Dr. Wright's Blog

What is an Audiologist?

Broadmead Hearing What is an Audiologist?

 

When someone asks me, “What is an Audiologist?” I often find the answer involves more than a brief description because the term Audiologist—when compared to other health professionals such as physiotherapists, optometrists, and dentists—is not well known. To help explain what an Audiologist does (hint: they don’t record music), I have answered the most commonly asked questions that I receive about Audiologists and what Audiology means.

Audiology, hearing and balance

An Audiologist is a health professional who specializes in the detection, diagnosis, and management of hearing and balance disorders.

They specialize in hearing and balance? Are those two things even related?

Yes! The inner ear, which is one part of the ear that an Audiologist will test, has two main components:

  1. The cochlea, which is our hearing organ
  2. The vestibular system, which plays an important role in balance

Certain conditions can affect both systems. By conducting a thorough case history and diagnostic evaluation, an Audiologist can determine if one or both systems are affected and what the next appropriate step is. 

Broadmead-Hearing-Anatomy-of-the-Ear 

You mentioned the inner ear. Do Audiologists ever test other parts of the hearing system?

Yes, Audiologists routinely test other parts of the hearing system, which extends from the outer ear, all the way to the brain. 

Can you explain a bit more about the different parts of the pathway?

Absolutely.
 
Let’s start with the outer ear. The outer ear begins with the pinna, which is the only part of the ear that can be seen without specialized equipment. A visual examination of the pinna will tell an Audiologist if there are any abnormalities that require a medical referral.
 
An otoscope, which is a visual device used to illuminate and magnify, is used to examine the rest of the outer ear, which includes the ear canal and stops before the eardrum. If a person has significant wax in the ear canal, it can often be removed by the Audiologist. 
 
The next part of the ear that an Audiologist will test is the middle ear. The middle ear includes the eardrum and the 3 tiny bones (malleus, incus, and stapes) that connect the eardrum to the inner ear. Testing the middle ear does not require active participation by the person being tested, which means it can be performed on people of all ages. If a hearing loss is caused by a middle ear issue, the person will often be referred to their physician or to an Ear, Nose, and Throat (ENT) specialist, who may be able to treat the hearing loss with medication or surgery. 
 
Testing of the inner ear involves multiple components. A basic screening test will determine what the softest sounds are that a person can detect. A diagnostic evaluation will also involve a person’s ability to understand speech in quiet and in background noise. These speech tests have important implications on how well a person will hear with hearing aids and what technology is appropriate for them.

You’ve gone over the outer ear, middle ear, and inner ear. Does the testing end there?

It depends on each person.
 
If somebody needs a hearing test as part of an application for a job, such as the RCMP, and does not report any hearing difficulties, a hearing screening will often suffice.
 
If the person reports tinnitus (more on that later) or sound sensitivity, a different test battery as well as evidence-based questionnaires will be used. 
Sometimes, a person will report significant hearing difficulties and will have a normal result on a diagnostic hearing evaluation. In these cases, the person is often referred for auditory processing testing, which is a thorough audiological test that determines how the brain processes sound.

That sounds complicated. What is the minimum education required to become an Audiologist?

In Canada, the minimum education required to become an Audiologist is a master’s degree in Audiology, which includes at least 350 hours of supervised clinical practicum. To practice Audiology and dispense hearing aids in BC, Audiologists must pass a written and practical exam. They must also accumulate continuing education credits on a regular basis. 

Do all Audiologists do the same work?

Good question! Like most healthcare professions, Audiology has become increasingly specialized over the years. While many Audiologists routinely perform diagnostic hearing evaluations, fit hearing aids, and provide aural rehabilitation, some will focus on a particular specialty. For example, there are Audiologists who specialize in tinnitus, the ringing/buzzing/hissing sound that some people get. Others focus on vestibular (balance) or sound sensitivity issues. 

Where do Audiologists work?

  • Hospitals and health units
  • Private practice
  • Schools
  • Universities
  • Hearing aid and cochlear implant manufacturers
  • Professional associations and regulatory bodies

When should I see an Audiologist?

  • If you or others have noticed a change in your hearing
  • If your hearing is affecting your ability to participate, or how you participate, in day-to-day activities
  • If things are not sounding as clear or sharp as they used to
  • If you have tinnitus, especially if it is bothersome
  • If you are sensitive to sounds that do not bother the average person
  • If you have been unsuccessful with hearing aids or other amplifying devices
  • If you want to better understand and manage your hearing loss, tinnitus, or sound sensitivity issues

 

Now you know what a professional Audiologist does! If you or someone you know is experiencing any of the symptoms described above – or if you are over the age of 60 and have not had your hearing tested in the last 3 years - call to schedule an appointment with one of our professional Audiologists at the Broadmead Hearing Clinic: 250-470-2926 or Oak Bay Hearing Clinic: 250-479-2921. Your hearing and balance will thank you!

How Concussions Impact Hearing and Balance

Brain made of little colourful blocks hearing loss concussions

By Martine Schlagintweit, M.Sc., AUD, Aud(C), RHIP

Why you should see your Audiologist after experiencing a concussion.

While the media spotlight has focused on sport-related concussions in recent years, Audiologists have been treating changes in hearing and balance resulting from concussions for the past three decades. From our experience, anyone with a concussion—including veterans, athletes, seniors, workers, and children—must treat it as an important health concern.

Concussions are a form of traumatic brain injury, which happens when the brain is shaken around inside the skull, usually following a direct blow to the head, an acceleration injury (e.g. whiplash), or exposure to a blast. Brain Injury Canada reports 160,000 Canadians experience a brain injury annually, and there are currently 1.5 million Canadians living with the effects of traumatic brain injury. 

According to Speech-Language and Audiology Canada, 40-85% of individuals who sustain concussions report some balance and hearing issues following their injury. The Ontario Neurotrauma Foundation recommends that any individual who reports changes to their hearing or balance related to a concussion should be referred to an Audiologist for evaluation. Further to this, “It is the position of Speech-Language and Audiology Canada that Audiologists are essential to quality, client-centered, interprofessional concussion care across the lifespan.”

Common hearing and balance complaints with concussions

It is common for people who have had a concussion to report consequent changes to their hearing and balance.
 
Hearing and balance symptoms of concussion include: 
  • Decreased hearing
  • Quality of sound is ‘different’ 
  • Difficulty hearing speech when other sounds are present
  • Tinnitus 
  • Sensitivity to loud sounds or certain types of sounds 
  • Feeling off balance 
  • Dizziness
  • Nausea with quick motion
  • Falls 

How do concussions affect hearing and balance? 

The initial trauma to the head, the cause of the concussion, can also cause structural damage to the organs responsible for hearing and balance, the outer middle and inner ear; this usually happens with more severe head trauma. 
 
More commonly, structures inside the brain and brainstem are impacted by the trauma, causing an array of symptoms that relate to the specific structures that have been injured. Parts of the brain that are often injured by concussion include: 
  • Corpus Callosum 
  • Thalamus & Internal Capsule 
  • Temporal Lobe 
  • Brainstem
 
Each of these regions in the brain has cells that are dedicated to supporting auditory functions like hearing speech in noise, recognizing sound patterns, localizing sounds in space, and associating a sound with a linguistic label (e.g. hearing a noise and labeling it as a ‘beep’ or a ‘boop’). Damage to these structures can make it difficult for people to make sense of sound, follow conversations, or identify where sounds are coming from, which can make participating in daily activities difficult.
 

How can Audiologists help with concussion management? 

Audiologists are key members of concussion management teams. By providing specialized diagnostic services that extend beyond the basic hearing test, Audiologists can assess the functional impact the concussion is having on a person’s hearing, auditory processing, and balance. This information is essential to evaluate the overall wellbeing of the individual after they have experienced a concussion and can be used in collaboration with other professionals including physiotherapists, occupational therapists, speech-language pathologists to develop a client-centered recovery strategy. 
 
If you or a family member are experiencing hearing or balance related issues resulting from a concussion, call us to schedule an appointment with an Audiologist. Broadmead: 250.479.2969 or Oak Bay: 250.479.2921.
 

Hearing Loss And Social Isolation

One bird on a wire separate from the rest of the flock social isolation hearing loss

By Martine Schlagintweit, M.Sc., AUD, Aud(C), RHIP

Social distancing measures relating to the COVID-19 outbreak have been in place in British Columbia for well over a month now. And while social distancing is unusual for most of us, people with untreated hearing loss experience social isolation on a day-to-day basis, often for years. 

 

Hearing loss causes isolation

Our lives have changed significantly. Individuals who previously worked in offices now work remotely from their homes, virtually connecting with clients and colleagues instead of meeting face to face. Non-essential medical appointments, social gatherings, exercise classes and more have been cancelled or altered to comply with the mandatory two-metre distance between people. Neighbours, friends and families do not physically come together for fear of spreading illness. 
 
The general feeling towards these changes is a mixture of uneasiness and sadness, as people keenly feel the ache of forced social isolation. What many people do not know is that a significant portion of the population, up to 19% of Canadians according to Statistics Canada, have lived with some degree of forced social isolation relating to their hearing loss for years. 
 

Hearing loss is a barrier to communication

The mandatory social distancing measures put in place in British Columbia have brought to light how people with communication barriers must feel all the time. Hearing loss acts as a communication barrier, which by nature socially distances people from their surroundings and their peers. In fact, a health report for Statistics Canada notes that untreated hearing loss has been linked with higher rates of social, emotional and health consequences, including: 
 
  • Chronic fatigue
  • Anxiety 
  • Depression 
  • Loneliness
  • Cognitive decline and memory issues 
  • Self-reported social isolation
  • Lower quality of life 
  • Mobility issues and falls

 

Hearing loss creates social isolation

Social isolation caused by hearing loss may be at the heart of these issues. So how does hearing loss contribute to social isolation? Given the gradual onset of hearing loss, the condition can go undetected and therefore untreated for many years. When people do become aware of their hearing loss, the average delay between acknowledging the condition and seeking treatment is about seven years. Because of its slow onset, individuals with hearing loss and their peers will often subconsciously make changes to their communication to accommodate the hearing impairment, for example:
 
  • Limiting group activities due to a sensation of not being able to “keep up” with conversations
  • Avoiding noisy places like restaurants because you cannot hear speech clearly
  • “Tuning out” in conversations with multiple people, thereby excluding oneself
  • Relying on familiar speakers to repeat or “translate” what someone has said
  • Communicating via text or email instead of phone calls
  • Avoiding meeting new friends
  • Limiting the acquaintances, one spends time with to those they can hear easily 
 

Reverse isolation by treating hearing loss

Collectively, these changes lead to less social connection and with fewer people. By contrast, individuals who have treated their hearing loss with hearing aids are generally less affected by the outcomes of hearing loss discussed above. 
 
Treatment of hearing loss with hearing aids has been associated with better cognition, less cognitive decline, better speech recognition, and overall better quality of life. It’s important to treat hearing loss as early as possible—doing so will help avoid social isolation later on. 
 
If you live with hearing loss, are feeling socially isolated, or both, the following resources are available to you:

If you or a loved one is socially isolated because of untreated hearing loss call us at Broadmead: 250.479.2969 or Oak Bay: 250.479.2921 to make a Telehealth (video) appointment with an Audiologist.

 

Starkey Livio Edge AI: A World First!

Rechargeable hearing aid Starkey Livio

 

Starkey has released the first-ever custom (in-the-ear) rechargeable hearing aid, the Livio Edge AI. Starkey is using the reliable lithium-ion battery, a mainstay in behind-the-ear hearing aid technology since 2016. The hearing aids are placed in a contact charger every night and can be used for up to 23 hours before needing to be recharged. The hearing aid is visible in the ear in order to make room for the battery and other features but the black design with gold battery contacts give it a high tech look. It is available in traditional hearing aid colours as well. 

 

Starkey Livio AI In-the-ear Hearing Aid

 

4 key features that set the Livio Edge AI apart from other hearing aids:

Edge mode:

Edge mode is a feature that improves speech understanding in the presence of background noise. It is available by tapping twice on either hearing aid to achieve a crisper, clearer speech signal in difficult-to-hear listening environments like in a restaurant, at a party or in a crowd. 
 

Fall Alert System:

Research shows that hearing loss is linked to an increased risk of falls. This hearing aid has sensors built-in and will detect when the hearing aid user has fallen. The hearing aid will relay this information to their smartphone and will automatically send a text message to 3 pre-selected emergency contacts. This feature can offer peace-of-mind for caregivers of those most at risk of falling. Starkey has really focused on features that can contribute to improving quality of living as well as improving quality of hearing. 
 

Voice commands:

This hearing aid can translate 27 different languages in real time. This feature operates through Starkey's Thrive App and will display the translation on the screen and by voice directly into the hearing aid. In addition, voice access to Siri is provided for voice-activated commands (for example, "Call Abigail") or set reminders for appointments and tasks, such as when to take medications. 

Starkey Livio Edge AI has direct connectivity via Bluetooth® to iPhone and Android smartphones. Any audio, including phone calls, audio books, Facetime, music or podcasts, can be streamed directly through both hearing aids for a clear, crisp sound.  

The Thrive App can be downloaded on both Apple and Android 7.0+ smartphones. The app is a remote control for the hearing aids, allowing the user to increase or decrease the volume on the hearing aids or change the program. It also records information on physical activity (step count) and social engagements which can then be shared with individuals of the wearer's choice. This can be valuable information for any caregiver who wants to know, for example, if their loved one is awake and going about their everyday routines. Through the Thrive App, the hearing aids can be checked to ensure proper functionality without having to visit the clinic. 

 

Starkey Livio Thrive App on an Iphone

 

Balance Builder App:

And finally, their new Balance Builder App provides guided exercises to improve balance, stability, strength and gait using data from head movements detected by sensors in the hearing aid. In our evaluation, this hearing aid has the most features for clients with hearing loss who have concurrent balance issues. 

 
This is an exciting time for hearing aids. Starkey is a leader in custom in-the-ear rechargeable lithium-ion hearing aids and in terms of the "health-able" hearing aid technology. If you are interested in learning more about whether the Starkey Livio Edge AI is right for your hearing loss and lifestyle, call us for an appointment - we love talking about new technology!
 
Broadmead: 250-479-2969
Oak Bay: 250-479-2921

Telehealth For Hearing Aid Users

Telehealth video conferencing hearing appointment
 
The COVID-19 pandemic has changed the way healthcare professionals interact with their patients. Some clinicians have been doing telehealth appointments for a while now; others are having to get on board quickly to be able to serve their patients during this crisis. 
 
Telehealth is a platform for clinicians to interact with their patients remotely either over the phone, using a tablet or a computer’s camera (webcam).
 
When it comes to audiology, many hearing aid manufacturers have created online platforms for audiologists to remotely adjust a client’s hearing aids outside of the office. Typically, most audiologists agree that we can do so much more to help clients in person. However, we have found telehealth useful for clients who live in remote areas or those in poor health who can’t make it into the office. The client needs to have access to a smartphone, computer or tablet to enable telehealth appointments. 

Online support is available

During the COVID-19 situation, we are offering online support for clients who need adjustments. This works well for clients who have recently been fit with hearing aids and are adjusting to new sounds around them. I have had a few telehealth appointments for clients who have recently been fit with hearing aids. The clients logged in through an app on their phone and I was able to video-chat with them to address their needs, make real-time adjustments to their hearing aids, and save the adjustments remotely to their hearing aids. It worked seamlessly and our clients were pleased that they were able to have their hearing aids adjusted quickly in the comfort of their own home. 
 

We are able to do telehealth adjustments for the following hearing aids:

  • Phonak – all Marvel and B-direct 
  • ReSound – Linx 3D and Linx Quattro, Enzo Q and Enzo 3D
  • Signia –  NX or X models
  • Oticon – Opn or Opn S, xceed, siya and Ruby models
  • Widex – Moment, Evoke, Beyond, Dream and unique models (needs an adaptor)
  • Starkey – Livio and Livio Edge

If you require assistance, or are unsure if you can do a telehealth adjustment with your hearing aids, please email erin@broadmeadhearing.com or call us at Broadmead: 250.479.2969 or Oak Bay: 250.479.2921.

Here is a photo of Audiologist Martine Schlagintweit and I checking our telehealth setup. It works very well and it's nice to see a friendly face!

Audiologists Martine and Lia practicing telehealth on their smartphones