The Power of a Mother’s Advocacy

By Vicky Chan

Like most moms, Brandy has always been a champion for her three sons, Anthony, 12, Andersyn, 10, and Ayden, 7. Her sons are unlike most sons; each has bilateral sensorineural hearing loss and enlarged vestibular aqueduct syndrome.

Brandy’s journey as a parent-advocate had a difficult start. She was completely unfamiliar with hearing loss in children before she became a mother, and accessing proper treatment for the trio was a challenge. Brandy juggled numerous audiologist appointments that were a five-hour round-trip drive from home. And, for her oldest child, Anthony, a hearing loss diagnosis came two years delayed.

Clockwise from left: Ayden, Andersyn, Anthony, and Brandy.

Anthony had typical speech development and passed all his first- and second-year wellness and hearing checks by his pediatrician. When he was 2, Anthony fell and hit his head. Brandy suspected the trauma had caused either hearing loss or a cognitive disorder, but the doctors assured her Anthony suffered no permanent damage and took no action for him.

Brandy’s instincts were correct. When her second child, Andersyn, was diagnosed with hearing loss at birth a few months after Anthony’s head injury, she insisted Anthony receive a detailed hearing evaluation. Born in 2005, Anthony never received a newborn screening despite the passage of the Newborn and Infant Hearing Screening and Intervention Act of 1999, which mandated the practice.

The legislation quickly improved the rate of newborn hearing screening. In 2005, 94.2% of babies in the U.S. were screened, but some states lagged behind. In Tennessee, where all three of Brandy’s sons were born, only 66.9% of newborns were tested—the lowest in the nation. Unfortunately, Anthony was among the 30.1% of Tennessee’s babies not screened. However, by Andersyn’s birth in 2007, the state’s rate increased to 91%. It was only due to Brandy’s perseverance that Anthony was ultimately given a comprehensive exam, diagnosed with severe bilateral hearing loss, and fitted for hearing aids.

Brandy’s message is that newborn screening is vital. “If your child has hearing loss, it is best to start intervention as soon as possible and have your child fitted for hearing aids or cochlear implants if they need them.”

With his hearing aids, Anthony was fascinated by all the new sounds he could hear—including the squishy sound of Brandy’s flip-flops as the pair walked through a parking lot. At that moment, Brandy realized it was likely that Anthony, like Andersyn, was born with hearing loss, but it only became detectable to her after his head injury.

Andersyn was given a newborn hearing test so Brandy knew immediately that he had severe bilateral hearing loss. Later on, one audiologist suggested he wasn’t benefiting from his hearing aids, but Brandy knew differently; with Andersyn’s hearing aids turned up, a sound as subtle as crinkling paper near his ears would startle him. Andersyn now does exceptionally well with hearing aids, as does Brandy’s third and youngest child, Ayden, who was also born with severe hearing loss in both ears. The boys’ doctors have cited a genetic connection of unknown cause.

Today, hearing loss is an ordinary part of life for her three boys, thanks to Brandy’s tireless advocacy. With help from FM systems and speech therapy, Anthony, Andersyn, and Ayden all receive a mainstream education. They enjoy baseball, basketball, hunting, swimming, riding four wheelers, and fishing. HHF’s CEO, Nadine Dehgan, exclaims, “All three boys are incredibly fortunate to have Brandy, a devoted mother who has prioritized their hearing health.”

Anthony, Andersyn, and Ayden are participants in HHF's "Faces of Hearing Loss" campaign.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

San Diego Tunes In to Hearing Health

By Jordan Conole

On February 11th, Hearing Health Foundation (HHF), the nation’s largest nonprofit funder of hearing and balance research, hosted a public seminar on hearing health and hearing loss in at the Central Library in Downtown San Diego.

Guests mingle before the start of presentations on hearing loss research and treatments in the Shiley Special Events Suite of the San Diego Central Library.

Event attendees included members of the public, scientists and researchers, many of whom have devoted their careers to finding a cure for hearing loss.

Ronna Hertzano, M.D., Ph.D., a surgeon at the University of Maryland Medical Center, spoke about the need for change in the way we treat hearing loss, noting, “Just as a doctor would now take a patient with elevated or slightly higher blood pressure seriously, we must do just the same with hearing.” Dr. Hertzano claimed that those who experience hearing loss oftentimes can suffer from loneliness and feelings of isolation.

According to a recent study by the National Aging Committee, more than 11% of those with some form of hearing loss suffer from depression compared to only 5% of the general public.

Dr. Harrison Lin, a scientist funded by HHF’s Emerging Research Grants program, and colleagues discovered that of the 48 million Americans who report experiencing some form of hearing loss, only about one-third of those actually seek out treatment.

Ken Knoblett, a San Diego resident who counts himself as part of that third, noticed a drastic change in his interactions with friends and family once he began to use hearing aids. “I was immediately able to be more connected to my friends and family and enjoy gatherings again. The hearing aid and treatment really changed my life for the better!”

Based on the strong connection to hearing loss and its strong emotional side effects, testing for hearing loss and treating it is the best way to combat and prevent its underlying side effects.

Hearing loss is an isolating condition for hundreds of thousands of Americans, but the scientists working for HHF hope to someday end that isolation.

Jordan Conole is a freelance journalist who covers San Diego local nonprofits and charity events in the surrounding areas. 

Mapping Better Hearing

By Vicky Chan

Hearing Health Foundation (HHF) is grateful to the many individuals and organizations who have empowered groundbreaking hearing loss research in the last 60 years. A new interactive map displays every institution in the U.S. where HHF has been fortunate to fund groundbreaking research, yielding outstanding advancements in hearing and balance science. The map also indicates the rates of hearing loss in each state, signaling that additional work is urgently needed.

The colors—light yellow, yellow, green, teal, blue, and purple—represent the rates of hearing loss in each state. The calculations are based off 2015 U.S. Census Data, using estimates from the well-known prevalence of hearing loss among specific demographics. At the lowest end of the range in light yellow, hearing loss affects 13.71% of Colorado’s population. The highest rate was found in Missouri, purple, where the prevalence measured 20.15%. The mean for all states was 18.16%. The numbers signal the significance of hearing loss research.

Nearly all of the institutions on the map represent recipients of the Emerging Research Grants (ERG) who have carried out investigations related to tinnitus, hyperacusis, Ménière's disease, Usher syndrome, hearing loss in children, Central Auditory Processing Disorder, and strial atrophy.

A few institutions are home to the work of the Hearing Restoration Project’s (HRP) domestic consortium members, who focus on investigating hair cell regeneration as a cure for hearing loss and tinnitus. They conduct research at Baylor College of Medicine, Harvard Medical School, Oregon Health & Science University, Stanford University, Stowers Institute, University of Maryland, University of Michigan, University of Southern California, University of Washington, and Washington University.

By mid-year, the institutions corresponding to HHF’s newly formed Ménière's Disease Grants (MDG) program will be added to the map.

HHF envisions a world in which no one lives with hearing loss and tinnitus—until this is realized, we’ll do everything we can to put more innovative hearing loss research on the map.

HHF Launches Faces of Hearing Loss Campaign

Think of someone you know who has hearing loss. Who do you see?

You envision a relative, but you are not thinking of your 4-year-old niece. A neighbor comes to mind, but not the 32-year-old who lives across the street.

This is a trick question. Hearing loss—and related conditions like tinnitus, Ménière's disease, and hyperacusis—can affect anyone, anywhere. Hearing loss is your 4-year-old niece, your 32-year-old neighbor, your colleague in her mid-20s. Hearing loss affects every age, race, ethnicity, and gender.

No one is immune from developing a hearing and balance disorder—and hearing loss has no single face. To refute common misconceptions that it only affects older adults, HHF has collected images of individuals living with a hearing condition to capture the diversity of its impact across the country. These are HHF’s “Faces of Hearing Loss.”

Participants shared their picture, current age, state of residence, type of hearing condition, and the age at onset or diagnosis. Among the tens of millions of Americans with hearing loss are an 11-year-old boy in Oregon, an 80-year-old woman living in Washington, and a 47-year-old man in North Dakota. These individuals may never meet, but “Faces of Hearing Loss” connects them through their shared experiences.

If you or a loved one has hearing loss, please consider participating in “Faces of Hearing Loss” by completing this brief form, sending in picture, and answering a few basic questions. If you are the parent of a child under 18, you may sign a release form on their behalf.

The Hearing Journey: What Matters to You?

By Laura Friedman

Participants used post-it notes to express their desired improvements to the hearing journey. Photo by Darcy Benson.

Recently, in October 2017, I represented Hearing Health Foundation (HHF) at a seminar that took place in Skodsborg, Denmark, where I and 30 other attendees from around the world were tasked with closely exploring and developing tactical strategies to better the patient experience when receiving audiological care.

The seminar conversations focused on person-centered care, a treatment model that focuses on the whole person, rather than just the ailment or condition experienced by the patient. The peer-reviewed Permanente Journal says that person-centered care is “based on accumulated knowledge of people, which provides the basis for better recognition of health problems and needs over time and facilitates appropriate care for these needs in the context of other needs.” Furthering this sentiment, the World Health Organization identifies empowerment, participation, the central role of the family, and an end to discrimination as the core values of person-centered care.

The two-day symposium was titled, “The Hearing Journey: What Matters to You?” The 31 attendees fell into one or more of the following groups: individuals with hearing loss, representatives from prominent consumer-driven associations for people with hearing loss, audiologists, and hearing healthcare thought leaders. The conference was hosted by the Ida Institute, a Denmark-based nonprofit that aims to better understand human dynamics associated with hearing loss.

The symposium participants pose as a group. Photo by Darcy Benson.

One of the most eye-opening takeaways was recognizing that all those who are part of the care-cycle feel shared sentiments of frustration, poor communication, lack of access, and high costs. Addressing each of these hurdles from a variety of vantage points is key to bettering person-centered care and may not be limited to just audiological care, but rather medical care as whole.  

Exercises and projects resulted in several meaningful insights related to person-focused hearing healthcare. We spoke openly about stigma, barriers to rehabilitation, and the need for creating a “new narrative” for how we speak about hearing loss. Changing how we talk about hearing loss, such as how our current nomenclature addresses it as a loss or deficit, will hopefully play a role in changing social stigmas and taboos experienced by those who are hard of hearing, like myself.

HHF's Laura Friedman presents to the group with Paul Breckell, Chief Executive of Action on Hearing Loss. Photo by Darcy Benson.

All parties stressed the importance of including caregivers and family members in the rehabilitation process, and the need for a multidimensional model of care to address the psychological and emotional aspects of hearing care. This included developing a “human audiogram” to discuss diagnoses and their subsequent treatment options in more friendly terms that empowers the patient, rather than discouraging them. It was also advised that clinicians should be more cognizant that diagnoses are difficult for the patient to come to terms with and remember that the most successful patients want treatment, but that it may take time for them to feel motivated to take that next step. Follow-up appointments, rather than immediate discussion of treatment options, was a suggestion most agreed would serve the patient and clinician well.

I feel honored to had been afforded the opportunity to represent HHF at this important symposium and to meet and learn from fellow leaders in the hearing healthcare space. I look forward to working with Ida and my fellow attendees to develop and employ tangible tools and solutions to better a patient’s hearing journey both in and out the audiologist's office, as well as provided better resources to health care providers.

Laura Friedman is the Communications and Programs Manager of Hearing Health Foundation. Read her hearing loss story in the Spring 2016 issue of Hearing Health magazine.

Protecting Your Hearing Means Protecting Your Mental Health

By Carol Stoll and Lauren McGrath

October is Protect Your Hearing Month—and, today, October 10, is World Mental Health Day, a time for mental health education, awareness, and advocacy. Hearing loss and tinnitus (ringing in the ears) can increase one’s risk of developing mental illnesses including depression, anxiety, schizophrenia, and dementia, and can trigger episodes of extreme anger and suicidal ideation. Protecting one’s hearing not only prevents or delays hearing loss, but also benefits mental wellness. Understanding the signs of mental illness and having access to mental health resources is critical—and can even be life-saving—to all individuals with hearing loss or tinnitus.

According to an April 2014 study published in JAMA Otolaryngology Head & Neck Surgery, 11.4% of adults with self-reported hearing impairment have moderate to severe depression, significantly higher than the 5.9% prevalence for those with typical hearing. Individuals with hearing loss have reported feeling socially inept in group settings, entering conversations at inappropriate times, talking off-topic, or dominating conversations and coming across as rude simply because talking is easier than listening. When a person cannot hear properly, engaging in conversations is a daily struggle, and can lead to social isolation and depression. Other factors that increase the risk of depression include being female, low-income, a current smoker, binge drinking, having fair or poor health status, trouble seeing, and sleep disorder. However, even controlling for these factors, those with hearing impairment still had significantly higher rates of depression than those without hearing impairment. In people 65 and older, hearing impairment is among the most common chronic conditions associated with depression.

In addition to depression, hearing loss has been linked to schizophrenia. Several studies support the social defeat hypothesis, which proposes that social exclusion and loneliness can predispose people to schizophrenia by increasing sensitization of the dopamine system. In a December 2014 study published in JAMA Psychology, participants with hearing loss reported significantly more feelings of social defeat than healthy controls. Though their psychotic symptoms were similar to the control group, exposing them to a stimulant drug showed that those with hearing loss had significantly higher than normal dopamine sensitivity. Further studies are needed to draw definite conclusions of the causation, but this research is a first step in understanding the relationship between hearing impairment, social defeat, and psychosis.

In older adults, hearing loss is associated with cognitive decline and dementia, according to a February 2013 study published in JAMA Internal Medicine and several other studies conducted at Johns Hopkins University. The scientists concluded that reduced social engagement and a cognitive load focused on coping with hearing loss rather than higher level thinking can lead to poorer cognitive functioning and faster mental decline. Hearing aids could possibly be a simple fix to increase healthy brain function in the older adult population and reduce the risk of dementia.

Exposure to noise often results in tinnitus instead of or in addition to hearing loss, which can also contribute to a range of psychological disorders. Tinnitus affects about 1 in 5 people in the U.S., and causes permanent ringing in the ears. Though research for therapies is ongoing, there is currently no cure. Without therapy, constant ringing in the ears can be debilitating; it can affect job performance, cause insomnia, and provoke fear, anxiety, and anger. This can lead to depression, anxiety, suicidal ideation, and can exasperate post-traumatic stress disorder (PTSD).

Compromised hearing is an invisible disability, often unnoticed or ignored even by those affected. However, hearing loss and tinnitus are widespread and can have serious psychological repercussions. Hearing loss caused by noise exposure is completely preventable by taking simple measures like turning down the volume on your earbuds and using hearing protective devices in loud situations. Regular hearing screenings can also help detect hearing issues early on. Talk to your audiologist about best ways to treat or manage your hearing impairment. Find help for mental illnesses here.

Per the National Institute of Mental Health: "If you are in crisis, and need immediate support or intervention, call, or go the website of the National Suicide Prevention Lifeline (Voice: 1-800-273-8255 or TTY: 1-800-799-4889). Trained crisis workers are available to talk 24 hours a day, 7 days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals. If the situation is potentially life-threatening, call 911 or go to a hospital emergency room.”

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

Understanding Auditory Processing Disorder

 By Frankie Huang

April 4 is Auditory Processing Disorder Awareness Day and the Hearing Health Foundation is highlighting the effects and challenges associated with living with APD.

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is an auditory deficit affecting how the central nervous system interprets verbal information. Those living with APD show impairments in sound localization, specifically their ability to isolate a sound source in social environments.

Approximately 5% of school-age children have APD. Children with APD often are uncertain about what they hear and have difficulty listening in loud background noises as well as understanding rapid speech. Often distracted, they can struggle to keep up with conversations which impedes their ability to read, spell, and follow oral directions.

Researchers found a correlation between working memory capacity, which is the ability to retain and manipulate information, and speech development. They found that working memory capacity was significantly lower in children with APD and may be the cause of their inability to separate and group incoming information and, in turn, lead to poor speech perception in noisy environments.

Other researchers found that peripheral hearing loss may affect performance in certain APD tests in older adults. Older adults with mild to moderate hearing loss did significantly poorer on tests that require recalling words, identifying high and low tone patterns, and repeating short sentences.

Although APD can be difficult to diagnose, there are telltale signs: poor auditory memory, difficulty identifying sounds, and a delayed response to verbal requests and instructions. APD is sometimes misdiagnosed as ADD/ADHD or dyslexia, so if you suspect you or a loved one may have APD, it is advised that they go through an individual comprehensive assessment with an audiologist for a more accurate diagnosis.

It is important to understand that research is still needed to understand auditory processing disorders, accurate methodologies for diagnosis, and the best interventions for each child or adult. Even though there are available strategies to treat children with APD, researchers are hard at work finding alternative treatments that will improve the lives of those suffering from APD.

Learn about Hearing Health Foundation’s 2016 Emerging Research Grants recipients who are conducting research to improve the lives of those affected by APD. These grantees are General Grand Chapter Royal Arch Masons International award recipients and we are grateful to the Masons for their ongoing support.

8 Reasons to Put a Hearing Test at the Top of Your To-Do List

By Better Hearing Institute

Of all the life hacks for better living, taking care of your hearing is among the smartest and most economical.

From pilfering away at your relationships and quality of life, to putting you at risk for other health conditions, untreated hearing loss is a silent thief. Here are eight reasons why you should get a hearing test today.

1. It may help your pocketbook. A study by the Better Hearing Institute (BHI) shows that using hearing aids reduces the risk of income loss by 90 to 100 percent for those with milder hearing loss, and from 65 to 77 percent for those with severe to moderate hearing loss, and lost as much as $30,000 annually.
    

2. Your mind may benefit. Research shows a link between hearing loss and dementia. Leading experts to believe that addressing hearing loss may at least help protect cognitive function.
    

3. It could boost your job performance. Most hearing aid users say it has helped their performance on the job. That's right. Getting a hearing test could benefit all those employees (a whopping 30 percent) who suspect they have hearing loss but haven't sought treatment.
    

4. Life’s challenges may not seem so intimidating. Research shows people with hearing loss who use hearing aids are more likely to tackle problems actively. Apparently, hearing your best brings greater confidence.
    

5. Your zest for life might get zestier. Most people who use hearing aids say it has a positive effect on their relationships. They’re more likely to have a strong social network, be optimistic, feel engaged in life, and even get more pleasure in doing things.
    

6. It could protect you against the blues. Hearing loss is linked to a greater risk of depression in adults, especially 18 to 69-year-olds.
    

7. You’ll probably be more likely to get the drift. The majority who bought their hearing aids within the past five years say they’re pleased with their ability to hear in the workplace, at home with family members, in conversations in small and large groups, when watching TV with others, in lecture halls, theaters or concert halls, when riding in a car, and even when trying to follow conversations in the presence of noise.
    

8. Your heart and health may benefit. Some experts say the inner ear is so sensitive to blood flow that it’s possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body.

So do it for your health. Do it for your happiness. Get a hearing test.

To take a free, quick, and confidential online hearing check to help determine if you need a comprehensive hearing test by a hearing health care professional, visit www.BetterHearing.org

The content for this blog post originated in a press release issued by The Better Hearing Institute.

An Ice Storm or a Nice Storm?

By Kathi Mestayer

When we get fuzzy speech data to work with, such as in music lyrics, noisy settings or, if you have a hearing loss, everywhere, our brains can come up with some pretty silly interpretations, like “I led the pigeons to the Flag…” instead of “I pledge allegiance to the Flag …”

But even when we hear correctly, that same brain can play it back to us more than one way, with more than one meaning.  Kind of like an optical illusion…but with sound.

A string of words that has multiple interpretations is called an oronym.  Like “I scream, you scream, we all scream for ice cream.” You can interpret it either way, depending on the context, the way it is said, or the phase of the moon.  

Why?

In his book, “The Language Instinct,” the Harvard psychologist and linguist Steven Pinker tells us: “In the speech sound wave, one word runs into the next seamlessly; there are no little silences between spoken words the way there are white spaces between written words. We simply hallucinate word boundaries when we reach the edge of a stretch of sound that matches some entry in our mental dictionary.”

So, if our mental dictionary contains more than one match for what we hear, well, we can hear it both ways. In fact, the sound input doesn’t even have to be speech for our brains to have a crack at it. Pinker explains: “The brain can hear speech content in sounds that have only the remotest resemblance to speech.”

So, we will superimpose meaning onto just about anything, and if it doesn’t make sense, we just keep trying until something fits. Kind of like when my brain heard baroque music coming from the vacuum cleaner, or the countless phrases I swear my parrot says (everything from “ashram” to “wiki” with “kabuki” and “Nietzsche” and many more in between). 

While our brains are busy riffing on what we hear, programmers and engineers are working hard trying to create devices that can interpret speech, even passably, well. One application is online captioning, or what I call “robo-captions.”

The results are not particularly impressive so far, but our brains are a tough act to follow. According to Pinker, “No human-made system can match a human in decoding speech.” That fact was brought home to me when my friend complained about the speech-activated calling system in her car. “It can only interpret the numbers if I read them without any pauses. If I pause, for just a second, the computer inserts the number eight,” she says.  

Online captions created by speech-interpretation software are particularly bad at it (the real-time captions on TV are much better). You can go here to get a quick chuckle.

Staff writer Kathi Mestayer serves on advisory boards for the Virginia Department for the Deaf and Hard of Hearing and the Greater Richmond, Virginia, chapter of the Hearing Loss Association of America. This is adapted from her reader-sponsored work, “Be Hear Now.”

Are You Wireless Enabled?

By Paul Harrison, Guest Author

This is the first in a two part series on wireless technology and hearing aids.

With the introduction of wireless technology, hearing aids are now able to do more than ever before. Just making things louder is a thing of the past with new devices containing more and more advanced features with each new generation of hearing aid.

Wireless technology in hearing aids means that they are able to connect both with each other and with a number of different devices using a signal that is similar to the Bluetooth in mobile phones. When the hearing aids work together it is known as binaural technology. With this feature, they can communicate with each other and work together to improve your hearing. There are some binaural features that will analyze your environment, detect which hearing aid is receiving the clearer signal and then transmit this superior signal to the other side. This ensures that you are always getting the best sound available, whatever your environment may be. Binaural microphone applications work in the same way to ensure you hear sounds from all directions clearly but can give priority to speech over background noises.

When most people mention wireless technology in hearing aids, they are referring to their ability to connect to other things. This signal allows the hearing aids to be paired with different accessories that in turn can be connected to your various audio devices.

Each manufacturer has their own range of accessories which can only be used with their own hearing aids. Some require a device called a streamer to be used in addition to the other accessories. This streamer is used to relay the signal from each device into the hearing aids and is often the point of control as well. Some manufacturers use a different or more powerful signal which can send the sounds directly without the need for this additional device.

So what can you connect to?

Television

Many manufacturers now have a device that can be easily connected to most televisions. It is usually a discreet little box that sits by the TV and picks up the sound coming from it. It then transmits the sound into the hearing aids, either directly or through the additional streamer. This can give you the effect of wearing headphones without the inconvenience of actually wearing them. It also allows you to control the volume by adjusting the hearing aids rather than the television. This can be particularly useful if you are not the only person watching, as it means you can watch at your own level without affecting the listening comfort of others. In most cases, if an additional streamer is required, this unit will also act as a charger for it.

Telephone

Many hearing aid users struggle when using their home telephone for several reasons. Some people find that the conversation sounds muffled and some even report that they often don’t hear it ring. There are now wireless accessories that can help with this by connecting you directly to the telephone. An alert will sound in your hearing aids when the phone rings so you never miss a call and then you don’t even have to get up to answer it. You can answer the call by simply pressing a button on your device and you will then hear the conversation through your hearing aids. This gives you the benefit of a clearer sound and also means that you hear the conversation in both of your ears at the same time. The built in microphone in the device then allows you to enjoy your conversation without having to go to the phone.

Mobile Phone

These work in a very similar way to the home phone accessories. They allow you to receive alerts when calls come through and then answer the phone without having to remove it from your pocket or bag.

According to YourHearing Wireless, technology is advancing all the time, making it easier for hearing aid users to enjoy things that they previously found difficult or frustrating. Each manufacturer has a different range of accessories so you would need to check to see what is available for your particular hearing aids. There are so many options available today it is possible for everyone to get themselves and their hearing aids wireless enabled.

Stay tuned for part two to be posted in early 2014 which will highlight other types of devices that can connect to your hearing aid and help you hear better.

Author Bio:

Paul Harrison has been in the Hearing aid industry for 20 years and in that time has worked at both manufacturer and retailer level before managing his own online hearing aid business www.yourhearing.co.uk which is a national network of local hearing aid audiologists who offer the main hearing aid brands at less than the high street but with the same quality aftercare and warranty.