Tuesday, April 19, 2011

Have you been dizzy or experienced vertigo?

Take a look at this excerpt from the American Speech Language Hearing Association about issues pertaining to balance and dizziness:

How Our Balance System Works

Balance and equilibrium help us stay upright when standing and know where we are in relation to gravity. Our balance system also helps us walk, run, and move without falling. Balance is controlled through signals to the brain from your eyes, the inner ear, and the sensory systems of the body (such as the skin, muscles, and joints). This balance system is also known as the vestibular system.
In the inner ear, the balance system consists of three semicircular canals that contain fluid and “sensors” that detect rotational movement of the head. Each of the semicircular canals lies at a different angle and is situated at a right angle to each other. The semicircular canals deal with different movement: up-and-down, side-to-side, and tilting from one side to the other. All contain sensory hair cells that are activated by movement of inner ear fluid (endolymph). As the head moves, hair cells in the semicircular canals send nerve impulses to the brain by way of the acoustic nerve. The nerve impulses are processed in the brain to help us know where we are in space or if we are moving.
Located near the semicircular canals are the utricle and the saccule. The ends of the semicircular canals connect with the utricle, and the utricle connects with the saccule. The semicircular canals provide information about movement of the head. The sensory hair cells of the utricle and saccule provide information to the brain about head position when it is not moving. The utricle is sensitive to change in horizontal movement. The saccule is sensitive to the change in vertical acceleration (such as going up in an elevator).

Balance Testing

Balance system assessment is often recommended when a person has:
  • Rapid, involuntary eye movement (also known as nystagmus)
  • Complaints of vertigo or dizziness
  • Balance dysfunction
  • Gait abnormalities
  • Suspected pathology or disease of the vestibular system
Tests of the balance system are performed to determine:
  • What is causing the symptoms?
  • Where in the balance system is the problem occurring?
  • Are any changes happening in the balance function?
  • How are vision, the inner ear, and sensory systems impacting functional balance?
Some of the tests of balance can be done in the physician’s office or at the bedside in the hospital. Others require specialized equipment that is in the audiology office or clinic.

What should I do if I have a problem with balance or dizziness? 

It is important to see your doctor if you have unexplained dizziness or balance issues. If you have any of the following other symptoms, be sure to seek emergency medical care:
  • Chest pains
  • Numbness or tingling
  • Falling or problems walking
  • Weakness in the legs or arms
  • Blurred vision
  • Slurred speech
  • Sudden hearing loss
  • Severe neck stiffness
  • Head trauma or injury
  • High fever
Dizziness and balance difficulties are symptoms of another problem. The first thing you should do is try to find out the underlying cause. You should have a medical examination with special attention given to checking for problems that can be associated with balance difficulties.
Unfortunately, in many cases, the dizziness and balance difficulties cannot be treated medically or surgically. In these cases, the balance problem itself may need to be treated through balance rehabilitation.

Thursday, April 7, 2011

So...You're thinking about hearing instruments eh?

Alot of people are a bit apprehensive about the idea of trying hearing aids.  Here is a small blurb about "what to expect" that all of my patients read prior to initiating the process....

What to Expect

The Hearing Instrument Fitting

If you go through the hearing aid evaluation process with an open mind, you will make a sound and educated decision about which hearing instrument to try. Also, you should remember that the decision you make is not set in stone until the completion of your 30-day trial period.  But now what? 
          About two weeks after the hearing instrument evaluation you will be fit with your hearing instrument(s).  Most people are very apprehensive about what to expect during this appointment.  There is one fact that is certain, when it comes to the initial experience of using hearing instruments;  it will not be easy!  You should not expect to leave the fitting appointment hearing “perfectly”.  Your brain has learned to live with hearing loss for the past 5, 10, 15, or even 20 years…so it will take longer than the fitting for you adjust to hearing well again.  When you’re in the office for your fitting, all of the sound you have missed for so long will be returned to your ear and brain in the matter of 45 minutes.  Although you will not initially be given the entire “dose” of sound that your ear will eventually need, it is a lot of sound to deal with in such a short period of time.  Most people wonder, “What will I initially experience?”
          The first thing that people typically notice is that they hear certain environmental sounds that they had “forgotten about”.  Examples include certain outdoor sounds such as birds, crickets, tree frogs and other sounds “inside” such as the turn signal of the car, your refrigerator, and creaks in your floor at home.  You need to remember that hearing these sounds is perfectly normal.  A combined effort consisting of your patience and my help with appropriately programming the instruments will make the process of “re-adapting” to these sounds as smooth as possible. 
          The second most common observation that people have is that their own voice “sounds funny”.  The majority of all first time hearing instrument users will immediately experience what is called the occlusion effect.  The occlusion effect is an overall change in how you perceive your own voice.  It is experienced differently by everyone.  The most common patient descriptions of the occlusion effect are:  “sounds like I’m talking in a barrel”, “my voice echo’s”, and “I feel like I am speaking so loud!”  The occlusion effect is a natural occurrence when wearing hearing instruments.  Some of the undesirable effects can be changed with special reprogramming of the instruments, some will go away with time, and any remaining effect is usually slight enough that it goes unnoticed by the patient. 
          Regardless of the type and technology of hearing instrument you have chosen, our overall goal is to help you communicate better in your own environment.  We will work together in the next month, so that you can hear and communicate to your best ability.  It is not an easy process, but with an open mind and a little hard work you should meet all of your goals!

Beyond The Hearing Instrument Fitting

          After the fitting you will enter into the 30-day trial period.  During that time you can expect to have anywhere from 2 to 4 appointments, depending on how well you are adapting to the new sound.  After the trial period you can expect about 3 – 4 appointments for the remainder of your first year wearing new instruments.  The first post trial appointment will occur about 3 months after your fitting.  Most individuals need some additional fine tuning at that point due to the brains adaptation to the sound.  The next appointment is six months after your fitting.  This appointment is typically needed for some fine tuning of the instruments programming and routine cleaning of the instrument. 
          After this appointment it is recommended that you are seen every six months for routine follow-up or earlier as needed.  Routine follow-ups are very important to the function of your hearing instrument as well as your communication abilities.  If needed, we will also test your hearing and adjust the hearing instrument accordingly to any documented hearing sensitivity changes or changes in your lifestyle.
          Individuals who follow up on a routine basis enjoy better hearing and less hearing instrument problems.  Please remember that the cost of your hearing instruments includes office visits for the first 90 days after fitting.  After that time you may be responsible for an office visit fee which is determined by the complexity of the appointment.