Now Where Did I Leave My Ears?

Adult onset hearing loss is a slow, gradual process, sneaking up on you one lost decibel at a time.  Many people who have responded to this blog have mentioned how they noticed they were losing their hearing only on reflection, realizing that for some unknown but definite period of time they had been missing words in conversations, laughing a little late as they processed the context of a joke, been frustrated because people were mumbling or just not speaking up!

There comes a day when it suddenly hits you–you have lost a good portion of your hearing.  I am not sure that it is denial that keeps you from this reality, although for me that was a major component of not dealing with my hearing loss until it had reached tragi-comic proportions.  I think it is more that hearing loss is usually very gradual and stuck in your head.  My stepson is partially color blind, but no one knew this for many of his early years–for example, he knew that the upstairs bathroom was the “pink” bathroom from the context of conversations, even though he did not see the color pink.

Still, I remember the first time I truly, unequivocally, irrefutably accepted the fact that I was hearing impaired.  Hearing loss is like walking out to get in your car and realizing it has been stolen.  You stand on the sidewalk twisting around looking for your car, certain that you have just forgotten where you parked it.  Your mind is sifting through dozens of possibilities of where you left it, or perhaps your partner moved it with her spare key, but somewhere in the back of your mind you know that it is gone, stolen, lost for good.  When the realization finally sets in, before you call the police and start all the drudgery of filing insurance claims and figuring out a new ride, you feel a sick hole open up in your life in that spot by the curb where your car last stood.  This is what the acceptance of hearing loss felt like to me.

And like with that stolen car, I still stand by the sidewalk of my life every so often and wonder if by some stroke of luck or brain lock or premature senility, I really did simply misplace my hearing and I will turn around and it will be right where I left it and the world will sound normal again.
              
Losing a sense is disorienting, resonating throughout your life.  Our senses connect us to the world in rational and non-rational ways, so that the loss of hearing has an emotional impact that goes beyond simply not being able to hear music or conversation the way I used to.  As I said in another entry, the first time I put in hearing aids and heard the sound of car tires on a wet road, I spontaneously broke down in tears.  The sound resonated in parts of my brain that had remained dormant and stilted for years.  Every time I get new hearing aids it takes a week or so for my brain to reorient itself to hearing certain sounds again.  Standing in a crowd or on a subway I become dizzy with the kaleidoscope of random sounds flying unmediated into my head, until my brain eventually re-learns to filter.

I have become a greedy consumer of sound, seeking the most powerful hearing aids I could find to recapture at least some of the sound I can remember in distant parts of my mind.  I am a sound junky, as my most recent audiologist said when he first tested my hearing.  Give me more sound, I cry out when I get new hearing aids.  And I don’t want to just hear better, I want to hear better than I used to–I want to listen to mouse heartbeats in the walls and the whisper of satellites as they spin in orbit.  The universe owes me this for having stolen my hearing for so long.

But still it is not enough.  Hearing aids are a hollow replacement for normal hearing.  Basically, hearing aids are tiny microphones and amplifiers in your ears, with all the attendant problems you remember from High School assemblies.  They whistle and whine with feedback when something gets too close to them, like your partners lips or a hat or even your hair.   Remember the entertainers on variety shows who blow into a microphone to imitate trucks roaring or trains rushing by?  That is what hearing aids sound like when you are walking in a stiff wind, or when the car windows are open on the highway (I shudder to think what it would sound like to be in a convertible with the top down).

Hearing aids fit snugly into your ear canal so that the only air that comes in should be through a small air channel running the length of the hearing aid.  But if you turn your head or take a large bite from an apple your ear canal may move, and the hearing aid will whistle.  Try having that happen to you when you are having lunch with your boss or a client.  Hearing aids also magnify most sounds with little discrimination, so that the sound of your own chewing can drown out any conversation at the table.  And forget about wearing them to bed at night, unless you want to whistle and tweet every time you roll over on your side.

Another problem with hearing aids is that they cannot get wet.  It may not seem like much, but swimming in a pool with your kids becomes a lot less fun when you cannot hear them call to you or laugh.  I imagine that folks who have been deaf from birth are not disoriented by their hearing loss, but for me I always feel jumpy when I don’t have my hearing aids in.  I am constantly turning my head to see what is going on around me because I don’t have the audible cues I am used to from my environment, even after so many years of hearing loss.

Even with hearing aids, there is much that I miss in most conversations.  I have to work very hard to concentrate, to listen, and it is exhausting.  Hearing aids amplify noise, but they do not necessarily enhance clarity.  Sure, I hear sounds much louder with them in.  But I still miss a lot of the overtones and nuances of conversations, and if someone turns away from me or covers their mouth with their hand (which happens more than you realize), or if there are background noises which are being equally amplified, then some of the conversation gets lost and I start interpolating and reading lips, laughing when others laugh even when I have missed the context or punch line.  By the end of most days, my mind is tired from straining to distinguish conversations and I have a headache from concentrating so hard–and from being so frustrated at what I am missing.

You would think that sleeping would be one area that being hearing impaired helps.  Think of it–you never hear your partner snoring, garbage trucks beeping at 4 AM, or jets flying overhead.  Heck, landlords should give me a rent break for living in a house near active train tracks!  But even in sleep I find the lack of sound disorienting.  The complete and total lack of any sound–night sighs and the house settling, wind in the trees and the air conditioning cycling on–registers in my mind like that stolen car, and a part of my brain keeps reaching out and trying to find the familiar in the velvet, isolating deadness.  Deep inside I have an uncomfortable disquiet that something terrible will happen and I will not hear it–a fire alarm, my child being ill, a break in, and this gnaws at my sleep.  I remember how my dad would leap up in a panicked startle whenever I shook him to wake him up, to the degree that I would hate to go near him when he was sleeping. Now I understand him all too well.

Many years ago I heard about an operation that could potentially fix my hearing loss, or at least remediate a good portion of it.  My ENT, Robert Fieldman, was working on my sinuses at the time and told me about it, referring me to his associate, Laura Downey, who is one of the best ear surgeons in the region.  Dr. Downey is a peppy yet blunt and confident woman who told me that my conductive bone hearing loss was a candidate for a stapedectomy, but she also said that there was a 30-40% chance that the operation would not work, and a higher-than-I-wanted chance that I would completely lose hearing in an ear after the surgery.  This was about 10 years ago, my hearing loss was bad but not too severe–about 25%–and I decided that the risk was not worth the benefits.

But this year I could tell that my hearing was taking a dramatic turn for the worse.  I had put off getting re-tested because I did not have the money saved up for new hearing aids, and so I limped along with an older pair.  Then one of them died and I resurrected an even older one, but it was clear that I was having a harder time hearing.  My poor wife, Michele, was patient but had to struggle more than ever in talks with me, repeating herself sometimes two and three times before I got what she was saying.  At work I had to keep excusing myself while asking colleagues, clients, and bosses to speak up or repeat themselves.  More often I simply faked it, like I used to before I first got hearing aids, hoping that my lip reading and contextual reading didn’t fail me too often (although meetings with my Korean clients on one property were almost comical at times).

I finally made an appointment with an audiologist located a few blocks from my house, Craig Barth.  I had heard that he was good, and it turned out he is phenomenal (I have subsequently learned that he was on his way to a PhD in hearing when he diverted to being an audiologist, but his research background and deep knowledge of hearing functions is telling).  During the hearing test, where I found that I had lost about 80% of my hearing, he casually mentioned that I was a good candidate for a stapedectomy.  I laughed and said that the odds of losing my hearing were too high, but he said that the success rates were much higher now.  And it turns out he recommended Dr. Downey.

The stars were aligning.  I needed to do something to arrest the decline of my hearing, which is getting worse every year.  And so I made an appointment with Dr. Downey.