US Audiology Students in Zambia

Would you believe that for the whole of Zambia, there is only one audiologist? You can imagine that for students from the Department of Speech, Language, and Hearing Sciences (SLHS) of Purdue University in the US, spending two weeks in the field on an exchange programme in Zambia must be quite an adventure. An opportunity to see healthcare in a completely different context, to gain clinical experience in a setting where their actions have meaning, in addition to the life experience every exchange programme is bound to provide.

In zambia at work with screenings

I discovered their programme though the blog set up by their professor. The blog is a very lively of their trip, with lots of anecdotes and information on what they did there, from the preparation classes before their departure to a complete account of their last work day in Zambia. Go and read it and look at the photos!

I wrote to them to see if they would be interested in contributing an article for Open Ears. Two of the students, Breanne and Andrea, sent me this overview of the programme and what it had meant to them.

Graduate and undergraduate students at Purdue University have the opportunity to participate in the speech, language, and hearing sciences (SLHS) in Zambia study abroad program. This past May a group of 12 students traveled to Lusaka, Zambia to learn about the culture and provide speech and hearing screenings. We had the opportunity to meet numerous professionals at a variety of facilities to learn about the healthcare system and the services for children with disabilities in Zambia.

This year, we received a donation of hearing aids from Phonak and were able to bring these to Zambia to fit as needed. At our main partnership location, Beit Cure Hospital, we fit a hearing aid on a girl who was about 11 years old as well as an older adult. We programmed each hearing aid for their individual hearing loss and made an instant ear mold. Using instant ear mold materials is much more efficient and is used very frequently in Zambia.

Both of these patients were so thankful and we hope the follow-up goes well. The 11-year-old girl is doing very well in school and we hope that her new hearing aid will help to decrease her listening effort and enable her to make even greater progress. The adult we fit told us that she had walked to Beit Cure Hospital, which took about an hour for her to reach us. Transportation is a struggle for those in need of healthcare in Zambia and this woman walked an hour to avoid paying for the bus. She was so thankful and said “God bless you for your help” to everyone involved in the appointment, making it a very emotional appointment. She is very excited to try her new hearing aid at church and plans to continue to follow-up at Beit Cure Hospital as needed.

Working in the audiology department at Beit Cure Hospital in Zambia was a little different from the experiences we were used to at the teaching clinic within Purdue University. Everything was very fast paced and we worked alongside an ENT, which was a new experience for many of the students. Zambia has one audiologist and several audio technicians and nurses who do remarkable work. They make instant ear molds, counsel patients and answer questions, remove cerumen and foreign bodies from the ears, and many other tasks related to the ears and hearing. The teamwork we witnessed was amazing. Everyone collaborates as needed to ensure his or her patients receive the best possible care.

Zambia SLHS group photo

This was a very unique experience and we are so fortunate that this is offered through Purdue University. This was the second class of students to go to Zambia and the first time we were able to bring hearing aids to fit (thanks to Phonak for their donation!). Hopefully the program will continue and many students have the opportunity to participate in this program. We learned so much more than what we provided.

I think it’s important to remember that hearing care professionals work in very different contexts all over the world. I hope we’ll have more posts here in the coming months which go beyond Europe and the US!

Photos from the SHLS in Zambia blog.

Silence Is Golden… Sometimes

The times I feel ‘least deaf’ are actually the times when I am most deaf. Allow me to explain…

When my partner’s at home, I tend to use my hearing aids all day so that I’m ready for any interaction. If he comes into a room to speak to me, I want to be able to know what he’s saying, so, wearing my aids at all times seems a reasonable course of action.

silence is golden sometimes

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The Future May Not Be All About Technology

The world we live in is bursting with new and exciting technology. As an audiologist I am astonished by the technological achievements that are implemented into today’s hearing aids, while other times I feel constricted and limited. How can this be? I can get into my car, connect to a “smart system”, browse my music and pictures, ask the system for directions by simply talking out loud; the possibilities are endless. Why then aren’t we farther along in hearing aid technology? Why isn’t there a proper “smart” hearing aid? Would we even want one if it existed?

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Trying Something Different

It’s no secret that I’m not a Phonak customer, despite being the editor-in-chief of this blog. It could be argued that this is a good or a bad thing, but right now I’m actually not convinced that it’s all that important.

Fitting some Phonak hearing aids

Anyway, since I started working with Phonak, it’s been (kindly) joked about that something needed to be done about my hearing aids. To tell the truth, I’m very happy about my current hearing aids, and not just because of their colour. I like the sound quality, I like the way my voice sounds (important! I speak a lot!), I even find their operating noise soothing. They allow me to understand people so much better and have really changed my life.

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How Exponential Growth in Computing Power Will Bring About ‘Magical’ Hearing Aids

On National Public Radio’s “All Things Considered” recently was the story of a woman whose hearing problems were diagnosed at age 5, in 1993. She had moderate to severe loss of high- and low-frequency hearing, and got her first hearing aids — which were large and crude compared to today’s hearing-aid technology.

You can read or listen to the story here: “Hearing Aid Evolution Unveils What The World Sounds Like In ‘3-D’.”Music to the ear, notes flow into an ear

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Accepting Silence

As I ride the train every morning, I am reminded of what quiet and/or silence really is. That brief moment when you can hear a pin drop in a packed train car, when someone rustling an umbrella or opening a bag catches your attention because it is a harsh invader in the heavy fog of silence. Everyone seems tired, there aren’t any jovial conversations being had — just the undeniable silence that leaves only the rhythmic steel wheels churning along the rails. When did silence become so thick?

On the train

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You Are Not Alone

When I was first told I needed a hearing aid, the last thing I wanted was for other people to know about it. I felt like I was the only person in the world with this ‘problem’ and that it was a private matter and not something I wished to discuss with other people. I now wonder if, because I discovered my deafness in a hospital setting, that’s why I felt that way about it: it was a medical diagnosis and therefore private, right?

Alone

I wonder if I’d had my hearing tested and been told I needed a hearing aid at an independent dispenser’s or an opticians with a hearing care centre, if I would have felt differently about the whole experience. (I may still have been advised to go to hospital later to discuss the prognosis but perhaps the initial experience of being told I needed a hearing aid might not have felt so ‘medicalised’.) Perhaps it would have felt more like being told I needed glasses, which was easy enough to come to terms with, as I recall.

Anyway, in the beginning, I couldn’t get used to the ‘in the ear’ hearing aid I’d been given at the hospital: it was so uncomfortable, made my ear and jaw sore and the volume was ‘deafening’ and it gave me terrible pains in my head after just a few hours of use. I consigned it to a drawer and instead embarked upon lip-reading classes. I remember that my goal was to become so proficient at lip-reading that nobody would know I had hearing loss. (I think I’d seen one too many spy movies with people looking through binoculars and reporting what was being said!)

My plan worked well for a time but then my hearing loss got a lot greater and I had to go and have another hearing test.

The student who announced the results of my hearing test did not realise the impact of what she was saying to me when she told me the hearing loss had begun in the other ear. She said it so matter of factly — but to me, I saw it as the ‘beginning of the end’. I needed hearing aids — not just one but TWO, and I was going slowly deaf in both ears. I was heart-broken.

The hospital offered me another in-the-ear aid but after the pain I’d had with the first one, I couldn’t face it. I chose to go private. When the audiologist told me I needed BTEs, again I was upset. “They’re just for really deaf people right? Surely I didn’t need those? I worried they’d be really noticeable but actually, I got the ‘open ear fit’ (the plastic tips have air holes in them) and they were light, discreet, and I honestly couldn’t always feel them. It was a revelation after having the ‘ear full’ experience.

open domes

When I did finally get these discreet hearing aids, I felt much less self-conscious about them and I started to tell a few people that I had hearing difficulties and when I did, I was amazed at how often people’s replies were that they were deaf in one ear or one of their relatives or their best friend. People at work told me about other people at work who had hearing aids and I’d never guessed (and why should I?). But it was far more common than I’d ever realised. I even showed my hearing aids to a couple of people and recommended my audiologist when it turned out they too had hearing loss. (I should have been on commission!)

I started to feel OK about having hearing aids, and the more people I met who also had hearing problems, the better I felt. Knowing other people trundle along through life with the same problems as you helps to put it all into perspective. Once the dust settles, you just ‘get on with it’, don’t you?

Your Audiologist — A Life-Long Relationship

It was another “normal day” at the office. My schedule was full of hearing evaluations, hearing aid fittings, and follow-up appointments. No boring routine, as each client was unique in their history and needs, as well as their expectations. As any doctor does, I had developed a mental check list I would follow when meeting a new patient. Medical history, listening needs, diagnostic testing, explanation of evaluation results and counseling. The process had never failed me.

I met Jane in the waiting room, brought her back to the testing area, and introduced myself. After completing the diagnostic testing it was time to start the counseling portion. Jane was not unlike other individuals I had worked with, however she was unique and to this day has made a lasting impression on my professional career.

Audiologist for life

Jane was young, in her early thirties at the time of her evaluation, and had experienced a rapid decrease in hearing in her right ear. Over a very short period of time, Jane had lost approximately 75% of her hearing in that ear, while her left ear remained unaffected. She worked in a multi-physician office that required her to perform quickly and efficiently, two qualities which were starting to be affected by her hearing loss. She described anxiety, stress, exhaustion, and an overall feeling of desperation for any intervention that may help her “get her hearing back”.

As her audiologist I could see the physical evidence that her hearing evaluation revealed. However, I knew that if I simply started to read the results back to her, I would only be adding to the sense of helplessness she was describing. So I did the next best think I could think of. I pulled my chair up next to Jane and her husband, left her results on the table, and told her that she already knew what the results were. Her hearing was indeed measurably worse in her right ear in comparison to her left ear. She had been working overtime trying to compensate for the difference. I told her that she had every reason to be upset, to feel stress and anxiety while trying to perform her job. Most importantly, I told her that she was exhausted at the end of the day because she was doing the job of two ears with one. She was working to compensate and function as if she still had normal hearing in both ears. Her brain was literally exhausted. Everything she described, every function and emotion, was valid. She was exhausted.

It was only a matter of seconds before she started to cry in the middle of the office. For a hearing healthcare professional, crying is not out of the norm to experience on a daily basis. Jane’s crying surprised me, however, and I think it surprised her husband as well. When I was finally able to ask her if she was okay, she looked at me and simply said, “thank you”. I asked her why she was thanking me, as I must admit you do not always receive a “thank you” when you explain results to clients. Her explanation was easy: I had been the only person who had taken the time to validate what she was experiencing on a daily basis.

The rest of the appointment was filled with discussions of Jane’s unique hearing loss, her work environment, the amplification options available, and the expectations of what may or may not be possible. Regardless of the outcome of Jane’s appointment that day, she left my office a vastly different woman than when she first arrived. She was not the only person who had been transformed in the 90 minutes that had elapsed, however. She also made a lasting impression on me. To this day I remember Jane and I can feel the emotions of that appointment rush back over me. I only hope that in the 5, 10, or 20 years even, Jane remembers the same thing. These relationships are the ones that last forever.

Relationship? Is that the right word to describe the interaction between a patient/client and a doctor? If you’re talking about your general healthcare provider perhaps it is, but your dentist? Maybe not. Your audiologist? Absolutely! The definition of relationship says it all: “The way in which two or more people or things are connected”. A hearing loss impacts the rest of your life, as does your decision to (or not to) wear hearing aids. The routine testing, maintenance of hearing aids, fine tuning and programming, repairs,etc., these are all actions taken between you and your audiologist. When something is not functioning appropriately or broken, you depend on your audiologist to know the answer and get you communicating again! Your audiologist, when you find one that you feel comfortable and happy with, will always be a part of your life.

It is our human nature that causes us to “judge” someone when we meet them — do we like their personality, are we “on the same page”, will we work well together? These are all questions that you should ask yourself when you meet your audiologist, because it is important to remember that if you are starting this relationship out on the wrong foot, then it cannot grow and evolve like it needs to. Not only do you make an impact on the audiologist, but we can only hope to make an impact on your life — your communication. We do all that we can to provide you with the tools you need to have continued success and a life full of unlimited communication and interaction with the world around you.

I’m Not Going on Vacation

I don’t know if this is peculiar to where I live but here professionals tend to have a habit of talking about people’s experiences of hearing loss as a ‘journey’.

Hearing Loss Luggage

According to the Oxford dictionaries, a journey is ‘an act of travelling from one place to another’. To me, a ‘journey’ involves setting out with the aim of reaching a destination. But that does not fit with my experience of deafness. I didn’t choose a destination or route and I certainly didn’t buy a ticket.

If life’s a ‘journey’, then the destination is the coffin, is it not? In this metaphor, having hearing loss is not the journey itself — rather it’s a heavy and somewhat cumbersome piece of luggage which some of us have to carry around. Sometimes, there may be a luggage trolley (hearing aid or other device) to make things easier and on occasion, someone might carry the luggage for us (watching something with the subtitles), meaning someone else has done the hard work for us, but, for the majority of us with hearing loss, we’ll be ‘carrying it’ with us for life.

And that’s fine. Everyone has something, don’t they? High blood pressure or a bad back. But do their doctors refer to those people’s conditions as ‘blood pressure marathon’ or a ‘bad back ramble’?

In the same way the media likes the phrase ‘battle with cancer’, so health professionals like a ‘hearing loss journey’.

Perhaps the ‘hearing loss journey’ phrase came about because of professionals studying the Kübler-Ross ‘five stages of grief’ which is also referred to as a ‘journey’, but is that enough for the phrase ‘hearing loss journey’ to have caught on?

Or is it something to do with the whole ‘pathway of care’ way of thinking and speaking about patients? Pathways, journeys… us deafies are clearly going somewhere. Perhaps at some point the professionals will let us know where they think we’re heading: that way, we’ll know what to pack!

So, this is a plea to the professionals out there: becoming deafened isn’t a journey with a destination. We haven’t bought a ticket, so please don’t talk about ‘journeys’: we’re adjusting to living with a disability, not going on vacation.

The Wash of Shame

It began with an ear infection and an early return from choir practice. My director sent me home after noticing that my energy levels were cut in half. Usually, I was center stage, singing at the top of my lungs and making a complete fool of myself—a change in pace from my self-conscious 12-year-old peers. When she saw me slink to the back, my director knew something was wrong. Upon revealing that I was sick, she wanted me to stay in bed.

“We can’t have you missing the concert in two weeks!”

pants in washer
Photo credit Petras Gagilas

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