The Top

In my professional life I have the privilege of going to conferences and workshops at which I get to hear amazing speakers. Over the years I have heard billionaires, presidents, CEO's, authors, thought leaders, elite athletes and then there is little old me. Being driven has always been a part of my makeup and while I may have lived a life of humble achievement I come away from these encounters feeling the need to be more, feeling like I have not done enough in life. This weekend as I was at the Academy of Doctors of Audiology Conference in Washington D.C., I was hit by a bit of an epiphany. As much as I feel the need to be like some of these high achievers perhaps offering my expert knowledge to the masses, the core of my being is moved by personal relationship. Being in my clinic allows me to get to know people, to get to know my patients. As I go through the journey of diagnostic assessment and then the process of intervention or remediation or sometimes simply visiting with or counseling the patient, there is a richness that forms in the relationships that occur. I don’t want to just help people I want to really know the person that I help. I don’t want to just share ideas I want to see change actually take place. It is on this grassroots level that I live and thrive. When we work with people in any capacity there is a great deal of pride that should be taken in what we do. The role of service to our fellow man is a worthy one and it is of primary importance that the world is filled with those that take this role on with enthusiasm. Those that care for the individual and work with people on a micro level rather than a macro level also need to know that what they do is important. To affect the life of one person at a time is still a worthy aspiration.

I Don't Have A Problem!

What do you do when you have a family member or friend that you know is having trouble hearing but either does not want to admit it or is completely unaware? First you have to understand that hearing loss more often than not is insidious creeping up on you just a little at a time . Those that suffer from hearing loss are often the last to know and recognize that loss.  It is not easy to admit that we are less than  perfect and that our body is failing us in some way .  I remember when I first recognized that I needed reading glasses, my arms just were not long enough to keep the book far enough away from me to read, eventually it dawned on me that maybe my eyes were not what they once were. As my eyes have changed for the worse over the years I find myself irritated by this inefficiency in my life, you can say the same about hearing loss but with the significantly added stigma of hearing loss being a sign of ageing. The reality is that our eyes changing and our hearing changing is a part of our natural deteriatory process. When patients ask me if their hearing will improve my answer is that when it comes to the ageing process very little if anything about our bodies improves (insert smile as I too am in that category).

It is amazing to me how many husbands and wives come in together for hearing tests. I often get a kick out of these appointments having to tell them that I am not a marriage counsellor and this is not a competition. Of course this is with a smile on my face. Often the couples come together because one of them recognizes that the other has a hearing problem but will not come in unless the other takes the initiative and comes with them making it less about their problem. The reality is that for many this routine assessment of one of their major senses is one that is approached with greater trepidation than a visit to the Dentists for tooth extraction without freezing.

Here is my advice when trying to get a family member to have their hearing checked. First approach with caution as this is a sensitive topic for many. It is important to point out that having a hearing test is much like having your eyes tested, it is just knowledge gained on the state of one of your major senses, what you do with the knowledge you have is another issue altogether. This is an important element to communicate as most people equate going to a hearing test with an admission of fragility and jump to the conclusion that the only reason to go for a hearing test is to get a hearing aid. Not everyone that comes in for a hearing test has a hearing loss of significance, many come in recognizing that their hearing is not what it used to be only to find that it is still normal but perhaps lower in the range of normal than it once was, others will present with some hearing loss but not enough to do anything about just yet, others still require further medical followup due to the parameters of their loss.

In recent years I will say that there has been a shift in who comes in my door with far more coming in between the ages of 40 to 60 than ever before. This age group seems to be far more self aware and would choose to know what is going on with their bodies and their functional ability especially in the context of the effects socially and in the workplace.

Changing the perceptions of what it means to have a hearing test is a long term societal and cultural issue but a good place to start is one person at a time.

Staying Connected

I was at a conference recently where we were discussing what our profession would look like in 2020. As a part of the discussion we were asked what we see as very different now than when we first started. As people began to talk I considered how my profession as well as my world has changed in the last many years. As much as I feel very current in my knowledge due to the education I have added in the recent past I still have a good recollection of what things were like in the early years of my profession. The cutting edge computer based technology that stood floor to ceiling has been replaced by hand held devices, the hearing aids that were adjusted with a screwdriver now have innumerable adjustments and functions that we could not have imagined in those early years. Technology certainly has come leaps and bounds. What did we ever do without the Internet or Google or texting or email.

How communication has changed. We live in a world where we are now able to contact one another and have conversations almost at will. We can Skype, email , text, even make a phone call from almost anywhere, we talk on Facebook, on imessage and other forms of social media. The reality is that we are far more connected now than ever before, perhaps sometimes to our own detriment.

In the world of the hearing impaired, staying connected has many meanings and implications. Certainly all of the technological implications apply but when the communication method is Auditory there can be some limitations and therefore lack of adoption or avoidance of use. Take the old school approach for example. The telephone can be a piece of technology that is avoided in a big way by those that are hearing impaired. I have many patients that simply will not answer the phone as it is just too difficult for them, instead they will allow other family members to take this task on for them. Some of my patients will use  a speaker phone to make it a little easier. The inability to see someones face in communication can certainly negate many of the nonverbal elements of communication that help the hearing impaired individual cope with their hearing loss.

Connected communication is for every age group. At one time texting and Facebook and Skpe etc. might have been considered to be used primarily by the young however in actuality every age group is now using this technology with those over 65 growing rapidly as a user group. Grandparents wish to stay connected with their grandchildren and their families and will use the technology that is used by that generation to keep in touch. To digress, it is a rare and wonderful occurrence to get an actual handwritten letter in the mail in today's society.

What I want to discuss her today is actually connectedness in communication on a one on one or group basis. In recent years my patient base has been getting younger and younger. I am seeing more people coming in to my clinic in the 40-60 age group than ever before. Given the change in our demographic  we are diagnosing mild hearing losses and moderate hearing losses that previously had gone undiagnosed till they were far more severe. Common to these losses are normal low frequency hearing and reduced high frequency hearing loss with the patient

not needing volume but needing clarity.  With clarity being the target we often do a trial fit with our patients fitting them with the appropriate device and allowing them time to be in their world assessing what differences and benefits they observe with the appropriate amplification. While the benefits can be many I want to focus on one in particular. One of the major benefits that can become apparent is connectedness. Those with mild and moderate hearing losses typically find themselves filling in the blanks during conversations, sometimes by context other times by the visual cues etc. . When the hearing is improved with appropriate amplification the patient will often report that they find themselves connecting to the conversation quicker and are able to stay connected to the flow of communication.

When one is fighting to stay connected with communication they are constantly recalculating what the possible pieces of missing information may be. For anyone observing they may notice that it takes these individuals a slightly and sometimes perceptibly longer time to catch on to the conversation. When one has to work this hard to stay connected they may find themselves fatigued when in prolonged listening situations. With the use of appropriate amplification one of the observable differences in communication ability is that the hearing impaired person tends to be able to follow the conversation with greater fluidity, in a more natural manner. Staying connected in conversation is not often discussed relative to hearing impairment but is definitely a significant goal with the use of amplification.

When one struggles with communication to a significant degree the tendency is then to disconnect from the difficult. To disconnect is to move towards isolation to pull away from those difficult situations. Finding ourselves connected to one another in conversation allows us to connect to one another on a deeper level as well. Communication connects us which is a good reason to communicate as well as we can.