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TINNITUS – THE END OF QUIET MOMENTS?

Tinnitus is the perception of sounds that have no external source. The severity of tinnitus varies from an occasional awareness of ringing, hissing, buzzing, roaring, clicking, or other rough sounds in one or both ears, to an unbearable and incessant noise that drives some people to consider suicide.

Tinnitus isn’t a “phantom sound” or “condition” — it’s a symptom of an underlying medical problem, such as noise trauma, age-related hearing loss, ear injury, or disease of the circulatory system.

Tinnitus is relatively common, but in rare cases it can be a symptom of a serious underlying condition, such as a vascular tumor or a slow growing acoustic neuroma (a generally benign tumor that forms on the vestibular nerve that leads from the inner ear to the brain).

Tinnitus facts: If you have tinnitus you aren’t alone. More than 50 million Americans have tinnitus symptoms. 9 in 10 patients with tinnitus also have hearing loss, and 1 in 5 patients find the symptoms hard to endure. 10-15% of Americans experience chronic troublesome tinnitus, lasting more than 6 months.

Tinnitus is frequently caused by prolonged exposure to loud sounds from industrial, recreational, or military noise, or from a sudden impulsive sound from an explosion, gunshot, etc. Tinnitus can also be caused by ear injuries, cardiovascular disease, age-related hearing loss, wax build-up in the ear canal, medications (aspirin, certain antibiotics, diuretics, chemotherapy), ear or sinus infections, misaligned jaw joints (TMJ), head and neck trauma, and Meniere’s disease.

Auditory Pathways and tinnitus. Sound waves travel through the ear canal to the middle and inner ear, where sensory hair cells in the cochlea help transform the sound waves into electrical signals. (See the figure) The electrical signals then travel through the auditory nerve to the auditory cortex of the brain, where they are processed. When hair cells are damaged (figure inset)  by loud noise or drugs known to cause hearing loss, the brain doesn’t receive the signals it expects. This stimulates abnormal neuron activity, which causes the illusion of sound, or tinnitus.

What are the consequences? Tinnitus causes fatigue, stress, sleep difficulties, trouble concentrating, memory problems, anxiety and irritability, and trouble with both work and family life. The degree to which tinnitus invades a person’s life depends on the volume, frequency, and duration of the perceived noise, and on the emotional reaction provoked by that irritation. Tinnitus is no laughing matter; the fear and depression associated with tinnitus can destroy a person’s well-being.

Tinnitus can’t be cured…but it can be managed! Our Doctors of Audiology have the knowledge and training to help you manage your tinnitus. They will assess the personal impact of your symptoms, and then present options for alleviating those impacts. The initial assessment takes 2 hours, and guides us in determining the best therapy for you.

The goal of tinnitus management is to “train your brain” to ignore tinnitus sounds as unimportant. This process is called habituation, and empowers tinnitus patients to overlook the disturbing emotional trauma of tinnitus, in the same manner that many of us have learned to overlook the disturbing effects of a train whistle at night. Other tinnitus remediation therapies include sound therapy, which can be supplied by smart phone apps through hearing aids.

Tinnitus therapy is highly tailored to account for your perception of symptoms and their disturbing impacts. There is no “one size fits all” therapy! Effective treatment strategies generally focus on counseling, sound therapy, relaxation, and stress-reduction methods. If you have tinnitus AND hearing loss, hearing aids can improve your hearing while relieving the negative impact of your symptoms, and this can help restore your quiet moments!

Dr. Li-Korotky, AuD PhD is a Gold member of the American Tinnitus Association

The Bend Oregon Hearing Tech Expo

Pacific Northwest Audiology had a full house in attendance at our Hearing Tech Expo on Wednesday, Feb 8, at the Mount Bachelor Village Conference Center.

Event Collage

Dr. Li began the day with a very well received talk on age-related hearing loss (her PhD thesis at the world renowned Karolinska Institutet in Sweden). The Doctor also reviewed new scientific studies which strongly linked untreated hearing loss and dementia. 

Dr. Odgear, also from Pacific Northwest Audiology, was the second batter, and he knocked it out of the ball park with his talk on hearing trends and the future of hearing tech. 

We convened for a hot lunch buffet, which consisted of Brisket of Beef Au Jus, baked beans, potato salad and a creamy coleslaw.  According to my polling, everyone thoroughly enjoyed the buffet!

We shook things up after lunch and reconvened in an adjacent room, which we had set up for interactive tech activities, led by Dr. Muto-Coleman from Resound. By the end of the session, everyone was able to put the pieces together…the past, present, and future of hearing tech.

Our next event will be the third week of May. Call Kat for early details at 541-678-5698

Pacific Northwest Audiology Sponsors Another Hearing Aid Luncheon in Bend Oregon

Pacific Northwest Audiology had a another successful “Dine and Demo” luncheon at Gregg’s Grill in Bend Oregon on October 26, co-hosted by Unitron. 

So, what is a Dine and Demo Luncheon? Simply put, it’s an opportunity for guests to sample the latest hearing enhancement technology in a real world environment over lunch. 

Greggs GrilThis event was NOT designed to meet a sales quota. Guests learned important facts about hearing loss while sampling the advantages of new hearing technology…hearing aids that push the limits of hearing!

Dine and Demo luncheons are limited to only 14 invited guests. The event was designed to be relatively small, informative, and friendly, a learning environment that allowed each guest to evaluate new hearing solutions with no outside stresses or obligations. 

For those selected to participate in the event we tested their hearing (or used their latest hearing test of record) and then fitted them with personally customized Flex:Trial hearing aids, diagnostic instruments that can be programed to different technology levels to suit the needs of individual patients. Flex:Trial hearing aids are particularly well suited for increased sound clarity in otherwise noisy environments like a busy restaurant, so our guests were able to verify the technology claims…which they did!

The picture (below) shows Dr. Li (Pacific Northwest Audiology, bottom panels) and Felipe Ovando (Unitron, top panel) discussing new technology to alleviate hearing loss while enhancing hearing and communication. The middle two panels show Dr. Odgear and Grace Gardner (both from Pacific Northwest Audiology) answering general questions from our guests. Grace is completing her externship with Pacific Northwest Audiology prior to becoming a full-fledged Doctor of Audiology.

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We were very pleased with the outcome of this event…the food was high quality, everyone had their questions answered, and all of us had a great time!

There will be one more Dine and Demo event this year: November 30. Call now if you want a seat… 541-678-5698-5698.

 

Pacific Northwest Audiology Hearing Aid Luncheon in Bend OR

Pacific Northwest Audiology had a very successful “Dine and Demo” luncheon at Gregg’s Grill in Bend Oregon on October 11, co-hosted by Widex High Definition Hearing. 

So, what is a Dine and Demo Luncheon? Simply put, it’s an opportunity for guests to sample the latest hearing enhancement technology in a real world environment over lunch. 

Greggs GrilBut we’re not talking about yesterday’s hearing tech. Guests sampled hearing aids that push the limits of hearing!

Dine and Demo luncheons are limited to only 14 guests. The event was designed to be relatively small, informative, and friendly, a learning environment that allows each guest to evaluate new hearing solutions with no outside stresses or obligations. 

For those selected for the event we tested their hearing (or used their latest hearing test of record) and then fitted them with state-of-art hearing aids so they could experience ground-breaking sound clarity in the real world.

The picture (below) shows Dr. Li (Pacific Northwest Audiology) and Dr. Antonio (Widex) discussing new technology approaches to hearing loss. The food was high quality, everyone learned what they came for, and all of us had a great time!

 

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We will have two more Dine and Demo events this year: October 26 and November 30. Call to confirm your place.  541-678-5698.

 

The View from Tomorrow

This was a wildly successful event …87 registered…15 on standby…engaging speakers, a highly responsive audience, and dancing during the breaks!

PNWA and Phonak Hampton 7.20.16

What we learned…

  • Tomorrow’s hearing technology is available today!
  • Hearing loss no longer means the end of a good life!
  • Hearing loss is no longer stigmatized!
  • Hearing technology is cool…even desirable!
  • Hearing care options have never been better!

What is the View from Tomorrow?

  • Streaming audio from HDTV, iOS, Android, and other devises
  • Connecting without wires to an iPhone, iPad, or iPod Touch
  • Controlling hearing aid settings with a smart phone
  • Communicating in any environment
  • Using Apps to enrich our hearing
  • And much more!

We still have special promotional deals from this event, and we are preregistering for future events…call 541-678-5698

Look for our Open House at the end of August…more to follow!

Hearing Aids Improve Brain Function

A new study, “The benefit of amplification on auditory working memory function in middle-aged and young-older hearing impaired adults,” by Jamie Desjardins, PhD, an assistant professor in the Speech-Language Pathology Program at The University of Texas at El Paso (UTEP), found that hearing aids improve brain function in mature adults with hearing loss.

Texas study, hearing aids restore cognition

Previous Studies

Previous studies have shown that untreated hearing loss is associated with serious emotional, medical, and social consequences, including unnatural mental decline and dementia. These disabilities often result in reduced job performance, lower income, and a generally diminished quality of life. Declining cognitive function is also associated with a loss of auditory working memory, the ability to pay attention to conversations in noisy environments. Working memory is important because it is critical for understanding speech.

Sustained hearing loss causes problems because the brain must allocate extra resources to the task of understanding speech. When this occurs, other areas of the brain associated with cognitive functions are “starved”.

As Desjardins explained, “If you have some hearing impairment and you’re not using hearing aids, maybe you can figure out what the person has said, but that comes with a cost. You may actually be using the majority of your cognitive resources, your brain power, in order to figure out that message.”

Purpose Of  The UTEP Study

As we age, our thinking and memory skills naturally decline. The purpose of the present study was to assess the effect of hearing aid use on the auditory working memories of middle-aged and young-older adults with mild to moderate sensorineural hearing loss. Sensorineural Hearing loss is caused by damage to the inner ear or the nerve from the ear to the brain, and isn’t typically correctable with surgery. The study included 24 adults in their 50s and 60s with bilateral (involving both ears) hearing loss who had never before used hearing aids. 

Cognitive skill trends can be measured by changes in working memory, the ability to process information during conversations. For the present study, cognitive tests were used to measure the working memory, selective attention, and speech processing speed of study participants before and after wearing hearing aids. 

Study Results: Hearing Aids Improve Cognitive Function

Results from this study indicated significant improvements in the auditory working memory of participants after 6 weeks of hearing aid use. Why is this important? Using hearing aids in the early stages of age-related hearing loss, even mild hearing loss, can have a positive impact on working memory performance. 

According to Desjardins, “Most people will experience hearing loss in their lifetime. Think about somebody who is still working and they’re not wearing hearing aids and they are spending so much of their brainpower just trying to focus on listening. They may not be able to perform their job as well. Or if they can, they’re exhausted because they are working so much harder. They are more tired at the end of the day and it’s a lot more taxing. It affects their quality of life.”

An Allied Study

Another study recently published in the Journal of the American Geriatrics Society by researchers at the French National Institute for Health and Medical Research in Bordeaux France found that “Use of hearing aids attenuates cognitive decline in elderly people with hearing loss”. 

The bottom line of this study? Hearing aids appear to have a positive effect on thinking and memory functions, by restoring communication abilities and promoting social interaction, qualities that are known to reduce isolation and resulting depression.

Final Comments

Hearing impairment is one of the most common health problems in the United States. It affects more than 9 million Americans over the age of 65 and 10 million Americans between 45 and 64, but only 1 in 5 people who need hearing aids actually wear them. That means 4 in 5 people with hearing loss are tossing dice that only allow bad outcomes.

Our take-away from these studies? We have choices and those choices effect the way we live. We urge older adults with hearing loss to seek qualified treatment by a Doctor of Audiology.

Patient-Centered Hearing-Health Care vs. Sales-Centered Hearing Care

The Bottom Line

The following table compares the professional business model, represented by doctor-level audiologist such as those working at Pacific Northwest Audiology, and the corporate business model, represented by “Big Box”, manufacturing, and franchise retailers.

The bottom line is that when you select a hearing care provider you also accept their business model…and the consequences of that model. You can choose patient-centered hearing-health care by a Doctor of Audiology, or volume sales-centered care by a technician.

Given the increasing evidence linking medical, emotional, and social consequences to hearing loss, we hope the table guides you to your best choice for a hearing provider.

 

AuD vs. Dispenser table 3

Untreated Hearing Loss

The consequences can be severe but treatment offers hope!

Untreated hearing loss has been linked to disabling medical conditions such as dementia, Alzheimer’s disease, depression, and cardiovascular disease. Studies and observational evidence indicate that untreated hearing loss can damage your physical, emotional, and social health and well being.

Your family, friends, and others will not escape these changes. In a very real sense they will share the unwanted consequences of your hearing loss.

The good news is that the worst effects of hearing loss can be moderated with hearing aids, cochlear implants and post-fitting rehabilitation. When people with mild-to-profound hearing loss use hearing aids, they experience less depression, less anxiety, and less emotional stress… while showing significant improvements in their quality of life and well-being.

Given the undesirable consequences of untreated hearing loss, it would be a good idea to get a hearing exam by a well qualified Audiologist, especially if you suspect that you are developing hearing problems. Being more safe than sorry has real meaning when the consequences of inaction are potentially so severe.

See our Brochure on Untreated Hearing Loss, here

There was a Time…

…when hearing aids weren’t cool.

But that time isn’t now! The stigma of hearing loss is settling quickly into the past as hearing aids become cool. Why? Because Bluetooth technology allows hearing aids to communicate wireless with an iPhone, iPad, and iPod touch… directly or through the use of external streamers. That’s right..no wires..cool!

And you aren’t limited to IOS products! High end wireless accessories are also available with Android and Windows products. That means you can have all the benefits of wireless streaming with your favorite devises!

The bottom line: you can stream audio from Skype calls, TVs, MP3 players, smart phones, or other computing devices, or connect directly to an iPhone, iPad, or iPod touch. That will let you bring the world to your hearing aids…and that is cool!

See our Brochure on new wireless technology, here.

Choices and Consequences

Audiology Business Models

Introduction

We get many customers who initially responded to “Big Box” discount advertising, only to discover later that they had expensive products that didn’t help them communicate any better than they did before spending a large chunk of cash. This article was written as a response to that sad fact of life…and to give consumers the fire power they need to make informed choices. If you are in a hurry look for the Einstein Icons, but we recommend reading the entire article…it could save you from considerable frustration and disappointment.

You may not be aware of it…but when you choose a hearing provider you are also choosing their business model. One model works off the proposition that profits alone are the bottom line for generating future profitability. This corporate model is exemplified by “Big Box” stores such as Costco, and their legion of minimally trained hearing aid dispensers. A competing business model assumes that customer satisfaction drives customer loyalty…and customer loyalty drives profitability and growth. This business model is typified by audiologists, who are trained in an end-to-end process of patient-centered hearing care. The following paragraphs will show that consumers adopt not only a business model, but also the consequences of that business model.

It will be shown that hearing care business models are strongly related to the education requirements necessary to lawfully provide various audiological services. Well credentialed audiologists can pursue a full course of professional services…but less credentialed hearing aid dispensers are legally bound to a limited set of services focusing on the sale of hearing aids.

Audiologists

Audiologists must earn a Doctor of Audiology (AuD) degree. This requires 4 years of undergraduate study in Communication Sciences (speech and hearing) and an additional 4 years of specialized academic work, including high-level training in the prevention, identification, assessment, and treatment of hearing disorders.

Their extensive academic credentials, professional certifications, and licensure, allow audiologists to legally provide a full range of patient-centered care, a set of professional standards that include a thorough patient assessment, comprehensive diagnostic tests, a consultation to discuss treatment options, highly specialized hearing aid fitting and programming, and a process of post-fitting adjustments and counseling.

Profit is certainly important to independent audiologists, but it doesn’t generally dictate the patient process. Many of the diagnostic and counseling efforts that define professional standards of patient-centered care offer low-profit margins compared to hearing aid sales…but these are critical elements of comprehensive hearing care. Take away any of the links from a patient-centered chain and you also disrupt the process of end-to-end care.

Hearing Aid Dispensers

By contrast, hearing aid dispensers, (AKA hearing aid specialists), can recommend, select, or adapt hearing aids and may alter, adjust or reconstruct hearing aid specifications for functionality, such as taking ear impressions for proper fit. Hearing aid dispensers can sell hearing aids in many states if they have a high school diploma or GED Certificate, pass a license exam, complete a brief apprenticeship with a licensed hearing aid specialist, and earn continuing education credits (usually from correspondence courses). Reduced standards for hearing aid dispensers have led to a proliferation of clinics with superficially trained staff, whose primary lawful focus is limited to hearing aid sales…not audiological services.

 

choices and Consequences

ENT Physicians

An increasing number of Ear Nose and Throat (ENT) physicians are using audiology as a supplementary service to boost their bottom line profits. This is accomplished by hiring audiologists and/or dispensers to administer basic audiological exams, often with dated equipment, to support their surgical requirements. Since ENT physicians focus on surgical solutions, you shouldn’t expect broad audiological support at an ENT clinic.

Corporate Hearing Centers

The hearing health market is expanding. In response…the number of corporate hearing centers is also increasing. Why is this important? Because corporate hearing centers (many owned by hearing aid manufacturers) are motivated by the dictates of corporate growth and bottom-line profits, and these profits are achieved through hearing aid sales…not diagnostic or rehabilitative services. Large corporations are purchasing independent practices across the country, often stripping them of important diagnostic capabilities, and staffing their new hearing centers with non-audiology staff, including hearing aid dispensers.

“Big Box” Stores

Using the power of their marketing wealth, corporate retail giants like Costco are repositioning hearing care as a commodity based solution. These stores are typically staffed by hearing aid dispensers, and their business model is dominated by profit concerns...so don’t expect a full range of audiological services at any of these Big Box giants.

 The Bottom Line

Hearing aid dispensers and audiologists are both licensed to fit and program hearing aids…but that is where the similarities end. There’s a vast difference in education and training requirements between Doctors of Audiology and hearing aid specialists. This training edge allows audiologists to pursue a rigorous process of professional diagnosis, treatment (including hearing aid fitting, programming and verification), and rehabilitation. In contrast, most hearing aid dispensers work for large corporations such as Costco, and must, by law, concentrate their efforts on a narrow range of services, including hearing aid sales, fitting, and programing.

It is important to understand that corporations are motivated to control the distribution of hearing care, and profit margins dictate their treatment process. They are not in the business of marketing comprehensive audiological services to consumers because their corporate model lives and dies by sales and profits. Since they are “bottom liners” they are primarily in the business of selling hearing aids.

Choices 2

Choose Your Business Model

There’s an ongoing struggle between opposing business philosophies to define the scope and practice of hearing care. Most Audiologists believe hearing care should be patient-centered and managed by Doctors of Audiology. This business model emphasizes an end-to-end process of professional services, including consultation and diagnosis, hearing aid fitting and programming, validation of hearing aid functions with advanced technology such as Speech Mapping, and post-fitting counseling and rehabilitation.

Opposing business models …represented by hearing aid dispensers, hearing aid manufacturers, and retail giants such as Costco …are much more focused on high profit margin sales. With these business models, hearing care is managed primarily by non-audiologists and hearing aid sales defines their bottom line …often at the expense of professional audiological services. Ear Nose and Throat (ENT) practices are also in the mix, as they increasingly train technicians to perform basic audiometric and vestibular testing under minimal supervision to support their primary focus of surgery. So…if you need hearing care…choose your business model!