Bill Diles is an audiologist and 4th generation hearing care professional. Bill and his wife Christine, who is also an audiologist, own 5 clinics in Sonoma County California. Besides running the local clinics, Bill consults with private practices around the country representing the family business known as Pivot Hearing. Bill is often a guest speaker at regional and national meetings. His passion is bringing optimal hearing solutions to those who suffer from hearing loss.
Transcript:
Frank: Welcome to Boomers Today. I'm your host, Frank Samson and of course, each week we bring you important, useful information on issues facing baby boomers, their parents and other loved ones.
I want to thank everybody for just wonderful comments we've received on the show. And our list is growing, of listeners and that's because of our great guests and we have another one with us today. And I'm proud to say it's somebody right in my local area.
We have with us, Bill Diles. Bill is an audiologist and a fourth generation hearing care professional. Bill and his wife Christine, who's also an audiologist, own five clinics here in Sonoma County, California. Besides running the local clinics, Bill consults with private practices around the country, representing the family business known as Pivot Hearing.
Bill is often a guest speaker at regional and national meetings. His passion is bringing optimal hearing solutions to those who suffer from hearing loss. So Bill, thank you so much for joining us on Boomers Today. Really appreciate it.
Bill: Oh thanks, Frank. Nice to be here.
Frank: Yeah, so I was just amazed. I mean, you have a long family history in the profession. Something like, is it 85 years? Did I read that right?
Bill: That's right. As far as I know, we're the longest running family in the industry. My grandfather started in Billings, Montana in 1934, fitting hearing aids. And you can just imagine what those hearing aids looked and sounded like. But yes, so we are actually, there was a brief time he hired his mother. So my children are actually the fifth generation in the industry. So it's quite a legacy we have going.
Frank: That's fantastic. I think that's, I love hearing those types of stories. So, so let's get in, let's talk about the issue at hand. How big of a problem is hearing loss in our country? I'm sure it affects other countries as well, but let's talk about the US. How big of a problem is it?
Bill: Oh, it's a major problem, especially with the baby boomers, right? We have 10,000 people turning 65 every day and that will continue into the 2030s. And so it's estimated that there's about 28 million Americans between the age of 20 and 69 who could benefit from wearing hearing aids, who do not wear hearing aids. And over the age of 70, people are wearing, fewer than 30% are wearing hearing aids. We have a large population of untreated hearing loss and that's where we find ourselves today.
Frank: I mean, can hearing loss be prevented, or is it just a normal progression with aging and there's nothing any of us can do anything about? Except maybe move into a hearing aid and we'll talk more about that. But is it preventative at all?
Bill: In some situations, there's a medical issue that can be surgically or medically treated, but as we age, the condition's called presbycusis. And really nothing to do but treat that hearing loss with hearing aids, which is actually an excellent treatment, which I'm sure we'll get into.
Frank: All right, so what is the normal progression of hearing loss? What could people generally expect as they age?
Bill: Yeah, it starts with straining to hear, right? Going through your day and working a little harder. You have to hear conversations. Maybe leaning in, you might even find your neck is a little tense from the straining and then you find yourself asking for repetition.
And we have discussions with our patients and one of the things we talk about is just how many times can you ask somebody to repeat? And I think the answer is two, right? "Excuse me. What was that you said?" And then the third time you go, "Wow, even if I ask again, I'm probably not going to get it. I think I'll fake it." I think we've all done that in a noisy environment.
You smile like you heard it and what if you're smiling at something you shouldn't really be smiling at? And next thing you know, you realize that was inappropriate, so you get embarrassed. And maybe you withdraw from these kind of social situations, gradually. Because hearing loss comes on so gradually. You can become isolated as a result and ultimately, depression can set in. The hearing loss is slowly working on you, without you being quite aware of what's going on.
Frank: I agree that depression is setting in to the elderly, and that it’s a big issue. In your opinion, do you think that could relate to loss of hearing?
Bill: There are instances where that is the case, for sure. That's an extreme example of this. But we do see that from time to time. It's, as I think, I hope we'll get into, it's a little bit more of a gradual cognitive decline, is an issue that I would be more concerned about.
Frank: So, yeah, so let's talk about that, now that you brought it up. I mean, as you know, I'm involved in the senior care industry. And there's all sorts of studies that say that there's a link between hearing loss and some sort of cognitive decline that could lead into various forms of dementia like Alzheimer's. Which is probably the most known type of dementia, but as you know, there's lots of different types of dementia. What do you, what's your thoughts on that? What do the statistics show? What's your opinion? What about all that?
Bill: Yeah. Well, I, first off, one of the interesting statistics is that the average person will wait seven years before taking the first step towards treating their hearing. So seven years are going by and these things are happening, this progression of hearing loss.
It's something you put off. You go, "I think I hear okay." It's confusing, right? People are mumbling or I don't want to do anything about it. Hearing aids cost too much or maybe my hearing aids will end up in the drawer. We have lots of excuses to put treatment off.
But what we're finding is that only about a third of the physicians in the country will ask a patient about their hearing during the annual physical. So when you're having your physical, you're usually in the doctor's office concerned about other things, right? Hearing loss just doesn't get brought up that often. You're in a brightly lit room, there's no background noise. It can be easily missed there. And if it's not brought up, it's not addressed.
What happens then, with untreated hearing loss, are several things. You've got, see, we hear with our brains, not with our ears. So what we have is a decreased audibility and a distortion, which is interrupting the signal between the ears and the brain.
With this lower signal quality, it leads to an increased cognitive load. So, in other words, the part of your brain that's dedicated to understanding and judgment, and responsible for executive functions like planning, the future, judgment, decision making calls, tires out much faster. All those things that your frontal cortex is involved in executing, you're having to use that part of your brain just to hear what's being said to you.
Frank: Right. So, someone may recognize the fact that they're having hearing loss. I mean, I know I am. I mean my kids tell me all the time. But why don't you think people go for help? What do you think are some of the top reasons?
Bill: Yeah, I think first and foremost, it's just a denial, right? Ignore it, it'll go away. And it's, hearing loss is kind of confusing. It's not like vision. We know pretty quickly when we can't read that menu, it's time to go by CVS and pick up a pair of cheaters. We won't put up with straining to read a menu very long before we'll do something.
But hearing loss, is like, "Wow, I hear that speaker clearly. I'm hearing in church fine, but I think it's just my wife's voice or it." Or if there's just a little background noise. "Is this normal?" It's just such a gradual thing. And then once you start to decide, "Okay, I need to do something", it's hard to know where to take that first step. And so there's lots of options, but it's not real clear to the average consumer how to take that first step. Make sure you're going about this the right way.
Frank: And what should be the first step?
Bill: Well, in my opinion, and you should go, you should seek out a practice that handles multiple brands of hearing aids. When I started in this industry 43 years ago, we had 30 or 40 different manufacturers of hearing aids. We had all these choices, not that any of them were very good back then. And today we're down to just six players.
There's six manufacturers that make up 95% of all the hearing aids in the world. They're each different. They all have their different pluses and minuses and their different approaches to getting information to the brain. And one thing, as a consumer you want to make sure of, is that you're going somewhere who's independent and has access to these different manufacturers. So that's the first thing I would suggest, is finding an independent practice.
Frank: Yeah, that's a good, that's a great point. Sorry, I kind of bounced around. So we were talking about some of the consequences for untreated hearing loss. And we were talking about the possibility of cognitive decline. So sorry, I interrupted you and your thoughts, but what other consequences could come about, if it goes untreated?
Bill: Yeah, there are two other things I'd like to discuss. Unfortunately Frank, as you know, our brains are shrinking as we age. And if parts of our brain are being deprived of stimulation, that brain tissue is going to shrink at an even faster pace. It’s kind of like, use it or lose it, you know.
And the third factor I'd like to discuss is the change in social behavior. Let’s say as we talked about earlier, you've been embarrassed in some situations, you start to withdrawal from your healthy activities like bridge or line dancing or church or rotary. These things that keep your brain sharp and you're not doing them now. That's just another factor.
To tie it all together, we've got hearing loss, which is bringing a lower signal between the ears and the brain, which results in a higher cognitive load. We have changes in brain structure, brain tissue, and we have changes in social behavior. And these can actually lead to health problems like depression, dementia, accelerated cognitive decline.
These are the subtle factors that are working on a person behind the scenes, so to speak, with an untreated hearing loss. You're going around and, with everything slightly muffled. You're not quite tuned into what's going on around you.
Frank: Right. Yeah, and everybody's situation is different. I know personally, I experience sometimes if I'm in a room and the acoustics are not good in that room, and many people are talking, it can be hard to hear. It's tough to hear, but every situation is different and that's why they have specialists like you.
Bill, is just really to talk about some of these newer developments. I mean, I see people that I know, whether it be business or professional and there's been such a change. Those that might be wearing hearing aids and there's just such a change.
I remember my mom when she were alive. And she never liked wearing her hearing aid because it was just, she was maybe a little vain. And we all are in a certain way and it bothered her, these hearing aids. And she didn't want to wear them all the time. And now you can hardly see them.
So I'm just saying from a cosmetic standpoint, there's been huge changes. Maybe you could talk about that as well as just the quality of the hearing itself.
Bill: Absolutely. Yeah, so not only was that hearing aid you're talking about unattractive, it was pretty unpleasant to wear as far as adjusting for sounds. And if you could just imagine a linear type hearing aid and you're sitting in a noisy restaurant and we're having a conversation. And you've got a volume control, so you have to turn it up to hear me. Then a waitress drops dishes, wham. Ah, so you reach up because that hurt, you turn it down. Well now you can't hear me.
You crank the volume control back up and then here comes another loud crash. And so the point is, that your hand just isn't fast enough to make the adjustments. So those hearing aids back in that day were quite jarring and unpleasant to wear. And in recent years, with the technology, these adjustments are made so fast that when those dishes hit the floor, that hearing aid's gone off before it ever got to your ear.
The automatic nature of the technology makes, that's just a huge jump and just makes them a lot more comfortable to wear. And so through the years, like in the 90s, we'd have to wait about five years for a new product, that was the product cycle. And we were told back then that we're going to see faster product cycles. And sure enough, these six manufacturers there, it's gotten to the point where it's six or eight months now before someone's got something new.
Before we get into any more specifics on technology, I want to mention that it's really important to experience these for yourself. We call it the test drive, the hearing aid test drive. And if you really want to make the right decision about your hearing, makes sure you go to a clinic that allows you to test drive before you make that big purchase. It's a major investment and not just financial, but you, it's something you're wearing all day long. And you want to wear the hearing device that fits your brain.
So to touch on some of the exciting technologies. So there's that device I was just talking about, FLEX:trial. It recognizes seven different environments, noise, quiet environment, conversation in a quiet environment, conversation in a small group versus conversation in a crowd and conversation in street noise and music. So there's seven environments that the hearing aid will move through, throughout the day as you go through your life.
There's another innovation that's come out recently from a company called Signia and some people are bothered by their own voice. It's almost like hearing yourself on a recording and you say, "That doesn't sound like me." So there's a time where you need to get used to your own voice. Well, this technology allows us to, we have the patient talk out loud for maybe 30 seconds, the hearing aid captures that voice and knows to amplify that differently than all the other voices around. Just amazing.
Frank: That's amazing. It's amazing.
Bill: Making it a lot easier to get used to your own voice. Another manufacturer, what's interesting Frank, too. Of the six manufacturers, three of them are from Denmark.
Frank: Wow.
Bill: So, 50% of the hearing aids in the world come from a country the size of New Jersey.
Frank: I'm sure that's a whole other conversation, but that's amazing. That's amazing.
Bill: I think it's the cold weather. They sit around and think. And Oticon is the big Danish manufacturer and they've come up with a product, it's called the Opn. Which just gives you, it gives the patient a 360 degree type of signal, rather than directional microphones. Just been a really natural, very easily accepted product that people really like.
Another Danish manufacturer called Widex, we call them the musicians' hearing aid. They let the most sound into the instrument and there's, for certain brains, this is the kind of signal they like.
And if you have an iPhone, you may not even know, but under your settings you can find a tab there that says MFI hearing devices, made for iPhone hearing devices. Using that, we can pair it to your phone and you can stream phone calls and everything else you need straight to your hearing aids. It works a little bit like Bluetooth. This way, everything you hear will hopefully sound good because it will be programmed to your hearing aid.
It also works well with TVs. All of these manufacturers have available little boxes that we plug into the TV and they stream beautifully, from Bluetooth stereo to the hearing aids. You just pull your phone out, hit TV on your app and you're streaming. I really enjoy mine at home.
Frank: That's amazing.
Bill: Yeah. As of recently, we now have the ability to stream to any Bluetooth phone. So Phonak, the Swiss manufacturer, came up with a product called Marvel and it now streams binaural to any Bluetooth phone, Android or anything.
This means that you could actually leave your phone in your pocket and the hearing aid itself, the microphone on the hearing aid, is what the person on the other end of the call is hearing you through. You'd be walking down the street and you look like you're talking to yourself, but you're having a conversation, phone in your pocket, completely hands free and you're hearing the person in binaural, into each ear.
Frank: That's great.
Bill: There’s one other product I wanted to mention, made by Phonak is the Lyric. And this is a little disposable product that we put in under a microscope, very soft little device. And we place it down in the ear canal and it stays in the ear for two or three months at a time. And then when it dies, we pull it out, throw it away and put a new one in.
So it's a whole other solution. It's very convenient, no batteries to change, nothing to take in and out. You can sleep with them, shower with them. So those have been, for certain people, that has just been the ultimate answer. Totally invisible for those who are extra cosmetically concerned. That's a neat product that we've had for about a decade now.
Couple of other features I thought I'd touch on. We now have GPS on the app, like with the Oticon hearing aid, for example. You lose the hearing aid, we can pull up the phone and, "Ah, there it is. It's in the bushes at your house. Or it's in that restaurant." Isn't that neat?
Frank: That's great. That's great. Yeah.
Bill: And what's making all these hearing aids so much better than in the past is that they now communicate with each other, all day long at high speed. The hearing aids are aware of each other and the environment you're in. And as we learn more and more about the brain and computer chip speeds keep increasing, they're just getting a better and better signal.
Frank: I could talk to you for another hour or so on this subject matter, but unfortunately we're getting out of time here. How would our listeners be able to get in touch with you and your practice?
Bill: The best way would be to send us an email. We're goodhearing.Com, on the web. And if you're local, you want to give us a call. Our Santa Rosa main office number is 707-538-1000. And if you're looking for a clinic, a reputable clinic, and you’re not in our area, I would read Yelp reviews. I'd make some calls. I would ask the clinic, do you handle multiple brands? Will I have the chance to experience a few before I make my decision?
Frank: Great. Great. Bill Diles, check it out, goodhearing.com. Thank you so much for joining us on Boomers Today, Bill. Really appreciate it. Very informative.
Bill: Thank you, Frank.
Frank: Yeah, thank you. And I want to thank everybody for joining us out there on Boomers Today. Just be safe out there and we'll talk to you all soon.
