Preventing the scourge

The new patient had been in her chair about ten minutes, when I entered the waiting room near the end of the clinic day. Just above her chair, there was a banner sign that read "PREVENT the Scourge: Get Tested". She was about 60, dressed well and appeared poised, even when she was forced to wait a few minutes. Cleaning up an exploded Twinkie cake had taken more time than I thought. Oh well, I'm glad she did not leave - and when she had heard her name and we exchanged introductions at the door of our exam room, she came in and started telling her story. There was a chance we could head off a big problem for her, if I had read her case history closely.

Like most of us over 50, she had noticed that she was not understanding what people were saying to her. She had obtained a master's degree in education when in her 20's, and had retired two years ago after 25 years of teaching. At times through her tenure, she said, working conditions in her schools may have taken a toll on her hearing. High ceilings, cavernous classrooms and smooth building surfaces in older school buildings forced her to struggle to be understood by her students. Not only was she fatigued daily near her retirement time from listening, but she also found her voice was becoming strained and dogged her continually. Her circuits were getting fried, it seemed.

The testing was routine and went smoothly, and it felt easy to empathize with her during the evaluation; - to acknowledge her responses to the procedures, keep her energy up for participating actively through all the exams, and to help find some reserves to digest their meaning: what next?
We took a good break before reviewing the information, and planning any interventions. We each get a cup of tea, and a Fig Newton or two. Then the review and the counseling started: I hope we were not too late.

"Thanks for coming today, and letting us serve you. I think you understand well what has happened, and  we'll need to decide together what the best course is for you. Your audiogram says - "

"You've lost some significant ability for understanding conversations. You see, we use the high frequencies to understand speech in daily situations, and those frequencies are often the most sensitive to the stresses our ears take. Noisy and echoing listening conditions, and the changes in our general health that feed the health of the ear, can cause those sensitive frequencies to be lost for processing sound. When you lose those frequencies for fast processing of sound, the brain can step in and 'fill in the blank', so you understand the message. BUT, that loss of processing power in the ear may and often does continue, so that the brain has to compensate more and MORE for your conversations. Tell me this - do you ever feel exhausted from the effort you give to listen to conversations??"

"Because we're trying to prevent these problems from becoming a chronic communication problem that affects most daily function, we do the hearing and cognitive, or thinking, tests - and then help you estimate what effect your hearing changes might have on your daily living. Once again, do you ever feel exhausted from listening?"

(Blogger's note: Thanks to Jennifer Jones Lister and Jerri Edwards, for their July 2017 article in Access Audiology titled "Lose Your Hearing, Lose Your Mind?: The Relationship between Hearing and Cognition".)