Monthly Archives: December 2012

Hearing My Own Voice: a tribute to Dr. William F. House

The title of the December 17, 2012 edition of Toronto’s The Globe and Mail newspaper obituaries page caught my eye. “Inventor’s implant device restored hearing”. It had not really occurred to me before that someone had to be the first to invent this miraculous device. According to the obituary written by Douglas Martin of the New York Times News Service, Dr. House was a medical researcher who also developed a surgical procedure to combat vertigo, an often debilitating condition that causes extreme dizziness.

As is often the case with first inventors, others were skeptical about this cochlear implant device and felt it wouldn’t work. Lucky for me and many others, Dr. House persisted. While later scientists and researchers refined and enhanced the original concept, the intent was always the same – to bring sound to those who had not heard before.

I won’t get into the murky field of research and who claims ownership of this invention. Suffice it to say that many people including me are just happy it exists. Those like young Dara, a VOICE for Hearing Impaired Children poster child at age two who was fitted with an implant before she reached kindergarten. Or VOICE kids John and Jonathan, one now a lawyer and the other a financial advisor, both with profound hearing losses from birth who received cochlear implants in their early adult years. Or the woman in the waiting room at Sunnybrook that I spoke to just this week. She is from northern Ontario and had spent the entire day going through hearing tests, a C-scan of her head and the rather awful balance tests where the technician deliberately makes you dizzy so she can test the health of the nerves that control balance. Trust me, you don’t want to do this test unless it is absolutely necessary! After five hours, she was waiting for her final appointment of the day with the surgeon who would tell her if she would receive this amazing gift of hearing.

There are thousands and thousands of babies, youngsters and adults who are able to hear because of Dr. House’s initial work. We owe him a debt of gratitude.

And what about the title of this post: hearing my own voice. Those of you who read my cochlear implant posts know that the sounds I hear in my implanted ear are very robotic, much like Darth Vader. One of the exercises I do to help my brain learn to adapt to the sounds is reading out loud without my hearing aid. This week for the first time just using my implant, I heard my own voice – the voice I hear with my hearing aid – along with the Darth Vader version. The normal voice was very faint and was somewhat overpowered by the robotic sounds, but it was there.

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Hearing Loss: the good, the bad and the ugly

I was thinking about my grandmother the other day. She became deaf as a young woman and I always remember her with her hearing aid. It was about the size of a Blackberry and twice as thick. She wore it in a little pocket fixed to a harness that went around her chest. When she didn’t want to hear my grandfather talk any longer, she would turn off her hearing aid. This was quite the visual as the off/on switch was in the middle of the hearing aid and she turned it off with an elaborate twist of her hand. I always thought that was such a neat way of signaling, “I’m done with this conversation!”

This memory got me thinking about other memories of hearing loss – some good and others not so much. Just so you know, there will be no ugly list in this post. It just sounded good in the title.

Here are some benefits of hearing loss for me:

I have a mute button on my hearing aid. Before I received my cochlear implant, which unfortunately doesn’t have a mute button, I could cut out irritating sounds such as dogs barking, the hammering of new roof shingles in the neighbourhood, and the irritating signal trucks make when they back up. It was lovely to be in my backyard and not hear these sounds. I would also use the mute button when on the subway. I never could understand the instructions over the loud speakers even with my hearing aids and the silence was heavenly!

Because those of us who are deaf lip read, we watch faces closely. We attend to others. This eye contact is a really great way to connect and we do it automatically because we need to see their faces in order to hear what they are saying. As a result people like talking with us.

I give workshops for a living and invariably there is at least one person in the group who wants to speak with me after the session because she either knows someone who is deaf or has some concerns about her own hearing. We all have frailties and life can be made easier when we are allowed to share those frailties with others.

However hearing loss can be a great challenge. In a nutshell, the biggest issue is that we can’t hear! So we miss.

I remember when I was about 14 or 15 years old celebrating New Year’s Eve with friends of my family. Just at midnight, everyone trouped outside. I went along, not knowing why we were doing this. While we were outside, I noticed that others were exclaiming about something but I couldn’t understand them for the most part because it was dark. It wasn’t until we were back inside and I asked my mother what that was all about that I found out the church bells were ringing in the New Year. I didn’t hear them and missed the experience.

School was a challenge in many ways. Although I had a seat up front and could for the most part understand the teacher until he or she turned away to face the blackboard, I couldn’t hear any of the students behind me. I disliked ‘reading out loud’ the most of all the work we did. I would watch to see when others turned the page so I could at least be in the general vicinity of the book and dreaded my name being called because I did not know where to start.

One of the things I really don’t like about being deaf is missing the joke – especially the punch line. Have you ever noticed that when someone is telling a joke, he will lower his voice slightly just as he gets to the punch line? It is for effect and helps draw people in but it is frustrating for those of us who can’t hear. And asking to repeat the joke really spoils the party. So I miss.

But back to the good.

My favorite memory of the advantages of being deaf has to be when I was about 7 or 8 years old, the youngest in a family of six. We had a television set that didn’t always work and when the sound went, I was called on to lip read. People tended to speak directly to the camera in the early days of television so it was very easy for me to lip read. Talk about power! The red letter day for me was being able to stay up long past my bedtime, lip reading and watching I Love Lucy. What a treat!

Do you have experiences, good or bad, with hearing loss? I would love to hear your stories.

Rosemary Pryde

The Hearing Tests, Part One

In my previous post I started to discuss what you should expect to happen when you get your hearing tested. I explained the importance of the interview and described the otoscopic examination.

During the otoscopic examination, the clinician checks the outer part of the ear (the part you can see at the sides of your head) to make sure everything looks okay. Then s/he looks down the ear canal to make sure it is clear to proceed with the hearing test. 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 excessive 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 but 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 tests.
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.

Before I continue to explain hearing tests, I want to briefly describe the different parts of the ear and explain how sounds are transmitted to the brain so we know what we are hearing.

The Ear

The ear is divided into three sections: the outer ear, the middle ear and the inner ear. The outer ear consists of the parts of the ear that you can examine visually and includes the ear canal and the ear drum.

Just beyond the ear drum is the middle ear which is a space about the size of a pea and which houses the three smallest bones in the human body, the malleus (hammer), incus (anvil) and stapes (stirrup). These bones together are referred to as the ossicular chain. The middle ear is attached to the back of the throat by the eustacean tube. The purpose of the middle ear is to direct sound from the outer ear to the middle ear.

The inner ear (cochlea) is a snail-shell shaped, fluid-filled cavity in the temporal bone. It is filled with a special fluid and hundreds of thousands of tiny hair cells which turn the sound waves into electrical messages which are sent along a nerve to the brain.

You can see pictures and diagrams of the human ear by searching, ‘Human Ear’, on Google and then checking Images.

How We Hear: a simple explanation

Sounds are conducted from the environment around us into our ear canals. Sound energy pushes against the ear drum at the end of the ear canal, making the ossicular chain (in the middle ear) move against the oval window which sits between the middle ear and the inner ear. Generally speaking, the movement of the ossicular chain helps to determine the power of the sound which is perceived by the listener. Sound is conducted into the inner ear which translates sound energy into meaningful messages and transmits those messages to the brain.

Impedance Testing

On completion of the otoscopic examination of the ear canal and ear drum, the clinician may complete impedance testing next. Simply put, impedance testing is an indirect measure of the middle ear.

Impedance testing includes a series of tests which help the clinician to determine if the middle ear is working properly or not and if the ear is able to transmit the sound waves from the environment around us across the middle ear into the inner ear.

The clinician will place a probe into your ear canal. You will feel a slight change in pressure and hear some loud sounds. You are required to sit still and say nothing. The impedance machine will complete the test in less than a minute and record the results so that the clinician can determine the status of your middle ears. The clinician should explain the results of these tests once the hearing assessment is completed.

In a future post, I will review impedance testing in more detail and tell you what different results mean.

Puretone Testing

Perhaps the most familiar hearing test to our readers is the puretone test or “the test where you hear the beeps and you raise your hand (or push a button or say “beep” every time you hear a ‘beep’). Typically, puretone testing is completed at several frequencies between 250 Hz (like middle C on the piano) to 8000 Hz. Simply put, these frequencies, typically, 250, 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz., represent the main frequencies which are make up the components of speech in the English language.

The puretone test determines your ‘threshold of hearing’ or the lowest level where you just barely hear sounds (the beeps). Now-a-days, puretone testing is completed through insert ear phones which are held in your ear by soft foam inserts rather than the more traditional head phones. Generally speaking, the sounds are presented through the inserts and you indicate that you hear them by responding via raising your hand, pushing a button or saying, “I hear it”.

The clinician records the softest level when you indicate that you hear the sounds and records your responses in a graph called an audiogram. S/he will be able to compare your hearing graph to a graph of normal hearing to determine your degree of hearing loss. Again, at the end of the hearing assessment, the clinician will explain what the results on the audiogram mean and will answer any questions you might have about the audiogram.

You can see pictures and diagrams of the audiogram by searching, ‘Audiogram’, on Google and then checking Images. In a future post, I will describe the audiogram and tell you what information we get from reviewing the results on the audiogram.

As 2012 winds down, I want to thank you for reading my monthly posts. I hope you find them helpful and interesting. I wish you a warm and safe holiday season and wish you all the best in 2013. More posts to come in 2013! Cheers!

Glen Sutherland, MCISc
Audiologist

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.