2020 Ep 4. The Brain and Hearing Health

The Transcript

Dale Johnson: Welcome to The Conversation Starts Here. It’s a conversation every Saturday morning about America’s need to improve hearing, on KFOR FM 103.3, 1240 AM. This is Dale Johnson. I’ve invited back to the show, Gail Jungemann-Schultz, she’s the outreach marketing coordinator for Complete Hearing here in Lincoln, to talk about the relationship between traumatic brain injury and hearing loss. And once again, we have an expert. Introduce our expert.

Gail Jungemann-Schultz: Dan Kasparek from Bryan West. I first met Dan because he actually was the provider for my husband following his stroke. And we developed a great relationship and I have a lot of respect for Dan and this is his area. So, we’re going to let him go.

Daniel Kasparek: Well thanks Gail, thanks for having me back. Appreciate it.

Gail Jungemann-Schultz:
Thanks Dan very much for coming back in.

Daniel Kasparek: Thanks for having me.

Dale Johnson: As I went down the path of head injuries, traumatic brain injuries and then see your area of expertise Dan in Parkinson’s, my first question is what does Parkinson’s have to do with the brain? I think of Parkinson’s as a muscle disorder, muscle disease.

Daniel Kasparek: Yeah, it will affect the muscle eventually. It’s a neurological disease.

Dale Johnson: That’s what we see.

Daniel Kasparek: Right.

Dale Johnson: That’s exactly where we see the effects of Parkinson’s is in the muscles.

Daniel Kasparek: Right and oftentimes we see folks that have Parkinson’s, you’ll notice that shuffle walk. We see that fairly early on with small steps, small movements. It also greatly affects loudness. It’s very difficult for someone with Parkinson’s to communicate because they have to put so much more effort in. So what we see is sort of a shift and they become very quiet which eventually leads to withdrawal. Just the communication’s so difficult that they… It takes so much more effort on their part and the listener gets… They get tired of saying what or you need to speak up, which obviously causes a number of problems.

Dale Johnson: Does Parkinson’s impact hearing? Parkinson’s affects muscles. Is the inner ear a muscle?

Daniel Kasparek: It’s that same age group is really the-

Gail Jungemann-Schultz: The connection, sure.

Dale Johnson: The connection. It isn’t so much Parkinson’s, but it’s the age group of people who suffer from Parkinson’s.

Daniel Kasparek: Right. And so the fear is you’re suffering from hearing loss and communication deficits, right? So you have sort of both things working against you.

Dale Johnson: So is the tendency to focus more on the Parkinson’s and less on the hearing?

Daniel Kasparek: Yeah, I think it is. Yeah.

Gail Jungemann-Schultz: I think we see that a lot. I certainly saw that very early on in my career when I was working in healthcare facilities. We are great at being specialists, but sometimes that keeps us from checking all of the things that people need. And hearing was one of those things that we often didn’t check with our Parkinson’s patients, with people with traumatic brain injuries from car accidents or whatever, from stroke, from any of those things that really affect the brain. And because of our inability to take a look at the whole person always, we missed that piece.

Daniel Kasparek: Yeah. We’ve talked about this before, It’s the teasing apart of, well we don’t look at the hearing loss. So we assume that there’s a deficit in cognition and we attribute everything to cognition. Where it may be very easily treatable if they could just hear what’s going on.

Gail Jungemann-Schultz: Right. So we need to be good partners.

Daniel Kasparek: Right.

Gail Jungemann-Schultz: That’s really the issue is health providers need to be really good partners with each other.

Dale Johnson: And we’ve talked before Gail, just last week and Dr. Miller does this all the time on this show, talks about how hearing is work and when you have to work at it and pay attention to that, sometimes it pulls a person in and has withdrawal, but you combine that with Parkinson’s.

Daniel Kasparek: Right.

Dale Johnson: That in and of itself, regardless of a hearing impact that comes from it because of the age of the patient is enough to take a person into a shell.

Daniel Kasparek: Absolutely. Imagine taking away all those pieces. You take away the hearing piece, speaking, movement and how you mentioned work, now everything is work, right? The amount of effort to put forward any of those acts, then becomes just beyond what they want to put forward.

Dale Johnson: Because just having Parkinson’s is enough to withdraw a person.

Daniel Kasparek: Right.

Dale Johnson: And Gail, I want to go back to something that you just said, working together. Is that a big gap these days? Is that a chasm or is it shrinking? Do you get a sense of more cooperation? There’s always a need for more.

Gail Jungemann-Schultz: We’re a very fast paced society and I think part of what happens is we move patients through so quickly that we sometimes forget to check other things or we’re so focused on what we do well, that we forget to remind them and they rely on us to take another step to check something else or a couple something else. So that really is part of the issue and I think that really leads to the fact that we just don’t get the services that we need and we don’t always know as patients, what we need. So it’s circular.

Daniel Kasparek:

Dale Johnson:
I think also last week, Gail, you mentioned the fact that when someone has a hearing issue, they pay less attention to instructions. And I’m guessing Dan, that physical therapy, medications, treatment for Parkinson’s, requires a focus.

Daniel Kasparek: Certainly.

Dale Johnson: I need to know what you’re telling me and what you want me to do.

Daniel Kasparek: It certainly does. We at Bryan, we do the Lee Silvermen Voice Training, which works on big movements for the physical piece and speaking loudly and the entire thing is based off of the individual understanding what you’re saying, right? Being able to follow directions. The whole program is based off of that. So without that hearing piece, if we had an unchecked hearing loss or the person’s not getting the message, well then nothing else is going to work as well either.

Gail Jungemann-Schultz: And that includes medications, diet, a whole variety of things that affect the wellbeing of any patient that’s going to walk through your door.

Daniel Kasparek: Right.

Dale Johnson: Not a Parkinson’s patient, but if I was one and I’m at home and I have a question, one of my first reactions would be, “Well I wonder if Dan told me that already.”

Daniel Kasparek: Yeah.
Dale Johnson: “I’m wondering if I should have or if I need to.”

Daniel Kasparek: Right. “Did I miss that?” Yeah, yeah, yeah.

Dale Johnson: What did I miss?

Daniel Kasparek: Right. Well it’s not just Parkinson’s that we need to worry about with the hearing. It can affect after a stroke. And Gail, we talked about this earlier with your husband.

Gail Jungemann-Schultz: So as I shared last week, my husband had a stroke, it’ll be two years ago in May, and when we were going through rehabilitation services, we were aware and we shared with staff, that my husband had a hearing deficit in one ear. But he was continuing to have some significant problems with his hearing. We went to Complete Hearing, which is how I got involved with Complete Hearing and did a hearing test and Dr. Miller happened to look in his ears and say, “Oh my goodness. The ear that hears well was heavily impacted with wax,” and we’d never checked that particular ear. Nobody even looked in his ears to double check.

Gail Jungemann-Schultz: When we were able to get that wax removed and his hearing on that side came back and fully came back, what I noticed was an increase in cognitive skills and that reestablishment of neuro pathways absolutely necessary to cognitive skills. You can speak to that.

Daniel Kasparek: You know in Robin’s case he’s able to actually follow the directions, right? He’s absolutely participate in the task without having to concentrate on staring at your mouth and finding out what you’re saying, right? So in order to build or rebuild those neuro pathways, we need all of our senses. If we limit it in any way, we’re obviously going to have much more difficult time getting back the cognitive areas that we’re looking for.

Gail Jungemann-Schultz:
Cognitive wellness, so we can be the best we can absolutely be.

Daniel Kasparek: For sure.

Gail Jungemann-Schultz: And that’s where we all want our patients to be, right? Is the best they can be.

Daniel Kasparek: Did it help your husband recover from his stroke faster?

Gail Jungemann-Schultz: Oh absolutely. Absolutely.

Daniel Kasparek: How so?

Gail Jungemann-Schultz: The inability to hear and follow directions and to really have to work at hearing as we’ve said, that’s work. It was exhausting. He was missing pieces of the information he needed to get better. It made management of, for example, medications my responsibility. He’s quite capable of doing that. So there was no reason not to do it except that hearing and understanding what had been said was lacking.

Daniel Kasparek: Well and it increased that frustration level too.

Gail Jungemann-Schultz: Oh, absolutely. Well, and you saw that as his therapist.

Daniel Kasparek: Absolutely, yeah.

Gail Jungemann-Schultz: That’s true of all of us.

Daniel Kasparek: Right? And I think, you want to participate, you want to get better.

Gail Jungemann-Schultz: Absolutely.

Daniel Kasparek: But when you don’t have the pieces available to you, you’re going to struggle.

Gail Jungemann-Schultz: Sensory deprivation is a big deal in people’s lives.

Dale Johnson: But it comes upon so slowly.

Gail Jungemann-Schultz: It does.

Dale Johnson: That it takes someone else almost to initiate some course of action.

Daniel Kasparek: Right. And I think it’s difficult too with hearing, it’s one of those areas… You’d know how high your arms should be able to be raised, right? So if it’s not going as high as you want it to, it’s very easy to notice that. But when you’re incrementally losing hearing, you don’t notice as much, right? It’s going to take something significant to make you aware of that.

Dale Johnson: I work in the newsroom with a colleague that has hearing aids and we were talking this morning prior to our conversation and he admitted that he had a tendency to blame it on his wife for not speaking loudly.

Daniel Kasparek: I hear it all the time, I hear that all the time.

Dale Johnson: And his aha moment was at the theater and he couldn’t hear a portion of the movie and he asked his wife, “Did you just hear that? She says, “Yeah, I’m hearing it just fine.” Well, the light went on. It wasn’t his wife, it was his ears.

Daniel Kasparek: Right, right. When I think… If you look at vision in comparison, people are much more apt to get their vision checked. And I can tell… My wife, the first time she got glasses, was amazed. She never thought she had a vision problem, right? Then she put the glasses on and said, “This is what I’m supposed to be seeing?” I think this could be the same way with the hearing loss.

Dale Johnson: So again, it’s a second party almost, or even a third party or someone outside the person who is actually suffering the hearing loss to bring it out.

Gail Jungemann-Schultz: And the truth is we don’t check our hearing regularly and we don’t have a good baseline to begin with for many of us. So we don’t know what we were able to hear when our hearing was good. And now that our hearing is diminished, we don’t even understand how much it’s diminished. So that is a really interesting process and unfortunately last week you shared some statistics about the number of individuals in middle age who are losing their hearing. I believe it’s like 40%. If that is the case, and we’re not checking that, how much more productive could we be if we were checking our hearing regularly?

Dale Johnson: In the middle part of our life instead, toward the upper years.

Gail Jungemann-Schultz: So employers pay attention. That might be something you want to know.

Dale Johnson:
Gail, before time slips away from us, let’s remind folks just one more day to enter online, Lincoln’s Choice Awards.

Gail Jungemann-Schultz: Yeah, go to our website, complete-hearing.com. Go ahead and vote for us there and other individuals and other specialties as well.

Dale Johnson: You’ll find the health and wellbeing tab, click on that-

Gail Jungemann-Schultz: Thank you.

Dale Johnson: …and that’s where you can enter Complete Hearing.

Gail Jungemann-Schultz: Absolutely. And you only have one day to do it. So it’s important that you get that done and we encourage everyone to do that. And in addition to that, coming up January 31st through February second, is the Nebraska Boat, Sport and Travel Show. We will have a booth there. We’ve got some awesome koozies. You’ll just going to have to stop by the booth and check them out, pick yours up and find out about hearing protection. That’s really what we’re going to be focusing on there, so we’re excited to have that booth.

Dale Johnson: And the podcasts, also, you can hear this conversation again and prior conversations with Dr. Miller and other experts on your hearing at complete-hearing.com podcast tab. Gail, thank you very much.

Gail Jungemann-Schultz: Absolutely.

Dale Johnson: Dan. Thank you very much.

Daniel Kasparek: Thanks for having me again.

Dale Johnson: Thanks everybody for being here on The Conversation Starts Here.