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Say what? Hearing loss is common and hearing aids can help
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By Michael Spilane
Have trouble hearing when you’re in a crowd? Do you find yourself frequently asking people to repeat themselves? You are not alone. Hearing loss is a significant problem for 25 percent of people over age 65, and for almost half of those over age 80.
Hearing loss has many causes, but the type that shows up in later years is almost always due to degeneration of the sensory nerve cells in the inner ear. In the normal ear, sound waves proceed through the outer and middle ear and then tickle tiny hairs that are attached to nerve cells in the cochlea of the inner ear. In sensorineural hearing loss, the hairs and nerve cells are unable to collect the vibrations and transmit sound messages to the brain. Sensorineural hearing loss can be hereditary, but it most often occurs in a person with no family history of hearing problems. The best answer to the “why” question is not a very elucidating one — it appears to be due to simple wear and tear. Some loss of hearing acuity can be demonstrated in almost all persons by age 50, but it is usually insufficient to cause trouble. As the years go by it becomes increasingly more likely that degeneration of the nerve cells will cause significant hearing symptoms.
Other factors can also cause or contribute to sensorineural hearing loss. Loud occupational or recreational noise is very harmful to the nerve cells in the inner ear. With prolonged exposure, hearing loss is likely. These days the wise worker wears ear protectors in noisy environments. The unwise kids who like their music at 100 decibels are fodder for tomorrow’s hearing aid manufacturers. Some drugs have the potential to damage the ear’s nerve cells. The list of problem drugs is not long, but includes life-saving agents in the antibiotic and diuretic (water pill) groups. Aspirin and quinine can also cause trouble at high doses.
Not all nerve cells are affected equally in sensorineural hearing loss. Those that detect high frequency sound wavelengths are most prone to damage. And this is not a good thing. High-frequency sounds are the ones that enable discrimination of speech sounds. Since they carry the consonants of speech, losing the high frequencies makes the words sound like all vowels and make the speaker sound mumbly. The words are heard but not understood. In the early stages of hearing loss, comprehending the spoken words is more a problem than the volume of the speaker. The nerve cells in normal ears have sufficient power to detect and separate specific conversation even when there is a lot of background noise. But the nerve-damaged ear is overwhelmed by background noise and separation is impaired. An early symptom of sensorineural hearing loss is trouble hearing conversation in the presence of background noise. Conversation in noisy places is lost, and the impaired person is likely to avoid such environments.
It is common for an older person to tolerate and adapt to hearing loss rather than seek professional help. But the toleration and adaptations typically lead to yet more problems. The impaired person may stop attending movies and plays, avoid dining out with friends, sit mute in conversational groups, and avoid initiating conversation. At its worst, the progressive social isolation can lead to depression and even confusion. The absence of pain or acute distress, along with the insidious progression of the hearing loss, makes the afflicted person under-aware of the severity of the problem and its social consequences. Too often a spouse, friend, or family member has to use the baseball bat approach to convince the deaf one to seek help.
Sound is one of the riches of life. Missing out on sound is missing out on life. Only about one in five people with hearing loss uses a hearing aid — cost, embarrassment, and misinformation are the common reasons. Like all technologic devices, the performance of hearing aids has advanced dramatically over recent years. Yes, they are costly. Yes, they are worth the investment.
Dr. Spilane practices at the Seniors’ Clinic at the HealthPartners Specialty Center in St. Paul, Minn.
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Macular Degeneration
By Michael Spilane, MD
Few parts of our body are as small and vital as the eye’s macula. This organ is the size of a tiny button, but is responsible for 90 percent of our vision. It is the workhorse part of the much larger retina, the image-capturing membrane at the back of the eye. Degeneration of the macula is the chief cause of severe and irreversible loss of vision in persons living in developed countries, and is almost exclusively a problem of older adults. Prevalence of visual symptoms caused by macular degeneration increases with advancing age, with about 10 percent of the older population having significant symptoms by age 85. Its cause is unknown, and treatment is often frustratingly unsuccessful. Recent scientific advances do allow help for some. There are two types of macular
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Ode to the great American supper club
By Carol Hall
Wisconsin is known for its beer, cheese, and supper clubs. The beer and cheese, of course, are part of the supper club experience: the part that comes before consuming the signature Friday night fish fry or Saturday prime rib of beef. Supper clubs are a Wisconsin institution. For reasons no one can explain, they abound throughout the state. Most sprang up in the 1930s and ’40s, but some date back to the 1920s, and are reputed to have been prohibition roadhouses, frequented by the likes of Al Capone and John Dillinger. Today, they have a reputation for good food at a reasonable price. Often located on the outskirts of a town, they have an unfailing ambiance: dark, cool, and slightly masculine. You don’t expect to see a gathering of Red Hat ladies at a suppe
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Lessons from a grand generation
By Dave Nimmer
When I was a kid growing up, I could have learned some of my best life lessons from my grandparents, each of whom modeled a trait or trademark to make the journey easier, richer, sweeter. As it turns out, I went two for four — not a bad batting average in baseball, but a little less impressive in real life. From my Grandpa Nimmer, I learned the joy of hard work, as in manual labor: getting your hands dirty, working up a sweat, mopping your brow, taking a break and looking at what you did. The old boy worked as a brakeman on the railroad, survived the depression and provided for his family. He was thin as a rail, maybe about 135 pounds, 5'7", usually wearing overalls and carrying a corncob pipe in the breast pocket. As far as I can remember, he never took
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