The Three Stages of Energy Expenditure

The Three Stages of Energy Expenditure

This topic is related to the previous article, but more specifically related to a phenomenon commonly experienced during the adaptation phase of using hearing aids. As previously noted, listening takes a great deal of effort for those with hearing loss, an issue that is compounded if they aren’t using proper amplification. Hearing aids function to help pick up sound and speech around you so that your body doesn’t have to work as hard to listen. This provides the hearing aid user with energy reserves that can be applied to anything else they desire. However, this process is not automatic and requires effort, which this article is designed to outline.

I often refer to this process as the three stages of energy that the typical hearing aid user goes through. There is no predetermined length of time to move from one stage to another, one stage can take longer to complete than another, and many individual factors impact the long term success of each hearing aid user. In general, those people who wear their products consistently in ALL of their personal listening environments move through the stages more rapidly, where they reach the optimal end stage and achieve the greatest communicative success.

The three stages I have referred to are the period before using hearing aids, during the acclimatization phase of using hearing aids, and after your body has fully adapted to the use of hearing aids. Each stage has different challenges and, thus, each will be addressed separately. No two people are the same, and no two approaches will be exactly the same; but, in general, the majority of hearing aid users have similar experiences as they become accustomed to hearing in an amplified manner.

Stage One: Pre-hearing aid introduction

This period can last for many years and, truthfully, a large percentage of people with a hearing impairment never move forward from this stage to actually utilize hearing aids. People in this stage often have to ask for repetition during conversation (especially in background or competing noise situations), turn the TV up louder than others would prefer, and generally comment that other people don’t speak clearly (i.e. mumble) or that they talk too fast. In this stage, people often have to expend a great deal of additional energy to communicate in an effective fashion. For these people to have a conversation in a restaurant, at a family gathering, or during a card party, they must concentrate much harder than someone with normal hearing. More concentration means more energy used, and less residual energy is remaining after the event is complete. The funny thing is that most people don’t realize how much extra energy it takes to have a conversation when you need that much focus just to hear what’s being said. All that energy is essentially wasted, and eventually leads to individuals with hearing loss avoiding situations where they must focus so intently. Just BEING in a place does not mean you are actually involved in the activity; and very often we hear people say they don’t bother going to restaurants/meetings/church events anymore because they can’t hear what the people are saying.This is the sad side of a hearing impairment that truly can be minimized or even avoided, leading us to Stage 2 where the help begins.

Stage 2: Acclimatizing to hearing aids

At this stage we have earned our patient’s trust, and they have decided to take the plunge and try hearing aids. This is usually met with apprehension on the part of the user, and excitementin the family and friends of the user. We try to set the proper expectations for how the world will sound when first using hearing aids, but in most cases people do find the noises in the world around them to be quite prominent.We hear all sorts of examples like the toilet flushing, water running, wind noise, church music, squeaks in the hardwood floor, microwave beeps, fridge running, in general just about all sounds tend to be unusual at first. What’s important to keep in mind is that we EXPECT them to sound different. If everything sounds the same then we have failed miserably in our attempt to improve your hearing. There is an old saying by Albert Einstein that goes “The definition of insanity is doing the same thing and expecting different results.”If you want to hear BETTER, then you have to hear MORE, and you can’t pick and choose what you hear more of. The world is a noisy place, there’s nothing we can do about it. Go camping in a secluded campsite for two weeks, then come back and visit the food court in your local mall. What does that sound like?Noise is everywhere; that is the reality of the situation. Unless you want to live in the woods, you must become used to the sounds around you and accept that they do become more normal over time. Be patient and understand this is perfectly normal for most hearing aid users.

So, how exactly does this pertain to energy? Basically, as you are hearing these familiar sounds in an entirely unfamiliar way, your body has to relearn what they sound like and this takes energy. You will be paying attention to sounds you haven’t heard or haven’t noticed for an extended period of time. Your brain has to adapt to what these things sound like, and must become accustomed to ignoring the meaningless sounds that fill our world. The sound of the fridge running has ALWAYS sounded exactly like it does when you’re wearing hearing aids, you just didn’t hear it that way. That squeaky sound you hear in the cupboard doors or when walking up the stairs didn’t just appear out of nowhere, they have always been there. In time, they will once again be something relegated to the background and you can ignore them, but for now they are demanding your attention. Let your body hear them, don’t reflexively reach to turn down the hearing aids or take them out. They will eventually go away, but you should always hear them; after all, they do make a sound.

People tell me that as they are moving through this adaptation phase they find themselves quite tired at the end of the day from all the sounds they’ve been hearing. I often tell people to start your day with them in your ears and wear them as long as you can. If you can wear them until you go to bed then fantastic, but if you need a break don’t be afraid to give your ears a break. Take them out for an hour, even two hours, but put them back in your ears the same day. I often tell those patients that are still working to remove their aids at the end of the work day and leave them out for 1-2 hours, but get them back in their ears once they’ve finished supper. Take a break, but don’t stop for the rest of the day. This allows your brain an opportunity to consolidate the acoustic information is has received throughout the day, gives your ears a rest from the constant sound barrage of the world around you, and tends to alleviate any tension you may be feeling from hearing so differently over the past 8-12 hours. You will be less tired at bedtime, less irritated by your hearing aids, and adapt to sound much more quickly.We take breaks from our work all the time to have a coffee, have lunch, talk to a co-worker, just to “decompress,” and it is no different for hearing.As I mentioned, the key is to just take a break and not to abandon it until the following morning. Putting in the effort at this time will result in your ears and brain adapting to your new hearing world in a much more seamless fashion.

Stage 3: Fully acclimatized to your hearing aids

Once this point has been achieved in our process, everyone involved in your hearing world will be much happier. You are no longer repeatedly annoyed by the useless noise around you, using hearing aids has become second nature, and your brain has adapted to the intrusion of all these new sounds. Your ears and your brain are no longer wasting their attention and energy on meaningless sounds; which frees up a significant amount of energy for everything else you like to do. At this stage you will begin to feel at ease with your hearing aids, appreciate what they do, and typically being testing the boundaries of how well you can hear with them. Getting back involved in organizations you once belonged to; attending meetings, card plays, or theatre productions; going to restaurants or social gatherings with your spouse; these are some of the huge number of benefits you receive from properly wearing the appropriate hearing devices.I once worked with a clinician in Bedford, NS, who would say “wearing hearing aids makes you ten years younger.” While that may be a stretch, you certainly will have energy to use that you haven’t had access to for a number of years. Less straining to hear means enjoying the conversation more; enjoying the conversation more means getting involved and feeling better about yourself. It is achievable, you just need to be committed to the process and get rid of the quick-fix mentality of our current health care system. You didn’t become hard of hearing quickly, and we can’t reverse the effects quickly. Stick with it; you WILL get here with a little patience.

To summarize, we have talked about energy in three simple stages as it relates to the hearing aid user. At first, you are tired because you have to work so hard to hear the conversations around you. Second, you are using hearing aids but are tired from hearing so many new sounds that you must become accustomed to. Then, finally, you have adapted to using hearing aids and hearing is much easier, providing you with excess energy that you can use for anything you desire. We see this happen all the time at Audiocorp, but it can be disheartening for people to realize that improving their hearing and getting the most out of their hearing aids will take both time and effort.They say that anything worth having is worth working for, and I believe that hearing more effectively is well worth the effort you have to put in. You stand to lose nothing, but can potentially regain a huge amount of communicative competence. All it takes is patience, time, and little instruments that help your ears to hear sounds they can no longer pick up naturally. I often say to people “You already spent the money; you might as well get the most you can out of them.” No one expects a card player to immediately become an expert the first time they play a new game. No one expects a bowler to throw ten strikes the first time they go bowling. EVERYTHING in this world requires some time and effort to improve. Put in the leg work and the results will be surprisingly positive. We will support you, but you need to support yourself.