Hearing clinic: Perception vs reality (Part Two)

Dear Reader, this blog is the conclusion to the first impressions series about what goes on in a hearing clinic. In this second blog, we look at the last two questions I have asked the members of the Hearing Excellence Team. We hope you come away with a more informative sense of what hearing diagnosis and treatment can do for all individuals.

First Impressions of the Hearing Clinic (Part Two)

Throughout my clinical years of experience I have noticed that many clients, and sometimes their loved ones, are surprised at how much one can benefit from hearing treatment. I found that people are not aware of how common hearing issues are until they encounter it either themselves, or through the experience of someone close to them. This idea lead me to asking two more questions regarding hearing loss and treatment towards some of the members of the Hearing Excellence Team:

  1. Did your encounters or observations with hearing loss change your perspective about how

    important hearing treatment can be?

  1. How aware do you believe the general public actually is about hearing related issues?

In answer to my third question, Cathy, another member of our Hearing Excellence Team, shared with me her first hearing related experience:

“When my niece got hearing aids, my perception changed, she had really cool molds, swirls of pinks and purples with a small back piece. I was surprised how sophisticated devices were, how much technology could fit into such a tiny device. It’s mind boggling! With the proper treatment, you can’t tell how bad the hearing actually is because of how well the devices actually work!”

Another member of our team, Heather, had shared a similar perspective change:

“[I] previously thought hearing loss wasn’t a big deal. Then I completed a placement observing patients being treated within the hearing clinic. I saw those who had hearing loss and were fit with hearing devices. That’s when I also saw that it really changes people’s lives, and, that it is actually more important than you first would believe!”

These statements fall in line with what I have experienced as a clinician when I receive feedback from clients and their loved ones. However, my last question, which was how aware was the general public about hearing related issues, really got me thinking. I mean, was it just me, or was hearing loss not as publicized as other medical maladies? I was not alone in this thinking. Many of my colleagues in the team agreed with me:

[Daniele] “A lot of people don’t have any idea of it (hearing treatment) really. I always find myself taking pictures of aids on instagram to show people how far technology has come, what variety they have and the better quality of life it provide if they had their hearing loss treated!”

[Sharad] “The general public is not very aware. Even medical professionals are under aware of this issue. For example, the family doctor is a hub connecting patients to specialists, if they themselves are not aware of how important hearing treatment is for their patients’ quality of life, patients will be under diagnosed. ”

Before I started interviewing my team members about their first impressions and thoughts about the field, I wasn’t sure what I would find. From their shared experiences I realized that, even though there are many different types of hearing issues and client populations within the field, there were quite a few commonly shared experiences. These shared experiences were truly unique to the field of Audiology as to the lack of awareness of how common hearing loss is and the benefits of hearing treatment to one’s quality of life. What’s more, these interviews reminded me why I entered into this profession as a clinician.

I hope you, the reader, have benefited from the conclusion to our first impressions series as much as our Hearing Excellence team has in sharing our experiences with each other.

Mitra Mehra

Audiologist Reg. CASLPO. M.Cl.Sc. Aud (c)

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Hearing clinic: Perception vs reality (Part One)
Dear Reader, this blog is part one of a two part series featuring an in-depth look at one’s first impressions of what goes on in a hearing clinic. It sheds light on what others perceive hearing loss or treatment to be about based on a couple of questions. Due to the length, variety, and nature of responses I’ve covered, I have decided to write on this topic in two parts. This blog post looks at the first two questions that I have gathered responses from within the Hearing Excellence Team. First Impressions of the Hearing Clinic (Part One) When explaining the field of Audiology and what it is applied to, I’m often asked “So what’s it like when someone has to go to a hearing clinic? How is it different from other clinics? What services do they offer? Are there really that many people that walk in with a hearing problem?!” My standard reply is that there is actually a lot more to a hearing clinic than what others realize! However, these questions also got me thinking; what do people think of when mentioning a hearing clinic? What do they know about it and what are they expecting? As a clinician I was really curious to hear what others thought about the subject. So I asked various members of our Hearing Excellence Team what were their first impressions of the hearing clinic were previously. I chose a couple of probing questions and collected responses:
  1. What did you imagine a hearing clinic to be before you stepped inside one?
  2. Were you surprised about how prevalent hearing loss is and what populations needed treatment for hearing loss?
When I asked my first question, most members interviewed stated that hearing clinics were different from what they imagined. For example, one member of our team, Nioka, stated: “I had no idea what a hearing clinic would actually look like... I thought it was something similar to a dentist clinic or any other clinic. I was so surprised that so many people had hearing issues, I really had no idea...I saw young people walking in and that was the biggest surprise of all. I didn’t know that it was such a big issue! I just thought that hearing loss was a part of getting old and that it’s a part of life that you just have to live with. Now I’m thinking about getting my mom
  1. I had no idea there was a solution to her problems before!”
Another member of our Hearing Excellence team, Sharad, stated the following: “ I thought hearing clinics were supposed to be very medical. I expected clinicians to wear lab coats with big and scary machines or gloves.” I find that Nioka’s and Sharad’s  responses are very common for anyone entering the clinic for the first time. Often, they are surprised at how the hearing clinic seems to take care of so many different people for some many different ear related issues. When I asked my second question as to whether they were surprised about how common hearing loss actually is, most responded that it was very unexpected. One of our members, Martha, had the following to say about the matter: “Before, I had no idea about how many people were actually in need of hearing treatment. I was indifferent about the whole thing because I had never gone through anything like that myself. I really wasn’t aware about how common hearing issues were!” Another member of our Hearing Excellence team, Michelle, stated the following: “I was surprised about how much technology has changed, and how much is available for treatment today as opposed to twenty years ago.” When clients first come through the door, many share what they have heard about hearing treatment from others they know who have had hearing issues. It’s a mixed bag of positive as well as not so positive past experiences from years or even decades ago. But one commonality I’ve observed when comparing what they have heard before with the information I give them is that they are pleasantly surprised. They are in awe of how far treatment has changed in recent years. I hope you, the reader, have enjoyed part one of our first impressions series and look forward to our part two conclusion.

Mitra Mehra

Audiologist Reg. CASLPO. M.Cl.Sc. Aud (c)

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Common Hearing Complaints (Part Two)
Dear Reader, this blog is the second segment of a two-part series examining universal hearing complaints made by those experiencing hearing related issues. It has been written in the hopes of voicing common experiences of those who struggle with communication on a daily because of their hearing. Due to the fact that there are three very common general complaints most commonly associated with hearing loss and two other complaints related to a very specific hearing issue, I have decided to write on this topic in two parts. This blog post looks at the last two complaints related to a specific type of hearing issue that is very commonly heard from my patients when they come in to see me. The Maladies of Hearing; Common Hearing Complaints (Part Two): When I talk to my patients about the specific hearing issues they have, they may mention the common complaints of not being able to hear in certain situations or hearing certain people. But every so often, I get a completely different set of complaints that, although they are also very common, are very different from the issues I described in part one of this series. What makes these problems different in nature is the fact that it is not perceived as a lack of hearing. These voiced symptoms don’t appear to be a by-product of the hearing loss. To them, it seems to be hearing related, but almost as if the patient’s hearing is overstimulated. These two issues are as follows in no particular order: “I can’t stand loud sounds” Once in a while. I will have a patient come in and report that the main hearing issue is the loudness of sounds. “Every time I hear construction outside I just can’t stand the noise” or “There are times when I have to turn the television or music down because the sounds are a nuisance.” Within the hearing clinic, there is a loudness test that may be conducted to uncover whether the patient is overly sensitive to loud sounds when compared to the normal hearing listener. Solutions for what we refer to as abnormal loudness sensitivity can vary from using hearing protectors when sounds reach a dangerous hearing level, or the use of acoustically filtered devices that only reduce certain bothersome sounds while still being able to hear. In order to find the solution that is right for you, it is advisable to consult a trusted hearing healthcare professional. “There’s a ringing or buzzing in my ear” Very often I find patients reporting a ringing or buzzing sensation in one or both ears “I hear a noise in my ear, a constant hum, especially when it’s quiet.” or “There’s a buzzing sound that seems to be coming from my ear and it gets in the way when I’m trying to listen to others”. This sensation, otherwise known as tinnitus, is a type of internal noise perceived by the individual and is a very common issue directly associated with hearing loss. The root cause for the majority of tinnitus cases (roughly 80%) are identified as hearing loss or hearing damage related. In fact, for 60-90% of those cases, shortly after treating the hearing loss itself, the tinnitus symptoms are reported to have been reduced if not completely eliminated. So, although, the sensation of tinnitus may not be identified as a hearing difficulty, the key to the solution lies in treating the hearing loss and re-stimulating the auditory nerve. Again, in order to identify which solution is right for you, we advise you to consult with a hearing healthcare professional that offers specialized services for tinnitus-related symptoms. Maybe your specific hearing complaint or the hearing malady of someone you know wasn’t mentioned in this blog. But there just might be a solution to the problem that you weren’t aware of before. One way of finding out is by visiting a hearing clinic dedicated to providing client-centered care. Mitra Mehra Audiologist Reg. CASLPO. M.Cl.Sc. Aud (c)
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Common Hearing Complaints (Part One)
Dear Reader, this blog is the first segment of a two-part series examining universal complaints made by those experiencing hearing-related issues. It has been written in the hopes of voicing common experiences of those who struggle with communication on a daily basis because of their hearing. Due to the fact that there are three very general complaints most commonly associated with hearing loss and two other complaints related to a very specific hearing issue, I have decided to write on this topic in two parts. This blog post looks at the first three common complaints that I have heard from my patients when they come in to see me. The Maladies of Hearing; Common Hearing Complaints (Part One): Every time someone new enters our Hearing Excellence clinic, I always ask them what their main hearing issue is or if the problem is actually ear related. I get many different answers to my question. However, there are always some answers that are mentioned the most often. I’ll be going into detail with these answers, but not in any particular order, as it varies from person to person. “I can’t hear in certain situations” The details of this answer may vary, but the underlying message is clear. “I seem to be able to hear okay in most places or situations, but I do have more trouble with…” Although the type of listening situations may differ, the commonality is that it’s not like there is a hearing problem in every listening environment or daily interaction. In fact, because of this infrequency, the hearing issue becomes something that is uncertain, or unknown to that individual. After all, how can you be sure there is an actual hearing problem when it’s only happening some of the time or only in certain instances? That is actually to be expected, as research shows that we stimulate more of our acoustic or hearing memory in some situations than others. It would make sense that some listening environments are easier because individuals rely more heavily on their acoustic memories rather than acoustic cues. These acoustic cues may be needed and missed in certain hearing situations when there is some hearing loss involved. It is often the case that not hearing in certain listening environments are symptoms manifesting from a very common hearing loss related to noise exposure coupled with aging. The two factors are very hard to tease out, although, when inquiring with your local Audiologist they may be able to go into detail based on the specific characteristics of your hearing loss. “I can’t hear soft or high pitched voices” Many patients report having trouble hearing soft spoken people. They may describe this in different ways; “I have trouble hearing people who mumble…” “I have trouble hearing female voices”. Often times I find that the hearing loss is perceived as more of an issue with the particular speaker rather than the hearing itself. This misconception is common because other sounds, such as background noises of fans, music, or outside environmental noises are heard just as clearly as ever. For this reason, the hearing loss itself can be more significant than what is expected by the patient. It is also because the hearing loss severity is different for different speech sounds, that it is subtle and often not noticed until the hearing loss has occurred for a longer period of time (years). Usually the best hearing treatment strategy requires a device that functions under all listening situations, is portable, and regularly provides the hearing nerve with sound stimulation so that the hearing nerve remains active. “I can’t hear over the telephone” There are times when a patient reports no trouble hearing except in demanding phone situations. Sometimes this complaint may be accompanied by trouble hearing the television as well or hearing certain background sounds. It is hard for the patient to pinpoint a perceived hearing loss because he or she is able to hear others in conversation with relative ease. Under these circumstances, the type of hearing solution may be tailored more towards hearing in those situations rather than a solution to hearing speech sounds. For example, an amplifier on the telephone, or a television enhancement device may be helpful. If the lifestyle demands require hearing accurately over the phone, being able to hear without closed captioning in other electronic devices, or even being able to hear outside sounds that may alert one to danger, a more comprehensive hearing treatment solution may be required. The complaints that I have discussed above are very common and shared experiences for those suffering from a variety of different types of hearing loss. However, there are a specific category of complaints for those suffering from a particularly common hearing issue. These special type of hearing complaints will be discussed in part two of the maladies of hearing series. Mitra Mehra Audiologist Reg. CASLPO. M.Cl.Sc. Aud (c)
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A Unique Case of Tinnitus and a Successful Partnership
  I remember one of my very first tinnitus cases. She was a patient with an unusual hearing loss. When I asked her what her primary hearing concern was, she related the following to me… “I’ve had this buzzing sound in my left ear since last year. It seemed to have happened all of a sudden. I also have this sensation of fullness in the same ear, almost as if something has plugged it up. I’ve seen the Ear-nose-and-throat specialist, and he told me that the buzzing is due to hearing damage! I wasn’t even aware that my hearing had gone down in my left side and he told me it was due to a virus that I had a year ago. Ever since then, I’ve had trouble hearing the television, hearing over the telephone with that ear, and hearing softly spoken people. But I tell you, the worst part is that the sound in my ear keeps me up at night! Is there nothing I can do? I don’t want to just live with my tinnitus.” I explained to her that there was a way to treat the tinnitus and that it would take some time to reduce the severity of the sound. The suddenness of the hearing damage along with the distortion of hearing meant that my patient would need a more gradual treatment plan. There were many modifications that had to be made to the type of sound therapy device used. There were also changes that had to be made to her daily routine used in the treatment that I had originally prescribed to her. Near the beginning of treatment, the patient’s tinnitus felt, at times, to be insurmountable. How could she let herself relax and enjoy life when a constant reminder of her hearing loss was buzzing or ringing in her ear? Not to mention the distortion heard in that same ear every time she was faced with a listening situation! It took some time not only for me to determine the proper treatment regimen, but also for her to adapt to the techniques and strategies necessary to achieve a reduced tinnitus result. For her particular case, the positive results of the treatment came later rather than sooner. However, there was a significant benefit. My patient now felt that, although the buzzing sound was annoying at times, the tinnitus was perceived much less often. More importantly, she felt that her tinnitus was manageable and under her own control. Near the end of the treatment plan, I noticed my patient was much happier. Her previously central problem of tinnitus seemed to have faded into a once in a while mild annoyance. Other improvements, such as speech understanding, was noticed by her much more. The experience made me realize how important it was to stick with the end goals of tinnitus treatment, as long as they were reasonable and realistic. I also realized the importance of the partnership between clinician and patient. If the patient isn’t able to take part in their own treatment management, it is less likely that progress will be made. At the same time, the patient would need the guided input of the clinician to help modify the plan as the tinnitus changes during treatment. In the end, it takes both parties to create a successful partnership. Mitra Mehra Audiologist Reg. CASLPO. M.Cl.Sc. Aud (c)
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The Introductory Blog: The Audiologist’s Corner

The Audiologist

“Hi, my name is Mitra, and I’m an Audiologist” Most of you would probably ask me after I’ve introduced myself is either “What’s an Audiologist?” or “Sorry, what did you say? I didn’t hear that?” whether it’s inside the Hearing Excellence Clinic or during my off hours, I’m asked these questions often. The latter of the two questions is a very common joke. It’s definitely not the first time I’ve heard that phrase and I am 100% certain it won’t be the last time either! The first question, though, is also very common. In fact, it’s so common that I’m actually surprised when someone says “Oh I know what that is!” I almost have to stop myself from launching into an explanation. I find myself giving a very general description of what to expect from an Audiologist “I test, diagnose, and treat hearing loss”. This answer is usually enough for anyone asking me about what I do that they are satisfied. audiologist toronto But, of course, there is so much more to the field of Audiology that can affect one’s quality of life in so many different ways. In fact, as clinicians, we are also trained for pediatrics, central auditory processing disorder, earwax management and much more. I felt that if I ever wanted to write about what the scope of Audiology really contains, it would fill up entire bookshelves! Many of the colleagues that I work with agree with me. There are so many areas of specialty within the field that each of the clinicians within one hearing practice may have various expertise that remain unknown to most people. That is, unless someone comes across the specific subject or issue in their own lives. Nowadays, there is so much involved in hearing healthcare that, at times, it can feel like you’re navigating through a maze without a map to point you in the right direction. This is why, within the company of Hearing Excellence, we have collectively decided to create this writing platform. A place where we can talk about hearing issues. An opportunity for our team of professionals within the Healthcare profession to talk about what is involved in the practice of Audiology. A voice for the patients and clients we encounter who have become experienced in specific hearing issue and how to prepare. A link to the latest breakthroughs in hearing science and how that affects our everyday lives. Wouldn’t it be great to be able to navigate through the maze of such a broad field? We certainly thought so. We, at Hearing Excellence, wanted to create a channel where we are able to give the inside story about what happens within the hearing clinic so that you can successfully manage your hearing healthcare. We want to gather the information gleaned from professionals within and outside of the hearing clinic to help you have a better understanding about this field. We hope to give you the necessary tools needed so that, if you are ever experiencing hearing related issues, you have the knowledge of what you can do about it and where you can go to seek treatment. The ultimate goal here is to provide you with what you need to know about the hearing profession to make better hearing health choices, and what affect your hearing health can have on your quality of life. In this blog, I’m going to be discussing many different topics relating to the field of Audiology. Many of the topics, such as the client-care experiences, or diagnostic outcomes will be shared knowledge from myself as well as from the professionals of the Hearing Excellence Team of Clinicians. Our knowledge is derived from our many years of experience in the field. Other times, when discussing the profession from the perspective of others, looking into the latest advances in the field, or the many roadblocks encountered by the industry, I will be bringing in the voices of other knowledgeable persons that work closely within those subject areas. One of the most exciting and anticipated segments of this blog will be dedicated to the voices of our many patients and clients who would like to share their own experiences and thoughts on the subject of hearing healthcare. We especially wanted this last segment included in our blog because we identify strongly with the client-centered care model where the client experience comes first when talking about any hearing related issue. Improving the quality of life for every patient or client is, in fact, the whole basis behind providing hearing healthcare, and it is what drives us to continue to grow the expertise of the Audiological profession. Lastly, I hope you enjoy reading this blog as much as I enjoy writing about the field that I’m very passionate about.
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