Category Archives: Audiology

Me and My PowerPoint

There are two things in life that I am terrified of – spiders, and talking in front of a group of people.  The former is avoidable.  If there is a spider in the area, I leave.  Until it has been squished dead.  End of story.  The latter is harder to avoid.  My whole life, my heart has raced, my face goes beet red, my voice shakes, whenever I am called upon to hold court in front of a group of people.  It doesn’t even have to be a big group, and it can be people I kind of know – still terrible.  Even the “Let’s go around the room and everyone say your name and one thing about yourself that no one else knows” crap will get the adrenaline pumping.

So going to graduate school was a trial.  We frequently had to present research we had done, in front of our peers, in front of our professors.  And then I was tapped to teach an undergraduate course of 16 students.  Over time, I got used to the feeling of having people watching me, and I would just barrel ahead with my lecture.  The key was not giving myself time to think too much.  Show up right when class is supposed to start so that there’s no time to hang around and build my nerves up.

I figured that once graduate school was over and I was out in the real world, I could relax.  But NO.  Apparently, one of my duties as an audiologist is to go out into the community and educate people about hearing loss, communication, and hearing aids.  And – here’s the weird part – I love it.  My first one was small, only 5 people came.  It ended up being more of a dialogue than a presentation.  I did a couple more that were a little larger, and then last week I got up in front of 40 people, just me and my PowerPoint, and talked for over an hour.

I know why it’s easy – I love the topic, and I know the topic, and I could talk about it uninterrupted for hours and hours just to share my love of it with someone else.  That kind of enthusiasm about a subject is hard not to pass on.  It’s not really boring when the person who is presenting is in love with it, no matter what it is.  The topic could be the life and times of the dust mite, but if you really, really love everything about dust mites, it’s going to be interesting.

And now that I’m more comfortable with the terrible prospect of opening my mouth when more than two people are paying attention to me, I hardly ever go beet red.  My voice doesn’t shake.  I still feel my heart race a little, but I just tell myself, “Calm down.  You’ve got this.”  And I usually do.

 

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One Day At a Time

We have had a terrible week around here.  Jake came down with a cold early in the week, and then passed it on to both me and Nate.  It’s not a terrible cold, but it’s bad enough to make us feel crummy and tired and sneezy.  It’s been hard for all of us to get up and moving all week long, and I struggled through each day at work.

My job is very communication-oriented.  When people come to see me for a hearing test or for new hearing aids or help with their existing hearing aids, there is a lot of talking involved.  It’s not just throwing them in a sound booth and pushing buttons.  There is a history to take, and counseling to do.  There is critical thinking involved.  What is the patient telling me about their communication difficulty, and can I adjust their hearing aids to help them?  When you’re off your game, it’s exhausting.

So I struggled through my week.  And Jacob struggled through his as well.  It was curriculum night at the Middle School on Thursday evening.  We had eight minutes in each of Jake’s classes, with five minutes to change between them.  We were very happy with his teachers and classrooms – his homeroom teacher, who is his primary teacher, covering Language Arts, Reading, and Social Studies, is very energetic, dynamic, young, and male.  I think we hit the lottery with that one.  The band teacher is full of energy and excitement, and his science teacher is appropriately nerdy.  Nate and I both came away very happy, but also a bit overwhelmed.  Our feelings echoed those Jake had expressed earlier in the week.  I knew he had been having a tough week, but had chalked it up to his cold.  After curriculum night, I reevaluated a little bit.  Yes, he is more tired than usual, and not feeling his best, but I have to acknowledge that the transition from elementary to middle school is difficult – maybe more difficult than I had anticipated.

We are taking this weekend to lie low and recuperate.  Hopefully next week will be easier – or at least less sneezy.

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Can You Hear Me?

One of the most challenging aspects of my job is testing the hearing of someone who is not responsive.  Think of someone with such severe cognitive impairment and physical impairment that they cannot understand that when they hear a sound they can look at a toy and it will dance for them.  Or someone who doesn’t have sufficient control over his or her body to turn the head toward a sound.  I have a patient like this every so often, and had one this week.  She was wheelchair bound with a tracheotomy tube, and communicated with her caregivers through facial expressions.  They watch her carefully to make sure she doesn’t appear to be unhappy or in pain, and that’s about all she can communicate.

With patients like this, you have to be able to focus on them with laser-like attention, because the way they signal that the heard a sound is often as small as a shift in their breathing or a flick of the eye.  In addition, they tend to fatigue to tones very quickly.  Once they’ve heard a particular sound a few times, it isn’t novel any more and they stop noticing it.  So you have to go really slow, and change things up all the time – warble tones, voice, narrow-band noise.  Just to keep it fresh for as long as possible.

Luckily, we have a two-tester system, so there is another person sitting in the booth where it’s easier to see the small signs that the patient has heard a sound.  And in my case, that second tester is much more experienced than I am and can help me decide what is an actual response and what is a blink.  Some of the responses I was really sure about and she would shake her head no, others I thought were random movements and she gave me an enthusiastic nod.  I defer to my colleague in cases such as these – not only is she in the booth and therefore able to see the patient better, but she’s also been doing this kind of thing for 15 years and has what you’d call a knack for it.  I’ll get there someday hopefully.

You might be thinking, why does it matter that someone like this can hear?  Well, it’s not because people are having conversations with her, or reading to her, or calling her on the phone.  It’s because a large part of human connection comes from the human voice.  Even is she doesn’t have enough language to understand a word of what someone is saying, she can hear intonation, which conveys so much emotional information.  It is important to be able to hear her caregivers, even if she can’t understand or respond.  It’s part of being human to connect to other humans, and our hearing is an important part of how we do that.

 

 

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Getting Old

One great aspect of my job is that I get to hang out with old people.  I never really thought about the elderly before I discovered the field of audiology.  My grandparents were old, sure, but they were the only elderly people I was exposed to in any significant way.  Once I started meeting older people and getting to know them, I couldn’t help but start looking at life a little bit differently.

When you think of old people, you usually picture the stereotypical old person – the man with the trousers pulled up to his armpits, the checkered shirt, and thick glasses.  Or the woman with the straw hat, permed grey hair, old lady shoes, and cane.  Well, my friends, you will be very surprised to find that old people come in all shapes, sizes, and styles.  Shocker!

I have some eighty-five year old patients who come to me from nursing homes who are wheel-chair bound and don’t communicate well, and I have some 98 year old patients who I have trouble keeping up with.  I know one gentleman who strolls in with his cane and absolutely refuses to let me hold the door for him.  Some people come with their spouses (I know a lovely couple – both 96 – who have been married for 73 years), or with their grown children (who are sometimes elderly themselves!), or with their grandchildren.  Sometimes they come with friends from the senior center.  I met a pair of 90 years olds who have been fast friends since they were 6.

It really does put things into perspective.  It is so hard to imagine what my life will be like then.  The things that I spend so much time and energy worrying about today will be completely inconsequential and forgotten by the time I reach my dotage.  I sometimes imagine Nate and I sitting in an audiologist’s office together completing each other’s sentences and chuckling at inside jokes.  And our audiologist will look at us and think, “Well, aren’t they just the cutest things you’ve ever seen!  Adorable!”

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Poor Stuart Little

You know your kid is growing up when he’ll willingly sit and listen to a story without pictures.  Aaron and I have been reading Stuart Little together before bed.  He’s really enjoying it.  Just a few months ago, he got rather bored when we tried to start Harry Potter, but he seems to be quite taken with little Stuart Little.

So last night we’re reading together, and we get to this part:

“It was George who had the idea of stationing Stuart inside the piano to push the key up the second it was played.  This was no easy job for Stuart, as he had to crouch down between the felt hammers so that he wouldn’t get hit on the head.  But Stuart liked it just the same: it was exciting inside the piano, dodging about, and the noise was quite terrific.  Sometimes after a long session he would emerge quite deaf, as though he had just stepped out of an airplane after a long journey; and it would be some little time before he really felt normal again.”

As I’m reading the passage, I start getting slower and slower as I realize exactly what it is saying.  At the end, I unknowingly pause lost in thought.  Poor Stuart.  His little mouse ears getting damaged over and over again just because precious little Georgie and his parents can’t bother to get the piano fixed.  Have they thought about Stuart and his hearing at all?  What’s going to happen to him when he starts to get older and these Temporary Threshold Shifts have degenerated into permanent hearing loss?  Do they even make mouse-sized hearing aids?

So I’m lying there thinking about poor Stuart and his ears, and Aaron says, “Well, Mom, it looks like Stuart is going to have to come see you at your work.”

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Making a Difference

One of the things I like the most about my job is the immediacy of it.  There are lots of things I do every day that make an immediate improvement in someone’s quality of life.  Every so often I get a patient who has been neglected, either by falling through the cracks on our end, or due to health problems or cognitive issues on theirs.  Their hearing health is a wreck.  They haven’t had a test in five years, their hearing aids are dirty and barely functional.  They are unhappy because they can’t hear and don’t realize there is something to be done about it.  I even had a woman tell once tell me that she threw her hearing aids away.  I thought she was joking of course, and then suddenly realized that she actually had thrown them in the garbage.  After realizing that this had occurred several months ago, I stopped envisioning picking through her trash with rubber gloves on, and we decided to order new ones with the understanding that she should consult with me in the future if she ever feels like throwing her hearing aids away again.

Anyway, I had two patients this week who desperately needed my help.  Neither had had a hearing test in over three years.  Both of them had tubes that were rock hard, molds that were caked with wax, and microphone ports clogged with yuckiness.  Luckily, in both cases they had had just minor shifts in their hearing.  I was able to sweep out their microphone ports, change their tubes, clean their molds, then adjust their hearing aids on the ear, and it was like a revelation for them.  They were so happy and relieved that they didn’t have to spend thousands more dollars on hearing aids.  And both of them commented on the fact that they can tell that I really like my job.  Which I do.

Just another week helping people hear better, one at a time.

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Back to Work!

The wheels of the state have finally turned, and I am officially licensed!  I very happily went back to work  on Monday.  On that first day, I noticed that I was a little bit slow – it just took me a little longer than it should have to do various things, but as the week has progressed and I’ve settled in, I’m getting back to where I need to be.

It struck me this week that my job satisfies a need in me that I never knew I had.  It’s really an amazing feeling to meet a perfect stranger and forge a connection with them.  It’s because hearing loss is such a personal thing – it affects your life in ways that are very profound – and talking about it with someone automatically brings you close.  This happens with almost every patient – parents, little old ladies, middle-aged truck drivers, even grumpy old men.

If you had told me four years ago that I would be able to talk to this wide variety of people, mostly ELDERLY (shudder!) people, and enjoy the time I spend with them, I would have thought you were nuts.  And yet, here I am – looking forward to work every day.  I feel so fortunate to have stumbled upon this career!

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