Sorting the Priorities

By Carol Milano

When I told my internist about a weird two-hour attack I’d had, he called it a classic description of vertigo. That can be connected to an ear problem, so he sent me to an ENT specialist. 

No one asked for a referral or why I was there. They just had me do a hearing test. I was surprised—I had no hearing problem, and was there because of vertigo. 

Carol Milano

An active, health-conscious New Yorker, Carol Milano had a strong, unexpected need to research any connection between hearing loss and cognitive impairment.

The test was easy. Amazingly, the audiologist said, “You have a severe hearing loss in both ears.” I was sure the results were wrong, but minutes later, the doctor said the same thing. In shock, I blurted, “But, I’m sitting here talking with you! I never have trouble hearing.” He told me I need hearing aids, that hearing loss is connected to dementia, and to make an appointment immediately.

I know heredity can be a factor with hearing loss. My mother was very hard of hearing, constantly pulling out her hearing aids and saying, “I can’t stand the background noise!” I wanted a second opinion before I’d believe that test result. I got one suggestion from my network and made an appointment, expecting reassurance that I have no serious problem.

At Brooklyn Audiology Associates, a small, friendly practice, an audiologist named Dr. Jennifer Levy listened to my shock and confusion, but confirmed that my test printout showed severe hearing loss. She did one other brief test, which showed 95 percent word recognition. I always hear conversations, so how could I have all this hearing loss?  

She patiently explained that my case is unusual. The damage has not left me hard of hearing. “I can’t bring back what you’ve already lost, but I can help protect what you have,” was her summary of what hearing aids do. So, if I experience no difficulty hearing in my everyday existence, why do I need these expensive little devices? Resistant and skeptical, I left with instructions to “think about it.”

No matter which online hearing quiz I took, the only yes I ever answered was in regard to TV volume, and I solve that with the remote control. My insurance will cover doctor visits, and Brooklyn Audiology offers a free trial period to try out and test the programming of the hearing aids they suggest. So I returned to Dr. Levy, since there was no risk or cost to me. After we reviewed things they might improve, she programmed a test pair of Phonaks. Trying them out during the trial period of nearly two months, I found little difference in sounds, with or without hearing aids. 

After several visits for adjustments, I decided to postpone hearing aids until my next hearing test nearly a year away—why buy until I have trouble with conversation? Dr. Levy asked if I had 10 minutes to take some tests that measure hearing-related skills. Curious, I agreed. Some were easy, some I struggled with. The printout showed good functioning on several skills, but midrange or lower on two: Memory, and Information-Processing Speed. Wow. A lot to go home and think about.

I started researching connections between hearing and cognitive impairment. I found few studies, with unimpressive results. At the last one I looked at, the researcher's conclusion seemed to be, “So, can hearing aids help prevent cognitive impairment? It's not proven. They might help. And they can’t hurt.” Dr. Levy agreed, there isn't much research, and there's no proof.

But clues about where my own hearing loss was appearing brought a dramatic level of concern. I don't want to lose memory and processing speed! With no science to guide my decision, I resorted to logic.

If hearing aids protect the remaining hearing ability, could they protect the skill set that hearing supports? I landed right where that researcher did. If I can defend my cognitive functions—even a little—that's my priority. I bought the Phonaks. 

Did I make the right choice? Is this investment worth it? I will never know! My insurance covers one hearing test a year. Even if the next one shows zero change, it's impossible to say whether results would have been different without the hearing aids. The same for cognitive function tests. It became a matter of carefully weighing how much I want to reduce a risk that's very important to me. What’s the dollar value of my memory? My debate was over.  

Freelance healthcare writer Carol Milano lives in New York City.


Editor’s note: Many states have a trial period for hearing aids; ask your hearing healthcare provider for details. 

Untreated hearing loss is associated with a greater risk of dementia, according to Johns Hopkins University. Studies, including by the National Institute on Aging, are currently underway evaluating whether hearing aids can help reduce this risk. For more, refer to this February 2020 New York Times article.


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