 Welcome back to Don't Just Age and Gage on Think Tech Hawaii. I'm your host Dr. Larry Grimm. Today on the show we'll be discussing the question, do you hear what I hear or auditory changes in aging? And we have as our guests Ms. Lisa Stales and Mr. Robert are introducing all from a very good company that are going to represent their products, but also we'll look into what it is to age and how we deal with how we encounter age in our aging auditory changes. Welcome Lisa and Robert. Thank you so much for joining me here today. It's really wonderful to have your expertise. Thank you. Thank you very much. I'd like to begin just giving our audience viewers an opportunity to get to know you a little bit about your career, your history. Tell us Lisa, would you first tell us something of your story of your work and your service and your life here on the island? I moved to the island a couple of years ago, however I've been with Miracle here for well over 20 years and I've been in practice much longer than that. I myself am very hearing impaired as is my husband. I have two degrees in the field. She really does have great skill and abilities and she's very effective and efficient. Robert, this is my first opportunity to meet you face to face so to speak these days and would love to hear a little bit more about our viewers of your journey. Sure. I actually have a background in health care going back to coming out of high school and into college initially. I started my career working in x-ray and in CAT scan, so got to transition into hearing because Lisa and I actually have a mutual friend, Erin Toth, who's an owner in the industry and has worked with Miracle here for several years as well and upon me getting ready to move to Hawaii, I learned of the opportunity with Miracle here. So I started to shadow with him and some of his associates and that's actually how I met Lisa way back in Michigan before either of us ever lived here in the islands. And I studied hard and switched over from as I mentioned x-ray, CAT scan and polysomnography actually working with sleep studies but transitioned over to the hearing side of the world and moved out here in 2014 when I opened the very first Miracle ear location where Lisa currently is working at the Nimitz Highway office in Honolulu. And I've been doing it ever since. We've slowly expanded to seven locations throughout the islands and I look forward every day to getting up and helping more and more Kapuna throughout the islands and really having the opportunity to change people's lives. So it's been an interesting journey for me but one that I wouldn't trade for the world. And you are on the Big Island? That's correct. Yep. I work in our locations that are in Hilo and Kailua Kona. And Lisa, you're on Oahu? Yes, I am on Oahu. I'm in Honolulu. I'm in Nimitz Highway and as you well know. Excellent. And in Oahu now we have several offices. So there are other options other than just traveling to Honolulu. If you live in Kailua or White Papu we have a service series. Well, I thank you both for being here again and what I generally want to do is like to have my viewers come away with some sense of how they can evaluate or assess their own hearing capacity and then how they can respond and follow through to do whatever is helpful in correcting or modifying or enhancing that that auditory experience. But let's first take a look at what is it that happens in our aging process both emotionally and spiritually, relationally, as well as physically with regard to our hearing senses. Oh, there's a lot. In particular, we're talking about untreated hearing loss. You know, it's not just an issue of the year. It's a lifestyle quality that's lacking and it also affects many other health issues that are either exasperated by an untreated hearing loss or the hearing loss is resulting from some other illnesses, which is quite common. And you know, hearing this is a naturally occurring thing, but it can also be caused by many other things like diabetes. People with diabetes have a much higher chance of having hearing loss. So it can be related to a to a constellation of of issues, physical issues in particular. One of the other big concerns that we look at when it comes to hearing loss is isolation factors and withdrawal as well. You know, that's one of the biggest concerns because as we start to age being active is and still being cognitively healthy and functional is something that we have to try to maintain. And when we start to develop a hearing issue, it's natural to not want to participate in cocktail parties or birthdays or graduation celebrations and other things like that. Because if you're not hearing very clearly or very well, then it's it's much more difficult to to participate in those environments. Well, to each of you, I ask, would that be the same for somebody losing their sight? It can be. But even Helen Keller herself stated that the auditory perception is the larger of the two deficits that she perceived to be more valuable because communication is the way that we function together, you know. And so seeing is one thing, but hearing quite essentially is another. Sound travels. I come up. Go ahead, Lisa. What sound travels? You can hear something around the corner or in another room or outside you can see what's in front of you. You have a much greater sense of your environment if you can hear and your brain needs those sounds to stay active in that area also. And it's 90 to 95 percent of people with hearing loss can be treated with hearing aids. Unfortunately, that's not what's going on. There's about 38 million people in the United States with hearing loss and about 20, 25 percent are actually treated for that loss. I think when I came in first auditory test I had, the person who took it said, did you listen to a lot of concerts when you were good? Go ahead, Rob. Most certainly noise exposure is a huge factor, environmental things. So it's not just about health conditions that we already have. It's also just part of the natural aging process. So it's not something that we can really avoid as we age. It's going to happen. And so getting the health that you need to as soon as you possibly can is also a very crucial factor. It's a lot like anything else. If you don't use it, you'll lose it. But unfortunately, these are not nerves that we could ever regrow. So when the damage is done, it's not something that's reversible. So another reason to be proactive and not reactive. Another aspect of that is what causes or the atrophy that's related to the brain. Same concept. Once it's gone, we can't bring that stuff back. So it's not always just about how we hear. It's also about how our brain is able to process the information that we give it. So another large concern for those that put off getting hearing help for maybe 10 or 15 years in some cases. The atrophy that's occurred to the brain to some level, even when we start to restore sound, if their brain is no longer able to process that information, then the clarity that they're trying to get may still not necessarily come to light. Would you say that hearing loss is related to dementia? Absolutely. It's an accelerator. So not something that's going to, per se, give you dementia, but like being overweight makes you more susceptible to heart disease. Same goes to hearing loss with dementia. Untreated hearing loss is up to five times more likely to happen and result in dementias than treated hearing loss. So if it's statistic, if you have interest in this, not treated, it's up to five times more likely that the individual will have some type of Alzheimer's or dementia. Well, that is such a significant number. So any family member who has an aging parent, Kibuna, would be wise to make sure their hearing is tested regularly. Absolutely. It's recommended by 60 years old, actually, or even 55 in some cases, depending on which studies that you read. But definitely something that the sooner you start to at least be aware of where you are, maybe that is, do you actually have a loss, but at least be aware of where you are on the chart and what is in relation to normal. Excellent. So that's good advice and good being aware, being aware of context surrounding environment and how it contributes to the hearing loss is important as well. That's great. And on a self-assessed level. Oh, sorry, go ahead. Yeah. Oh, please, Robert, continue. Yeah, on a self-assessed level, some of the things that I try to have patients look for specifically is, you know, how many times are we accused of mumbling, you know, or that everybody mumbles, my hearing is fine. People just need to articulate or maybe not talk quite as fast. Typically, those are signs that they are indeed missing parts of what's being said. And therefore, maybe the individual they're talking to is not actually mumbling. It's just the way they're perceiving what they're hearing. Or if you start to notice things, very subtle stuff, like one common thing that people notice when they first wear their hearing aids is they can hear their feet when they walk, you know, or turn signals in their cars. And, you know, there's a lot of little things in the environment that we just don't notice aren't there anymore because they're so subtle to begin with that your brain really just starts to, or you just dismiss the fact that they're there. And ringing in the ears is also something that a lot of people dismiss as just, it is, you know, from noise exposure or something, which is often the case, but it is also a big red flag for having some high frequency hearing loss. And of course, now that we all wear face masks, you know, this is something that has made even mild hearing losses that much more evident, because we all do a very small portion of lip reading when we don't necessarily understand something in its entirety. And so if we find that we can't really hear and understand unless people are looking at us, well, there's another indicator that maybe there's something going on. Oh, ringing in the ear. How often are we seeing this misunderstanding or missing phrases, high pitches that we don't notice, and not being able to hear without seeing the person. I'm a theater, I was a theater major in college. And one of the things we always said to our technical people was, you can't see, if you can't see the actor, you cannot hear the actor. And so it's important, it was always so important to light, light the faces of the actors adequately, so that people could hear the audience get here. Excellent. Now, Tintinitis, you're just, you've described a little bit, is that correct, Robert? You touched on. Tintitis or Tintitis? Tintinous. Tintinous. What's the cure for Tintinous? Well, hearing aids in a lot of cases, but there really is no cure for it. That's something that, again, to be understood is we can't ever really make the signal go away. But with hearing devices, there's both Tintitis management therapy inside, so we can essentially present you with a sound that is more tolerable than whatever the noises that you hear to preoccupy your brain, because it's actually a neurological symptom. It's not really coming from your ear. And so when we are able to do that, we're kind of playing the sleight of hand. We're sort of tricking the brain into not having to manifest the signal that it makes on its own by giving it something to focus on otherwise. But the same rule applies when we start to give you the ability to notice those sounds that you were missing. And so therefore, by wearing the hearing aids and, again, being able to start to hear things like your turn signal and your feet on the ground and birds chirping and other things like cars driving by and being more aware of what's around you gives your brain the ability to actually relax itself. And therefore the Tintitis typically will start to organically get better. Yeah, that's amazing. That is truly amazing how the body adapts. Anything to add, Lisa? On that one, no, other than the fact that scientifically, when you present two identical tones at the same time, which is what the hearing aid does, and the brain is making that sound because there is no sound there, which is what Robert just said, but if you're trying to present them at exactly the same time, there is no sound. And that's what the hearing aid does for a Tintitis mask, which is we have built into our instruments today, just for that reason. Good. I'm wondering what are some of the barriers, emotional barriers, perhaps, that you encounter in people who, for the first time, come to you and recognize that they have hearing loss? By emotional barriers, do you mean how do they feel? No, emotional barriers. Emotional barriers. Adults with untreated hearing loss, or more, and Rob touched on this earlier, are more likely to report being depressed, having a anxiety, paranoia thoughts, much more common than people with hearing loss that wear hearing aids. They suffer. It's emotionally stressful. Stressful is a bad thing for anybody. There's a circle of people, they can't understand them, and it gets to be a very vicious cycle. And with the emotions, it's emotion to that circle. Spouses, family members, friends all have a part of it, own it, you have to raise your voice, you're out in public with your dad, and you've got to yell at him to get him to understand you, and then he wonders why you're mad at him. That's an emotionally stressful environment for everybody. It's toxic. Thank you for that illustration, that's very helpful. Any more to add to that, Robert? It's that kind of stuff, or typically speaking, they've either embarrassed themselves in a situation, or potentially even almost hurt themselves or somebody else maybe driving a car and didn't hear an ambulance coming or something to that effect. So there's definitely an emotional aspect to hearing loss, and sometimes I use the analogy it's like bad breath, you're the last person to know that you have it as well. And so that's another concept is that you have to really try to wrap your head around what the people have been dealing with or going through, and sometimes they don't even know it. And so it's also having to try to open them up and break down the barriers to get them to really discuss what's been going on or what maybe they have or haven't been noticing. And it is ironic how in some cases, the loved ones are saying, no, you have a problem, and then in their case, they just don't necessarily perceive it. So through the testing procedure, we're not necessarily trying to point out that people have an issue, but there are ways to help slowly ease them into the idea that maybe it is in fact their own their own issue that they have to deal with. But so emotionally, and that's really what we want to try to capture is the idea that there's more to life than just throwing in the towel. And that certainly is what we don't want to ever see happen. So when someone comes into Miracle Layer, the first thing that they get from you is a welcome and a big smile. That's right. And the second thing is a discussion will lead us through the next thing and then the next thing and then the next thing. Yeah, go ahead, Lisa, I'll let you go ahead and start. Okay, well, there's obviously some paper work to fill out so that we have some idea of what's going on with them, some medical history, how they perceive their loss, how if they have a loved one with them, how they perceive the loss. And I feel that it's very important for a person who has a hearing impairment to understand their loss and to own it and try to wrap their head around it that way. But versus understanding and understanding what it represents, you know, if you've got a sensory neural loss, you might be able to hear your best buy. You can't hear your wife or your daughter or your grandchildren. And that's the issue of actually educating the patient understand what their loss is. And by doing that, throughout the course of the testing procedure, I find that people are pretty open when we're all done and are ready to try a hearing aid. Another big aspect and I think what separates us and what we do better than most is, like Lisa had mentioned, educate. That's first and foremost what we want our patients to understand is not necessarily just do they need a hearing aid or don't they, but exactly what's happening in their hearing loss and why particular technologies may be more effective for them versus other technologies even when it comes to style, you know, in the ear versus over the ear. We really try to be that solution for every single issue that you're having and really walk your hand, walk you through and guide you through this process because it truly is a lifestyle change as well. It becomes something that you know, it takes there's a learning curve, you know, the amount of time that some people take to just learn how to put the hearing aid incorrectly is different for everybody. You know, even how we perceive sound is different. So two people with similar hearing losses, we program hearing aids, they aren't necessarily going to sound the same for every individual. And so doing protocol like speech mapping is something that is necessary, not just something that should be done, you know, for the sake of doing it, but it's really what helps us ensure that the patient is getting the benefit from their devices that they should always be getting as well. No throwing darts at the wall, if you will. We like to make sure that everything is done correctly. And what kind of information do you get from that auditory test? Sitting in the soundproof cube and listening to all the heads up? Well, that really is just giving us a painting of picture of as if you were to go down and have your eyes tested, we need to find out necessarily, you know, what your prescription is, if you will. So that gives us a baseline to initially tune the devices. But everybody's ear canals are different shapes and sizes. And so therefore, like a big room versus a little room sound reverberates differently based on those kind of characteristics. And so that's, you know, the initial testing is really just a very small part of what's necessary to fit the hearing aid correctly. That's excellent. Thank you very much. We only have five minutes left. One of our viewers has asked the question, what makes Miracle Ear special compared to other hearing aids? And a nutshell, it's our technology. It's capable of doing things that other technologies are not. Our ability to adjust the devices is much more elaborate than a lot of the other technologies out there. So because Miracle Ear only deals with one specific brand, our software is very unique in the way that we have access to adjusting the devices. And with that being said, we're constantly being trained on technology changes within not just the industry, but with our tech or with our products themselves. And so when if you're ABC hearing and you sell, you know, 10 different types of hearing aids or 10 different brands, well, now that's 10 or more different things that you actually have to be adapted to learning and understanding if, you know, your patients are using different kinds of technologies. So in my opinion, that just makes it a little more confusing. But the reality is, is, you know, I have not met a person yet that wears competitive hearing aids that when I put our hearing aids in, they don't say they sound better, you know. So the proof really comes in the fact that they just do sound better. Now, the technology of the instruments, the technology of the support system, the technology of tuning them up. May I, I'm going to use a quick, quick view of my hearing aids by me. Absolutely. This one on my right ear and the one in my left ear looks the same. Yep. And I had another, I had another previous to these had another brand. Alisa fit in me with these and she has worked with me twice, several times to fit them. And then there's this little device, which is a Bluetooth, which connects this little device directly to my hearing aid. And I have so much fun with this. I can't tell you how much sometimes I go places and I turn on my Bluetooth and I listen to the what I have programmed in my phone because it's more interesting than what's going on out in the community that I'm walking in. Otherwise, this can also amplify from the environment directly serve as a remote microphone. Yeah, it's a microphone. So I said to my girlfriend, really what I ought to do is give this to her so that she can walk across the house and still be in touch. Yeah, I always tell my patients, we reserve learning how to use this five year until week two or three usually, you know, so. Remarkable devices and just take it from me viewers. It's a whole new world. And to have these hearing aids and to have this supplementation of my hearing ability. And I love it so much. We have one minute left. Is there any last thing you'd like to say both of you from either of you? I would like to say, you know, I've I've been hearing it's for the majority of my life at this point. And if somebody tried to hearing a five years ago and said, oh, I just didn't like it, I took it back. They should try again. Technology has made its huge impact on us. It really has. Yeah, I couldn't agree with Lisa what she just said anymore, you know, technology has made leaps and bounds in the last five to seven years. And that has made a huge impact on how well and how effectively we're able to help, especially the more challenging hearing losses in the world. But but bottom line is, is as we mentioned earlier, you can't do this stuff soon enough, you know, so if you have a problem, try not to ignore it. And the sooner you act the happier you're going to be in the long run, that's a guarantee. And and again, just thank you for giving us the opportunity to get on here and to speak about something that I know I'm very passionate about. And I know Lisa is as well. And, you know, we really are blessed to be able to help people every day. And just just grateful for that opportunity. My my mission is to help people form extraordinary elder hoods, because I know it can be the richest time of life and hearing and do you hear what I hear? Hearing that as the rest of the world does makes a huge difference in extraordinary elder hood. Thank you so much, everybody for joining with us. Lisa sales, Robert, Susan, yeah, Susan, yeah. And on on a while and on on the big island and other islands throughout. Join me again in two weeks, and we'll have another progressive show about making your elder hood extraordinary. And go to our website, if you will, and during our spring fundraiser, contribute a few bucks, quite a few bucks, in fact, a lot of dollars. And to keep us going here, I think tech Hawaii providing the wonderful exposure to the community life that they do. Looking forward to seeing you and welcoming you back into weeks. Aloha.