Audiology services appointments

Hearing and hearing loss. How to prepare for your appointment

Why have you been referred?

We have been asked to see you to look at your ears and hearing. There are a number of reasons you may have been referred but it 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 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 (see steps 1 and 2 on the diagram above). The outer ear collects the sound waves and delivers them to the middle ear (steps 3 and 4) which makes the ear drum and the tiny bones vibrate (steps 5 and 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:

• part of the aging process, in many cases
• long-term exposure to noise
• inherited factors
• illness or infection
• reaction or side effects to medicines
• injury
• blockage 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. 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. Below we 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.

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 thoughts	Others’ thoughts
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. Tt 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.

Hearing history

Please complete the following and bring along to your first appointment.

Have you experienced persistent pain affecting either ear? (This is defined as earache lasting more than 7 days in the past 90 days before appointment.)	Yes	No
Have you experienced discharge other than wax from either ear within the last 90 days?	Yes	No
Have you experienced sudden loss or sudden deterioration of hearing? (Sudden means within 1 week.)	Yes	No
Have you experienced rapid loss or rapid deterioration of hearing? (Rapid means over 90 days or less.)	Yes	No
Have you experienced fluctuating hearing loss, other than associated with colds?	Yes	No
Do you hear very much better in one ear than the other?	Yes	No
Do you experience troublesome noises (tinnitus) different or worse in one ear than the other?	Yes	No
Do these noises cause you sleep disturbance, anxiety or depression?	Yes	No
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?	Yes	No
Have you ever had injury or surgery to your head or ear?	Yes	No
Have you ever been consistently exposed to very loud sounds?	Yes	No
Do you have a pacemaker?	Yes	No

How you can prepare for your hearing assessment

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.

Priority	Situations
1
2
3
4
5
6

If you suffer with ear wax build up and regularly have your ears cleaned, please arrange to have this done 2 to 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 medicines you are currently taking.

Sources of further information

Royal National Institute for the Deaf – RNID (formerly Action on Hearing Loss) Freephone: 0808 808 0123, Freephone Textphone: 0808 808 9000 Telephone: 020 7296 8000, Textphone: 020 7296 8001 Email: information@rnid.org.uk Website: www.rnid.org.uk
Tinnitus UK Telephone: 0800 018 0527 free of charge within the UK 0114 250 9922 national rate within the UK Email: info@tinnitus.org.uk Website: www.tinnitus.org.uk
Kingston Tinnitus Support Group Website: www.kingstonhospital.nhs.uk/departments-services/support-services/tinnitus-support-group.aspx
Hearing Link Hearing Link provides advice, information and support. Helpdesk: 0300 111 1113 SMS: 07526 123255 Email: enquiries@hearinglink.org Website: https://www.hearinglink.org/contact-us/
Sense (for deafblind people) Telephone: 0300 330 9256 or 020 7520 0972 Textphone: 0300 330 9256 or 020 7520 0972 Email: info@sense.org.uk Website: www.sense.org.uk
Signia hearing aids www.signia.net/en-gb/local/en-gb/nhs-public-sector/
Lip-reading classes To find out about classes in your area ask 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.

Contacts

Audiology Department, Kingston Hospital, Galsworthy Road, Kingston upon Thames, KT2 7QB	020 8934 6406 option 1 khft.audiology@nhs.net
Audiology Department, Queen Mary’s Hospital Roehampton Lane, SW15 5PN	020 8934 6406 option 1 khft.audiology@nhs.net
Dorking Community Hospital, Horsham Road, RH4 2AA	01483 362619 khft.aqpaudiology@nhs.net
Cobham Day Surgery Hospital, 168 Portsmouth Road, Cobham, KT11 1HS	020 8934 6406 option 1 khft.audiology@nhs.net