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Liz Unruh (Host): Hello, listeners, and thanks for tuning in to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Liz Unruh. And joining me today is Jana Wahlen, an audiologist with Riverside Hearing Specialists, who is here to talk to us about the signs of hearing loss and what to expect from a hearing test and some options that are available. Welcome.

Jana Wahlen: Thank you. Thanks for having me.

Host: Yeah. So before we jump into this, can you talk to us about your role here at Riverside and what you do?

Jana Wahlen: Absolutely. So, we want to make sure everybody knows we're still here. We've lost a couple of our ENTs this past year. But our office over at The Pavilion on the sixth floor is still open for audiology services.

Host: Yeah. So, you know, starting with the basics, before we jump into hearing loss and options, what does an audiology do in knowing that there's not currently an ENT? What is the difference between the two?

Jana Wahlen: Right. Yeah, I think there's a lot of misconceptions. An audiologist is a hearing specialist. So, we do diagnostic testing to determine hearing levels. We can also do balance testing, auditory processing testing, lots of different things. An ENT is a physician who went to medical school, and they treat ear, nose, and throat disorders.

Host: Okay. So, that kind of explains what the difference is between the two. So, knowing that you specialize in hearing and ears, what are some of the early signs of hearing loss that people might brush off? Like, are there some things that maybe, like, our friends and family might notice before we notice?

Jana Wahlen: Absolutely. That kind of is the norm. People will come in, because their wife sent them or their husband sent them. They may not realize that they have a problem. That's the biggest first sign, I'd say. Or people turning the TV up. Often they can't hear their grandchildren because they're so soft-spoken. Those are pretty common ones.

Host: Yeah. So if someone starts hearing that from their wife or their husband or they can't hear their grandchildren, so they decide, you know, "It's time to get my hearing checked," first of all, do they need a referral? Like, how long does a hearing test take? Talk to us about what a hearing test is.

Jana Wahlen: Sure. So, whether we need a referral or not kind of depends on your insurance. Most private insurances don't require it unless it's an HMO. The best way to determine it is to check with your insurance and see if you need a referral. You can get that from your primary care doctor. And then, once you call and schedule the appointment, we have you scheduled for an hour-long appointment where I'll talk to you about what's going on.

And then, we'll do a full diagnostic evaluation, which includes otoscopy, looking in your ear, making sure it's not wax. Sometimes it is wax. Also evaluate your middle ear to see if there's any fluid in your ear due to an infection or something like that. Then, I would go on and determine your hearing levels through pure tone testing, and then also some speech testing to see how well you're understanding things. And then, we would discuss the results and see if you may want to try hearing aids if you're considered a candidate.

Host: Yeah. It's interesting. So, you get the results of your tests almost in real time. You have that conversation with you in the appointment.

Jana Wahlen: Yes. I explain the results at that time. I write the report up immediately after we're done. So, I can even give the patient something to take with them that day. Otherwise, it goes into their myChart where their doctor will see it, and they can see it as well.

Host: Yeah. I think we're so used to, like, instant gratification, so, like, knowing the answers right away, especially when it comes to medical things is very important, and it's great that they have that answer when they're walking out of your office.

If you do end up recommending a hearing aid or that they might be a candidate, how do you help someone determine what type they need? Because I know there's, like, all different types of hearing aids.

Jana Wahlen: There is. It's a very complicated process. It's mostly based on the degree of hearing loss and the difficulties the patient is having. Budget is a consideration of course. How well they're hearing in noisy environments, their lifestyle, if they're still working and they have a job with a lot of challenging environments like meetings or things like that. Or if you're more of a homebody and aren't out and about as much, you may not need something quite as advanced technologically.

Host: Yeah. I think that's great information. And before we continue our conversation, we're going to take a quick break to talk about the importance of primary care.

At Riverside, our primary care providers are right here in your community offering personalized care for you and your family, close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing every day's concerns when they pop up, because remarkable care should never be out of reach. Remarkable care right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

All right. And we're back. So, something you mentioned is obviously like the cost, and I know that is a big concern for patients. Does the cost of a hearing aid typically include things like follow-ups or repairs or anything like that? Or how would someone go about finding a—I don't know if it would be called a vendor, but like somewhere where you would go and get hearing aids and have them serviced?

Jana Wahlen: So, there's lots of different models out there. At Riverside, if you come to us, the price you pay for your hearing aids includes all your service as long as you own them. So, patients don't have to worry about paying additional fees once they pay that amount. And that includes really anything they need. Cleaning the hearing aids, adjustments, things like that.

Host: Yeah. I know this is, like, a hard topic Because everyone's insurances are different. But is there certain things that people might qualify for a hearing aid? Like, what should someone look for in their insurance to understand if a hearing aid would be covered under their insurance?

Jana Wahlen: Sure. So after the hearing test, if someone's interested in hearing aids, that's the first question I ask, "Do you have a hearing benefit?" And often, they don't know. So, Medicare does not pay for hearing aids. Medicare and most insurances will pay for one hearing test a year.

But Medicare itself does not pay for hearing aids, but some of the supplements do, and sometimes people aren't aware of that. So, I always tell them to check their insurance see if they have an insurance benefit, and then they'll be told if they need to go somewhere else or go to a different place.

Host: Yeah. I know that all those, you know, different Part B, Part C, all of that can get confusing with Medicare. So definitely, talk to your Medicare plan provider to see if a hearing option is in your plan.

Jana Wahlen: Absolutely.

Host: Yeah. So, I know that something I've seen as a younger person, I'm not necessarily of the age that people are thinking that we need hearing aids, but there's more and more over-the-counter type hearing aids. Like, I know people use, like, AirPods and apps to hear better. What types of options are there, and who might those be a good option for?

Jana Wahlen: Yeah. People ask about over-the-counter hearing aids a lot. There is a wide range of devices out there, a wide range of prices. You could get something for $100 or thousands of dollars.

The thing about OTC hearing aids is that you usually don't get any help with them from a professional. So, that's not necessarily a bad thing. If you have a very mild hearing loss just starting to have some trouble, sometimes it could be a good bridge. And like you mentioned, AirPods have a feature that might give you a little boost until you need prescription hearing aids.

Host: Yeah. I think just hearing from people that are of the millennial generations, like, "We didn't know you needed all the hearing protection when we were younger, and it's not as prevalent. I know my kids have like the big sound dampening things when we go and see fireworks or go to a sporting event or any of that. I think our generation didn't necessarily have that. So, we might start seeing hearing loss earlier, which is a scary thing.

Jana Wahlen: Absolutely. It's good to hear that people are starting to protect hearing better, because it's very common that when you're younger you don't think about it, of course.

Host: Yeah, for sure. So if someone were to have a hearing aid, how long does a typical one last? You said there's different models, but average, how long do they last? And, like, is there a special way to take care of them?

Jana Wahlen: The average is five to seven years that people keep their hearing aids. Obviously, if you keep them nice and clean and go in for regular checks, they'll last longer. But like you said, there is a wide range.

Host: Yeah. I know I've experienced that, you know, five to seven years seems like a great investment in your hearing, but sometimes you hear that people get hearing aids and then they just stop wearing them. Is there something that might happen that causes them to no longer want to wear them? And is there something that you as an audiologist can help with to, like, adjust it to make it more comfortable for the person?

Jana Wahlen: Absolutely. Good question. That's something I hear from people who kind of are dragged in by their spouse. I know so many people who have their hearing aids in a drawer. And I think the common denominator usually is that they're not going in for regular checks, that they may get the hearing aids, maybe someone kind of pushed them to get the hearing aids. And then, they get frustrated and instead of going in and having a professional adjust them for them, they just throw them in the drawer. Or their hearing may get worse over time if they're not getting regular hearing tests, which I mentioned before you could do every year or even every other year, and the hearing aids may not be benefiting them anymore.

Host: Yeah. So, definitely go in, get your checks. Get your hearing checks however often your insurance allows because hearing is such an important thing to be able to know what's going on around you.

If someone has noticed changes in their hearing but might be putting off getting checked, what would you want them to know and how can they make an appointment?

Jana Wahlen: Yes. You can make an appointment just by calling our office. We schedule hour-long appointments. And then, what I would tell somebody and what I do tell people all the time is don't wait too long.

Hearing loss is not a condition that you want to wait until it's so bad that you're just not hearing anything. All the research points towards treating your hearing loss early. Hearing loss is a big risk factor for many other conditions. Like, if you have a hearing loss, you're more at risk for falls. If you have a hearing loss, you're more at risk for cognitive decline, and that is a big one that nobody wants to go down that road. So, many people come in, because they've heard that hearing loss is a risk factor for cognitive decline, and that is true. Especially if you are already at risk for cognitive decline and you have a family member that has dementia, it puts you at greater risk.

And the good news is that it's a modifiable risk factor. So, if you do get hearing aids, studies have shown that some changes that may have already taken place to your brain may reverse. So, definitely, don't wait too long.

Host: Yeah. That's really important, and definitely check out the Riverside website, riversidehealthcare.org, to find that phone number and more information about Jana and her team who can help you with your hearing loss. Thank you so much for joining us today.

Jana Wahlen: You're welcome. Thanks for having me.

Host: And thank you for tuning into the Well Within Reach podcast with Jana Wahlen with Riverside Hearing Specialists and your host, Liz Unruh. Be sure to like and subscribe to Well Within Reach podcast on Apple, Spotify, or wherever you get your podcasts. To learn more information about services at Riverside Healthcare, go to riversidehealthcare.org.