Don’t Put Anything Smaller Than Your Elbow in Your Ear!

I actually have worked with one doctor who said it’s ok to use Q-tips, as long as you dip it in alcohol. They’re abrasive and the skin in your ear is delicate. On the other hand, I have a friend who ruptured her eardrum with a Q-tip because someone opened the bathroom door and it hit her elbow.

I told my son this rule when he was about four and he looked down at his elbow for a moment before deciding it wasn’t possible. Anyway, your call. But, officially, nothing smaller than your elbow.

There’s a lot going on right now, so I thought we could use some humor. It’s my favorite coping mechanism. Enjoy

Black Lives Matter – a statement from the American Academy of Audiology

Call to Action
June 8, 2020

We sincerely hope that members of the Academy join us in expressing our deepest sympathy to the families of George Floyd and others whose tragic deaths have sparked long overdue conversations in our nation.

We ask that you share in our sadness for the unbearable stress these unthinkable events have placed on Black Americans and specifically on our Black members. While the majority of the membership cannot even begin to imagine this type of stress, we can use this time to imagine and realize a different future in the Academy.

The Academy leadership has been taking time in recent days to listen to Black national leaders and Black colleagues within the association. Although these individuals naturally have varying opinions, one piece of advice has been clear: Listen and create a pathway to action.

The Board recognizes that the organization does not have a track record of inclusion and that action is needed. The lack of diversity is evident across our committee, council, and board leadership structure, within our leadership development program—Jerger Future Leaders of Audiology Conference (JFLAC), and in our awards and recognition. In these very preliminary conversations, it is evident that the problems run much deeper and permeate all aspects of audiology from the student experience, preceptor experience, daily work experience, convention experience and more. We have not even scratched the surface in these conversations and understand that a tremendous amount of work needs to be done across all aspects of our profession.

The Academy will not tolerate discrimination, racism, prejudices, or bias. Our next step is to implement methods for institutional change by collaborating with our Black colleagues on how to execute a plan for change. This is a first step on a journey to institutional change, all members will be part of this journey; in fact, all members must be part of this journey for there to be real change. We are purposefully starting this conversation with Black members. This is not meant to minimize the experience of other members of color or other individuals who feel marginalized. This is a starting point in the current context, and we will expand this conversation over time. We will facilitate the needed dialogues and listen to how we can achieve needed shifts within the profession and truly be the organization of, by, and for each audiologist serving all individuals who need our help.

Please consider this an invitation if you identify as a Black audiologist (member or not) or a Black audiology student to click the link below and provide your contact information so we can engage you to lead this conversation. The Academy leadership is committed to your voice being heard and for you to dictate the path forward that can lead to inclusion, representation, and equality.”

I think this is awesome. May it be a call to action in whatever profession or sphere of influence you have.


Santa Barbara Audiology: working from home

I woke up this morning remembering something learned in the school of hard knocks: Work smart. Not just hard.

So here are the “smart” ideas that will keep everyone safe and hopefully keep me from going out of business. It turns out I can work from home in a lot of cases. Here’s how:

1) If get a buy a hearing aid or if you have a current hearing aid, I can program it remotely. The setup takes maybe half an hour. Remote programming is not ideal because it’s only so effective without “real ear” measurements, so I’ll eventually everyone will have to follow up in the office.

2) I can troubleshoot and help you do basic repairs remotely too, either via Skype or the manufacturer’s remote programming software. If you need help with Skype, I can walk you through it over the phone.

3) Manufacturer repairs can be sent from and to your home. Manufacturers are now willing to send repairs directly to patients for free. You can give me repairs through the mail slot or I can mail the repair form, box, and label to you to send it in yourself. Sometimes I have to reprogram a repair first though. In that case, you’ll have to pick it up at the office or pay for me to FedEx/UPS it to you.

4) And finally, I can mail batteries, domes, wax guards, tubing etc

These days it feels like what my grandmother went through in her lifetime – the flu epidemic, the dust bowl, the depression… only it’s happening all at once. We have to stick together (6 feet apart).

Life in Santa Barbara with Covid 19

We’re still open during this crisis. But there are a few changes though. Carol and the pups are staying home for now. I’m answering the phone as I can. I’m seeing only one patient in the office at a time and I’m encouraging everyone to make an appointment rather than just drop by. I’m wearing a mask and gloves, although I’m not sick, and I’m cleaning everything throughout the day. There are so many people who come here who are in the highest risk group and I’m doing all I can.

A woman was walking by and decided to ask about the chair. She said amiably, “Is this your chair? Is it just siting here all lonely?” I told her that I had put the chair outside for anyone who feels safer sitting in the sunshine when there’s another patient in the office. It’s also for people in the long line at Trader Joe’s if they get tired. Sunshine and a nice view of the mountains. What could be healthier, eh? She really liked the idea and told me enthusiastically that I had to post it.

Please stay well and safe everyone. Practice patience and kindness.

Over the Counter Hearing Aids

NPR covered over-the-counter hearing aids back in 2017. Since then, politicians have passed legislation that provides access to these new amplifiers. NPR, like the politicians, dismissed the audiology profession without talking to an unbiased expert in the field – not a doctor and not someone who sells hearing aids. Ruth Bentler at University of Iowa would have been a good choice. Todd Rickets at Vanterbilt would have been another.

The only way I’ve thought of to concisely explain what audiologists do is to compare them to orthodontists. You might ask why a bunch of wires cost $6,000. They’re just wires. It’s because they don’t help much if you don’t have an expert, with 6-8 years of education, custom fit them and fine tune them over time. Audiologists require at least 8 years of education.

I’m glad these amplifiers are out there, but they’re only appropriate for a limited group of people. I tell patients to try it out, but keep your receipt. I guess you could compare them to something like Invisalign knockoffs that you get on Amazon or at the drug store. They’ll work for a few people with slightly crooked teeth.

One last thing. The NPR podcast inferred that you have to spend $5000 on a pair of hearing aids. The $5000 ones can have a lot of benefits, but the quality of the fitting is at least as important as which hearing aid you get.

What really needs to happen is for legislators to come up with policies that help enforce competence and ethics. There are problems with both of those in this field. How you legislate something like that, I don’t know. That’s their expertise.

Costco Hearing Aids

I’ve gotten a lot of questions lately about the difference between me and Costco and why Costco’s hearing aids are so much less expensive.

Well, partly it’s because they buy a limited number of models from a limited number of manufacturers. So they buy in bulk. I can get any hearing aid from any manufacturer (except a couple of proprietary companies). I like that because they don’t all make the right hearing aid for everyone. I spend a lot more time keeping up with technology than they do, but it’s worth it. Here are some examples of hearing aids and why I might choose them.

Some people won’t wear hearing aids because they think it makes them look old. So, I can choose Phonak Titanium or Signia Styletto. Some work in an environment with lots of people and noise. So I have Oticon OPN S. Some people need rechargeable batteries. So I have a lot of options, but usually I think ReSound Quatro. I have people with deafness on one side and might try a CROS hearing aid. I’ve been trying Signia Nx for that lately. I have people with profound hearing loss and I’ll usually choose Oticon Exceed. Some people need to answer their Android phone, hands free, so I get Phonak Marvel. Starkey Livio Ai has fall detection, heart rate monitoring, and language translation. Widex Evoke has a great tinnitus masker.

I can also change manufacturers for things like earmolds. I’ve switched between companies like Westone, Starkey, ReSound, Oticon, Emtec, and Microsonic because quality can vary over time. They also have their own specialty. Microsonic is excellent at children’s earmolds and Westone is great at musician’s monitors.

Also, I’m an audiologist. They are usually hearing aid dispensers. While I’ve met dispensers that are stellar and audiologists that aren’t, audiologists have an advantage of graduate school education. The focus is different. Audiologists are trained to think of treating hearing loss, and that includes more than hearing aids. Sometimes it doesn’t include a hearing aid at all. A liberal education teaches more than how to do something. They teach why. So when you get unexpected results, you have half a chance of figuring out the why and how to fix it.

A few random things that come to mind: I take insurance and I work for free in Starkey’s Hear Now program. Costco’s ReSound hearing aids are locked – meaning only Costco can program or fine tune them. And, finally, I hope you enjoy this video, because it circles back to my first example of patients who think hearing aids make them look old.