October 22, 2007

This week in clinic, I wasn't very busy. I only saw one client and I will not have clinic on Wednesday due to the Romney trip for the juniors. The one client I did see has been to the clinic many times over the years. She started coming to the clinic when she was 2 years old and she is now in her late 20's. She had a severe to profound hearing loss and wore bilateral behind the ear hearing aids. She came in to the clinic because he earmolds were irritating her ears. Otoscopic examination revealed a little bit of pink irritation in the EAC. The earmolds were ground down a little bit to make them more comfortable for the client. During the session, the client stated she was in need of new aids, her present aids were analog, she was wanting new digital aids. The Oticon Tego Pro was recommended for the client. The client was concerned about the cost of the new aids and said she would need to think about the purchase before committing to them.

I know that cost is a major concern for the majority of our clients, so I wanted to find an article dealing with cost. I found an article on the effects of economy and FDA intervention on the hearing aid industry. The results from this study showed that when the economy was in a recession period, the hearing aid industries supply and demand also saw a lapse in the purchase/selling rate. However, the demand side is effected more so by the recession. Since the FDA has intervened the market supply of hearing aids has diminished while the cost of hearing aids have increased. I thought this article was pretty interesting and also sad that when the FDA intervened the cost of the aids ended up going up.

Reference:
Amlani, A.M. & De Silva, D.G. (2005). Effect of economy and FDA intervention on the hearing aid industry. American Journal of Audiology (14), 71-79.

Article link:
http://aja.asha.org/cgi/reprint/14/1/71?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=when+to+purchase+new+hearing+aids&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&fdate=1/1/2000&resourcetype=HWCIT

October 19, 2007

During clinic this past week I saw a couple of really adorable little old men! The one had previously come to the clinic and had decided he wanted the recommended amplification. The other man was also new to the clinic and to hearing aid use. We performed a complete auditory evaluation and determined he had a moderate hearing loss. He didn not feel he had a hearing loss, but his wife did. We discussed amplification options with him and he decided to purchase bilateral in the ear hearing aids. He did not seem too happy about the purchase, so I have a feeling we will be seeing him a lot over the next couple of years!

The second man wanted in the ear hearing aids so they couldn't be seen, so I wanted to find an article about perceptions of hearing loss. I found an article about hearing loss- and hearing aid-related stigma: perceptions of women with age-normal hearing. While this research was conducted with women, I still feel it is relevant. In the article, they discuss how hearing impairements and hearing aids are typically viewed negatively. They also discussed that many people reject the fact that they have a hearing loss and using hearing aids because of the stigma associated with the two. The purpose of the present study was to examine the degree of stigma associated with hearing loss and hearing aid use among women from 35-45, 55-65, and 75-85. The results from this study showed that the stigma associated with hearing loss and hearing aid use is related to age. The younger the person, the greater the stigma associated with the hearing loss/hearing aid use. This article was pretty interesting and I definitely suggested reading through it.

Reference:
Erler, S.F. & Garstecki, D.C. (2002). Hearing loss- and hearing aid-related stigma: Perceptions of women with age-normal hearing. American Journal of Audiology (11), 83-91.

Article link:
http://aja.asha.org/cgi/reprint/11/2/83?maxtoshow=&eaf

October 11, 2007

I really didn't see too many interesting client's this week. I did get to follow-up with one of my previous client's though. We originally saw him in September, but could not complete the evaluation due to excessive cerumen. He came back to the clinic on Wednesday for a complete evaluation, clean ears and all. We found that he client had a significant hearing loss that began at 500 Hz and sloped to a profound hearing loss at 8000 Hz. The client was very interested in amplification, so we recommended the element 8 in the Moxi. He took the literature home and said he would call back if he decided to purchase the hearing aids. From the case history and general conversation with the client, I would say that he will purchase the aids. He stated he was having difficulty not only with background noise, but that it had progressed that he was now having difficulty hearing in "ideal" situations. I really do hope to follow this client through this process.

I wanted to find an article about elderly patients and their hearing aids, and I found one in which they examined a holistic model for matching high-tech hearing aid features to elderly patients. The study looked at matching the hearing aid features specifically to the client and stated we must look at the client's communication, physical, psychological, and social demands. The article provides a check list of different areas that we should assess. This is a really interesting article and I suggest everyone take a look at it to get an idea of some areas we may want to pay attention to.

Reference:
Johnson, C.E., Danhauer, J.L., & Krishnamurti, S. (2000). A holistic model for matching high-tech hearing aid features to elderly patients. American Journal of Audiology (9), 112-123.

If you would like to read this article, please click on the following link...
http://aja.asha.org/cgi/content/abstract/9/2/112?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&titleabstract=Hearing+Aid+Technology&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&fdate=1/1/2000&resourcetype=HWCIT&eaf

October 4, 2007

The week I saw a few clients, but for the second time I saw a person with tons of wax! Thi's man had so much wax that you could not see the tympanic membrane. We told him he should go to a doctor to have it removed since it was very deep in the canal and then come back to see us. The man did not seem to really care and said that he may "see us in 5 years". I doubt that he will go to the doctor or schedule his annual evaluation. Even though we tried to explain that the cerumen could effect his hearing, he really didn't seem to care.

So since this was my second time seeing someone with an excessive amount of wax, I thought I would look for an article on how it can effect a person's hearing. I found an article that discussed the role of impacted cerumen in hearing loss. The researchers conducted the study on 80 patients (109 ears). In the article, they classified impacted cerumen as more than an 80% occlusion with associated conductive hearing loss and an air-bone gap > 10 dB at two or more frequencies. The results from this study should that the impacted cerumen did cause the individuals to have a significant degree of conductive hearing loss. They did not find a correlation between the length of the wax plug and the severity of the hearing loss. They also did not find any correlation between the presence of impacted wax and the age, sex, ethniticy, or the side with the impacted wax. I thought this article was kind of interesting. An article like this could be provided to client's, like the one I had, to counsel them about why they should have the impacted cerumen removed.

Reference:
Subha, S.T., Raman, R. (2006). Role of impacted cerumen in hearing loss. ENT-Ear, Nose, & Throat Journal. (85)10, 650-653.
If you would like to read this article, please use the following link:
http://web.ebscohost.com/ehost/pdf?vid=5&hid=117&sid=6878c21c-00d7-48e0-a6f3-deb13655d59f%40sessionmgr103