Diplomas or Worms?

As an audiologist I have three degrees a Bachelors , a Masters and  Doctorate but what is interesting is that the paper with the most power hanging on my walls are pictures. When I first graduated and started working as an audiologist I was proud to put on my white lab coat over my formal shirt and tie attire. As a young man I felt like I really needed my diploma on the wall to convince my patients that I was qualified to see them. In some ways this might have been my own insecurities coming forward. I honestly had to pinch myself in those early days knowing that people actually came to see me as the expert in my field. The lessons I started to learn however moved me slowly in a different direction. I started to learn that the white lab coat actually scared little children as they related the coat to pain incurred through needles etc. . I learned that my ability to learn to listen to my patients and my ability to communicate valid applicable pertinent knowledge to them instilled far more confidence in them than the multiple diplomas on the wall. 

I was in private practice when my wife and I had our first child and I was definitely the ultimate proud father. In my private practice I had a beautiful new office and I started to put on the walls and on my desk pictures of my son. As the years went by my wife and I added to our family with five more boys, six in total, we had six sons in ten years. As you might imagine my collection of pictures grew. As a father I wanted those pictures of my family in my office to remind me of how blessed I was as well as to sit back and imagine what in the world that child might have been thinking. My wife loves taking pictures and she gifted me with many pictures of my boys simply living their lives which found their way onto my wall, there are pictures of the boys on the ski hill, on the beach, snuggling with Dad, eating snow, eating worms ( this is one of the favourites of other children)and the list goes on. 

Here is the interesting phenomenon. What I have found over the years is that when patients walk into my office/testing room the conversation often turns to family. When children come into the room it is so apparent that they are drawn to the pictures on the wall as their eyes take it all in and as they glance around there is an effect on young and old alike. I can visibly observe these people relax. This observation actually is one that I even see in prelingual toddlers and babies. I can see them drawn to the pictures on the wall. Many of the conversations I have with these young children are about the boy eating the worm or the boy at the beach or the boy on the ski slope etc. . 

It is my contention that in our human interactions and in the early stages of relationship we all search for commonality, there is comfort in knowing that the person we are with is somewhat like us. We probe and delve until we find that thing that gives us some degree of comfort before we start to trust the person we are with. When we become comfortable with the professional we are talking to and we begin to relate to them we are more likely to take in their words with confidence. As an audiologist I too want to know the person I am with and have that same sense of connectedness with them as they seek in me. 

When I learned to combine the ability to listen to my patients, relate to my patients, find commonality with my patients our clinical relationship was vastly improved. The knowledge and information I share is taken in by them with greater confidence and trust and as a result their outcomes improved. My patients end up leaving having somewhat enjoyed their time in office and are willing to tell others about their good experience. 

My lab coat and diplomas told my patients that we were different my pictures tell them that we are the same.

Sudden Hearing Loss

A common discussion point with patients is often whether loss of hearing or loss of vision is the poorer fate in life. Speaking in the theoretical is one thing but actually going through it is another. There is a condition in which in the blink of an eye you can go from perfectly normal hearing to a sudden and profound loss of hearing, typically in one ear. The effect this sudden change in a perception has a major impact on ones psyche. What might have been considered to be the better option to blindness can quickly be recognized for what it is. Here is a little information on this disorder.

Sudden Sensorineural Hearing Loss (SSHL) sometimes called sudden onset hearing loss is a condition on which one has a reduction in hearing typically in one ear that occurs suddenly and with significant impact on inner ear function. The cause of this disorder is sometime unknown (idiopathic). It is suggested that some possible causes are infectious diseases, head trauma, vascular issues such as insufficiency, and the list goes on. In most cases it is difficult or impossible to know what the specific cause of the sudden loss was.

Correct diagnosis and treatment of this disorder immediately is of ultimate importance. The typical first diagnosis for this condition is that this is an ear infection and antibiotics are prescribed however this approach is one that does not address the real issue. It is important to see an audiologist immediately to document and verify the nature of the loss. Once diagnosed correctly a typical approach is the prescription of corticosteroids either taken orally or sometimes injected intratympanically (through the ear drum), recovery can be spontaneous but also may be aided through intervention occurring primarily in the first two weeks after onset.  The audiologists should be included in monitoring the recovery.

https://www.nidcd.nih.gov/health/sudden-deafness

http://american-hearing.org/disorders/sudden-hearing-loss/

http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/sudden-deafness

Just Check it.

As the New Year is upon us many of us see this as an opportunity to start afresh on various fronts. A common theme is taking better care of ourselves from the perspective of our health. Often we vow to loose weight, eat better, exercise more and simply be on top of our health. When it comes to our hearing health it is often forgotten amongst the many things we consider important. We remember to visit our Dentist or Optometrist annually and consider that our vision and dental health is an important part of our well being yet we may not categorically put our hearing health on the same level. We are happy to have our eyes checked even when we are certain that they are good and we understand the importance of monitoring our dental health but when it comes to our hearing we often wait until we have a significant problem before we visit the audiologist. In many cases we wait far past the optimum time for excellent and positive intervention. I have seen people ignore their hearing health for years all the while having reversible pathology that would have best been dealt with early, simply because they were afraid they would need a hearing aid. Baseline hearing testing, much like regular check ups and screenings for many of our other senses and health indicators are simply a good idea. As a whole we are far more likely to be informed and in control of our own destiny when it comes to our health than ever before.

There is no need to hide from  knowledge regarding your hearing health, knowing what is going on is simply just that, knowledge. What one does with the knowledge they have is really up to them. This is the message that I often share with that family member that comes in complaining that another will not get their hearing checked primarily because they fear that that they have a problem.

This year I am making it my goal to communicate the need for baseline hearing testing. The concept that each person should know how well they hear is one that I intend to propagate with a question and a directive. The question,” How’s your hearing?” The directive, “Just check it.” Just a part of that new years theme of making sure we are taking the best care of ourselves that we can.

The Commoditization Of Better Hearing

So here is a topic that has been a point of significant contention for me. If you have ever spent any time in Florida and picked up a newspaper there you will notice the inundation of advertising for hearing aids. You see coupons and graphics and “Free, Free, Free” in everything, the end result is sensory and information overload. Even though we live in Canada we are seeing this kind of advertising and marketing hitting us as well, messages like two for one or 40% off or free this, free that, full page colour adds, direct mail, T.V. offers etc. You see the big box stores like Costco selling hearing aids at discount rates making you feel like you have saved money, you see hearing aid manufacturers buying up clinics to set up distribution chains for their products. The world of better hearing has been commoditized leaving you feeing like a consumer unsure of what is real and what is the best decision to make in your health care. The reality is that the world of better hearing should be in its best form; part health care and part technical care. Health care from the standpoint that hearing is a function of ones body and a change or deterioration of that function is relative to a component of your health. Working inside the ear by the standards of our province is a regulated controlled act. Hearing and communication cannot be minimized to the point that a product is your entire solution. Understanding and accepting and seeing the difficulties that you have with hearing and communication as well as vestibular function (balance) is why you come to an audiologist.

Identifying pathology and the correct intervention is a job that an audiologist is trained for, many audiologist today posses a Doctoral degree to know enough to get started in the field. Anyone that has worked with hearing and hearing loss as well as hearing aids no matter what their qualifications will tell you that there is so much more to successful intervention than a simple fitting of a product. I have learned much from my patients over the years as well as the knowledge of formal education, and what I know is that a one size fits all solution does not exist, I also know that there is no Santa, or Easter Bunny and that advertising that seems too good to be true probably is exactly that.

Helping my patients hear better, live living to its fullest, is a journey that begins long before wearing a hearing aid. Understanding the patient’s needs comes from understanding physiology but also understanding psychology as it applies to the individual. The journey of better hearing is an ongoing one that the audiologist and patient go on together it takes place over many years as we constantly work at doing better and dealing with the challenges that can come our way. Perhaps a better way to understand where importance lies is in considering the use of hearing aids as a part of a rehabilitative process with far more than just the involvement of a device.  Learning how to hear again is a process that takes time and effort. The effort that I speak of one that the patient puts forth as well as the audiologist.  Perhaps when we approach the hearing aid fitting as just the beginning of rehabilitation we can start to understand the importance of a team that helps to get you to your ultimate goal.

At The Ear Company we have refused to product advertise or price advertise because we believe that better hearing is not a commodity. While it is sometimes disappointing and difficult to see others in our profession following a different path in advertising we believe that it remains important to hold to what we believe serves our patients in the best way possible and we have been rewarded with loyal patients and friends of our company that spread the good word, which is far more powerful than any coupon or marketed discount can ever be.

Shoot Yourself In The Foot

We in the Audiology profession sometimes forget the importance of what we do and how our job really does change lives for the better. Within our own profession we have insecurities that sometimes get the better of us. Ours is a profession based in science and research yet we sometimes get uncertain about ourselves as professionals given the variability of outcomes in the area of hearing aids. We sometimes get caught up sidetracked by our own technology and fail to remember that we are not in the hearing aid business, instead we are in the business of empowerment. Ours is a profession in which lives are changed through reconnecting our patients with those that are important to them, by creating opportunity for better communication ability. Sadly many Audiologists get caught in the world of product rather than the Doctoring profession that ours is. 

In recent years we have seen research validating what we have understood to be true regarding the effects of auditory deprivation. In a nutshell what this research shows is that untreated hearing loss can lead to accelerated cognitive decline with measurable central neural deterioration apparent on imaging. The implications of this study by Doctor Frank Lin and colleagues has led to further research along the same lines with similar findings but other researchers as well.

What has bothered me is the response of the industry to these findings. I have seen these findings being used as a marketing tool with the belief that given this medical evidence we should be able to move more people towards earlier adoption of prescribed hearing aids. Quite honestly as a consumer I would find that someone telling me that I am going to go through cognitive decline if I don’t get hearing aids as another reason to pull away from the industry. Societally we have already had to fight the stigma that has long been associated with hearing loss and now the message becomes one that is supposed to motivate with fear of mental decline. The stereotype we already have in place is that hearing loss is associated  with aging and now we have associated mental decline. While this is not necessarily true for all this  is a very powerful suggestion affecting our perception of reality. If I am in my 40s or 50s suffering from mild or early stage hearing loss I would have to overcome these stereotypical understandings given to me by society and now our own profession in order to come to terms with doing something about it. My belief is that taking this approach to motivating people will cause further resistance and negative feelings towards a profession that fights an uphill battle with inaccurate  perceptions and stigmas already associated with hearing loss.

The message of empowerment in life is a far more potent message to communicate, focusing on living life the way you choose to live. To be able to choose a life of involvement in which human relationship and interaction is important to us is a far better message to communicate as an industry and as a profession. Beyond this message being the better message it is also an authentic message that is honest and true. While fear may motivate it is not a positive motivator. Yes I want to maintain my cognitive abilities but that message pales in comparison to having great relationships and interactions with those who are important to you.

To Soar Above The Clouds

Dealing with death is really hard for me. I don’t like going to funerals at all primarily because they are so emotional for me. Over the years I have had so many patients pass away and on my own I mourn the loss. I am happy to sit with their family in office and talk, share and grieve yet I have a hard time getting myself to go to funerals. Recently I had a patient pass away unexpectedly, this was someone that I have known in excess of 15 years. I was so saddened by his death and felt it deeply. After a few days this gentleman’s wife came by the office to talk and to donate his hearing aids. We spent time talking about their life together and the special relationship they shared. This lovely lady eventually asked if I would come to the memorial service that was to take place in a few weeks. I said I would come. As I said I do have a very hard time with these types of events but I said I would be there and knew that I would go. This last Saturday I put on my best suit and headed out to the funeral home.

It is amazing what a small community we live in and the way out lives cross. At this memorial service I ran into patients, friends and acquaintances that I had no idea were connected to these folks. The celebration of life was full of stories that amazed me moved me and yes, made me cry. You see this man was stricken with polio at the age of 9 and was hospitalized for three years returning to his family at the age of 12. I heard stories of the fierce determination that he possessed to overcome and be a part of society without the boundaries of inhibition that polio had rendered in his life. I heard a beautiful love story set around his love for sailing where he met the love of his life, his beautiful. I heard of their special life in a cottage community swimming and sailing and enjoying the company of friends and family, I heard about their travels to Brazil or the West Coast of Canada. All through this story I continued to hear about the determination that persisted in this man that helped him overcome and adapt to life’s challenges and the further limitations in mobility that afflicted him. It should be no surprise to me that when he saw me in the context of seeking help with his hearing loss that he approached this disability with a will to find success and did.

One of the most beautiful parts of the service was when his wife spoke and shared pictures of their life. Towards the end of the talk she shared with us his love for airplanes and how he loved to fly. At one point in her story she shared with us a story, a special experience. Even though this man was wheelchair bound he wanted so badly to fly an airplane and eventually found his way into a glider with another pilot.  In order to get him into the plane they had to remove much of the safety equipment that would be of little use to him anyway. This lovely lady shared the story of his time flying and how the pilot let him fly and even extended their time significantly given the sheer joy that this man felt gliding silently through the clouds. When listening to this story many of us were brought to tears because as his wife shared this was a time in this mans life where he felt like he was not limited where he felt free. As she concluded with this story we could all infer our own belief system and how we viewed death with this visual in our minds. In the end I was lifted up by having attended this celebration of life being blessed by the experience.

While many have limitations either of mobility, or hearing or visual acuity etc. it is an important lesson in life to take on that challenge and find ways to live you r life to the fullest and in the way you choose. This very specific message is one that we as a company have been communicating this year through our marketing campaign. The message is to life your life in the way you choose being empowered to control what you can and in our case this is about hearing loss and communication. In the end I was honored and blessed to have experienced this celebration of life, as it was another learning experience for me.  Determination, stubbornness, a will to succeed can be such a valuable characteristic in life.