A proper introduction

Hearing Loss
1

Sorry for the lengthy post but my situation is a little different than the norm and I wanted to be clear on that. I’ve made a short reference to same in my profile.

I’ve been lurking for awhile and that was extremely beneficial, then joined the site a couple weeks ago so I can start asking specific questions. But first I should introduce myself because I’m not actually an HA user, yet, but my Mother and sister are. I’m not entirely sure what will prove relevant so I’ll offer some brief background. The main thing is that I’m here to represent my Mom, so if I seem not to “get it” sometimes, I probably don’t. Feel free to tell me so. My perspective is that of the concerned and affected family member only, which I suspect puts me at a disadvantage when trying to understand some of what you deal with. That’s my main point, the rest is some background details which may or may not be relevant to questions and comments I’ll be posting.

Mom and sis both experienced very sudden hearing loss, though interestingly sis was first when she was in perhaps her 30s (now in her 60s). Her loss coincided more or less with strong tinnitus and severe bouts of vertigo. Oddly, the latter was not accurately diagnosed at first nor did she ever really know why her hearing failed. The assumption is Meniere’s is involved. Her tinnitus remains very bad and seems exacerbated by high salt and caffeine consumption, which also bring on the vertigo. Logically there’s a link to water retention in the ears and she takes a diuretic. She is not currently my primary concern though I hope she too can benefit from what I learn from working with Mom.

Mom had sudden loss in one ear about 15 years ago and it also coincided roughly with occasional severe bouts of vertigo, but in her case no apparent issues with tinnitus. At that time I was not directly involved with her care so I have few other details except that after seeing an ENT she declined pursuing an aid for that ear. Fast-forward to 2011 and a repeat of sudden loss and vertigo but this time the other ear failed and the vertigo was more frequent. Still little or no audible tinnitus. I took her to a series of ENTs and other docs and specialists. They put her on prednisone (oral only), a diuretic, and I don’t recall what else. Again no solution or even definitive cause though vertigo was determined not to be BPPV. We were not able to establish a clear link to salt/sodium as a contributing factor with the vertigo as sis has. Over a span of about a year episodes of vertigo receded in frequency but hearing did not improve. By now Dad was gone and I had started learning about HAs.

We ended up at Costco and brought home a set of KS3s (Rexton) along with some accessory gadgets. Several follow-up visits later Mom was clearly better off with aids than without but conversations were still difficult. Unfortunately Mom is also effectively blind so she is unable to watch lips or use closed-captions to augment her hearing. I prefer not to dwell on imagining the level of isolation she feels, it’s too depressing.

Fast-forward again to current and it seems to me that Mom’s speech recognition has gradually declined. The most recent visit to Costco didn’t seem to help at all and the situation is getting desperate. Hence my return to lurking here and eventually joining on Mom’s behalf.

The first thing I did was get an appointment with an ENT to check for any sign of issues that might be contributing to her decline. It’s been gradual so I didn’t expect anything but it seemed a necessary starting point. The ENT office has a resident audiologist so we had her hearing tested as well. We also had an appointment to re-test at Costco but it snowed that morning and the HA staff we were scheduled to see didn’t make it in. I plan to reschedule for comparison and to get copies of prior tests. Exactly how to proceed from there is still TBD.

I’ve posted the new audiogram and word recognition values. I have a lot of questions banging around in my head but I’ll resist posting them all at once. In this introduction I will simply ask how best to characterize her degree of loss in discussions, is it moderate to severe?

Thanks,

Steve

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Characterizing loss in a single word is always tough because it varies depending on frequency. You could call the loss in the left ear mild to severe since it’s mild in the low frequencies and severe from 6k up. If I were trying to briefly describe the loss, I’d say moderate in the left and moderately severe in the right. New hearing aids will hopefully help some. I don’t see her word recognition scores. They will predict to a certain extent how successful hearing aids can be.

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Thanks. I entered the word scores, not sure what it takes to display them with a given device and browser.
Right: 60% 95 db HL
Left: 72% 85 db HL

Frankly, the word recognition test didn’t inspire confidence in its resolution or accuracy, absolute or relative.

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Word recognition scores are not a precise measurement–more of a rough indicator. Hers aren’t horrible. Properly adjusted hearing aids should help.

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That’s really highest on our priority list, so I was crushed when the audi told us that those scores are effectively Mom’s best-case rather than a baseline from which to work on improvement. I suppose an optimistic view would be that her current aids don’t achieve those scores so in fact there is hope for improvement compared to what we’ve been experiencing. But there was no attempt to quantify her current aided word recognition and if it were much worse than her scores I don’t see how we could communicate at all.

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My word recognition scores were 12% in each each ear when tested a few months ago at Costco. I do not know what dB this was at.
With aids word recognition is much higher.
What MDB said is correct from what I have been told but the brain is capable of doing many things. Many members have totally turned their word recognition scores around from wearing aids. It might take a while but it comes back.

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Steve, if you “mouse over” the audiiogram you posted, a tag will come up telling your what degree of loss is indicated by the mouse cursor position. It does dip into the severe range at high frequencies, but for the most part is moderate.

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Steve, thanks for sharing the full story of why you are here. It helps a lot in understanding where you are coming from.

My quick thoughts are that you mom’s hearing should be helped quite a bit with hearing aids. Is she still using the KS3 aids? It would seem they must be pretty old if that is the case.

As for the speech recognition, those tests are done without aids. Since your mother’s loss is right across the frequency spectrum she is missing a lot of the sounds of speech. Her right ear is worse, and as you can see from the overlay of her audiogram on the speech banana, she is missing a lot of the speech.

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The left ear is better, and the good news is that I think, from someone who has asymmetrical hearing loss, that the good ear can make up a lot for the poorer one. But still much of the speech elements are being missed.

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My thoughts would be that if she is still using an old aid like the KS3, she might benefit quite a bit with the newer KS9 aids.

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Although word recognition tests are done without aids, they are done at significant volume (85dB and 95dB in this case) It’s likely a pretty good approximation of what one will hear with aids. Something to keep in mind is that we generally don’t communicate in single words. We communicate in sentences and the brain can use clues from context to make sense of things. Word recognition in sentences that “make sense” are usually much higher. (In contrast, word recognition in nonsense sentences is awful) In short, I think there’s much to be hopeful about, but don’t expect miracles.

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MDB is correct. You can go a long way with context if you have 72% clarity. But you’ll want to focus on getting really well-fit hearing aids. Given that your mum is legally blind, I’d consider BTEs with molds. Or ITEs if she still has good sensation in her fingertips. Something with pretty good tactile indicators. But she needs to be at least properly fit to adult targets.

With a loss like that and no visual support, expect her understanding in noise and at distance to be compromised regardless of her hearing aids. Friends and family are going to need to be able to support her with good communication strategies.

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11

You mentioned feeling in her fingertips, in other efforts to help her do routine tasks I’ve noticed that her sense of touch is very poor. Why is that important with ITEs? I would have expected that the key to getting them in correctly is more about how they feel in the ear. Or is it something else?

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Other than getting them in the ear, the most frequent task will be opening and closing the battery door. Depending on the manufacturer, this may be easier to feel with a BTE.