“My hearing aid doesn’t seem to be working as well…”

Do you have a patient or two who wear hearing aids and over time do not seem to be benefitting from the well fit, verified hearing aids that you programmed? This patient may express increased hardship communicating with their families and friends. This patient may be having a hard time at work and reluctant to advance to new opportunities. This patient may express that she is exhausted from paying attention and listening throughout the day. This patient may mention that it is stressful to make a phone call.

The scenarios mentioned above were a reality to me. I knew that as an audiologist who has congenital bilateral normal precipitously sloping to profound hearing loss, I had the top of the line fitted hearing aids, hearing assistive technology, coping strategies, and advocacy skills; but I was struggling. I was in denial (and didn’t want to find out) that these above scenarios were a result of a decrease in hearing and speech discrimination. Instead, I blamed myself for not paying close enough attention, multitasking, and not getting enough sleep.

Why was I scared to find out? Deep down I knew that my comfort zone of wearing bilateral hearing aids was not enough. Deep down I knew that I was likely a candidate for a cochlear implant. Deep down I knew that I would need to make a choice to better my hearing or continue to struggle.

The little voice inside my head that said you need to go see if you are a candidate kept getting louder and louder. This prompted me to start asking questions in every opportunity. My audiology friends with cochlear implants were became my sounding board. I was able to ask this circle of colleagues and friends unfiltered advice about how they started their own journey. I also began asking my ENT/cochlear implant colleagues more about the process and criteria. Being able to ask others who had been on the journey gave me the courage to make that important next phone call for a cochlear implant assessment.

 

How you can help as an audiologist

Clinical Audiologists are uniquely positioned to help patients address these fears and plant the seed for taking a next step for a cochlear implant consultation. Here are a couple of tips to get started:

1. Educate yourself about the changing criteria for cochlear implants. It is OK to start the conversation a long time before criteria are met. Introduce cochlear implants as part of a continuum of care that starts with hearing aids and often progresses to cochlear implant assessment.
2. Reach out and meet your local Cochlear Implant Specialists. Many cochlear implant centers will host continuing education events throughout the year which gives an opportunity to meet the team. If not, schedule a time to meet the cochlear implant audiologist. You will feel much more confident referring your patient for a consultation if you have a professional connection.
3. Know your patient’s struggles. Continuously ask your patients about how they hear and understand with their current technology in their work, home, and community activities. There are many different tools that can be used to track over time how a patient perceives and rates their hearing and listening skills.
4. Complete Aided Speech Discrimination and Speech in Noise Testing. Speech testing such as QuickSIN helps bring “real life” into a controlled setting. This can take some time, but it can also be concrete evidence that a patient (and loved one) needs to see in order to realize that their struggle is real!
5. Don’t wait until hearing aids have failed. Plant the seed: Any big life decision starts with a seed that is planted. Talk to your patient about this possibility of assessment for cochlear implants. They most likely feel comfortable and trust your professional advice as their hearing aid audiologist.
6. Connect your patient with a cochlear implant consumer specialist in your area. If your patient shows interest, ask them if they would like to talk to someone who has gone through the process. Many of the cochlear implant companies have consumer specialists or you might have a hometown patient that is willing to share their journey.

 

My Decision

In July 2019, I listened to the voice inside my head telling me to make an appointment for a cochlear implant evaluation. With much courage and support, I went through the cochlear implant consultation at Ohio State Medical Center. After a long day of testing and consultation, my own observations of decreased hearing and understanding were confirmed. My left ear was performing significantly worse than my right ear. Because the seed had been planted, the decision to schedule for surgery on November 2019 was the right decision.

December 4, 2019 was activation day and my bimodal journey began. I am now on a new hearing journey learning how to blend a new bionic signal with my lifelong acoustic signal. Stay tuned for future insights on how bimodal listening can be the next best step!

 

For more information about hearing loss solutions and cochlear implants visit Phonak and Advanced Bionics websites.