Thursday, July 19, 2012

What if hearing loss "hurt'?


I spoke to a Chiropractor friend of mine earlier this week. By 3:30 p.m., his office had already seen 56 patients. I can't imagine seeing 56 patients in one day! But that's a fairly normal day for this doctor. People come to him for relief from pain, among other things. After he adjusts them, they feel better, which is obviously the reason people continue to make their follow-up appointments.

Which got me thinking. What would people do if hearing loss was painful? I'm not talking about ear infections and the like. I'm talking about normal (physically) pain-free sensorineural hearing loss that plagues most people with hearing loss. If the treatment involved temporary relief from pain until the next time, would there be more adopters of treatment by way of hearing aids? I'm not saying I wish hearing loss hurt; what I'm saying is I think it would be easier to convince someone with a newly diagnosed hearing loss to take that next step towards amplification if they had a nagging, painful reminder of their ailment.

As an Audiologist, it is so incredibly frustrating to see a patient that needs hearing aids, knows they need hearing aids, but decides to not use amplification. It leaves me scratching my head, asking, "why did they even bother to get a test if they weren't going to accept help?!?" Which leads me back to my question of, "if it physically hurt them, would it have made a difference?" I think about patients of mine that have had hip and knee replacements and most say that what drove them to having it done was the excrutiating pain they felt, the activities it kept them from doing. In general, their quality of life suffered as a result of their ailment.

Yet, many people with hearing loss say they can 'get by' without hearing aids. They never stop to think what the consequences of not taking the next step to amplification will be. While they may be able to ignore their hearing loss because it doesn't physically hurt, few consider the consequences of untreated hearing loss. Studies have linked untreated hearing loss to:
  • fatigue
  • reduced job performance and earning potential
  • impaired memory and inability to learn new tasks
  • reduced alertness and increased risk to personal safety
  • depression
  • increased stress
  • avoidance or withdrawal from social situations
  • irritability
  • anger and negativism
  • social rejection and loneliness
  • diminished psychological and overall health
Hearing loss is not just an issue for the elderly and infirm. It happens to people of all ages. Those who have difficulty hearing can experience such distorted and incomplete communication that it seriously impacts their professional and personal lives, which can lead to isolation and withdrawal.

Tuesday, July 17, 2012

The trouble with "discount" plans

I got a call this morning from a representative for a 'discount' hearing aid plan we somehow got affiliated with because we accept the insurance plan they are affiliated with. This has become a pretty regular thing and ,while I don't always care for their policies and procedures, it seems to be the 'wave of the future' so I am doing my best to accept this trend in the industry.

This representative was very nice, telling me she had a patient she wanted to schedule for a hearing test and hearing aid consult. I got the patient's name, address, date of birth, and other necessary information I needed to schedule her appointment and then I asked the rep for the patient's type of insurance and their primary care doctor. She asked me why I needed that information and I explained that I would need to get an order from their physician so I could bill their insurance for the hearing test. To which she replied, "you will not be able to bill for the hearing test. The patient's contract states that they are entitled to a free hearing test and it is against our policy for you to bill for your test."


Excuse me?




You want me to test your patient for FREE?


No. My time is not free. My landlord requires I pay rent for my beautiful office, Georgia Power requires payment for their electrical services, the City of Pooler wants me to pay for water as well. You get my point? And the bigger issue? It is ILLEGAL for me to perform a hearing test at no charge for someone if I accept Medicare and bill (the government) for the same test.

And besides the illegal part, what other doctor's office do you go to where their services are free? Nowhere! Even for those individuals on Medicaid and such that don't have any out-of-pocket expenses for their healthcare, SOMEONE is paying for the care. Why would that be true in my office or any other Audiologist's office, for that matter? Hearing is one of your senses, a vital part of your life. Is it not worth the small investment to have a comprehensive evaluation to determine the status of your hearing? For those that have insurance, it typically only costs them their co-pay. For those without insurance, most offices will gladly negotiate a discount based on the fact that payment would be made immediately without the hassle of filing insurance.



Back to the representative for the discount company. I brought up the fact to her that, if the patient chooses to NOT pursue amplification through their plan, they have my test and have used my time to get said test and I''m left with nothing. To which she proceeded to tell me that 'their referrals are carefully counseled and screened and most have no problem going with the Audiologist's recommendation'. Which is complete hogwash. In most circumstances, I am the one that is left to explain the plan's details, NOT the company's representative. The individuals who call their insurance company to get the referral to the discount company have been so snowed into thinking that the plan gives them

 BIG, HUGE,COLOSSAL  

savings and when they learn how much (little?) the discount really is and how, when you compare apples to apples, they'll actually end up with less service than if they'd gone through the Audiologist directly, many of them choose to continue to do without amplification. In their marketing and advertising materials, most of these discount plans make outrageous claims, such as "up to 40% off!" What patients don't realize is that their discount is off the MSRP (Manufacturer's Suggested Retail Price), not off the ASP (Average Selling Price) found in most private Audiologist's offices. You would be hard-pressed to find an Audiologist who is dispensing hearing aids at the MSRP! When I compare the prices of most discount plans and my office for the SAME EXACT HEARING AIDS, there *might* be a $200-$300 difference per hearing aid. Don't get me wrong, that's $400-$600, not little money. But when you compare the service package with the discount plan versus the independent Audiologist, you can see why it's worth paying a little more to work with the independent Audiologist.

You are, most importantly, supporting a local, (probably) small business. You are working directly with the Audiologist, not someone in a corporate call center who has no power whatsoever to negotiate a discount, perk, extra accessory, etc. The service included with most discount plans is either a fixed number of visits or a fixed amount of time (i.e. 3 visits, 1 year) When you buy directly through your Audiologist, you typically get service 'for the length of the initial warranty period' (which is 1-3 YEARS). Every office is different, of course, depending on their pricing structure. We have entertained many options over the years, and while I don't claim to have it all figured out, I feel like we give each individual patient what they need, whether it is a comprehensive service package or a reduced up-front cost and then allowing them to pay for supplies and visits down the road. These are options you will not get when you choose to circumvent your independent Audiologist to purchase through a 'discount' plan.

I suppose it's time to wrap up this ramble. But I'll leave you with this.

Most discount plans will pay Audiologists such as myself a fitting fee to fit the hearing aid(s) and for their time for the included visits. But all supplies and additional visits are not included. So before you look at the price the plan is offering and compare it to your local Audiologist's price, find out what is included for each and make your decision from there. Recently, I had a patient that paid $5800 for a pair of premium digital hearing aids through one of these discount companies. Had he bought them through us, he would've paid $6200 for the pair. With the discount plan, he got a year of follow-up included for cleanings and adjustments. Had he bought them through us, he would've gotten 3 years of follow-up service included as well as 12 (8-packs) of batteries. Because there would've been no middle man, he would've been fit about a week earlier than he was. And if he loses one or both of his hearing aids, this 'discount' plan will require him to pay $400 per ear as a loss and damage deductible to replace each aid. Through my office, it will cost him $300 per ear; we don't charge the additional $100 per ear the 'discount' plan does as an administrative fee. So despite the $400 difference up front, when you compare apples to apples, you can see the said 'discount' plan isn't really a discount at all.

All I ask is that before you take business away from your local business, take the time to educate yourself on the ins and outs of the plan. You may be surprised what you find out!

Thursday, June 21, 2012

10 Signs It May be Time to Get Your Hearing Checked

  1. You Find Yourself Saying "what?" or "excuse me?" a lot or asking people to repeat themselves.
  2. You feel like no one speaks clearly anymore.
  3. Friends and Family Members remark that you keep the volume on your TV up very loud.
  4. You can't hear the person in front of you in a restaurant because of the deafening background noise.
  5. People shout at you.
  6. You misinterpret conversations
  7. You find yourself less willing to go out in public or talk on the telephone.
  8. The ringing in your ears never stops
  9. Your boss has indicated your hearing may be affecting your job performance.
  10. You have failed a hearing exam.
Call us today to schedule your hearing test. We can let you know 'where you are' and what can be done about it, (912) 748-9494 or email me, dawn@coastalaudiology.com

Tuesday, June 19, 2012

Ear Candling: Why It's NOT a good idea!

Imagine if you were introduced to a product that claimed to do the following:
  • strengthen the brain
  • purify the blood
  • stop ringing in the ears (tinnitus)
  • stabilize emotions
  • assist lymphatic circulation
  • aid sinusitis
  • clean wax from the ear canal
  • release blocked energy
  • release TMJ pain and stiffness
  • reduce stress and tension
  • and much, much more!
Would you use it?

Millions of people around the world do, though none of the above statements have ever been proven to be true!

Auricular candling, or auricular coning, is more frequently known as "ear candling". Thought to originate from ancient Tibet, China, Egypt, and the pre-Columbian Americas, the origin of ear candling is rather obscure. It involves a linen or cotton cloth, soaked in wax or paraffin ('the candle') and allowed to harden. Most instructions involve the person undergoing 'treatment' to lie on his or her side. A collecting plate is placed above the ear and a candle is inserted through a hole in the plate and into the ear canal. The candle is then lit. The "vacuum action" created by the candle in the ear allegedly pulls out "impurities" such as earwax, toxins, dead skin, drug residues, or remnants of past yeast infections (none of which has been verified!) After the candle is blown out and removed, it is often unrolled or the debris on the collection plate is touted as the impurities as mentioned above.

SO....why DOESN'T it work?

Cerumen, more commonly known as earwax is sticky by nature. It's designed that way. It is made up of dirt, oil, and a sticky discharge from cerumenous glands. And did I mention it's sticky? The negative pressure that would be required for an ear candle to actually work would be so significant that it would rupture the tympanic membrane (eardrum) in the process. Ear candling produces no vacuum whatsoever.

Let's go back to the claims at the beginning of this post.  Strengthen the brain? Purify the blood? If someone took a good look at a good 'ole fashion anatomy book, the notion that an ear candle somehow affects structures beyond the tympanic membrane is false. In someone with an intact tympanic membrane (no pressure-equalizing tubes, ruptures, etc.) the ear canal is not connected to the brain, the sinuses claimed to be affected by this procedure, or the Eustachian tube (what you "pop" when you pop your ears as when you go in an airplane, the mountains, etc. to equalize pressure). There have been some individuals who have said that the tympanic membrane is porous and the impurities can "pass through" and be sucked out by the candle but this is completely false. Any impurities that appear to have been sucked out by the candle are nothing more than burned wax and cloth from the cone itself.

Dangers of ear candling

The most dangerous issue about ear candling is the false claims it makes. For someone truly suffering from swimmer's ear, sinus issues, TMJ syndrome, a CNS issue, or other medical problem ear candles claim to help, it can be disheartening to try something only to end up no better, or worse, with a burned eardrum! So, in addition to being a complete waste of money (a local 'spa' in my city charges $75 for this "procedure"!), what's the harm if someone has money to burn (literally)?

The most commonly reported risk involves hot wax dripping down the candle and into the ear canal, burning the canal and eardrum. One story reported that a woman, attempting to candle her own ear, caught her gown and bed linens on fire, which resulted in her home being engulfed in flames. While she escaped the fire, she had an asthma attack and died on the way to the hospital. All because she tried an ear candle. So sad.

What should I do?

Many times, ear candling is seen at health shows and exhibitions, but many reputable salons and spas are now offering ear candling as a service (and a very expensive one, too!) If you suspect you have wax in your ears, don't use cotton swabs and don't use ear candles. Call a licensed Audiologist or physician and have them take a look with their otoscope. If they see an overabundance of earwax (earwax isn't bad, unless it's occluding the ear canal completely) they may give you some softening drops and have you return a few days later to remove the wax. This is the safest way to remove wax. All other methods are just foolish and can end up doing more harm than good.


Friday, June 15, 2012

Swimmer's Ear

So what is it?

Fun,Sun, Sand, Chlorine....Swimmer's Ear. Nothing will ruin a good time like an ear infection. Swimmer's Ear, or Otitis Externa, is an infection of the ear canal. It can be caused by many types of bacteria and fungi. The exernal ear canal is a great breeding ground for the infection due to the fact that it is warm and dark, and then moisture is introduced from being in the water. Though we see an increase in Swimmer's Ear in the Summer, it can happen to most anyone year-round.

The infection commonly occurs in individual who spend a lot of time in the water. Because summertime is a time where we are constantly in the water, this excess moisture in the ear canal can break down the delicate skin of the external ear canal, allowing bacteria and fungi to grow. The skin can also be broken down and irritated when the ear canal is scratched, as when people use cotton swabs or use foreign objects to scratch their ear, like pen caps, bobby pins, and paperclips.

Signs and Symptoms

The primary symptom of Swimmer's Ear is ear pain. Sometimes the ear canal itches before the pain begins. It may become painful for a person to chew or when the ear is pulled or pressed on. Swelling of the ear canal may make your child complain of a full or uncomfortable feeling and the outer ear may become red and swollen. You may also see some discharge/drainage from the ear canal as well. At first it may be clear, but turn cloudy, yellow and pus-like and may have a foul odor. Though not impossible, Swimmer's Ear is usually not accompanied by fever. Fortunately, Swimmer's Ear is not contagious.

Treatment

If you or your children experience any of the above symptoms, you should seek medical treatment. Treatment of the infection depends on the severity of the infection. In mild cases, an antibiotic eardrop may be prescribed to fight off the infection and reduce the swelling. This will usually be prescribed for 7-10 days, several times a day. It is important to finish ALL the drops and use them as directed.

In more significant cases of Swimmer's Ear, the swelling may be significant enough that drops will not go into the ear canal. If this happens, a physician may place a wick, (a thin piece of cotton that has medicine in it) in the ear canal to reduce the swelling so the drops can get in the ear. The drainage may have to be cleaned out first to make the drops more effective.

How can Swimmer's Ear be prevented?

The source of Swimmer's Ear is moisture, so keep the ear canal dry is the best way. THIS DOESN'T MEAN USE COTTON SWABS. There are a variety of over-the-counter ear drops that can be applied to the ears after exposure to water to help evaporate the water from the ears. Theses drops are available at pharmacies and large-chain retailers like Wal-Mart but should not be used in individuals with ear tubes or a hole in the eardrum. Another way to prevent water from enter the ear canal is to use earplugs.

Coastal Audiology has a variety of earplugs. We carry Doc's Pro Plugs, an ear-shaped non-custom, non-invasive plug that prevents water from flooding into the ear canal. We have these in our office ready for immediate purchase.  These are a good choice for individuals who will not sit still or cooperate for making a custom swim plug. We make two different kinds of custom swim plugs, Quik-Floaters and Lab-Manufactured. Our Quik-Floaters come in red and blue and are available the same day. Lab-Manufactured plugs are available in many colors and combinations and take about two weeks to make and return to the wearer.

Avoiding Swimmer's Ear altogether is better than treating it! Call our office today, (912) 748-9494, for more information.

An example of a set of Custom, Lab-Manufactured Swim plugs