Mini reunion

15 June 2013

Phonak had launched their 4th chip, Phonak Quest at Ritz Carlton Hotel, Bukit Bintang. Today post is not about their new products, but a mini reunion that i had with my friends.

Izzati.. izzati.. k.amnah

Me with malini

Gosh! I dont even know what they are talking about

The best part? Makan

The importance of history taking

HISTORY TAKING

"People doesnt care how much you know, until they know how much you care".

History taking is the fundamental part on every session. Generally, this help in letting you know about patient's background, their concern, and it helps on digging the why the problem arise.

Basicly, in audiology field, history taking helps in ruled out the cause of loss, the triggering factor that are non pathological as for example physical abuse.

The main idea to generate history taking sheets is the WH QUESTION (who, when, why, what and how)

What is important?

Separately, questions are different between adult and peadiatric cases.

ADULT

As an audiologist, i need to know about: 

• Hearing problem

1. When the problem arise?
2. Which ear?
3. How the problem happened? Suddenly? Gradually?
4. Any hearing test conducted before? If yes, what is the result?
5. Are there any experienced with hearing aids?

• Patient's job
• Ear' history

1. Is there any ear pain? If yes, since when?  How it occured? How it been treated?
2. Is there any ear discharge?
3. Any ringing sensation? If yes, what kind of sound is it? The duration of ringing? What trigger it? Are the ringing annoyed you? How you handle or cope with it?

• Medical history

1. Any medical problem? 
2. Are you taking any medication daily? If yes, since when? 

• Head and neck injury
• Facial weakness
• Noise exposure ( relate with job scope)

1. If yes, how many hours of exposure? 
2. Is there any prevention act been done?

• Family history

PEADIATRIC

There are different area of concern when taking history in this population. Generally, the age of the patients will help on selecting the appropriate question. 

Obviously, we ask those question towards the parents or guardian, unless the child is well understood upon the question asked ( reach mental age)

• Parent concern

1. Are you suspecting your child having hearing difficulities? If yes, why you said so?  Since when you notice the problem?

• Pregnancy history

Prenatal

1. Did you take any medication during pregnancy other than multivitamin that physician suggest to?
2. Did you do x-ray during pregnancy?
3. Are there any infection that you suffer from pregnancy? ( try to rule on TORCHES)

Perinatal

1. Are there any complication during delivery?
2. Did your child reach maturity?
3. Birth weight?
4. Apgar score?

Postnatal

1. After delivery, are there any other problems? Did your child been warded, ventilated? 
2. Jaundice? If yes, how it been treated? Any blood transfusion? 
3. Any infection detected?

• Medical and ear history
• Speech development

1. The question should be according to age of the child. General milestone can be use to guide if the child have any delay on speech production.

• Physical development
• School performance
• Family history

Why hearing loss increasing worldwide?

Auditory system are separated into 3;

There are different causes in each region.

... the outer ear:

Typical problems will include excessive accumulation of earwax and infections of the ear canal

... the middle ear:

Perforation of the eardrum, infection or fluid in the middle ear and otosclerosis ( a calcification around the stapes that limit its movement)

... the inner ear:

As this is the house of auditory receptor, damaged inner ear structures will lead to hearing loss. Typical causes are the natural aging process, excessive exposure to noise, medication that is toxic to the system and head injuries.

How Hearing Aid help?

 "Losing your eyesight separates you from things, losing your hearing separates you from people"      Helen Keller

Hearing loss is a serious disability that can impose a heavy social and economic burden on individuals, families and communities. (WHO, 2006)

The impact of hearing loss depends on the severity of the problem. Negatively, in our community, we have a wrong stigma about this impaired community and this yet isolating them. This will lead to emotional instability, low self esteem , depression and even paranoia in this people.

According to WHO, properly fitted hearing aid can improve communication in at least 90% of people with hearing loss.

Hearing aid helps: 

1) Greater earning power ( for severe profound)

2) Improved interpersonal relationship, including greater intimacy and lessening of dysfunctional communication.

3) Reduction in discrimination.

4) Reduction in anger and frustation

5) Enhanced emotional stability

6) Enhanced group social activity.

www.betterhearing.org

Why then people choosing on doing nothing about it, rather than taking hearing aids to help?

Stigma. That is the main reason. Our community love to label and have an old fashioned stereotypes prevail. Those who have or wear hearing aid, is "cacat"

Secondly, awareness. This lack of awareness not only in the effects of hearing loss on a person's quality of life but also about hearing aid design and technology.

People will follow their physician advice. They seen physician as the most reliable source of information and recommendations. However, there are not many physician aware upon hearing aid technology. Their recommendation is important that can help to encourage people with hearing loss to wear one.

Hearing loss as a global concern

Hearing loss is a health issue that should be concern.

The number of people who are having hearing problem is growing each year, and it is expected to grow to 1.1 billion by 2015 ( ASHA). Studied conducted by ASHA, showed that in United States, there are approximately 29 million who are having hearing loss. The prevalence is increases with age. Most residence age 80 or older have some degree of hearing loss.

Nevertheless, age is not the only reason for hearing loss.

Malaysia as one of developing country is far behind. We are still lacking in technology, knowledge and awareness about hearing problems. And the number of this disable community is increasing.

Ministry of Health (MoH) need to work harder as this disability can impose a heavy social and economic burden on individuals, families and communities.