According to the National Center for Health Statistics, more that 9 million Americans over the age of 65 suffer hearing loss, but only one in five of them pursues treatment.
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Hearing loss creeps up quietly, usually gradually. At first, you don't notice the absence of leaves rustling, water dripping, wind whistling through trees, tissue paper crinkling or violins singing in high register within the orchestra. There's more than enough you can still hear and listen to.

After a while, you begin to ask your walking partner to stay on your "good side," you cup your ear to better catch social conversation at a noisy party, you need someone to repeat a question addressed to you from afar. Voices at the other end of the conference table at work start to fade. Now you to strain to hear your clients, patients, colleagues. You turn the TV volume up to a new level, to the discomfort of those around you.

Meanwhile, as you continue in denial, your partner, coworkers, children and friends are well aware of your diminished acuity. They learn quickly that you can't hear them in a crowd, or from behind. They grow familiar with your, "Huh?" and "Whadjasay?" and with those often humorous misinterpretations that signal dampened reception of high frequency sounds, "Your mother is coming?" "No, the water is running."

Yes, hearing loss can actually become annoying to others, long before you're willing to acknowledge and deal with it. According to the National Center for Health Statistics, more that 9 million Americans over the age of 65 suffer hearing loss, but only one in five of them pursues treatment. So many excuses: "I can hear well enough." "I already wear glasses, -- not another device to deal with." "I don't know who to trust with this problem." "Those aids are just too expensive."

Hearing loss impacts some work settings more than others. Imagine the speech therapist testing for articulation errors in children, "Say that again, a little louder, please," as she homes in on visual cues from the child's mouth. The social worker in the noisy NICU, the public speaker fielding questions from the audience, lawyer with clients, doctor with stethoscope to patient's chest -- the list goes on.

What to do? How to cope? What are some ways to compensate for this loss?
Here are some ideas:

•Have hearing tested by a licensed, certified Audiologist (CCC-A from the American Speech-Language and Hearing Association or certified by the American Academy of Audiology).
•Follow-up with periodic re-testing of incipient loss.
•Be examined by an ENT to rule out any treatable medical problems associated with the loss.
•When ready, and on the advice of the audiologist, purchase the best hearing aids available for your needs -- choose among the newest small, digital, multi-channel, background sound- dampening wonders.
•Let others know about your loss -- but caution them not to talk with extra volume when hearing aids are on -- That can be painful.
•Move to a quiet environment for important conversations -- an empty office; just beyond the chattering of a party crowd.
•Face the speaker. Capitalize on facial cues and lip reading.
•In restaurants, seek a seat in a booth with your back to the wall.
•Get used to no longer overhearing interesting conversations at the next table.
•In theatres, take advantage of free FM listening devices -- especially if you don't wear aids yet, but need some help.
•Remember to routinely touch each ear before stepping into the shower -- just in case you've forgotten to remove your aids -- they respond poorly to water.
•Put hand lotion on after you've placed your aids in your ears. That way, the cream won't clog the microphone opening.

At home, set round rules:
•No talking room-to-room
•Best to communicate face-to-face and within close range.
•Say the person's name and get their full attention before speaking.
•Suppress background noise (TV, music, etc.) when conversing.

Here's what will still be true:

•You may have to devote your full attention to "listening."

•The loudest auditory signal in the environment still will win. It's hard to suppress all competing sounds.

•Your own vocal volume and projection will be affected by the feedback of your own voice-- so you might speak too softly. Louder may sound too loud to you.

•In less than ideal listening conditions, there will still be messages missed, or misunderstood. Repeat back what you have heard for confirmation. Laugh at the unintended errors.

Through it all, remember to enjoy the precious sounds and voices around you, and treasure the hearing you still have.

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