Menopause, Your Ears, and the Dementia Link No One Told Women About

MELISSA Imagine being a kid in elementary school and already wearing hearing aids. Now also imagine growing up, becoming an audiologist and spending your entire adult career sitting across from patients who waited 20 years to do the thing that you've done since you were a child. So this is the woman who I'm sitting down with today, Dr. Mandy Rounsville-Norgard. She's worn hearing aids since she was a kid. She's an audiologist with a practice here in Sioux Falls, South Dakota. She's been in the field for decades and she's watched the same pattern play out thousands of times. People know something's off, usually for years. We turn the TV up. Maybe our spouse asks us to repeat ourselves a second or third time. The spouse finally drags them in and by the time they get tested, the brain has been working overtime to compensate. there's also something that no one is telling women in their 40s and 50s. And that is that perimenopause and menopause is not just about hot flashes and sleep. There are estrogen receptors throughout your inner ear. And when estrogen drops, your hearing changes. And most of us have no idea. Most doctors are not bringing it up. And the gap between the first sign of hearing loss and the day someone finally gets tested is 20 years. So in today's episode, you're going to hear Mandy's own story. The first real signs of hearing loss, what perimenopause and menopause is doing to your ears that no one is talking about. Why untreated hearing loss is now one of the top modifiable risks for dementia and the difference between an over the counter hearing aid and a real evaluation. So she's going to bust the biggest myths, including the one where you think you would know if you had hearing loss. Spoiler alert, you might not. And the audiologist wearing hearing aids is on this episode is proof of that. So if you've ever turned the TV up, ask someone to repeat themselves, which I've done that many, many times. I might need to come and see you or notice a ringing that never quite stops. This episode is for you. So let's get into it. Health and wellness is confusing. There's a new trend every week. Everyone's got an opinion, and half the time, you can't tell what's legit and what's just good marketing. And we get it. We're in it too. Welcome to Dialed In Health. I'm Melissa Goodwin. Every episode, we bring in the people who actually do this work, providers, practitioners, the experts who see clients and patients every day. We ask the questions you'd ask if you were sitting across from them so you can find the right people, make better decisions, and feel confident about what's out there, whether it's peptides, gut health, water quality, ADHD, biohacking, or something you've never heard of, we're covering it. So let's get into it. Let's get Dialed In. It's a lot of stuff. Yes, it is a lot of stuff. Dr. Mandy, great to have you on the show. Thank you. Thank you for being here. So you've worn hearing aids since you were a kid. So tell us back about that experience. What was that like?

DR. MANDY Well, I don't know any different just because I have a twin sister. We were born six weeks early. We were in the NICU. The story was from my audiologist was our lungs were underdeveloped. So back then they just pumped you full of meds because they didn't know what your survival rate was. So they're thinking it was genomized. And my mom kind of knew something was wrong when I was two. She was pregnant with my brother at the time. So she called school for the deaf. And back then the audiologist came to your house and I honestly don't remember the hearing test or anything. And they're like, yeah, she's got hearing loss. And then they tested my sister and my sister had hearing loss in one year, but I had it in both ears. And so I don't remember this either, but they came when I was three because they, my mom was having complications with my brother and they fit my hearing aids at home. And the first thing I did was walk to the refrigerator. Like I somehow heard the humming of the refrigerator and just stood there and stared at it. That was like the memory my mom tells me.

MELISSA That's amazing. Yeah. You know, I remember when I got glasses and I was legally blind, no one knew, I had, no one knew, including myself had, I didn't know I had a vision problem. And then I got my glasses and I was like, I can read license plates. It was like a whole new world. Yeah. And I was in fifth grade, like I was older. So I can only imagine as a little child, like, it's like a whole world opens up.

DR. MANDY Yeah. Well, and I asked, did I take my first steps up that, you know, the one year mark? Yes. Did I say my first words? I did. But they think, if I didn't have my twin sister, I probably never would have done all that stuff on time. Yeah.

MELISSA That's amazing. So when you were young and you had hearing aids, did you ever like feel different or did that? Yeah. Yeah.

DR. MANDY Tell us what that was like. Well, so hearing aid were analog back then. Okay. You had feedback, you know, you had to wear them over your ear. You had to get new molds every few months because you're growing and you want to play sports, but they don't sit on your ears. I mean, people make fun of you on the playground. I mean, all the things. So the, what was available back then is a far cry from what's available now.

MELISSA Do you treat kids here today? I bet that's such a cool experience. Oh yeah. Yup. Yeah. So tell, how did that shape your decision to become an audiologist? How did you come into this field?

DR. MANDY Well, I didn't accept it. It took years to accept it because I always thought it was a reflection of something negative. Yeah. And I didn't, you know, I went through college and my handball coach, so we played handball in college and my sister and I said, you have got to get a degree. You've got to declare a degree and get on with undergrad. And I'm like, okay, fine. So they had started a communication sciences and disorders degree and audiology, deaf ed and speech pathology. And I went into deaf ed. But then as I was getting through it, I started to realize there's more to having this, it's not even a disability anymore. It's just, I call it a gift. Like this is my gift and I need to share it. Yeah. So I took it one step further and just decided to go the audiology route.

MELISSA How does your experience do you think shape the way that you interact with patients?

DR. MANDY It's much easier to when they're explaining to me what's going on with their hearing aid or just how they're experiencing their hearing loss. It's like, yep, I get it. I get it. I know it. I mean, of course hearing aids aren't perfect. And that's like the biggest conversation. I think we have with these patients, we're never going to restart restore those inner hair cells until science does what science does. But in the meantime, we can try to wear this technology, these hearing aids that are trying to mimic what the hair cells are trying to do and improve our quality of life. People are like, do you remember what it's like not to hear? And I said, I know what it's like when I take them out, when I don't hear, when I put them in, I can't function. Yeah. So, I mean, we can sit here and nitpick like what we want these hearing aids to do, but if you look at, look at it as a whole, isn't your quality of life much better?

MELISSA Yeah. And you have a YouTube channel and some of your highest ratings are the, the reviews of the hearing aids too. Yeah. So you kind of have a first, first hand opportunity to review them and see what you think of them as well as a practitioner and is aware.

DR. MANDY Yeah. And I think that's where it gets muddy in the water when people are looking online, what's the best hearing aid? Yeah. Over the counter. Is that really a hearing aid? You know, all the stuff, because every hearing aid manufacturer has the patient's interest, their best interest. They want to improve your quality of life. And everybody's complaint is I can't hear when there's background noise and multiple conversations. So the technology that comes out every six to 12 months, we're trying to improve that, that quality in background noise. I still struggle, but I know that if I take my hearing aids out, I would get nothing. So yeah, I mean, it's, it's everybody's goal is to hear better when there's noise and when there's multiple conversations going.

MELISSA Does your hearing get worse if you don't get hearing it? I know if for glasses, like my eyes get worse pretty much every year. Is it the same way with your hearing? I think you just realize how bad it is.

DR. MANDY Okay.

MELISSA So it wasn't that bad. If you do get hearing aids, does it halt the progression at all? No.

DR. MANDY No. No. And that's where we're going to talk about probably the dementia part. Sure. Okay. It's the brain, the brain's interpret, your ears channel the sound. Your brain has to interpret what it's getting.

MELISSA So it's the interpretation piece, not necessarily the hearing. Got it. Okay. So one of the things in the, in the introduction, we talk about how many of us wait 20 years too long. So, so tell me, you know, what is it like being on both sides? You were a child and you had hearing aids, but you have a lot of people that come in and that wait way too long. Tell me what that's, tell me why that happens.

DR. MANDY Number one, but there's two reasons. Probably number one is the stigma. I'm getting old. Yeah. I don't want people to see the hearing aids. And then it probably boils down to denial. Yeah. I'm not really that bad. And then cost. Those are probably your biggest factors.

MELISSA Well, and you're used to, I kind of joke about it all the time. I'm like, well, maybe I went to too many concerts and I just did fit 50. So I'm, I probably should get my hearing checked, but I'm always saying like, what, what my kids tease me about it all the time. And I joke about, I went to many concerts or I have my Peloton headphones on too high or we're going to get really stoked about a ride or something. Yeah. But you know, I guess what is the age that you should absolutely get it checked?

DR. MANDY I think fifties, you know, starting your fifties because that's when age related loss starts. You're going to see probably more hearing loss. It's more prevalent in men, but that's just because of the lifestyles that, that men live, you know, the occupational noise, the recreational noise, they're probably more exposed to noise and typically than women typically are.

MELISSA Sure. Well, I have a, I have a seven year old boy who's pretty loud. So I don't know, maybe some moms might be able to hold their own in that daycare.

DR. MANDY Workers, I always wonder, you know,

MELISSA so tell me about audiology associates. Have you always been on your own? Did you start this practice by the day you got out of college?

DR. MANDY No, I worked in, so I went to school later in my mid twenties because I kind of had that period of trying to figure out what I wanted to do. So I finished undergrad took about, I don't know, six, seven years off and then went back to school. Um, and then I went and worked, um, at school for the deaf in Minnesota for a while. And then I transitioned into private practice, kind of like what I did do here. And then, uh, ear, ear, nose, and throat, the VA, uh, worked at our local VA for almost eight years and then I opened this in 2018.

MELISSA Okay. So 20, what made you decide that it's time for you to start your own business?

DR. MANDY I felt like my service and I love our veterans and my husband, the veteran, I could do more outside of the VA. I still help the veterans and I could help just people in general that, that needed hearing, hearing aids or struggle with the hearing loss. Cause you kinda, you kinda get, you know, in the VA world, you kinda, you're kinda limited on what you can do. And I just knew that there was just more for me out there.

MELISSA What is one of the things that surprises you the most about how people behave around, um, getting their ears checked, getting hearing aids, you know, you've lived with it your whole life. So you've probably just been like, to me it's nothing. Yeah. Yeah. But for some people it's a very real, real thing. So I have a someone in my life who's older that definitely, but is, is very against coming to even get checked.

DR. MANDY Yeah.

MELISSA What is that about?

DR. MANDY I just don't think they, they know there's something wrong and they just don't want to know it or see it or, or deal with it. Okay. Yeah. Yeah. But I mean, every day is a different day. We'll get people that come in, you can tell their spouses, drug them in. And by the end of the appointment, they're, they're smiling, they're, they're relaxed. They're like, okay, I guess I need hearing aids. I mean, it's just crazy. You can't really read somebody right away until you've taken them back and got to know them. Yeah.

MELISSA So, um, you said hearing out, hearing loss usually starts in the fifties. So it's so fun. I don't know. One tells you to go get your, your ears checked though. It's, at least no one told, has told me that yet until I started talking with you. Um, why, you know, we know to get our eyes checked. If you're kind of having to squint or something, what are some of the symptoms that might that might let you know, like I should maybe get this checked. What, what might be happening?

DR. MANDY Um, well you've kind of hit all of them. The asking what repeating, asking people to repeat, especially when there's background noise or a couple of conversations going on, ringing in your ears or noises at tinnitus, you might notice that. Um, you might be more tired at night because maybe, you know, cause hearing loss is so slow that you adapt. And so sometimes you might realize, okay, well, I feel like I'm not hearing as well as I did this morning. You know, I feel like I'm struggling. So maybe you're exerting some effort to hear better. Okay. So those kinds of things are probably more noticeable, but the biggest thing other people are probably going to tell you before you tell yourself.

MELISSA Okay. Tell me a little bit about, you mentioned it's a brain interpretation. Tell me more about that. Like how is our brain having to work over time when you can't hear what's, what's happening?

DR. MANDY So if the brain can't get the signal, it can't interpret it. It can't hear it. So, so it's always trying to fill in the gap. So if, if somebody's having a conversation and you're saying, pass me the chips and they say ship, what ship, you know, like those miss miss informed words because the brain, it's not hearing it correctly. Okay. Because it's not getting the volume or signal that it needs.

MELISSA Quick break, this episode is brought to you by Vitality Growth Labs. If you're a health or wellness practice and you're wondering why your phone isn't ringing the way it should be, Vitality Growth Labs builds the systems to fix that. Get found, build trust, fill your calendar. AI authority stacking, videos that connect with your clients, real tools, strategy, and execution that results in real revenue. Visit VitalityGrowthLabs.com or check the provider directory at VitalityGrowthLabs.com slash the directory to find a trusted wellness provider near you. All right, back to the show. if you, we talked a little bit about waiting. So if I wait too long, what is something bad that might happen? That if I just get it checked, what, what, what might I avert?

DR. MANDY If I get something to make it that much harder when you are ready to adjust to the hearing aids. So if you think of your brain as a muscle, if you're not given that the signal exercising it, you're going to lose what, you're going to lose what it's capable of doing. So, you know, if I sit here and I, and I do my biceps, but then I wait 10 years to do another bicep, I'm pretty sure this muscle isn't going to be as toned and big as it is now. The brain needs to be stimulated to maximize your quality of life. So you're so it's not so hard, not so difficult. And you're not going to reject that hearing aid. I mean, we do get 80, 80 to 90 year old still. That's the first age of when they get their hearing aids and it's a lot of counseling and it's a lot of, you're going to have to be patient with yourself. Right. Because the brain hasn't heard any of this stuff. It's got to reorganize it. It's got to learn what it is and pay attention to it or ignore it.

MELISSA So since we're talking about the age thing and dementia in hearing loss, so tell me about the connection between hearing loss and dementia and, and what treating hearing loss does to reduce your risk.

DR. MANDY So hearing loss does not cause dementia. Okay. If you are at risk for dementia, it runs in your family. Yeah. And you don't treat your hearing loss. Again, the brain's a muscle. If it's not getting that stimulation, it may increase that onset of dementia.

MELISSA Okay. So if you feel like you're, you've got dementia in your family, you may, you might want to get tested earlier. Okay. And then another thing as we think about if you have dementia, I mean, I would, and I have someone in my family, you know, that that does run in my family. If you have dementia and you can't hear, does that cause more of a rapid decline?

DR. MANDY That's what research is showing.

MELISSA Yeah.

DR. MANDY Because you can't hear anything. Yeah. You're not stimulating the brain.

MELISSA More and more isolated, all of those things. Cause you just can't hear conversations. So if someone is in the middle or maybe they've been diagnosed early on, can they still get hearing aids and get tested? Will that help?

DR. MANDY Yeah. I recommend it. Okay. Because you're, you're stimulating the brain and, and it, it creating, you're maximizing that quality of life long-term when you catch it early.

MELISSA So why do you think, you know, a lot of primary care physicians, they don't screen for this. Like, you know, I just went into a primary care visit about six months ago and it was like, have you had your mammogram? Have you had your colonoscopy? They did not ask me about hearing whatsoever. Um, or they didn't, sometimes they'll ask you about vision, but usually they assume you're going to get your eyes checked. Why don't they ask you about your ears?

DR. MANDY I know. I think, I think over the years, our industry hasn't, um, made it important. Okay. And I think as time goes on, how long did you spend in your primary care appointment?

MELISSA Honestly, I don't know, 15 minutes, 20 minutes, maybe not very long.

DR. MANDY Yeah. So we're kind of, we're, we're not adding, we're not thinking about those things because the healthcare industry has changed.

MELISSA And if you present healthy enough, they're going to tackle whatever the worst thing that you bring into them is and they actually

DR. MANDY do a memory test on some patients, you know, in that older category, are they taking the time to do that? I don't know.

MELISSA Uh, not to my knowledge screening. Yeah. I would doubt, unless you bring it up. Yeah.

DR. MANDY Well, look at children, they get screened and up through elementary school and then after elementary school, nobody's screening them. Right.

MELISSA And that's sort of how we think about like, whether it's vision or hearing, it's sort of like ancillary to regular primary care. And so unless you're like, Hey, I can't see, or I have to squint all the time or my spouse is telling me I need to get my ears checked. It's just not on many people's radar. I feel like, yeah.

DR. MANDY Or I guess with the physicians asking you a question, you say what, then they might trigger them to ask you, you know, have you gotten your hearing checked lately?

MELISSA Right. Exactly. So we haven't talked to, we talked a little bit about, um, where you get your, you know, the hearing aids that you've tested and that you have a, a, a channel where you've, you've, um, tested a few different models and given reviews, you can get hearing aids at Costco and you can get them on Amazon now. So tell me what is, how is that different than what happens here at your clinic?

DR. MANDY So we only deal with the medical grade hearing aids and on our website, you'll find all the manufacturers they've been around for decades and decades. They're the only ones that we consider prescriptive hearing aids. Okay. Um, the ones that you're going to find online or at Costco, I mean, if you find an actual medical grade product, um, on eBay or something, somebody might be selling their old hearing aid. I don't know. I mean, I don't recommend it. Um, sure. Just, but the Costco ones are private labeled through Costco and they have their own separate technology. So you're kind of buying this very basic type hearing aid that is programmable, but a lot of times we can't program them because it forces you to go back to some of those places like Costco where they, they adjust them. So we don't really have access to that computer chip, even if we wanted to.

MELISSA Okay. So help me understand cause I don't know the necessarily difference between a medical grade and a Costco. So like, you know, if you get, you break your foot and they give you a cast, it's molded to your foot, right? But you could go to Amazon and get a boot and wear a boot around. Is it similar to that?

DR. MANDY It's similar. Yeah. I mean, you're basically, you're basically, if you go online, you're treating yourself, right? So you're going to figure out how to adjust these. They're not even really hearing aids. If you're finding something that's that makes no sense, like your go or, I mean, there's a whole bunch of them out there, but they're basically amplifiers. They're just amplifying everything. They're not dialing in that prescription at all the frequencies where your loss is. Cause you don't need as much volume or prescription here as maybe you do here. Okay. So that's where the difference comes in and then how it's processing that signal. So your brain can interpret it and separate it out.

MELISSA Got it. So it's just like putting a speaker into your ear.

DR. MANDY And if you're not careful, you can cause more problems

MELISSA with the, with what you can already hear a sample buying that too.

DR. MANDY So, yep. But most patients that are buying them over the counter, they end up in somebody's office anyways, because they're, they know it's not working.

MELISSA Are they custom like fit to your ear too? Cause we have different sized ears and different. Yeah.

DR. MANDY Yeah. So there's a lot of options. You just got to find the right provider. That's going to allow you to have the options. Explain to me my audio gram. Tell me what my options are. Can I have an in the air one? Do I have to go over the ear? You know, I love it when patients ask me those questions because I do find that, you know, some providers aren't giving options. I want, if you're going to invest in your hearing, I want you to know what all your options are, the pros and cons.

MELISSA So is, is that why, you know, I often hear because we have a lot of older adults in our lives now that are like, God, they're so expensive. I don't know if I can afford to get a hearing aid. What happens? Like, is that something you hear often?

DR. MANDY Oh yeah. Yeah. We hear it often. And I think the, over the years, the, the perception that hearing aids are expensive and they don't work, you know, there's a lot of factors that go into that. Are you going to a provider that does best practice? Are they doing speech mapping? Are they doing all the things that you're supposed to do to make sure that hearing aid is dialed into your prescription? If they're programming the hearing aid and saying, Melissa, how does that sound? That comfortable and send you out the door. That's not a way to program a hearing aid. Okay. What is speech mapping? Speech mapping is real ear measurements. It's the same thing. Um, we stick a microphone down in your ear with the hearing aid and we're, we put your hearing test in this machine and we're watching what that hearing aid is doing in real time. So we know if this frequency is getting too much volume or if it's not, and we're, we're running our soft speech because if patients aren't able to pick up that softer speech, that hearing aid, we're trying to get that hearing aid to maximize what it's supposed to do to bring you back that natural hearing that you've been missing all these years. So it's, it's basically evidence based practice. So are you going to recommend something and then not back it up with research that you've done it right correctly? You know, if just like the physical, or the OT that was just in here, you know, I cut my tendon, the doctor fixes it, but I've got a baseline of where my random motion was and where it needs to be. We're measuring our evidence based practice. So that's huge.

MELISSA Let's talk a little bit about, um, you know, we've talked a little bit about dementia. We've talked about like where people get their hearing aids. I, you know, I followed some because I'm at the age I'm at. There's a lot of now new influencers in the perimenopause menopause space. Yes. And they've talked about research that menopause can trigger hearing decline. So I'm curious, is that real? Is this new information? I've never, this is new to me.

DR. MANDY It's probably silent. We just never talked about it. Okay. You know, perimenopause menopause, um, it's boiled down to estrogen levels. Okay. So when women's estrogen levels fall, estrogen tends to be almost a protector of our, of our hair cells inside of our inner ear. And when those change, then we don't have that protection anymore from age related, just different changes in our body. Sure. And you know, I kind of looking at the research again thinking, okay, so if, if we need to be mindful of our estrogen levels, then what does HRT do? Well, if you do the research on HRT, it makes it worse. Oh really? Yeah. So what is the recommendation for women? It boils down to lifestyle, living a healthy lifestyle, healthy diet, exercise, taking care of herself. I mean, I know, but it, but it really does make a big difference to try to prevent some of that, um, age related loss.

MELISSA So if I, if I'm starting to notice some, um, hearing issues and I take estrogen, it can make it worse. Yeah.

DR. MANDY So I would consult, definitely consult before you start taking some of that stuff.

MELISSA Consult with an audiologist or

DR. MANDY consult with your primary care or whoever your functional health provider,

MELISSA wherever your primary care doesn't know anything about estrogen. It feels like they just seem very good.

DR. MANDY Yeah. Probably functional medicine. I'm guessing.

MELISSA Yeah. Yeah. Well, that's good to know. Cause I don't know that I heard that either. So, um, definitely probably consult with your, uh, functional medicine or primary care provider, but then also get your, your ears checked as well. Cause you might get a baseline at least. Okay. Good to know. So if a 48 year old woman is listening to the, to this right now and has noticed that her hearing is off, what would you recommend that she do?

DR. MANDY Just call, make an appointment and just get a baseline test and just see where it's at.

MELISSA Okay. So I have a few myth busters or maybe not myth busters. I'm going to read a few statements and you can tell me what you think about these. If I had real hearing loss, I would know it. Not necessarily. So tell me why that's not true.

DR. MANDY Because, um, it happens so gradually. Typical age related noise related loss is a gradual, gradual process. So your body almost adapts to it. And that's where I kind of make the statement. Other people might tell you burst, but you're not hearing before you might notice.

MELISSA Okay. Now, uh, another one hearing aids are mostly for old people. I've, I hate the word old people now cause now that I'm hitting this certain age, I'm like, ooh, am I, am I, when do I hit that category?

DR. MANDY I know, I know it's not, it's a, it's a stigma that's been there forever. I think a lot of it is what hearing aid used to look like and what they look like now. I mean, if you haven't seen a hearing aid in a while, 10 years, they've definitely come a long way. They look so different. They can be almost invisible. You don't even notice them.

MELISSA Do you have people in your fifties that we're hearing? Oh yeah.

DR. MANDY A lot of them. I even got guys in my twenties and thirties that come here. I mean, yeah, they've got acoustic blast or they, you know, they were construction workers and they know that their hearings crap and they just, they want to fix it.

MELISSA So if you're in one of those noisy jobs, I'm going to digress for a second here and they, you know, they give you those like little earplugs you get at the gas station, whatever. Do those help at all? If you're in properly, they, they can help. Okay. So is there anything else we should be doing if we're in noisy environments, construction or whatever that might look like?

DR. MANDY It's just, just kind of know what your ocean noise levels are. I mean, if, if you're know that that noise is 85 decibels or 85 to 90, you can only be in that noise, you know, eight hours for, it just depends. I mean, just kind of know what you're surrounding yourself by and how long can you typically should be in that noise.

MELISSA Okay. Do you make your kids wear headphones and stuff when they go to places? Do they just roll their eyes? No, they like them. Okay. Make them cool as stickers or something. Okay. Um, now I, I know a person near to me who's done this. I can buy a hearing it at Costco and it works just fine. What would you say to them?

DR. MANDY You know, it depends on the degree of loss. I mean, if they're just kind of in the beginning stages of loss, it might just be enough. You know, they're, you know, Costco's gonna program the hearing aid based on your perception. So your perception might be, oh yeah, this helps us help. But over time within a year, most patients will tell you, it just don't notice it anymore. Okay.

MELISSA So that's where a real audiologist would be able to dial it in and make sure you just have what you need and you're,

DR. MANDY you know, you're not getting too much or you know, you're, you're getting enough.

MELISSA So the words that you'd mentioned, but I, I wasn't familiar with, you said sound mapping and then audiogram.

DR. MANDY The audiogram is your hearing test. Okay. Yeah. And then the speech mapping is that, that real room measurement where you're fitting the hearing aid, you're dialing them in the prescription. Dialing it in. Okay. I like that. Just kind of like a show. Yep.

MELISSA Yeah, exactly. All right. Um, tinnitus or tinnitus means your hearing is going or gone.

DR. MANDY Now tinnitus just means there might be, it might be a symptom of noise exposure or it could be a symptom of hearing loss. So if you've been around a lot of, a lot of noises lately and you're noticing it might be time to back off. I mean, putting yourself in that noise. If you haven't been around the noise and you're at that kind of that, you've got a noise history, you're over 50 and you're starting to notice it, then it could be a sign of hearing loss. Okay. Or it could be a sign of plugged wax to your ears. I mean, there's all different reasons why you have it.

MELISSA If my hearing loss isn't bothering me, I don't need to do anything about it.

DR. MANDY Do you live alone?

MELISSA All right. Hearing aids will make everything too loud.

DR. MANDY Well, did you get it over the counter? Are you trying to fix it yourself? Are you trying to, trying to cut some corners because you don't want to spend the money or you don't, you don't like the idea of the way it looks. Yeah. You might experience something like that, but if you go to a provider that's doing best practice and knows what they're doing, you're not going to experience that stuff. And then you have, they clearly give you the expectation. That's the other thing. I think we're all missed, you know, we hear these things all the time, but I think the society has given us this expectation of supposed to be like glasses the second I put them on, it should be perfect. Right. It's a process. It can take at minimum two weeks for people to adapt. I've seen it and people are really fighting it almost a year before they adapt. Oh wow. It is a big range of, of adapting and just having those expectations and just getting all the information and know what you're getting yourself into.

MELISSA So why is the adapt, the adaptation process, so difficult because if you get glasses and that's also kind of a brain interpretation, but those work right away with what is, what is it about hearing?

DR. MANDY I think it's just the, you know, are you ready for it? You're not ready for it. You're doing it because your spouse to telling you to do it. Okay. Um, did you wait too long? Are you 78 years old now and you waited too long? I mean, it just, there's so many factors that, that affect how long it takes. Okay. Degree of loss. If it's really bad and you waited for sure.

MELISSA So the one, if you've waited a really long time, let's say you're 80 and you should have had them 20 years ago, what happens in their brains or that, that makes that struggle so hard. Are they just not, it's like they can't, it's too loud or the brain interprets

DR. MANDY it as a noise. It doesn't know what that sound is, but the more you expose yourself to that sound, the brain remembers it. Okay. So it's just comparing eyes and oh, that's the water dripping. Ignore that. Oh, that's the conversation. It's doable. I mean, it's doable to be successful hearing aid user, even at that point, as long as you know the expectations and you know that this is going to be a process. Sure.

MELISSA That makes sense. So if anyone's listening to this and they haven't gotten their earring checked and they're maybe thinking that they should, what does that first appointment look like? What, what can they expect if they were to call and make an appointment?

DR. MANDY So they'll just, when they call, make the appointment, we'll just kind of ask you like, what, what are the things that you're experiencing? No. Do you have ringing ears? Somebody telling you you can't hear, or you know, you can't hear. And then when they come in and we go through their whole health history, I mean, we catch things that maybe primary care doesn't catch. You know, we're asking you about ear infections, surgeries. Have you had a stroke? Have you had a heart attack? I mean, there's a lot of other reasons why hearing loss was caused, not just noise and age and medications. Sure.

MELISSA So if you're in your car and you've got like a really nice sound system, but you have to turn it up like almost to 75 to 80% to get like really good. Do you feel like that's a point where you should get your ears checked?

DR. MANDY Well, how long are you going to sit in the car and listen to that?

MELISSA Along like six years, just saying for a friend.

DR. MANDY You can download age. Um, and, and you can download a noise meter. Okay. And a Starkey, one of our main manufacturers, they've got an accurate one and you can watch that decibel level. Yeah. And say, okay, this is maybe, um, or if your kids are wearing personal earbuds, AirPods, if you can hear it, it's too loud. If you're out here and they're using it, it's too loud. That's kind of the rule.

MELISSA So that's a good question for the teenagers and the kids with the, with the AirPods. Um, is there something that like that we should be aware of or thinking about as our kids are wearing those everywhere?

DR. MANDY Yeah. You can go into the phone and do the self-livener. Okay. Especially in Apple products where it will tell, Hey, you need to turn it down and tell them, or you can actually limit the volume so they can't go higher. Right. But I mean, the biggest rule of thumb is if you can hear it, it's too loud. Yeah. That's swell off to have some conversations when I get home. Well, and if they're wearing them all the time, then we end up cleaning out a lot of earwax. That's true.

MELISSA And they get disgusting. So what is something, what's the thing that the one thing that you want someone to walk away from this episode, knowing the

DR. MANDY hearing hearing aids, it is, I don't want it to be a stigma. I, it shouldn't be a, a process that you avoid. I mean, it is something that definitely improved your quality of life. I mean, if I'm going to spend thousands of dollars on hearing aid, would I rather go spend it on a trip? Of course I would, but it boils down to your quality of life. And you, you really have to think about that. We're only on earth for a short period of time and you want to be able to enjoy your family, your friends, your grandkids. I mean, you don't, you don't want to just go into isolation because you don't like the idea of a hearing aid. It makes me look old. I think over the years we've gotten a little bit better at getting rid of that stigma. Yeah.

MELISSA I appreciate that. So how can people find you? Where do they get ahold of you?

DR. MANDY Well, we're kind of all over. We, you can find us on Tik TOK. We have a lot of ear cleanings. If you enjoy that we're on Facebook. We also have our own website. Okay. Um, YouTube. I mean, we get comments all the time and we're always trying to answer that. Otherwise just call our office. Okay.

MELISSA And they can book an appointment with your, on your website or just by calling.

DR. MANDY Well, we don't have appointments on our website, but yes, just call the office or send an email through the website and we can email and get you scheduled to.

MELISSA And we'll make sure to put a link to Sioux Falls Audiology Associates and the show notes. Um, so if you're watching on YouTube, hit the description and you can click on the link there and we'll also make sure to include the phone number as well to Audiology Associates. So thank you so much. This was a great episode. Learned a lot about how your hearing can affect and how that interacts with different, you know, disease states or age and all kinds of good things. Um, and I'll have to check my kids ear buds when I get home and check, put the limiter on the iPhones. I didn't know that was a thing. So it's good to know. Yeah. Thank you so much. Dr. Mandy. Uh, and yeah, we'll see you next time. Appreciate it. Yeah. Thank you. Hey, that's our show. If someone came to mind while you were listening to this, if you thought, "Hey, my sister needs to hear this," or, "I should send this to my mom," or, "My buddy would get a lot out of this," please share it with them. Just hit the share button and send it their way. You never know what one conversation, one episode, or one piece of information can do for someone who's been looking for answers. If you haven't subscribed yet, please do it now. It takes two seconds. It's free and it means you won't miss an episode. We've got incredible stuff coming up and I don't want you to miss any of it. If you're a health or wellness provider and you want to be on the show, we'd love to hear from you. There's a link in the show notes to get in touch. We're always looking for people doing interesting work who want to share what they know. One last thing, I get asked all the time about the products and brands I actually use, so I've put together a list of sponsors and favorite products that have worked for me and my family. If you're curious, that link is in the show notes too. Thank you for being here and I really mean that. I'm Melissa Goodwin. The line is open. See you next time.