[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

Re: Inexpensive hearing aids



I fit hearing aids to the psychological comfort at the time of the fitting.  I don't try to make patients wear a hearing aid that it too loud or soft.  This is my attempt, whether you agree with it or not, to merge what I know about audiology, auditory neuroscience, psychology and any other related area to make sure that patient is comfortable with the sound they have to listen to.  I am very successful at what I do and I have shown my patients, my ENTs and the other audiologists that this approach is valid and appropriate.  I have often had patients come in after several years of being unhappy with the aids and all I did was turn it down and modify the sound quality to their psychological comfort first and then modify the sound again as they achieve more efficiency and representation for sound through neural plasticity.

I've been doing this for almost 16 years.  When I got into reading about neuroscience and other related medical fields, it completely changed the way I fit aids.  I used to tell the patient that they would "get used to it" knowing they were uncomfortable with the volume because that's what the "presciption formulas" the REMs and the audiogram demanded to bring them up into normal hearing.  The more I understand about the changes that occur as a result of deprivation and the subsequent changes and the time involved in re-establishing neural efficiency I felt awful for the way I had been prior to that knowledge.  But I was following the established doctrines of audiology. 

I'm very sorry you don't see the approaches I make as valid.  But I know that I'm effective and I care a great deal about my patients.  I will use whatever information I can gather to increase their understanding of their conditions, the limitations that may exist and the encouragement to try to wear the hearing aids long enough to achieve some recovery.

Barb

>From: g_brennantg@TITAN.SFASU.EDU
>To: Barbara Reynolds <br_auditory@HOTMAIL.COM>
>CC: AUDITORY@LISTS.MCGILL.CA
>Subject: Re: Inexpensive hearing aids
>Date: Sat, 27 Mar 2004 20:50:45 -0600 (CST)
>
>Subjective preference is a whole new can of worms if you will.  We have (by the
>very fact of the need for a hearing aid) an auditory system not functioning
>correctly and we fit it according to the preference of the system?
>
>Tom
>
>
>Tom Brennan  KD5VIJ, CCC-A/SLP, R/D - AU
>web page http://titan.sfasu.edu/~g_brennantg/sonicpage.html
>
>On Sat, 27 Mar 2004, Barbara Reynolds wrote:
>
> > Date: Sat, 27 Mar 2004 19:47:15 -0600
> > From: Barbara Reynolds <br_auditory@HOTMAIL.COM>
> > To: AUDITORY@LISTS.MCGILL.CA
> > Subject: Re: Inexpensive hearing aids
> >
> >
> > I probably wouldn't tune them to piano harmonics. I would try to adjust
> > the response of the hearing aids to you're subjective preference, which
> > is ultimately my point.  Using your musical history as a guide instead of
> > ignoring would give me a better idea where to start not necessarily where
> > we would finish.  What the ultimate fitting would be after a year would
> > still be to your subjective preference regardless of whether you played
> > harp or tuba or nothing at all.
> >
> > >From: susan allen <susie@SHOKO.CALARTS.EDU>
> > >Reply-To: susan allen <susie@SHOKO.CALARTS.EDU>
> > >To: AUDITORY@LISTS.MCGILL.CA
> > >Subject: Inexpensive hearing aids
> > >Date: Sat, 27 Mar 2004 11:50:03 -0800
> > >
> > >As a professional harpist, I would be very confused if my hearing
> > >aid
> > >was tuned to piano harmonics.
> > >Susan Allen
> > >
> > >
> > >
> > >
> > >
> > >
> > >I see your point but it does clinically concern me to "not be hung
> > >up on the
> > >specifics" when dealing with clients as we're dealing with specific
> > >problems.
> > >I've seen you state a lot of opinions and you are obviously working
> > >for the good
> > >of your clients.  Others on the list have asked you for specific
> > >data and you
> > >have yet to provide that and now when I have asked you specifically
> > >about what
> > >you have stated on the list using specific numbers to justify what
> > >you do you
> > >say the specifics do not matter.  Certainly when we treat clients
> > >there is a
> > >clinical apsect to things just as there is a scientific aspect.
> > >When I tune a
> > >piano for someine who is an advanced musician I may not tune a
> > >purely equally
> > >tempered scale because of what they prefer or the instruments they
> > >will play or
> > >the music they use.  However, when I do deviate from  the accepted
> > >norm I always
> > >have a reason for doing so and can demonstrate that reason to any
> > >other
> > >professional who asks.  That duplication of knowledge is the reason
> > >I have
> > >questioned you and attempted to learn something of your methods only
> > >to have you
> > >tell me that I should not deal in specifics.  I apologize if you
> > >have been
> > >offended by my questions but I thought they were quite basic rather
> > >than
> > >specific.
> > >
> > >Tom
> > >
> > >
> > >Tom Brennan  KD5VIJ, CCC-A/SLP, R/D - AU
> > >web page http://titan.sfasu.edu/~g_brennantg/sonicpage.html
> > >
> > >On Sat, 27 Mar 2004, Barbara Reynolds wrote:
> > >
> > >>  Date: Sat, 27 Mar 2004 13:06:30 -0600
> > >>  From: Barbara Reynolds <br_auditory@hotmail.com>
> > >>  To: g_brennantg@TITAN.SFASU.EDU, AUDITORY@LISTS.MCGILL.CA
> > >>  Subject: Re: Inexpensive hearing aids - Consideration of Piano
> > >>harmonics
> > >>
> > >>
> > >>  I don't have the equipment to be that exact.  I fit on a general
> > >>  principle that keeps in mind that I am working with a musician
> > >>with an
> > >>  expanded representation for sound that is different than
> > >>non-musician's.
> > >>  They may not like the sound of an aid precisely because I haven't
> > >>matched
> > >>  a certain band of frequencies as well as I could if I tried to
> > >>shift the
> > >>  response of the aid off the more traditional "pure tone"
> > >>  recommendations.  Pure tones don't occur in nature, so why should
> > >>we be
> > >>  married to the idea that people hear the best when we match the
> > >>  prescription formulas or the audiogram to a psychological,
> > >>subjective
> > >>  system.
> > >>
> > >>  I've noticed that some people are spend too much time on the
> > >>specifics
> > >>  rather than the general priniciple.  I'm not concerned with exact
> > >>  measurements, but I am concern with the difference in programming
> > >>that
> > >>  may be necessary because of vastly different auditory systems
> > >>based on
> > >>  environmental or genetic influences.
> > >>
> > >>  Please don't get hung up on the specifics, see the point for what
> > >>it was.
> > >>
> > >>  >From: g_brennantg@TITAN.SFASU.EDU
> > >>  >To: Barbara Reynolds <br_auditory@HOTMAIL.COM>
> > >>  >CC: AUDITORY@LISTS.MCGILL.CA
> > >>  >Subject: Re: Inexpensive hearing aids - Consideration of Piano
> > >>harmonics
> > >>  >Date: Fri, 26 Mar 2004 19:39:09 -0600 (CST)
> > >>  >
> > >>  >Barb, I'm inpressed if you have instrumentation to fit to exact
> > >>tones
> > >>  such as
> > >>  >"2048" which is, by the way, a C of 512 which is not a temered C
> > >>so
> > >>  would
> > >>  >usually be inappropriate to fit as a tempered C is at
> > >>  523.25.  Interestingly,
> > >>  >this makes your C at 2048 come out at 2093 which is only three
> > >>cycles
> > >>  less than
> > >>  >being out by the same amount your 2048 would be from the 2000 of
> > >>the
> > >>  audiometer.
> > >>  >
> > >>  >As an aside, if we multiply the A which is the more commonly
> > >>used not
> > >>  for
> > >>  >tempering scales, that has your A at 1600.  In Europe rather
> > >>than using
> > >>  440
> > >>  >currently many people now use 442 which brings the 1600 to 1608.
> > >>  Of
> > >>  course, all
> > >>  >of this becomes of questionable value either in a porrly
> > >>tempered scale,
> > >>  with a
> > >>  >piano either flat or sharp in pitch (this applies to other
> > >>instruments
> > >>  as well)
> > >>  >or with instruments which are not tempered or which are not
> > >>equal
> > >>  temered.
> > >>  >Since the band spreads on audiometers are standardized to neural
> > >>  response etc.
> > >>  >al be it sometimes after the fact, I am still left with the
> > >>question of
> > >>  how much
> > >>  >good this actually does for a client.  I also wonder about these
> > >>single
> > >>  cycle
> > >>  >frequency adjustments to aids.
> > >>  >
> > >>  >Thanks.
> > >>  >
> > >>  >Tom
> > >>  >
> > >>  >
> > >>  >
> > >>  >Tom Brennan  KD5VIJ, CCC-A/SLP, R/D - AU
> > >>  >web page http://titan.sfasu.edu/~g_brennantg/sonicpage.html
> > >>  >
> > >>  >
> > >>
> > >>
> > >>_____________________________________________________________________________
> > __
> > >>  Get tax tips, tools and access to IRS forms all in one place at
> > >>MSN
> > >>  Money!
> > >>
> >
> > ________________________________________________________________________________
> > FREE pop-up blocking with the new MSN Toolbar get it now!
> >
>


Free up your inbox with MSN Hotmail Extra Storage. Multiple plans available.