Audiologist, Dr. Daniela Cardona, speaks with Shelby Stockton about hearing loss, how it affects patients, their friends, and their family. Dr. Cardona explains the benefits of treating hearing loss with an audiologist, and how we can communicate more effectively with people who are experiencing hearing impairment.
Shelby Stockton (00:00):
Welcome to the South Florida ENT Audio Blog. I'm your host, Shelby Stockton. And, today, I spoke with audiologist, Dr. Daniela Cardona about hearing loss. We talked about how hearing loss affects patients, their friends, and their family. Dr. Cardona explains the benefits of treating hearing loss with an audiologist, and how we can communicate more effectively with people who are experiencing hearing impairment. If you or a loved one is suffering from hearing loss, take some time to listen to Dr. Cardona's advice.
Hi, Dr. Cardona. Thank you so much for spending some time with me today.
Dr. Daniela Cardona (00:36):
Hi, Shelby. It's so good to hear from you.
Shelby Stockton (00:38):
Today, I want to talk to you about, well, your specialty, hearing loss. And what we can do to make our lives a little bit easier. Can you share how hearing loss affects the world around you?
Dr. Daniela Cardona (00:49):
Absolutely. Hearing loss has a global impact. It is an invisible disorder, so it's very difficult to empathize and conceptualize what patients with hearing loss go through. In terms of social impacts, patients with hearing loss, we know that they isolate. And that is a risk factor for depression and anxiety. Functionally, patients feel very limited by their hearing loss. It's not black or white. It's not the patient hears or is deaf. There's a wide variety of hearing losses. There's a wide variety of types of losses. It's not just blanket. There's certain sounds patients will miss, such as the high tones or the high frequencies. That's the most common type of hearing loss in adults. And that means the patient can hear, but they're missing clarity or consonance of sounds. And that hearing loss is most noticeable in a group, or when there's background noise present. It's very challenging for the person experiencing this because they don't feel that they're missing hearing, per se, but they can't quite understand why they're struggling in certain situations.
This also leads to the patient feeling sometimes excluded. I've had a lot of patients share that they feel bullied or discriminated against, treated less than intelligent because they're not catching certain sounds. On a more extreme level, we do have patients who are not able to work because of their hearing impairment, who will stop going to their favorite places, or stop meeting with their family members. It's very difficult to empathize unless you're walking in those shoes. And I think the first step is education, being able to learn about your hearing loss, what can you do to treat it. And then we'll move forward and try to help the patient get back to a healthy and empowered state where they can feel part of their community again.
Shelby Stockton (02:46):
Can we address hearing loss and its emotional impact over time?
Dr. Daniela Cardona (02:50):
Absolutely. Once we get the intervention, be it a surgery or a hearing aid, some patients are fortunate that, right away, they're able to notice the benefits and integrate themselves again. For others, it does take some time to gain the courage to get back out there, to feel confident that they'll be able to do the things they weren't doing because of their hearing loss. As audiologists, we're here to walk the patient step by step through that process. And to make sure we're addressing everything that needs to be addressed. The important thing is making sure that you are coming to see us, you're following up, being honest, and sharing your true experiences, so that we can help the patient and help you get back to where you need to be.
Shelby Stockton (03:39):
How does treating hearing loss impact brain function?
Dr. Daniela Cardona (03:43):
So this is a hot topic in audiology. We've been talking about it for years. We've had a lot of wonderful new research come out of Johns Hopkins University. What we do know is that hearing loss is a modifiable risk factor for dementia. The most recent study in July told us that for older adults who have more risk for cognitive decline, when you treat the hearing loss, you can slow down loss of thinking and loss of memory abilities by 48% over three years. And this is something that was not seen in healthy participants in the study.
There's a lot of other global benefits that come with hearing aids. We know about improvement in balance, focus and attention, reduce the risk of falls, which I think a lot of patients don't understand the real threat and significance of addressing falls. There's overwhelming amount of research to show that hearing loss, or cochlear implants, if that's the case, do improve balance function.
And, overall, there's so many different benefits that patients don't know about it. Emotionally, the patient is less stressed, less anxious about being in the world, and knowing, I can now hear things approaching me. I know when somebody's calling me. I'm not straining to hear my phone ring, my child calling me, or my mom, or my family member calling me from another room. So there's a lot of different benefits. And it's very important to treat a hearing loss if you have one.
And, again, it doesn't matter if it's just a certain range, if it's just a mild hearing loss. Those same studies do show that those risks exist as early as a mild hearing loss, which most adults have. So, again, very important to get checked out. Talk to your audiologist. We'll walk you step by step. There's a lot of different options available. We have invisible hearing aids, there's rechargeable hearing aids, there's Bluetooth hearing aids. If you're not happy, if you're not comfortable with what you selected, there's a trial period you can exchange it.
The importance of choosing, and having someone help you in choosing a product that's right for you, is because in order to obtain all those benefits we discussed, you do need to wear that hearing aid all day, every day, a minimum of eight hours a day. So it's important to have that support. First impressions are very important. A lot of patients who purchase hearing aids either online or over the counter, their first comment is, "Well, I just didn't like it. It didn't sound good. I didn't know there were different options." And we can address that if you come and see one of us. And we're more than educated and willing to help you explore other options if we need to.
Shelby Stockton (06:25):
Well, you just gave me a perfect segue to my next question for you, which is, what are the benefits of treating hearing loss and working with an audiologist?
Dr. Daniela Cardona (06:34):
So adaptation or getting used to hearing aids is complex. Not any two patients are going to be the same. There's a lot of different things that we, as audiologists, evaluate when you come to see us. Not only do we walk you step by step through the process and help you choose something you're comfortable with, give you tips and tricks on how to make it easier for you, but we're also trained to look for other red flags, or other things that should be addressed within your medical case history. We know when there's another referral that needs to be made to another specialist. If it is a balance concern, some audiologists, such as ourselves, we are trained in what's called vestibular workup or the balance workup. Here at our office, we do have a full vestibular lab, where we can assess the balance function as well as the hearing function. If it is a concern for balance, we have treating doctors here, a big group of ENTs. We're very experienced in treating vestibular disorders or getting you the right referral.
It's important that you don't treat it lightly. Hearing loss is very much tied to the rest of your body. It is directly tied to your central nervous system. So there's a lot of different things that people are not aware about. And as an audiologist, we can make sure that we're not missing anything and that we're checking off all our boxes.
Shelby Stockton (07:54):
What communication strategies can I use to enhance my interactions with friends and family who have hearing loss?
Dr. Daniela Cardona (08:01):
So the first thing to understand is, if a patient is wearing hearing aids, it's still not going to be perfect. All technology has limits. A lot of patients come in with their family members and there's discord because they think, "Why, if they're wearing hearing aids, are they not hearing me from two rooms away?" So one of the things I tell my patients and their family members is sound does not travel farther than six feet. So it is not realistic to try to speak to somebody from another room.
Also, hearing aids tend to have a tendency of facing forward. So if you're going to speak to somebody with a hearing loss, even while wearing hearing aids, make sure to grab their attention. You need to face the speaker. If there's any background noise present, such as kitchen equipment, if there's a television, if there's a radio, we need to either turn those things down, turn them off completely, or wait until that sound is no longer being played, to speak to that person. There's different ranges of technology with hearing aids and not all of them have background noise reduction. If you're not wearing a hearing aid that has background noise reduction, it is unrealistic to expect great communication in noisy settings.
There's other tools that we can use, what we call communication strategies. You can either try to control the environment you're in, control the speaker, or control your position in relation to the speaker. So when you are in a restaurant, we teach patients things like try to get yourself in a booth, put your back against the wall, sit away from the kitchen, away from entrances or busy places like the entrance. Try to reduce noise as much as possible. Never sit in the center of a restaurant. That's usually the worst place to sit.
And just little things that you can do with technology itself. There are extra accessories, there are microphones. There are programs within the hearing aids that you can access through either an application or a touch of a button. Certain programs to try to maximize speech, understanding when the acoustics, or the environment is unfavorable.
But I think the biggest thing is just having some empathy. If you said something to your family or your friend with hearing aids and they didn't quite catch what you're saying, rephrase, change how you said that. Make sure you catch their attention. You're looking at them when you're speaking to them. It's not an issue or a matter of raising your voice. I know that's a pet peeve for a lot of my patients. They don't want to be screamed at. It's not a matter of volume. It's a matter a lot of times of just the environment and placement.
Shelby Stockton (10:43):
Yes. That's all great advice. Because, sometimes, I think we forget that this is not just an issue for the person who has the hearing loss. It's an issue for all of us and how we deal with it as well.
Dr. Daniela Cardona (10:53):
Absolutely.
Shelby Stockton (10:55):
Well, Dr. Cardona, this was educational. I talk to a lot of audiologists. I learn something new every time. I didn't know about the falling thing. That's so interesting. Thanks for taking time to educate us on all of this.
Dr. Daniela Cardona (11:07):
Absolutely, Shelby. It's my pleasure. And always, always, even if it's just getting your hearing checked, just get educated and see where you're at.
Shelby Stockton (11:14):
Precisely.
