Monthly Archives: October 2012

Your first hearing test: more about the testing procedures

Glen Sutherland, MCISc
Audiologist

In my previous post, “Your First Hearing Test: what you should bring”, I mentioned that your hearing health care professional would examine your ears and perform a series of tests to determine the nature and degree of your hearing loss. In this post and the next, I will explain more about the most common testing procedures used during your first hearing test.

The Client Oriented Scale of Improvement (COSI)

At the beginning of the appointment, your hearing health care professional (clinician) will spend about 15 to 20 minutes talking to you and asking you some questions about your hearing history. S/he may use a form such as The Client Oriented Scale of Improvement (COSI™), an assessment questionnaire for clinicians, to gather pertinent information about your hearing. The COSI allows the clinician to document your needs and goals for better hearing at the first appointment and to measure improvements in your hearing ability at future appointments.

Some questions that may be asked include but are not limited to:

How long have you been experiencing your hearing loss?
Do you experience any tinnitus (noises/ringing in the ear)?
Have you experienced any dizziness (vertigo)?
Have you ever had ear infections?
Have you ever had surgery on your ears?
Have you ever been exposed to loud noises that resulted in a hearing loss?
Does anyone else in your family have a hearing loss?
Was your hearing loss sudden or gradual?
Have you seen an Ear, Nose and Throat doctor for help with you ear/hearing problems?

Be thorough and honest with your clinician. Be sure to provide as much information that you can remember so s/he can provide you with the best hearing care to meet your individualized needs.

Otoscopic Examination

After the clinician has asked questions and taken notes about your hearing history, s/he will conduct an otoscopic examination, which is an examination of the outer ear, ear canal and eardrum. This procedure is completed with an otoscope, a medical device which is used to look into the ears. During this procedure the clinician wants to make sure that the ear canal is free of wax and that there are no skin irritations or other problems that would affect the test results.

The clinician is not performing an otoscopic examination to make a diagnosis. S/he wants to make sure that the ear drum can be seen and that the ear canal is clear to test. Typically, if the outer ear looks fine and the ear canal is clear of any debris, the clinician will proceed with the hearing test.

If there appears to be some condition on the outer ear or in the ear canal, the clinician will refer you back to your family doctor for further examination and assistance as required.

A Note about ear wax (Cerumen): ear wax is a natural part of the body and part of the ear’s own cleaning system. Wax stops incoming dust, dirt, bacteria and other debris (bugs, pussy willows, peas, etc.) from entering the ear canal. It also helps to rid the ear canal of such debris. A certain amount of ear wax is natural in the outer ear. If it is not causing bothersome symptoms ear wax should be left alone.

However, if there is an abundance of wax in one or both of the ear canals the wax may need to be removed before the hearing tests are completed. Some clinicians may refer you to your family doctor to remove the wax while other clinicians may be trained and qualified to remove the wax themselves.

I do not recommend that you to try to manage your own ear wax by pushing cotton swabs down your ear canals. If you know there is excess wax and you try to remove it with a cotton swab, you are more likely to push it further down the ear canal rather than getting the wax out of the ear canal. This will most likely cause more troubles for you than less. Leave wax removal to the professionals.

If the wax is hard, dry and difficult to remove, you may be asked to put some oil (mineral, baby, olive) in the ear canal(s) for several days before wax removal is attempted. The wax absorbs the oil and becomes soft so it is easier to remove (or it may fall out of the ear canal on its own). The clinician will explain the procedure to you if it is required.

After the otoscopic examination, there will then be a series of tests to assess your hearing. I will explain more about the hearing tests used to determine the nature and degree of your hearing loss in my next post.

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.

A special request for families experiencing hearing loss

I have a special request for those of you with normal hearing that either have or had a family member with a hearing loss.

The tag line for my blog is “sharing stories of hearing loss”. So far except for the occasional comment, the sharing has been pretty much one-sided!

While I have been writing over the past few months about the challenges of being deaf, I have also been thinking about the challenges of those living with someone who has a hearing loss. I want to write about those experiences too and would like to hear from you.

If a member of your family, immediate or extended, has a hearing loss and you would like to share your stories, please let me know. Or you may have grown up in a family where a parent, grandparent or sibling had a hearing loss. You can write about the highs and lows, the celebrations and the challenges, the frustrations and the sadness. Any story that you would like to share would be welcome.

I will keep your identity private unless you wish to be acknowledged and will respect your willingness to share so that others can learn from your experiences.

If you do not belong to a family experiencing hearing loss but know of one that does, please invite them to write to me.

Here’s how you can do it. Send me your first name and email address through the ‘leave a comment’ section so that we can correspond. I will write back to you and start the conversation.

I look forward to hearing your stories.

Rosemary Pryde

First lessons, initial sounds

It has been four weeks now since my implant was activated. A very interesting four weeks! Almost immediately I started hearing environmental sounds. When I got home that first day I heard what I thought was a whole new set of creaks going up the stairs. When I sat down for dinner even my dining room chair creaked. I had no idea.

I don’t wear my hearing aid while I learn how to hear with the implant unless I need to talk on the phone or am with a group of people. I have an extremely powerful hearing aid that actually overpowers the implant in my right ear at the moment. The sounds I am describing I hear with the implant only.

In a matter of days from the initial activation of my implant, the computer keys and mouse went from a buzzing sound to sounding just like they should – click, click, click.

The second or third day I heard myself crunching toast very loudly. I have not heard this sound before.

I want to utilize my implant for as much sound as I can and as I work from home, have been watching and listening to the noontime news. The news reader is very easy to lip read and I turn the sound way up so I can get the gist of it. In my third week she was interviewing a reporter from London. I actually heard his English accent! I wasn’t sure what he said but I definitely heard the upper class tones.

I have a whole host of friends and neighbours signing up for ‘tutoring’ sessions to help me learn to hear again with my implant. We started with simple two-syllable words such as weather, cookie and snowball and I try hearing them without lip reading. To my amazement, I get many of them right. This week we start on short sentences.

In addition to the lessons, I also have conversations one-on-one in quiet surroundings using only the implant and lip reading. By the end of week two, I could manage about 20 minutes of conversation before fatigue set in.

And oh my goodness, the mind numbing fatigue!! I thought it was tiring to hear just using my hearing aid. And it was. But this – trying to hear with the implant alone – is a huge job. I’m lip reading and that helps a lot. But I really want to be able to actually understand the words and that is taking its toll. I need to step back on occasion and rest my ears. This is really hard work! But it is so much better than it was. Before my implant, I knew this constant fatigue would only get worse as my hearing got worse. Now I know it will only get better. I can live with this.

Music is one of the most complex sounds around and it is the most challenging series of sounds for an implant. It was suggested that I play a very simple melody several times until I recognized the notes. So I started playing Twinkle Twinkle Little Star on the piano during the second week. All the notes sounded exactly the same and they most definitely did not sound like music. In fact it was pretty terrible – like the beat of a kettle drum played badly and with lots of static. This will take a while.

Thanksgiving weekend I was in New York for a four-day family celebration. Talk about surround sound stimulation! I took in all the noises of the street, even those that really didn’t sound like much. By the end of the trip, I thought I heard words in both my hearing-aided ear and the implanted one. My audiologist assures me that this is likely. The implant is catching up to my other ear. The sounds are still very Darth Vaderish, low, fuzzy and robotic, and I don’t hear the entire word yet, just bits of it. I have been told that it will likely take anywhere from six months to a year before the sounds I hear with my implant are ‘normal’.

A few days ago, I tried Twinkle Twinkle Little Star again. It actually sounded like the song – notes and all. An octave lower than the middle C I was using and pretty fuzzy, but unmistakable. On to Chop Sticks!

Ah, the magic of the telecoil and hearing aids

For those of you not familiar with this term, let me explain that a telecoil or T-coil is a tiny coil of wire built into most hearing aids that transmits sound through the telephone via an electromagnetic field. It allows those of us with hearing losses to hear on phones that are T-coil compatible. When you activate the T-coil in your hearing aid all you hear is the voice on the phone. It cuts out environmental noises so makes it easier to hear the caller. It’s a great tool but as with everything connected to hearing aids, cochlear implants and other devices that enhance sound, it can be tricky.

I have two stories to tell you. One illustrates using a mountain to solve a molehill problem and the other is just plain odd!

First, the molehill. This story took place about 20 years ago but I still dine out on it and want to share it with you. The job I had at the time required that I spend a fair bit of the day on the phone. My hearing aid was fitted with a T-coil so telephone work was pretty easy for me.

One day when I was on the phone, I heard a very loud buzzing sound in my ear. It was like a series of regularly spaced longish beeps, so loud that I actually couldn’t hear the person on the other end of the phone. I tried the phone in the office next door – same thing. This happened several times over the next week or so and I decided to have my hearing aid checked but it was fine. My hearing aid specialist and I couldn’t figure out what was wrong.

One morning I had just picked up my phone to make a call and the beeps started. I put the phone down and for some reason happened to look out my office door. I could see one of my colleagues at the photocopier. A little light went on in my head and I picked up my phone again while watching my colleague. Every time he made a copy, the light in the photocopier went on and I heard the beep in my phone. The electromagnetic field was creating this interference. The photocopier had recently been moved and was now too close to my hearing aid.

Well great. Now that I knew what was causing the problem, it would be easy to solve. Just move the photocopier a few metres down the hall out of range of my hearing aid. I’m not sure why this was not a suitable option, but instead of unplugging the photocopier, trundling it down the hall and plugging it in again – five minutes tops; the powers that be decided to move me instead. Luckily my good friend Lois agreed to switch offices with me or who knows where I would have ended up! A full day was spent packing, unpacking, moving furniture and changing telephones, all because the photocopier couldn’t be moved. I never did find out why the photocopier had to stay where it was but it was obviously more important to the efficient workings of the office than me! Making a mountain to solve a molehill problem indeed.

Now for the second story. I was giving a training course in a hotel near the airport and went into one of the small-group rooms to make a phone call. I pressed the switch to activate the T-coil in my hearing aid, picked up the phone and instead of a dial tone I heard a radio station! The electromagnetic field does it again. True story.

Your First Hearing Test: what you should bring

Glen Sutherland, MCISc
Audiologist

In previous posts I have discussed how important it is for you to get a hearing test and why you should get your hearing tested sooner than later. Now that we’ve convinced you to get your hearing tested pronto, you may be wondering what you need to bring to your first hearing test!

Quite simply put, you are not required to bring much of anything to your first visit except of course yourself. When you arrive for your hearing test appointment, someone at the front desk of the clinic will assist you to register. As part of the registration process, you may be asked to provide some personal and medical information that will help to prepare your hearing health care professional for your appointment.

It may be useful to have your health card (or your health card number) available. When you make your appointment, the clinic where you will be tested should let you know if it requires that information.

Other than that, as long as you’re ready to answer questions about your hearing as well as other provide noteworthy information such as some contact information and your doctor’s name, you don’t need to prepare anything further for your first appointment.

HOWEVER, I strongly urge you to bring a notepad and pen to your appointment. During the appointment, you will be given a lot of information. It is helpful to write down the information so you can refer to it later. You might also want to jot down any questions you think of during your appointment so you don’t forget to ask them.

Once you are registered at the clinic, a hearing health care professional such as an Audiologist or Hearing Instrument Specialist will come to the waiting area to get you. Once in a private office, you will be asked some preliminary questions about your hearing experiences and environments. Be sure to give the clinician as much information about your hearing as you can remember. This is definitely a case where more is better!

The clinician will conduct an otoscopic examination, which is an examination of the ear canal and eardrum. During the examination make sure the clinician reports what is being seen and what it means.

There will then be a series of tests after which your hearing health care professional will explain the results of your hearing test. Again, the clinician should aim to be clear, patient and approachable when explaining the results of all the tests and should happily repeat any information or answer any questions you may have at any point during your appointment. Don’t be afraid to ask your questions as you think of them. As you have been told for years, no question is too simple to ask!

Even after you’ve left the clinic, you may think of some other questions. It is important for you to note them and either make another appointment with the hearing health care professional or call the clinic to have your questions answered. You’ve taken the time to get your first hearing test; make sure you get all your questions answered to your satisfaction!

Disclaimer
Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.