Hear for the Holidays

Communication check list especially during the holidays.

1.) Reduce the background noise.
2.) Be at a good listening distance from each other 1 meter to 1.5 meters apart.
3.) Speaking slower is a better approach in communication that speaking louder.
4.) Maintain eye contact. This means that you are facing each other and that your voice is going towards the person that you are talking to, it also allows for some speech reading to take place as well as helping to           interpret body language.
5.) Confirm that the person you are speaking to understood what you said.

The holidays are such a wonderful time of year a time where we spend time with one another enjoying the company of family and friends. It seems like every weekend and sometimes weeknights are filled with get -togethers and parties and yes lots of eating. Even if the Holidays are not quite this busy for all it is a time when we tend to be in and around groups of people socializing. For some this time of year can be difficult and stressful. The group that I speak of are those that suffer from hearing impairments.

The hearing impaired are often torn between their wish to be in and around family and friends and their wish to be nowhere near these difficult listening situations. The Christmas and holiday season is often unavoidable and therefore a time of great difficulty for the hearing impaired. How much fun is it to sit down to a large family dinner and not be able to follow the conversation entirely? How frustrating is it to go to a school Christmas program and find the gym too reverberant to hear the presentation ? How out of control does one feel at that office party where everyone seems to be following and getting the joke when all you can do is smile along to cover up your inability.Those with hearing impairments typically struggle to hear clearly in a background of noise, things might be loud enough but perhaps not clear enough to understand. I know many of my patients that avoid these difficult situations sometimes consciously and other times unconsciously.

 It is discouraging not to feel a part of something. So how do those with the impairment deal with this difficulty. As an Audiologist I would obviously say that you should visit an Audiologist and seek help and advice. For those that have an appropriate hearing loss the use of amplification can be a phenomenal beginning to claiming back this part of your life however there is more to functioning well than that. Using your eyes to hear is a common strategy, watching the persons face that you are communicating with allows one to pick up visual cues. We do a lot of reading intent and intention by visualizing peoples body language. When someone is smiling as they talk they are probably saying something worth smiling about and so on. Our brains also do make a connection sorting out what we hear by correlating it with what we hear. Locating yourself close to and in front of the person you are communicating with also makes a significant difference in picking up clearly the conversation. Another variable that can help is to reduce the background noise whenever possible. If you are trying to have a conversation with the television on you will probably struggle even with normal hearing at times. The reduction in the background noise is a significant factor in speech intelligibility especially when combining that with the other strategies. These are strategies for the hearing impaired but perhaps even more significantly it is important that the friends and family members of those that have the impairment should think outside of themselves and consider just how difficult and frustrating it is for the hearing impaired individual to function in these complex listening environments.

 It is too easy to forget that unseen impairment. If our family member were physically impaired we would often be more considerate and accommodating their needs than those with a hearing impairment. How often I hear my patients tell me of their family that just do not understand how difficult this time of year is for them. While Christmas and the holidays should be a joyous time of celebration  for some it is a time of great struggle. As we consider what nice thing we do for our family during this time of gift giving perhaps giving the gift of better hearing is something to consider.

Take the time to spend some one on one time with that family member in a quiet environment having that conversation that they would otherwise miss in a group, make them feel a apart of the conversation by placing them at a preferential listening spot around the Christmas tree of dinner table, talk to them not around them. More than the gifts we receive at this time of year we most cherish the relationships we have and the time spent together laughing and sharing, communicating.

Ho Ho Backhoe !

As the Holiday season is upon us many a wife and husband start to become perplexed as they try to find the perfect gift. Many of my male friends and I have actually come to the same conclusion about what we would consider the perfect gift. Even moments ago I just had a conversation regarding this perfect gift.  The unfortunate part is that men and women tend to see the world differently and what a man might consider just perfect a woman may consider impractical, what a man might consider most practical and useful a woman may consider ridiculous. While this perfect gift exists it is the rare man that has ever had his wife get him one for Christmas or his birthday or another important special occasion. Yes men I do speak of the Backhoe. I have mentioned to my wife on more than one occasion that I need a backhoe.  The first question my wife asks is usually why? Well I may not be sure exactly what I might need it for but I feel the need for a backhoe. I am certain that many an outdoor job around my property would be made much easier with a backhoe. I could dig ponds, dig a hole for roasting Meat, move those piles of snow. I really could come up with a lot of things I could do. I am convinced that it would be the best gift ever. As a reader you have probably already guessed that I have not yet received this perfect gift. I do suppose that there are lots of gifts that we men feel we need that our significant others just shake their heads at. I think that specialty tools fall into that category.

Men and women are different for sure in so many ways. In the clinical setting I am often reminded of how the genders differ. I watch as my older patients are not able to drive and have their licence taken away, men seem to take this much harder than women as they consider this a part of their manhood or independence, while women tend to take these things in stride. For a man to accept that he has a loss of hearing can sometimes be difficult. This difficulty might be one that women face as well but men sometimes seem to struggle more with even wanting to know what their hearing really is. Men want to be able to fix things and seem to have a hard time dealing with the things that they can't fix themselves. I have recently seen this happen with one of my patients, a young father who had his child diagnosed with a hearing loss. While this family was very practical in accepting the loss and was extremely proactive in getting amplification on this infant, Dad was still trying to find a fix for it. In this case he was hopeful that an alternate medical approach would work although this was an impossibility. In the end the Father came to terms with the realities they were facing and took the challenge head on.

Yes we men want to fix things, dig holes, be the masters of our own destiny but sometimes it is better to accept the practicalities of life and face them head on. Maybe I do not really need a Backhoe after all.

Better Hearing = Better Living

At times the first step can be the biggest one.  In talking to patients I have come to realize that the journey to the front door of my clinic can be the longest, most difficult one.  It would appear to those who suspect they have a hearing loss coming in for a simple hearing test does not just represent knowledge. It potentially represents a prejudged string of events that many find daunting.  A hearing test can take away one’s ability to continue to deny that they have a hearing problem.

I just had a conversation with one of my patients that had felt this way.  This woman was having trouble hearing in her workplace and finally made an appointment to see me.  She didn’t want to use a hearing aid; she didn’t want to be hearing impaired but her reality was that she did have a hearing loss and she did need hearing aids.  Today, weeks after being first fit with hearing aids, she sat in my office telling me how much her hearing aids were helping her to live her life to its fullest.  This woman puts her hearing aids on in the morning and forgets about them.  She simply hears…in the workplace, in the boardroom and socially.  As this woman describes it “life is now better.” 

The first step to better hearing may be hardest but perhaps it will lead to a life lived to its fullest.

A Picture is Worth A Thousand Words

In 1993 when I started my clinic I was young and single with so much in life that would change in the next 20 years. The snap shot that one would take of my personal life would be very different than it would be currently. From the very beginning of my life as an Audiologist I was always very comfortable sharing a view into my personal life as my patients and I got to know each other, so it was not out of character for the proud new father to have his office plastered with pictures of his newborn son in1995. Even in the beginning the effect on my patients was a significant one. As was often the case the initial conversation I would have with my patients would center around those pictures.  In the next ten years we had five more children, all of them boys, yes that is six boys in ten years. My office wall had a great deal of pediatric content with all the pictures of my children that I wished my day to be surrounded with. I had these pictures on the wall for myself so that in the moments I had to myself I could sit back in my chair and take in my family. I could look at a picture and smile as I considered what that look on that child’s face represented. Many of the pictures that were (and are) on my wall have been candid shots of the boys in play, just living life. There are pictures of my two year old on the beach his face plastered in sand stuck to the left over virgin Pinna Colada that he had spilled on his face, or the picture of my three year old at the ski slope happily skiing with his brothers, or my boys held in my embrace, or another boy with a lump of snow on his stuck out tongue with a big smile on his face, or what I think is my patients favourite the picture of one of my boys dangling a big juicy worm over his mouth as his brothers had dared him to eat it after seeing the movie “How to Eat Fried Worms”, and yes I think he ate it. I have come to understand over the years what a profound effect those pictures have had on all that have seen them. The grandparent that walks in my office can’t help but relate to their grandchildren, the parent to their own children and their experiences and so on.  There is an interesting phenomenon that I have observed that has really made me think relating to this topic. When I have toddlers and even babies in office it is amazing to me to see how they tend to gravitate to the things in the office that they relate to such as the pictures of children on the wall, or my not so obviously placed treasure chest or a random toy in the office. . Children seem to notice these things long before adults. I can’t tell you how many children I have had conversations with regarding “the boy eating the worm” as a way of making the child comfortable with this clinical environment. The point is that we all want to have something in common with each other, we wish to relate to and personalize the health professionals we come in contact with, there is a need to humanize the interactions that we have in a potentially uncomfortable professional environment. This understanding has been one that has become apparent to me over the years and as a result we now have in our clinic intentional processes and directives to enable our staff to engage our patients from the moment they reach out to us. When we hire, we hire staff that enjoy getting to know other people, that have a very real and authentic approach to the relationships they build. It is human nature to work harder for those that we connect with and know, which is why I love the fact that my staff take great joy in getting to know each and every patient that they come in contact with.  

What Is Your Story ?

There is much I learn from my patients. I may not have a hearing loss but if I listen to my patients I gain a greater understanding of what their struggles can be like. I have a patient who shared this story with me. We were talking about some things that were difficult for her relative to her hearing and how she coped with them, what strategies she used. Keep in mind that this particular patient has a severe to profound hearing loss. So many of her daily situations are ones I never thought about.

Problem: going through a Time Hortons drive through. What do you do once you put your order in and  the person at the other end wants to tell you something or ask you something that you can not possibly hear? place your order and start your can moving before they can say anything.

Problem: how do you know when your seat number for your airplane trip is being called? Ask a friend to hear for you.

Problem: how do you hear your husbands conversation at bedtime or nighttime when the lights are out?


Coping strategies vary depending on the degree of hearing loss as well as the cognitive abilities of the impaired individual, as well as the complexity of the situation and so many other variables. We have all met people with hearing loss and may or may not recognize the strategies that are being employed.

Strategies

Talk too much : I have many patients that seem to talk a lot being gregarious with so much to say, so much so that you may not a get a word in edgewise. Sometimes this is a strategy to get by, as it is too difficult to listen it becomes easier to talk keeping the subject matter under ones own control.

Smile and nod: Here is another strategy, not a good one but a strategy non the less. We have all met that individual with a hearing impairment that seems so jovial, that seems to smile and nod a lot but not have a lot to say that fits the conversation. The problem is when you smile and nod and that universal response was not appropriate to the other end of the conversation. Who knows what one might have agreed to do  or how a smile and nod might not have been appropriate to the gravity of the conversation.

Not respond: I have had many a patient that one might have thought to be unfriendly or stuck up as they did not seem to want to respond in conversation when the reality is they just could't hear.


So I ask the question "how do you get by" or "what is your story"?

I would like to start a forum of dialogue where these experiences can be shared. It is good to know that you are not alone in your struggles and that the strategies we end up having to use are ones that many use. Please share this post on your facebook page and invite your hearing impaired friends to contribute to this dialogue.

Mr. Piano Man and Then Some

Sometimes as I take my boys to the doctor’s office, I find myself wondering about the person underneath the doctor’s facade?   I mean, are they married? Do they have kids?  Are they social? An introvert or extrovert? What do they do for fun?  Usually, if you are lucky, you may get a peek into their life by pictures they may have, but usually just a little peek!

You are in luck!  I’m going to give you a little peek into your audiologist’s world outside of the clinic. Many of you know Sanj to be a social, friendly guy, well educated on the ins and outs of the hearing or lack of hearing world.  If you are lucky, you’ve heard his great laugh!

Of course, if you are a patient, one of the first things you would learn is that he is the father of six beautiful, energetic boys, ages 18-8 years of age.  You would see the walls of his office plastered with pictures.  You may learn that Sanj is an avid sportsman with a love for hockey, baseball, fishing, golf and all things in between.

Did you know he is a gifted musician?  He is also humble so unless you have had the privilege of hearing him play, you may not have realized how talented he is.  He also has an amazing singing voice… beautiful, actually!

Sanj is so committed to his clinic and his patients.  He rarely takes time off or cancels appointments, as this is part of his personality- he is loyal and dependable.  He is dependable so much so that on a few occasions, it was almost problematic.  I remember being in labour with baby number 2, stopped by the clinic to let him know and he said, “I just need to finish with this patient.  I’ll meet you in a few minutes.”  Hum…. He ended up getting a call from the doctor who told him if he wanted to see this child’s birth, he needed to get there NOW.  (He made it, barely).

You get the idea, right?  Taking time off work, cancelling appointments and rebooking isn’t something he does.

Our boys go to Rhema Christian School.  It’s a great place to learn, grow and a place that becomes a part of your family.  Since Sammy, our oldest son, was in Junior Kindergarten, Sanj has taken every Friday morning off for a couple of hours and gone into the school and to sing and play piano with the kids.  Every Friday!  I’m never sure just who enjoys it more, the kids or the Big Kid?

It’s one of those things that money can’t buy, joy that is on the faces of the little ones as well as the Big Guy on the Piano, teaching them song after song about Jesus’ Love that bubbles over.

This year marks 14 years that Sanj has been at Rhema.  It was a special thing last night as the school honored him with a special volunteer award last night.

It’s one of those things that you may never know, if his wife had not hacked into his account to write this but some things are pretty special and worth sharing.  This is just  a little peek into the life of your audiology.

 Written by Reema Sukumaran

Louder Is Not Always Better  

It can be frustrating trying to communicate with someone that has a hearing loss.  I often watch as patients come in to my clinic with family members or friends that try desperately to get a point across.  Sometimes I see the same message repeated over and over, to no avail, other times I observe an increase in volume and other times I see repetition with increased volume occurring.  Often this approach fails to create any better understanding on behalf of the hearing impaired individual.

Sometimes talking louder can actually make it even harder to understand.  This statement sounds a bit counterintuitive but it is accurate.  When damage is done to the cochlea (the hearing sensor) through excessive noise exposure or the ageing process, sometimes there can be a distortion of sound as it is received in the auditory system.  When the volume of sound, such as louder speech, takes place there can be an even greater distortion to the sound making speech even harder to understand.

So what should you do?  Here are a few tips that can help with communication with the hearing impaired…

1)     Talk slower – break up your phrases.  This gives the hearing impaired person time to process the information - to put two and two together, so to speak.

2)    Position yourself well.  This would mean facing each other so that you are at a distance that allows you to see and hear each other.  In this way you can pick up better visual cues as well as have sound arriving at an optimal level.

3)    Reduce any unnecessary background noise in the room as it makes it harder to understand speech.

These are just a few helpful tips.  In the case of hearing impairment – louder is not always better.

Sanjeev Sukumaran Au.D.