May 2019 The Hearing Journal
One moment, she was a 23-year-old audiology student working on her clinical doctorate degree at Vanderbilt University in Nashville. The next, Allyson Sisler-Dinwiddie, AuD, CCC-A, was a long-term patient recovering from a serious vehicle accident that set her on a long road to recovery. It was while on this path working with speech pathologists, physical therapists, and occupational therapists when she realised the hearing loss she had been born with took a noticeable dip. She needed cochlear implants in both ears six months apart.
In another part of the world far away from Nashville, Viral Tejani, AuD, PhD, was born with hearing loss that was not officially identified until he was 3 years old, at which point he began wearing hearing aids. “Nowadays, newborns undergo a hearing screening before leaving the hospital, so hearing loss can be detected and managed by audiologists and physicians much more effectively,” said Tejani, a cochlear research audiologist at the University of Iowa. “However, I was born in 1986, and also in India, and newborn hearing screenings did not even really take off there.
A DIFFERENT PERSPECTIVE
Audiologists with hearing loss can relate to their patients’ experiences. For Leslie Soiles, AuD, the chief audiologist for the Campaign for Better Hearing, her genetic hearing loss provides her with a special connection with patients. “Having a hearing impairment has allowed me to identify with my patients and be more empathetic about their challenges,” said Soiles. “They are dealing with the same feelings and concerns that I've experienced. I'm able to connect with them on a level that surprises them. They also trust that I can understand what they are going through. Some people may say that hearing loss is unfortunate, but for me, the way my hearing loss has unfolded—personally and professionally—has been a gift. Having hearing loss makes me a better audiologist.”
Because of her enhanced understanding and empathy, Soiles chose to branch out from standard ENT practices and form her own, HearingLife, in Shrewsbury, MA. “Working in busy ENT practices sometimes meant that I didn't get to spend as much time with my patients as I wanted,” she said. “Eventually, I decided to open my own audiology practice so I could tailor my practice to give patients more time for education to help them make informed decisions.”
Despite that it absolutely helps him connect with patients, Tejani does not use mutual hearing loss as a topic of discussion with patients. “As an audiologist with severe hearing loss, I know what the experience is like,” he said. “Patients know that I know what it's like. They don't need to explain. At the risk of not sounding professional, sometimes patients will say, ‘This just simply sucks,’ and I'll say, ‘Yeah, I know.’ It puts them at ease.”
CONNECTING WITH PATIENTS
Tejani uses many devices, such as a vibrating alarm clock, wireless microphone technology, and CART (computer and real time translator), to help him personally and professionally. He also has hearing aids that are clearly visible to patients. “If patients notice my hearing aids, they will comment—and I am happy to talk about my experiences with hearing loss,” he said. “However, the appointment is about them, so I'd rather talk about their problems first and interject my experiences afterwards. I have a few audiology colleagues with hearing loss, and they also agree—it's about the patient, not the audiologist.”
Those sentiments were echoed by Sisler-Dinwiddie, who is primarily, but not exclusively, a paediatric audiologist. She sees the role of an audiologist, any audiologist, as sending patients into the world better equipped to deal with their loss. “The importance of connecting with your patients, whether a provider who has hearing loss or not, is critical in establishing a trusting patient-provider partnership, and it truly is a partnership—providing an individualised treatment plan that will help them achieve what's most important to them,” said Sisler-Dinwiddie, who spends most of her time as a member of Vanderbilt's cochlear implant team. “At the end of the day, I hope each patient I have been given the opportunity to see feels I have been able to help them as much as the many audiologists and other health care providers who have impacted my life for the better when I needed their help the most.”
After her accident, it took a long time for Sisler-Dinwiddie to return to her old self. “Auditory processing had already been a challenge as a result of my hearing loss,” she said, and to this day, she still battles with debilitating and excruciating headaches from her head injury. But she finds herself most at home in the workplace. “I don't think of myself as being any different than my hearing colleagues, and, to be honest, I forget most days that I'm even deaf,” said the Ohio native. “While yes, I have magical magnetic, electric ears that allow me to hear and understand my family, friends, and patients as an audiologist, my hearing loss has never by any means defined me as a person, nor has it ever been the reason I've refrained from taking part in any sport or extracurricular adventure in this beautiful life. “The only thing I don't feel comfortable or confident doing is I never calibrate audiometers/sound booths in the morning,” she noted. “It needs to be performed by someone who has normal hearing.”
Soiles shared her ongoing challenges as well. “Even with my hearing aids, there are times, especially in large meetings where a microphone isn't being used, that I can't hear what is being said. When this happens, sometimes I find myself feeling like that struggling student,” she noted. “Fortunately, this doesn't happen very often as technology has advanced a lot, offering new options for such situations.”
Tejani recalled his own obstacles as a student, although he was still able to participate in sports (cross country and winter track) and admitted that they still remain in his career. “Now that I work with patients, it's critical that I can hear and understand them properly. I also go to the operating room (OR) for many cochlear implant surgeries—and the OR is quite a noisy place!” he said.
“I also attend conferences two to three times a year, and it can be difficult to hear a lecture in a large meeting room. Some presenters have a great voice made for public speaking, but others are too fast, too soft, etc. Video conference calls can also be difficult… But there are many ways to address those obstacles,” he added.
Despite their commonality of relating to patients from unique perspectives, these audiologists pursue different passions in their daily professional lives. Soiles, for example, is on a mission to educate baby boomers about the importance of putting hearing care on their health care radar. And it is not a mission she takes lightly. “I was inspired to enter the field of audiology by an audiologist who was a powerful force in my life,” she said. “He educated me about hearing loss and helped me understand why it caused me to struggle. Up to that point, no one had explained it to me. As a kid, I was in and out of testing booths, but no one told me what was happening. I found understanding the relationship between my hearing loss and my everyday challenges very liberating.” With her work at the National Campaign for Better Hearing, Soiles aims to educate people about the need to monitor their hearing since hearing loss is a natural part of the ageing process.
“It's typically slow and not something you realise right away,” she said. “Having a baseline hearing test is going to provide beneficial information to people 60 years old and over because it will determine their current hearing levels and make it easier to identify future hearing loss. “We have an incredible capacity to cope with things that are not perfect. Baby boomers are likely to struggle for years with a slowly progressing hearing loss before they do something about it.” She says baby boomers may “needlessly put themselves through hearing challenges,” such as compensating by lip-reading or by avoiding noisy restaurants, that could have been addressed earlier. “Most hearing loss is easily treatable,” she said. “I want to make sure the Campaign for Better Hearing educates people about how hearing loss can impact their lives and what their options are, so they can lead their best lives.”
Tejani's passion, on the other hand, is in research. “I am involved with seeing cochlear implant patients for both clinical and research duties, though my primary role is research,” he said. “I am involved in several clinical research projects at our clinic, and I also work with undergraduate and graduate students, as well as medical residents, who are involved with projects in our lab.” He is also deeply immersed in advocacy for the hard of hearing, supporting the efforts of colleague Eric Nordlof to get captions in movie theatres. “Despite the Americans with Disabilities Act being in effect since the early ‘90s, there continue to be barriers, and there are deaf and hard-of-hearing individuals who fight for their right to equal access,” he said. “Barriers continue to exist for the deaf and hard-of-hearing population. Advocacy is very important.” Tejani is an active member of the Hearing Loss Association of America (HLAA) as well as the Alexander Graham Bell Association for the Deaf and Hard of Hearing AG Bell. “I am also one of the moderators of the Association of Audiologists with Hearing Loss, an online group of professional audiologists and students studying to become audiologists,” he said, describing it as “a closed group and a safe space to have open discussions.”
Sisler-Dinwiddie–in addition to her work at Vanderbilt—is an educational audiologist for several public school systems in middle Tennessee. “I love working in the schools for many reasons, but it's there that I find myself feeling extraordinarily useful,” she said. “Not that I don't feel useful in the clinic or in the operating room because I absolutely do, but there's never a dull day spent helping teachers ensure their classrooms are acoustically appropriate.” And special moments make it all tangibly worthwhile, like when one boy's mother embraced her after her son wrote an essay titled, “My Cochlear Implant.” “His mom was in tears and gave me a hug as she whispered, ‘Thank you for giving me hope, and my son his life back,’” recalled Sisler-Dinwiddie. “It's moments like that that stay with you forever. The hope and help for the best possible hearing solutions for those in need is why I do what I do. I can't imagine having a job that is more fulfilling than this one, and I am forever grateful for the opportunity to do what I get to do each day with hope of making a difference.” For all the moments when she felt like giving up, moments like these prove the long and winding road to recovery have left her at the ideal destination. “It makes a world of difference when you really love what you have the opportunity to do each day,” she said. “There's nothing more gratifying than the honor to be a part of a patient's journey out of silence and witness their lives transform as their quality of life in a world of sound soars beyond what they ever imagined would ever be possible.”