Friday, March 31, 2017

High-Tech Hope for the Hard of Hearing

When my mother’s mother was in her early twenties, a century ago, a suitor took her duck hunting in a rowboat on a lake near Austin, Texas, where she grew up. He steadied his shotgun by resting the barrel on her right shoulder—she was sitting in the bow—and when he fired he not only missed the duck but also permanently damaged her hearing, especially on that side. The loss became more severe as she got older, and by the time I was in college she was having serious trouble with telephones. (“I’m glad it’s not raining! ” I’d shout, for the third or fourth time, while my roommates snickered.) Her deafness probably contributed to one of her many eccentricities: ending phone conversations by suddenly hanging up.

I’m a grandparent myself now, and lots of people I know have hearing problems. A guy I played golf with last year came close to making a hole in one, then complained that no one in our foursome had complimented him on his shot—even though, a moment before, all three of us had complimented him on his shot. (We were walking behind him.) The man who cuts my wife’s hair began wearing two hearing aids recently, to compensate for damage that he attributes to years of exposure to professional-quality blow-dryers. My sister has hearing aids, too. She traces her problem to repeatedly listening at maximum volume to Anne’s Angry and Bitter Breakup Song Playlist, which she created while going through a divorce.

My ears ring all the time—a condition called tinnitus. I blame China, because the ringing started, a decade ago, while I was recovering from a monthlong cold that I’d contracted while breathing the filthy air in Beijing, and whose symptoms were made worse by changes in cabin pressure during the long flight home. Tinnitus is almost always accompanied by hearing loss. My internist ordered an MRI, to make sure I didn’t have a brain tumor, and held up a vibrating tuning fork and asked me to tell him when I could no longer hear it. After a while, he leaned forward to make sure the tuning fork was still humming, since he himself could no longer hear it. (We’re about the same age.) There’s no cure for tinnitus. The ringing in my ears is constant, high-pitched, and fairly loud—it reminds me of the cicadas I listened to on sweltering summer nights when I was a kid—but I’m usually able to ignore it, unless I’m lying awake in bed or, as I discovered recently, writing about tinnitus.

Unlike taste buds and olfactory receptors, which the body replenishes continuously, the most delicate elements of the human auditory system don’t regenerate. The National Center for Health Statistics has estimated that thirty-seven million American adults have lost some hearing, and, according to the National Academy of Sciences, hearing loss is, worldwide, the “fifth leading cause of years lived with disability.” Hearing problems can lead to social isolation and cognitive decline, both of which make getting older—itself a cause of hearing loss—seem worse than it does already.

In recent years, scientists searching for ways to restore hearing have made a number of promising discoveries. There are also increasingly effective methods of preventing damage in the first place, and of compensating for it once it’s occurred. The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong. (People who notice they’re having hearing problems typically wait more than ten years before doing anything about them.) I recently heard a joke about a man who was worried his wife was going deaf. He told his doctor, who suggested a simple test. When the man got home, he stood at the door of the kitchen, where his wife was at the stove, and asked, “Honey, what’s for dinner?” She didn’t respond, so he moved closer and asked again. She still didn’t respond, so he stood directly behind her and asked one more time. She turned around and snapped, “For the third time, chicken!” (...)

If I could relive my adolescence, I wouldn’t listen to Steppenwolf with loudspeakers leaning against my head, and I wouldn’t have cherry-bomb fights with my friends unless I was wearing ear protection. On the recommendation of James Henry, at the V.A., I now own several sets of so-called musician’s earplugs, which reduce the over-all level of sound but maintain the full sonic spectrum—unlike regular foam earplugs, which disproportionately mute high frequencies. I wear them even while vacuuming (or will the next time I vacuum anything), and if I were a hunter I would buy a pair of microprocessor-controlled earmuffs, which amplify quiet sounds but turn gunshots into muffled pops.

Luckily for those of us who have been careless with our ears, there are hearing aids. Most of them are made by six major manufacturers, only one of which is based in the United States: Starkey Hearing Technologies, whose headquarters are in Eden Prairie, Minnesota. Starkey’s greatest marketing triumph occurred in 1983, when President Ronald Reagan revealed that he was wearing one of its products. (The main source of Reagan’s hearing problem was a gun that someone fired near his right ear on a movie set in the early thirties.)

I visited Starkey in February, and when I arrived at the company’s testing department the receptionist greeted me in a voice that she seemed to have turned up a couple of notches—an occupational necessity, I assumed. Another employee told me, as I waited to be examined by an audiologist, that I had been preceded recently by two members of a well-known rock band that’s been around since the early seventies. The rockers, she said, looked “very old and very weathered,” and had hearing problems they’d apparently ignored for decades. “Oh, my gosh, they’ve lived hard,” she said. But they have hearing aids at last. (...)

Based on my audiogram, I was fitted for a pair of Starkey’s Muse hearing aids. Each unit sits behind an ear, as my grandmother’s hearing aid did, but is so small that it’s all but invisible. A coated wire leads to a receiver—red for right, blue for left. Each receiver is about half an inch long and the diameter of a kitchen match, and it goes right into the ear canal. A button on the part behind the ear allows me to choose among settings programmed by the audiologist. Two of them add a subtle tone that’s meant to mask my tinnitus, which during my hearing test she pinpointed at about six thousand hertz. My main reaction when I first put the hearing aids on was mild annoyance at the sound of my voice. I also became more aware of turning pages, creaking doors, and the surprisingly varied noises made by my pants. The audiologist said that people with new hearing aids get used to all that within about a month, as the brain adjusts.

With my hearing aids on, I was given a tour of the premises. Hearing aids that fit snugly into the ear canal, as many do, are custom-made from silicone impressions that audiologists create by injecting goop into patients’ ears. The cured impressions look like miniature Henry Moore sculptures. Laser scanners turn them into three-dimensional digital files, and the images are trimmed, shaped, and manipulated by technicians using an in-house computer program that’s essentially Photoshop for ear canals. I saw test hearing aids being subjected to stresses that were meant to replicate the surprisingly hostile microenvironment of an external auditory canal: baking in an oven suffused with “salt fog”; lengthy exposure to blowing clouds of dustlike talc; submersion for days at the bottom of a metre-tall column of water.

The Starkey line with the most features is Halo, the first version of which was introduced in 2014. Halo wearers can stream music, phone calls, recorded books, television shows, and other audio content via Bluetooth directly into their hearing aids from all current Apple devices. The hearing aids adjust automatically to different environments. They eliminate wind noise and reduce background sounds between spoken syllables during conversations in crowded places, and they can be used with a smartphone app that enables them to do things like switch to a customized automobile mode as soon as the phone’s accelerometer detects that the wearer is moving faster than ten miles an hour. Chris McCormick, who is Starkey’s chief marketing officer, told me, “If you regularly visit a Starbucks, you can fine-tune a setting for that particular environment—the barista grinding coffee beans, other customers talking—and then geotag it, so that when you pull into the parking lot your hearing aids will switch to that mode.”

by David Owen, New Yorker |  Read more:
Image: Sarah Illenberger