1. Surviving Hearing Loss: A Personal Perspective Katherine Bouton Michigan Audiology Conference October 16, 2014

2. Hearing Loss Health Hearing Loss Is Normal Hearing Aids Work Honesty Is Liberating Advocacy Is Empowering

3. Age of Onset of Hearing Loss Percentage distribution by sex and age, based on subjects' report of any permanent hearing loss (National Health Interview Survey, 2007). Female Male Birth2 2 0–2 years 3 2 3–5 years 3 2 6–19 years 12 11 20–39 years 20 32 40–59 years 30 32 60–69 years 14 12 70+ years 16 8 Source: National Health Interview Survey, 2007. Chart created by the NIDCD Epidemiology and Statistics Program. Updated in November 2012.

4. Prevalence of Hearing Loss in the United States, 2001-2008 Hearing loss defined as a better-ear PTA of 0.5-4kHz tones > 25 dB Lin et al., Arch Int Med. 2011

5. Hearing Loss & Hearing Aid Use Prevalence in the U.S., 1999-2006 Chien & Lin, Arch Int Med, 2012

6. Noise Aging.

7. Dangerous noise levels are a combination of time and intensity. Loud. But short.

8. Daily Exposure Blender Lawn mower Food processor Vacuum cleaner Power saw Football Game Restaurant

9. Audiogram 1988 New York Times

10. Audiogram 2008

11. HOW I HEAR TODAY September 2014

12. Ready? Say the Word…. Sheep Cheap? Mess Nest? Witch Rich? Sit Sh……?

13. Context is Everything What? Tour Four Shore Chore Thor Ah! I get it. The Viking Thor chose as his chore to take the four ashore and give them a tour.

14. Maxwell and one of his favorite foods. - Conversation in the dog park. “What’s his name?” “Four and a half.” Huh?

16. Misunderstanding Most People With Hearing Loss Can’t Read Sign Language. Where is the CART screen? The FM system? The induction loop?

17. Medicare and Hearing Health

18. Untreated Hearing Loss Depression and isolation. Anxiety. Paranoia. Increased risk of falls. Balance issues. Cognitive decline.

19. Hearing Loss & Incident Dementia Dementia incidence in 639 adults followed for >10 years in the BLSA Lin et al., Arch Neuro., 2011 HR95% CIp Mild1.891.00 – 3.580.05 Moderate3.001.43 – 6.30.004 Severe4.941.09 – 22.4.04 Risk of incident all- cause dementia (compared to normal hearing) a a Adjusted for age, sex, race, education, DM, smoking, & hypertension

20. The question of whether treating hearing loss could delay cognitive/physical decline or dementia remains unknown There has never been a randomized clinical trial of treating hearing loss to explore effects on reducing the risk of cognitive decline/dementia Frnak Lin

21. The Cost of Dementia By 2050 one in 30 Americans will have dementia. “ If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions in health care savings.” Frank Lin

23. Hearing Loss & Hearing Aid Use Prevalence in the U.S., 1999-2006 Chien & Lin, Arch Int Med, 2012

24. Medicare and Hearing Health

25. New York Times Newsroom (acoustic nightmare)

26. Honesty is Liberating

27. Which Would You Rather Been Seen As? Someone with Hearing Loss, a medical condition that is correctable with hearing aids. Senile, Drunk, Stupid, Burned Out, Snobbish, Bored, Uninterested, Empty-Headed, Vacuous, Ditzy.

28. Anger Can Be Destructive Or Constructive. Turn It Into Advocacy.

29. Support and Advocacy

30. Hearing Aids So many choices.And so expensive.

31. Audiology CareerCast ranks Audiology #5 on its list of Best Jobs of 2014. BLS Median Annual Salary: $69,720 Projected Job Growth by 2022: 34% Jobs Rated Score : 110

32. The telephone! It might as well be this…. Without this.

33. Phonak SmartLink+ FM Transmitter The speaker wears this transmitted around his neck or puts it on a podium. On the left, the settings for sound direction. On the right, settings for volume and program, as well as for answering the phone. Why are these on the speaker’s device when it is the listener who may need to use them?

34. Traveling With Chargers My chargers need a suitcase of their own. Adapter and Power Strip. Left to Right SmartLink charger MyLink charger MacBook Air charger Cochlear Implant battery charger IPhone (camera) charger. No room for the Nook or for my regular camera chargers.

35. Let’s Loop America These signs should be clearly posted inside and outside the venue. Loop sign Version 1 Loop sign Version 2

36. Looping may need to be supplemented by CART and ASL.

37. A New Life Career change. My own schedule. Advocacy. Friends.

38. HLAA ”The Nation’s Voice for People with Hearing Loss.” Advocacy, education, support, companionship.

39. Advocacy is empowering.

40. Advocacy “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” ― Margaret MeadMargaret Mead

41. Movie Theater

42. Garble vs. Clarity

43. Chaos vs. Order

44. What??? Communicate.

45. Looping = Hearing

46. Hearing is Good

47. Acknowledgements Thanks to my publisher, Sarah Crichton Books at Farrar, Straus & Giroux, for funding my research. Thanks to Frank Lin, Johns Hopkins Medical Center, for sharing his research, insight and slides.