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June 30, 2016 London Audiology Blog

Our blogs got swamped with news and newsletters, so now we are going to make a special effort to just blog on this site.

 

I think hearing is usually our most under appreciated sense. Most people say they would rather go deaf than blind. I certainly do not want to minimize the challenges a visually impaired person faces. However, Helen Keller, who was both blind and deaf said that being blind cut her off from things, but being deaf cut her off from people. Just imagine. If you close your eyes you can still hear the people around you but if you close your ears most communication is cut off. Of course deaf people who use sign language and a few of my patients who are phenomenal lipreaders are the exceptions to these statements!

 

For the vast majority of us communication involves hearing and speaking. Communication is a two way street. However, if one party cannot hear well the important interaction of speaking and listening breaks down. This can lead to all kinds of frustration, misunderstandings, fights, withdrawal, social isolation and loneliness.



162436-20141029Have you had your hearing checked lately?  Did you know that 1 in 5 adults has a hearing loss.

Maintaining a healthy lifestyle may help reduce the risk of hearing loss. Studies have shown that smokers have a higher risk of having a hearing loss than non smokers!  Did you know that hearing loss is twice as common in people with diabetes than those without?  Hearing loss is the third most common physical condition!  Eek,  who knew!

So lets include our ears in the Healthy Lifestyle Plan.  When you are booking your next physical or your next dental check,  think about booking a hearing test!  Your ears deserve it!  It’s quick, easy, complementary  for fist time patients and no referral necessary.

 

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Mary DeMelo

HID

 



249622-20140703An important part of a hearing test is speech testing. Audiologists typically like to look at two areas when doing speech testing.
1) How quietly someone can hear words and repeat them back, known as a
speech reception threshold and
2) How clearly someone hears, known as the word recognition score (WRS).

 

Speech testing is typically done while the tester’s mouth is covered as to
not allow the patient to pick up on any visual cues. The goal is to test
the hearing only and not lipreading skills.

 

Speech reception threshold (SRT) testing is done by first familiarizing the
patient with a list of two syllable words (spondees) such as “hotdog,
cowboy and baseball.” Next, the same words are repeated back, one ear at a
time, quieter and quieter. This allows us to find the softest word you can
hear and repeat back. Don’t worry, no one can get them all, everyone misses
a few because our audiometer (hearing testing machine) can go quieter than
the average person with normal hearing can even hear. SRTs give us an idea
about how well you can hear quiet speech sounds.

 

The word recognition (WRS) testing is done by presenting words at a
comfortable listening level and having the patient repeat them back. We
use words such as “knock, pick and home” presented to one ear a time.
Anywhere from 10-25 words per ear are tested. This gives us an idea of how
clearly a person hears in a quiet situation. How clearly a person hears in
quiet allows us to set up realistic expectations in various listening
situations.

 

As an aside, we never present off colour words. We once had a patient who
repeated some pretty bold words. When he got out of the booth he said to
his audiologist that he could not believe that she would use such
language. His wife who heard the whole test pointed out that the
audiologist did NOT say the words he thought he was repeating!

 

There are other types of speech tests, such as word tests in noise,
uncomfortable loudness and auditory processing testing. These are more
advanced diagnostic tests and are typically not part of a standard test battery.

 

Sean Brac

Audiologist

London Audiology Consultants



girlAfter examining the ear with an otoscope, the next step is to test how the middle ear is functioning. For more information about examining the outer ear see the previous blog post.

Middle Ear Analyzer:

As long as the ear canal is clear enough we’ll test your eardrum and ossicles (middle ear bones.) This is achieved by sealing the ear canal with a soft plastic plug, playing a sound in the ear, applying and removing pressure from the eardrum and measuring how much sound is going into the ear and how much is bouncing back into the plug. Not to sweat though, the amount of pressure is less than what is typically felt by riding in an elevator; we are talking small amounts.

While we are on the subject of pressure in the ear, let me digress about candling. This procedure places a lighted candle in the ear canal. It is claimed to remove wax from the resulting slight amount of negative pressure. Our routine test of the middle ear causes more negative pressure in the ear than candling and I can assure you that in all the years of doing this test we have never removed any wax from anyone’s ears. Candling is not only ineffective it can be downright dangerous. Take a look at Wikipedia’s blurb on the subject. Or better yet read what Health Canada says. (You can google: Health Canada Ear Candling.)

Now back to middle ear analysis. This measurement tells us the volume of your ear canal, how well your eardrum is moving and can give clues if there are issues with the eardrum, ear bones or middle ear space in general. Another test typically done at this time is looking at reflexes of the middle ear, which is done by playing fairly loud beeps into the ear and measuring the response of the eardrum. Loud sounds will typically make the eardrum go stiff due to a middle ear muscle reflex. This may sound scary but it really isn’t. Even very young children are OK with this test. This test is important because it gives us information about the overall health of your ears.

Pure Tone Testing:

Next we will ask you to sit in our sound room. This room is not really a sound proof booth. In order to be sound proof the walls would need to be a few feet thick and I do not think our poor old house’s floors would be able to hold it. Sound proof booths are typically located at universities where they conduct scientific research. Our booths are designed to be very quiet (every home with young children really should have one!)

In the booth, you will be given a clicker and asked to push the button every time you hear a tone. The tone sounds like a beep. We present medium and quiet tones with different pitches. We recently had a very elderly patient who reported “I wouldn’t bother with that one” after every quiet tone. No really, we DO want you to press the button even for the very quiet ones!

We are interested in the different pitches or frequencies that make up speech sounds. We plot the quietest sounds that you can hear on a graph called the audiogram.

Speech-Banana

Quiet sounds and normal hearing are shown at the top of the graph. Louder sounds are shown lower on the graph. As hearing gets poorer the Xs for the left ear and the Os for the right ear are plotted lower on the graph.

If a person hears at 60dB across the graph they will hear dogs barking and a few vowel sounds but will not hear birds chirping or most speech sounds. Hearing aids are extremely useful for this amount of hearing loss.

Next time we will discuss the importance of speech testing.

 

 

marg-brac-thumb

Marg Brac

Audiologist/Co-Owner

London Audiology Consultants

 



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Hearing testing is a funny thing, no really it is funny. Many people have this preconceived notion that they do not want and will not get their hearing tested. It is likely because they do not want to “know” if they have a hearing loss even if they struggle to hear daily (or are reminded by loved ones that they have trouble hearing hourly…)

 

There are many more reasons why people do not get their hearing tested and I hope to remove at least one of those reasons with this blog: the unknown. Many people do not know how a hearing test is completed. I will describe how an adult’s hearing is tested and hopefully make you laugh as well by throwing in a few funny stories.

 

Case History:

A proper hearing test typically starts with questions regarding your health in general, and your ears in particular (history of ear infections? ear surgery? etc.) We typically ask if you have trouble hearing, which may seem like a moot point but is actually fairly important. It will help the audiologist judge if you have accepted the fact you have hearing loss (the test will show later), and also in which situations you have trouble hearing. This helps us get to know where you may want help hearing. When asking a man if he has trouble hearing he’ll answer “only my wife” or “my wife thinks so” or if she is in the room we will hear about his “selective hearing.” The case history is nothing to worry about; we don’t ask anything TOO personal or embarrassing. A proper case history typically takes about 5 minutes.

 

Otoscopy:

Next, believe it or not, we like to look into people’s ears! Using our little handheld “ear flashlight” we can obtain a lot of information. Proper otoscopy starts on the external ear and continues all the way to the eardrum or if anything can be visualized beyond in the middle ear as well. The jokesters will typically ask if I can see “all the way through” or “if the light hits the wall on the other side.”

 

We look for anything out of the ordinary, including excessive earwax. Many people think using cotton-tipped swabs (one particular popular brand is Q-tips) in their ear canals helps clean it out. (Just a quick aside, Q-Tip is a mighty fine product and has many great uses, just not poking in the ear!) Many people use cotton-tipped swabs in their ear and when they pull them out they see a tiny bit of wax or the colour of wax on the cotton and say “got it!” Well, actually you most likely just soaked up good oils in your ear and pushed the wax deeper in your ear like a plunger…. I have personally taken a “piece” of wax out of someone’s ear that uses cotton-tipped swabs that was the size of my pinky finger (I have the photo proof!)

 

Sorry, I need to apologize, this section was about otoscopy and I have gone off on a tangent about cotton swabs. Looking into someone ear can give us clues about the status of the eardrum, if it has a hole in it, or if there is pressure present in the middle ear. We also look for signs of ear infection or foreign bodies. It is quite amazing what people can hide in their ears! I have seen hearing aid parts, insects and a toy bead.

 

The next blog will continue with describing the tests we perform to assess an adult’s hearing. If you have questions about what’s involved in a hearing test or want to share your experiences with having a hearing test, please leave me a comment.

 

An otoscope is the what audiologists use to examine the ear.
An otoscope is the what audiologists use to examine the ear.

 

 

 

Sean Brac, Audiolgist

 



People often ask us after a hearing test if they need hearing aids. If the person has a moderate hearing loss or poorer the answer is “yes” and we encourage them to give amplification a try. However, with this amount of loss, the hearing impaired person almost always knows they have a loss and is usually motivated to take the next steps to better hearing.
Sometimes it is more difficult for people with slight or mild hearing losses to decide if they should try hearing aids. Mild hearing losses do cause communication problems but the amount of difficulty really varies from one person to another. In these situations a communication assessment needs to be done. Some questions the audiologist may ask are:

 

Who do you communicate with the most? Can you hear that person? Are you or your significant other getting frustrated with your poor hearing?

 

How often are you in groups or crowds? Do you attend meetings, church, or family gatherings? Are you having difficulty in these situations?

 

Do you have difficulty hearing the TV or radio? Are other people complaining that you have the volume too loud?

 

What are the demands on your hearing? Are you still working? How important is it to hear what clients, co-workers, or supervisors are saying? Are you on the telephone a lot with your job?

 

How difficult is it to hear in your everyday environment? Is there background noise? Are you listening over a distance?

 

Is your hearing loss causing stress in your life? Are you less likely to attend social events because you worry that you cannot hear?

 

These questions help us answer whether hearing aids are needed. We have to take into account more than just the amount of hearing loss and consider how much communication loss results. How we interact with our communication partners is key. They are affected by the hearing loss as well. For this reason it is a good idea for family members to attend these appointmentments with you.

 

Together, we can answer the question, “Do I need hearing aids?”



Welcome to London Audiology Consultants’ new website and our first blog.  Check here for updates on hearing information and what’s new at London Audiology Consultants.

 

Our clinic is locally owned and independently run. Catherine and Margaret established London Audiology Consultants in 1985. Both worked for a few years prior to that after graduating from UWO as audiologists. Margaret is very proud of the fact that she has some patients who are still with her since 1982!

 

Some of the themes that we will cover in future blogs are the importance of hearing in our lives, misconceptions about hearing loss and what hearing aids can and cannot do for you.

 

Our goal is to help people hear better. We hope this blog will help people understand and enjoy the journey to better hearing. We invite you to travel with us!


London Audiology
London Audiology Consultants is an independent Hearing Health Care clinic established in 1985 by co-owners and audiologists Margaret Brac and Catherine Moore.

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