‘What did you say?’: Coming to grips with diminished hearing

  • Laurie Smith, the director of the Clarke Hearing Center in Northampton, says hearing aids — though they’re not inexpensive — have become more sophisticated in the last several years and do a better job of screening out background noise. STAFF PHOTO/CAROL LOLLIS

  • Dr. Christine Kelley, an audiologist at the Clarke Hearing Center in Northampton, says there’s typically a seven-year gap between the time patients become aware they have hearing loss and when they actually seek treatment for it. STAFF PHOTO/CAROL LOLLIS

  • Dr. Christine Kelley, an audiologist at the Clarke Hearing Center in Northampton, says there’s typically a seven-year gap between the time patients become aware they have hearing loss and when they actually seek treatment for it. STAFF PHOTO/CAROL LOLLIS

  • In this booth at the Clarke Hearing Center, explains audiologist Dr. Christine Kelley, children’s hearing is tested both for clarity and volume. STAFF PHOTO/CAROL LOLLIS

  • Elizabeth Cosmos, at left, and her husband, Tom, of Chicopee, meet with audiology assistant Sarah Verteramo at the Clarke Hearing Center to discuss some repairs being made to Elizabeth’s hearing aids. She says getting the aids has made a huge improvement in her quality of life.  Photo by Emily Rae

  • Sarah Verteramo, an audiology assistant at the Clarke Hearing Center, describes how a pair of temporary replacement hearing aids for patient Elizabeth Cosmos work. Cosmos’ hearing aids were being fixed at this time. Photo by Emily Rae

  • Elizabeth Cosmos tries out a replacement hearing aid at the Clarke Hearing Center as her regular one gets repaired. Cosmos said her hearing loss had made her avoid social scenes in recent years but that she’s now “back to her regular life.” Photo by Emily Rae

Staff Writer
Published: 2/4/2020 10:11:54 AM

About five years ago, Elizabeth Cosmos started having trouble hearing things during normal conversations. She was missing certain words, sometimes whole sentences, and she had to ask people to repeat themselves. She also had to keep turning up the volume on her TV — enough that her husband, Tom, had to retreat to a different room to watch a program on a different television.

It got bad enough in the past year, she says, that she started avoiding social situations, not going out with friends for a meal or other activities — and that began to take an emotional and psychological toll on her.

“I was getting really depressed,” Cosmos, who lives in Chicopee, said during a recent interview. “I felt like I didn’t belong anymore. I was making excuses to avoid going out and doing things.”

She also remembers trying to talk with her granddaughter one day in the car as she was driving and having to ask the girl to speak up. “She said, ‘Grandma, I’m already speaking as loud as I can.’”

Cosmos is hardly alone. About 15 percent of Americans 18 years and older report some degree of hearing loss, according to the National Institute on Deafness and Other Communication Disorders (NIDCD), a division of the National Institutes of Health. That percentage rises considerably with age: The NIDCD says 50 percent of Americans age 75 and up have what’s considered “disabling” hearing loss, in which they can benefit from a hearing aid.

And Dr. Christine Kelley, an audiologist at the Clarke Hearing Center in Northampton, points to another troubling statistic: On average, she says, it takes about seven years before a person who notices a hearing loss actually seeks help for it.

“That’s a long time to go when you’re having problems,” says Kelley. “It can affect your job, your social behavior … People can isolate themselves, and that can lead to health issues like depression, and it can affect relations with family and others around you.”

Tom Cosmos gives a rueful smile when he recalls jokingly asking his wife, “‘Is the TV loud enough for you?’ Sometimes I’d be in another room with the door shut and I could still hear it.”

But the Cosmos’ story has a good ending. Elizabeth came to the Clarke Center last year and had her hearing tested by Kelley, and she was diagnosed with a mild to moderate hearing loss. She was fitted with two hearing aids that are designed to “talk” to each other and automatically adjust to the volume of the sounds she hears, balancing the needs of each ear.

The difference is like night and day, says Elizabeth. “I got my life back. Now I can hear the ticking of Tom’s clock, on the other side of the bed, I can hear my granddaughter, I can hear what everyone is saying.” And the family television, she adds with a laugh, is back to a normal volume.

A slow loss of hearing

The issue with hearing aids — more specifically, the reason some people resist getting them, Kelley says — boils down to a couple things. A big one is price. She and Clarke Director Laurie Smith say a pair of the devices — and many people with hearing loss will need a hearing aid for each ear — can cost anywhere from about $3,000 to $10,000, depending on their sophistication and the degree of a person’s hearing loss. But very few health insurance plans cover them, Smith notes, and paying for them out of pocket can obviously be a challenge to many people.

In addition, some people object to the cosmetics of wearing a hearing aid, says Kelley. “There can be a stigma about it. [Patients] will say ‘It makes me look old’ or ‘It make me feel old.’ I think that emotional piece has a lot to do with it.”

Yet as Elizabeth Cosmos puts it, “How do you put a price tag on the quality of life? If you’re not hearing things around you, you’re just missing out on so much … I know, because I went through that.”

The Clarke Center, which opened in 1974, has long worked with children with hearing loss. But Kelley and Smith say the vast amount of those cases are caused by genetics or sometimes a serious illness. With adults, hearing loss tends to be much more gradual, such that people don’t realize they’ve been losing ground, sometimes for years.

“That’s why it can be common to think ‘Oh, I’m having trouble [hearing] because this restaurant is noisy, or because someone tends to mumble,’” says Smith.

Kelley says adult patients in the Clarke Center are most typically in their sixties or older, though of late she’s talked to people in their 40s and even a few in their 30s — probably a good sign, she adds, because they’re seeking help before a problem might get worse. She notes that most patients the center sees come in “because someone told them to come in. It can be a partner or maybe their kids telling them they’re saying ‘What?’ a lot, or they’re turning up the TV. They don’t realize it’s too loud for other people.”

Going long periods without hearing properly can also create what’s known as “auditory deprivation,” Kelley adds, in which the part of the brain that processes speech and sound “is not getting exercised. It’s not as efficient — there’s a certain amount of atrophying in a sense. When you put a hearing aid in, you’re getting those pathways to the brain to work again.”

But, she and Smith note, the longer you’ve gone with diminished hearing, the longer it can take to get used to wearing a hearing aid.

Hearing loss, for most adults, itself comes in two basic forms. Sensorineural loss results when the tiny hairs in the cochlea, the inner air, are missing or damaged and cannot produce nerve impulses in response to sound vibrations. This is permanent and is usually a function of age. “Think of a field of wheat blowing in the wind, and then a terrible storm flattens everything,” says Kelley. Short of surgery, only hearing aids can correct this kind of problem.

Conductive hearing loss, by comparison, tends to be temporary — from a bad ear infection, for instance — and can usually be treated with medication or, more rarely, surgery. A mixed hearing loss can include both sensorineural and conductive conditions.

Another problem, which can crop up in younger people, is Otosclerosis, a buildup of bone tissue around one of the tiny bones in the middle ear — usually the stapes — that prevents it from vibrating and passing sound from the middle to inner ear. Surgery, called a stapedectomy, is sometimes performed to replace the stapes with a tiny prosthesis; the NIDCD says the procedure has a good rate of success but can sometimes fail down the road during a patient’s life, and in some cases actually cause hearing loss to worsen.

Hearing aids can also correct for Otosclerosis, Kelley and Smith note, as well as other types of hearing loss. But they caution that the devices are not a perfect replacement for a normal ear, even as they’ve become more sophisticated and smaller, do a better job screening out background noise, and address both volume and clarity in hearing loss.

“They’re not like glasses, where now you see perfectly,” says Kelley. “Hearing aids are just that — they really help improve people’s lives and hearing, but they cannot replace an organ.”

That said, if you were only understanding 50 percent of what you heard before, “and now you’re getting 90 to 95 percent, that’s obviously a huge improvement,” she adds.

Meantime, she and Smith say there are plenty of basic steps people can take to protect their hearing, such as wearing earplugs when operating loud machinery and turning down the volume of their iPods or computers when listening to music through earbuds or headphones. (A report from the federal Centers for Disease Control two years ago said hearing loss rates were rising in people aged 12 to 20, likely due to exposure to loud music, especially through earbuds.)

“We also teach communication skills, so you have something to go home with in the event you can’t or won’t buy a hearing aid,” adds Smith. “We’re trying to help you in whatever way we can.”

As well, the Clarke Center has just started a leasing program for hearing aids, in which people can pay between $100 to $200 a month to try out a hearing aid and then eventually buy the device outright if they like it. “Some of our patients might say, ‘I’m too old to buy a new hearing aid,’ and this could be an option for them,” says Smith.

Elizabeth Cosmos says her only regret about her hearing aids is that she waited a number of years before she got them. “It would be nice to have that time back,” she said. “But I’m happy about where I am now.”

Steve Pfarrer can be reached at spfarrer@gazettenet.com.


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