Sound Hearing Clinic Inc offers hearing tests and more in Vancouver. It is rare that clients visit their audiologist only once. Apart from a hearing evaluation required for pre-employment purposes, or perhaps for insurance purposes, most visits to your audiologist will be multiple. Whether it is for investigation of middle ear dysfunction or for hearing instrument fitting and follow-up, visits to your audiologist will be on-going.
Typically, the timeline for the fitting of the hearing instrument(s) goes as follows:
1) Hearing Assessment
Your first visit will begin with you providing us with information about yourself and your need. This is typically done by you filling out a questionnaire. The audiologist will then review this with you and go through a detailed client history questionnaire as well. A hearing evaluation follows, which includes pure tone air, bone and speech audiometry. Speech in noise testing is done in most cases as well. Assessment of middle ear function, including acoustic reflexes, is done for new evaluations and tympanometry for recheck evaluations. Otoacoustic emission testing will be performed as will obtaining of the frequency-specific threshold of discomfort information.
If you currently wear hearing instruments, an evaluation of their performance, both electroacoustically and using real-ear probe microphone measures, will be performed.
Impressions may be taken of your ear(s) if you choose to proceed with hearing instruments.
If you do proceed with the purchase of hearing instruments, manufacture of the devices typically takes about 10 days to two weeks.
2) Goal Setting
This information may be collected during your interview at the time of your hearing assessment. It is extremely important to re-visit the goals set for yourself post-fitting.
A fitting appointment will be booked to fit and program your hearing instruments.
The fitting appointment will consist of an introduction to the function, care and maintenance of your hearing instrument(s). Programming of the hearing instrument(s) occurs. Verification (real-ear probe microphone measures designed to ensure appropriate power is delivered by the hearing instruments based on your hearing loss) will be performed, followed by counselling on what to expect and how to adapt to the use of your hearing instrument(s). Fitting appointments last 1 - 1.5 hours.
4) Aural Rehabilitation
Hearing aids are the treatment for your hearing loss (remember they do not correct the sensory hearing loss but will certainly help you to hear better). Aural rehabilitation is also required to help you re-train your auditory system to link meaning to the sounds that you are now able to hear. Over the course of time, hearing loss results in decreased auditory processing ability. It also takes time for you to “re-adjust” to a new sound.
Follow-up appointments consist of your audiologist ensuring the hearing instruments continue to function as expected electroacoustically and to your subjective expectations.
1st follow-up appointment (two weeks after fitting)
2nd follow-up and begin LACE aural rehabilitation training (one month later)
3rd follow-up appointment (one month later); Outcome measures provided
4th follow-up appointment (three months later)
Every six months following and/or anytime you have a question or concern
6) Keeping in Touch
Your audiologist wants to see you for follow-up visits every six months.
You will be contacted for a check of your hearing instrument(s) prior to warranty expiration.
Anytime you have a question or concern, please do not hesitate to contact us. We are available by telephone or email.
Do you wonder whether or not you have hearing loss?
This is a quick questionnaire that can be completed prior to a full hearing evaluation by an audiologist. It is designed to give us more information about your current hearing experiences. It does not in any way replace the need for a full and complete audiology evaluation by an audiologist.
Please complete and submit your responses to the clinic prior to your appointment. Thank you.
About Your Hearing
Hearing is one of our most important senses. It connects us to loved ones, colleagues, our community, and to the world around us. With the decreased ability to hear, communication becomes difficult, social gatherings become frustrating, and quality of life suffers. In fact, there are numerous studies detailing the association between hearing loss and increased risk of social isolation, depression, and cognitive decline.
Hearing loss usually develops slowly and often worsens with age. There are many reasons for hearing loss including ageing, congenital, noise exposure, disease processes and medications. Often persons with hearing loss may be unaware of their difficulties, even though family and friends are often quite aware of the problem hearing loss causes.
Hearing loss is invisible and almost always painless. There are no physical warning signs, except in some cases there may be ringing in the ear(s). Most hearing losses develop over a period of years. By age 50 or 60, there can be enough deterioration to interfere with conversation.
Hearing loss is more common than most people realize. Statistics show that one in 10 people are affected by the loss of hearing, and this number increases in persons over 60 years of age.
An audiologist is a hearing healthcare professional who holds either a master’s degree or a clinical doctorate degree. An audiologist specializes in the assessment, prevention, and remediation of hearing and balance disorders. At Sound Hearing Clinic Inc, we are audiologists.
Consult one of the audiologists at Sound Hearing Clinic Inc for more information or for an appointment.
How We Hear
The ear consists of four parts that work together to help us detect and interpret sound:
The Outer Ear
This part of the ear functions to collect sound and aid in sound localization. If the outer ear is damaged or the ear canal is occluded with cerumen (ear wax), the result is a conductive hearing loss.
Parts of the Outer Ear:
Pinna: the visible protrusion at the sides of the head.
External auditory canal (ear canal): an opening that funnels sound toward the eardrum. It contains cerumen, a wax-like substance, which helps to moisten the skin of the canal to protect the inner portion of the canal.
The Middle Ear
The function of the middle ear is to transmit sounds from the outer to inner ear. When damage occurs to the middle ear, the resulting hearing loss is termed a conductive hearing loss.
Parts of the Middle Ear:
Tympanic membrane (eardrum): serves as a seal between the outer and middle ear. Acts as a receiver of mechanical sound energy, sound waves from the ear canal hit the eardrum and set the middle ear bones into vibration.
Ossicles (middle ear bones): the three bones - malleus, incus and stapes, work together to transmit vibration from the eardrum to the oval window of the inner ear.
Eustachian tube: it is an opening connecting the middle ear space to the nasopharynx. It functions to equalize middle ear pressure.
The Inner Ear
The function of the inner ear is to convert sound waves from the middle ear (vibration) to electrical energy, which is then transmitted along the acoustic nerve. The inner ear also houses the vestibular system, which is responsible for balance and orientation in space. Damage to the inner ear results in sensorineural hearing loss.
Parts of the Inner Ear:
Cochlea: shaped like a snail shell and contains the essential organs for hearing.
Semicircular canals: essential for balance and orientation in space.
Auditory (Acoustic) Nerve
Transmits the electrical auditory signal from the cochlea to the brain (temporal cortex) where the signal is interpreted. Damage to the auditory nerve is termed sensorineural, retrocochlear, auditory neuropathy, or central.
Potential Consequences of Hearing Loss
Ear hearing loss can interfere with the quality of life you've hoped for. It can restrict your ability to interact with others, prevent you from hearing important information, cause misunderstandings, heighten stress, cause unnecessary fatigue and filter out the subtle sounds of nature. Don't let poor hearing make you miss out on the many good and vital messages of life.
Noise and Hearing Protection
One of the most common cause of hearing problems or hearing loss is exposure to loud noise.
The best way to protect yourself from damage by loud noise is to wear hearing protection. There are a number of different devices available for hearing protection, ranging from devices used by construction workers, for example, where they're exposed to extremely high noise and they want to take as much of that noise away as possible, to those devices that can be used by musicians where they want to maintain fidelity of the music.
Hearing protection devices also range in price from inexpensive foam earplugs to the more expensive custom-made silicon plugs. If you're using foam earplugs, it really is very important that you insert the plug deeply in the ear canal by pulling back on the pinna at about 45 degree angle while inserting. Always remember that your ear canal is elevated from the point of entry upwards.
Another type of hearing protection are circumaural headphones. They cover the entire ear. The use of circumaural headphones in conjunction with foam or silicone earplugs provide the best hearing protection.
If you're concerned about the level of noise that you're around, you might want to consider downloading a free app from the iPhone or Android platform called a Sound Level Meter. This app allows you to measure level of noise that you are exposed to. Also, if you're concerned about hearing or noise that are around, contact us for an assessment.
The following advice is meant for those individuals who:
Have been fit with hearing instruments
Know someone who has recently been fit with hearing instruments
Know someone who has a hearing loss
Keep in mind that everyone has some degree of difficulty hearing and understanding speech when in groups or noisy situations. While most people can benefit from properly fit hearing aids, they do not solve all problems of hearing loss and will not make your hearing “normal” again.
When you're speaking with someone who has a hearing loss, you should keep in mind the following:
Talk at your normal conversational rate.
Talk in a normal tone of voice. Shouting does not make your voice clearer.
Keep your voice at the same volume when talking.
Do not exaggerate when speaking. This distorts the message and makes use of visual cues from your face difficult to understand.
Avoid chewing, eating, or covering your mouth. These activities make your speech more difficult to understand and speechreading more difficult to accomplish.
Communication with the hearing impaired person is much more difficult when there is environmental noise. Try to find a quiet room or corner to converse if possible.
Avoid sudden changes in topic. If the subject of conversation is changed, check to be sure the hard of hearing person has followed the change.
If a person is having trouble hearing a word or phrase, try using a different word or re-phrasing the sentence rather than repeating the original words over and over.
If you are giving specific information, such as a time or place, be sure it is repeated back to you correctly by the hearing impaired person. Many words and numbers sound alike.
Face to Face
Face the person directly, on the same level with them whenever possible.
The best distance when speaking to hearing impaired persons is from three to six feet from them.
Wait until you are visible to the hearing impaired person before speaking to them.
Never speak directly into the person's ear. This may further distort your message and hide all visual cues.
Recognize that everyone hears less well and understands less when tired or ill.
If you know the hearing impaired person has a hearing aid and does not use it, or it is not working, encourage them to see their audiologist.
Frequently Asked Questions
About Your Hearing
How can I prevent hearing loss?
Protecting your hearing from noise levels greater than 85 decibels at work and during leisurely activities will greatly reduce your chances of noise-induced hearing loss. Many manufacturing jobs require hearing protection in loud environments, but hearing protection is also recommended while ATV riding, hunting, attending concerts and sporting events, and playing music - all situations where your hearing is vulnerable.
How do I protect my ears from loud noise?
Earplugs that fit snugly and seal tightly in your ear canal typically offer protection for a variety of situations. Custom-fit hearing protection offered by Sound Hearing Clinic Inc can protect your ears from harmful noise levels while still allowing you to enjoy the activities you love.
How often should I get my hearing tested?
We recommend an initial hearing assessment at 50 years of age. If hearing loss is identified, hearing devices may be recommended and an annual hearing test thereafter. If you have a history of noise exposure, then have your hearing tested annually.
If you feel you have hearing loss have your hearing tested now. Signs and symptoms of hearing loss include:
Trouble hearing and following conversations
Feeling as though people mumble
Having to turn up the volume on television or radio
How long can I be exposed to loud noises before it affects my hearing?
Permissible noise exposure levels vary. Hearing loss is cumulative, meaning that the less time you're exposed to loud noises over the course of your life, the better your hearing health is likely to be. The point at which sound begins to damage hearing is 85 dB, for which the permissible continuous exposure period is about eight hours. For each 3dB increase in noise pressure, the permissible exposure time before hearing damage can occur is cut in half. For example, permissible exposure to 88 dB would be four hours, 91 dB would be two hours, 94 dB would be one hour, etc.
My ears hurt after being exposed to loud noise. What should I do?
Do whatever you can to get away from that noise immediately. When a noise is painful, it's likely that damage is being done to your hearing. Noises loud enough to cause pain are also typically loud enough to cause permanent hearing damage almost immediately. If the pain persists, please see a medical professional.
What should I do if I get sudden hearing loss?
See your physician immediately; sudden hearing loss is considered a medical emergency. Sudden hearing loss typically resolves on its own within two weeks, but it might not - meaning your hearing might be gone for good. Seeking medical assistance within 72 hours of the onset of sudden hearing loss greatly improves the chances that your hearing will recover.
Are there any health downsides to not treating hearing loss?
There is now a significant amount of research on the negative effects of untreated hearing loss.
First, the psychosocial impacts of untreated hearing loss resulting in reduced quality of life including increased social isolation (Arlinger 2003); withdrawal, stress, depression (Castiglione et al 2016; Hsu et al 2016), anger, and fatigue negatively affecting families and relationships (Chia et al 2007; Sindhusake et al 2001) have been well documented. Conversely, the benefits of amplification by improving quality of life (psychological, social and emotional) have also been documented (Chisholm et al 2007; Boi et al 2012; Mulrow et al 1990).
Second, there is an increased cost to the healthcare system, with increased need for support services and hospital services (Schneider et al 2010).
Third, 30% to 40% of people with hearing loss are at greater risk of experiencing cognitive decline as compared to those who have normal hearing. Why? Likely due to a reduction in neural stimulation, loss of environmental stimulation, poor social interactions, and exhaustion due to increased auditory effort (Lin et al. 2013).
Fourth, hearing loss has been linked to a range of disease processes including:
An association with Type II diabetes (Bainbridge et al 2008)
Cardiovascular disease (Gates et al 1993; Fisher et al 2014)
Fifth, research also exists on the increased incidence of falls in the elderly with hearing loss. Research shows that an individual with untreated mild hearing loss is three times more likely to fall down than those without hearing loss. The likelihood of falling increases as severity of hearing loss increases (Lin and Ferrucci 2012)
Finally, there is lost contribution to the economy and communities and increased risk of poverty (Jung et al 2012)
Arlinger, S. (2003) Negative consequences of untreated hearing loss: A review. International Journal of Audiology, 42, 2S17-21.
Bainbridge, et al. (2008). Diabetes and hearing impairment in the United States (NHANES). Annals Intern Med. 149(1): 1-10.
Boi R, Racca L, Cavallero A, Carpaneto V, Racca M, Dall’Acqua F, Ricchetti M, Santelli A, and Odetti P. (2012). Hearing loss and depressive symptoms in elderly patients. Geriatr Gerontol Int. 12(3):440-5.
Castiglione A, Benatti A, Velardita C, Favaro D, Padoan E, Severi D, Pagliaro M, Bovo R, Vallesi A, Gabelli C, Martini A (2016). Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults. Audiol Neurootol. 2016; 21 Suppl 1:21-28
Chia EM, Wang JJ, Rochtchina E, Cumming RR, Newall P, Mitchell P. (2007) Hearing impairment and health related quality of life: the Blue Mountains Hearing Study. Ear Hear 28(2) 187-95.
Chisholm, Theresa Hnath; Johnson, Carole E; Danhauer, Jeffrey L; Portz, Laural J.P.; Abrams, Harvey B; Lesner, Sharon; McCarthy, Patricia A; Newman, Craig W (2007) A systematic review of health-related quality of life and hearing aids: final report of American Academy of Audiology Task Force on the health-related quality of life benefits of amplification in adults. Journal of the American Academy of Audiology, Vol 18(2), feb, pp. 151-183. Publisher: American Academy of Audiology.
Fisher, et al. (2014). Impairments in hearing and vision impact on mortability in older people. Age and Ageing. 43(1):69-76.
Gates GA, Cobb JL, D’Agostino RB, and Wolf PA. (1993). The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg. 119(2): 156-161.
Hsu WT, Hsu CC, Wen MH, Lin HC, Tsai HT, Su P, Sun CT, Lin CL, Hsu CY, Chang KH, Hsu YC (2016). Increased risk of depression in patients with acquired sensory hearing loss: A 12-year follow-up study. Medicine (Baltimore). 2016 Nov;95(44):e5312.
Jung, David & Bhattacharyya, Neil, (2012) Association of Hearing Loss with Decreased Employment and Income among Adults in the United States. Annals of Otology, Rhinology & Laryngology, Dec; 121 (12): 771-5.
Lin F, Ferrucci L. (2012). Hearing loss and falls among older adults in the United States. Arch intern Med. 172(4): 369-371.
Lin F, et al. (2013). Hearing loss and cognitive decline in older adults. JAMA Intern Med. 173(4)293-299.
Mulrow CD, Aguilar C, Endicott JE, Tuley MR, Velez R, Charlip WS, Rhodes MC, Hill JA, and DeNino LA. (1990). Quality-of-life changes and hearing impairment: A randomized trial. Ann Intern Med. 13(3):188-194.
Schneider J, Gopinath B, Karpa MJ, McMahon CM, Rochtchina E, Leeder SR, Mitchell P (2010). Hearing loss impacts on the use of community and informal supports. Age Ageing. 2010 Jul:39(4):458-64.
Sindhusake D, Mitchell P, Smith W, Golding M, Newall P, Hartley D. (2001). Validation of self-reported hearing loss. The Blue Mountains Study. Int J Epidemiol 30 (6) 1371-8.