The Top 10 Hearing Loss and Hearing Aid FAQs, Answered

What’s new in hearing aids? Which one is right for me? Can they relieve my tinnitus? And aren’t they all the same? Host Dave Fabry, Ph.D, Archelle Georgiou, MD, and Jamie Myers, Au.D. answer these questions and more in this special Better Hearing Month podcast.

Link to full transcript

Transcript

SPEAKER_00 0:02

Welcome to Starkey Soundbites. I'm your host, Dave Favrey, Starkey's Chief Innovation Officer. Now, May is Better Hearing Month, and in observance of this important month, we've decided to dedicate one episode of the podcast to answering the top ten most frequently asked questions that we receive about hearing loss. I'm so happy to be joined by two of my uh Starkey colleagues today to help answer these FAQs. First, Starkey Chief Health Officer, Dr. Arkel Giorgio, is a medical doctor, and Dr. Jamie Myers is a doctor of audiology. Arkel and Jamie, thank you for joining us today for this special uh issue, uh special version of the podcast. And I look forward to uh this discussion today on Starkey Soundbites.

SPEAKER_01 0:51

Thanks, Dave, for having us. Happy to be here.

SPEAKER_00 0:54

And and Arkel, for you, it's uh it's a reprise of uh one of the earlier episodes. And Jamie, welcome to the podcast. We look forward to more interactions in the future, too. Uh I'm excited to have this conversation with both of you, and we're gonna take turns answering these questions. Uh and I'm gonna take the moderator's prerogative and answer the first one, which is I think I might have hearing loss. What should I do or how do I start this process? And I guess what I would say, and please both of you chime in if you uh want to add anything to this, but for me, if you think you have hearing loss, you're not alone, first off. In the U.S., it's estimated by uh current figures from the NIDCD, National Institute of Technical, or National Institute of Deafness and Other Communication Disorders, that approximately 48 million people have some degree of measurable hearing loss. And worldwide, the World Health Organization estimates uh around 466 million people with hearing loss. So certainly you're not alone if you're thinking that you're having some difficulty. It usually occurs when a family member or colleague or friend mentions it to an individual. And on average, it's about a 10-year journey from the time that a person first thinks that they have hearing loss until they get hearing aids for the very first time. So the thing I would do and would recommend if you think you uh have some difficulty hearing is get a test. And there are a wide range of ways that you can do this. First of all, seeing an audiologist or a hearing instrument specialist would be the best way to do this face-to-face in a clinical or retail environment where they can calibrate and get a very accurate assessment of your hearing. If that's not possible or convenient, the other thing that COVID has taught us and delivered really are other means of screening your hearing. Uh you can go to Starkey.com and do a hearing screening there. Um you can also uh uh purchase or download a number of apps, including the Starkey uh app that allows you to as well screen your hearing on an Android or iPhone. Um and really I think uh doing that is the most important thing that you can do. So you calibrate and see do you have enough hearing loss that you should uh consider wearing hearing aids? And then the second step with that is to do something about it in the form of amplification. Anything to add from either you, Jamie, or Arkel?

SPEAKER_03 3:39

Well, the only thing that I would add to what you said, Dave, is that you should do something. And Dave gave you so many different options and ways to explore whether or not you have hearing loss. Do something. And the other thing, you know, Dave, we talked about this on a previous podcast is that I wouldn't ever think, well, it's not bad enough. Right. Um, any even a small amount of hearing loss uh is significant. Even if you can deal with it by turning the volume up, your brain is going to notice the difference. We'll talk a little bit about that later. But um, even a mild amount of hearing loss is something to think about addressing with hearing aids.

SPEAKER_00 4:19

Yeah, and and the journey, if you will, the hearing loss journey in many cases is interrupted over that 10-year period from the first uh observance of some difficulty, or when a family member or friend talks about it to when you get it. And part of that journey in many cases is because when uh an individual even goes to their primary care physician uh and raises the concern, in many cases, people will say, ah, your hearing's normal for your age, or there isn't a bit there isn't a need to rush into this. And yet, as we will discuss on some of the other questions, we're seeing increasing links between untreated hearing loss and other related health conditions. And uh and so maybe there is uh a benefit to having some sense of urgency to shorten that delay from the time of uh noticing that you have difficulty until action. And the final thing on that is that in many cases, the best litmus test is when you go to a crowded restaurant or you go to a proverbial cocktail party and note that you're having some difficulty in those environments because the although the hearing test will help confirm where your sensitivity of your hearing is across all of the pitches of sound that are important for hearing, um those uh real-world uh environments are the ones where hearing loss sort of first crops up and hearing difficulty. Anything else, Jamie, that you have to add to that?

SPEAKER_01 5:52

No, you covered it perfectly. I mean, the first step is a test and there's there's really no harm in it. Um so I think the the sooner the better, and just go see a hearing care professional, or like you said, just do a simple online screening to see where where you're at.

SPEAKER_00 6:07

Yeah, and I I I sort of my dream is to see uh that the welcome to Medicare evaluation includes uh something beyond a pencil and paper screening or questionnaire of hearing. Uh and really we are seeing raised awareness for the importance of hearing imbalance conditions, and uh hopefully we're moving in that direction as we uh move toward the future. But uh Arkel, you raised this issue of uh, you know, some of the the issues about uh hearing and comorbidities, but um hearing loss doesn't hurt. It's not accompanied by uh in many cases any visible sense of uh disability. But uh, you know, to the end of what we already started to discuss, why should I proceed with treating it if I have a hearing loss?

SPEAKER_03 6:57

Well, Dave, you've been in this industry a lot longer than me, and I've learned a lot from you. And one thing that you've shared that resonated is that Helen Keller said that vision loss separates us from things and hearing loss separates us from people. And connecting with people is part of being human and it keeps us healthy. So not connecting with people because of hearing loss means that you are at risk for social isolation and depression that can turn into loneliness. And loneliness has been scientifically linked to premature death. And the reason it's actually been compared to the risk of smoking a half a pack of cigarettes per day. So um so that is a really important reason why you should address hearing loss even though it's not painful. But for those who are thinking, nope, I'm not, I'm fine, I'm not lonely, I'm not depressed. Um, there really is uh an important additional non-painful reason to address your hearing loss. And that's because hearing loss increases the risk of dementia. Even mild hearing loss doubles your risk of dementia, moderate hearing loss triples it, severe hearing loss makes it times five. So, no hearing loss doesn't hurt in the early stages, but the dementia that can follow can certainly hurt you and especially the people that love you. So, again, like Jamie said, um, there's no harm in getting addressed, getting it addressed early.

SPEAKER_00 8:34

Yeah, and and and the harm, you know, uh the Hearing Loss Association of America has for years made the comment that your hearing loss is more conspicuous than your hearing aids. Unfortunately, even though, and perhaps if we have time, we'll talk a little bit about over-the-counter hearing aids and the fact that you know they're becoming a reality in the U.S. Um that really addresses accessibility and affordability of hearing aids. But we know that even in those countries where there is a social benefit that includes provision of hearing aids at no additional cost, less than half of people in those countries uh choose to proceed. And so that stigma remains, even among uh people in my generation, baby boomers. But I think we are seeing, and and Jamie, perhaps you'd wish to comment on this because I know you've worked clinically as well. Um, you know, I I think among my generation, the baby boomers born between 1946 and 1964, that we're less stigmatized by hearing loss and even the use of hearing aids than our parents were, but we do have higher expectations for what hearing aids can do.

SPEAKER_01 9:47

Yeah, absolutely. We're certainly seeing the age creep down of first hearing aid adoption. And with that comes usually technology lovers, you know, usually the people that aren't afraid of it. And even, you know, I'm hoping that these OTC hearing aids and more of these hearables on the market will make it more not as stigmatized to have something in your ear all the time. And so hopefully we can kind of combine our worlds and reduce that stigma. Um, but certainly, I mean, I think it's the technology and the technology and Starky Hearing Aids is a great example of it, trying to make the hearing aid more than just a hearing aid. And I think hopefully that will help in the long run with destigmatization.

SPEAKER_00 10:30

Well, and staying on that topic to move into question three. Um, if you do proceed with the decision to get a hearing test and you know that it doesn't hurt, but as Arkel said so well, um uh proceeding without delay, if you have a hearing loss and hearing difficulties, how do I know what type of hearing aid is the best one for me?

SPEAKER_01 10:55

Yeah, that's an excellent question. And I mean, there are many different models or styles to choose from. And it's a loaded question because in for my audiologist's mind, I go through so many things when thinking about what style is right for a patient. So it's not as easy as just a oh, one size fits all, click add to cart. Yeah, that'll work for me. Certainly, there are some models that work for most, but when you're looking at a style, you have to think about what is your ear like? What is your ear anatomy? Do you have a tiny ear? Is it tipsy and turny and curvy? And nobody knows because you've never been able to look inside of your ear. As well as your hearing loss. I mean, that's the first step in getting the hearing test. What is your hearing loss? And it's not even the severe hearing losses we worry about. I think as an audiologist, we see the most people that still have some normal residual hearing, usually in their low frequencies, and they have a sloping loss where they've lost high frequency hearing loss, which ties back to misunderstanding, not hearing well in background noise, all of those first symptoms of hearing loss. And though that hearing loss is particularly difficult because we don't want to plug your ear up. You know, if you try to put a custom hearing aid in that ear, sometimes it's difficult. Sometimes you feel like you have your fingers in your ear, um, everything can sound a little more muffled, you're especially your own voice. So your hearing loss we have to take into consideration. And then now the perk of having so much more connectivity with hearing aids is that we have to discuss what is your technological savviness? Do you like Bluetooth? Do you like connecting it to your phone? Do you like using apps? Do you still work? Do you use your cell phone? Do you use a landline? Do you use a walkie-talkie? Do you use a radio? You know, what do we need you to use your ears for? Um, and so all of those things in combination with your hearing care professional and your relationship with them, they're really the steward of this journey that can guide you through all of those questions and then say, okay, based on what we know now, you have either this one option or you can choose from these three.

SPEAKER_00 13:08

Excellent. Yeah, and when when I was working, and I still work with patients now, but we would talk about the size, like you said, the performance as well, and then cost. And I think the great thing is that we are seeing channels that allow really uh price points that can fit most people's budget. Um, as you mentioned, uh from being down to devices that fit almost invisibly in the ear canal that still enable a connection uh directly to a smartphone, Android, or iPhone, all the way up to the most powerful ones that may fit behind the ear or the receiver in the canal devices. Um, and then really looking at the um the lifestyle uh uh beyond the audiogram, as you said, I think is so important to considering what the best solution will be. And then uh and that's why we at Starkey uh still believe that even with some of these new channels that may allow direct to consumer, that uh everything you articulated is is often best handled uh and the best results achieved when the patient and the professional engage in the uh the diagnosis and then the discussion over all of these different factors that will help them to uh come up with a solution of the best size, the best uh performance, and the best cost of device for them. And then the last thing I would say is um we have two ears, right? We have two eyes, two ears. Um, and when people are looking at a hearing aid, um they should be looking at two hearing aids. And and I think you know, if you're looking at if price is a sensitive factor, I would say um, and and I'd look to see whether you agree that um getting two uh uh devices is critical in terms of the best outcomes. Would you agree, Jamie?

SPEAKER_01 15:02

Oh, absolutely. And I mean studies have shown it. I mean, if you aid one ear and leave the other unaided, we can actually see your word discrimination or your word understanding decrease in that unaided ear. And that really goes back to what Arkel was saying. You know, all of this leads back to your brain. I mean, all of it is being processed up there. So really two is better than one when you do have hearing loss in both ears.

SPEAKER_00 15:27

Excellent. Well, Arkel, let's uh come back to you for question four now. And uh that one is why should I see a hearing care professional over just visiting my primary care physician?

SPEAKER_03 15:41

Well, I was trained as a primary care physician. I'm an internist, and there are also family practitioners. There are some other doctors that work as primary care physicians, so I feel like I have license to say the following. What I'd say is that primary care physicians are generalists. They know a little bit about a lot of things. So, for example, Dave, if you sprained your ankle, which is a very complicated joint, if you went to your PCP, they don't have the equipment or the expertise to tell you whether it's a sprain or a fracture. And they shouldn't guess because that can be a dangerous poor outcome for your ankle. They know even less about hearing. So if you have any, if you have any complaints about your hearing, um, they might be able to sort of do some direct observation of the ear, they can diagnose an ear infection, they can certainly do that. But to actually test your hearing, they don't have the equipment or the expertise to do that. So I want to make it really clear that um a good doctor isn't one that a good primary care physician is not one that is able to do that or tries to go beyond what they've been taught to do. A good doctor, a good PCP is one who asks you whether you have any difficulty hearing. And if you just say yes, then um having them refer you to a hearing instrument specialist or an audiologist is the best thing that they can do for you because anything else that they attempt to do is outside of the scope of their training. It may not be outside the scope of their licensure, that's unfortunate, but it is outside the scope of their training.

SPEAKER_00 17:31

Yeah, I think that's a great point, is that in working with my primary care physician, I know that she will take care of my primary needs, as you say. But then if I need a referral to a specialist, that is really the action, the next action that will be required. They are often primary care physicians in the U.S. still are the primary gatekeeper on the hearing journey, where a patient will, because of that trust that they have with their primary care physician, they'll begin to ask the question there.

SPEAKER_03 18:04

Absolutely. It's it's hard being a PCP. There are every single patient that comes through your door is going to have a slightly different set of symptoms, and the human body is really complex. So a good PCP knows what they know and they know what they don't know, and they quickly refer to get the person the best care that they can. Excellent.

SPEAKER_00 18:23

Well, Jamie, going back to uh the hearing aids at this point again. I mean, some people will say that, well, aren't all hearing aids the same? You talked already about a couple kind of issues and diving into the technology a little bit, but maybe you could go a little bit more. Isn't it the case that just all hearing aids do is just make things a little louder? Like if I have a relative who has a hearing loss, if I just shout at them a little bit, won't that just uh really uh uh eliminate the need for a hearing aid anyway?

SPEAKER_01 18:51

Oh, yeah, I wish. You know, wouldn't life be so much easier?

SPEAKER_00 18:55

And you're just be shouting at each other all the time.

SPEAKER_01 18:58

Yeah, that's true. Our voices might be strained. Um, you alluded to it um earlier with the different, you know, technology tiers we have within each of our models. And that is really to help usually budget and also lifestyle. So, you know, beyond the style, the model that we have to make the decision on, then we start asking you more of those lifestyle questions and listening needs. And, you know, those are real audiology terms for what do you do every day and what's important to you? You know, again, do you still work? Do you like going to restaurants? Or are you in more quiet settings? Do you like to spend time at home, watching TV, talking to your grandchildren, um, and helping you um prioritize again your listening needs will help us narrow down which technology you need. So we have the more basic hearing aids that help you mostly in quiet. And then as you go up, they help you more in background noise, essentially, to super simplify it. Um we have nice little charts and graphs that'll help you make this decision, um, but they certainly do get more complicated in how we process the sound. So if we just make everything louder, you really wouldn't like that. Um, really, when we start to lose that high frequency hearing, we start to lose those consonants, which in the English language is what we need to understand each other. So I always use the analogy of Charlie Brown's teacher talking, you know, that wah wah wah wah wah wah wah wah is what you can start to hear when you lose that high frequency hearing loss. And hearing aids can bring back those consonants. But with that comes a lot of really annoying sounds, you know, the clicking of pins, the swishing of paper, your feet on the carpet, even your hair brushing back. All of those make sounds. And perhaps you've lost the ability to hear those really uh soft sounds throughout the years and years that you've had untreated hearing loss. And so hearing aids have gotten really smart over the years to really be able to pick up on those speech sounds while also not making those really annoying soft sounds just as loud. So it's actually very complex. Um, and the research that's been done, especially in the last decade, um, has just been incredible to really make them less of that overall amplification device and really more precise with what we amplify.

SPEAKER_00 21:21

Excellent. Well, and to expand on that, maybe for both of you, uh, as we approach the two-minute warning of the first half of our program today, and I'll put in a shameless plug for Starkey Technology and talk about the fact that we have been on uh uh a journey to really redefine and reinvent uh the hearing aid from a single purpose device into multipurpose, multifunction one that can help really address not only hearing, which, as you've said, really is the job one of any hearing aid for quiet and noisy benefit in quiet and noisy and challenging listening environments, but also. So talk briefly, either one of you, about the way that we're incorporating embedded sensors in our technology and why that's important to hearing aid users.

SPEAKER_03 22:12

Well, Dave, I'll take that and Jamie chime in afterwards, of course. But you know, we talked earlier about the fact that hearing loss is associated with depression, social isolation, loneliness, and of course dementia. But wait, there's more. There are more health conditions that are associated with hearing loss. And one of them is that people with hearing loss have three times the risk of falls. They have twice the risk of getting injured doing everyday things that you love. So this isn't just your grandmother or your grandfather falling. This is people with hearing loss that are 50, 55 years old, older, a little younger, a little older, might be playing golf or riding a bike. They have an increased risk of falling. A few possible reasons for that. One is that with hearing loss, you do become more socially isolated. So you're uh you have less activity, therefore, you have less muscle strength, therefore you have some frailty. Um, it could also have to do with the with the inner ear, the vestibular system, because our ears make us aware of our environment and keep us balanced, number of different factors that um that put us at put people with hearing loss at risk for falling. And so, for all of those reasons, uh we have made our hearing aids much more sophisticated by putting sensors as them in them and then applying artificial intelligence so that your hearing aids not only give you this great starky sound, but they also monitor your activity levels, your the number of steps you take, whether you're running or walking or sitting, and giving give you feedback about that, because it's really encur uh important to encourage yourself to remember to stay active. Along with that, our hearing aids and the sensors and the AI that go along with that also have a fall detection feature because um we're all at risk for falling, regardless of our age. And the uh the more you get beyond the age of 65, the higher risk you are. So recognizing that we've made it even more multi-purpose than just a hearing aid by offering a um a fall detection feature so that if you are wearing your hearing aids, you fall. It triggers an alert to a loved one that you have preloaded into your contact so that they can get notified that you might need help. So um that was a long way of get answering your question, Dave.

SPEAKER_00 24:44

No, I am I'm glad you did. And and I would just point to one other element, too, that relates into that health and wellness piece that with the physical activity and cardiovascular health, and then as you already discussed, the cognitive health, the nutrient of getting speech to the brain. Um, the other area and the virtual assistance is um medication adherence. And particularly in the aging population, we know that adherence to chronic medication protocols is about 50 percent in many individuals. And so we can have a reminder that can actually be set on a daily basis throughout the day if you're taking multiple medications that will give you an audible alert to say, take your medications at a designated time. And that's been something that's been really well received by many of uh our patients and providers alike because it it just helps give you that additional edge to stay on top of your medication protocol or not be late for your meetings.

SPEAKER_03 25:43

Well, across the general population, Dave, you're absolutely right that adherence to medication for the entire country, hearing loss, no hearing loss is really just at 50%.

SPEAKER_02 25:53

Yeah.

SPEAKER_03 25:53

And the whole medical industry doesn't know how to crack that nut.

SPEAKER_02 25:57

Yeah.

SPEAKER_03 25:57

But I'll say that people with hearing loss have even lower adherence. Um, and as a result, also have a higher risk of being readmitted to the hospital because they didn't hear. It's not that they just don't want to take their medication, they couldn't hear their practitioner when they advise them on the frequency of taking their medication, et cetera. So um people with hearing loss really benefit from those reminders and the assistant because they're at risk for so many reasons. And um it begins to mitigate a little bit of that risk.

SPEAKER_00 26:30

Thank you. Jamie, anything to add to that before we reach halftime?

SPEAKER_01 26:34

Yeah, I mean, the reminders is one of my favorite, favorite features. And I even had a hearing care professional tell me they set reminders for their patients to come in for their cleaning appointments to clean their hearing aids themselves. Um, and per your medical reminders, the transcribe function on the app to be able to type out what somebody is saying. You know, I always think of doctors' appointments because my mom will accompany my grandma's and she's there taking notes. But if you don't have that person, or if you don't take the notes, or if you can't fully understand them, this transcription component writes out what anyone says, and then you can save it to your phone, email, et cetera. So just a more fun feature.

SPEAKER_00 27:16

Yeah. So I I think as I like to say, to make a long story long, uh uh question number five really points out that all hearing aids are not created equal, and there are a huge, there's a huge range of choices available that begin with that fundamental focus on better hearing, followed by these uh opportunities to link to overall health and wellness, and even go a little into the future with those virtual assistants. Um let's transition quickly into question number six. Uh and this will um come back to um R. Kell on the issue of does hearing loss really affect my overall health? We've kind of touched on this a little bit already, but do you want to elaborate on anything additional in this question beyond what we've already addressed?

SPEAKER_03 28:08

I just can't emphasize enough, Dave, that hearing is part of your overall health. So, yes, we covered the, you know, we covered the specifics, but I'm gonna repeat them because I think we'll be able to do that.

SPEAKER_00 28:19

It's so important. Yeah.

SPEAKER_03 28:21

Social isolation, loneliness, depression, falls, injuries, dementia, and cognitive impairment. Um, you know, that is that, and and there's more. And the most important thing is that that the hearing is related to all of these other medical conditions. And I think that if more people were aware of that, rather than just thinking that their decreased hearing is causing a little bit of a communication problem that they can solve by turning the volume up, I think that more people would care and less people would delay in addressing their hearing loss. So thank you for letting me say all those things three times in one podcast. But um, the more the better, because I believe that educating people on the health-related effects of hearing loss is gonna be the key strategy in getting people to overcome the hump, overcome the stigma of feeling like your hearing loss makes them feel old. Um, hear that um the hearing loss and therefore getting hearing aids makes them feel feel old.

SPEAKER_00 29:30

Well, and I would just oh, go ahead, Jamie. Sorry.

SPEAKER_01 29:32

Well, I was gonna say to build on that, the the recent um Lancet Commission study on dementia really showed that treating your hearing loss is the number one modifiable risk factor in mid-age, which I believe was like 40 to 64, is what they define as mid-age. And that is the number one modifiable risk factor for preventing dementia. The number one, I mean, that I I just wish there was on every billboard. You know, it's such a seemingly simple treatment for us to prevent such a disease that can cause so many more problems for yourself, for your family.

SPEAKER_03 30:08

And our own federal government earlier this year issued in their annual report that is a regulatory requirement to issue a report on the prevention and treatment of various Alzheimer's and various dementias, they added a new section, a whole new section that's never been in that report before, about um making hearing aids more accessible because they are a modifiable risk factor for dementia. So our own federal government is supporting that as well.

SPEAKER_00 30:40

Well, and I've always said that if you want to get a baby boomer's attention, talk to them about cognitive decline. And uh we've likely gone to school more than our parents did, and we want to preserve as much of that kidney function uh as possible. I'm pointing to my brain, uh, and uh or what's left of my brain. And we want to keep it as sharp as we can throughout every uh uh sector and segment of our life. But then I would also uh say, Arkel, the other two areas, I have both cardiologists and orthopods on speed dial. And um cardiology, uh you know, in in an answer to the question of why would we want a hearing aid that can monitor physical activity, like your steps or your exercise throughout the day. And um and I think I'm not overstating what cardiologists have told me in the aging population that the ear is one of the best overall barometers of cardiovascular health, even in a population or a person that didn't have difficulties with hearing younger in life because of the comorbidity between hearing loss and high blood pressure, at risk of stroke, diabetes, a host of other general and specific cardiovascular conditions. And then the other thing that you mentioned is already the risk of falls, but in general, in the aging population, just that reminder or that monitoring of getting up and moving around for a few minutes every hour is good for musculoskeletal strength as we look at um aging, too. So I've I think that physical activity piece also goes hand in hand with the cognitive social engagement score that uh report in our hearing aids to ensure that people are staying more physically active to prevent uh some of those cardiovascular, well, to to address some of those cardiovascular conditions as well as the musculoskeletal strength of keeping moving every day.

SPEAKER_03 32:34

And wait, there's more. So to just add two more things to the list. Uh people with hearing loss also have a higher risk of high blood pressure. And we know that activity, um, being physically active is one of the important parts of the treatment plan for anybody that has high blood pressure. So um, you know, the ear is a vascular organ, so um it it feels the effects of high blood pressure. Um, and so, and and also people with hearing loss have a higher risk of developing diabetes as well. And so exercise is also important for the management of diabetes because we have to maintain our weight, uh, et cetera. So, so many links between hearing and overall health, and so many important reasons why the activity monitoring is um is is a key feature.

SPEAKER_00 33:27

Thank you. I think we've we've emphasized that uh hearing is a connection to overall health and well-being. So, Jamie, the next one is for you. You mentioned that uh in addition to that, wah, wah, wah, wah, wah, Charlie Brown voice, um, that sometimes people who are trying and wearing and experiencing hearing aids for the first time report that they sound a little strange, a little different, a little unnatural. Can you talk a little bit about that?

SPEAKER_01 33:54

Yeah, absolutely. And you alluded to it, I think, first in the podcast, you know, most people wait about 10 years, you know, five to seven being on the low end. And during that time, your brain is not used to hearing sounds, you know, certainly some speech sounds. But again, like I said, those environmental sounds that don't necessarily jump out to you that you're missing them, you know, like your blinker even on your car. Um, and so I always use the analogy of, you know, let's say you're in a room for five to seven years and we start slowly turning down the lights. And by the end of those years, you know, maybe the room's dark, maybe it's still a little dim. What if somebody just walks in that room and just flips on the light? You're probably not gonna like that very much. You're probably gonna go, oh, whoa, that's way too much. It's way too bright. It's very similar with hearing loss and treating your hearing loss. We can't just come in, put the hearing aids on you, turn them on to prescription, say, sound good, okay, see ya, never see you again. We very much have to ease you into it, ease your brain into it. And you have to work to identify those sounds that you've been missing again. So oftentimes people might realize that, you know, their car actually needs maintenance because they haven't been hearing this whirring and clicking from their engine, or perhaps the refrigerator, you know, those are the more umny stories. But we certainly have to start you below prescription first to help acclimate your brain. And we even tell you, you know, listen to an audiobook, go out and talk to your friends and family. Really, like you said, what did you say? The nutrients of the words to the brain. I like that because you really need to reacclimate to all of these things that you've been missing and feed your brain again. Um, and I would always tell my patients, you know, I'm gonna fit you a little below your prescription this first week, maybe the first two weeks. When you come back, I want you to tell me you're not hearing as well as you did when you first got your hearing aids because that means you've acclimated and we can start to turn you up again. So certainly don't have the preconceived notion that it is just a once I like my glasses, you know, I put them on, I'm good to go. It always has been. However, your hearing loss is a little more complex with its um connection to your brain. So we certainly need to give it a little more time.

SPEAKER_00 36:10

That's great. And I think as well, you know, sometimes people uh also report that when they're first fitted uh with hearing aids, that my own voice sounds funny, you know, and um and it does take a while for people to adapt to that. Can you talk a little bit, Jamie, about how the technology has really improved uh the sound of a person's voice, their own voice when they're talking for the first time in recent years?

SPEAKER_01 36:38

Yeah, absolutely. I mean, our our goal, I think, with any new hearing aid is to have it sound more natural and have it sound more clear, um, as well as the processing speed always gets faster. So some of it is kind of the delay and what you're hearing. You know, there's a just this like millisecond delay, but our brains are quick, they can catch it. Um, and so you start to hear that delay. But rest assured, within days of wearing them full time. That's another thing I will say. You know, wearing your hearing aids eight to 10 to 12 to 14 hours a day is what you have to do. You know, I don't want to give away industry secrets, but we can tell how long you wear your hearing aids. So don't try to trick your audiologist, your hearing instrument specialist. You need to be wearing them, especially when you first get them, to get used to your own voice as well as these other sounds. Did you have something else you wanted to add about that, Dave?

SPEAKER_00 37:32

So we've seen again the technology, but what I'm hearing you say with this answer is for the hearing aid user, when they're first starting out with amplification, be patient with yourself. If it sounds completely natural, it's probably not doing enough to give you that benefit. But to use that dimmer, and I really like your analogy of a dimmer switch that we're slowly bringing up as you get used to hearing some more of those sounds. But to give yourself uh the grace and the patience to acclimate to that because it will take time to get there.

SPEAKER_01 38:06

100%.

SPEAKER_00 38:07

Great. Arkel, um, your last question is as follows. I think my loved one has hearing loss. How can I help them? And how do I even approach the subject with them?

SPEAKER_03 38:21

Well, I face this as a daughter to my mom who um has severe hearing loss. I would say that this is tricky, and it's tricky because you want the person you love to feel loved and not judged. So I would plan out the communication over a few conversations, and I would start by um having a general conversation about something new that you learned about hearing. So if you're listening to this podcast, you have probably learned something about the health effects and the relationship between hearing and overall health. I won't repeat them for the fourth time, but you've hopefully learned something new and you could just start a conversation about something interesting you learned about hearing. You didn't know it before. And then in a future conversation, a few days or maybe a week later, then let them know that you care about your own hearing because of what you've learned. And then I would say walk the talk. So you should care about your own hearing. So go to Starkey.com and do your own online hearing test and share the results with your loved one who you think may have an issue. Share them. Don't be embarrassed to share them, whatever they are. Be transparent about it, and then offer to see if maybe they'd like to do the same test on Starkey.com so that they can get that objective information about their hearing. In my experience, when someone feels love, not judged, and when you give them objective evidence, then they're much more apt to at least start seriously thinking about taking the next step. So that's how I would approach it.

SPEAKER_00 40:04

That's great.

SPEAKER_03 40:05

And for my mom, it worked.

SPEAKER_00 40:06

Excellent. Yes, I know that's she's uh a successful hearing aid user.

SPEAKER_03 40:11

Yes.

SPEAKER_00 40:12

Excellent. Um anything else to offer on that, Jamie, or shall we go to your last question?

SPEAKER_01 40:19

I can take my last question.

SPEAKER_00 40:21

All right. So, first of all, tinnitus or tinnitus?

SPEAKER_01 40:25

Oh, tinnitus.

SPEAKER_00 40:26

Okay, all right, me too. Um so tinnitus, for those who are uninitiated to the term, is ringing in the ears. Um, and many people, actually more people, suffer from ringing, occasional ringing at least in their ears, than they do from hearing loss. But how do hearing aids come into play with this? For someone who maybe have ringing in their ears and only minimal loss or hearing loss in combination with that ear ringing? What can you what can be done?

SPEAKER_01 40:55

Yeah, the good news is hearing aids are the best treatment for tinnitus that's known. There's there's no cure for tinnitus, which is something that should be put in bold. You know, anything that says it can cure it is is likely a snake oil. So be cautious there. Um, but to go back to what is tinnitus and how is it um, how does it come about, it's largely due to damage to your hearing mechanism. And tinnitus is often a symptom of hearing loss. So 90% of people that have tinnitus have hearing loss. That's not true the other way around. Not everyone that has hearing loss has tinnitus, but people that have tinnitus often have hearing loss. So the first step when you start to hear a continuous or mostly continuous ringing, hissing, buzzing, it can be really anything that's not in the environment that you're hearing all the time is get your hearing tested. Um, and then from there, the treatment process can be varied. So 60% of professionals said that when their patient had a hearing loss and they just wore hearing aids, their tinnitus, they experienced relief. One in five experienced major relief just from wearing a hearing aid. So that alone is what I've experienced in clinic as well. I mean, if I were to just, I would say 75% of my patients, you know, they say, oh, wait, I'm not hearing my ringing anymore. And it's a little varied on on the cause of that. You know, part of it is again, those soft sounds that we just reintroduced back to you. Your brain is on high alert, going, ooh, what's that? Ooh, what's that? And it's not paying attention to your ringing anymore. So that's part of the treatment. However, if you don't see relief from just wearing the hearing aids, there is something that we call sound therapy that is built into every Starky hearing aid and most modern hearing aids on the market now. There's some kind of sound therapy, or you can get it through many uh noise generation apps. So just playing a very low-level, constant sound, and it can be anything that's you know soothing to you. It can be white noise, brown noise, ocean waves, wind chimes, whatever you prefer. And really just that same principle of distracting your brain from not paying attention to the tinnitus or really paying attention to that other sound. People see relief, um, sometimes minutes, sometimes hours, sometimes days from their tinnitus just from using that um hours on end, days on end. Um so again, there's no cure. However, we do also know that there are stressors to your tinnitus. So oftentimes people first experience tetis after a stressful event in their life or a stressful time in their life. And then we know from there, once you have tetis, it can certainly ramp up when you are more stressed, when you're drinking more coffee or alcohol or smoking more or angry or anything like that that really ramps up your system. It can make your tetis see. Seem louder. But again, the good news is hearing aids alone oftentimes are the relief. And if not hearing aids, hearing aids in conjunction with that sound therapy is an excellent treatment option.

SPEAKER_00 44:12

Yeah, and I think you said it so well. I mean, tinnitus is one of those conditions that range from a mild inconvenience that is only noticed in quiet rooms or if they go into a sound booth and they hear it up to people can be in full-blown despair with tinnitus and almost incapacitated. Those are very rare, but it can occur. And as you said, there are treatments in the form of amplification. There are other treatments, none that is a proven cure on everyone. But in rare occasions, particularly if the tinnitus is getting rapidly worse or is in only one ear and not the other, there can be underlying health conditions that could require treatment. And so if you have tinnitus in one ear or something that has just gotten progressively worse very rapidly, see your physician, maybe start with your primary care physician, ear, nose, and throat specialists, audiologists as well, that can work to diagnose and treat and determine if it is something that does require additional investigation to rule out any underlying health condition. But for the vast majority of people for whom tinnitus is a mild inconvenience, hearing aids alone or using some of the sound therapy programs embedded in a hearing aid can ameliorate that problem related to the ringing in their ears on an occasional basis.

SPEAKER_01 45:41

Yeah, and that's a great point. And bringing up the people that are very um severely bothered by it. I mean, hearing aids alone, you know, that's great, but there's also cognitive behavioral therapy that has been shown to reduce your um emotional response to that. So that is certainly another um great call out to say, you know, it's not if hearing aids don't work for you, because again, I said 60% and then one in five. So there's going to be a chunk that they may not be the best treatment for you. Cognitive behavioral therapy is another great route to explore.

SPEAKER_00 46:18

It's a great point. And we've all been under increased stress over the last few years, I think, going pointing back to some of the loneliness and some of the isolation and just uh uh during the COVID-19 era. So some people may have only recently begun to experience this uh stress contributing to tinnitus. So then the last question, I think we've really addressed this throughout the last uh 45 minutes or so, and that is how hearing aids have gotten better over the years. When I think of summarizing it from my uh perspective, and then I'd go to each of you to maybe add additional commentary, but I think the way I've seen hearing aids improve is uh really becoming more and more effortless in terms of the user interface. That is, once the hearing loss has been measured and been uh programmed by the professional to compensate for the hearing loss, that in many cases now hearing aids automatically adapt as I go from quiet to noisy listening environments, even music and other specialty things, that I don't have to make a lot of adjustment. The automatic nature using artificial intelligence and advanced signal processing enables me to go from uh throughout my day without having to intervene a lot. But but we do also, in some uh technologies, have the capability of me engaging additionally with a user-evoked scan of an acoustic environment to optimize further if I want to. But for most people, what they really want is effortless hearing to just put them in and go about their day. Then I would also say effortless connection, given that, as you mentioned, Jamie, now hearing aids connect to smartphones, iPhones, and Android phones so that I can stream phone calls to both ears, which makes a huge difference. Um, stream any audio coming from my smartphone. My wife now thinks I have a sense of direction since I started wearing hearing aids, but secretly I'm just streaming the map directions, the audio directions in my ear when I'm driving or we're driving somewhere. And I listen to podcasts and music as I'm working out with them. And that connection uh to the technology is a great one, also enabling me to be connected to the professional if I can't or don't want to always go in for face-to-face visits. I can do some of those follow-up visits for adjustment or counseling with my professional using telehealth. And then the last plug is for an application that we have that enables, with permission, family members or colleagues or even professional caregivers to monitor my progress in terms of physical activity, wearing my devices, even social engagement through the use of a companion app. So whether it's connecting to technology, to the professional, to family, that effortless connection, I think, is another area I've seen improvements. And then you hit on it so well, Jamie, the effortless selection of the most appropriate technology from the smallest to the largest, most powerful devices with the different price points, with the Android or iPhone that are very, you know, a broad array of them are compatible with these devices. And then even using specialized accessories like remote microphones, TV streamers, um, and really all of that is best handled to make this an effortless experience between our technology fitted with the hands of the professional to optimize or exceed outcomes for the patient. That's all I have to say about that. Any any other any other comment?

SPEAKER_01 50:00

I'll add one more thing, and you guys might be surprised for when you when you first started saying the, you know, how has changed. I've been around with hearings for 10 years now. This will be my 10th year, so I may I hope I look young. I may look young or sound young, but I've I've seen them for a bit now, now I think about it. Um, rechargeability. You know, it's something that we really take for granted with our smartphones, with really any electronic we have now, we expect it to be rechargeable. And the same is true with hearing aids. And Dave, you might know the number more off the top of your head, how many hearing aids, you know, the percentage. It's it's surely the majority now.

SPEAKER_00 50:40

It's two-thirds are rechargeable. Yeah.

SPEAKER_01 50:42

You know, the the Rick devices, the behind the ear. And then Starkey had the first custom in the ear, rechargeable hearing aid, which is really exciting. So I just think rechargeability is another one.

SPEAKER_00 50:54

That's a great call out. All right, Kel, any other final words from you on that?

SPEAKER_03 51:00

Um, that was a really beautiful summary that you gave. So I'm not gonna add to that. I'll just say that what I see is that here Starkey and our hearing aids and our devices are recognizing that hearing is personal. So just like so much of healthcare is personal, we want we want um our treatment plans to be tailored to us. And what our hearing aids are doing is it's tailoring the sound to us because hearing is so very personal. And it is really cool to see out how our technology can do that.

SPEAKER_00 51:37

It's it's the the best thing uh for me about my job is that I still get to see patients as well as uh have a hand in helping develop the new technology. It's amazing to sit across from a person that is experiencing the technology and the benefits that come with it, and that's what I like best. So I would encourage listeners who are considering uh uh uh getting an assessment of their hearing and proceeding on this hearing journey to try amplification. Don't delay, just do it. And uh, Dr. Arkel Giorgio and Dr. Jamie Myers, it's been an absolute pleasure to uh speak with you here today on Starkey Sound Bites.

unknown 52:17

Thank you.

SPEAKER_01 52:17

Thanks for having me.

SPEAKER_00 52:19

Well, and to our listeners, thank you for listening to this episode of Starky Soundbites. If you enjoyed this conversation, please rate and review us on your preferred podcast platform. You can also follow this podcast or subscribe to be sure that you don't miss a single episode. And we'll see and hear you next time.