First, I want to tell a story of a Veteran I've seen a couple times now. Not the funniest story ever, but definitely a memorable one. I first saw this guy about 2 months ago. He lives in a nursing home and came to us on a stretcher (traveled in an ambulance) with two EMS guys. Having someone come to you on a stretcher obviously presents some difficulties when you consider we are trying to test somebody in a relatively small sound booth. Of course this guy is strapped to the stretcher and there was a 0% chance that he would be able to sit in a chair. So I put him in the biggest booth we have, which gave me about 12 inches to walk around him. He was coherent enough to answer most of my questions, but clearly this was somebody who needed an expedited hearing evaluation. Our ultimate goal was go get him set up for some new hearing aids.
Long story short, he was a pretty tough one to test. He needed to take 3 bathroom breaks in 45 minutes, kept yelling "help" for no reason, and eventually got tired of testing and said he wanted to leave. We hurried and made ear mold impressions and told him we would get his hearing aids ordered. We didn't end up getting a full hearing test on him that day so we figured when he came back in a couple months to get the hearing aids we would do a quick recheck of his hearing to make sure what we originally got was accurate. Then we would do the hearing aid fitting.
Not so fast! He came back a couple weeks ago as an inpatient in the hospital! Yeah, we're not talking about coming in on one of those skinny stretchers that go in the back of an ambulance. He showed up in a full-size hospital bed! Yeah, the kind with the big railings on the side. That thing barely fits through our extra-wide door to get into the clinic. There was no way that bed was going to fit in one of the sound booths. So this appointment quickly turned into an exercise in "do the best you can with what you have". We just rolled his bed up to the door of a sound booth and tested his hearing in the hall! Clearly not the best testing environment, but it's all we could do! To say this Veteran was impatient with me would be a huge understatement. About 1/4 of the way through the hearing test, he barked at me that he wanted to leave.
"Tiiiiiim, what's all this racket I'm hearing?"
"Those are the soft beeping sounds I need you to be listening for. Remember, when you hear them, I need you to let me know."
"Well turn that stuff off! I'm ready to go."
His physician told me earlier that day that all the Veteran had been talking about upstairs was how much he wanted to get new hearing aids. So I reminded the Veteran that we were working on getting his hearing aids for him.
"Oh, ok", he said. That bought me a little bit more time! I got 500-4000Hz in the left ear and switched to the right ear. I got 500-1000Hz before he spoke up again, this time much more angrily...
"Tiiiiiiim, I want you to stop those sounds! I've had it with these tests and I don't want to do this any more! Get me out of here!"
"Ok Mr. ______ . We're all done with the hearing test. Let me get you unhooked and we'll get your hearing aids set up for you."
"Well, you'd better not make me do any of that stuff any more. I'm never listening to those dumb beeps again. Got it?"
I should be clear. His tone wasn't overtly angry, but more grumpy than anything.
"You bet Mr. ______. I have your hearing aids right here. It will just take me a few minutes to get them ready for you."
For those of you not familiar with hearing aids, there is quite a process involved in fitting hearing aids. It involves putting a microphone in the patient's ear, playing speech sounds at fixed levels, and recording the amplified levels in their ear canals. This allows us to set the hearing aid volume to a level to match a prescription based to their hearing loss. Of course, this process involves having the patient sit in a chair in front of the speaker that plays the speech sounds. Since this patient was in a full-sized hospital bed that wouldn't even make it into our fitting room, we had to improvise! Again, there we were doing the best we could with what we had. We were fitting Starkey Wi i110 Series ITE aids which we know from experience have a first-fit that is very very similar to NAL-NL1. There is typically very little adjustment to be made. So we were pretty comfortable putting these on his ears and just making sure they weren't too loud. Oh, but hearing aids are typically physically connected to the computer during the fitting process so we can make adjustments to their settings. Mr. _______ had to stay in the hallway during this step since his bed doesn't fit in the room! Fortunately, we were set up to do wireless fittings. Granted, this process usually happens, again, right in front of the speakers that play the speech sounds we record. The patient is always in the same room as me. Not this time! We made this one a long-distance fitting. :)
As I'm getting the hearing aids connected to the computer and getting some settings adjusted...
"Tiiiiiiiiiiiiiiiiiiiiim!!!!!"
I stopped what I was doing and went over to his bed.
"Yes Mr. ______. What is it?"
"I want you to get ME OUT OF HERE!!!"
"We're working on that. I just need a couple minutes to get your hearing aids ready for you. I'll bring them out to you in just a minute".
"If you don't get me out of here right now, I'm going to sue you for libel!"
Hmm, I think to myself. Does this make any sense at all? Nope! Guess I'll get back to the hearing aids.
After just a minute or two, we got the hearing aids on him. Oh, I forgot to mention that he was admitted to the hospital for low oxygen in his blood, so he came to us that day with an oxygen tank on his bed and he was wearing a mask the whole time. Naturally, when we turned the hearing aids on, he heard the oxygen pump which was sitting next to him.
"WHAT'S ALL THAT RACKET????"
"That's your oxygen pump Mr. ______". It's there to help you breathe.
"Well, turn that damn thing off!"
"I'm sorry, we can't do that. You need that to breathe. Once you get back upstairs, they'll hook you up to oxygen from the central system that doesn't make any noise."
"Well, if you don't get me out of here soon, I'm going to sue you for damage".
"Ok, sir. We'll get you out of here as soon as we can. We just need to make sure these hearing aids are set up appropriately for you".
After a couple more minutes, we got everything set up the best we could. I called the medical transport guys to come get Mr. ______ to take him back upstairs.
" TIIIIIIIIMMMMMMMM!!!!!!!"
"Yes Mr. ______?"
"I don't want to be in here anymore! Take me back upstairs! If you don't get me out of here now, I'm going to sue you for every penny you're worth".
"I've already called the transport guys and they're on their way. We'll get you out of here in just a minute or two".
"What's the hurry?"
:)
No comments:
Post a Comment