cheshire-hearing

Alan accepted he was getting older and his hearing was not as good as it used to be.

Fri, 31 Mar 2023 08:39:10 GMT

HISTORY

I first met Alan in 2002, he was 75 and had purchased his first hearing aid from another supplier a few years previously. He accepted he was getting older and in addition to his hearing problem his sight was not as good as it used to be. He thought it wise to stop driving and with this in mind he wanted someone closer to home to look after his hearing needs.

Alan spent his working life in the insurance industry, working in clients homes and office environments. He had not worked in noise at any time.

Over the years Alan has had a number of strokes, these have affected his fine detail dexterity and his ability to write or hold a pen. He has been diagnosed with Advanced Macular Degeneration (AMD) which affects his ability to read, but also prevents him from changing the batteries or routine maintenance of his hearing aids.

NEEDS ASSESMENT

Alan is a widower, he lives alone and tries to be as independent as possible. His enjoyment comes from watching television and listening to commentary on his beloved Manchester City on BBC Radio Manchester. He has a number of friends who visit him regularly and of late he has started to attend a seniors day care centre once a week, which is a great source of pleasure for him, but he does find it incredibly challenging and frustrating.

During his latest hearing assessment we discovered Alan's hearing had deteriorated. He now has a severe to profound Sensory Neural Hearing Loss - he was no longer able to hear normal conversation without the assistance of hearing aids. It was established from his Speech in Noise test that he needed a Signal to Noise Ratio (SNR) improvement of over 15 decibels (dB). This basically means that the sound of speech he is listening to needs to be 15dB above the background noise.

SOLUTION

With all his health issues I needed to select a system that would allow Alan to use and maintain it himself as long as he is able. I obviously had to consider his hearing ability but also his failing eyesight and his dexterity issues.

Alan was fitted with a pair of Siemens Binax 7 behind the ear instruments with rechargeable batteries using the Siemens eCharger. As Alan was unable to see fine detail such as the conventional red and blue markings that define right and left hearing aids it was decided to fit him with one beige aid and one silver aid. One last detail I employed was to modify his ear moulds.

Most ear moulds for use with behind the ear hearing instruments are fitted with a standard tube. A once popular but now almost forgotten method of ear mould tubing is the Libby Horn. Originally developed as a method of improving high frequency sounds before the advent of digital hearing aids, it has the advantage of providing a sound hole 3-4 times the size of conventional earmould tube. The size of this aperture allows Alan, despite his dexterity problems to provide some form of basic maintenance in terms of keeping the aids clean.

The effect this small action has on his self confidence and independence has been remarkable.

Alan says that his new Binax system is "much clearer than his previous aids". He now finds TV and radio easier to understand but it is in his social situation he notices the biggest improvement. While he still has to concentrate he can now understand people either side of him at the day centre. He is enjoying his time there and can look forward to "his Wednesdays".

Andrew at first sight is not your stereotypical hearing aid user.

Fri, 31 Mar 2023 08:30:49 GMT

HISTORY

Andrew at first sight is not your stereotypical hearing aid user. When I first met him for his initial hearing assessment I pictured him as a real life Action Man. In his early fifties, Andrew felt his ability to hear was holding him back at home, at work and socially. Andrew had overcome the biggest hurdle when it comes to hearing loss and accepted himself that something needed to be done.

His wife had been complaining that he could not follow conversations when they were with company, The television was up far more than was comfortable for her and that he would often miss-hear what she was saying or worse still, appear to ignore her.

Andrew had been a career soldier serving in the RAF regiment for 22 years. One day during a training exercise he was exposed to the loud bang from a stun grenade at close quarters. He initially experienced a severe dullness to his hearing and horrendous tinnitus. Within a day or two his hearing level improved and the tinnitus eased but his full hearing ability never returned to its original level and the tinnitus persisted.

NEEDS ASSESMENT

Andrew currently runs a number of businesses. Two in particular place serious demands on his ability to hear, understand and communicate. Firstly, he runs his own security company with all the demands that modern business brings today, negotiating contracts, managing staff and dealing face to face with clients. He has also developed his passion for keeping fit and is a 5th dan in karate. He teaches the martial art at multiple locations to numerous age groups.

During his hearing assessment we discovered Andrew had a moderate to severe Sensory Neural Hearing Loss - this is typical for someone with symptoms from noise damage.

With the highly active life Andrew leads, he needed a system that was small. It was imperative that he could use it while taking his karate classes and that it would not impede his demonstrations of moves and techniques. In his business life he would find himself in demanding listening environments and could not afford for clients to see him as having any disability or be at a disadvantage that in their mind could compromise their safety.

SOLUTION

I recommended an IIC (invisible in canal) system. Andrew was fitted with a pair of Phonak Q90 Nano instruments. At fitting his initial reaction was "wow", this was from a system set to 90% of its capability.

Many first time hearing aid users need to acclimatise to amplified sound, all modern digital hearing systems have some form of acclimatisation process which can help wean a client from the comfortable sound they have been accustomed to, steadily increasing to what they really need over time.

Like many new hearing aid users, after four months or so Andrew was starting to feel his hearing instruments were not as clear as they were when first fitted. This was not in fact the case, he had simply got used to sound the hearing aids produced and was ready to move on to the next level. The acclimatisation level on Andrews was set to 100% and the "wow" factor returned.

Andrew would not want to be without his hearing instruments now. It is not that he has become dependent on them, it is that they have improved so many different aspects of his life he feels why would he choose to struggle. His confidence has improved and he can put his energy into the matter at hand, rather than using it purely to try and understand what has been said.

Frank is in his 70's - wearing hearing aids for over 20 years.

Wed, 29 Mar 2023 10:16:58 GMT

HISTORY

Frank is in his 70's he has been wearing hearing aids for over 20 years. Frank has a severe hearing loss and was becoming increasingly frustrated with the performance of new hearing solutions his current providers were getting him to try, as he was offered more and more powerful instruments in attempt to help, he was actually finding conversations more difficult to understand.

When we first met up to assess Frank's hearing, beside the routine hearing health questions we ask we also use COSI. COSI stands for client oriented scale of improvement, it is a questionnaire that helps a client document their goals and needs quite specifically so we may revisit them during rehabilitation appointments.

This tool gives us a subjective measure to improvements in the clients hearing ability.

Through the COSI questionnaire I learnt that Frank‘s great passion in life is music, he is, despite his hearing loss an active participant in his local brass band and loved classical music. Frank played an active role in his local church and longed to be able to join in conversations during coffee mornings after services as well as to take part in church group meetings.

During the test procedure it was established that there was a high probability that Frank had what we call dead regions within the cochlea of his right ear. This means that no matter how loud sound was played at particular frequencies during a hearing test or through a hearing instrument the tiny hair cells within the inner ear were to all intent and purpose dead and unable to process some particular frequencies which left sounds distorted. Frank's left ear was performing in a normal manner albeit exhibiting a severe hearing loss.

SOLUTION

I recommended that Frank be fitted with an Audibel A4IQ Silver BiCROS, Receiver in the Canal system. It was decided that we would not attempt to amplify the right ear and try a CROS system. CROS stands for Contra Routing Of Signal, a microphone equipped device would send sound from the right ear to a compatible hearing instrument on the left ear that will pick up the sound from the right wirelessly.

In Frank‘s case the fitting was actually called a BiCROS as we were amplifying the sound from both sides. This gave Frank the benefits of directional hearing, improved quality of speech understanding in difficult listening situations and helped with his meetings at church.

I also recommended that we should fit the Lithium-Ion Rechargeable version as the constant streaming of sound data from one ear to the other is extremely demanding on conventional battery technology.

We routinely use Real Ear Measurement when fitting a hearing system, this means that instead of a hearing aid fitting being based on average data, we are measuring precisely how the hearing system is performing in the ear against a highly personalised prescription.

For many clients we will often set up a hearing system with one program for the initial two week trial. We had planned at Frank‘s first follow up visit to introduce a dedicated music program, Frank brought in a CD of his favourite violin concerto. Once this program had been activated and we played the music Frank became very emotional as he had not heard and enjoyed the concerto for many years.

Frank‘s hearing aids are not top of the range instruments but it shows how by thoroughly assessing a clients hearing, their needs and expectations and then accurately fitting with Real Ear Measurement, a life changing outcome can be achieved.