Final Word | October 2018 Hearing Review

A couple walked into the office last month for an initial appointment for the husband. The wife expressed support, but frustration with communication involving her spouse. She complained of communication problems between the two of them, and when they were out socially with others.

He didn’t say much but appeared to be sizing me up. He is an imposing figure in his mid-80s, about 6′-5″ with a full head of longish white hair (picture Doc Brown from Back to the Future). He held his head cocked to one side as he intently stared at me as we discussed the plan for their visit. I soon learned that he is a retired physicist who worked in aerospace during the years of the Space Shuttle development.

His hearing aids were dilapidated RICs unfamiliar to me, one of which was dead. He reported they were 10 years old and were purchased at a big box store. The complaints reported were communication difficulties in all environments. His spouse noted that he exhibited withdrawal behavior in social situations, to which he replied that most people “…didn’t have much of anything important to listen to.” The evaluation revealed hearing levels to the extent that conversational speech is not audible to him. Probe microphone measures of the one functional hearing aid revealed a small peak of audibility at 2000 Hz.

We discussed my recommendations for treatment which also included a description of the full-service model offered in this office. He warmed up a little as we discussed what he could expect, and he agreed to purchase a set of new RIC-style instruments. I was prepared with battery milliampere hour ratings and the whys and why nots of rechargeable battery systems, but he didn’t ask beyond the “how long do they last?” question, and I didn’t offer additional unsolicited information.

The fitting appointment was a little more than a week later, after custom molds and the new aids were ready. He remained tentative, but cooperative throughout the fitting, noting that the sound was “much too loud” although just at audibility as measured by the probe mic. We set him up with a volume control, and sent him out into the world asking that he return in about 2 weeks, or sooner if problems came up.

We didn’t hear from him during the next 2 weeks except for the follow up appointment confirmation. As the couple walked into the waiting room for the follow up appointment, she wore a broad smile, and he had a bit of a smirk on his face. She offered in a stage whisper that “He’s doing great!” Recounting his experience at home on the morning following the fitting, he first explained that they live right on the beach, and that on the morning after the fitting, the surf was up, actively producing crashing wave sounds. When he donned the hearing aids, he turned to his wife and exclaimed “We’re going to have to move!”

I loved the response, and was a good audience for his quip. Instead of the new fitting complaints about the hearing aids we frequently hear, his jesting suggestion to move away was a declaration of acceptance of the devices.

Most of the follow up appointment was spent with the two of them recounting the increase in his participation in social situations and the overall improved communication and better quality of life with the hearing aids. Since he hadn’t said much during the first visit, I remarked on their report that he seemed much more engaged in our discussion.

He offered that he had decided that I had information worth listening to.

The Final Word? This patient shouldn’t have been a surprise. His outcome is what we strive for every time we approach a patient with a treatment plan. I think I expected more difficulty because of his initial apparent reluctance, and the fact that he came to the table with prior scientific knowledge that may have led us off into a discussion of gigawatts and other tangential information that wouldn’t help us with the fitting and his communicative ability.

The surprise to me was the open embrace and acceptance of the amplification and that the burden of acceptance was on him, not on me, to adjust away his complaints. I’m going to enjoy working with him as we go forward.


Dennis Van Vliet, AuD

Dennis Van Vliet, AuD

Dennis Van Vliet, AuD, is Senior Clinical Educator for the Bloom Hearing Specialist Network, based in Miami, Florida. He provides clinical services in Dana Point, Calif, and has been a prominent clinician, educator, and leader in the hearing healthcare field for over 40 years. His professional experience includes working as an educational audiologist, a private-practice owner, VP of audiology for a large dispensing network, and senior director for a major hearing aid manufacturer. As a columnist, his work spans three decades. Correspondence can be addressed to HR or: [email protected]

Citation for this article: Van Vliet D. We’re going to have to move! Hearing Review. 2018;25(10):50.