Key Strategies for Maintaining Good Hearing & Ear Health | Dr. Dan Troast

Don't wait. Hearing aids aren't scary. Hearing care professionals are not scary. The tests are painless. Just come in, see what it's about, and understand what's going on with your ears and your hearing. So it's better to be proactive than reactive.

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My guest today is Dr. Dan Trost, and we'll be digging into all things hearing and hearing loss. Dr. Dan Trost, AuD, is a hearing care professional at HearUSA, America's largest hearing care retailer with over 350 locations across the United States. And Dr. Trost chairs the company's HCP advisory board, The board, which comprises HearUSA's HCPs from across the country, leverages its collective professional expertise to develop new programs and initiatives that improve patient care. Welcome to the Longevity and Lifestyle Podcast, Dr. Dan. It's such a pleasure to have you on.

Thank you very much for having me. I'm excited to be here.

I'm really excited to be here too, because I think hearing loss is something that everyone is aware of. I think a lot of people are in denial about, Sometimes I also wonder when my kids are talking, they're like, "Mommy, why do I have to repeat myself?" I was like, "Oh my gosh, I probably need to get my ears tested more often." But particularly in my parents' generation, it's quite typical. We speak louder, slower. We realize that they're just not hearing things as well. So I think this is such an important topic for so many people looking to live well for longer that we really get into, you know, learning more about your area of expertise. So excited to have you on. And what I'd love to start with is in general, like hearing loss. Right? Why do we lose our hearing as we age? Like, what is going on there? And obviously there's a genetic component, but for those that are not genetic component, like what is happening there?

So hearing is a very complex system. Okay? And so as to hear a sound, it has to get into our ear, down our ear canal, and slowly make its way into this central part of the hearing mechanism, okay, called the cochlea. In the cochlea, there's these little receptor fibers that are called hair cells. Not hair cells like what you'd have on your body, but they're called hair cells because they're like these little cilia that are in there that are responding to these sounds, okay? Now, just looking at age-related hearing loss, okay, like most things on our body, as we age, they don't work as well, they atrophy, things of that nature. So even if you've not been exposed to noise or anything like that, you have a lifetime of hearing going on. And all your life, every sound, these little fibers have been responding. And over time, they just fatigue a little bit. And when they fatigue, it requires more energy to stimulate them. And then that is where that sensory loss is coming from. Now, you can be, you know, genetic variables, you know, you can be more predisposed to starting that age-related hearing loss at a younger age, 50s and 60s. Or you could have good hearing genetics and not start that age-related process until your 80s or 90s. So, and that's just one of the variables that we would want to look at.

So what would you say are some great strategies and tools to help people maintain, you know, good hearing? And even now, what we're learning more and more about with genetics is that, you know, there's a lot of epigenetic variants to it. So you can, you know, lifestyle, and the environment can really impact how the genetics are affected as well. So I'd love to hear some of your view on some of those key strategies.

So first is to know your background, know your genetics, right? So everybody knows, oh, you know, mom and dad are going to pass down, you know, diabetes or heart disease or all these other things, but they don't think about the hearing loss variable. And it's not just, you know, when did mom or dad start wearing hearing aids? When did you notice that they should be wearing hearing aids, right? Because most people, when we notice they should, that doesn't mean they're going to go and get it right away. They're going to wait a little bit, unfortunately, because that's a key variable to understand for yourself. So again, if you are somebody that noticed your parents, you know, they can't hear as well in their 50s, 60s, 70s, you should be thinking about, I need to be getting baselines done when I get to that age to kind of understand where I'm at. Outside of that, you know, protect your ears. You only have one set, right? So you think, oh, well, it's just one concert. Oh, it's just, you know, one time, you know, cutting the grass. It's just, you know, one time cutting this piece of wood. All those incidences pile up over time, right? So it's generally not the one incident. It's all of those incidents of noise exposure over time that are going to pile up. So again, protect your ears wherever you can. Wear hearing protection wherever you can. You know, don't put your, you know, headphones on and listen to your music for hours on end at high volumes. Again, just be smart with what you're doing with your ears.

I'm curious in terms of physiology, like what is actually happening? So say you go to this concert and you end up standing beside the largest box that you've ever heard speaker, right? What actually happens in the ear? Is it the vibration is so such that it starts to kill off the hair, or what's, what's happening?

So remember, we have these little hair fibers, okay? And what I want you to think, these hair fibers are in a fluid-filled chamber, okay? So what I want you to have the mental picture in your mind is when you've seen the nature documentary and you see the seaweed in the, in the current kind of flowing in the current, right? Then it shows you what happens when there's a violent storm and there's the big waves on top of it, and that seaweed is really crunching down. So What's happening is every sound that comes in puts a nice wave in there to stimulate those fibers, okay? Those louder sounds are a more violent, dramatic wave crashing down on those fibers. So it's going to crash down and it's going to accelerate that decline. So similarly, you have like a professional athlete, for instance, professional athlete, we think, you know, peak physical fitness, right? But they tax their body so much more that suddenly their knees when they're 40 years old are like knees of somebody that's significantly older than them, right? Because they put so much extra taxation on it. So again, you're putting all that extra taxation on your ear system, a lot more of that dramatic crash, and they're just not going to bounce back as quickly as they did. So again, if you go to that concert and you come out of that concert and your ears are ringing and you feel like everything's quiet because your ears are saying, ouch, that really hurt and it's taking time for them to try to recover. And then over time, they're just not going to recover all the way anymore.

So what are some of the most dangerous sort of day-to-day culprits that impact hearing loss? So you were mentioning, you know, headphones on, music very loud, lawnmower, you know, would you say people who live in cities, there's like ambulances and fire trucks going by that can be really, really loud. Like, should people be covering their ears? Like, what are the day-to-day things just for my audience listening that people really should be paying attention to?

An ambulance driving by is going to be there and gone in a matter of seconds. So you're probably not going to be able to protect your hearing from that too much. But even just think about what you're doing as a career. So somebody that works on a train or a subway or something like that, if I'm a passenger on that train, I'm on and off that train in a short period of time. If I am working on that train and I'm exposed to that train noise for an 8-hour shift, now that's too long, right? If I'm a hairdresser and I'm exposed to that hairdryer for an 8-hour shift, that's too long. If I'm a barista and I'm exposed to all those blenders, you know, for an 8-hour shift, now that long shift is taxing your ear. So that one moment, that one smoothie, that one time of styling your hair is probably not gonna be the issue. But again, a lot of that is over time. Now, Other things that I can do to hurt myself would be like if I'm on a snowmobile, if I'm on a lawnmower, if I'm at the concert, if I'm running a piece of loud equipment like a chainsaw or something like that. Yeah, those are going to be short instances. If I'm, you know, shooting a firearm without, you know, ear protection, again, those are all going to be instances where just that one incident can cause the damage. The other ones are that length of exposure. So again, going back to the headphones, it's the length of exposure. So if I just put them on and I just have that music just banging in my head all day to drown everything else out, that's usually too long of an exposure time.

What would you recommend are good devices or tools for people to wear? I see sometimes at concerts people even have like cotton wool in their ear versus, you know, larger headphones. Obviously there's EMF radiation to think about as well with if you have headphones on. So what are some of the devices that you recommend?

You can go anywhere from a custom-made earplug, and there's custom earplugs specifically for listening to music and concerts so you don't lose the integrity of what you're trying to listen to. You can also get, you know, over-the-counter little, you know, squeezable insert protection that you can put in there. It's not going to be quite as strong, but it is going to give you some protection over what you had, what you'd have without anything in your ears.

I'd love to understand, is there a way— obviously in the community here as well, we like biohacking and like how to get to it, right? And so is it sort of lack of mitochondrial function that these hairs, if you will, are losing, or is there a way to replenish that? Has there been any research around what could be done?

So there's definitely research being done about what can be done. Okay. The most difficult part with these hairs compared to other parts of our body is that inner part of your ear is actually inside of your skull bone. So we don't have the same access to it that we do to other parts of your body. Your eye, again, we can see your eye. It's right there. Your heart, if we need to get to it, again, we can open your, your rib cage. We can get in there. Sounds dramatic, but we can get in there. We have access, right? With the ear, it's inside of your skull bone. Okay. So most research is on people that have already passed away. So we can't really get a full gauge of what's going on there. Some on animals and how, how that relates, but animals are obviously not exactly the same as we are as humans. And there's not too many people with that are alive that are signing up to have their heads cracked open so we can see what's going on in there. So I mean, the research is being done. They are trying to figure it out. It's just a little bit more slow going. And even the field of audiology and hearing in general is a relatively young field in the field of medicine compared to some of the other fields. So again, research is being done, but it's just a little bit slower because of the access to some of those important components. That hearing mechanism is one of the smallest mechanisms in your body. So again, getting that good access to see what's actually going on is very difficult.

I think it's so fundamental as well because, and I'd love to touch on this too, I mean, lack of hearing, you kind of close yourself off to the outside world, especially, you know, for older people who generally would have less social contact than someone who's, say, working in an office and interacting more. So it becomes or can become very lonely. So I think it's, you know, so important for people to get on top of this. And I hear you have a phrase you use often, if you don't use it, you lose it.

What do you mean by that? That is correct. So if you don't use it, you lose it. So again, you already kind of touched on it in what you just said. So when we have hearing loss, several things start to happen. If we have untreated hearing loss, several things start to happen. You know, one is you will isolate yourself a little bit more so because communicating with others in social situations becomes more difficult. Even when you're in those situations, you can't fully participate, okay? And your brain is not getting the stimulation that it needs, okay? So your brain is designed to get this input and it's not getting that stimulation that it needs. So if your brain is not getting that stimulation, it's going to start to atrophy. It's going to start to repurpose itself. It's not going to work the same way that it did before. So again, if you don't use it, if you don't use your brain properly, you're going to start to lose it. So you're going to lose the ability to process that sound. So maybe you do end up getting hearing aids, but now your brain works a little bit differently. So you don't have the same amount of brain power to process that incoming signal. So that's going to change how well you can function with hearing aids, but also cognitive decline. So you don't use it, you lose it. If you're not using your brain, there's lots of studies out there that show you are at much greater risk of dementia, cognitive decline if you have untreated hearing loss. Even a mild untreated hearing loss is going to put you at risk of cognitive decline.

So this is huge, particularly because my mother has dementia. So I'm all about this topic. And my father's 85 and he definitely needs hearing aids. He says he doesn't want to wear hearing aids. It's hard to, you know, negotiate with an 85-year-old who can be a little bit set in his ways. But I see how painful dementia can be. And so can you talk a little bit more in depth in terms of untreated hearing loss and how quickly that can expedite cognitive decline? Like, what does that process look like?

So again, like I was mentioning, even in a mild loss, so this is a very low-grade loss, even in a mild loss, there's studies that show brain scans where those areas, receptor areas of the brain, are functioning less than what they were with somebody with normal hearing. In the most recent studies, we actually can see that they were looking at specifically at-risk people. So people that are at higher risk for cognitive decline and the group that wore hearing devices, that wore hearing aids, had an almost 50% slower decline than the untreated group. So again, that study is huge, right? That's saying that if you wear hearing aids, you can slow that progression by almost 50%. That's a very staggering number. If that's not motivation to treat your hearing, I don't really know what else is.

So I'm going to be sharing this interview with my father and make sure that he hears this. So hopefully I'll get him to see you guys. You're also known to say that your normal is not normal. So what does this mean?

So hearing loss is something that happens gradually for most people. Okay. So this is not, oh, you know, an explosion went off next to me and now I can't hear. This is again that aging process that we were talking about earlier, that life process that we were talking about earlier. It happens very gradually. Okay. So usually from when you first start having hearing loss to when you even can kind of acknowledge that you have hearing loss is 7 to 10 years. Okay. So that means you're living with this hearing loss. Your brain is kind of acclimatizing to where you're at. So you have in your head, this version of what is normal. Okay, now that version is not what actual normal is, but it's your version of normal. So then what happens is when you do get hearing aids on your ears, you say, "This doesn't sound normal. This isn't what I'm used to." Now, that's kind of the point, right? Because you have hearing loss, we need to get you hearing better. But that's why hearing aids are rehabilitation devices. They take time, right? So anything that's rehab is going to take time. When we're fitting somebody, we're looking at that rehabilitation process as well, getting that individual used to hearing things again, used to hearing their own voice louder, used to hearing the speech louder, used to hearing even the things that they don't want to hear, but are normal to hear at a louder level, right? And so at a level that's not louder than normal, but louder than what they're used to. So we have to change what their version of normal is back to an actual normal version.

And you were saying rehabilitation process. So let's say someone has mild hearing loss or even more advanced hearing loss and they get hearing aids fitted. What's that journey look like to restoring it? Is it sort of 1 to 100 and then they can hear, but the brain has to reaccustom to hearing noises at a louder sound? Or what does that journey normally look like?

So every patient is a very individualized journey. And so that, you know, hearing care professional is going to evaluate where that person is at and how to help them in their journey. Most people that try hearing aids and give up, give up in the first couple of weeks. Okay. So, and the reason why they do that is because there's too much of a change. A lot of providers, myself included, again, use that rehabilitation approach, meaning on that first day, I'm not looking to be at your prescriptive target on that first day. I'm looking to give you more than what you have, but make sure it's at a comfortable level where you're not going to reject it. And then have you come back over a period of, of weeks to work you up to that level where you're supposed to be at. So again, if I had my knee replaced, I'm typically not going to go jogging out of the hospital, right? I might walk out of the hospital, but then I have to go to physical therapy and get that leg back up to strength before I get to that level, right? So if I put a hearing aid on for the first time and went right out to a busy restaurant, I'm going to be like, what did I do? This was a big mistake. So again, we want to ease ourselves into it, ease those patients into it. So we have a much higher retention and acceptance rate, and then work them up and make sure they understand how the process works. It's not an overnight process. Now, for some it is. I mean, I do have some patients that first day we go all the way up to prescription and they're like, oh my goodness, this is amazing.

Yay.

But that's not the norm, right? So the norm is we have to get used to it over time. And the greater the hearing loss, the longer that takes because there's more to get used to. Right? So if you come in with a mild loss, that process is generally going to be a lot faster because the difference from mild loss to normal is this. The difference from moderate or severe loss is much greater. So it's going to be a much greater adjustment.

No, that's really helpful to understand as well. For people, I mean, throughout your lifetime, like how often do you recommend people have their hearing tested? And does it differ at different stages of life?

So generally speaking, we would recommend when you get into your 50s, you should get a baseline hearing test, not because we're expecting that everybody in their 50s is going to have hearing loss, but because that is typically where we can start to see the signs of hearing loss come about. So like we were saying earlier, some people, that aging process is going to start in their 50s. So again, get that test done, kind of see where we're at. Okay. And this is not a, you know, we're going to fit you with hearing aids. That's get that baseline done. Okay. From there, then we want to evaluate where you're at, right? So if you have normal hearing, then maybe you're going to come back in a few years for another test. If you have any hearing loss, then you want to come back every single year for that hearing test. Now you may have hearing loss, but it's so insignificant that it's not even worth correcting at that point in time. Maybe you only have hearing loss in a very small area. So we have, you know, normal hearing over here, Then there's just maybe 1 or 2 sounds that you don't hear quite normally. So again, we want to pay attention to all that so we know exactly what's going on. So one of the common questions that I get from a first-time hearing test is, well, how much worse is it going to get and how fast is it going to get there? Well, I've only tested them one time, so I don't know that answer. But if we have that baseline, I can say, well, from here to here, this is how much your hearing has changed. So now we can kind of extrapolate or guess what that's going to look like moving forward.

The projection, and then to ideally fit hearing aids as well. I'd actually like to touch on hearing aids and how they've kind of developed over time and what is available, I guess, on the market today. I've seen one person was able to sort of control their hearing aids with an app. It was like super high tech. So I'd love to just share with my audience so people if they feel that they might be a contender, just to understand what the devices are, what they look like, how large they are, what they're capable of. Can you walk us through that?

Absolutely. So hearing aids, first of all, again, definitely you want to talk to your hearing care professional so that you figure out what's going to actually work for you, be right for you. They are not one size fits all. Everybody has different anatomy. So even what can physically fit on your ear is going to change from person to person. That being said, hearing aid technology is changing at a rapid rate. Manufacturers are putting out new product at least every couple of years. So again, just like any other technology, cell phones, things like that, it's rapidly advancing. So what was a high-end feature even 5 years ago is a standard feature today. So you were mentioning controlling it with your phone. Almost every hearing aid that's put out now, you have the ability to put an app on your smartphone, connect your hearing aid to it, and do a variety of controls from basic volume control to some of the more advanced hearing aids where you can actually control where the microphone is focused. So if you're in a noisy place and you just want to hear that person across the table from you, you can actually tell the hearing aid, "I only want to hear here." So again, in a variety of things in between, you have Hearing aids that are now rechargeable. So a charge that lasts all day long. So you don't have to mess around with those teeny tiny little batteries anymore. Some even have portable charging cases. So the case holds power in it. So you can travel, you can go out camping in the woods and still be able to power your hearing aid for several days. So just in general, you have hearing aids that have dual processors and multiple microphones. They're actually real-time processing the environment that's happening around you, where the speech is, where the noise is, and actively trying to pull the speech out and reduce the impact of the noise so that you can understand it. So again, understanding what your needs are versus what's available. And that's where, again, the hearing care professional can kind of work you through that journey a little bit about what do you want, what do you need in a hearing aid, what's going to fit what's appropriate for your anatomy, your ears, your hearing situation. They're also very, very small. So an example of an over-the-ear one, I have one right here. Okay. See, very teeny tiny. Okay. So it's not like the old hearing aids from 10 years ago where it was like a big thing hanging on the side of your ear. So, and what I tell most of my patients as well, everybody wears things on their ears nowadays, right? 'Cause everybody has, you know, Bluetooth earpieces and things like that. So some of the hearing aids are actually even designed to look like Bluetooth earpieces. So you can't tell the difference one or the other. So most people are not even going to think hearing aid nowadays. When they see something on your ear, they're going to think it's just a Bluetooth piece. And that's regardless of age, 'cause I've had many patients that are older than I am come in that, quite frankly, know more about technology than even I do. And I think I'm pretty up on technology. So again, just a lot of really advanced technology out there.

That's really exciting. And especially the ability for extracting voice, 'cause I think the original hearing aids, and I have some cousins who wear hearing aids since childhood, it just made everything louder. So if you're in a loud space, it makes everything louder, which is different. And that's the beauty of the human ear is able to differentiate and you're able to zoom in. So the fact that technology catching up. Sounds really phenomenal. I'd love to move over to children and hearing loss. Obviously, there's hereditary hearing loss, I believe it affects 1 in every 1,000 newborn babies. So what is happening there with children born with it? And I'm also curious as a sort of follow-on question, I have 3 cousins, same family, all 3 born with hearing loss. And it doesn't run in the family. So is there something that goes on during pregnancy that could impact it as well if it's not specifically genetic?

So yes to both things. So one of the things sometimes is just how the genetics of the parents mesh together, right? So each individual parent might not have that hearing loss variable, but just how their genetics happen to mesh together kind of creates that variable. There are lots of variables with pregnancy, which is again why you would, if you're pregnant, you'd want to follow up with the proper medical professional to follow those things, check your different levels, things like that, being premature, too much of different types of things, vitamins and different things like that, again, can impact that as well. Sometimes at the end of the day, there just is no rhyme or reason to it and we can't figure it out. So the good thing with nowadays is that any child that's born is required to have their hearing tested so that hearing loss doesn't go untreated. So previously, years ago, you could have a child born with hearing loss they leave the hospital without ever being tested. And it's not until the parents or somebody feels like maybe they're not responding the way that they should, and now they're getting that intervention, but they're, you know, maybe 2, 3, 4 years old. So during those critical language acquisition years, they're not getting the help that they need. Now, because you have to have that hearing evaluation before you leave the hospital, if you fail that evaluation, which doesn't necessarily mean that you have hearing loss. There's lots of reasons why you could fail that newborn hearing screening. You could still have, you know, some of the fluids in your ears and stuff like that from the birthing process, but it puts you on that path of follow-up care so that if you do have a hearing loss or if you do have a child with a hearing loss, they get that help that they need right away. And they can develop, you know, language and things like that just like somebody with normal hearing because they're getting that intervention at an early age. So it really does not stop or hinder them from, again, those key developmental milestones.

Yeah, which is really phenomenal that that's done. My cousin, I mean, born early '80s, it wasn't until he was about 2 and a half that my mother picked up on like, something's not right because he used to come to our house and was able to take out pots and pans and was banging it on the stone, which was obviously giving a vibration so he could hear. We were always like, it's so loud, why are you doing that? And then, you know, now looking back, obviously it's very obvious in the old family videos of what was going on. But yeah, I guess back then it just wasn't always a standard test. So yeah.

Well, and speaking to the point of hearing and audiology being a relatively newer field, it was something that we just didn't, pay attention to. So there's lots of things now that we pay attention to that we didn't pay attention to before when I was growing up, when you were growing up. And now there's a lot more standards in place, thankfully, because again, medicine continues to advance, the medical fields continue to advance. So there's a lot more things in place to catch, you know, a whole host of different things that we just were out of our peripheral before. They were there, but it wasn't really at the, at the forefront.

Yeah, which is phenomenal to help those children in those key development years of learning speech and language as well. I'd love to ask your view on what CRISPR gene editing is doing around treating hearing, genetic hearing loss. What are you seeing and what is your view on that?

So with the genetic hearing loss, obviously it's, you know, a whole different ballgame. So there's a lot of obviously different genetic conditions that they can identify as hearing loss being a risk factor. And genetic testing just in general has come so far from where it's been. Again, one of those fields that we're talking about are advancing rapidly. Genetic testing is one of those as well. And so we definitely can see where they are identifying, again, some of these key components and actually seeing where in these different genetic conditions is the anomaly that's causing the hearing loss. So it's definitely very exciting to see that some of these strides are being made, that in instances of a genetic type of hearing loss, that things could potentially be done very early on, be done, you know, even in utero in some cases they're looking at, right? So there's a lot of things to be excited about to see how that's going to work out. Even more exciting would be how that then extrapolates to people that don't have genetic hearing loss. And is there anything that we can learn from these genetic conditions and how they're treating those that could potentially be extrapolated somewhere else down the line? So now obviously I am not a geneticist, so I don't do everything with that, just what I see in the research journals and the research articles and things like that. Definitely, again, it's exciting to see some of the things that they've been able to identify and kind of put together and kind of work out, okay, how can we modulate this in just the right time and development to get the outcome that we want is really a fascinating, fascinating thing to see.

Such an interesting space and really exponential growth through technology supporting it as well. So yeah. So we'll see next time we have a follow-up conversation, we can see where we are, Dr. Dunn.

That's the exciting thing. Like we were, you mentioned earlier, like what's being done to see how to regenerate those hair cells, what's happening, you know, here again, it's just an exciting, you know, field and time to be a part of because those things, you know, we're just making such tremendous strides, whether it's just the hearing aid technology or it's even looking at how can we treat some of these, you know, other things, how can we treat, You know, tinnitus, how can we treat a genetic hearing loss? And some of these different things that are coming down the pike, or you see the early stages of the research in some of these things. Even the study that we were mentioning earlier with the impact of hearing loss on cognitive decline and dementia, you know, those studies have been in place for a long time. You can track them back, you know, even 10, 20 years, some of those studies. But again, as we're able to research the brain and map the brain more so, we're seeing even more impacts of what that relationship is. So earlier studies were maybe at, you know, 20 to 30% of a reduction in cognitive decline. Now again, most recent studies showing almost 50%. So again, as we can understand more of what the brain does and the complexities of the body, we're just seeing more of these things that we can pull out and extrapolate.

Yeah. And I'll link that that study in the show notes for people interested in looking at it. I am myself as well. I think more people need to know about this. So we'll be excited to share that. What would you say are some of the biggest benefits or learnings or insights that your patients, when they've gotten their hearing back, have come to realize?

The biggest thing is that they get their life back, right? So they were not participating in things, they were withdrawing from things, and now they get their life back, right? Now they don't mind going to the book club, having the family dinner, family over, going out to lunch, doing things that they maybe were doing, but slowed up doing or didn't enjoy participating in anymore because it was too cumbersome. Okay. They couldn't understand. They were afraid of saying the wrong thing, answering the wrong way, you know, things of that nature. So, you know, they get their life back. I have, you know, patients every day coming in excited about even just the little things that they can hear. Oh my goodness. I heard the noise that my washing machine makes when it's done with the washing cycle. I never heard that before, right? It's a simple sound, but they can hear. I have birds on my back lanai. I didn't know that there was birds back there, right? Because they didn't hear them before. So the simple sounds, being able to communicate, participate back in life, that's really the biggest feedback that I get is that they're getting their life back. And then also I get the feedback from the family members, from the loved ones. Oh my goodness, I can have a conversation with mom. I can have have a conversation with Dad. I feel better that they're safe when they're at home because they can actually hear if somebody's coming into the house or ringing the doorbell or their phone is ringing, right? So even for the family members of somebody that has a hearing loss, it's like a relief for them because they feel that their parent is safer, but they also feel like now I can communicate and that relationship is not frustrating anymore. So it's not, oh great, I have to go talk to mom or dad and they're not going to be able to hear me and I'm going to have to repeat myself 10 times, you know, sort of thing.

Yeah, it's really phenomenal. I'd love to talk about tinnitus or tinnitus. It depends where you are in the world, how you call it. A lot of people suffer. I have friends who suffer. Yesterday I was actually talking to someone who used to suffer and she was convinced it was to do with sort of muscular structures also in the neck. So I'd love to hear your view on tinnitus or tinnitus and what is going on there. What are some things people can do to alleviate that ringing in the ear?

Yeah, so tinnitus is basically your brain perceiving a sound that's not in the environment. So that could be ringing, that could be crickets, that could be buzzing, that could be white noise. It could be any host of different sounds. But you're hearing it and it doesn't exist. Nobody else hears it. I, even as the audiologist, don't get to hear it. I can't, you know, stick a probe in their ear and be like, oh yeah, that's your tinnitus. So no, it's just for that particular person. Now, there are different causes of tinnitus that are easily treated. So for instance, there's a lot of different medications out there. When you look at the whole list of side effects, one of them is tinnitus. So definitely if you start having tinnitus and you changed a medication or you changed a dosage, you want to look at that and talk to your doctor right away. 'Cause then usually if you stop that medication or change your dosage back, the tinnitus will resolve itself. You also can have tinnitus that's caused by too much stimulant. So too much caffeine, too much nicotine, things like that. Sometimes that can cause that, you know, tinnitus to spike as well. But then you have the more complex tinnitus, the tinnitus that's caused by that, noise exposure caused by the hearing loss. Again, where we have those fibers that are just not responding the way that they're supposed to. And now you're getting these impulses up into your brain that you don't want to hear. Okay? The best treatment for that type of tinnitus is actually wearing hearing aids. Okay? Because if you have hearing loss and you wear hearing aids, it's going to help to cover it up. So we're not curing the tinnitus, but we're covering it up, right? So if the tinnitus is occurring right here, but you can only hear right here, then the tinnitus is going to be what you hear, right? If we put a hearing aid in, now you can hear right here. Now anything that's in your environment, you're going to hear over the level of the tinnitus. So again, we're basically trying to mask or cover that up. And again, there's research being done. The most recent study that I saw, I just had a colleague send me the other day, they were actually again, looking at brain scans on people with tinnitus. So we were talking about brain scans earlier to see where the brain is firing when the patient is complaining of tinnitus to try to figure out, is there something in the brain that can be done to help? So again, very novel study to begin with. So, but again, the research is in the process of trying to figure it out to try to help.

And have they come to conclusions yet or they're just still in the process of—

Still in the process. Yep. Okay. Still in the process. So they've, I mean, their conclusions in their original study of that particular study was that they believe that the tinnitus is occurring in a region that's slightly different than the normal auditory processing sensor. So they think that potentially down the line, they could do something to alter, again, a neural pathway that would solve the tinnitus problem. But again, very, very early on. So for any listeners, don't think that this is going to be happening next month or any time soon. Thing like that.

So yeah, very, very early on in that particular study, would you say, and I know this is a bit alternative space, I'm not sure how much you're familiar with, with this or look into this as well. But, you know, some people have it obviously from changing medication or whatever that might be, or increasing dosages. But for people, maybe it's caused by stress or some other alternative, or I guess emotional state. What are some therapies above and beyond, obviously repairing the hearing or looking at the hearing, but to try to get to the root cause of tinnitus? What would you suggest? What is out there?

So, I mean, obviously, you know, stress is a variable and it's easy for me to just be less stressed, right? You know, just be calmer, have less anxiety, you know, things like that. So I'm not that professional. Obviously there's professionals for that particular thing. But absolutely, when you're stressed, your body's not going to work the same way. So a good example would be, I have many patients and they're like, "I was at this funeral and I had a hard time even understanding speech and my hearing aids weren't working." And in that case, it wasn't necessarily that their hearing aids weren't working, but the emotions and the stress of being at that funeral, their brain was trying to manage the stress and the emotion of that. So there was less for trying to process the speech, right? So your brain has X amount of power and how you divvy that up, okay, means that there's less for something else. So again, as we become more stressed, a lot of our systems in our body don't work the same way that they should, right? So thinking about what your triggers are is what I would say. So, you know, there's some people that have that tinnitus all the time, okay? That's a separate issue. But there's some people where the tinnitus comes and goes. So try to be able to identify what are my triggers? When do I notice it? Okay. Is it completely random or is it whenever I do X, do Y, do Z, and identify what those triggers are. If you know what the triggers are, then you can either self-diagnose and be like, okay, when I'm in this type of situation, I need to, you know, do X, Y, and Z, or you can, seek the proper medical professional that says, okay, this is what's happening when I'm here. How can I remain calm when I'm in this situation? Or is there anything to help me, you know, when this is happening so that I feel less stressed and things like that? So by identifying what those triggers are, I mean, everybody, myself included, randomly I have tinnitus in my ear for like 30 seconds, you know, and then it goes away, just weird things. Happen. So I'm not talking about that because that's just kind of random and, and everybody gets it every once in a while. But for the people that, yes, I have it on a regular basis, you know, is it random or can you identify what is the trigger that's causing it to happen?

Yeah. I think that's really helpful because I know some who can't, can't sleep. It's, it's really distressing and really impacting lifestyles. So I think, you know, it's, it's probably those cases. Yeah.

And I've had just to touch on the can't sleep. I've had some patients with that particular issue. And so we've talked about different strategies for them. I've actually, some of them have actually fit with hearing aids that have little tinnitus managers. So sound managers in them. So we crafted a noise that they felt helped relax them and take that tinnitus out. And so they sleep with their hearing aids instead of wearing them during the day, they actually sleep with them. So again, Figuring out where that trigger point is and then talking to the right professional to see what your options are are going to be key.

That's exciting. That's great to know that that's an option. So I will be sharing that as well. What trends and developments, perhaps above and beyond what we've discussed in the hearing space, do you find most exciting? You know, what are you seeing coming in the next 5 years, 10 years? I mean, really looking into the future.

It's really exciting. I've been doing this for almost 15 years and what was available 15 years ago to what is available now is almost comical, you know, comparing the difference. When I think about what I could do to help a person when I first started was very, very limited. Even just from a basic programming standpoint, the most advanced hearing aids 5 years ago broke your whole hearing test of all these different sounds into 3 pieces. So now, you know, we have, you know, 20+ pieces that we can really fine-tune that hearing aid. And that's just the basic programming part, not even the most advanced part. So even within the last 5 to 10 years, all the Bluetooth connectivity, the apps and how you can control the hearing aids, hearing aids that we can program remotely. So the person can be in their house saying, I can't hear the TV and we can remote into their hearing aids and adjust it for them. Again, it's just really exciting where the technology is going. I would say the biggest focus that is always on the table for all these manufacturers is in hearing in noise. That's always the biggest complaint. I can't pull out the voices in the noisy environments. And each iteration of hearing aid that comes out, they just make that a little bit better. They just make that a little bit better, separating that out. And like I was mentioning earlier, it's just really, really exciting. Outside of that, I see them making hearing aids smaller than they ever did. So again, they're finding ways to make this technology really teeny tiny. You know, unfortunately I get the question sometimes, how come hearing aids are so expensive? And I'm like, well, you know, 15, 20 years ago, a hearing aid was a big box that you wore around your neck with a wire going up to your ear. And now it's this size. To create that takes a lot of research and development to make it into such a desirable package. And unfortunately, sometimes cost comes with that, but it also means they're a lot more accepted, right? So you're going to be a lot more willing to wear something that nobody can see that's more comfortable. Again, 15 years ago, people would tell me, I'm excited to take my hearing aid off at the end of the day, 'cause it's not comfortable to wear. Now I have people telling me, oh my goodness, I wore my hearing aid in the shower because I forgot that I had it on. Not that I want them to wear it in the shower, but to me, I'm like, that's awesome. It was so comfortable that you forgot that it was there. So again, what I have seen is just even how much more comfortable the hearing aid is, is just remarkable that the person can wear it and forget that it's there. So again, smaller, lighter, more comfortable, way more technology. Where it goes from here, again, it's hard for my brain to fathom just in what I've seen, but I'm excited for where it's going, absolutely.

Beautiful. If you could live to 150 years old with excellent health and good, great hearing, I should say as well, how would you spend it?

If I could live to 150 years old, I definitely would want to do lots of traveling. Um, I like to see the world. I like to experience things. Um, I like to see all that the world has to offer. So I think that the, there's so many amazing places in this world, so many amazing experiences to be had. So I definitely definitely would want to travel. Obviously, I'd want to spend a lot of time with my family. I'm a big family man. So, I'd want to, again, continue to watch them grow and develop and things like that and take them with me on all my worldly exploits. But just continue to learn. I love learning. I love my field. I love challenging myself. And so, I think that in all my years of practice, what I've learned from many of my patients is Don't stop learning. Don't stop pursuing things. Just kind of stay active and keep doing things regardless of age. I have some really inspiring patients that are 100 years old and they're still getting out there. And I have one patient, she's 99 and she still volunteers at the hospital. So, just be participating in life. I would want to be participating in life the whole time. Mm-hmm.

Beautiful. For my listeners interested in understanding how to maintain hearing or reverse hearing loss more, and people around the world listening with us here today, what are good online resources they can start with?

So, I mean, definitely our website. So hearusa.com, there's going to be a lot of content in there about hearing, hearing loss, again, how to connect to a local professional. And then make sure you're going to a professional site. So that's obviously the key thing with anything that you're going to research online is if you just put it into the search bar, you're going to get a lot of stuff that pops up that may or may not be 100% accurate. So locally, you might want to look at the Academy of Audiology or different fields like that, the International Hearing Association, different organizations like that and what content are they putting out? Because that's gonna give you the most accurate and relevant field-related content where you're not being misled by a study that somebody randomly did that is not actually a clinical study. But that's where you'd wanna make sure that you find that information. Again, talk to a, a professional, you know, come see somebody like myself, look at their content, but look at an accredited foundation organization for their content to make sure you're getting actual accurate information.

Very important. Where can people follow what you are up to or find out more? Would you point them to hearusa.com or where's the best place to follow you?

So definitely hearusa.com is going to come to the whole company as, as a whole. You can find me more locally on social media, Facebook, things like that. So for my local clinic here in Winter Garden, Florida, I have a more, you know, localized page and things like that. So if you wanna find me specifically, that's usually the best place to, to find me. Or again, the, the company website is going to direct you to our organization as a whole.

Beautiful. Dr. Dunn, do you have a final ask or recommendation or any parting thoughts or message for my audience today?

So the parting thing, what I would say is don't wait. So the average person, I mentioned it a little bit earlier, they wait maybe 7 to 10 years before they actually do anything. Okay? So don't wait, even if you're not going to get a hearing aid or you have no plans on getting a hearing aid, get that baseline hearing test, see what's going on, understand what's happening with your ears and your hearing. And use it as an educational experience, if nothing else. But don't wait. Again, most of this conversation has been talking about what happens if you do wait, right? What happens if you don't treat your hearing loss? So hearing aids aren't scary. Hearing care professionals are not scary. They don't bite. The tests are painless. So don't wait. Just come in, see what it's about, and understand what's going on your ears and your hearing. So it's better to be proactive than reactive.

With many things that we look at in the longevity space as well. Yeah. So it's, well, prevention is better than cure. So anyone who is having difficulty listening to this podcast, perhaps take it as a sign as well to go get your hearing checked.

Absolutely.

Thank you so much, Dr. Dunn, for coming on today. It's been such a pleasure.

You're very welcome. Thank you for having me.

Pleasure.