Clinic - Week 6

This week in clinic was kind of slow as a lot of the people scheduled during my time did not show up. The only people I saw were DPS. I did see one patient who worked in the office of DPS and therefore this person was not part of the hearing conservation program. The patient scheduled the appointment on their own. Otoscopy and tympanograms revealed normal findings. Although when puretone testing was done a sloping, mild to severe loss was the outcome. The patient reported no recreational hobbies such as target shooting, etc and seemed to have an unexplained hearing loss.

Once the results were explained, it was then reported that the patient sometimes had trouble understanding in the presence of background noise and often had to ask people to repeat themselves. It was also mentioned " I don't have trouble hearing people, I just can't understand what they are saying."

At this time further questions began about the patients medical history, previous employment, hobbies and activities, etc. We were trying to understand such a severe loss that seemed unexplainable for a person who had never had their hearing tested before or noticed any difficulty. After about 30 minutes of talking with the patient it was revealed that they had been to the POC a week earlier and the same results were found and the discussion of amplification had happened (with the recommendation of getting bilateral hearing aids). My patient did not believe them and was coming to our clinic for a second opinion. The patient also revealed enjoying going to Nascar races and had been to many in their lifetime!

I was completely shocked at the information that starting to be revealed after specific questions had been asked regarding hearing, hearing protection, previous jobs, etc during the case history and during the first 30 minutes of talking with the patient!!

At this time the patient was not ready for amplification and really didn't want to talk about it. It was recommend that she think about it and could return in a week and we would be happy to continue talking about amplification. With the severity of the loss annual hearing evaluations were also recommended. I found out today how the importance of case history and spending 30 minutes and getting to know your patient can affect the outcome of the results!

This article talks about the importance of counseling and learning to listen to your patient. Most audiologists did not have training in counseling and I think is it a VERY important part of the rehabilitation process and understanding your patients needs. I also picked this article because it was written by one of my professors that I had in Pittsburgh, Dr. Kris English! Check it out!

English, K., Mendel, L., Rojeski, T., & Hornak, J. (1999). Counseling in Audiology, or Learning to Listen: Pre- and Post-Measures From an Audiology Counseling Course, American Journal of Audiology, 8, 34 - 39.

http://aja.asha.org/cgi/reprint/8/1/34?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=counseling&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT