Our eyes and ears (and money)

Eyes

For a little while, a few years ago, I had an eye doctor with a local office downtown, one that I could walk to easily, but I switched away from him when my eyes started doing the aging thing.  As long as I had 20/20 vision, he was a great doc, but once I started needing reading glasses he became a salesman.  To get from the waiting room into the eye exam office, I'd pass through a well-lit room full of glasses on display; to get from the exam room back out to the desk where I'd pay my bills, that well-lit room became a hard-sell room.  No, thank you.

I use reading glasses these days, but I get them from one of those stores that sells things that other stores couldn't sell; I'll buy 3 pairs for $8, or single pairs for $3.99, or similar kinds of thrifty things.  I'm willing to pay good money for a good eye exam, but I'm not going to a place that tries to upsell me on accessories. 

At any rate, earlier this month I went to my not-quite-so-local, but still nearby, eye doctors.  My previous visit was two years ago; in 2021 they gave me a prescription and told me my eyes were good enough that I didn't need to come back for two years.  It's 2023, so back I went.  This time, I'd had minor floaters and some flickering vision.  My doctor dilated my eyes, and peeked around inside my head, and declared me good for another two years, same prescription.  In fact, after he checked out my optical anatomy, he reassured me about my concerns by saying, "the blood vessels in your retinas are the most normal I've seen all week."  

I have to say, this is the only situation I've ever been in where someone has told me I'm the most normal person they've encountered this week. Perhaps it will be the only such situation.  (And I'm enough of a mathematician that I argue in my own head about the paradox of what "most normal" is).  Still, I'm happy, and my discount glasses have been green-lighted, so I guess I'll see my eye doc again in 2025.

Ears

My husband's hearing is going the way that often happens with people who are fortunate to live for many decades: he's having a harder time hearing kids and women with high voices.  A few theater shows we've been to have been almost inaudible to him if the main cast and characters aren't strong altos, tenors, or bases.  He'd tried hearing aids a few years back, but they made uncomfortable electric crackly noises and didn't help much, but we thought the continued changes in his hearing warranted going back and trying again.

So, he went to an audiologist who tested him, and then told him he'd need to come back with his wife.  Whatever; he figured that for some reason the audiologist needed to use my voice or my knowledge as further data, and so we made a joint appointment and went in together.

Oddity number one for me was that the magazines in the waiting room (of the audiologist, remember) were all about some Alzheimer's association.   Then, when we went into the doctor's actual office, next to the sound booth, he started giving us a lecture on how hearing worked and showing us the results of the last exam, but didn't actually perform any other tests.  And then he launched into telling us about studies that had come out of Johns Hopkins ("Have you heard of Johns Hopkins?  It's a research hospital") that showed a connection between hearing loss and the onset of dementia.  I told him that I'd read second-hand reports of these papers -- which was true; that was part of why I urged my guy to get retested now. 

As the appointment progressed, it was clear we were there not for testing, but for a sales pitch, and that I was there to be part of it: it was almost like being in a time-share promotion.  He emphasized the studies ("mild hearing loss doubles your chances of getting dementia; moderate hearing loss makes your chances of developing Alzheimer's 6 times greater!")  He led us into another room where he fitted my guy with hearing aids and had me talk to him, either from behind him or even from down the hall, and verified that my husband could hear me much more clearly with them in.  (He also made jokes about how my husband could avoid hearing me by turning the hearing aids off -- it was my husband who said that we're not that kind of couple and those jokes weren't welcome).  

Then the doc repeated the dementia stats, and asked my husband "do you want to hear better?" -- and when, of course, the answer was "yes", he brought out the laminated brochure with his recommended hearing aids: the "decent quality" $2000 version, and the excellent quality $5500 version, which was (he assured us) actually a reduced price because his medical practice had made bulk-purchase deals with the manufacturer.  Which of these hearing aids did we want?

I'm glad my husband and I are a great, think-alike team, and we both responded that we'd think about it and get back to him later, thank you.

For the record, I want to say that I am very much aware that hearing loss is something to take seriously.  But the doctor's strong-arming us with skewed statistics, that's another matter.  Here's a bit of context for those stats:  while hearing loss is correlated with dementia risk, so are other things.  The NIH says, for example, that dementia risk doubles every five years for people over 65 (so getting older is also a risk factor, by that definition!).  But if your risk of dementia is, say 10%, then doubling that risk still means there's an 80% chance of not developing Alzheimer's, so scary words like "double" aren't death sentences -- or even dementia sentences.  Even more significantly, hearing aids aren't a magic bullet that cures all: they chip away at the increase in dementia, but only by about 20%, from what I've read since.  

We were fortunate that Consumer Reports came out with a helpful article on over-the-counter hearing aids right after we visited that doc.  Kind of in the same way many people get their reading glasses from a drug store instead of an optician, it's going to be more and more common for people to get their first sets of hearing aids from Costco and Walmart, where they cost hundreds instead of thousands of dollars.  And since my husband's medicare (medicaid? I guess I have to learn the difference soon) actually covers hearing aids up to $1200, that's the direction we're going soon.  

He hasn't gotten the hearing aids yet, because a few other life events have gotten in the way; I'm really looking forward to seeing (hearing?) how this all works out.  More later, I'm sure!