It’s probably a faux pas to revive an older thread, but this one jumped out at me.
I have experienced a number of occasions wherein patients had normal hearing but who swore they had a hearing loss. Sometimes we forget that so much of hearing does not occur in the ears, but in the brain. Other things happening in the brain can have an impact on the capacity to process what one is hearing.
One patient (who I made sure never met my wife since he looked like a very buff Ryan Reynolds) was a firefighter who swore that he had trouble hearing his daughters and even hearing the alarms at the fire station. Testing showed normal hearing. That being said, I really try to observe behaviors of patients in my booth. You never know when a patient may be claustrophobic, or having a sudden health issue, etc. Since the patient is in my care while in my office, I keep a close eye on them. In this case, I noticed the patient was really struggling to verbalize the words used in word recognition testing. Turns out the patient had recently returned from Afghanistan as a Marine and was suffering from severe PTSD. I actually got a “thank you” letter from a psychologist at the VA for forcing the issue and pleading with the patient to address his issues.
Another patient swore she couldn’t hear well. Testing showed normal hearing. The patient really wanted to try aids. I fitted some for her. She immediately started crying stating that she could finally hear. So guess if I was confused? I would not sell her hearing aids until she visited with a physician first to figure out why her perception did not match the test results. Turns out she was way strung out on opioids, which was obvious the second time a saw her. The opiods were affecting her brain’s ability to process information.
Other patients have simply had previously undiagnosed processing difficulties. Amplification can help “kick start” the brain in some of those cases.
In the case of the OP, an audiogram that isn’t “that bad” when paired with an individual’s ability to process can lead to wildly varying perceptions of hearing even among people with nearly identical audiograms.
So, I always advocate that the first thing we as audis/specialists and, indeed, physicians, too, MUST do is listen to the patient, and observe the patient’s mannerisms and actions. It is so super easy for us to just rely on computerized data on a screen, but the data doesn’t always tell us everything. I have to guard against this myself to insure that I have happy, hearing patients.