Life in the "What'd You Say?" Lane


by Beth Levine
Photograph: Illustrated by Dan Page

I’m watching Law & Order: Criminal Intent, and as usual, actor Vincent D’Onofrio is mumbling. Or I think he’s mumbling. What’s definite is that his lines are all lost on me.

“What did he say?” I ask my husband for not the first time this evening.

“Shhhh! I just missed an important plot point!” he snaps.

Yeah, well, that makes two of us, pal.

At the end of the show, he says, “Would you please get your hearing checked?”

Nope, I will not. Even though this scenario seems to be occurring more frequently—at movies, parties, plays and even at work—I tell myself my hearing is not that bad. I tell myself the problem lies with everyone else—all those people who refuse to speak up and enunciate properly. But the real reason I refuse to see an audiologist is that I will not wear a hearing aid, thank you very much. Only old people wear those, and that just doesn’t jibe with my self-image. I know I’m no teenager, but I’m too vain to accept looking like someone’s grammy. It’s bad enough I wear trifocal glasses to see and sensible shoes to protect my knees. Add in hearing aids and you might as well park me on the front porch in a rocking chair and call it a day.

I’m not the only one who needs to turn up the volume: A new study from the nonprofit EAR Foundation found that people ages 40 to 59 are losing their hearing at faster rates than previous generations, presumably because we were the first to grow up with rock and roll and to use listening devices with in-ear headphones.

But even though hearing loss is becoming much more common, a lot of us are in denial. Of the more than 34 million Americans who suffer from some form of impairment, about 75 percent choose not to get hearing aids, says Sergei Kochkin, PhD, executive director of the Better Hearing Institute. Even those who do eventually seek help are stalling: People often wait several years between the time they first suspect hearing loss and when they do something about it, says Susan Erler, PhD, coordinator of the Doctor of Audiology program at Northwestern University.

This means many midlife women are operating with faulty information. “I always assume I hear things right and go on,” says Jennifer Truitt, 45, of Campbell, California. She’s sticking to that story, even after embarrassing herself at a family dinner, when her 20-year-old stepson mentioned having read that dogs could smell one part in a million. “I said I didn’t understand how a dog could smell one fart in a million,” she says. Oops.

While hearing-loss denial sometimes results in comical stories like Truitt’s, it can also take a huge toll on personal relationships and quality of life. When the National Council on the Aging surveyed hearing-impaired adults ages 50 or older, those with untreated hearing loss were more likely to report depression, anxiety and paranoia than those who wore hearing aids.

That’s partly because auditory problems can lead to isolation. Case in point: Before giving in and getting hearing aids, Elizabeth Pace, 50, of Brentwood, Tennessee, struggled in social situations. “People didn’t understand that I didn’t understand them. I needed to have things repeated a lot. If a friend was talking behind me, I didn’t hear her. When people talked with their hands in front of their mouths, I wanted to slap their hands. My husband got irritated because I had to turn up the TV volume so loud. I avoided certain situations—for example, I didn’t go to movies as much as I would have liked because it was too difficult to hear them.”

Gaye Simmons, 54, a chef in Manhattan Beach, California, concurs: “Losing your hearing takes you out of society. I miss subtleties of conversations. I just nod and smile, and hope that’s an appropriate response.”

Work takes a hit too: According to Kochkin of the Better Hearing Institute, people with untreated hearing loss make $23,000 less annually in their jobs than those with normal hearing because they don’t get promoted or receive raises. “It’s inadvertent discrimination, because bosses are not aware of the hearing loss. They just think the person isn’t so sharp. If you are going to be competitive in the workplace, you have to deal with your hearing impairment,” he says.

It was the fear of losing her job in public relations and grant administration that finally prodded Kendal Miller, 48, of Dillsboro, Indiana, to get hearing aids. “With cutbacks so prevalent, I didn’t want my record suggesting I wasn’t doing my job very well when I might just have missed hearing what needed to be done.”

Many women who delay dealing with their problem don’t realize how much hearing aids have improved in the past decade. Now benefiting from digital technology, the newer instruments are almost invisible, don’t whistle (give feedback), do stay in place when you move around a lot and have sound quality superior to the old versions. People used to complain that their hearing aid couldn’t filter am­bient sound, which makes it hard to follow conversations in noisy environments, but many hearing aids now allow the wearer to switch between picking up all sounds and picking up only those that come from one particular direction.

Hearing aids come in four types: in the ear (ITE), meaning a shell fills the outer ear; behind the ear (BTE), meaning the device fits in back of the ear; in the canal (ITC), meaning the device sits in the outer part of the ear canal, and completely in the canal (CIC), meaning the device is placed inside the ear. The aids that are most concealed and therefore look the best are CIC and the mini-BTEs with nearly invisible tubing; they also have some amplification advantages. The mini-BTE improves the sound of your own voice because it doesn’t plug up your ear canal; it also has directional microphones that may improve your ability to understand speech in a noisy room. The CIC increases your ability to detect where sounds originate and may work better on the phone because it is deep inside your ear canal. “What is best for you depends on your degree of hearing loss, your manual dexterity, how comfortable each style feels and which look you prefer,” Kochkin says.

Federal regulations require that you have a medical exam before you buy a hearing aid. When visiting your family physician, ask for a referral to an audiologist certified by the American-Speech-Language-Hearing Association, an otolaryngologist (American Academy of Otolaryngology–Head and Neck Surgery) or a hearing instrument specialist. You need a specialist because hearing aids must be custom-fit and finely calibrated to your specific condition. Don’t get suckered by come-ons for free screenings or by salespeople who promote only one kind or brand of hearing aid.

The bad news is that hearing aids are quite pricey—the cost ranges from $300 to $3,000—though some health insurance providers do cover them. (Medicare covers physician-ordered diagnostic tests but not the aids themselves.) Screening fees and optional add-ons such as remote controls can up the cost considerably. To avoid getting stuck with expensive duds, make sure the hearing aids you’re considering come with a warranty and a trial period.

There are also nonprofits that can provide financial help or access to refurbished hearing aids: Contact the National Institute on Deafness and Other Communication Disorders Information Clearinghouse. For a comprehensive list of programs that may provide assistance, go to the Better Hearing Institute’s Web site to download “Your Guide to Financial Assistance for Hearing Aids.”

Women who finally give in and get hearing correction are delighted by the positive difference it makes in their lives. Elizabeth Pace says, “Hearing aids saved my life. I didn’t realize how much stress and energy I was putting into just figuring out what people were saying.” Notes Simmons, “After my appointment to get fitted, I felt so excited. I feel like I am finally getting back into the game.”

First Published Wed, 2010-01-27 09:49

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