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HEARING LOSS IS A FAMILY MALADY

In a recent Washington Post article by Marlene Cimons, former President Jimmy Carter, 91, said that 90% of the arguments he has with his wife of 70 years, Rosalyn Carter, 88, are about hearing. Mr. Carter said that having to repeat things “drives him up the wall”.

According to the article 25% of people 60-69 have some degree of hearing loss. That grows to over 50% for those 70 to 79 and to almost 80% for those over 80.   Curious isn’t it, that this is such a prevalent health care problem, yet most insurance coverage totally omits hearing loss?

Provoked by the article about President Carter and Mrs. Carter’s candor about hearing loss and its impact on their lives I decided to interview a friend that I knew had recently gotten hearing aids. Call him Eric. He’s 57 and otherwise in excellent health. His wife Nancy had been complaining about his hearing for the past 2 years. When he went to the audiologist for testing, sure enough he found that he had a gradual, early form of slow hearing loss. Hearing devices were required prescribed and delivered to him, along with education about how to use and maintain them.

Eric and Nancy, both attended a new-hearing-aid-device-wearer lecture. They continued to cling to the false notion that once the hearing aids were in place and Eric was accustomed to them; life could and would go on as before.

Some things did change, of course. Wearing his new hearing devices at home, Eric’s first question was “Who turned the tv up so loud?” Nancy was quick to point out that it wasn’t turned up. This was the volume level he had needed pre-aids. Also, Eric was much more aware of Nancy speaking to him from another room. He just couldn’t understand what she had said, which left him having to go find her and ask “What did you say?”.

Eric was the first to realize that even with hearing devices life wouldn’t return to exactly what it had been before hearing loss. While he was getting increasingly real about what he could hear and what he could not, Nancy continued in the opinion that hearing aids should fix everything.

He realized the devices really helped but he wouldn’t ever have the hearing of a 30-year-old again. This meant that he and Nancy needed to begin to look at home environmental factors that affected his hearing; ambient noise, proximity, volume and pitch, and a much greater moment by moment awareness of each other.

Thus began the real hearing arguments between them.

Paying close attention to his environment, Eric noticed 4 key factors:

  1. Nancy frequently begins conversations with Eric just AFTER he has left the room
  2. Nancy frequently speaks to him facing away from him (he jokes that it’s common for her to talk with him with her head in the dishwasher as she works)
  3. Nancy, at 57, no longer projects her voice the way she did when she was younger. Her voice is simultaneously softer, quieter, and airier.
  4. While it’s easy for Nancy to notice, comment on, and even complain about Eric’s hearing before and after hearing aids, it seems almost impossible for her to admit to her part in the environmental factors and make a commitment to do something about them.

Earlier they had almost gone to a counselor to air the friction over Eric’s hearing loss.   Now, because they have begun to fight about it, he is asking her to go to a counselor with him discuss the environmental factors in their communication and her part in them. So far she is resisting.

We’ll see what happens. Hearing loss as it turns out, can indeed be a family malady.

What is the condition of your hearing, and what have you been able to do about it that really worked in your daily life?

 

The After 50 Goal Shift – From Validation to OK Anyway

Aging, let it be acknowledged, seldom arrives in our lives all at once. Instead, it appears in large and small changes in our environment. I was recently on a crowded metropolitan bus and a very polite teenager stood up and offered her seat. At first I looked around to see where her gestures were directed and was flabbergasted to realize…she was offering her seat to ME.

Gray hair. Loss of longtime friends. Fine print getting smaller (Surely it can’t be our eyes!). Consonants or vowels becoming more elusive in fast paced vocal music.  Widespread challenges to our iconic values and beliefs (like permanent employment, home ownership, the relevance and place of a college education, our alliances with one political party or another). Our precious little grandchildren turning into people as tall (or taller) than we are, with strong opinions and positions of their own. Loss of muscle tone and skin suppleness. The winnowing of what’s important to us and how we continue to reassure ourselves of our potency and efficacy.  Openness (or the opposite) to new experiences.   The tectonic shifts in what we aspire to and what these aspirations mean to us.

All of this is offset, at least in part, by some magical combination of having little left to prove, greater patience with ourselves and others, a much shorter list of things we think of as life and death issues, the reward of longtime friends to whom we don’t have to explain a thing, and new friends who bring fresh ideas and interests to the mix of our lives.

If we’re paying attention this can be an amazingly rich period of life regardless of the national elections and turmoil.

Which brings me to our increasingly tricky relationship with goals After 50.

Earlier in our lives goals were a part of a complex approach to our personal development, and focusing primarily on our goals could be a kind of roller coaster. Still, If things didn’t work out we had lots of recuperative years left to move on and conquer something else. Goals were often irretrievably intertwined with our validation.

Example: Being a salesperson with significant, monthly territory sales goals. If you made your numbers you were on top of the world, but you were only as good as this month’s numbers. Next month you had to prove yourself all over again.

Example: Being a parent whose sense of successful parenting depended upon kids’ grades, athletic prowess, and college admissions. If your kid did well in your eyes, you had achieved your parental goal. If your kid did not do well there was something wrong with both of you. And you couldn’t be really OK until your kid was.

Example: Taking off 25 pounds and fitting into that dress or suit for your high school or college reunion. You were often only as good, at least for that evening, as your weight loss achievement.

Note in each example the direct correlation between your goal achievement and your sense of your own OKness.

Linda and I have friends (a married couple) who are serial entrepreneurs. They worked together in each business across the decades. Two years ago, for the first time, they disagreed. Her goal was to retire. His goal was to start a brand new entrepreneurial business. Eventually the wife capitulated. It was a struggle. He was only going to be as OK as his new venture was successful. How did they get through?  For the first time in their lives together it was OK to have goals BUT NOT to hook their personal OKness to goal achievement. Their OKness had to be hooked to something else or, like the salesperson example above, they could only be as OK as their latest performance and results. Not the ideal condition for high quality of later life.

We also have long time friends who set up an elaborate set of travel goals. They had just retired and were so happy together. Their sense of self-esteem was closely coupled to the goals of being able to check each of the continents off their bucket list until none remained. Quite suddenly the husband died of lung cancer. Was it great that they had goals? Yes. Was it great that, as a widow, the wife’s OKness was uniformly tied to her husband and their shared bucket list of goals? No. She had to do the painful work of creating new goals for herself and not tying her ultimate OKness to them.

This all comes up for me now because I’ve just realized one of my biggest goals. I have signed a contract with a national publisher to publish my new book. Manuscript is due 12/15/16. Publication date is around July 1, 2017.  What’s different for me – and somehow paradoxical – is that I can and do have goals but no longer have the luxury of letting them define my OKness. It’s not easy to give up the success/failure paradigm. I’d have to be pretty much OK whichever way the publication hammer falls.  This is a huge shift in my relationship to goals.

What are your goals now?

What do you do to create your consistent OKness that isn’t tied to goal achievement?

 

Men And Their Major Organs

Bless the news cycle and social media.  Without them I wouldn’t be able to keep my worrying updated and prioritized.

The New York Times published this challenging piece on May 17th:

A man whose penis was removed because of cancer has received the first penis transplant in the United States, at Massachusetts General Hospital in Boston. Thomas Manning, 64, a bank courier from Halifax, Mass., underwent the 15-hour transplant operation on May 8 and 9. The organ came from a deceased donor.

To my substantial, revolving list of topics to worry about I can now add two new concerns:

  1. Penile cancer
  2. Finding a suitable/compatible/willing donor should a new penis be required

Stop and think about men and their top-tier organs.  Stick with me here.

I’ve long been aware—from my own experience and from observing male colleagues—that the two major organs for men are:

  1. their penises
  2. their wallets

So long as both organs are healthy and can respond reasonably on command, we men have a stable, even upbeat sense of ourselves.  Reduce either one or both to a substandard state of performance and our sense of self suffers.

I admit that second-tier organs are important, too, including heart, liver and lungs.  Still, I seldom hear those organs spoken of by their possessors with the same flair and passion (you should pardon the expression) that is reserved for penis and wallet.

This has all led me to thinking about the connection between the top-tier organs and the nontraditional Presidential campaigns we are seeing.  I think organ erosion, so to speak, explains the widespread support for something – anything – different AND the concurrent support for non-traditional and presumptive candidates.

Imagine you had worked long and hard – with or without a college education – and found yourself unemployed and/or financially disadvantaged and/or embarrassed in front of your wife and children and/or without the secure belonging and sense of productivity that you had earlier enjoyed and/or you suddenly realized that for all your hard work your children might not have a better life than you originally expected for yourself and/or you felt both hopeless and impotent.

A double whammy to the two top-tier organs.

No wonder we men are fighting among ourselves, voting for radical alternatives, and wondering where all of this is taking us.  It hurts, and our top-tier organs are letting us know it.

Manning was stunningly candid with the Times reporter about his experience:

Mr. Manning welcomed questions and said he wanted to speak out publicly to help dispel the shame and stigma associated with genital cancers and injuries, and to let other men know there was hope of having normal anatomy restored.   “Don’t hide behind a rock,” he said.

I think the gentleman makes sense and I’m seriously thinking of voting for him if he gets around to running for national office.  At least he’s connected to his top-tier organs, which is more than we can say of many male members of Congress.

Read the full article HERE

Attention to intentions

As I’ve been saying for a long time, we focus way too much on the negative aspects of growing old. When we do, we miss the point—which is that the quality of life is really all that matters, no matter what our chronological age.

We spend our life aging, starting from birth.  The older we get the more important health, adequate finances, relationships, community and spirituality can become.  We must attend to these faithfully to age well.  That said, attending to them does not and will not make us younger.   We can eat right and exercise, dye our hair and remove our wrinkles, but we won’t lose years.

Quality of life is all about deciding the elements we want in our life and then pursuing them. That requires insights, frequent reality checks and shrewd decisions.

Take Lew, 68, a widower from Rochester. In this stage of life, he wanted good health, low-demand companionship, interesting travel and immersion in the worlds of food and music.  Knowing these were the primary characteristics of a high quality of life for him, he used them as his “North Star” to guide every decision concerning:

  1. Where to live
  2. What kind of community to live in
  3. How near a major city he needed to be
  4. How exercise-friendly a climate to choose
  5. Which clubs to join
  6. How to budget for adventurous meals and theatre tickets

When last seen, Lew had moved to coastal South Carolina and was busily and happily pursuing his hobbies and interests, surrounded by like-minded people.

Then there’s Alex, also 68, who always knew he and his wife would retire in Ohio and move to Florida.  They picked a town his wife really liked and built a house she designed and decorated. He takes care of the house and reads. Alex never questioned the plan, and didn’t think about imagining in detail what would happen after the move—he just went along with what he considered a fait accompli.

When last seen, Alex was struggling.  He showed:

  1. An increased need to be right
  2. Significant bickering over details
  3. Loss of curiosity and interests
  4. Decreased social network size and diversity
  5. A new, short-fused temper
  6. Decreasing mobility from lack of exercise
  7. Treating his significant other more like a prisoner than a partner

What’s the difference between the two men? They’re both smart. They have the same financial resources. They both planned ahead. But the quality of their lives is much different.

It really boils down to attention to intentions.  How do you intend to live this stage of your life? Play out every conceivable what-if scenario, because this kind of planning can make the difference between a rich life and a meager one.

Singing (the praises of) the blues

Dan_BZSGiven the current popularity of Dan Buettner’s Blue Zone Solutions for eating and living like the world’s healthiest people, I had to give it a try.  Buettner has traveled extensively, researching what the world’s longest-lived people have eaten over the past 100 years.  Then he builds on his key insight that lasting health is “more the result of our surroundings than our conscious choices.”

I bought the book.  I read it.  I cooked. I began with the meatless Ikarian Stew, a “savory one-pot meal that fuses the iconic flavors of Ikaria with the faintest hint of sweet fennel.”  My wife and I both liked the Mediterranean flavors in this dish.  Our dinner guests liked it, too, being long accustomed to me trying out new recipes on them at the drop of a hat.

The whole thing got me to thinking about the old nature/nurture controversy.  Is who I am/how I think and behave more inborn or more a result of my environment?

As an American and as a developmental psychologist, I tend to come down on the side of my daily decisions being the major factor in my health. Who could and should be more responsible for me than me? Voilà!  I’m responsible. Individualism, the rugged American way.

On the other hand, if I’m really going to be honest about it, food advertising and marketing are now so sophisticated that I may develop a craving as a result of something that I don’t even remember seeing or hearing.  I’m bombarded with food images all the time, through all kinds of media.  And I’m by no means constantly on guard.  There is also the matter of my ongoing relationships with the three basic food groups: sugar, fat and salt.  So is my environment really more powerful than I am when it comes to what I eat?

I’ve put it to the test.  I’ve applied Blue Zones theories to my own life, monitoring my accumulated habits and decisions. I’ve also decided my environment plays a greater role than I previously acknowledged, and will have to drag it, probably screaming and kicking, into that furnished Blue Zone in my head for regular reality checks.

None of this, however, deals with the next two questions which are vexing me:

  1. Is greater longevity in and of itself a great thing, and desirable for me?
  2. Just because someone lives much longer, does that necessarily equate to superior health and satisfaction?

Earlier generations would not have had extended longevity on their menu (so to speak) of choices. We do.  I need to work on questions 1 and 2.   Who knows what recipe I’ll be springing on dinner guests in the future?

Read more about the author and the book here: www.danbuettner.com

A TROUBLING DIAGNOSIS 

I have to admit I took it badly.  Not for long but badly nonetheless.  You’d think I could simply test out of the emotional part of this.  After all, I’m a professional counselor, a psychology PhD, an author and expert on human behavior and adaptability.

Wrong!

What set this in motion was the shocking number of times I tipped over. Once, after turning around quickly in a walk-in closet.  (How is it that I can repeatedly ride my new bike for 30 miles without incident but just fall over in my closet?)  Then, getting out of a car on my way to an important meeting.  Then again in my closet.  And again.  My own diagnosis: doing too many things at once; distraction.  My doctors’ diagnosis: peripheral neuropathy.

Peripheral what?  I’d never heard of it.

That may be because it’s most commonly associated with diabetes, which I do not have, and as a side effect of chemotherapy, which thankfully I haven’t ever needed.  Peripheral neuropathy (PN) is a condition that affects more than 20 million people in the US.  It usually involves pain, numbness or tingling (or some combination thereof), but in my case I don’t have any discomfort whatsoever.  It’s just that my brain doesn’t seem to know where my feet are when they are in close proximity to one another, especially when they’re turning.

There’s no cure for PN, but for some people—especially those with pain and tingling—a drug (sometimes Lyrica) is prescribed and may help with symptoms.  For me, the treatment is physical therapy and better shoe support.  That’s for my feet.  For my head, I needed some other things,  which I’m recommending to other PN sufferers:

  1. Get Educated. A good source of information is the American Chronic Pain Association, ACPA.org. There also may be support groups in your area. There’s no PN support group where I live, but it is discussed at diabetes support groups, so I may try those.
  2. Inform and educate your family and friends.  Let your loved ones know about your diagnosis. They already will know something has changed just by observing you, but may not know the cause.  In the case of PN, stumbling can be mistaken for having a drinking problem. Help your loved ones worry about what’s really going on and let them know how they can help.
  3. Have a heart-to-heart talk with your life.   I often say that there are a minimum of five of us living in my house at all times: my wife, me, our marriage, my life, and my wife’s life.  Each of them needs nurturance.  Each doesn’t always see eye to eye with the other.  My wife and I were already in agreement.  My life and I had some decisions to make.  What do we want our quality of life to look like going forward? How dedicated to being active and vital are we? What kinds of limitations does this diagnosis place on us and what do we want to do about it?
  4. Work seriously at whatever treatment process you choose.  I’d never had physical therapy before, and was surprised at how much work it is.  After the first few sessions, it’s easy to see progress and even easier to slack off.  Kind of like dieting.  Stick with your treatment for the long run, even for the rest of your life.  You and your life (not to mention your family and friends) deserve it.

I also now know from experience that there is one thing NOT to do.  With temporarily runaway emotions, I made the leap from a troubling diagnosis to OLD AND SLIDING DOWNHILL, which, of course, made it just that much more difficult for me to get centered again.  So:

  1. Do not succumb to the drama of the moment and translate your diagnosis into a confirmation that it’s the beginning of the end.   It’s easy to do.  This is where items 1-4 above come in.  They are all essential.

It’s likely that this won’t be the only opportunity I will have to react to a medical/social/financial/professional announcement.  I’m starting to think of it as practice for the ups and downs of life.  I’ve found a lot of meaning in a song performed by the wonderful Christine Lavin, with apt rollercoaster metaphors.  Be sure to watch Christine’s face as you are listening. Music and lyrics by Matt Alber. https://www.youtube.com/watch?v=Z8xgoa04SNY

 

After the fall

I had the second major fall of my life last week.

The first was years ago in Barcelona.  We were in the ancient part of the city.  My favorite part of being a photographer is the composition, and it consumes me in the moment.  Stepping onto some uneven pavement, I went down like a boneless sack of corn meal. One second I was taking pictures, the next I was lying on the ground on top of my camera.

But that experience didn’t trigger any particular kind of reflection or fear.  I just got up and went on about my life.

The second major fall has been different.  I was getting out of the Board Chairman’s car; we were on our way into a company meeting called by the CEO. I either didn’t see the curb (which I have stepped over successfully hundreds of times in the past) or I just didn’t lift my right foot high enough.  Suddenly I was halfway into a face plant onto a muddy sidewalk.  I had the wherewithal to grab a large planter to help break my fall. With bandaged arm and muddy clothes, I proceeded into the meeting and participated in a serious discussion about the company’s strategic pathways forward.

During the meeting, I stayed focused.  Call it reflexive professionalism. It wasn’t until later that I really acknowledged the fall to myself.

In retrospect, my three injuries were:

  1. A bleeding, butterfly-shaped gash in my left forearm (from the planter).
     
    Fortunately, I was immediately treated by a senior colleague who spent three unhappy years in medical school before abandoning it to become who he really wanted to be: a world-class chemist.  My arm was so cleansed, disinfected, and well bandaged that it felt like a holiday ham dressed in gauze.
  2.  

  3. Major bruises to my competence-centric identity, accompanied by a major dose of embarrassment.
     
    Ordinarily, I feel capable and self-assured. And I am.  I think of myself as the CEO of my career and my life.  But that trip and fall in front of a client made me feel like a clumsy fool—certainly not a CEO. Barely an intern.
  4.  

  5. A lingering, several-day level of doubt that I don’t usually experience.
     
    To my shock I eventually realized that the doubt was actually a deep, morbid fear of ageism, aimed at myself.  I already wear hearing aids to help with mild loss.  Now I have fallen.  If more age-related issues start stacking up, will people stop taking me seriously or question my competence? Will I stop worrying whether this is the beginning of an irreversible physical decline? It has taken several days for me to find my center again.

 
I’m a strong, capable guy committed to the quality of this phase of my life.  I’m running four small businesses simultaneously, my new book will be out in 2016, I have a virtual team of brilliant people working for me, I ride my new bicycle up to 30 miles at a time, am a committed board member of an NPR/PBS affiliate, have stimulating friends unwilling to coast at this time in life, and am married to a brilliant woman who challenges me every day on some front.  It’s a wonderful way to live.

I know I shouldn’t let a simple stumble trip me up this way. So why has it shaken me up so profoundly?  I think it’s because ageism – and the fear of it – wasn’t part of my past.  I don’t plan to let it be any part of my future, yet on some level I know it inevitably will be.  This is completely new territory for me.  I’ll have to work with what’s new as it arrives.

The fall was my first opportunity to adjust to the new normal.  I suspect it won’t be the last.

ANGRY OLD MEN

I have a friend. Call him Sam. He’s in his late 60s. He lives across the US, so I don’t see him that often.  Our friendship has endured for years. I really like and respect him.  Yet I am watching him grow angrier before my eyes. If his purpose is to teach me what NOT to do, he is succeeding brilliantly. I imagine his wife is as bewildered as I am by his increasingly unpleasant behavior.

Like many of us, Sam is a walking paradox. Great at mechanical things. Kind and gentle with people in genuine need. Well versed in everything from quantum mechanics to the Bible, military history to Edgar Cayce. Yet he’s become impatient, harshly judgmental and belligerent.

Here’s an example: We were out for a walk in his neighborhood. Bicycle riders came towards us over a footbridge. They crowded us to the edge and swept past us at an unreasonably fast clip.  Sam turned around, and, for several minutes, yelled about how stupid they were while I stood there wishing I were somewhere, anywhere, else.

Here are other troubling symptoms:

  1. His growing adoption of hostile and rigid language: stupid, hate, dumb, idiotic, can’t stand, ridiculous, terrible, dangerous, intolerable.
  2. His nearly uncontrollable edginess.
  3. His active confrontations with anyone and anything in his path that doesn’t meet his standard for order or timeliness.

I’ve asked him what’s going on with him. He blows me off. I’ve asked him to listen to the transition in his language.  He’s not interested.  He thinks nothing of releasing his anger but says he doesn’t want to talk about it when I express my own impatience with his impatience.

My hypothesis is that he has experienced a number of retirement-related and health-related losses that he hasn’t fully come to grips with yet. He isn’t who he was and seems not to have arrived at who he is becoming.  Whatever the explanation, he isn’t open to those conversations now.

So, for now, I’ve fallen back on the Serenity Prayer: God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. My plan is to stand by him and wait to see what happens, which is what I think friends do. And I certainly intend to remain his friend.

There’s a difference between grumpy old men and angry old men. One is tolerable, and the other requires support. But what kind and when?

 

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