridianhearing.com and you can always get ahold of us there. We’re on Facebook now, so people can look up our Facebook and make communication there with us. There’s lots of ways to contact us. We have 3 office in London now, in Byron, in old Wortley village, and in Beaverbrook in behind Angelo’s in that building there. So we are easily accessed, were in Strathroy as well.
C: Oh, you’re all over.
B: So we are always available, any questions I’m happy to take and see anyone at any time.
C: So let’s just come full circle, we got 30 seconds left. Let’s talk about Tinnitus
B: Tinnitus ‘tinnitus’ I mentioned that in the beginning. About 90% of people with tinnitus have hearing loss. That’s usually the root cause.
C: And that is when you have the ringing in your ears.
B: It’s a noise. Any noise that is in your ear that’s not happening out in the world is called tinnitus. And there can be multiple reasons for it. There’s no magic cure for it, but what we do is an assessment to find out why it’s there. And then there are different ways to help with it. No one’s going to give you the magic cure but we can teach you ways to reduce its effect and bothersomeness.
C: Okay, absolutely. Okay great, that’s another thing to call about.
B: One thing I specialize in. Yea absolutely that’s one of the things I do.
C: Great, thank you for joining us. (And then his sign off)