Thursday, April 20, 2006
BTE vs. ITE
bte - behind the ear hearing aids
ite - in the ear hearing aids
what's with people (old people, to stress) being so vain! most of our patients here (mostly geriatrics - 50-90++) prefer to have ite aids. but unfortunately, the national health service (nhs) finds it an "inefficient way of spending money". so they are given bte instead. on the bright side, most of it are digital aids na.
there were some centres in uk which conducted research on whether ite aids would be better than the bte in terms of performance, feasibility and people's responses to them. considering all factors are equal (age, hearing loss, dexterity, etc.) the study shows (as we were told) that there are no known advantages aside from cosmetic reasons. in fact, there are more disadvantages to it than good:
1. actual aid goes in the ear so if it gets blocked with wax or condensation (i've never seen such filthy ears anywhere else!), aid would need to be sent back to manufacturer for cleaning. people will be without an aid for a while (and they will grumble that they couldn't hear!) they can't be given a replacement aid as they will need their own mould.
2. ite aids are smaller so are more fiddly to use. our patients are mostly grannies and they couldn't even change the batteries themselves! what more miniature aids? (and they complain about ther fingers/hands being arthritic, numb, yada yada) - duh!
3. they are more expensive than the bte aids. nhs are actually cutting down on their expenses bec. of the millions of deficit they have. hmmnn...bte aids with staff fitting them (meaning: shorter waiting times) or ite aids with no one to fit them (miles long waiting time)....nuninu..
4. high maintenance.
advantages and disadvantages of bte and ite aids here
i know people should have an option of which type of aid they get. but beggars can't be choosy. and people should not get cross at you for not giving them what they want. hey, i'm not the one who makes the policy here! they moan and whinge like duh! me magagawa ba ako?!
nakakainis pa, they believe that digital = ite. they couldn't grasp the concept of 'digital'. they think it's about the size and not the performance. duh!
anyways, not all types of hearing loss can be fitted with an ite aid. very limited din ang capabilities nila. you just don't fit them bec. you want to! it should be based on what you need. and people here could be so stubborn. mas pipiliin pa ung vanity than necessity. considering no one will even notice! more than 50% of them are wearing one naman so why feel insecure and be embarrassed? mas nakakahiya naman not getting what's being said to you all the time.
and they moan about not getting what they paid for (with their taxes). hello, ako ba hindi nagbabayad ng tax ko!? sorry nan, u're barking at the wrong tree! =p
Posted by QT at 4/20/2006 12:12:00 pm
Wednesday, April 12, 2006
Apprentice
we have a student with us (for 6 months) gaining some experience with audiology works. whenever i'm at our main office, she's with me. she does most of the work but i guide her through the system. she's still nervous dealing with actual patients and it takes a lot of will power on my part not to interfere. and that could be hard! imagine trying to see patients in their specified times without running over!
i could just remember how i started =p. but hey, you get better over the years (and i've been doing this since 1999!). so i have to be patient and i make sure i don't interrupt unless necessary and called for bec. it would be very embarrassing for her.
i enjoy having a student with me. admittedly, everytime they will book one with me (could be a BSc, MSc or med students), i really feel nervous and would often consider calling in sick *lol*. pero i don't. i go to work and go through my day's list. when i'm with them na, all apprehensions disappear - syempre, la naman sila masyadong alam no! hahaha. i just need to pretend i know a lot of things (joke!).
siguro, i feel that way (anxious) bec. i'll be handling foreign students and baka maubusan ako ng english (hahaha). seriously, they could be intimidating at times and would really try and see whether you really know what you're talking about. buti nd pa ako pumapalpak =p. they are even impressed bec. i did not do my training here in uk yet, my knowledge and skills are actually better than most of them *ahem* (modesty aside - totoo naman e!) =p
i am really proud of where i am from. excellent teachers, world-class facilities, good exposures. i think audiology in the philippines (ust ha!) is the best! =p
Posted by QT at 4/12/2006 01:16:00 pm
Monday, April 10, 2006
Open Fitting Moulds
we are now currently trying out these open fitting moulds (by siemens). we are using these for people with normal hearing to about mild hearing loss from low to mid freq. then slopes down at higher frequencies. but our boss said they have tried fitting a be55d (that's for profound loss) with this mould and there was no feedback!
advantages of an open fitting mould:
1. ensures that the ear is well ventilated, avoid overheating thus reduces collection of moisture in the tube.
2. avoids distortion in the wearer's own voice and unnatural amplification of swallowing and chewing noises (similar to the effect of talking or chewing with a finger in the ear).
3. The wearer experiences a more natural sound because the sound propagation to the ear drum and the directional function of the outer ear and the ear channel are maintained.
4. there is optimal amplification in particular in the high frequency range.
it will, however, only work with selected hearing aids. The hearing aid must have an excellent quality of sound reproduction, with imperceptible noise levels and an effective suppression of feedback. On the other hand the open set could lead to unwanted amplification of signals picked up by the microphone and amplified again (feedback) causing an unpleasant high-pitched whistling sound.
An open system is not suitable for all kinds of hearing loss. It is most appropriate for cases of slight to medium loss of hearing, or for loss in the high-frequency range (precipitous hearing loss). The greater the hearing impairment, the more closed the ear mould needs to be, thus reducing the occurrence of feedback and achieving the necessary amplification.
info taken from: siemens' website.
anyways, its advantage to our department is that, it cuts down patient journey time. with people being fitted with the aids on the same day as their first assessments, that's like taking 4 months (only in our department - other places have diff. waiting times) off the waiting times (as you know, before you get medical help here, you have to wait for months before you get seen). if fitted properly, it matches rem targets very well and patient happier with the sound being close to 'natural' - none of the occlusion effect.
disadvantage though is, it's not for people with dexterity problems (e that's mostly our patients). insertion could be fiddly. you will need to insert the thin silicon strip into the the flap of the of the ear and get the aid over the top of the ear. with the mould not really securely in place, patients would have difficulty keeping the mould in while getting the aid in place.
anyhoo, we're still in the trial stage. and so far, so good. i've only fitted one and it worked really well. it definitely makes a difference. too bad it's not for everybody.
read more about the studies made for these open fitting moulds here
Posted by QT at 4/10/2006 10:40:00 am
Friday, April 07, 2006
Audiologist - Summary
Audiologist: autonomous professionals who identify, assess, and manage disorders of the auditory, balance, and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit, and dispense amplification systems such as hearing aids and related devices. Audiologists prevent hearing loss through the provision and fitting of hearing protective devices, consultation on the effects of noise on hearing, and consumer education. Audiologists are involved in auditory and related research pertinent to the prevention, identification, and management of hearing loss, tinnitus, and balance system dysfunction. Audiologists serve as expert witnesses in litigation related to their areas of expertise.
Audiologists currently hold a master's or doctoral degree in audiology from an accredited university or professional school. Audiologists provide services in private practice; medical settings such as hospitals and physicians' offices; community hearing and speech centers; managed care systems; industry; the military; home health, subacute rehabilitation, long-term care and intermediate-care facilities; and school systems. Audiologists provide academic education in universities to students and practitioners in audiology, to medical and surgical students and residents, and to other related professionals. Such education pertains to the identification, assessment, and nonmedical management of auditory, balance, and related disorders.
As Described in friendster by UST AUDIOLOGY...
Posted by QT at 4/07/2006 11:16:00 pm
Work Blog
yeah yeah..another blog. i made this out of necessity, though.
we were told that we need to make our own portfolio and it should contain all the work we've done as an audiologist. we also need to build up points for our cpd and it's one heck of a job, if i may say (being in the office most of the time and not having time for seminars and the works). good thing though, self-study (like reading) and personal experience could earn you points. as long as you'll be able to make a reflective summary out of them (sorry, glossy mags not included! =p).
this is all part of being a registered audiologist here (or so we're told) and being members of the BAA, we are expected (but not forced) to complete our portfolio requirements. this is all for our own benefits.
we're told that when the registry is transfered to the hpc (health professional council), we might be summoned for an interview by a panel who will review our eligibility. and having a portfolio will make things easier as that would present our stint as audiologists. they said that in our entire working life (in this field), there is a probability that we may be called twice. pero that is if you'll be working till you retire. =p
anyways, im starting this 'work blog' bec. as it is, there is still no definite outline of what to include and how to present the portfolio. but one of the suggestions was to make a 'diary' of our everyday job and reflect on them. so when the final outline comes out, we can just go back and review what we have learned and select the highlights.
o well, easier said than done. i have finished the basics of the portfolio (cv, job description, yada yada). i just need to write my daily activities and reflect on the day's events.
hope this won't just be an outlet for my rants! =p
