Thursday, October 18, 2007

Air Travel (Part II)

My experience at the airport was more of the usual. Busy, Chaotic, and mostly Unfriendly. I know that over the years I have modified my behavior and I made a point to "observe myself" (if there is such a thing) and really think about how I was accommodated at the airport.

My arrival in the car was uneventful. My husband dropped me off. I had already logged into the airline website and had my ticket. So, all I had to do was check my luggage. I went to the desk and the lady behind the desk said "Mmm hmm mhhh *muffle* *muffle*" and she was not looking directly at me. I was lipreading and anticipating that she would talk to me. So I knew that she was asking how I was. I anticipated that she would also ask the usual questions about my luggage like "have you had your luggage within your control at all times?" I vaguely remember that the first time they asked this very strange question I had no idea what they were trying to say and had them repeat it like 20 times. This trip, there were no questions about my luggage. *whew*

I took my luggage over to the ramp for the xray and the staff took it from me without much interest. I think I initiated a question about whether or not they needed me to stand by or if I should continue to the security check line. I again anticipated the answer and did some lipreading.

I am realizing that I maintain my independence by lipreading and anticipating. I knew this but only partially realized the extent of my reliance on experience. Anyone new to flying would be neglected in a lot of ways at a public airport.

I got to security and knowing that I don't want to cause alarm I immediately told every security staff and office that I was hard of hearing and pointed to my ears. I make a point to do this with exaggeration so that they pay attention. Lots of people point to their ears even if they are not hard of hearing because of noise levels or inattention. So pointing to your ears doesn't necessarily identify your hearing loss. I thought for a moment that I should have worn my pin (face me I read lips) but I rarely think it works with most people, so I resort to the pointing and telling instead.

I got through security check without issue and there is never a problem with my hearing aids and the detector devices.

I then went to catch the tram to transit over to the gates. The tram had some outlandishly loud announcement that said "HOLD ON" and I could have heard that without my aids. But it would still be a concern for those with profound hearing loss and those with loss of clarity. I found myself wishing that the cars were staffed or at least had bright visuals.

I arrived at my gate and spent some time walking about the airport. I noticed as the time drew near for my flight that people were walking out of the gate and heading elsewhere. I had time, so I followed the "herd" and when I arrived at the new gate I asked the attendant if I was indeed at the right location. I was and the airline had switched gates. That happens alot. So, I anticipated it and watched others for reactions. But I didn't know from any announcement. I was not able to understand the announcements. However, knowing my abilities, I made a conscience effort to be aware of my surroundings, ask frequently when I was unsure and refer to the Arriving/Departing flight boards which give the status of the flights and the gate numbers.

When it got close to boarding time I assessed the group to determine if I would need to tell anyone I was hard of hearing. But the airline had boarding corrals and so, I knew when my line started to move, I was going to be boarding. When I stepped onto the plane I immediately spoke to the attendant who was welcoming us and explained that I would not be able to hear on the flight. I hoped that they would accommodate me by getting my attention when necessary. I probably could have gone into more details, but being a frequent flyer I determined that was unnecessary... plus it was a short trip.

The flight went well and I actually was in "hard of hearing bliss" with my hearing aids turned off. I didn't have to hear the babies and small children screaming the whole way down or the loud engine noise. I just enjoyed my book and when the drink cart came around I gave my order (I anticipated this, of course).

I missed all the airline instructions and announcements because my hearing aids were turned off. I don't recommend that a new flyer ignore these very important pieces of information.

When it was all said and done, my experience was good. But I realize that it was only good because my expectations were lowered. I anticipated everything and I knew what signs to look for and how to advocate for myself. There is much to improve on and I think all the industries can learn from our experiences. I encourage all of you to write to vendors and companies that you interact with and give your feedback. I hope that you can learn from my experience and hopefully be a little more prepared for your next trip to the airport.

Wednesday, October 10, 2007

Air Travel

I was catching up on some online reading and looking over Hearing Loss Association of America's website http://www.hearingloss.org/ and the blog by Terry Portis and I was reminded of the struggle for hearing assessibility in airports. I am about to leave for a convention in Orlando, FL tonight and I'll be flying again. I think I will make it a point to really pay attention to the experience. I am a frequent flyer and so I know what to expect when I get on a plane. I have to really think back to recall the first time I flew.

Friday, September 7, 2007

Hearing Aid Tax Credit

Hearing aids are considered medical devices and are tax deductible. There may also be a tax credit if the Hearing Aid Tax Credit Act - H.R. 414 passes legislation. Check with a tax preparation specialist or accountant for more information on this. And find more about advocating this bill at the American Academy of Audiology website.

Financial Assistance and Hearing Aids

There are many programs that assist patients in the purchase of hearing aids.

This is not a complete list
  • Low-income programs (typically less than 200% national poverty levels). Obtain hearing aids for a greatly reduced cost HearNow, Audient, Lion's Club, Rotary, etc. Many programs will have a 2-3 month wait time.
  • Programs for Veterans depending on service (we can help you determine your qualifications).
  • Working adults and college students may be eligible to receive assistance through the Office of Vocational Rehabilitation, Department of Labor in the state of Pennsylvania.
  • Children age 21 and under can obtain coverage through the Medical Assistance (ACCESS) program in the state of Pennsylvania.
  • Children can also receive special services through the school system whether public, private, or charter school.

At HearWell Center we will help you determine your qualifications for such programs and help you understand the limitations as well. Financial assistance programs will generally dictate the type of hearing aids allowed.

Financing Hearing Aids

Financing plans are great for those that find a monthly payment plan is most desirable.

At our office we generally use third party financing who can offer promotions such as no-interest for 3 or 6 months.

Here's what to expect with financing options:
  • You can expect to apply for financing as you would a credit card.
  • Interest is often compounded if you do not pay off the balance by the end of the promotional period.
  • The interest rate can be very high after the promotional period is over.

The well-advised consumer can benefit greatly from financing options.

Promotional plans vary so call for more information.

Are Two Ears Better?

Two ears are better than one.

Hearing loss is more complicated than most people think. Your ears are an instrument that communicates to your brain the information about the auditory world around you. When your hearing is "less than perfect" the brain receives only part of the information it needs to be aware and fully comprehend what it is hearing. So, for instance...with both ears functioning you can localize the direction of sound; is it coming from the left or the right? With both ears you can pick apart the different aspects of sound; is that noise I am hearing? is someone talking to me in the car? is there a piano playing in the bar? With both ears you can understand more clearly; is that person saying "I love my cat" or "I love my hat"? With both ears you can feel more balanced and natural.

If you are unfortunately left with only one functioning ear all the above mentioned benefits are diminished or completely disappear. If you have usable hearing in both ears, use both ears and benefit fully from hearing aids.

With very few exceptions most people with hearing loss in both ears will perform better with two hearing aids.

Search Keywords: Binaural hearing; Binaural benefit; Unilateral hearing loss; Auditory Deprivation

Guidelines for when to visit an Audiologist

Here are some general guidelines to follow when choosing who to visit first for your hearing or vestibular disorder:

For Emergencies such as sudden, dramatic hearing loss, extreme pain, excessive bleeding, and head injuries please visit your local emergency room.

See an audiologist for hearing or vestibular conditions that have occurred gradually without incident or injury to your ears. Audiologists specialize in the diagnosis and treatment of hearing loss and vestibular disorders. You can see an audiologist at anytime in the course of your treatment for a hearing or vestibular disorder. Audiologists will refer you to a medical specialist if symptoms and/or diagnosis are questionable or an obvious medical condition exists. Often hearing loss is caused by factors that are not medically treatable such as age, long-term noise exposure or hereditary hearing loss. Seeing an audiologist first can help you determine the best course of treatment for your hearing loss.

Audiologists have specialized training in the treatment of hearing loss including hearing aids, assistive devices, alerting devices, treatment of tinnitus (ringing in the ear), treatment of hyperacusis (sensitivity to loud sound), treatment of auditory processing disorders, and other disorders that affect hearing. Physicians rarely have this knowledge and unless they have attended an audiology degree program they would not be able to provide these services in a comprehensive manner without referral to an audiologist.

See a physician for any obvious medical conditions: sudden and dramatic changes in hearing, pain, drainage, unusual odor, injury, bleeding, skin lesions, debilitating dizziness and vertigo, etc. Physicians can prescribe medications or imaging (CT Scan or MRI) if necessary. Some physicians can also perform surgery where hearing loss is reversible.

In some offices you will find audiologists and physicians working side-by-side within the same practice. Today it is more common for physicians and audiologists to have independent practices and refer to each other when needed. Many insurance plans do not require a referral to be seen by and audiologist, however it is recommended that you confirm coverage before making an appointment to be seen.

Medicare patients are currently required to provide a referral from a physician for coverage of audiological services. In time Medicare patients will have the option to see an audiologist directly just as you have the option to see a Dentist, Optometrist or Chiropractor without a referral. Currently those under federal health plans are allowed direct access to audiologists. Would you like to have the same privilege and the ability to control your healthcare decisions when it comes to your hearing care? This will depend on the passing of Medicare Hearing Health Care Enhancement Act of 2007 (HR 1665- the Direct Access bill) and you can help by contacting your government officials through this website sponsored by the American Academy of Audiology.

HearWell Center strives to meet the needs of each individual patient by working as a team with the other medical specialists in the community. We will communicate with your family doctor and any specialist you see where necessary to ensure proper follow up and treatment.

What is an Au.D.?

Au.D. is a degree designation that stands for Doctor of Audiology.

Doctorate in Audiology (Au.D.) is the most common degree earned in order to practice audiology today. You may also see audiologist who have Master's degrees (M.A. or M.S. or M.Ed.) or Doctor of Philosophy (Ph.D.). An Au.D. is a clinical degree that can be used in many ways. Audiologists holding an Au.D. can practice clinical audiology, they can perform research and they can teach.

It is necessary in most of the United States to have an Au.D. in order to obtain a license to practice audiology today. Master's Degree programs are being phased out however, audiologists practicing with their Master's Degree or equivalent will continue under the licensure laws that were in place at the time that they were originally licensed. Some audiologists have chosen to complete this level of education by going back to school and earning the Au.D. and others have decided to continue practicing with their Master's or equivalent degree.

You can learn more about the Au.D. and the profession of audiology by visiting these links:
Academy of Doctors of Audiology (ADA) http://www.audiologist.org/
American Academy of Audiology (AAA) http://www.audiology.org/

Tuesday, August 14, 2007

Smoke Detectors and the Hard of Hearing

Recently there has been some coverage on how smoke detectors do not wake people who are hard of hearing. Although smoke detectors have very loud alarms and are "alarming" to most people... those with a hearing loss may not find that to be true. Depending on the degree of hearing loss, hard of hearing people may hear the alarm but it may not be loud enough to disrupt sleep; it may be soft or it may be completely inaudible.

I know hearing aid wearers who live alone in their homes and are concerned about taking their hearing aids off at night and for good reason. Hearing aids are the link to the audible world for many people and is often the only device people invest in to compensate for their loss. Alerting system can help fill the gap in accommodating for situations where hearing aids are not enough, when hearing aids can't be worn or are not an option.

Alerting systems are not new to the market... in fact strobe lights and vibrating alerts have been around for a long time. They are an everyday electronic in the homes of severe or profoundly hard of hearing or deaf/Deaf folks but they are not very common in the homes of the hard of hearing of lesser degree.

Unfortunately, many people with hearing loss deny themselves the protection of appropriate alerting devices because they do not believe their loss is great enough to justify the purchase or because they believe their family or friends or neighbors will help them if there is ever an emergency. This is truly troubling. Those who deny themselves the help are sacrificing their independence and possibly endangering their lives. It is not worth the risk. It is suspected that many casualties have resulted from this chosen isolation from the world.

Don't take the risk. Tell your family about it, too. Professional help is available and audiological care includes the assessment of your needs for alerting and assistive devices. Please call for more information. There is a solution for every household.

Saturday, July 28, 2007

Itchy Ears? Part One: Earmolds

Occassionally a hearing aid patient will ask about severely itchy ears and what they can do to stop the itch or prevent further irriation. Sometimes it is a simple issue of hygene and can be solved by keeping instruments that go in the ear clean. And don't forget to keep your hands cleans too. Often the germs that end up causing ear infections and other ear conditions come from dirty hands.

This article is all about cleaning your Earmolds. If you are not sure you have an earmold do not use these instructions. There are separate instructions for the cleaning of hearing aids.

The best way to keep earmolds clean is to wash and disinfect them. It is very important that you do not wash the hearing aid when cleaning your earmolds. The hearing aid and earmold disconnect (so long as they have been well maintained) and you can wash the earmold under warm soapy water. You will need to dry the earmold completely and use an earmold blower to remove moisture from the tube before you reconnect it to the hearing aid.

When you don't have time to wash the mold, you can use non-alchoholic disinfectant wipes. This can be obtained through your audiologist. You never want to use peroxide, alchohol or antibiotic ointment on your molds or in your ears. Do not put anything in your ears unless it has been sold to you by a professional (or prescribed by a doctor).

If your ears are reacting severely with pus or crustiness, you should see an Ear-Nose-& Throat Physician (ENT), Dermtologist or other medical doctor. These symptoms may indicate an infection and may require special medications. An allergic reaction to products or the earmold is another possiblity. You could also have an infection of the outer ear or you could have a middle ear infection that is draining. Regardless of what it is, it should be looked at.

Sometimes moisture can cause itchyness problems. Sweating in and around the ear can be uncomfortable for hearing aid wearers and is a common reason for hearing aid repairs. Consider a hearing aid dryer to remove moisture and protect your hearing aids and if you are sweating alot you may need to remove your hearing aids for more stenuous activities, wear a sweat band or protective cover over your hearing instrument.

All products mentioned in this article are available at the HearWell Center.

Can hearing aids be waterproof? Can I wear my aid in the pool?

The topic of moisture and hearing aids goes on.

It is a big topic and one that I discuss a lot with patients. Hearing aids are susceptible to all types of moisture and their is no way to avoid it completely. The best you can do to protect your investment and your instruments is to maintain an acceptable level of dryness and that can be done in a number of ways.

Sometimes I am asked if there is such a thing as a waterproof hearing aid. There answer is "none that have been successful." Part of the reason why hearing aids continue to have moisture issues is due to the battery. The batteries in hearing aids are air activated... that means that they need to be exposed to the air to work. If the hearing aids were completely sealed from air, the batteries would not function (consequently, they cannot be easily sealed from water for the same reason). Also, if the aids are sealed and moisture gets in the aid it won't be able to escape back out. If moisture becomes trapped inside the hearing aid you then have battery corrosion issues and possibly moisture related break down of the amplifier, and/or processor (or other delicate parts of the hearing aid). So, some leakage of air (and water) is necessary for a hearing aid to function. Perhaps in the future with sciences like Nanotechnology we will eventually be able to create a membrane barrier that will not allow moisture in but will allow moisture to escape and air in for the battery. Perhaps with improvements to the batteries (such as the new rechargables that are coming out) we will no longer need zinc-air battery cells for power. Some manufacturers are starting to play around with Nanotechnology and it is a fascinating science. I believe consumer will see many of their concerns slowly addressed as appropriate solutions are put on the market.

As for moisture prevention solutions...

Let me first say, you cannot swim with your hearing aids in but if you are going to wear your in-the-ear (ITE) aids in or around the pool or other potentially hazardous places, at the very least find a head wrap called EarBandit. This will also keep the aids from falling in the water. For those of you that wear behind-the-ear (BTE) hearing aids, you can also use the sweatband or EarGear products. These are not waterproof options and you still should avoid getting the aids wet... but they will provide splashguard. So, you can relax a little and have some fun. When you are done for the day at the pool... let your hearing aids dry out for 8 hours before wearing them again. Open the battery door and put in a dry, safe place. Never use hair dryers, heat lamps, hot air guns, microwaves or ovens to dry the aids.

Aids that are frequently exposed to water/sweat need a gentle, even, dry heat to remove moisture build up and this can only be found in electric drying kits. This is very important for those on the list that are profuse sweaters and love water sports. Even those who live in humid, muggy climates should consider an electric drying kit. If you are very active or if you sleep with your aids in (you know who you are) you need to give the aids a break once in a while and dry them out. Different companies offer different features in their drying units. You will find that most have a desiccant bar/bag/pouch and a heat source. Some also have ultraviolet light, thermoplastic heat and vibratory or mechanical spin dry cycles. Some are very simple, others more complex. Check to see if your audiologist has any demonstration units in their office. I've tried many drying units myself and I have always liked the Dry & Store brand. However, there may be a different unit that will fit your needs better. For BTE users on the list. Don't forget your tubing needs to staydry. Moisture sneaks into the hearing aid through the earmold and up the tubing. You'll see little bubbles around the bends of the tubing. This is best removed by disconnecting the earmold from the earhook/hearing aid and pushing dry air through the tube. Remember if you try to blow into the tube with your mouth you are only re-introducing the moisture from your own breath. So, it is better to have a "earmold blower" which looks like a nasal bulb or other compressed air. Be cautious with canned air... it can contain chemicals that can contain irritants that affect the respiratory system and cause skin sensitivities and possibly be toxic to your health.

Even if all the information above is not applicable to your situation because you are not active or don't sweat, you'll still want to at least open that battery door up overnight and have your aids professionally cleaned and dried twice a year.

Feel free to contact me for more information or to ask specific questions about this topic. info@hearwellcenter.com