Retail Model vs. Medical Model: Understanding the Difference in Hearing Care!

When it comes to addressing hearing loss, it’s essential to recognize the contrasting approaches offered by retail and medical model clinics. The disparity lies not only in the business structure but also in the level of comprehensive care and patient-centered focus. Let’s dive into the key distinctions and why choosing a medical model clinic can make a significant difference in your overall hearing health.

Retail locations often operate under the influence of hearing aid manufacturers, either directly or indirectly. Their primary goal is to sell as many hearing aids as possible. While hearing aids can undoubtedly be life-changing devices, it’s crucial to consider the impartiality of the recommendations provided in a retail setting. On the other hand, medical model clinics, like ours, are local and independently owned, with no affiliation to any specific hearing aid manufacturer. This allows us to prescribe the best solutions for our patients in an unbiased and personalized manner.

One of the significant disparities between retail and medical model clinics lies in their objectives. Retail clinics prioritize maximizing hearing aid sales, often utilizing tactics such as offering “free hearing tests” to attract customers. However, medical model clinics focus on the comprehensive assessment and treatment of hearing loss, recognizing that a thorough evaluation requires time and expertise, which comes with associated costs. By investing in a medical model clinic, you are receiving a higher standard of care, personalized recommendations, and a commitment to your overall well-being.

Moreover, retail locations tend to limit their scope to adults with straightforward cases of hearing loss, aiming for quick and straightforward transactions. In contrast, medical model clinics, like ours, embrace a patient-centered approach that extends beyond age and simple diagnoses. We provide care for patients from birth, offer specialized services for tinnitus management, and work with individuals concerned about their dizziness or balance. Our commitment to serving a wide range of patients underscores our dedication to comprehensive hearing care.

Another crucial aspect to consider is the compensation structure within each model. Retail clinics commonly operate on a commission-based system, where salespeople receive incentives for selling specific hearing aid brands. This may introduce bias and influence the recommendations provided to patients. In contrast, medical model clinics, like ours, do not offer commissions. We prioritize ethical practices and patient-centered care, ensuring that our recommendations are solely based on your individual needs and the best solutions available.

Furthermore, medical model clinics recognize the intricate relationship between hearing and cognitive health. We understand that addressing hearing loss goes beyond restoring auditory abilities; it involves assessing and supporting your cognitive well-being. Therefore, medical model clinics often incorporate cognitive screenings as part of their comprehensive evaluations. This holistic approach ensures that your overall cognitive health is considered and addressed alongside your hearing concerns.

Aural rehabilitation is another vital component of the medical model. While retail clinics tend to focus solely on the sale of hearing aids, medical model clinics understand that treatment extends beyond the device itself. We offer aural rehabilitation programs that encompass counseling, communication strategies, and ongoing support. This comprehensive approach empowers patients to adapt to their improved hearing, maximize their communication abilities, and enhance their overall quality of life.

Choosing a medical model clinic means investing in your long-term hearing health and overall well-being. By selecting a local, independent clinic with no affiliation to specific hearing aid manufacturers, you can be confident in receiving unbiased recommendations, patient-centered care, and access to a comprehensive range of services. Prioritizing your hearing health is an investment worth making, and with a medical model clinic, you are truly getting what you pay for – exceptional care tailored to your individual needs.

SUDDEN SENSORINEURAL HEARING LOSS (SSNHL)

One sign of sudden sensorineural hearing loss could be the loss of at least 30dB of hearing in three connected frequencies within a 72 hour period.

Everyone’s hearing naturally declines with age, and people often have one ear that hears better than the other. If hearing loss appears suddenly in one ear for no apparent reason, you may have experienced a sudden sensorineural hearing loss, a kind of nerve deafness.

Those who experience sudden sensorineural hearing loss generally discover hearing loss when waking up in the morning. Others might notice when they try to use the deafened ear, such as using a phone. Many note a loud “POP” just before they lose their hearing. People with sudden deafness can also experience one or more of these symptoms: dizziness, feeling of ear full­ness, ringing or buzzing in the ears (tinnitus).

If caught in time, sudden sensorineural hearing loss can be treated and corrected by an ear, nose and throat surgeon. Sudden sensorineural hearing loss symptoms should be seen as a medical emergency. Prompt treatment significantly increases the chance that at least some hearing can be recovered.

It is estimated that sudden sensorineural hearing loss affects between one and six people per 5,000 every year, but the actual number of new cases can be much higher, due to the fact that it often goes misdiagnosed­. Sudden sensorineural hearing loss can affect people of all ages, but is most com­monly seen in adults in their early 40s and 50s.

Diagnosing Sudden Sensorineural Hearing Loss

Ruling out conductive hearing loss, or hearing loss due to an obstruction such as fluid or wax in the ear is a good place to start. For sudden hearing loss without any clear cause upon examination, you should be referred to an ear, nose and throat surgeon and audiologist right away.

The ear, nose and throat surgeon can medically treat the condition at hand.

The audiologist will determine if the hearing loss is conductive or sensorineural with a diagnostic hearing test. Additional testing completed by the audiologist may include: (1) Tympanogram, (2) Acoustic reflexes, 3) Distortion product otoacoustic emissions (DPOAE) and/or (4) Auditory brainstem response (ABR). The information gathered by the audiologist will help guide the ear, nose and throat surgeons’ treatment plan.

What Causes Sudden Sensorineural Hearing Loss?

(1) Viral infections. One in four patients with sudden sensorineural hearing loss reports suffering from an upper respiratory infection within a month before the hearing loss. What virus caus­es sudden hearing loss? Viruses associated with sudden hearing loss include mumps, measles, rubella, as well as meningitis, syphilis and AIDS, among many others.

(2) Tumors. A variety of tumors in the ear, benign as well as malignant, may cause sudden sensorineural hearing loss.

(3) Head trauma affecting hair cells, eardrum or bones. Par­tial or total recovery from head injury induced hearing loss can be expected.

(4) Drugs and insecticides. Erectile dysfunction medications, a long list of prescription drugs and chronic abuse of painkillers may cause sudden hear­ing loss. Insecticides such as malathion and methoxy­chlor have been associated with sudden hearing loss in both ears (binaural sudden sensorineural hearing loss).

(5) Immunological disorders.

(6) Vascular disorders disrupting blood flow to the ear.

(7) Developmental abnormalities.

(8) Idiopathic disorders, such as multiple sclerosis, Meniere’s disease and others.

Sudden Sensorineural Hearing Loss Treatment

The most common treatment for sudden sensorineural hearing loss, especially when the cause is unknown, is corticosteroids administered by an ear, nose and throat surgeon. Steroids can treat many disorders and usually work by reducing inflam­mation, decreasing swelling, and helping the body fight illness. Additional treatments may be needed if you discover an underlying cause of your sudden sensorineural hearing loss.

It is very common for virally induced sudden hearing loss to be misdiagnosed as a middle ear infection. As a result, the typical treatments of middle ear infection, usually caused by bacteria, do not affect the virus actually causing the problem.

HOW DO YOU RECOGNIZE THE DIFFERENCE?

How Often Should You Have Your Hearing Tested By An Audiologist

Most people are accustomed to making regular health checkups a routine part of their medical care. Annual physicals, dental exams, and vision tests are all commonplace; however, few individuals pay as much attention to their hearing. How often you have your hearing tested depends on a few factors, one being age.

• Childhood: Newborn hearing screenings are essential, of course, and regular checkups throughout childhood are commonplace. Children should have their hearing tested prior to starting kindergarten, before starting any speech therapy plan or if there are any educational concerns.
• Adulthood: The American Speech-Language-Hearing Association’s (ASHA) guidelines state that healthy adults ages 18-40 years old, who are not experiencing any noticeable hearing loss, should have their hearing tested every three to five years.

We recommend more frequent diagnostic hearing testing for any of the following individuals:

• People over the age of 60: Presbycusis, or age-related hearing loss. Annual hearing tests are recommended for all adults beginning at the age of 60, regardless of whether or not they are experiencing symptoms. As we age, cumulative damage to the hair cells in the inner ear becomes more prevalent, affecting the ability to understand high frequencies. One out of three adult’s experiences presbycusis by the age of 65; that number increases to one out of two by the age of 75.
• People who are exposed to loud noises: Noise-induced hearing loss is almost as common as presbycusis, and affects individuals of all ages. Those who are frequently exposed to loud noises have a higher risk of suffering permanent damage to their hearing. These individuals should have their hearing tested once a year. Noise-induced hearing loss affects:
  • People who work in noisy environments (construction or factory workers, dentists, musicians, firemen and teachers),
  • People who regularly participate in noisy activities (concerts, hunting, riding motorcycles), or
  • People who are employed in professions where sudden loud noises are common (law enforcement and the military)
• People with hearing loss: This might seem counterproductive, but even if you have been diagnosed with hearing loss and wear hearing aids, it is more important than ever to have your hearing tested on a regular basis. Your hearing may continue to change over time, it is important that your hearing aids are properly programmed to ensure you are receiving the maximum benefit. These individuals should have their hearing tested once a year.
• Diabetics: If you have a health concern such as diabetes it is important to have your hearing tested annually. Over time, blood sugar levels that are too high or too low can damage nerves that affect your hearing in the same manner that they affect your vision. These individuals should have their hearing tested once a year.
• Cancer patients: If you are battling cancer and having chemotherapy treatments and/or taking ototoxic drugs you should have a baseline test immediately and hearing tests done every couple of months to make sure there is not a severe hearing degradation during your treatment.
• Vertigo: A hearing test should always be part of your dizziness workup. Certain conditions show up on the audiometric graph which will lead to possible earlier diagnosis of the condition responsible for your vertigo.
• Tinnitus: Anyone suffering from ringing or noises in their ear should have their hearing tested right away. Tinnitus is the first symptom of many audiological disorders. Although there is no cure for tinnitus, there are several ways that we can manage this condition. These individuals should have their hearing tested once a year.
• Sudden Hearing Loss: If you notice a sudden change or decrease in your hearing, you should promptly have your hearing tested. Often these losses are sensorineural hearing losses that are misdiagnosed as nasal or sinus conditions. Time is of the essence if we want to save your hearing. A diagnostic hearing test will determine the appropriate course of treatment.

Resolve to Treat Your Hearing Loss in 2022

The new year is quickly approaching and with it comes the hope for a better start! For many, relationships are restored, projects are completed, gym memberships are purchased, and resolutions are made for the coming year. People have a genuine desire to live a better year than the previous one. Unfortunately, they often overlook a very important part of their health—their hearing. 

According to Atlanta Hearing Associates, only 20 percent of people with hearing loss seek out treatment, and the people who do seek treatment will wait between 5 to 7 years before receiving a hearing test. This resistance to treatment means that hundreds of people are suffering year after year. They are missing the joys of effortless hearing and depriving their brain of the audible stimulus it needs to stay functioning and alert. 

Reasons Hearing Loss Remains Untreated

People refuse or postpone treatment for their hearing loss for several reasons. The most common reasons are the following:

• Hearing loss is gradual — Typically, people do not wake up one day and notice a large decrease in their hearing ability (unless they received an injury). Most often, hearing loss happens so slowly over time that my patient’s do not even notice the change. 
• Hearing loss is partial — Hearing loss may affect only high-frequency sounds while low frequencies remain the same. A person with partial hearing may assume that the people around him are mumbling. 
• Hearing loss is invisible — Hearing loss is typically painless; and, unlike a bruise, it leaves no physical mark. Problems that can’t be seen are often viewed as small threats that can be ignored. 
• Hearing loss is easily compensated — To some people, hearing loss isn’t a problem that necessitates immediate action. Instead of addressing the problem, people compensate by turning up the television volume and asking people to repeat themselves. Although these actions might postpone treatment, they are far from valid solutions. 

Beyond these, another reason that some people postpone treatment is that they have been miseducated about their hearing situation. People may struggle to hear only in noisy environments and suspect (or are told) that their hearing is normal. However, this problem may be caused by an auditory processing disorder.

Overcoming Barriers and Seeking Treatment

There is never a wrong time to acknowledge your hearing loss and seek treatment. The following are three ways you can overcome your resistance and start on the path toward better hearing.

• Acknowledge your hearing loss — Hearing loss is common. Approximately 1 in every 5 people will develop a form of hearing loss in their lifetimes. Acknowledging the problem is the first step toward treatment. Do you have a loved one who is resistant to scheduling a hearing test? Offer to go in with them and get your hearing tested too!
• Have your hearing tested — Not sure who to contact first? Give us a call and we can help you figure out who you need to contact first before your first scheduled visit! A hearing test at The Hearing & Dizziness Clinic will identify what is affecting your hearing and whether amplification is needed. I have some couples who come in together to get their hearing tested. This usually helps those who are resistant to getting help.
• Consider hearing aids — At The Hearing & Dizziness Clinic we can educate you about the latest hearing aid devices and their capabilities. We pride ourselves on giving a thorough explanation as well as demonstrate what a hearing aid will sound like!

Find Treatment Today

Don’t let another year pass you by as you struggle with untreated hearing loss. Overcome your barriers and seek treatment today! If you are experiencing hearing loss call one of our offices to book an appointment, or you can book an appointment online by clicking here.. We are more than happy to assist you as you resolve to make this year the best one for you and your hearing. 

References

“Hearing Loss: Overcoming The Barriers To Treatment.” Atlanta Hearing Associates. HearAtlanta.com. Published April 28, 2016. Accessed December 6, 2021. https://www.hearatlanta.com/hearing-loss-articles/hearing-loss-overcoming-barriers-treatment/.

Hearing Loss and Relationships

“He thinks I’m yelling, but I’m not. I’m trying to speak louder so he can hear me. But after raising my voice and repeating myself multiple times, he thinks I’m aggressive and mad. Upset, he asks me why I’m being so short with him. I just want to be heard, but, sometimes, saying nothing would be much easier.” 

Ahhh, the joys of relationships! Quite often, I see the highs and lows of relationships in our clinic—the agitated spouse bringing in her loved one for a hearing test or the concerned child motivating his parents to finally discuss getting hearing aids. 

However, I also see the joys of restored communication. When patients are fit with hearing aids, their perspective changes. They finally understand how impeding their untreated hearing loss was. I witness nervous patients rediscover their independence once they no longer need to rely on family members to repeat themselves.

HEARING LOSS ON THE HOMEFRONT 

Communication is a vital part of our everyday lives. We interact with people all day: working, parenting, traveling, gathering with family/friends, and running errands. Hearing loss can present challenges when conversing, particularly with strangers or when the location has poor acoustics. Life does not slow down for someone with hearing loss. Often, we see these individuals attempting compensation strategies to get by, such as lip reading or using their loved ones as mediators. 

Researchers have evaluated the relationship dynamic between people with hearing loss and their loved ones. Their studies demonstrate that hearing loss produces feelings of frustration, embarrassment, and distress. Partners of those with hearing loss often feel forced to involve their partners in social gatherings and to avoid embarrassing scenarios by smoothing social interactions. This voluntary responsibility can lead to significant stress and strain in the relationship. While one partner is trying to enjoy himself socially, he must also repeat words and phrases back to his hearing-impaired partner. 

I hear stories of patients struggling to have conversations even in their own homes. A spouse wonders why the other can’t hear his question while the dishwasher is rumbling and the TV is blaring. He raises his voice, thinking this will solve the dilemma. However, noticing his tone, his spouse feels attacked and accuses him of “shouting and yelling.”

When communication breakdowns occur, both sides feel annoyed, resentful, and irritated. The good news is that help is available!

DO’S & DON’TS OF COMMUNICATION

Communication strategies can go a LONG way, even for someone without hearing loss! Just because your loved ones are fit with hearing aids doesn’t mean they are now able to communicate from rooms away. To optimize conversation and reduce communication breakdowns, consider some of the following tips for talking with your family:

 DO:

•     Get their attention (say their names) prior to asking a question or talking.
•     Communicate face to face (visual cues help everyone!).
•     Speak slowly and clearly.
•     Try using different words.
•     Have patience.

DO NOT:

•     Shout or scream.
•     Speak rapidly.
•     Turn your face away or communicate from a different room.
•     Repeat the same phrase louder each time.
•     Get frustrated and say, “Nevermind! Forget it.”

WHAT CAN YOU DO TO HELP? 

“Hearing loss very often is such a gradual phenomenon that the person is in denial. You really have to be patient with them in getting them to come forward to get help.”

      — Marion Ross 

Communication is key to maintaining a healthy relationship. If you or your loved one is reluctant to apply these tips, consider educating yourself on the influence hearing loss can have. Also, share your feelings with your partner. Hearing loss isn’t “their problem.” It is a roadblock in your relationship that is affecting both of you and one that you must overcome together. 

The good news is that there are plenty of tools and technology for individuals with hearing loss to use to improve their communication and quality of life. One of the most important contributors to successful hearing aid use is support from loved ones. 

We want you to hear your best for yourself and for the people who mean the most to you. At The Hearing & Dizziness Clinic, our job is to walk you through your hearing loss and provide treatment options. Please contact us if you or your loved ones are experiencing hearing loss. Everyone deserves a chance to hear better.

REFERENCES: 

Morgan-Jones RA. Hearing Differently: The Impact of Hearing Impairment on Family Life. London and Philadelphia: Whurr Publishers: 2001. 

Tjørnhøj-Thomsen, Tine, and Hans Henrik Philipsen. “Hearing Loss as A Social Problem: A Study of Hearing-Impaired Spouses and Their Hearing Partners.” The Hearing Review (2019).

Alzheimer’s and Brain Awareness Month 2021

HEARING LOSS AND DEMENTIA

“I used to worry about my dad. I live out of state and call home weekly. On the phone, Dad didn’t seem like himself. He was aloof and sometimes unresponsive. I used to worry that he wasn’t following me on the phone or participating at family gatherings because of memory loss, dementia, or something else. But surely enough, once he could hear well, he was back to his old self. He smiled, laughed, and engaged in conversation just like he used to. Hearing aids were a game changer. They literally brought him back to life.”

During hearing aid consultations, family members often express concerns about hearing loss and the implications it can have on cognition and/or dementia. When individuals aren’t able to hear properly, they may seem disengaged, unresponsive, or they may respond inappropriately. Whether these changes in behavior result from hearing problems or reduced brain function is sometimes difficult to determine.

Hearing loss is one of the most common problems in the aging community. The prevalence of hearing loss increases with age, affecting 40% of people over 50 years old and roughly 71% of people over 70 years old. Untreated hearing loss can lead to difficulties when communicating and laxed participation in normal daily activities and social engagements. Withdrawal from these activities can ultimately lead to isolation, loneliness, and cognitive decline. 

Hearing loss has been identified as potentially the most modifiable risk factor for dementia. One study found that age-related hearing loss is associated with an increased rate of cognitive decline and an increased risk of developing dementia. In addition, the likelihood for developing dementia increases with the severity of the hearing loss (Slade 2020). 

WHERE DOES THE BREAKDOWN BEGIN?

So where exactly does hearing breakdown begin? The most common form of hearing loss seen in the aging community is formally known as “sensorineural” hearing loss. This hearing loss is either “sensory” or “neural” in nature. Sensory indicates that the hearing loss is caused by damage to the small sensory hair cells that are housed in the cochlea, the organ of hearing. The “neural” portion refers to the neurons that send the auditory message along the hearing nerve to the brain. 

When the cochlea is not functioning properly, it is less effective at decoding and relaying signals to the hearing nerves. This compromised signal results in diminished neural activity. Both sensory and neural changes disrupt the brain’s ability to comprehend speech properly. This lack of input and change over time can alter how the brain allocates its resources. Think of the saying, “If you don’t use it, you’ll lose it!” I often explain to my patients that hearing is not just an “ear” thing, it’s an “ear-to-brain” connection!  

THE EAR-TO-BRAIN CONNECTION

As we age, connections between brain cells can become lost or damaged. This disconnection is often referred to as cognitive decline. Research in hearing loss and cognitive decline has gained significant momentum over the past few years. Many studies continue to investigate the correlations and causal relationships between hearing loss and dementia. However, such study proves challenging since the brain and auditory systems are both quite complex. Even so, researchers have discovered evidence suggesting that changes are taking place at the level of the brain when hearing loss is present, particularly in the aging population (Slade et al. 2020).

Interestingly enough, research has demonstrated changes at the level of the brain in individuals with sensorineural hearing loss. One study that performed imaging on older adults to assess the brain’s activity while listening to sentences of varying speech rates found that individuals with sensorineural hearing loss experienced changes in brain activity while listening to faster talking rates than slower and simpler talking rates. Additionally, the study discovered reduced grey matter volume in the hearing portion of the brain–the portion responsible for processing information (Peele 2011)! Overall, people with hearing loss should focus on complex tasks because they are more profitable for the brain. In the real world, this equates to increased hearing effort, aka listening fatigue, when placed in those challenging listening environments. THINK: restaurant, large family gatherings, auditoriums, airports, etc.

Another study explored the association between hearing loss and dementia in the general population. They discovered that hearing loss is associated with significant increased risk of dementia, especially in patients aged 45 to 64 years. Their findings suggest that implementing early hearing protection, screenings, and hearing aids may help reduce this potential risk factor for dementia (Liu 2019).

WHAT CAN YOU DO?

So, what can you do to help yourself or your family members?

• Schedule a hearing test! It will NEVER hurt to have your hearing evaluated to establish a baseline. If we detect hearing loss, we can discuss options for moving forward. 
• If you use hearing aids, wear them whenever you are awake. Keeping the brain stimulated, even in quiet situations, is important. The brain needs to hear all sounds to stay sharp and active–this includes the sink running, newspaper rustling, and feet stepping on the floor.
• Stay up to date on screenings and re-evaluate your hearing every one to two years. Hearing loss can happen gradually, and your brain might not know what it’s missing!
• If your family member struggles with dementia or Alzheimers, please know many hearing solutions can improve communication. Reach out to us. We can walk through various hearing technologies or accessories that will suit the needs of your loved one.

Since hearing loss is a modifiable age-associated condition linked to dementia, the Lancet International Commission on Dementia, Prevention, Intervention, and Care has estimated that treating hearing loss may decrease the risk of dementia by nine percent. [Practice name] empowers patients and advocates that they treat hearing loss sooner rather than later!

During Alzheimer’s and Brain Awareness Month, we want to shed light on such a prevalent health topic. Experiencing Alzheimer’s, dementia, or any brain injury can be extremely challenging for our patients and their loved ones. At [Insert Practice], we have the patience, compassion, and empathy to walk through these challenges with you. Our goal is to ensure you and your loved ones are heard while helping you hear your best. 

REFERENCES

Liu, Chin-Mei, and Charles Tzu-Chi Lee. “Association of hearing loss with dementia.” JAMA network open 2.7 (2019): e198112-e198112.

Peelle, Jonathan E., et al. “Hearing loss in older adults affects neural systems supporting speech comprehension.” Journal of neuroscience 31.35 (2011): 12638-12643.

Slade, Kate, Christopher J. Plack, and Helen E. Nuttall. “The Effects of Age-Related Hearing Loss on the Brain and Cognitive Function.” Trends in Neurosciences (2020).

Uchida, Yasue, et al. “Age-related hearing loss and cognitive decline—The potential mechanisms linking the two.” Auris Nasus Larynx 46.1 (2019): 1-9.

Better Speech & Hearing Month May 2021

Better Hearing & Speech Month at The Hearing & Dizziness Clinic

Hello, Better Hearing and Speech Month! At The Hearing & Dizziness Clinic, I am passionate about educating my patients on the importance of hearing health. One of the simple ways I can do this is by sharing who I am and the types of problems we help our patients solve! Do you know what an audiologist is?

What is an audiologist?

Audiologists are health-care professionals who provide patient-centered care in evaluating, diagnosing, treating, and managing hearing, balance, and auditory disorders for people of all ages. From newborn hearing screenings, to fitting hearing aids, to testing balance, our services are needed across the lifespan.

Where do audiologists work? 

Audiologists work in a variety of settings. Depending on our clinical interest, you can find a lot of my colleagues in any of the places listed below:

• Hospitals  
• Private practices 
• Ear, Nose, and Throat (ENT) clinics
• School settings: Educational audiology (K-12) & Universities
• Industrial hearing conservation programs
• Hearing Aid Chains

What services do audiologists provide?

I am trained and equipped to perform a wide variety of services. Listed below are some of the many services an audiologist can perform: 

• Comprehensive hearing assessments ***
• Wax removal***
• Evaluating and providing treatment options for tinnitus (noises in the ears)***
• Assessing and diagnosing auditory conditions such as: auditory processing disorder, auditory neuropathy, hyperacusis (sensitivity to sound), and misophonia (hatred of specific sounds) 
• Evaluating vertigo, dizziness, and balance disorders***
• Selection and fitting of hearing aids***
• Verification and validation of hearing aids***
• Candidacy assessment and fitting of implantable devices such as: cochlear implants, bone anchored hearing aids, and middle ear implants

*** These are the services that I provide at The Hearing & Dizziness Clinic.

What training is required to be an audiologist? 

Recently I’ve noticed patients expressing curiosity in my job title, “Audiologist”. In Canada, Audiologist hold a Masters or Doctorate Degree. In the U.S., an audiologist requires a doctoral level degree. This degree is not equivalent to a medical doctor (MD), however an audiologist’s education requires four additional years of education after receiving a bachelors. That’s 8 years of school! After completing my Bachelors at The University of Ottawa, I went to Wayne State for 5 years to complete my Doctorate in Audiology. There is a lot of territory I had to cover in the doctoral program: 

• Anatomy
• Physiology
• Acoustics
• Diagnostics
• Clinical practicum
• Counseling
• TECHNOLOGY 

Audiologists truly never stop learning! As you can imagine, technology continues to evolve, which means audiology does too. Staying up to date on best practice includes being informed on the latest research, testing procedures, and advancements in hearing aid technology.

In addition to graduating from an accredited doctoral program, my colleagues and I must pass a national exam and are required to hold provincial licensure.

Why see an audiologist at The Hearing & Dizziness Clinic?

The comprehensive knowledge and training required to practice clinically speak volumes to the quality of care you will receive. With hundreds of hours in clinical rotations, audiologists are trained to help treat more than just hearing loss. For example, other conditions such as tinnitus are often co-existent with hearing loss. Audiologists are trained in managing this as well. 

In addition, the goal at The Hearing & Dizziness Clinic is always to provide patient centered care that is backed by evidence based practice. The objective is not to sell, but rather to improve an individual’s quality of life. There is a SCIENCE and SKILL that goes into picking the right technology for you or a loved one. When selecting hearing aids, there are many factors to consider. For example:

• What is your lifestyle?
• What areas are you hoping to see the most improvement?
• Should you get one or two? 
• Do you have trouble hearing in background noise?
• Do you have tinnitus?
• Do you have a history of ear surgeries?
• Have you had success or trouble with a different device before?
• Do you have vision or dexterity issues?

The list goes on…but the goal is always to help find technology that will help you thrive in your everyday life! For most, hearing is the gateway to communication, social interaction, and living your fullest life.

The latest MarkeTrak survey found that hearing aid owners almost unanimously agree that the hearing care professional they worked with played a critical role in their satisfaction with hearing aids. Hearing aid users reported satisfaction rates of 94% when working with an audiologist (Marketrak 10 results). They also found that patients strongly valued the quality of service during the fitting, professionalism of the audiologist, and the quality of service after the fitting. Additionally, patients reported that receiving realistic expectations and focusing on their individual needs was equally important in their success with hearing aids! 

Our primary goal at [Insert practice name] is to get you as close to 100% satisfaction as possible. [We/I] value creating a relationship with our patients and walking through your journey to hearing better with you. In light of Better Hearing and Speech Month, reach out to us if you would like to know more about how to hear your best. Our goal is to continue educating and empowering all of our patients!

References: 

Carr, K. (2020). 20Q: Consumer insights on hearing aids, PSAPs, OTC devices, and more from MarkeTrak 10. AudiologyOnline, Article 26648. Retrieved from www.audiologyonline.com

STRESS AWARENESS MONTH

STRESS AWARENESS MONTH 

It’s hard to believe the novel coronavirus began sweeping the nation almost one year ago. In the blink of an eye the entire world was turned upside down. Shelves went bare in grocery stores, businesses closed, jobs were lost, and social distancing became the “new normal”. Many people were forced to find creative solutions to work from home while also caring for their family. All of these factors created the perfect storm for life to feel very heavy and stressful. 

During the pandemic, about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder. This number was previously lower, averaging about 1 in 10 adults who reported the same symptoms in 2019. A recent poll from the Kaiser Family Foundation (KFF) in July 2020 found that many adults are reporting specific negative impacts on their mental health and well-being, such as difficulty sleeping (36%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus.

TINNITUS & STRESS 

Clinically, more patients seem to be reporting an increase in tinnitus (noises in the ears) since the pandemic started. However, this isn’t surprising, considering stress is known to have an effect on tinnitus. With all of the additional burdens and stress people are facing, it’s no coincidence their tinnitus decided to resurface. 

At the present moment, there is no formal data that suggests contracting the coronavirus leads to hearing loss or tinnitus. However, many studies have demonstrated that tinnitus is exacerbated by factors such as stress, lack of sleep, and unhealthy diet. Heavy alcohol consumption or large quantities of caffeine are also thought to negatively impact tinnitus.  Additional daily worries with managing the family, job security, and interpersonal relationships have increased stress and negative feelings. Not to mention anxieties about contracting the virus or spreading it to someone you care about. Throughout the pandemic, it’s safe to say many people have found themselves relating to at least one or several of these factors mentioned.

Many people find coping with tinnitus to be very challenging. There are products sold on the internet that make claims to “get rid of tinnitus”, but many of these supplements are not evidence based or clinically proven to work.  In fact, some of the most important strategies to help manage tinnitus come from retraining your brain and learning to manage stress…which is certainly easier said than done!

LESS STRESS, PLEASE!

So what can be done to help reduce stress? April is Stress Awareness Month, and who doesn’t benefit from strategies to keep our mental and emotional health in tip top shape? Listed below are some ideas suggested by the CDC to help cope with stress:

• EAT HEALTHY: Nourish the body with wholesome, healthy foods. Avoid large quantities of alcohol or caffeine. 
• EXERCISE: Spring has sprung (hopefully in your area!), so get outside and move your body. Sunshine and fresh air do wonders for the mind. Exercise boosts energy levels and releases endorphins that can help improve your mood.
• TAKE A BREAK: Hit pause on those social media platforms that keep you mindlessly scrolling. Give yourself permission to take a break from negative or biased media sources.
• BE MINDFUL: Practice yoga, stretch, or meditate! Some of these things may not come naturally at first, but practice makes perfect. 
• UNWIND: Find an activity or hobby you enjoy. Learning a new skill can be a positive, fun outlet.
• STAY CONNECTED: Check in on family and friends with phone calls, texts, FaceTime, Zoom, etc. Technology is a blessing and a wonderful way to stay connected, especially during times of social distancing.
• SEEK HELP: Do not be afraid to talk to someone about how you’re feeling. Seek help and guidance from a trained professional if needed.

(CDC 2019)

Let’s kick stress and jump into the spring season feeling refreshed! Implementing simple self-care steps can seem small and insignificant, but truly make a difference. By creating healthy habits we can positively influence our mental and emotional well being.  If you feel burdened by stress or are suffering from tinnitus, please contact our office. Our job is to walk through this with you and help provide solutions to improve your quality of life!

References: 

Baigi A, Oden A, Almlid-Larsen V, Barrenas ML, Holgers KM. (2011) Tinnitus in the General Population With a Focus on Noise and Stress – A Public Health Study. Ear & Hearing. 32(6):787-789.

Canlon, B., Theorell, T., & Hasson, D. (2013). Associations between stress and hearing problems in humans. Hearing Research, 295, 9–15.

Centers for Disease Control and Prevention (2019). Stress and Coping. Accessed on February 24, 2021.

Marshall D. (2020) Taking Care of Your Mental Health in the Face of Uncertainty. Accessed on February 24, 2021.

Nirmita Panchal, Rabah Kamal, and Feb 2021. “The Implications of COVID-19 for Mental Health and Substance Use.” KFF, 10 Feb. 2021, www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/. 

Pan T, Tyler R, Ji H, Coelho C, Gogel S. Differences among patients that make their  tinnitus worse or better. Am J Audiol. (2015) 24:469–76. doi: 10.1044/2015_AJA-15-0020

Vindegaard N, Benros M. COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain Behav Immun. (2020) 89:531–42. doi: 10.1016/j.bbi.2020.05.048

HEARING AND VISION

“Will wearing hearing aids interfere with my glasses?”

One of the most common questions patients ask me during a hearing aid consultation is, “Will wearing hearing aids interfere with my glasses?” I understand. Wearing one extra thing every day is a scary thought. After the rise of COVID-19 in 2020, we were all graced with yet another accessory–the facemask. Fortunately, hearing aids do NOT interfere with wearing your glasses. In fact, many patients wear both comfortably, mask included!

HEARING LOSS AND VISION LOSS

Hearing loss and vision loss are among some of the most common health conditions that our patients face. Nearly 38 million North-Americans experience some form of hearing loss, and one in three people in Canada and the United States between the ages of 65 and 74 has hearing loss. Noise exposure, aging, and genetics are just a few of the various factors that can lead to hearing loss.

Similar to hearing loss, vision loss also increases with age. Nearly 12 million North-Americans older than 40 experience a form of vision impairment, according to the CDC. Some of the most common causes of vision loss include macular degeneration and vision complications from diabetes, glaucoma, and age-related cataracts. Patients who experience vision loss face difficulties such as limited side vision, sensitivity to light, and reduced depth and color perception. These issues severely reduce one’s ability to perform everyday tasks.

THE EFFECTS OF HEARING LOSS AND VISION LOSS

Living with hearing loss can be exhausting! Adding vision loss is worse. Adding a mask that covers the mouth is inconceivable. During the pandemic, I’ve noticed now more than ever how much patients must strain their ears to hear what is spoken. With masks covering our mouths, many of the lip-reading cues we all rely on are out the window. I can tell when someone is leaning in, hyper-focused, trying to comprehend every word. Living with hearing and vision loss truly fatigues the brain. When the brain does not have adequate access to important speech sounds, it must work even harder to process what little it’s receiving. Hearing loss can significantly and negatively affect a person’s quality of life by causing embarrassment and social withdrawal or by making understanding speech and listening in noisy environments more difficult. 

If you couldn’t read street signs or if you noticed the words on a page were fuzzy, would you seek help? In my experience, many patients are well aware of their vision loss and have taken the appropriate steps to treat it. However, for whatever reason, hearing loss is a different story. Many people are hesitant to address their hearing problems because they feel embarrassed or even old. 

Generally, hearing loss tends to be a slow, gradual process. Many patients share initial comments such as, “Well, they mumble,” or “That restaurant was extremely noisy,” or “That person is so soft spoken,” when, in reality, those may be the early signs (years prior) that slight changes are happening to the auditory system! Most patients do not show up for a baseline hearing test until their hearing has regressed to a point at which they are extremely bothered by it or their family and friends are noticing. 

WHO CAN HELP?

Primary Care Physician: If you are experiencing hearing loss or vision loss, the first step is to consult your family doctor or primary care physician. They can evaluate your concerns and refer you to specialists to have your hearing and/or vision evaluated. 

Optometrist: A doctor of optometry can evaluate your vision and provide a rehabilitation program that addresses your needs. A wide variety of rehabilitation options are available to help people with low vision live and work more effectively, efficiently, and safely.

Audiologist: An audiologist or doctor of audiology can evaluate your hearing and balance related problems. An audiologist can perform a comprehensive hearing test, explain the results, and provide recommendations for hearing aids if they will benefit you.

TIPS FOR LIVING WITH HEARING LOSS AND VISION LOSS

Many of our patients wear glasses AND hearing aids! Many styles of hearing aids are available, and the following tricks can ensure an appropriate and comfortable fit:

• • Color indicators → Sometimes, patients must get creative by marking their hearing aids with small stickers or nail polish to identify which device belongs in what ear. For one patient with severe visual impairment, I ordered hearing aids with two different colors for each ear. The patient found it easy to remember that, “Light is right, and dark is left.” 
  • Tactile tricks→ Some patients prefer to have additional tactile buttons to help them remove their hearing aids from the charger or to identify the position of the device in the ear.

• Light indicators→ Many hearing aids are rechargeable and use blinking lights to indicate when the device is charging and when it’s ready to use.

• Large-printed materials in black & white→ Print a summary of what happened at the appointment in a large-print font that is easy to read and reference as needed. 
• CapTel phones→ Closed caption devices, such as CapTel phones, display a patient’s phone conversation in large text. The large text visually compliments what is being said, helping severely hearing impaired patients see and understand the audio they are receiving. CapTel phones are free with documented proof from a licensed professional of one’s hearing loss. CapTel phones are only available in the U.S. at the moment.

The month of March is “Save Your Vision Month.” In the words of Helen Keller, “Blindness cuts us off from things, but deafness cuts us off from people.” The combination of the two impairments can be isolating and difficult. At The Hearing & Dizziness Clinic, we aim to provide you with outstanding hearing health care that is personalized, professional, and improves your quality of life! 

References: 

1. Courtney-Long EA, Carroll DD, Zhang QC, et al. Prevalence of disability and disability type among adults–United States, 2013. MMWR Morb Mortal Wkly Rep. 2015;64(29):777-783. 
2. Deal JA, Betz J, Yaffe K, et al. Hearing impairment and incident dementia and cognitive decline in older adults: the Health ABC study. J Gerontol A Biol Med Sci. 2016;glw069.
3. Fast Facts of Common Eye Disorders. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 9 June 2020,www.cdc.gov/visionhealth/basics/ced/fastfacts.htm. 
4. National Eye Institute. All Vision Impairment. National Eye Institute website. https://www.nei.nih.gov/eyedata/vision_impaired. Assessed November 28, 2016
5. National Institutes of Health. National Eye Institute. All vision impairment. https://nei.nih.gov/eyedata/vision_impaired. Accessed January 4, 2016. 
6. Prevent Blindness America. Vision problems in the U.S.: prevalence of adult vision impairment and age-related eye disease in America. http:// www.visionproblemsus.org/. Accessed January 4, 2016. 
7. Rooth, Meredith Anderson. “The prevalence and impact of vision and hearing loss in the elderly.” North Carolina medical journal 78.2 (2017): 118-120.
8. Swenor BK, Ramulu PY, Willis JR, Friedman D, Lin FR. The prevalence of concurrent hearing and vision impairment in the United States. JAMA Intern Med. 2013;173(4):312-313.
9. Whitson HE, Lin FR. Hearing and vision care for older adults. JAMA. 2014;312(17):1739-1740.

Three Habits for Better Hearing in the New Year

Your habits may be sabotaging your hearing. In this article, discover how implementing exercise, hearing protection, and social interaction can help maintain your hearing even as you age.

Exercise

The pandemic has caused several of us to forsake the gym this year. Have you heard of the “quarantine 15?” Obviously, several factors contribute to gaining 15 pounds during quarantine, but the greatest of these is lack of exercise. In 2021, let’s purpose to improve our habits and, in doing so, lessen our risk of hearing loss.

Data on risk factors related to hearing loss are limited, but several reputable studies suggest that changing our daily habits can affect our hearing. One of those studies, published by the American Journal of Medicine, states that people who participate in physical activity reduce their risk of developing hearing loss. According to the article, this reduced risk is especially true of women who walk more than 2 hours per week.

Interestingly, hearing loss is not caused by strenuous exercise, but exercise can help maintain healthy hearing despite one’s age. As an audiologist, I counsel patients regarding the common stigmas associated with hearing loss, such as aging. These studies affirm that hearing loss isn’t always directly caused by age. 

Hearing Protection

Last year, a record number of people made improvements to their homes. Did you hear all the power tools running in your neighborhood? 

Everything from in-home offices to backyard decks were and still are being constructed as the pandemic sparks various home-improvement projects.

Tools such as table saws, drills, and sanders can cause hearing loss, especially if the sounds they make are long, repeated, or reach at or above 85 dBA. Before you start that new home improvement project, make sure to purchase over-the-counter hearing protection such as earplugs or earmuffs. 

If the over-the-counter options are not suitable, visit us to obtain custom hearing protection. You will be surprised by the functionality and durability of professionally made hearing protection. 

Interesting Facts

• • A handheld belt sander can reach up to 103 dBA, depending on the quality and condition of the tool.
  • An average table saw can reach up to 100 dBA.
  • The normal handheld drill produces between 90 and 94 dBA, and hammer drills produce in excess of 100 dBA.

Social Interaction 

During this pandemic, you have personally experienced social isolation. My patients have told me they haven’t interacted in-person with loved ones or friends for weeks, if not months. 

As humans, we thrive on healthy social interactions. Without them, your physical, mental, and cognitive health can suffer. According to a 2019 study led by Kassandra Alcaraz, Ph.D., MPH, a public health researcher with the American Cancer Society: “Our research really shows that the magnitude of risk presented by social isolation is very similar in magnitude to that of obesity, smoking, lack of access to care and physical inactivity.”

You might be thinking, “How can a lack of social interaction worsen my hearing?” While social isolation may not affect the level at which you can hear, it can affect your brain’s ability to process the information. Hearing is not just about your ears. Your brain plays a big role in how you process and understand sound.

As we age, our cognition can be affected by decreased social interaction. As our cognitive function declines, so does our ability to process information. For many, this change may seem like hearing loss, but what is actually happening is the loss of the ability to process the information while the function of hearing remains the same. 

Although safely interacting in [county name] may not be possible, make use of virtual communication methods this year such as Facetime or Zoom to keep your brain active and social.

Hearing Aids and Mobile Technology: How much can it change your life?

Streamer Solutions: “Well you could use this device that helps your cell phone talk with your hearing aids, yes you would have to wear it all the time around your neck”

Volume Remote: “You could use this remote control to turn up your hearing aids, yes you would have to carry it around with you”

TV Solutions: “Oh, we have a device that connects your hearing aids to the television, but you would need to wear this around your neck to adjust the volume”

These are phrases I don’t find myself saying very much anymore! All of these streaming devices were extremely popular (and still are if you don’t own a smartphone), however, smartphones now allow us to do it all in one application.

Hearing aids that are compatible with your smartphone allow for

– better understanding during a phone call

– better productivity

– optimizes sound while in background noise

– allows you to locate your lost hearing aid

– monitor brain and body health

– change volume and switch programs

Stream Audio Wirelessly*

Whether you’re on a walk, riding the bus or subway, if you have a podcast or audio book, you can enjoy hand and wire free entertainment. No need for headphones or to hold a book. Simply press play and your smartphone will stream the audio right through your hearing aids.

So many people have tons of books downloaded on their digital devices such as the Kindle reader. One commonality that most of them have is that they never have enough time to complete reading the books they’ve purchased. Drops make an ocean and you’ll be done with your books in no time at all.

Another option is to allow you phone to stream phone calls. This option is not only appealing because it’s hands free, but it also helps you understand the phone call better. When the phone call is processed through your hearing aids it reduces the background noise, streams through both of your ears, and it takes into account your hearing loss, only amplifying areas where you have hearing loss.

Monitors Brain and Body Health**

There is now hearing aid technology that is designed to help the wearer stay independent. With this technology falls can be detected and alert messages sent to selected contacts. Just like our smartwatches can track our steps and other movements our hearing aids can do that now too! Tracking fitness activities has shown to inspire people to continue or increase their activity. Lastly, we are all aware how social interaction can have a positive impact on our mental well-being. The smartphone applications can allow you to track your social interaction. Before our lives were changed due to COVID-19 a lot of my patients were intrigued by this feature!

Volume

There is no question that volume control is one of the most used features of the smartphone applications. Even though hearing aids will automatically adjust the volume on their own depending on your environment, some patients like to be able to manually adjust it themselves. Dare I say… there is a mute feature as well. 

Have hearing aids but struggling to understand someone with a mask on? Masks can actually decrease someone’s voice up to 12 decibels. When our patients’ hearing aids are fit we don’t account for that decrease. That is why a lot of our patients enjoy being able to make a “mask program” for themselves using their smartphone (or asking us to make it for them)! 

Location

Most smartphones applications also allow you to locate a lost hearing aid. Unfortunately, one of the downsides to wearing a mask and hearing aids is that sometimes the mask will remove hearing aids on accident. I’ve had a few patients lose their hearing aids this way. If they choose to allow the app to access their location they can ping the last known place they had their hearing aid.

Always remember that mobile technology is a tool that can help you immensely. Simplicity is the ultimate sophistication. Our moto at The Hearing & Dizziness Clinic is to keep things simple and straightforward when using them.

Each hearing aid and manufacturer has different features and each type of smartphone allows for different connectivity options. If you are interested in learning more please contact our hearing instrument specialist Celina at celina@youhear.ca our our communications disorders assistant Emily at emily@youhear.ca

*Depending on the type of smartphone.

** Available in certain Starkey Models

Diabetes: How It Impacts Hearing

If you or someone you love has diabetes you are probably aware that diabetes causes small blood vessel disease. What happens is blood vessels weaken and slow the flow of blood through the body which can lead to diabetic neuropathy or organ and tissue damage.

Since I am an audiologist I am particularly interested in what diabetes does to our inner ears. Both of our inner ears are made up of a cochlea and vestibular system.

Did you know that the same cranial nerve (8th nerve) innervates both the cochlea and the vestibular system? That is why I sometimes see patients with both hearing loss and balance issues. Since diabetes affects the entire neural system it is not uncommon for patients to report a disruption in the perception of hearing and balance as a whole.

Hearing Loss, How It Happens

Just like high blood glucose can damage organs such as eyes and kidneys it can also damage the inner ear. Our inner ears are extremely sensitive to blood flow and even our eardrums include a network of small blood vessels.

I often tell my patients a hearing evaluation is one of the easiest ways to identify if there has been any damage in the cochlea, the organ of hearing. Unlike a vision test where an optometrist can look into the back of your eye for signs of diabetic retinopathy we cannot look into your ears and visualize the inner ear, your eardrum is blocking our view!

If damage has occurred in the cochlea it will show up as a sensori-neural hearing loss. This type of hearing loss is referred to as nerve damage that can not be regained through surgery or medication.

Balance, How It Happens

As I mentioned above diabetes also affects balance. When there is too much sugar in the blood it can affect our balance in more ways than one:

• It affects the connective tissues inside the vestibular system making one feel off-balance.
• The myelin sheath that covers the vestibular nerves are damaged which doesn’t allow our inner ear to send messages properly to our brain.
• It can degenerate the hair cells inside the vestibular system just like it damages the hair cells inside the cochlea resulting in hearing loss.

As you can probably imagine we use several sensory inputs to remain balanced on our feet. One of the main inputs is our vision, can you see what is in front of you as you take a step? How about proprioceptive inputs like what your feet are telling you? If someone has a hard time feeling their feet they may be stepping on a surface that isn’t level, which will cause them to fall. Remember, diabetes affects the whole body so there are multiple systems at play when balance is an issue.

My Role As An Audiologist

Baseline Hearing Test

I tell anyone who is suffering from diabetes that a baseline hearing test is an important starting point. It is important to have a complete picture of hearing at the time of diagnosis! Therefore if any issues arise in the future we have something to compare to. 

Education

Another recommendation I commonly make may be diabetes education. Ask your physician about resources that are available in our area.

Balance Screening

Another recommendation may be a balance screening. We perform balance screenings here at The Hearing & Dizziness Clinic and if there are any concerns we can start a treatment plan.

I commonly will refer any of my patients to our occupational therapist for vestibular rehabilitation.

Vision Health

I will commonly ask my patients who their eyesight is if they are diabetic and having issues with balance. Make sure that you or your loved one is getting their eye exam with dilation at least once a year. As mentioned above, vision health plays an important role in balance.

Source:

Dowd, K. (2020). Audiology: diabetes in hearing & balance care. AudiologyOnline, Article 27259. Retrieved from http://www.audiologyonline.com