WEBVTT 00:00:00.000 --> 00:00:02.980 Coming up on the 40s Formula. Hearing loss is 00:00:02.980 --> 00:00:05.379 a risk factor for dementia. There's a condition 00:00:05.379 --> 00:00:07.719 called sudden hearing loss and this is considered 00:00:07.719 --> 00:00:10.539 a medical emergency. Anything that affects your 00:00:10.539 --> 00:00:13.419 calcium metabolism or the blood flow to your 00:00:13.419 --> 00:00:16.600 ear can contribute to that. So I always say to 00:00:16.600 --> 00:00:18.039 people who have this that they should check. 00:00:19.230 --> 00:00:21.929 The auditory pathway from the ear all the way 00:00:21.929 --> 00:00:24.750 up to the brain has oestrogen and progesterone 00:00:24.750 --> 00:00:27.510 receptors in it. We have seen that post -menopause 00:00:27.510 --> 00:00:30.890 there is a drop generally in women's hearing. 00:00:30.949 --> 00:00:33.689 I have even seen a patient who had this tickling 00:00:33.689 --> 00:00:35.789 feeling in their ear and when I looked in there 00:00:35.789 --> 00:00:40.270 they had a tiny spider. Oh my god. Dr. Rebecca 00:00:40.270 --> 00:00:43.009 Hayward is a UK -trained ENT specialist with 00:00:43.009 --> 00:00:45.869 over 25 years of experience. Rebecca specializes 00:00:45.869 --> 00:00:48.630 in otology, the medical and surgical treatment 00:00:48.630 --> 00:00:51.329 of ear, hearing, and balance disorders, and is 00:00:51.329 --> 00:00:53.049 passionate about helping patients with hearing 00:00:53.049 --> 00:00:55.310 loss to reconnect with people and sounds that 00:00:55.310 --> 00:00:59.429 matter most. The 40s Formula. The 40s Formula. 00:00:59.710 --> 00:01:03.950 The 40s Formula. Hosted by Jasmine Dillon, integrated 00:01:03.950 --> 00:01:06.590 health strategist specializing in gut health, 00:01:06.730 --> 00:01:09.370 hormones, and midlife well -being. and Amanda 00:01:09.370 --> 00:01:12.549 Lim, Director of Lift Clinic and a leading expert 00:01:12.549 --> 00:01:15.469 in female strength and metabolism. Name one of 00:01:15.469 --> 00:01:19.510 CNA's top podcasts and winner of the 2025 Asia 00:01:19.510 --> 00:01:22.129 Podcast Awards in the Best Health and Wellness 00:01:22.129 --> 00:01:25.170 Podcast category. The 40s Formula is your no 00:01:25.170 --> 00:01:28.730 -fluff, science -meets -real -life guide to thriving 00:01:28.730 --> 00:01:33.650 in your 40s. Most of us take our hearing and 00:01:33.650 --> 00:01:36.189 balance for granted until something goes wrong. 00:01:36.620 --> 00:01:38.719 In our 40s, we start noticing little changes. 00:01:39.040 --> 00:01:41.319 Maybe we keep turning the volume on the TV up, 00:01:41.400 --> 00:01:43.900 we feel a bit dizzy getting out of bed, or we 00:01:43.900 --> 00:01:45.980 catch ourselves saying, pardon, more than we'd 00:01:45.980 --> 00:01:48.400 like. But here's the thing, these changes aren't 00:01:48.400 --> 00:01:50.780 just inconveniences. They can affect our confidence, 00:01:51.060 --> 00:01:53.159 our relationships, and even our brain health. 00:01:53.400 --> 00:01:55.540 Today, we're tuning in literally to a part of 00:01:55.540 --> 00:01:57.299 midlife health that rarely gets a spotlight, 00:01:57.620 --> 00:01:59.959 our ears. So if you've ever wondered why sometimes 00:01:59.959 --> 00:02:02.159 you feel a little bit off balance, or if hearing 00:02:02.159 --> 00:02:04.299 loss really matters beyond just a few words, 00:02:04.500 --> 00:02:06.590 you'll want to listen to this one closely. And 00:02:06.590 --> 00:02:08.590 if you feel more clear -headed after this episode, 00:02:08.750 --> 00:02:11.229 why not share it with a friend or subscribe to 00:02:11.229 --> 00:02:13.430 The 40s Formula for more cutting -edge conversations 00:02:13.430 --> 00:02:16.909 helping your health. Hi, Rebecca. Thank you for 00:02:16.909 --> 00:02:19.050 joining us today. We're really, really excited 00:02:19.050 --> 00:02:22.189 to have you here to talk about hearing and balance. 00:02:22.689 --> 00:02:24.650 Thank you so much for having me. It's a pleasure 00:02:24.650 --> 00:02:27.030 to be here. Thank you. When we hit our 40s, we 00:02:27.030 --> 00:02:28.969 start to notice that certain things don't feel 00:02:28.969 --> 00:02:31.349 quite like they used to when we were in our 20s. 00:02:31.349 --> 00:02:33.909 Your eyesight goes a bit blurry. Your joints 00:02:33.909 --> 00:02:36.610 are a little bit creaky. But what are the first 00:02:36.610 --> 00:02:39.629 signs that we notice that our hearing isn't quite 00:02:39.629 --> 00:02:42.569 right? Hearing is such a precious sense and one 00:02:42.569 --> 00:02:45.030 of these things that really we only notice the 00:02:45.030 --> 00:02:48.150 benefit of when it starts to go. Now, the 40s 00:02:48.150 --> 00:02:50.689 and 50s are a time when age -related hearing 00:02:50.689 --> 00:02:53.509 loss starts to affect us. So age -related hearing 00:02:53.509 --> 00:02:56.210 loss tends to affect the high frequencies. And 00:02:56.210 --> 00:02:58.229 what people may notice, first of all, is that 00:02:58.229 --> 00:03:00.509 they can't hear very well in certain environments. 00:03:00.830 --> 00:03:03.710 So a common misconception is that when you've 00:03:03.710 --> 00:03:06.030 got hearing loss, you can't hear people talking. 00:03:06.270 --> 00:03:09.110 And actually you can hear people talking, but 00:03:09.110 --> 00:03:12.370 you just can't catch what they say. So you may 00:03:12.370 --> 00:03:16.289 notice for people in work, for example, if they're 00:03:16.289 --> 00:03:18.710 in a boardroom, they may not be able to hear 00:03:18.710 --> 00:03:22.669 people at the other end of the table. For people 00:03:22.669 --> 00:03:25.810 who work in an open plan office, they may not 00:03:25.810 --> 00:03:28.550 be able to catch what people say at certain times, 00:03:28.610 --> 00:03:30.969 particularly if it's a bit noisy. For people 00:03:30.969 --> 00:03:33.789 in jobs who have a lot of social commitments 00:03:33.789 --> 00:03:35.830 and they're going to restaurants, they're going 00:03:35.830 --> 00:03:38.830 to bars, they may not be able to catch what people 00:03:38.830 --> 00:03:42.699 say. So it's that real sort of... straining to 00:03:42.699 --> 00:03:45.259 hear like what did that person say you know and 00:03:45.259 --> 00:03:48.439 having to ask people to repeat oh god having 00:03:48.439 --> 00:03:51.539 to turn the tv up louder tinnitus is another 00:03:51.539 --> 00:03:55.460 symptom of early hearing loss so tinnitus is 00:03:55.460 --> 00:03:59.759 a buzzing or humming or hissing noise in the 00:03:59.759 --> 00:04:02.280 ear there are many different noises that you 00:04:02.280 --> 00:04:04.819 can hear and That can come for many reasons, 00:04:04.860 --> 00:04:07.460 but hearing loss is certainly one of the most 00:04:07.460 --> 00:04:10.139 common. You're scaring me now because every now 00:04:10.139 --> 00:04:12.759 and again I get this weird sensation like there's, 00:04:12.759 --> 00:04:16.160 I don't know, an insect like, like flapping its 00:04:16.160 --> 00:04:18.759 wings like really fast near my ear. And I'm like, 00:04:18.779 --> 00:04:21.579 oh, what was that? And I kind of, I don't know. 00:04:21.620 --> 00:04:24.459 I'm just like, oh, you know, was there an insect 00:04:24.459 --> 00:04:26.699 or, you know, like what's going on? Probably 00:04:26.699 --> 00:04:29.980 not. Get your ears looked at. I definitely need 00:04:29.980 --> 00:04:32.800 to go do that. Right. So. What would you say? 00:04:32.879 --> 00:04:34.959 Obviously, the buzzing, the tinnitus, that's 00:04:34.959 --> 00:04:36.740 something that we need to take into consideration. 00:04:37.000 --> 00:04:39.540 What other signs should we never avoid? If I 00:04:39.540 --> 00:04:42.779 just explain how our ear works briefly, sound 00:04:42.779 --> 00:04:45.439 is conducted along the ear canal to the eardrum, 00:04:45.459 --> 00:04:48.240 and then it passes through three small bones 00:04:48.240 --> 00:04:50.600 called ossicles, and then it's transmitted into 00:04:50.600 --> 00:04:53.600 the inner ear, which is called the cochlea. Now, 00:04:53.620 --> 00:04:56.980 the cochlea is an amazing organ. It turns the 00:04:56.980 --> 00:05:00.060 mechanical sound energy into an electrical signal. 00:05:00.540 --> 00:05:03.139 which then goes up to the brain. And that's where 00:05:03.139 --> 00:05:05.519 we actually hear the sound. So the ear is just 00:05:05.519 --> 00:05:07.699 the way that the body gets the sound to the brain. 00:05:08.079 --> 00:05:11.639 And then the brain is where we hear the sound. 00:05:11.939 --> 00:05:13.800 There's a condition called sudden hearing loss. 00:05:13.920 --> 00:05:16.699 This can happen in any part of the hearing pathway. 00:05:16.879 --> 00:05:18.680 So it may be that your ear is just blocked with 00:05:18.680 --> 00:05:21.240 wax. It may be that you've got fluid behind your 00:05:21.240 --> 00:05:24.339 eardrum because of a cold, for example. But there 00:05:24.339 --> 00:05:27.810 is in a small... number of people a condition 00:05:27.810 --> 00:05:30.230 where you get sudden hearing loss of the inner 00:05:30.230 --> 00:05:32.930 ear. And this is considered a medical emergency. 00:05:33.230 --> 00:05:35.970 So there's a lot of evidence now showing that 00:05:35.970 --> 00:05:39.670 the sooner this is treated, the better. And we're 00:05:39.670 --> 00:05:43.689 talking about within 24 to 72 hours. So if you 00:05:43.689 --> 00:05:46.389 notice a sudden deterioration in your hearing, 00:05:46.470 --> 00:05:48.949 if you notice a sudden blockage in your ear, 00:05:49.110 --> 00:05:51.850 then you should go to a doctor, maybe to an emergency 00:05:51.850 --> 00:05:54.750 department. um and get your ears checked and 00:05:54.750 --> 00:05:56.949 hopefully get a hearing test within the the next 00:05:56.949 --> 00:05:59.970 24 to 48 hours is that something more common 00:05:59.970 --> 00:06:02.110 as we age that the potential of sudden hearing 00:06:02.110 --> 00:06:05.910 loss yes so you said um like a sudden blockage 00:06:05.910 --> 00:06:09.170 in the ear now could that just be like a build 00:06:09.170 --> 00:06:10.629 -up of wax like how would you be able to tell 00:06:10.629 --> 00:06:13.930 the difference of like this is an emergency situation 00:06:13.930 --> 00:06:16.529 as opposed to oh you've just you know not cleaned 00:06:16.529 --> 00:06:18.850 your ears in a while Yes, so we could talk about 00:06:18.850 --> 00:06:23.129 cleaning your ears in a while. So you can't, 00:06:23.129 --> 00:06:25.569 you can't tell. You have to go and get someone 00:06:25.569 --> 00:06:28.370 to have a look. So we need someone who can look 00:06:28.370 --> 00:06:30.990 into your ear and see if there's a physical blockage, 00:06:31.050 --> 00:06:33.250 look at your eardrum and see if there's anything 00:06:33.250 --> 00:06:37.129 behind it. You can get a doctor to do some tests 00:06:37.129 --> 00:06:39.509 on your ears with tuning forks, but ideally you 00:06:39.509 --> 00:06:42.250 want to get a hearing test done, right? Is that 00:06:42.250 --> 00:06:44.290 that thing that you sort of bang together and 00:06:44.290 --> 00:06:46.170 you're going to hear the... Yes, that's right. 00:06:47.530 --> 00:06:50.709 With hearing loss, is it a gradual thing? Because 00:06:50.709 --> 00:06:52.870 I'm just wondering, are we meant to have perfect 00:06:52.870 --> 00:06:55.910 hearing up until we die? Or, you know, will there 00:06:55.910 --> 00:06:57.649 come a time where, you know... Is it like eyesight? 00:06:57.870 --> 00:06:59.949 Yeah. You need glasses at a certain point. Yeah. 00:07:00.329 --> 00:07:03.009 It's a gradual thing. So this is why hearing 00:07:03.009 --> 00:07:06.129 loss is often missed because the onset is so 00:07:06.129 --> 00:07:09.029 insidious. So hearing loss can occur at any age. 00:07:09.089 --> 00:07:11.009 It can be present at birth. It can come on during 00:07:11.009 --> 00:07:17.509 childhood, any age up to elderly. Age -related 00:07:17.509 --> 00:07:19.750 hearing loss is something that comes on very, 00:07:19.790 --> 00:07:23.810 very gradually. And so people don't notice that 00:07:23.810 --> 00:07:26.769 they can't hear things anymore. And often when 00:07:26.769 --> 00:07:29.290 people get treated, they suddenly realise, actually, 00:07:29.329 --> 00:07:30.910 they haven't heard the birds for a long time. 00:07:31.209 --> 00:07:33.230 Actually, they haven't heard the tap dripping 00:07:33.230 --> 00:07:35.129 for a long time. That's probably a good thing. 00:07:36.370 --> 00:07:38.269 Actually, they haven't heard the car indicator 00:07:38.269 --> 00:07:40.670 for a long time, right? So these kinds of small 00:07:40.670 --> 00:07:44.170 noises and they become, they zone out so quickly. 00:07:44.480 --> 00:07:46.879 that people don't notice that they're missing 00:07:46.879 --> 00:07:52.579 them. In answer to your earlier question, it 00:07:52.579 --> 00:07:55.319 is expected that our hearing will deteriorate 00:07:55.319 --> 00:07:59.360 over the lifespan due to a number of insults. 00:07:59.360 --> 00:08:04.300 So noise, medications, anything that affects 00:08:04.300 --> 00:08:08.100 our vascular system. So diabetes, high blood 00:08:08.100 --> 00:08:11.779 pressure, cardiovascular risk factors are also 00:08:11.779 --> 00:08:14.480 risk factors for hearing loss. Yeah, so we would 00:08:14.480 --> 00:08:17.480 expect nearly everyone to develop some hearing 00:08:17.480 --> 00:08:19.879 loss as they age. But the thing that we want 00:08:19.879 --> 00:08:22.420 to get away from is people thinking that because 00:08:22.420 --> 00:08:24.680 it's normal to have a bit of hearing loss as 00:08:24.680 --> 00:08:28.339 you age, that you shouldn't treat it. So just 00:08:28.339 --> 00:08:30.740 as people in their 40s, for example, may start 00:08:30.740 --> 00:08:33.399 to need reading glasses, everyone goes to get 00:08:33.399 --> 00:08:35.580 reading glasses, but they start to get a bit 00:08:35.580 --> 00:08:38.480 of hearing loss and they ignore it. And that's 00:08:38.480 --> 00:08:40.940 what, as a hearing professional, we're trying 00:08:40.940 --> 00:08:43.039 to encourage people, once they start noticing 00:08:43.039 --> 00:08:45.659 those signs, go and get them treated. Just because 00:08:45.659 --> 00:08:48.259 it happens to many people doesn't mean that it's 00:08:48.259 --> 00:08:50.159 something that you should ignore. It's funny 00:08:50.159 --> 00:08:52.039 you mentioned the car indicator because that 00:08:52.039 --> 00:08:54.279 just reminds me, like when I'm driving, you know, 00:08:54.299 --> 00:08:56.279 I'll see someone whose indicator is just on and 00:08:56.279 --> 00:08:58.039 I'm like giving them way. They're not moving. 00:08:58.100 --> 00:09:00.210 And I'm like, what are they doing? doing? You 00:09:00.210 --> 00:09:02.049 know, like why are they not moving? But it could 00:09:02.049 --> 00:09:04.409 just be as simple as they just can't hear the 00:09:04.409 --> 00:09:06.710 indicator. That's so interesting. I think that 00:09:06.710 --> 00:09:08.450 is a common one for old people. I feel like that's 00:09:08.450 --> 00:09:10.830 an old people driving trope, but that is kind 00:09:10.830 --> 00:09:13.590 of also true. And, you know, thinking about old 00:09:13.590 --> 00:09:16.789 people, you mentioned, you know, getting, acknowledging 00:09:16.789 --> 00:09:20.149 your hearing loss when it starts to happen. My 00:09:20.149 --> 00:09:24.490 dad was in a rock and roll band from age 15 to 00:09:24.490 --> 00:09:26.309 present. Like he still plays rock and roll. He's 00:09:26.309 --> 00:09:30.940 76. blasting amps, incredible noise, crowds all 00:09:30.940 --> 00:09:33.279 the time, late into the night, all the things. 00:09:33.360 --> 00:09:36.539 And yet he resisted acknowledging his hearing 00:09:36.539 --> 00:09:39.600 loss. What are some ways that you could have 00:09:39.600 --> 00:09:42.299 a conversation with a loved one that isn't ready 00:09:42.299 --> 00:09:43.980 to acknowledge their hearing loss, but to encourage 00:09:43.980 --> 00:09:46.240 them to at least get a screening? It can be difficult 00:09:46.240 --> 00:09:49.820 to talk to loved ones about possible hearing 00:09:49.820 --> 00:09:53.019 loss. I think really the thing is letting them 00:09:53.019 --> 00:09:56.649 know that you're on their side. letting them 00:09:56.649 --> 00:09:59.769 know that there is help out there. So people 00:09:59.769 --> 00:10:03.590 are scared when they have hearing loss. They 00:10:03.590 --> 00:10:05.690 don't want to acknowledge it. People think that 00:10:05.690 --> 00:10:10.450 hearing loss means they're old. That is exactly 00:10:10.450 --> 00:10:13.429 verbatim his issue. Sorry, dad, but it's true. 00:10:14.049 --> 00:10:16.970 And what I have found and what I always say to 00:10:16.970 --> 00:10:19.750 my patients is that actually it's the hearing 00:10:19.750 --> 00:10:23.730 loss that makes you feel old. and the sequelae 00:10:23.730 --> 00:10:25.789 of the hearing loss that makes you feel old. 00:10:25.889 --> 00:10:28.570 It's not the devices. So there's a real stigma 00:10:28.570 --> 00:10:30.610 still around wearing hearing aids, unfortunately. 00:10:31.429 --> 00:10:35.049 So people will get to their 40s, they get their 00:10:35.049 --> 00:10:37.809 reading glasses, but they start to get slight 00:10:37.809 --> 00:10:40.610 hearing decline and they resist getting hearing 00:10:40.610 --> 00:10:43.730 devices. And certainly for cochlear implants, 00:10:44.009 --> 00:10:48.289 which is one of the devices that I put in surgically 00:10:48.289 --> 00:10:53.139 to address severer hearing losses, there's evidence 00:10:53.139 --> 00:10:56.080 that people wait on average 10 years after the 00:10:56.080 --> 00:10:58.000 time that they could benefit from getting a cochlear 00:10:58.000 --> 00:11:00.299 implant to when they actually get one. Wow, that's 00:11:00.299 --> 00:11:01.960 a long time of not being able to hear things. 00:11:02.179 --> 00:11:05.659 Yes, so there's a lot of resistance to getting 00:11:05.659 --> 00:11:09.179 devices. But so many patients come and tell me 00:11:09.179 --> 00:11:12.399 that when they get hearing aids, they realise 00:11:12.399 --> 00:11:14.779 that it was the sequelae of the hearing loss 00:11:14.779 --> 00:11:18.179 itself that made them feel old. It's not wearing 00:11:18.179 --> 00:11:23.340 the hearing aids. So I think really, being understanding 00:11:23.340 --> 00:11:27.360 and explaining to them that this is not just 00:11:27.360 --> 00:11:31.139 not being able to hear a few words, but it actually 00:11:31.139 --> 00:11:33.519 has a big impact on your life. It has a big impact 00:11:33.519 --> 00:11:36.720 on your family. So as a loved one as well, some 00:11:36.720 --> 00:11:40.159 people, they start to feel a bit of resentment 00:11:40.159 --> 00:11:42.559 because they may, when they're going out with 00:11:42.559 --> 00:11:45.539 people, they find themselves translating, right? 00:11:45.620 --> 00:11:47.899 So they're repeating what was said to their loved 00:11:47.899 --> 00:11:50.379 one who can't hear so well. They don't want their 00:11:50.379 --> 00:11:53.809 loved one to feel stupid or to look silly in 00:11:53.809 --> 00:11:55.629 front of people when they reply to a question, 00:11:55.669 --> 00:11:58.389 which is not the one that was asked. So they'll 00:11:58.389 --> 00:12:00.490 help them along with these kinds of things. And 00:12:00.490 --> 00:12:02.669 so there's a big social burden as well for people 00:12:02.669 --> 00:12:05.190 with hearing loss. So you've mentioned now that, 00:12:05.289 --> 00:12:08.750 you know, your vascular system can affect your 00:12:08.750 --> 00:12:11.129 hearing. And you now also mentioned that sort 00:12:11.129 --> 00:12:13.190 of, you know, family relationships, like what 00:12:13.190 --> 00:12:16.330 else can affect quality of life then when your 00:12:16.330 --> 00:12:19.889 hearing isn't optimised? What other ways is your 00:12:19.889 --> 00:12:23.029 quality of life affected? Yeah, so hearing loss 00:12:23.029 --> 00:12:25.889 has very far reaching effects. There's a huge 00:12:25.889 --> 00:12:29.909 amount of data showing all of this now. In midlife, 00:12:29.970 --> 00:12:31.830 one of the first things to affect people is social 00:12:31.830 --> 00:12:34.470 isolation. So often when we talk about social 00:12:34.470 --> 00:12:37.049 isolation in relation to hearing loss, people 00:12:37.049 --> 00:12:40.250 will envisage an elderly person sat at home on 00:12:40.250 --> 00:12:48.750 their own with an ear trumpet. We're talking 00:12:48.750 --> 00:12:51.129 about people who may be at the peak of their 00:12:51.129 --> 00:12:53.330 career. They may have busy jobs. They may have 00:12:53.330 --> 00:12:57.309 kids. So people are busy and they are going to, 00:12:57.450 --> 00:13:00.570 for example, a family gathering, for example, 00:13:00.570 --> 00:13:03.870 a work event, going out with a group of friends 00:13:03.870 --> 00:13:07.350 and they're sat there and they get fed up of 00:13:07.350 --> 00:13:10.129 asking people to repeat because they can't quite 00:13:10.129 --> 00:13:15.789 catch what was said and they stop. As a result 00:13:15.789 --> 00:13:18.649 of what may be a relatively minor hearing loss, 00:13:18.789 --> 00:13:22.190 they are out of the group. And then what happens 00:13:22.190 --> 00:13:24.610 is they actually change their habits. So they 00:13:24.610 --> 00:13:26.269 may stop going out with this particular group 00:13:26.269 --> 00:13:28.450 of people. They may stop going out with people 00:13:28.450 --> 00:13:30.230 when they're going to a noisy environment. So 00:13:30.230 --> 00:13:33.210 their lifestyle starts to change with this. And 00:13:33.210 --> 00:13:36.070 people can really become very socially isolated 00:13:36.070 --> 00:13:40.139 with hearing loss that's not that bad. Now that 00:13:40.139 --> 00:13:42.519 then has knock -on effects. So as a result of 00:13:42.519 --> 00:13:44.940 that, people can develop anxiety. People can 00:13:44.940 --> 00:13:48.580 develop depression. Okay. Now, another thing 00:13:48.580 --> 00:13:52.559 that is often not considered is something called 00:13:52.559 --> 00:13:56.440 listening fatigue. So if you imagine a time when 00:13:56.440 --> 00:14:00.120 you have sat an exam, when you've studied for 00:14:00.120 --> 00:14:02.460 a long time and you get that real sort of brain 00:14:02.460 --> 00:14:05.200 ache and you're tired, right? People with hearing 00:14:05.200 --> 00:14:09.480 loss get that. All day, if we go back to how 00:14:09.480 --> 00:14:13.240 the ear works, the brain is how we hear. So whenever 00:14:13.240 --> 00:14:16.419 you have even mild hearing loss, if you're in 00:14:16.419 --> 00:14:19.059 a noisy background, certain words cannot be heard. 00:14:19.659 --> 00:14:22.940 And the brain gets a message that has bits missing. 00:14:23.039 --> 00:14:25.500 So I always say to patients, look, imagine you 00:14:25.500 --> 00:14:29.340 see a sentence written down and some of the letters 00:14:29.340 --> 00:14:32.159 are removed. They're erased from the sentence. 00:14:32.259 --> 00:14:34.850 And you're trying to read that sentence. And 00:14:34.850 --> 00:14:36.450 it will take a little bit more concentration, 00:14:36.690 --> 00:14:38.309 right? You're going to have to really focus on 00:14:38.309 --> 00:14:40.409 that sentence. And you'll get it, but it takes 00:14:40.409 --> 00:14:43.549 more brain power. So this is what happens when 00:14:43.549 --> 00:14:45.370 we have hearing loss. The signal that gets to 00:14:45.370 --> 00:14:47.590 the brain doesn't have all of the information 00:14:47.590 --> 00:14:50.370 there. And the brain is filling in the gaps, 00:14:50.450 --> 00:14:53.470 if you like. Now, for a person, especially someone 00:14:53.470 --> 00:14:55.429 who's working in a job where they're having to 00:14:55.429 --> 00:14:57.610 converse a lot, they're in noisy background all 00:14:57.610 --> 00:15:00.970 day. This is absolutely exhausting. So even someone 00:15:00.970 --> 00:15:04.090 with a mild hearing loss in a job like that, 00:15:04.559 --> 00:15:06.860 By the end of the day, they're wiped out. They've 00:15:06.860 --> 00:15:09.139 got nothing left in the tank for their family. 00:15:09.860 --> 00:15:14.100 And it's exhausting. It is. Now, if we move on 00:15:14.100 --> 00:15:16.419 a step further from that, so the brain only has 00:15:16.419 --> 00:15:19.620 a finite amount of resources. So every time you're 00:15:19.620 --> 00:15:21.360 doing that, you're actually taking resources 00:15:21.360 --> 00:15:24.000 from your memory and thinking part of your brain 00:15:24.000 --> 00:15:27.419 and using it for listening. And if we keep doing 00:15:27.419 --> 00:15:30.240 that over years and years, then there is actually 00:15:30.240 --> 00:15:33.740 a change in the structure of the brain. And this 00:15:33.740 --> 00:15:36.940 is one of the reasons why we think that hearing 00:15:36.940 --> 00:15:40.860 loss is a risk factor for dementia. Wow. I was 00:15:40.860 --> 00:15:42.299 waiting for you to make that jump because I was 00:15:42.299 --> 00:15:44.080 like, is that what you're saying? That basically 00:15:44.080 --> 00:15:47.720 you're reprogramming your brain to be dealing 00:15:47.720 --> 00:15:50.080 with this kind of stimulus that wouldn't exist 00:15:50.080 --> 00:15:52.820 without the hearing loss and diverting resources 00:15:52.820 --> 00:15:56.659 away. to that interpretation. Exactly. So hearing 00:15:56.659 --> 00:15:59.679 loss does not cause dementia. I'd just like to 00:15:59.679 --> 00:16:02.720 make that point because I think since this research 00:16:02.720 --> 00:16:04.860 came out, there's been a lot of fear mongering 00:16:04.860 --> 00:16:06.659 over here. You've got hearing loss, you're going 00:16:06.659 --> 00:16:09.440 to get dementia. That's not true. Okay. So dementia 00:16:09.440 --> 00:16:13.139 is a very complex disease. Many of the risk factors 00:16:13.139 --> 00:16:15.019 for dementia, we can't do anything about, for 00:16:15.019 --> 00:16:19.080 example, our genetics. But of the risk factors 00:16:19.080 --> 00:16:23.669 that we can do something about, There was a publication 00:16:23.669 --> 00:16:26.769 by The Lancet, which is updated every few years. 00:16:26.889 --> 00:16:31.470 And this currently details 14 risk factors for 00:16:31.470 --> 00:16:34.309 dementia and hearing loss, 14 modifiable risk 00:16:34.309 --> 00:16:36.570 factors for dementia and hearing losses is one 00:16:36.570 --> 00:16:39.549 of those. Wow. OK. And the great thing is, is 00:16:39.549 --> 00:16:45.759 that it's so treatable. OK, so. As I said, I'm 00:16:45.759 --> 00:16:47.120 not saying you've got hearing loss, you're going 00:16:47.120 --> 00:16:49.399 to get dementia. But what I'm saying is it has 00:16:49.399 --> 00:16:51.840 a significant impact on the brain and on the 00:16:51.840 --> 00:16:54.580 brain's resources every day. So other sequelae 00:16:54.580 --> 00:16:57.039 of hearing loss in midlife, for people who've 00:16:57.039 --> 00:16:58.960 got more severe hearing loss, they may lose their 00:16:58.960 --> 00:17:01.940 job. So I've got patients who have lost their 00:17:01.940 --> 00:17:05.279 job because they couldn't hear. And then if we 00:17:05.279 --> 00:17:07.640 look further on in life, there's, again, a lot 00:17:07.640 --> 00:17:10.039 of information these days showing that in older 00:17:10.039 --> 00:17:12.400 age, people with hearing loss, they get more 00:17:12.400 --> 00:17:16.799 hospitalizations. They have more falls. They 00:17:16.799 --> 00:17:20.980 do worse in a lot of domains. I was just saying, 00:17:21.019 --> 00:17:23.039 if we're talking about women in business already 00:17:23.039 --> 00:17:26.319 battling ageism on several fronts, already battling 00:17:26.319 --> 00:17:28.940 the effects of menopause on several fronts, and 00:17:28.940 --> 00:17:31.740 then being let go due to hearing loss, this really 00:17:31.740 --> 00:17:34.130 compounds for women, I feel. You know, this I 00:17:34.130 --> 00:17:37.289 feel is a trifecta of factors that if you add 00:17:37.289 --> 00:17:38.950 in the hearing loss, like I said, with the menopause 00:17:38.950 --> 00:17:40.730 and just the ageism in general for women in their 00:17:40.730 --> 00:17:43.789 40s, I think that that's a really powerful thing 00:17:43.789 --> 00:17:45.710 working against us if we don't take the steps 00:17:45.710 --> 00:17:49.109 to control. Yes, absolutely. And I think, you 00:17:49.109 --> 00:17:54.750 know, in this midlife time, so the auditory pathway 00:17:54.750 --> 00:17:57.089 from the ear all the way up to the brain has 00:17:57.089 --> 00:18:01.000 estrogen and progesterone receptors in it. So 00:18:01.000 --> 00:18:03.779 it is thought that the oestrogen is protective 00:18:03.779 --> 00:18:07.440 for the ear. It has a role in neurotransmission 00:18:07.440 --> 00:18:10.259 in the ear and in the blood supply to the ear. 00:18:10.460 --> 00:18:13.700 So what we have seen in population studies, so 00:18:13.700 --> 00:18:16.240 in studies of huge numbers of people, is that 00:18:16.240 --> 00:18:19.980 post -menopause there is a drop generally in 00:18:19.980 --> 00:18:23.680 women's hearing because that protective role 00:18:23.680 --> 00:18:27.220 of oestrogen is not there anymore. Having said 00:18:27.220 --> 00:18:30.660 that, There are lots of things that happen to 00:18:30.660 --> 00:18:35.099 the ear in midlife that are more complex than 00:18:35.099 --> 00:18:38.839 just the hormones, right? So in midlife, women 00:18:38.839 --> 00:18:42.019 may start to notice more tinnitus. They may start 00:18:42.019 --> 00:18:45.059 to notice more hyperacusis. Now, hyperacusis 00:18:45.059 --> 00:18:48.079 is where you're very sensitive to sounds. So 00:18:48.079 --> 00:18:50.359 you may notice that sounds seem particularly 00:18:50.359 --> 00:18:55.710 harsh or intrusive. And this is thought to be 00:18:55.710 --> 00:18:59.049 due to hormonal fluctuations at that time of 00:18:59.049 --> 00:19:01.470 life. But it can also be very much affected by 00:19:01.470 --> 00:19:05.569 sleep, by stress, by diet, by hydration and so 00:19:05.569 --> 00:19:10.730 on. So it's more complex than just the hormones. 00:19:10.970 --> 00:19:12.869 Could it be affected by three young children 00:19:12.869 --> 00:19:14.710 screaming in your ear? I was just thinking that. 00:19:15.170 --> 00:19:20.109 Just wondering. And it's fascinating, isn't it? 00:19:20.130 --> 00:19:23.259 Because it's like. you go through perimenopause 00:19:23.259 --> 00:19:26.500 and menopause and oestrogen just seems to be 00:19:26.500 --> 00:19:29.000 this magic thing that seems to help us. Protects 00:19:29.000 --> 00:19:30.880 your bones, protects your muscles, protects your 00:19:30.880 --> 00:19:33.480 ears. We now know. Yeah. So, you know, it's like 00:19:33.480 --> 00:19:36.319 we go through a lot of shit having to go through 00:19:36.319 --> 00:19:38.980 this. One of the things you mentioned, you said, 00:19:39.019 --> 00:19:40.900 you know, when your hearing goes, you're more 00:19:40.900 --> 00:19:43.420 prone to falls. Can you explain that to us? Like 00:19:43.420 --> 00:19:47.769 how, how is falling linked to your ears? So I 00:19:47.769 --> 00:19:51.009 think just off the record, so this falls, I know 00:19:51.009 --> 00:19:53.069 you put in a comment about the fall. So I think 00:19:53.069 --> 00:19:55.170 fall, generally people in midlife are not going 00:19:55.170 --> 00:19:58.369 to have falls because of hearing. So it's more 00:19:58.369 --> 00:20:01.930 for sort of older, like elderly people. Hearing 00:20:01.930 --> 00:20:05.069 loss helps us to understand our environment around 00:20:05.069 --> 00:20:09.130 us. So I think two reasons. First of all, that 00:20:09.130 --> 00:20:12.869 when we can't hear, we can't really. Judge what's 00:20:12.869 --> 00:20:14.990 going on around. And also because the hearing 00:20:14.990 --> 00:20:17.410 loss may also have an effect on the inner ear 00:20:17.410 --> 00:20:20.730 balance organs as well. Yeah. Depending on the 00:20:20.730 --> 00:20:22.990 reason that you've got the hearing loss. So the 00:20:22.990 --> 00:20:26.670 inner ear is a complex organ. It's got the cochlea 00:20:26.670 --> 00:20:28.650 that we mentioned earlier on, and it's also got 00:20:28.650 --> 00:20:31.549 the balance organs. So there are three semicircular 00:20:31.549 --> 00:20:34.150 canals and then there are two other balance organs. 00:20:34.190 --> 00:20:37.390 And these together work a bit like spirit levels. 00:20:37.750 --> 00:20:40.880 So at any one time, they'll tell the brain. Where 00:20:40.880 --> 00:20:45.420 is the head in space and how is it moving? And 00:20:45.420 --> 00:20:50.019 that part can also be affected by hormonal changes. 00:20:50.200 --> 00:20:53.000 It can also be affected by processes that affect 00:20:53.000 --> 00:20:55.380 the hearing. It's interesting, isn't it? You 00:20:55.380 --> 00:20:57.559 wouldn't think that your ears help with balance. 00:20:58.079 --> 00:21:01.440 I know that I had a friend, this was when I was 00:21:01.440 --> 00:21:04.299 little, like seven. I had a friend whose dad, 00:21:04.539 --> 00:21:07.980 while he was babysitting us, got a terrible ear 00:21:07.980 --> 00:21:10.779 infection or it was developing terribly. And 00:21:10.779 --> 00:21:13.579 I remember he fell to his knees and he said to 00:21:13.579 --> 00:21:15.759 us, he said, girls, you need to call the ambulance. 00:21:15.859 --> 00:21:18.579 You need to call the 911. And we were like, why, 00:21:18.759 --> 00:21:20.920 why? Again, we're seven, you know? And he's like, 00:21:21.000 --> 00:21:23.880 I can't stand up. I can't open my eye because 00:21:23.880 --> 00:21:26.480 the dizziness and the balance. And he was like, 00:21:26.539 --> 00:21:27.920 you need to call the ambulance. And I remember 00:21:27.920 --> 00:21:29.400 thinking, and then turned out it was just an 00:21:29.400 --> 00:21:31.980 ear infection, just, but it was obviously a bad 00:21:31.980 --> 00:21:34.099 one. But that was the first understanding that 00:21:34.099 --> 00:21:36.299 I had that like your ear could make you fall 00:21:36.299 --> 00:21:39.480 down. You know, or make you come, you know, disoriented. 00:21:39.640 --> 00:21:42.759 Yeah. So it sounds like he had vertigo. Probably. 00:21:42.819 --> 00:21:45.000 Yeah. I mean, and they were young parents, by 00:21:45.000 --> 00:21:46.420 the way, just like, you know, shout now. So he 00:21:46.420 --> 00:21:49.059 was like 26. Wow. Now thinking back to this time. 00:21:49.099 --> 00:21:50.680 That's really young. Yeah. So he was like a young 00:21:50.680 --> 00:21:55.819 dude. So anyway. Fun fact. Can we talk about 00:21:55.819 --> 00:21:57.519 vertigo? Because I feel like that seems to be 00:21:57.519 --> 00:21:59.279 something that tends to happen to women in their 00:21:59.279 --> 00:22:03.799 40s. What is it? What causes it? Like, and how? 00:22:04.200 --> 00:22:06.380 You know, how do we know what's going on and 00:22:06.380 --> 00:22:09.019 what do we do if that happens? Yeah, so vertigo 00:22:09.019 --> 00:22:12.339 is not a disease. Vertigo is a symptom and it 00:22:12.339 --> 00:22:15.319 can happen for many different reasons. So vertigo 00:22:15.319 --> 00:22:19.119 is used to describe a sensation of moving. So 00:22:19.119 --> 00:22:21.680 it may be that you feel that the room is moving 00:22:21.680 --> 00:22:24.700 around you. It may be that you feel that you 00:22:24.700 --> 00:22:28.309 are moving in the room. It may be that you feel 00:22:28.309 --> 00:22:32.250 that you've been on a boat. Okay. The most common 00:22:32.250 --> 00:22:35.569 condition that affects women in midlife is something 00:22:35.569 --> 00:22:40.490 called BPPV. So benign paroxysmal positional 00:22:40.490 --> 00:22:43.750 vertigo. And this is really, really common. So 00:22:43.750 --> 00:22:46.190 it can occur in younger and in older people, 00:22:46.230 --> 00:22:49.049 but midlife and the older we get, it tends to 00:22:49.049 --> 00:22:52.789 be more common. What usually happens with this 00:22:52.789 --> 00:22:55.589 is that when you put your head in a certain position, 00:22:56.039 --> 00:23:00.500 So most commonly it affects the posterior semicircular 00:23:00.500 --> 00:23:03.319 canal. So this affects people when they lie back 00:23:03.319 --> 00:23:05.579 in bed. So they get into bed and they lie back 00:23:05.579 --> 00:23:07.140 and put their head back on the pillow and they 00:23:07.140 --> 00:23:10.019 start to spin. And it lasts for a few seconds, 00:23:10.079 --> 00:23:12.480 then it goes away. Or they may notice that when 00:23:12.480 --> 00:23:13.980 they're lying in bed at night, when they turn 00:23:13.980 --> 00:23:16.279 to one side or the other, that they get this 00:23:16.279 --> 00:23:19.319 condition. And people don't know what this is. 00:23:19.400 --> 00:23:22.160 There's not a lot of information out there on 00:23:22.160 --> 00:23:25.210 it. So people panic. They don't know what it 00:23:25.210 --> 00:23:27.329 is. Right. And then they start to get really 00:23:27.329 --> 00:23:29.750 frightened of this vertigo feeling as well, which 00:23:29.750 --> 00:23:32.430 adds a whole nother layer of anxiety and so on. 00:23:32.569 --> 00:23:34.710 Do you know what I'm giving everyone this Christmas? 00:23:35.450 --> 00:23:38.509 Let me guess. Something cozy earth. 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And they 00:24:47.859 --> 00:24:53.400 can be carried out by some GPs, by ENTs, by some 00:24:53.400 --> 00:24:56.559 physiotherapists as well. So this is not something 00:24:56.559 --> 00:24:58.140 that you have to put up with. It's something 00:24:58.140 --> 00:25:02.200 that is really easily treated. BPPV as well, 00:25:02.200 --> 00:25:06.220 in some women, it's recurrent, right? So it goes 00:25:06.220 --> 00:25:08.039 away, they get it treated, and then they get 00:25:08.039 --> 00:25:12.539 it again. The current data suggests that anything 00:25:12.539 --> 00:25:15.799 that affects your calcium metabolism or the blood 00:25:15.799 --> 00:25:19.039 flow to your ear can contribute to that. So I 00:25:19.039 --> 00:25:20.619 always say to people who have this that they 00:25:20.619 --> 00:25:23.640 should check their vitamin D level. And generally 00:25:23.640 --> 00:25:26.500 observing good health in terms of looking after 00:25:26.500 --> 00:25:29.420 your blood pressure, looking after diabetes and 00:25:29.420 --> 00:25:32.500 your cardiovascular health is beneficial for 00:25:32.500 --> 00:25:34.640 this as well. Is there a hormone correlation 00:25:34.640 --> 00:25:37.059 as well? Because the only time in my life I ever 00:25:37.059 --> 00:25:40.299 had vertigo. vertigo was third trimester pregnancy, 00:25:40.500 --> 00:25:42.500 but I had it with two of my three pregnancies. 00:25:42.539 --> 00:25:47.059 Is that related? Yes. So there are hormone receptors 00:25:47.059 --> 00:25:50.619 in the inner ear and in all of the balance pathways 00:25:50.619 --> 00:25:53.680 going up to the brain. So certainly hormonal 00:25:53.680 --> 00:25:55.720 fluctuations like there would be in pregnancy 00:25:55.720 --> 00:25:58.950 can could affect that. Yes. Wow. I did not realize 00:25:58.950 --> 00:26:02.190 there were hormone receptors in the ear. Of all 00:26:02.190 --> 00:26:05.190 the places. Yeah, exactly. Wow. Okay. So we have 00:26:05.190 --> 00:26:07.130 talked a lot about treatments and, you know, 00:26:07.150 --> 00:26:09.769 what can be done if we get to a certain situation. 00:26:10.009 --> 00:26:12.109 What about on the preventative side? How do we 00:26:12.109 --> 00:26:16.049 manage good hearing and healthy ears? Yeah, several 00:26:16.049 --> 00:26:19.109 ways. So a lot of things, genetics, obviously 00:26:19.109 --> 00:26:21.130 we can't do anything about, right? So a big part 00:26:21.130 --> 00:26:23.630 of the age at which we develop age -related hearing 00:26:23.630 --> 00:26:27.259 loss is genetics. We can. You were talking about 00:26:27.259 --> 00:26:30.140 your dad earlier and I was thinking. Decades. 00:26:30.599 --> 00:26:35.339 Noise. OK, so our world is getting noisier. Living 00:26:35.339 --> 00:26:37.920 in a city like Singapore, it's vibrant. There's 00:26:37.920 --> 00:26:40.839 so much going on. It's noisy. So there's construction. 00:26:41.220 --> 00:26:43.880 There's traffic. You go to the shopping mall 00:26:43.880 --> 00:26:46.559 and there is music blaring. You go and watch 00:26:46.559 --> 00:26:50.200 a movie and the seats are shaking with the. I've 00:26:50.200 --> 00:26:54.000 done that. The noise intensity, right? There's 00:26:54.000 --> 00:26:56.420 noise everywhere. And this is really bad for 00:26:56.420 --> 00:26:58.920 our ears. Looking after your ears, protecting 00:26:58.920 --> 00:27:01.779 them from noise. That's one of the most important 00:27:01.779 --> 00:27:04.819 things. So generally, I would recommend that 00:27:04.819 --> 00:27:07.500 people carry earplugs with them. So just the 00:27:07.500 --> 00:27:11.579 simple foam earplugs that have a high noise reduction 00:27:11.579 --> 00:27:13.819 rating on them. So the highest you can get is 00:27:13.819 --> 00:27:18.599 33 NRR, it's called. And you can use those in 00:27:18.599 --> 00:27:20.759 very noisy environments. If you're going to... 00:27:21.069 --> 00:27:24.170 the F1 coming up soon. If you go to a concert, 00:27:24.410 --> 00:27:26.950 if you're going to a very noisy venue, if you're 00:27:26.950 --> 00:27:28.630 going to be by the speakers, you certainly should 00:27:28.630 --> 00:27:32.109 do something like that. On a more day to day 00:27:32.109 --> 00:27:35.349 basis, looking after your ears when you're listening. 00:27:35.509 --> 00:27:38.130 So I see, you know, a lot of people these days 00:27:38.130 --> 00:27:41.650 are wearing headphones, earbuds, whatever. Now, 00:27:41.670 --> 00:27:43.910 a lot of patients ask me, you know, is it dangerous 00:27:43.910 --> 00:27:47.519 to wear them? And the answer is. Actually, it's 00:27:47.519 --> 00:27:49.839 not dangerous to wear them, but the noise that 00:27:49.839 --> 00:27:51.559 you're putting through them may be dangerous. 00:27:51.819 --> 00:27:55.799 So the noise dose that our ears can take, it's 00:27:55.799 --> 00:27:57.819 a bit like the amount of salt that you can eat 00:27:57.819 --> 00:28:00.740 in a day, right? So if you've had a very salty 00:28:00.740 --> 00:28:03.269 snack or whatever. you're going to be trying 00:28:03.269 --> 00:28:05.410 to cut out salt as much as you can for the rest 00:28:05.410 --> 00:28:07.130 of the day. And the same thing goes for noise. 00:28:07.390 --> 00:28:10.430 So your ears can tolerate a certain dose, if 00:28:10.430 --> 00:28:13.210 you like, of noise in a day. One way that people 00:28:13.210 --> 00:28:15.430 really damage their ears these days is trying 00:28:15.430 --> 00:28:18.410 to listen to music or podcasts through earphones 00:28:18.410 --> 00:28:21.589 or earbuds. And then they go out of the house 00:28:21.589 --> 00:28:25.700 and get onto, for example, the MRT. And then 00:28:25.700 --> 00:28:29.019 they turn the volume up to hear that thing over 00:28:29.019 --> 00:28:32.660 the background noise. Yes. Now, one really good 00:28:32.660 --> 00:28:35.480 way of helping your ears is to invest in, for 00:28:35.480 --> 00:28:39.579 example, noise cancelling ear devices. I do have 00:28:39.579 --> 00:28:42.839 those, yeah. So this means that you can comfortably 00:28:42.839 --> 00:28:45.720 listen to what you want to listen to and you're 00:28:45.720 --> 00:28:47.720 not having to turn it up to a damaging level 00:28:47.720 --> 00:28:53.380 to... hear over the background noise. So generally 00:28:53.380 --> 00:28:56.720 for noise, people will talk about the amount 00:28:56.720 --> 00:29:00.720 of decibels that you can have in a day. So the 00:29:00.720 --> 00:29:04.180 safe limit is considered 85 decibels for eight 00:29:04.180 --> 00:29:06.920 hours a day. Now, people can't relate to that. 00:29:07.019 --> 00:29:10.579 That means nothing to me. So when you're going 00:29:10.579 --> 00:29:17.250 about your day -to -day life, generally... If 00:29:17.250 --> 00:29:19.569 you are listening to something such that the 00:29:19.569 --> 00:29:21.769 person talking to you has to raise their voice 00:29:21.769 --> 00:29:25.410 for you to hear, then you're listening too loud. 00:29:25.549 --> 00:29:27.849 And certainly if you are listening to something 00:29:27.849 --> 00:29:30.190 that hurts your ears, you're listening too loud. 00:29:30.569 --> 00:29:34.170 Another thing to consider is what we call a temporary 00:29:34.170 --> 00:29:37.849 threshold shift. So I'm sure all of us have experienced 00:29:37.849 --> 00:29:40.250 this at some time. This is when you've been to 00:29:40.250 --> 00:29:44.500 a noisy place and... On the way home next morning, 00:29:44.619 --> 00:29:47.900 you feel that slight blockage in your ears. You 00:29:47.900 --> 00:29:51.319 feel you can hear a slight humming tinnitus in 00:29:51.319 --> 00:29:53.680 your ears. You've actually damaged your ears 00:29:53.680 --> 00:29:58.500 doing that. Every time I leave a concert, that's 00:29:58.500 --> 00:30:00.480 exactly how I feel. It's the weird hangover ear. 00:30:00.579 --> 00:30:02.380 I don't know how to explain it. Yes, absolutely. 00:30:02.619 --> 00:30:05.700 So at that time, your hearing is actually slightly 00:30:05.700 --> 00:30:09.710 worse. It recovers. But there is a lot of evidence 00:30:09.710 --> 00:30:11.750 now that there is some permanent damage to the 00:30:11.750 --> 00:30:13.490 ear every time you do that. In one incident. 00:30:13.589 --> 00:30:15.710 So a little bit in every incident. A little bit. 00:30:15.849 --> 00:30:18.269 Wow. So if that happens to you, you should take 00:30:18.269 --> 00:30:20.309 note from that. Look, this is a warning sign 00:30:20.309 --> 00:30:23.250 of what can happen to your ears. Just stop going 00:30:23.250 --> 00:30:27.430 to concerts. That's my over 40 solution. So here 00:30:27.430 --> 00:30:30.109 at the 40s Formula, we do like to think that 00:30:30.109 --> 00:30:34.039 food is fuel. We have a question for you from 00:30:34.039 --> 00:30:36.259 our sponsors today, and that is The Meat Club. 00:30:36.319 --> 00:30:38.700 They provide sustainably sourced protein and 00:30:38.700 --> 00:30:41.099 produce straight to your door, and you can use 00:30:41.099 --> 00:30:44.940 code TFF20 for $20 off your first order. And 00:30:44.940 --> 00:30:47.440 the question they'd like to ask you is, it's 00:30:47.440 --> 00:30:49.680 not often that we think about our diet and our 00:30:49.680 --> 00:30:53.880 lifestyle impacting our hearing and our ears. 00:30:54.160 --> 00:30:57.400 So, Rebecca, what is one meal or one food that 00:30:57.400 --> 00:30:59.640 you like to include into your lifestyle daily 00:30:59.640 --> 00:31:03.839 to help you feel grounded? So I think my favourite 00:31:03.839 --> 00:31:09.119 things are I have a big glass of water with chia 00:31:09.119 --> 00:31:12.160 seeds and lemon juice every morning, which I 00:31:12.160 --> 00:31:17.460 find very cleansing and hydrating. I always have 00:31:17.460 --> 00:31:20.220 my cup of tea in the morning. I'm not a big caffeine 00:31:20.220 --> 00:31:22.400 drinker otherwise, but my cup of tea in the morning 00:31:22.400 --> 00:31:27.099 is essential for me. And apart from that, I think. 00:31:27.640 --> 00:31:31.259 I try to eat a very balanced diet with a lot 00:31:31.259 --> 00:31:34.440 of clean protein in it. So certainly in terms 00:31:34.440 --> 00:31:37.420 of hearing, things like the Mediterranean diet 00:31:37.420 --> 00:31:41.299 are supposed to help because, again, of cardiovascular 00:31:41.299 --> 00:31:45.579 risk factors. So really just eating fresh, clean 00:31:45.579 --> 00:31:48.519 food that's prepared at home as often as I can. 00:31:48.740 --> 00:31:52.650 Which is the best way to be. So if a listener 00:31:52.650 --> 00:31:55.069 really wants to start taking action about protecting 00:31:55.069 --> 00:31:57.849 their ears, what do you recommend are some strategies 00:31:57.849 --> 00:32:00.269 or some things that they should be looking out 00:32:00.269 --> 00:32:02.910 for? First of all, I'd say test your hearing. 00:32:03.029 --> 00:32:06.089 So patients come in to me all the time with very 00:32:06.089 --> 00:32:09.589 elaborate screening tests these days. So once 00:32:09.589 --> 00:32:13.130 they hit their 40s, definitely their 50s, they'll 00:32:13.130 --> 00:32:17.529 be having colonoscopy, OGD, looking at the upper 00:32:17.529 --> 00:32:20.440 gastrointestinal tract. cervical smear, breast 00:32:20.440 --> 00:32:22.819 screening. They have big booklets of blood tests, 00:32:22.920 --> 00:32:25.359 but no one ever comes in with a hearing test 00:32:25.359 --> 00:32:27.980 that was part of their screening. And hearing 00:32:27.980 --> 00:32:30.759 tests are so widely available. You can go to 00:32:30.759 --> 00:32:33.859 audiology clinics all over Singapore and get 00:32:33.859 --> 00:32:35.940 a hearing test done. You can go to an ENT and 00:32:35.940 --> 00:32:38.920 get a hearing test done. Many primary care clinics 00:32:38.920 --> 00:32:42.859 will also have hearing tests available now. You 00:32:42.859 --> 00:32:45.779 can even do them at home. So there are some online 00:32:45.779 --> 00:32:50.099 tests that you can do. Apple AirPods have an 00:32:50.099 --> 00:32:52.519 inbuilt hearing test on them now. No way! Okay, 00:32:52.599 --> 00:32:54.099 we're doing this. We're doing this after the 00:32:54.099 --> 00:32:57.339 show. Wow! That is impressive. Because we both 00:32:57.339 --> 00:32:59.579 wear Apple AirPods. No, I wear Beats. Sorry. 00:32:59.700 --> 00:33:02.319 Oh, excuse me. You're a Beats person. I'm a Beats 00:33:02.319 --> 00:33:04.900 person. Do you have an Android phone as well? 00:33:05.079 --> 00:33:08.579 No, I have Apple Fire. Either way, we're going 00:33:08.579 --> 00:33:10.759 to do it. Yeah, so the only thing I would say 00:33:10.759 --> 00:33:14.579 about them is that they do an average of the 00:33:14.579 --> 00:33:17.410 low frequency hearing. to say whether your hearing 00:33:17.410 --> 00:33:20.690 is normal. And actually age -related hearing 00:33:20.690 --> 00:33:22.549 loss affects the high frequencies first. So you 00:33:22.549 --> 00:33:25.890 can get a normal low frequency test result and 00:33:25.890 --> 00:33:27.529 you still have a bit of hearing loss, but they 00:33:27.529 --> 00:33:30.329 do give you a proper hearing test result. So 00:33:30.329 --> 00:33:33.750 certainly you can use that and then show it to 00:33:33.750 --> 00:33:35.829 a health professional. What's the cost on these 00:33:35.829 --> 00:33:38.309 tests? Not the Apple ones, you know, but I mean 00:33:38.309 --> 00:33:39.769 the ones when you go to the ENT, you go to the 00:33:39.769 --> 00:33:41.809 primary care. Are these within reach for most 00:33:41.809 --> 00:33:44.369 people? The cost. So some places will do them 00:33:44.369 --> 00:33:48.640 for free. In Singapore? If they want to sell 00:33:48.640 --> 00:33:50.740 you a hearing aid, don't put that in the show. 00:33:51.759 --> 00:33:55.000 We're not sponsored by any hearing aids. So hearing 00:33:55.000 --> 00:34:00.019 tests, you may be able to get them. What can 00:34:00.019 --> 00:34:02.180 I put for an answer to that question? Yeah, sorry 00:34:02.180 --> 00:34:04.079 to put you on the spot. I just figured just so 00:34:04.079 --> 00:34:06.619 people understand, it's not a... what I want 00:34:06.619 --> 00:34:08.719 to say, bank breaking level of confidence. Yes. 00:34:08.719 --> 00:34:11.719 Hearing tests are widely available and very affordable. 00:34:12.000 --> 00:34:14.800 Okay. So obviously we're in our forties and if 00:34:14.800 --> 00:34:16.739 our hearing is going, we don't really want to 00:34:16.739 --> 00:34:19.260 be wearing, you know, like hearing aids, which 00:34:19.260 --> 00:34:22.679 wire thing, you know, like you would expect your 00:34:22.679 --> 00:34:25.519 grandparents to be wearing. Are there like discrete 00:34:25.519 --> 00:34:27.920 things that you can get, which, you know, won't 00:34:27.920 --> 00:34:30.519 make you feel old, but will help you hear better? 00:34:30.760 --> 00:34:33.519 First of all, it's important to get your hearing 00:34:33.519 --> 00:34:36.849 tested. and assessed by a professional. So it 00:34:36.849 --> 00:34:39.090 depends why you have hearing loss. Now, some 00:34:39.090 --> 00:34:40.889 types of hearing loss are actually reversible. 00:34:41.309 --> 00:34:44.190 If we go back to how the ear works, so getting 00:34:44.190 --> 00:34:46.929 from the outer part of the ear, the pinna, all 00:34:46.929 --> 00:34:50.829 the way into the inner ear, the outer ear canal 00:34:50.829 --> 00:34:52.690 and the middle ear may have causes of hearing 00:34:52.690 --> 00:34:55.670 loss that we can do something about. So it may 00:34:55.670 --> 00:34:59.469 be wax, right? Sometimes people push wax into 00:34:59.469 --> 00:35:01.510 their ear so diligently every day with their 00:35:01.510 --> 00:35:03.960 cotton bud that it gets... Completely impacted 00:35:03.960 --> 00:35:08.019 on the eardrum over a long period, right? They 00:35:08.019 --> 00:35:10.219 may have something wrong with the little bones 00:35:10.219 --> 00:35:13.039 in the middle ear that can be fixed surgically. 00:35:13.800 --> 00:35:16.320 There's a condition called otosclerosis, which 00:35:16.320 --> 00:35:20.360 is one of the conditions that I operate on ears 00:35:20.360 --> 00:35:22.699 for. This is where the innermost of the hearing 00:35:22.699 --> 00:35:25.059 bones, it's called the stapes bone, that should 00:35:25.059 --> 00:35:26.699 move in and out of the inner ear is actually 00:35:26.699 --> 00:35:31.130 stuck. And so we can do a surgery to enable a 00:35:31.130 --> 00:35:33.690 piston to go in and out of the inner ear. And 00:35:33.690 --> 00:35:36.309 therefore you don't have to wear a device on 00:35:36.309 --> 00:35:39.150 the outside, right? So it depends on why you've 00:35:39.150 --> 00:35:41.650 got the hearing loss. Now for inner ear hearing 00:35:41.650 --> 00:35:46.150 loss, we're looking more at devices. So hearing 00:35:46.150 --> 00:35:49.849 aids and what you just said is exactly what. 00:35:50.170 --> 00:35:52.250 People say they all come in and they're like, 00:35:52.289 --> 00:35:54.269 I don't want to wear one of those big, ugly hearing 00:35:54.269 --> 00:35:56.989 aids. So people think of the banana behind the 00:35:56.989 --> 00:36:01.809 ear, big, orange, ugly device. Hearing aids are 00:36:01.809 --> 00:36:05.730 not like that anymore. Oh, good to hear. I'm 00:36:05.730 --> 00:36:07.630 definitely thinking orthopedic shoes of the ear, 00:36:07.730 --> 00:36:10.070 you know, just big and ugly. And this is why 00:36:10.070 --> 00:36:11.590 people don't want to wear them, right? Especially 00:36:11.590 --> 00:36:14.369 midlife. They say. I'm too young to wear that. 00:36:14.469 --> 00:36:17.409 So they're discreet. They look much better. You 00:36:17.409 --> 00:36:20.429 can get ones that fit behind the ear. And if 00:36:20.429 --> 00:36:23.210 you're looking from sideways on, you can't see 00:36:23.210 --> 00:36:25.369 the bit behind the ear. They're about this big. 00:36:25.489 --> 00:36:29.349 And they can come with very small, thin, clear 00:36:29.349 --> 00:36:32.269 plastic tubing that goes into the ear. So for 00:36:32.269 --> 00:36:34.829 one, they don't block the ear. And also, they're 00:36:34.829 --> 00:36:37.960 really discreet. You can barely see them. There 00:36:37.960 --> 00:36:40.679 are other types of hearing aid which fit into 00:36:40.679 --> 00:36:42.780 the ear canal, but these are really only for 00:36:42.780 --> 00:36:45.239 milder hearing losses. And the problem with these 00:36:45.239 --> 00:36:47.219 is that they can block the canal and make it 00:36:47.219 --> 00:36:49.800 feel blocked, like you can't hear certain sounds 00:36:49.800 --> 00:36:53.500 clearly. And they can predispose to ear infections 00:36:53.500 --> 00:36:58.239 in some people. Now, for people who have much 00:36:58.239 --> 00:37:02.420 worse hearing loss, So they may have an all singing, 00:37:02.480 --> 00:37:04.940 all dancing hearing aid, but they just still 00:37:04.940 --> 00:37:07.719 can't understand what people are saying. Then 00:37:07.719 --> 00:37:11.500 we have cochlear implants. So these are surgically 00:37:11.500 --> 00:37:15.699 implanted devices that enable you to hear again 00:37:15.699 --> 00:37:18.460 by doing the job of the inner ear. So they will 00:37:18.460 --> 00:37:20.300 convert the sound energy into the electrical 00:37:20.300 --> 00:37:22.880 signal and then they send it to the brain, bypassing 00:37:22.880 --> 00:37:24.820 the cochlea. So this is like the hip replacement 00:37:24.820 --> 00:37:28.300 of ear. Yes. Like it's a full new joint. Yeah, 00:37:28.360 --> 00:37:30.539 exactly. It's a new ear for all intents and purposes. 00:37:30.900 --> 00:37:32.820 Just thinking about my, I can't help but think 00:37:32.820 --> 00:37:34.300 about my dad when we're talking about all this 00:37:34.300 --> 00:37:36.739 stuff. He has one of these like invisible, invisible 00:37:36.739 --> 00:37:38.579 ones where he's always like, can you see it? 00:37:38.599 --> 00:37:40.679 No doubt. Like literally no one can see it. I 00:37:40.679 --> 00:37:42.739 was wearing it the other day. He's always wearing 00:37:42.739 --> 00:37:45.340 it. I did not. Yeah. You honestly can't see it. 00:37:45.500 --> 00:37:48.079 But thinking about the cochlear implant, is that 00:37:48.079 --> 00:37:49.980 something that you would have to get replaced 00:37:49.980 --> 00:37:52.619 down the line, tuned up, et cetera? Or is this 00:37:52.619 --> 00:37:55.880 a one and done situation? Ideally not. So this 00:37:55.880 --> 00:37:59.860 is a device which has two components. There is 00:37:59.860 --> 00:38:03.579 an internal implantable component. And we hope 00:38:03.579 --> 00:38:05.719 that once that is implanted, it will be there 00:38:05.719 --> 00:38:09.500 for your lifetime. Wow. There are reasons to 00:38:09.500 --> 00:38:12.699 replace them. Sometimes, very rarely, they break 00:38:12.699 --> 00:38:15.000 down. There's a fault. Something happens to it 00:38:15.000 --> 00:38:18.659 and it is an electronic device. But generally, 00:38:18.800 --> 00:38:21.969 generally not. This time of year gets so chaotic. 00:38:22.110 --> 00:38:24.690 School holidays, parties, work deadlines. It's 00:38:24.690 --> 00:38:26.570 mostly me running around trying to remember where 00:38:26.570 --> 00:38:29.289 I hid the kids' presents. Same. So I've decided 00:38:29.289 --> 00:38:31.909 that December is officially my self -care season. 00:38:32.230 --> 00:38:33.909 And Love Indus is honestly perfect for that. 00:38:34.010 --> 00:38:35.929 Their products feel like a little ritual. So 00:38:35.929 --> 00:38:39.550 calming and so luxurious. I agree. Nothing sticky, 00:38:39.710 --> 00:38:42.170 nothing heavy. Just these beautiful formulations 00:38:42.170 --> 00:38:44.769 that make your skin look alive again after all 00:38:44.769 --> 00:38:47.099 those late nights. And the best part for our 00:38:47.099 --> 00:38:49.320 listeners, free shipping on every order. Yes, 00:38:49.440 --> 00:38:52.280 even straight to Singapore and 21 % off with 00:38:52.280 --> 00:38:55.860 our code TFF. Treat yourself, treat your skin, 00:38:56.039 --> 00:38:58.820 treat someone you love. It's the easiest festive 00:38:58.820 --> 00:39:02.119 win. Just head over to loveindus .com and don't 00:39:02.119 --> 00:39:05.070 forget to pop in the code TFF at checkout. So 00:39:05.070 --> 00:39:07.789 that's really gold standard solution for severe 00:39:07.789 --> 00:39:10.190 hearing loss, the cochlear implant. Generally, 00:39:10.190 --> 00:39:12.690 we're looking at putting the implantable in for 00:39:12.690 --> 00:39:16.130 the rest of your life. But certainly for babies 00:39:16.130 --> 00:39:18.809 implanted with these these days, it may be that 00:39:18.809 --> 00:39:21.869 it has to be replaced at some point during their 00:39:21.869 --> 00:39:24.309 lifetime. Is that more from growth, though? Like 00:39:24.309 --> 00:39:25.929 because they would have because they're growing 00:39:25.929 --> 00:39:28.820 into it or that's just because it's... It literally 00:39:28.820 --> 00:39:30.840 can't be a lifetime. It can't be 100 years. Yes, 00:39:30.920 --> 00:39:32.519 it can't be. It can't be 100 years, although 00:39:32.519 --> 00:39:34.880 it's getting the technology is improving all 00:39:34.880 --> 00:39:37.619 the time with cochlear implants. Then there's 00:39:37.619 --> 00:39:41.000 the second part, the external processor. So this 00:39:41.000 --> 00:39:44.420 part is upgraded every five to 10 years. Generally, 00:39:44.539 --> 00:39:48.019 this is where the batteries are. And so this 00:39:48.019 --> 00:39:52.239 is the part that is upgradable now. To add on 00:39:52.239 --> 00:39:55.099 to that, there is actually a new cochlear implant 00:39:55.099 --> 00:39:57.760 that's just come onto the market, whereby the 00:39:57.760 --> 00:40:02.480 internal part can also be upgraded like a smartphone 00:40:02.480 --> 00:40:06.760 can. So it can receive software updates into 00:40:06.760 --> 00:40:09.760 the implant. It sounds like a computer processing. 00:40:10.039 --> 00:40:12.820 It just sounds impressive. They're amazing, amazing 00:40:12.820 --> 00:40:15.980 devices. And this reminds me, are you guys familiar 00:40:15.980 --> 00:40:19.300 with the show Black Mirror? It's about the evils 00:40:19.300 --> 00:40:22.599 of technology and a dystopian future. And there's 00:40:22.599 --> 00:40:25.500 this one where it's not about, thankfully, not 00:40:25.500 --> 00:40:27.719 about cochlear implants, but it's about basically 00:40:27.719 --> 00:40:31.599 a brain, a neurological control device that gets 00:40:31.599 --> 00:40:34.119 software updates. And the point is, it starts 00:40:34.119 --> 00:40:37.239 to make you say advertisements. So it basically 00:40:37.239 --> 00:40:40.480 programs your brain. So like they're giving you 00:40:40.480 --> 00:40:42.599 updates, but they're also implanting you with 00:40:42.599 --> 00:40:45.000 sponsor information. So it's like you become 00:40:45.000 --> 00:40:47.980 a marketing tool for that. So what you're saying 00:40:47.980 --> 00:40:52.579 is cochlear implants are not that, right? I think 00:40:52.579 --> 00:40:54.940 this is a great time to put in our hot or hype 00:40:54.940 --> 00:40:56.800 section, which is a little fun game we like to 00:40:56.800 --> 00:40:59.380 play. I'm going to be saying a few words to you, 00:40:59.480 --> 00:41:01.380 which could be trending or things that we've 00:41:01.380 --> 00:41:03.780 seen out and about here in Singapore. And we'd 00:41:03.780 --> 00:41:05.320 like to hear from you whether you think it's 00:41:05.320 --> 00:41:07.170 hot or hot. hype and you can give a reason if 00:41:07.170 --> 00:41:09.989 you if you'd like so first thing I see everywhere 00:41:09.989 --> 00:41:14.949 ear candling hot or hype definitely hype oh ear 00:41:14.949 --> 00:41:18.690 candling is an absolute no -no so it is very 00:41:18.690 --> 00:41:23.349 common there is no benefit of ear candling in 00:41:23.349 --> 00:41:26.489 my opinion and you can actually get burns from 00:41:26.489 --> 00:41:30.050 it it's supposed to suck the wax out of your 00:41:30.050 --> 00:41:35.639 ear I have even seen a patient who had the wax 00:41:35.639 --> 00:41:38.480 drop down into their ear and their ear got blocked 00:41:38.480 --> 00:41:44.400 from the wax. So I would definitely, no. No ear 00:41:44.400 --> 00:41:47.099 handling people. All right. Cleaning daily with 00:41:47.099 --> 00:41:51.579 cotton earbuds. No. So we mentioned this earlier. 00:41:51.659 --> 00:41:55.179 Now, there's been a real thing over years that 00:41:55.179 --> 00:41:58.960 wax is dirt. This has become a hygiene issue. 00:41:59.099 --> 00:42:03.260 And wax is not dirt. Wax is a substance that 00:42:03.260 --> 00:42:06.380 is supposed to be in our ear canals. It protects 00:42:06.380 --> 00:42:10.199 our ear canals. It stops bacteria that aren't 00:42:10.199 --> 00:42:12.380 supposed to be there growing in there. It stops 00:42:12.380 --> 00:42:15.719 insects going in there. It's very helpful. It's 00:42:15.719 --> 00:42:18.400 the way that the ear cleans the dead skin out 00:42:18.400 --> 00:42:21.320 of the ear as well. And generally, every time 00:42:21.320 --> 00:42:25.000 you move your jaw, talking, chewing, the wax 00:42:25.000 --> 00:42:27.659 is going to be moving slightly out of the ear. 00:42:28.010 --> 00:42:30.710 So it's normal for wax to be there. It's normal 00:42:30.710 --> 00:42:33.110 for wax to come out of your ear. So if you really 00:42:33.110 --> 00:42:35.309 want to clean your ear, you can clean the outside 00:42:35.309 --> 00:42:37.769 part of your pinna here, but you should not be 00:42:37.769 --> 00:42:40.449 sticking anything inside. What happens if you 00:42:40.449 --> 00:42:43.190 stick things inside? First of all, you push the 00:42:43.190 --> 00:42:45.170 wax in. So most people, they'll see a bit of 00:42:45.170 --> 00:42:46.769 wax on the cotton bud, but they're diligently 00:42:46.769 --> 00:42:49.869 pushing it in and it gets impacted, like I mentioned 00:42:49.869 --> 00:42:53.630 earlier. You can also scratch the skin of the 00:42:53.630 --> 00:42:57.300 ear canal. So the inner part of the outer ear 00:42:57.300 --> 00:42:59.760 canal has very delicate skin. It's not like the 00:42:59.760 --> 00:43:02.159 skin with hairs on the rest of our body. And 00:43:02.159 --> 00:43:04.420 even the cotton wool on the cotton bud can scratch 00:43:04.420 --> 00:43:08.099 that. So you can get infections. I have also 00:43:08.099 --> 00:43:10.739 seen people, if they're cleaning their ear and 00:43:10.739 --> 00:43:13.639 the child walks past, stick the cotton bud through 00:43:13.639 --> 00:43:16.340 their eardrum and even damage the little bones 00:43:16.340 --> 00:43:18.619 in the middle ear. Shouldn't clean your ears. 00:43:18.639 --> 00:43:22.460 Hard pass. Like real hype. Yes. The only thing 00:43:22.460 --> 00:43:25.340 you can do to clean your ears is use olive oil. 00:43:25.480 --> 00:43:28.780 So some people, they get drier wax. It tends 00:43:28.780 --> 00:43:33.000 to get clogged up. It's harder for them. And 00:43:33.000 --> 00:43:35.179 olive oil is really useful with this. Olive oil 00:43:35.179 --> 00:43:38.099 drops. So if you put them in, they're also useful 00:43:38.099 --> 00:43:41.670 for itchy, dry ears. So itchy skin. Olive oil 00:43:41.670 --> 00:43:44.070 acts like a moisturiser and it really just helps 00:43:44.070 --> 00:43:46.889 the skin to migrate down the normal pathway a 00:43:46.889 --> 00:43:49.829 bit more easily. So just like your standard extra 00:43:49.829 --> 00:43:51.849 virgin olive oil that you have in your kitchen, 00:43:51.969 --> 00:43:53.969 you can just drop it into your ear? Pretty much. 00:43:53.989 --> 00:43:56.510 We use a medical grade olive oil in our clinic, 00:43:56.570 --> 00:43:59.369 but you can use... Any olive oil. The problem 00:43:59.369 --> 00:44:01.210 is getting it into the ear. So you're going to 00:44:01.210 --> 00:44:03.809 need a dropper. Yeah. Otherwise, it's too thick 00:44:03.809 --> 00:44:05.889 to go in your ear canal. So the main thing is 00:44:05.889 --> 00:44:07.750 to get a dropper and you can buy those from. 00:44:07.789 --> 00:44:09.409 Can you imagine trying to pour it in from your 00:44:09.409 --> 00:44:12.250 bottom? Can you imagine my dear husband working 00:44:12.250 --> 00:44:15.730 in the A &E? Flushing cockroaches out of people's 00:44:15.730 --> 00:44:17.949 ears with olive oil because that is literally 00:44:17.949 --> 00:44:19.989 how they do it. How do you get cockroaches in 00:44:19.989 --> 00:44:22.650 your ear? When you said bugs in the ear and I 00:44:22.650 --> 00:44:23.809 was like, oh, people probably don't think that 00:44:23.809 --> 00:44:25.329 happens. No, I did not. I will tell you right 00:44:25.329 --> 00:44:28.309 now, my husband worked A &E for years and it 00:44:28.309 --> 00:44:32.539 happens a lot. Oh my God. That is disgusting. 00:44:32.659 --> 00:44:35.820 I have even seen a patient who had this tickling 00:44:35.820 --> 00:44:37.920 feeling in their ear. And when I looked in there, 00:44:37.960 --> 00:44:42.039 they had a tiny spider that actually had a small 00:44:42.039 --> 00:44:45.900 web near their eardrum. It's like almost making 00:44:45.900 --> 00:44:48.079 me gag. That's not a joke. When you said tiny 00:44:48.079 --> 00:44:52.219 bugs, I was just assuming, I don't know. Like 00:44:52.219 --> 00:44:56.179 bacteria. Yeah. No, like my husband has dislodged 00:44:56.179 --> 00:44:58.260 a minimum of three cockroaches from ears. Oh 00:44:58.260 --> 00:45:01.559 my God. Okay. It happens. What about over -the 00:45:01.559 --> 00:45:04.840 -counter hearing aids and stuff? Yeah. So this 00:45:04.840 --> 00:45:08.940 I'd say is hype, but you have to be careful. 00:45:09.940 --> 00:45:14.179 Over -the -counter hearing aids, over -the -counter 00:45:14.179 --> 00:45:17.699 devices to hear used to be terrible. I would 00:45:17.699 --> 00:45:20.260 have said no, no, avoid at all costs. Now, there's 00:45:20.260 --> 00:45:22.820 been a big movement, particularly in the United 00:45:22.820 --> 00:45:26.340 States, to make hearing care more available to 00:45:26.340 --> 00:45:28.400 people because the problem is hearing aids are 00:45:28.400 --> 00:45:31.280 expensive. Yes. People don't have access to them. 00:45:31.780 --> 00:45:35.139 So there has been this movement to make hearing 00:45:35.139 --> 00:45:40.699 aids affordable and accessible for people. And 00:45:40.699 --> 00:45:44.579 some of the big companies who were involved in, 00:45:44.679 --> 00:45:48.539 what are they called? Bose and Sennheiser and 00:45:48.539 --> 00:45:50.960 people, companies. Oh yeah, technology. Some 00:45:50.960 --> 00:45:55.420 of the big companies who are involved in sound 00:45:55.420 --> 00:46:00.900 delivery, speaker systems, for example, are now 00:46:00.900 --> 00:46:04.579 developing over -the -counter hearing aids. Here 00:46:04.579 --> 00:46:08.059 in Singapore, I think the reliable one would 00:46:08.059 --> 00:46:12.199 be, again, Apple AirPods. So I have had a number 00:46:12.199 --> 00:46:14.519 of patients who've come in, they've been struggling 00:46:14.519 --> 00:46:17.039 with hearing loss, they've bought Apple AirPods 00:46:17.039 --> 00:46:20.019 just to listen to things through and realised 00:46:20.019 --> 00:46:23.219 that, wow, this hearing aid setting really helps 00:46:23.219 --> 00:46:25.360 me. There's a hearing aid setting? There's a 00:46:25.360 --> 00:46:28.639 hearing aid setting on it. No way. So I know 00:46:28.639 --> 00:46:31.320 that my headphones that I use, I'm going to plug 00:46:31.320 --> 00:46:34.780 in Beats now. They've got different settings 00:46:34.780 --> 00:46:36.860 so you can have the sound off so that you can 00:46:36.860 --> 00:46:38.980 obviously block out all the background noise. 00:46:39.219 --> 00:46:41.380 They've also got a transparency one, which I 00:46:41.380 --> 00:46:44.320 think has got a microphone on the outside because 00:46:44.320 --> 00:46:46.599 if someone's talking to me and I'm out, I can 00:46:46.599 --> 00:46:49.820 hear them so clearly like they're speaking into 00:46:49.820 --> 00:46:51.059 my ear. I think that is like the similar feature. 00:46:51.059 --> 00:46:53.559 Maybe it's a similar thing. And so people use, 00:46:53.699 --> 00:46:55.940 I mean, so do people use that as hearing devices? 00:46:56.039 --> 00:46:58.019 I mean, I use it if I'm out walking the dog and 00:46:58.019 --> 00:46:59.619 there's like cars going by and I'm like, okay, 00:46:59.619 --> 00:47:01.860 if I need to listen to what someone else is saying 00:47:01.860 --> 00:47:04.619 rather than be like, pardon. Yeah, so this is 00:47:04.619 --> 00:47:06.860 actually a simple hearing aid function on the 00:47:06.860 --> 00:47:08.920 Apple AirPods now. So they can test your hearing 00:47:08.920 --> 00:47:12.679 and they can actually use your hearing test to 00:47:12.679 --> 00:47:18.250 amplify whatever needs to be amplified. There 00:47:18.250 --> 00:47:20.730 is a caveat to that. These are good for mild 00:47:20.730 --> 00:47:24.769 hearing losses. So if you have hearing loss that 00:47:24.769 --> 00:47:27.849 is more than mild, it's not going to be enough. 00:47:28.190 --> 00:47:33.010 And I think the problem with those, or two problems, 00:47:33.190 --> 00:47:35.329 one is that when you're wearing them, people 00:47:35.329 --> 00:47:37.829 think that you're listening to something. So 00:47:37.829 --> 00:47:39.829 you're trying to have an important conversation 00:47:39.829 --> 00:47:42.130 at work, for example, and people think, why is 00:47:42.130 --> 00:47:43.909 this person listening to a podcast when they're 00:47:43.909 --> 00:47:47.119 talking to me, right? The other thing is that 00:47:47.119 --> 00:47:50.920 people use these because they feel that they 00:47:50.920 --> 00:47:52.719 look more socially acceptable than a hearing 00:47:52.719 --> 00:47:55.539 device and they are struggling when their hearing 00:47:55.539 --> 00:47:58.980 is beyond the limits of what that device is made 00:47:58.980 --> 00:48:05.039 for. So really I'd say get your hearing tested, 00:48:05.320 --> 00:48:09.440 get a proper quantification of your hearing loss 00:48:09.440 --> 00:48:13.019 if you have one, get some advice on it. And I 00:48:13.019 --> 00:48:15.500 have that conversation with my patients. So if 00:48:15.500 --> 00:48:18.239 they come in and they say, look, I'm struggling 00:48:18.239 --> 00:48:20.519 at work, you know, every time there's a meeting, 00:48:20.579 --> 00:48:22.460 I'm struggling to understand. And we do a hearing 00:48:22.460 --> 00:48:24.219 test and they've got some hearing loss and I'll 00:48:24.219 --> 00:48:25.780 discuss with them, look, these are the options. 00:48:26.900 --> 00:48:31.260 You can get some hearing aids. And some of them, 00:48:31.280 --> 00:48:33.260 you know, they don't want to, they're not ready 00:48:33.260 --> 00:48:35.380 for that yet. And then I will discuss things 00:48:35.380 --> 00:48:39.099 like Apple. AirPods with them. There are also 00:48:39.099 --> 00:48:41.619 ear plugs that you can get, which do what you 00:48:41.619 --> 00:48:43.800 just mentioned. The loop as well. The loop, yes. 00:48:43.900 --> 00:48:47.119 So these will cut out the background noise just 00:48:47.119 --> 00:48:49.019 a little bit so that it makes listening easier 00:48:49.019 --> 00:48:51.780 for them. And that can be a transition phase 00:48:51.780 --> 00:48:54.059 so that they get used to wearing something in 00:48:54.059 --> 00:48:58.099 their ears. But I do say, look, this is in the 00:48:58.099 --> 00:49:00.840 knowledge that we're looking at hearing aids 00:49:00.840 --> 00:49:03.619 in the long term for this issue. Rebecca, you 00:49:03.619 --> 00:49:06.599 have really shared some amazing insights with 00:49:06.599 --> 00:49:09.940 us like I never would have connected like everything 00:49:09.940 --> 00:49:11.940 that you said with hearing I never would have 00:49:11.940 --> 00:49:13.699 thought of going to get my hearing checked but 00:49:13.699 --> 00:49:15.460 it's one of the things I'm definitely on the 00:49:15.460 --> 00:49:18.119 list for sure but before we finish off I would 00:49:18.119 --> 00:49:20.079 like to ask you one final question and that is 00:49:20.079 --> 00:49:22.400 what is your 40s formula if you had to give one 00:49:22.400 --> 00:49:25.719 piece of advice to women in their 40s on how 00:49:25.719 --> 00:49:28.219 they can thrive what would that be I think for 00:49:28.219 --> 00:49:33.219 me that has to be sleep I certainly went through 00:49:33.219 --> 00:49:37.199 my twenties and thirties in a job where I often 00:49:37.199 --> 00:49:40.739 didn't get as much sleep as I needed. And I thought 00:49:40.739 --> 00:49:44.980 that was fine. And in my forties, I discovered 00:49:44.980 --> 00:49:47.800 that it's really not fine. So I'd just say sleep, 00:49:47.820 --> 00:49:52.500 sleep, sleep, and we'll make it a priority because 00:49:52.500 --> 00:49:57.139 I think certainly for me, when I've had enough 00:49:57.139 --> 00:50:01.230 sleep, Anything is possible. When I'm sleep deprived, 00:50:01.650 --> 00:50:04.269 everything becomes a struggle. And that's so 00:50:04.269 --> 00:50:07.769 common for so many women, I think, in midlife. 00:50:08.090 --> 00:50:10.070 Yeah, you got that right. We're preaching the 00:50:10.070 --> 00:50:13.349 same gospel. I promise you. Yeah, you don't have 00:50:13.349 --> 00:50:16.530 to tell me to sleep twice or three times. Thank 00:50:16.530 --> 00:50:18.130 you so much for being here, Rebecca. It's been 00:50:18.130 --> 00:50:19.909 wonderful speaking with you. Thank you. Thank 00:50:19.909 --> 00:50:50.900 you for having me. I mean, my kids are all in 00:50:50.900 --> 00:50:53.860 international school, so they're just following 00:50:53.860 --> 00:50:56.239 the UK stuff. And at the moment, they don't do 00:50:56.239 --> 00:50:58.719 any exams. And when they're doing their benchmarks, 00:50:59.000 --> 00:51:00.719 they're like, oh, yeah, we don't tell them they're 00:51:00.719 --> 00:51:02.219 being tested because we don't want them to be 00:51:02.219 --> 00:51:05.019 stressed out. I'm like, OK, but part of me is 00:51:05.019 --> 00:51:06.699 kind of like, I feel like they need to have a 00:51:06.699 --> 00:51:08.539 little bit of pressure because then they don't 00:51:08.539 --> 00:51:11.539 perform to their best ability. But, you know, 00:51:11.539 --> 00:51:13.320 I don't want them to be overly stressed out. 00:51:13.360 --> 00:51:15.219 Just, you know, every once in a while, tell them 00:51:15.219 --> 00:51:18.679 that you're being tested. It's like, yeah, it's 00:51:18.679 --> 00:51:20.159 what is it like, you know, the ivory tower, like 00:51:20.159 --> 00:51:22.800 just you're being watched. Yes, exactly. Exactly. 00:51:22.920 --> 00:51:23.719 Don't fuck around.