BUSINESS PROFILE: St. Cloud ENT/Dr. Borders
Dr. Borders: Hearing loss can impact a person in many different ways
By Jim Palmer
As we age, hearing loss is common. But that doesn’t mean it’s something that we need to live with.
Alex Borders, Au.D., CCC-A, a clinical audiologist at St. Cloud ENT, works daily with people with hearing loss. She has heard many patients say hearing loss is “normal” for their age. She reminds them that hearing loss is anything but normal.
“Yes, you have a greater likelihood of having hearing loss because you are older, but that doesn’t mean it’s normal,” she said. “Any hearing loss is abnormal, and any hearing loss can affect a patient’s life. Just because you are 85 or 72, it’s not normal for you to have hearing loss. You are at a higher risk and more likely to have it, but that doesn’t mean it is normal.”
There are three main causes of hearing loss—congenital hearing loss, acquired hearing loss and age-related hearing loss, also called presbycusis. Some people have one of these causes; others have two or three of them.
“Congenital hearing loss is when people are born with it,” she said. “In these cases, we are often working with infants and children. Acquired hearing loss is caused by noise exposure. This often involves people who work with loud equipment. Age-related hearing loss, or presbycusis, often begins around age 65 and is a very slow-progressing hearing loss that starts out mild and gradually gets worse. The longer a person lives, the higher the likeliness that they have presbycusis. I should also add that hearing loss is not an old-age thing. It pops up and develops at any age. You can be born with it, or it can develop at any age and should be treated at any age.”
Avoiding loud noise environments and using hearing protection in loud situations can help prevent acquired hearing loss.
“Hearing protection is especially important when you are around firearms, farm equipment, events like tractor pulls and demo derbies, anything like that where you are experiencing very loud levels of noise,” she said. “You should wear earplugs or earmuffs to protect your hearing at all costs. Your hearing does not get better, unfortunately, so it is important to protect it.”
In contrast, presbycusis will affect all of us if we live to a certain age.
“Presbycusis is something that we don’t really have any good way to prevent,” she said. “There are some medical conditions like diabetes, thyroid disorders, cardiovascular issues and neurological disorders that can actually cause presbycusis to accelerate and get worse faster. So, we always encourage patients to follow medical advice and make sure they are getting a whole health check.”
If you are over 65 or have started to experience hearing loss (at any age), Dr. Borders recommends you take a hearing test (also known as an audiogram).
“Every patient should have a hearing test first,” she said. “We need to see how the ear is functioning normally. Hearing loss is basically an abnormal function of the ear.”
While a small number of patients may need to undergo medical procedures or treatments for medical conditions, such as wax impaction, ear infections and fluid buildup in the middle ear, the primary way to treat hearing loss is through hearing aids, said Borders. The hearing test will determine the level of hearing loss and whether it needs treatment, and the test will also play a factor in what hearing aids might work best for that patient.
“Typically, we recommend people having their hearing checked every one to two years at age 65, sometimes every year, depending on other medical conditions. But anytime someone is starting to see issues with communication, they should come in,” she said. “Because it is a progressive disorder, you can get diagnosed with hearing loss, but it is not going to stay the same, so monitoring the decline is extremely important because your communication needs will change as your hearing changes.”
Audiologists at St. Cloud ENT check in with each patient every two years to monitor their hearing loss. But the big thing, said Dr. Borders, is to come in the first time.
“People always delay coming in because, number one, they may not be ready to acknowledge that they have an issue, and number two, they may pass it off as being normal for their age. Well, just because it might be normal for your age doesn’t mean it isn’t an abnormal condition that needs to be treated. I always encourage people to reach out for help, even if they think it is just a small issue. An audiologist can be your biggest friend and asset. Our job here is to help and guide patients. Our audiologists want to be there to help the patient and their family through this process. Never just assume that it is OK and fine. Hearing aids are there to help, and audiology is there to be your resource and way to navigate and have the healthiest lifestyle that you can.”
Once the audiologist determines that a hearing aid is the best course of action, they consider several factors in selecting the right one.
“I always consider a combination of several things when selecting a hearing aid,” said Borders. “A lot has to do with the amount of hearing loss the person is experiencing and how they hear different pitches. We also have to look at the patient’s physical well-being. Is there an issue of rheumatic arthritis? Are there dexterity issues? Or eyesight or vision issues that may affect a person’s ability to be independent with a hearing aid. Our goal is to have the patient be as independent as they physically can be with their devices.”
A patient’s lifestyle is also a big factor.
“Are they in a large variety of situations in a lot of different environments, or are they someone who has retired to the country and is in peace and quiet most of the time, and maybe has family come over once or twice a week?” said Dr. Borders. “The person’s level of support may be very different than someone who is a snowbird who travels very often, maybe still working, volunteering, that sort of thing. We try to match the device with that person’s lifestyle.”
After collecting all the information she needs, Dr. Borders selects a hearing aid that best suits the patient. And she has a lot of models to choose from.
“Every manufacturer out there that we use has a good product,” she said. “They all create hearing aids, and what they create is based upon having tiers of technology. The beginner or entry-level tier is there to provide support in situations that don’t have a lot of background noise … all the way up to levels of aids that give patients a lot of support in managing their sound situation and hearing loss.”
And every manufacturer has those different levels of technology.
“What makes them different is, one, how the audiologist understands that technology and has been working with that technology and understands hearing loss and how it works, and then the support service that they are able to give. Not every situation requires the same help. Listening one-on-one to someone is very different than listening to a choir or production show or just having coffee with a few friends. The support system on the audiology side of things really helps make that device shine because it is our job to understand how that technology works and how that technology can work for the patient. That really can make or break any manufacturer’s product.”
Like many aspects of life, technology has transformed the hearing aid industry.
“Technology has drastically changed over the years,” said Dr. Borders. “It is very much like going from a black/white TV to high-definition TVs that we have nowadays. Just since I got out of school 16 years ago, the digital technology that was available back then is drastically different than it is today. We have more control over the way things sound, and we have more control over how noise is identified. We can offer much smaller behind-the-ear devices than we ever used to be able to fit. We have rechargeable technology, which we never thought we would have, and we really have now … just in the last five years … Bluetooth® connectivity. So we have the ability to connect to cellphones, iPads®—never something that we thought possible even 15 years ago.”
As good as the technology is and how effective hearing aids can be, Dr. Borders reminds patients and their families that hearing aids serve an important purpose but do not cure hearing loss.
“Hearing aids don’t give you normal hearing. What they do is help people hear more than they do currently,” she said. “You will be hearing better with a hearing aid, and you will be functioning and communicating much better than you were, but you still have hearing loss. That means you, friends and family need to make that conscious effort to have good communication with each other. This means not talking to each other from different rooms, assuming that the patient’s hearing aid will do all the work for them and thinking that you, as the loved one, have to do nothing. Hearing aids are extremely important, but that doesn’t mean that they can go back to being normal and communicating like they did when they had normal hearing. A hearing aid is a tool, and it is there to help that person function with a hearing loss.”
Why is treating your hearing loss important? Besides the obvious, losing the ability to hear, there are other major reasons you should wear hearing aids if you have a hearing loss, said Borders.
“We have seen a lot more research come out really looking at the effects of hearing loss in regard to general overall well-being and cognitive health, especially as our population is staying active and staying healthier longer in life,” she said. “Several research articles have been published recently that show cognitive delays with untreated hearing loss. For patients who are showing mild signs of dementia, depression or Alzheimer’s, it is really important to have their hearing checked. With untreated signs of dementia and Alzheimer’s, hearing loss can really progress that disease because hearing loss causes social isolation.”
Borders said hearing loss often leads patients to withdraw from conversations and social situations, which greatly affects a person’s well-being.
“When you are talking about keeping cognitive health high, you want that social interaction, and you want that communication accurate because you may be dealing with a patient who is experiencing memory loss and confusion. Is it confusion because they are experiencing memory loss, or is it simply because they cannot hear you?”
Not only can hearing loss cause isolation, but it can also result in some other negative responses from the people around them.
“Unfortunately, people who don’t experience hearing loss can often be very harsh toward those who have hearing loss,” she said. “People with hearing loss often hear, ‘You can’t hear me!’ or ‘Why aren’t you listening?’ This can cause a lot of issues—people feel insecure or that it is their fault—and this can lead to high levels of depression because they are constantly being yelled at by family members. Over time, this really affects mental health.”
After being fitted with the proper hearing aids, patients can often experience life-changing results. And playing a role in those success stories is very satisfying to Dr. Borders and the St. Cloud ENT team.
“I think every audiologist gets the biggest smile on their face when a patient comes back and says, ‘I am doing great! I am functioning so much better. I’m understanding my grandkids; I’m understanding conversation,’” she said. “They just feel reconnected. And it means so much to every audiologist to hear that because when you work in health care, you deal with complaints. To see patients positively connecting with family and friends, or even going outside and hearing the birds again, I think every audiologist does a happy dance.”
To learn more about the services of Dr. Borders and St. Cloud ENT or to make an appointment, contact their main clinic at 320-362-0233 or visit www.stcloudent.com.
St. Cloud ENT is a private, single-specialty clinic located in St. Cloud with outreach clinics in Alexandria, Little Falls, Sauk Centre and Staples.
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