Hearing and hearing loss – how to prepare for your appointment
This leaflet is for patients who have been referred to the audiology clinic. The leaflet provides information about what to expect at your appointment, all about your ears and how to prepare for your visit.
Why have you been referred?
We have been asked to see you to take a look at your ears and hearing. The reason for your referral will vary but is likely because there is some concern, either from your GP, yourself or even your family and friends about how well you hear.
Hearing loss indicators
Hearing loss can develop at any time. Most often, it is gradual and painless. As your hearing declines slowly you may not realise for several years that it is affecting you. At first it may be barely noticeable; in fact it may be that your friends or family notice this before you do.
Can you relate to any of the following?
People seem to mumble and not speak clearly
People always say that the volume on my TV or radio is too loud
I miss visits and calls from people because I didn’t hear the doorbell or telephone ring
I have trouble following conversations in crowded or noisy places
I frequently mishear and ask people to repeat themselves
My friends and family say that I have a hearing problem
People tell me that I speak too loudly.
Have you experienced any of these situations? If so, there is a chance you have a hearing loss.
Knowing your ears
To understand hearing loss, it helps to understand how we hear. Your ear is an amazing organ that, very simply put, turns sound waves in the air into information in your brain.
What we call ‘sounds’ or ‘speech’ are actually ‘sound waves’ transmitted through the air. (1&2) The outer ear collects the sound waves and delivers them to the (3&4) middle ear which makes the ear drum and the tiny bones vibrate. (5&6) These vibrations move the fluid in the inner ear, which in turn moves tiny hair cells and stimulates the nerve to send messages to the brain.
Causes of hearing loss
So why does hearing loss happen?
There are many factors that may affect your hearing, including:
In many cases hearing loss is part of the aging process
Long-term exposure to noise
Reaction/side-effects to medication
Blockages of the ear, such as wax.
Effects of hearing loss
As we get older, our hearing deteriorates. This is usually a gradual process.
No matter what the cause, hearing loss affects each person differently. Most people find that background noise prevents them from hearing speech clearly in social situations and others can struggle to hear a particular family member’s voice; no two people are exactly the same in what they can and cannot hear.
One of the ways that people manage their hearing problems is through wearing hearing aids. As well as this, there are several important social considerations. This leaflet will suggest ways to address these elements and improve your hearing and communication.
Communication is a key part in all our lives; if this is impaired through hearing loss it can cause difficulties, frustration and upset to you and those that you need and want to communicate with. It might be that the more important the person is in your life, the more frustrated or upset you might feel about your problems with hearing loss.
Think about the people you communicate with at home and when you are out. Who are the most important people you want to be able to hear and in what situations?
Take a look at the examples below, which show a number of situations where hearing loss can be putting a strain on relationships. Are any of these familiar to you? By thinking about your own daily communication it can really help to focus on where you need the most help with your hearing.
Hearing loss situations
My husband is always moaning at me to turn the television down, it gets me down.
Husband: The television is up so loud, she just doesn’t listen and it upsets me.
Children today just don’t speak clearly, they mumble, it makes me so cross.
Grandchild: Why doesn’t grandma answer when I ask her a question, it makes me sad.
I can’t hear my daughter on the telephone, these new mobile phones are not as good as old landline ones; it is so frustrating.
Daughter: It would be good to have a conversation with mum on the phone without having to constantly repeat myself, it is hard work.
I may as well not be there, I can’t follow the conversation. It’s a waste of time going out just to feel isolated.
Friends: We know she struggles with her hearing so we try to make sure she is following the conversation, but you can see by her face or her response that she has lost the thread, she used to be a real entertainer.
Why do they have to play music in public places? I can never hear how much I’m being asked for in shops and restaurants, it makes me look stupid.
Shop Assistant: She’s lovely but I wish she would get her hearing sorted, she never gives me the right money and I am embarrassed to keep repeating what I am saying.
What will happen at my assessment?
The audiologist will:
Ask you questions about your hearing difficulties
Go through your medical history
Perform an ear examination
Perform a hearing assessment
Discuss and agree the best options available to help you. This may include hearing aid prescription.
Please complete the following and bring along to your first appointment.
Have you experienced persistent pain affecting either ear? (defined as earache lasting more than 7 days in the past 90 days before appointment)
Have you experienced a history of discharge other than wax from either ear within the last 90 days?
Have you experienced sudden loss or sudden deterioration of hearing? (sudden = within 1 week)
Have you experienced rapid loss or rapid deterioration of hearing? (rapid = 90 days or less)
Have you experienced fluctuating hearing loss, other than associated with colds?
Do you hear very much better in one ear than the other?
Do you experience troublesome noises (tinnitus) different or worse in one ear than the other?
Do these noises cause you sleep disturbance, anxiety or depression?
In the last three months, have you experienced any dizziness or imbalance, for example spinning, swaying or floating sensations and veering to the side when walking?
Have you ever had head/ear injury or surgery?
Have you ever been consistently exposed to very loud sounds?
Do you have a pacemaker?
How you can prepare for your hearing assessment
Please think about the specific listening situations in which you would like to hear better, and write these here. For example, wanting to hear better at the dinner table or wanting to hear better when speaking on the telephone.
If you suffer with ear wax build up and regularly have your ears cleaned, please arrange to have this done 2-3 weeks before your appointment. If you have long hair you may like to bring along a hair band to keep your hair away from your ears during your appointment. It would be helpful if you could bring along a list of any medication you are currently taking.
Sources of further information
Royal National Institute for the Deaf – RNID (formerly Action on Hearing Loss) Telephone: 0808 808 0123 (freephone) Textphone: 0808 808 9000 (freephone)
Head Office: 19-23 Featherstone Street, London EC1Y 8SL Telephone: 020 7296 8000 Textphone: 020 7296 8001 Email: firstname.lastname@example.org Website: www.rnid.org.uk
British Tinnitus Association Telephone: 0800 018 0527 free of charge within the UK 0114 250 9922 national rate within the UK +44 (0)114 250 9922 outside the UK Head Office: Ground Floor, Unit 5, Acorn Business Park, Woodseats Close, Sheffield S8 0TB Email: email@example.com Website: www.tinnitus.org.uk
Kingston Tinnitus Support Group Website: www.kingstonhospital.nhs.uk/ departments-services/support-services/ tinnitus-support-group.aspx
Lip-reading To find out about classes in your area enquire at your local library, Adult Education Centre or write to the Information Officer, The Association of Teachers of Lip reading to Adults, 14 Grange Park, St. Arvans, Chepstow NP6 6EA.
C2 Hear Online Visit youtube.com and search C2 Hear for a series of short, interactive videos about hearing aids, hearing loss and communication.
Hearing Link Hearing Link is here to give you advice, information and support. Please contact our Helpdesk by phone. Telephone: 0300 111 1113 Head Office: 27-28 The Waterfront, Eastbourne, East Sussex BN23 5UZ SMS: 07526 123255 Email: firstname.lastname@example.org Website: www.hearinglink.org/contactus
Sense (for deafblind people) Telephone: 0300 330 9256 or 020 7520 0972 Textphone: 0300 330 9256 or 020 7520 0972 Fax: 0300 330 9251 Head Office: 101 Pentonville Road, London N1 9LG Email: email@example.com Website: www.sense.org.uk
Signia hearing aids www.signia-hearing.co.uk
To learn more about our services, or for more information or guidance, please contact:
Please speak to a member of staff before or during your visit to the hospital if you require translation support to access Patient Information. Please ring the phone number on your appointment letter, if you have one.
Request More Information
Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
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