Working Out Deaf


I won the contest at work.  We had a bet who could lose the most percentage weight.  Yippee for me!  I lost 29 lbs in 9 weeks.  Just over 11% body weight reduction.  I still need to lose about 25 more to finally put an end to the “chubby deaf guy.”

Working out Deaf…do you wear your hearing instruments or not?  Yes, I have a water resistant hearing aid and cochlear implant.  But years of being taught  to fear moisture on my expensive hearing devices still is in me and I can’t seem to get over that.  Thus I always remove my CI and hearing aid when I work out.  This has pros and cons.

Pros:  I like being in my own little world sometimes.  I enjoy the peacefulness, and I seem to focus better on exercising.  I can work out as intensely as I wish with no concern about damaging my hearing instruments.  Lastly, at the gym, there can be some arrogant jocks spewing off stupidity.  My son tells me some of the conversations he has heard.  A real classic was some meathead dude looking forward to visiting LA because  “Almost all the women in LA have done porn.  Its true dude!”  These are the times I consider myself blessed to be deafened.

But there are some cons and some safety points to consider.

First, I think I need a t-shirt that says “I am not a douche-bag…I am deaf”.  Although I try really hard to not block anybody and be aware of my surroundings, sometimes people ask me questions like “are you done with that machine”.  I look like I am ignoring them, which gets erroneously interpreted as arrogance.  I mean, thats what guys do in the gym, right?  It is almost a dick slapping contest.  Well, no, not for me…I am not a jerk like some of the other guys in the gym, I am just deaf.

Then there are the safety issues.  I also run outside with no hearing aid or CI.  Let me officially state that I am not advocating this for anyone because you may not hear a car and get run over.  The safest thing would be to run on a treadmill if you insist on doing it “deaf”. Or use your hearing instruments whilst running outside.  Try protecting them with products like the Hearing Aid Sweat Band or Ear Gear.  I have not personally used these products, so don’t interpret this as an endorsement…but check it out.  Lastly, you when you are done with your exercising, put the hearing instruments in a Dr-Aid kit of some type.

There are now hearing aids that are water resistant.  Phonak has the new H2O line of hearing aids as does Siemens with the Aquaris product.  In addition, the Cochlear Nucleus N5 is water resistant, while the Advanced Bionics Neptune is actually waterproof.

But I have taken some steps to increase my safety, namely by enhancing my visibility.  First, I wear a reflective safety vest.  This makes me pretty much glow when headlights shine on me.

This vest makes me more visible.

But I didn’t stop there.  I also added some flashing lights to the vest.  I have a white at the front and a red one on my back.  If you can’t see me now, should you legally be driving?

These lights make me look flashier than Elton John.

The decision to exercising “deaf” is entirely personal.  I prefer it for myself, and I accept the related risks (not hearing traffic, and not hearing jocks).
Advertisements

What Do You Do When You Can’t Hear Anymore?


Here’s a simple question that seems to confound many hearing health care professionals.  What do you do with a patient who can’t hear anymore?

I guess we should back up a bit a define what we mean by “can’t hear anymore”.  What I am referring to is patients with hearing losses typically in the profound hearing loss range with auditory-only monosyllabic word identification scores typically around 25% or less.  Note that we need to look at both the hearing loss and the word identification score as the variability of communication performance in this hearing loss range is massive.  Additional, we should look at auditory-visual word identification to see how well the patient can utilize the addition of lip-reading information.

Lets look at a case that I recently encountered.  The woman had a left corner audiogram.  Word identification score was 0%.  Auditory visual speech perception was not much better, but was not assessed by the clinical audiologist with an AuD so we don’t really know.

I was contacted and asked if I could help with the FM fitting at this office.  I agreed, but as is always the case, I was not given all the details.  I got there, asked to see the file and my jaw dropped.  The conversation with hearing health care professional (HHCP) went something like this:

Me: So what are we doing with this patient?

HHCP: We are fitting an FM system?

Me: Why?

HHCP: What do you mean why?

Me:  I mean “why?”, thats what I mean.  What will the FM system do?

HHCP: It will help the client hear better.  She and the family are pretty frustrated.

Me:  Well of course they are.  But how will the FM help the client hear better?  Will it improve her word identification score?

HHCP: Sure.

Me:  How?

HHCP:  By improving the signal-to-noise ratio.

Me:  When you did the word identification test, did you do it in background noise, or in quiet?

HHCP:  In quiet.

Me:  So we are already looking at the best possible score and thats 0%.

HHCP:  I guess…

Note that this is not the first time I have had a conversation like this with an audiologist or a hearing instrument practitioner.  It seems to me that most clinicians have no clue what to do with patients who have little or no hearing.  I am not 100% sure of the reason for this, but I suspect that it goes back to our problems with our training. And that is as follows:  We are only trained on how to assess hearing and how to fit a hearing aid.

The audiologist in this example is, like most of my colleagues, a good and decent human being who truly wants to help the patient, but doesn’t know how.  He is simply the end product of his training.

As an audiologist who also had 0% word identification and little hearing, I would like to offer my hearing health care professional colleagues a few suggestions on what to do with these kinds of patients.  This is just a starter list…books could probably be written on this topic.

1. Counsel the patient.  Specifically, let them know that they cannot hear anymore and we need to change tactics.  In the case example above, and with the managing audiologist’s permission, I sat down the patient and her family and told them just that.  The woman’s son practically had tears in his eyes…tears of frustration.  He said “You are finally the first person to finally tell us what we have been saying for years, “my mother can’t hear”.

2. Let them know what a hearing aid can realistically do.  In this woman’s case, it might provide a few basic awareness cues of loud sounds in the environment.  Thats it.  It will do little for speech perception.

3. The patient has two basic choices now.  1. Cochlear Implants or 2. Switch entirely to a visual approach.

4. Cochlear Implants:  Make the referral to the closest implant program.  Give a basic description of what it does, but stress that you are NOT a cochlear implant audiologist and they should get the correct information from the proper professional.  Resist the temptation to give too much information here, unless you are very informed about CI’s.  And don’t worry about candidacy.  Let the CI centre work that one out.  Most audiologists wait way too long to refer to an implant centre. When in doubt, refer to the CI centre.

5. The second option is to switch to visual approach.  This can include learning sign language, using written notes, using text messaging via a mobile phone, things of that nature.

6. Lip-reading as an exclusive method if communication is not an option in my opinion.  An explanation why is another entire blog posting, but basically far too many words look the same on the lips and it is extremely exhausting to lip-read all day long.  It is best used as a supplement to hearing.  Works great for folks who still have some usable hearing.  See a fellow blogger’s posting on this topic.

7. Discuss alerting devices that use visual or tactile stimulation.  This folks need to know when there is someone at the door, if the phone rings, if there is a fire etc.  Hearing Ear Dogs could be discussed here as well.

8. Give options for phone communication.  In the past that would have meant getting a TTY (sometimes called TDD’s).  Nowadays, we have even more options including text messaging, instant messaging, email via computers, email via smart-phones etc.

9. Make sure the patient knows about captioning.  This includes TV, but also real-time captioning (CART).

I provided all this information to this lady and her family.  I also took back the FM and told them that it would be a waste of money at this time, but if they got a cochlear implant, an FM system can be added then.

This woman, who’s hearing loss was progressive over the years, should have started using an FM system when her hearing loss was moderate-severe.  Her time for the FM came and went.  FM systems need to be added much earlier, not when the client is a CI candidate.  That’s too late.