budak perempuan itu.....

assalamualaikum.. wbt..
alhamdulillah internship dah selesai.. kini masa untuk mengasah segala ilmu yang dicurahkan...
satu kes yang terkesan sangat di hatiku, yang terjadi bulan lalu..

patient 2y.o/ gurl.. yang datang bersama ibu bapanya..
parent concern about their child hearing.. main complaint, speech delayed..
there's   no history of pregnancy problem, neither any related risk that can cause hearing problem.
mother claimed that her daughter can produce /ma/, once,  but then there's no progress of speech afterward.

history taking had been conducted. patient is healthy...

audiological finding

1. otoscopic examination : clear ear canal with intact tympanic membrane on both ear
2. tympanometry: Type A bilaterally; suggesting normal middle ear function
3. Play audiometry (HP): attempted, but then patient unable to comprehend the task. Bone vibrator had been used  to condition the patient, she can understand when the vibrator is  vibrating. but, when, the bone vibrator place, she unable to do so
4. acoustic refflex: absent reflexes, ipsilateral, bilaterally..
5. ABR ( diagnostic) : no present waves at 100 dBnHL on right, and present of wave V at 100 dBnHL at left ear
6. DPOAE: absent emission on both ear at all tested frequency

thus, the finding may suggest.. profound hearing loss bilaterally, which is sensorineural loss. bilaterally...

the findings, showed, why she unable to comprehend the behavioral assessment. she cant do well, because 1) inaudible conditioned level, 2) familiarization; with her hearing level, she cannot hear the normal conversation level.. up till 90 dBnHL.. she's  not familiar on how the sound are, and what they are..

macamana nak explain? kat parent?? oohh yes!! i do cry

in real world.. how can u not sympathize on others fate? a child, yang harapannyer, bila besar nanti.. yang nak jaga ibu bapa.. seyesly.. comel mute sgt.. sangat2... tp,, sapa taw, di sebalik itu.. ada rahmat yang tuhan ambil..

jadi hari ini,, ujian tunjukkan yang anak tuan/puan ada masalah pendengaran la.. jenis kekal yang melibatkan saraf.. pada tahap yang sangat teruk... bunyi2 sekeliling kita ni, semua dia tak dengar,, kalau org bercakap2 ni, level dia dlm 60, tp anak puan/tuan ada masalah,, yang kalau 100 baru boleh dengar.. jadi, ini adalah penyebab la kenapa dia lambat bercakap..sbb dia tak tahu bunyi tu cammane, n sbb tu dia tak tau camane nak kuarkan bunyi tu... tu je.. bila tgk ibu dia nangis?? tersedu sedan.... nak cakap lagi? tak pyh cakap.. aku dah baik punya nangis dah pastu.. 

option untuk intervention.. buat waktu dan tika ini,, adalah hearing aid.. harus secepatnya dipakaikan.. ini adalah perlu sbb 3 tahun pertama, adalah penting for acquistion of speech and language.. if then, there's no visual benefit.. cochlear implant can be the best option...

sympathy n empathy.. it's 2 different things.. professional? or been the human being?