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Welcome back to the All About Audiology podcast. I’m your host, Dr. Lilach Saperstein. I’m so excited you’re here for the All About YOU episode. Every other episode is all about YOU! Your responses, your comments to the episode, your comments on Instagram and on Facebook, or any emails you guys send me that you want me to share with everyone. That way this entire podcast project is a conversation and it’s a dialogue between all of us learning from one another. That’s what it’s all about.

In the last episode, All About BAHA, we learned about the bone-anchored hearing aid and we also got to hear the incredible story of Abbi, mother of five, who told us about her son who was born with microtia, and the process of getting a BAHA, in addition to lots of other inspiring and interesting things that she shared with us. So if you missed that episode, head on back to the previous one and then come back to listen to the responses here.

So one of the responses that I got on Instagram was from a mother of a child who is using the soft band BAHA, the BAHA that sits on a headband and she wrote something that made me giggle and I thought that you guys would appreciate it.

She said, “We use the band with our son’s BAHA. Growing up, I hated listening to the rules, LOL, I didn’t want to get the surgical ones because I want him to make the decision.” She continues to write, “If he’s sick of listening to my nagging, he can tune me out. All jokes aside, he complained a few times with noisy environments, of headaches and it being too noisy while wearing the BAHA. I’m waiting for him to be older before making permanent decisions.”

I really appreciated this comment and hearing from her because it is a very big decision and in fact, we want the children to be a little bit older so that they are ready for the surgery and their skull has finished growing, so about age 7 or 8 like we mentioned in the previous episode. But also she makes a good point that it is the kind of decision that a child can have input into as opposed to the cochlear implant where a child would otherwise have little to no access to sound and time is really of the essence. Many times children who are candidates for BAHA have some degree of hearing loss and so the stakes are a little bit lower in that case.

Recently, I have started working with cochlear implant patients when I joined the team at Rambam Medical Center in Haifa, Israel and I’ve been doing a lot of training and I”m jumping into the world of cochlear implants from the perspective of clinical audiologists and of course there is so much to learn. All of the technical aspect but you know, what I’m all about is making sure that the patient experience and the family is experiencing something positive that will lead to great outcomes for the family and for the patient of course.

So one of the things that I saw can go different ways, depending on which audiologist is running the session, I have seen a difference where some audiologists on the day of activation, on the day that the person is coming in about a month or so after their surgery, they are coming in to get the implant for the first time and they are getting an entire knapsack full of the equipment, backups, batteries, chargers, the drying chamber, all this different equipment. And I’ve seen some audiologists take it all apart ahead of time, prepare the processor, prepare the batteries and the charger and just have everything ready to go. Here we go, jumping into the activation appointment, right away, going in and trying to see if there are responses and beginning the process of acclimating to sound through the cochlear implant.

And other audiologists take this entire package and slowly, slowly open it up with the patient and their family, every little bag and box because every single piece comes in its’ own little baggie. So you have to open a baggie for the coil and the cable and for the magnet and for the processor itself in the box. So the two approaches are to either get it all prepared ahead of time, or go through each little piece together with the patient and their family putting the processor together piece by piece. And I can see pros and cons to both ways. You know, on one hand, you don’t want to waste any time and so you want to jump into the appointment. You also don’t want to have all this little packaging, little plastic baggies and boxes cluttering your desk, but on the other hand you do want to show the people how all the pieces fit together and going slowly, slowly through everything is also something to be taken into account.

So I opened up this question on my Instagram. Boy, did I get a lot of responses!!! I think this was the most controversial question. It really struck a lot of you guys and many of you sent me responses. I also had a poll and I will tell you the results of that poll. 34% of you thought it should be one piece ready to go and 66% of you thought it should be a slow, un-boxing. And here are some of the DMs I got from you guys about this topic.

One person said, “Our audiologist gave us the very basics at the first activation and then a little more each time we came in so we wouldn’t be too overwhelmed and we can really learn each part.”

Another person told me that, “It’s best to have everything ready to go. The audiologist I’ve observed, plans ahead, starts putting all the pieces from the box together and starts programming and activating once the patient is seated and then presents and explains to the patient what each item does afterwards. I find this to be the best method because it was all ready when the patient came in. The computer was up and running. I think it would be less of a waste of time and it’s more effective when they explain everything in the box together.”

Another mom sent me a message and said,

“Our audiologist went over all of what we would get before the activation. At activation, she just handed us the backpack. I would have been totally stressed out if we would have gone over the equipment and the programming. Woah!”

So that’s an interesting third option which I hadn’t included. Another person said,

“I enjoyed opening it together and showing me how to put it together and put it apart. It helped me to become self-sufficient and problem solve on my own.”

I thought this was a very important part of empowering parents, caregivers, and users to get to know the equipment and then be able to troubleshoot. But really the question is, if we want to do that right from the start, or how are we going to get to that goal. Everyone has the same goal, the question is just the approach. So it’s very interesting to hear all the different ideas.

This person said,

“I understand why it is more thoughtful to do it in a more ceremonial way, but it’s also more important to be practical.”

So this person understood exactly where I was coming from with my dilemma because I have to decide how I’m going to approach this with my patients. I was accompanied by a representative of the cochlear implant manufacturer so we did it together and I noticed that the way that she was doing it and the way that my colleagues were doing it was quite different.

So my conclusion from all of this is that there are lots of different ways to present the information to patients and the most important thing is to meet people where they are. To work with everyone in a way that’s going to be best for them. Some people really like to know every little piece and some people just prefer to get to the point. It also depends if you are dealing with a young child who will have a limited attention span to sit for you or an adult. Of course we have to mention that there are a lot of appointments, not just the first activation appointment, that’s just the beginning of the journey. And there’s a two week, one month, three months, six months follow up appointments, etc. So there’s lots of time to go through all of the other stuff.

I found it such a fascinating conversation that we had over on Instagram. The All About Audiology community is growing and I’m so grateful to be able to talk with all of you and learn from all of you and share what I’ve been learning too. So you are more than welcome to join me over on any of those platforms and if you are interested, I also do have email updates about the new podcast episodes. So you can join my mailing list on allaboutaudiology.com.

On the next episode, we’ll talk all about protecting our hearing. You can look forward to some practical tips on how we can protect our hearing and what are the things to look out for. What are the situations where you might want to start thinking about protecting your hearing. You’ll also hear my interview with a veteran and a very interesting conversation about hearing loss and tinnitus as a result of serving in the military. It’s a great conversation so come back soon for the All About Audiology podcast, hosted by me, Dr. Lilach Saperstein. Thanks so much for being a listener.