Audiology QUIZ

Time to change things up a bit. I am thinking about doing a weekly quiz (and we'll wait and see how long it actually lasts). I like to think of it as Audiology awareness! Once a week I will attempt to post a question related to Audiology in some way. If you want to play along, post your answers in the comments section. A few days later I will post the answer.

• Question #1

What is the best way to clean the wax out of your ears?

COMPASS Clinic

As promised, it is time to talk to you about COMPASS clinic. COMPASS Clinic (or team clinic) is a multi-disciplinary approach to caring for a patient. My placement offers this clinic once a month, every second Friday of the month. COMPASS clinic stands for Colorado Multi-Disciplinary Program for Assessment, Strategies, & Support. K-Mo's and my job is to coordinate the whole day. We arrange the families that are invited to attend the clinic and make sure they are dedicated to showing up for it. There are usually 3 children who attend the COMPASS clinic. We mail them some forms to fill out regarding their history, family history, health, professionals they work with (for example: teachers, family physician, speech pathologist), etc. When they send it back, we contact the other professionals to get any relevant info they have on the child and write up a summary. Then we send the summary out to all professionals the child sees the day of the COMPASS clinic. K-Mo and I schedule the appointments and send the family their schedule for the day, a list of what to bring and some info regarding what to expect the day of. We each stay with one of the families throughout the day and act as their support for the day. We coordinate and assist. The day of, they see some or all of the following: an audiologist, the ENT who is a neurotologist, a developmental pediatrician, a genetics counselor, a psychologist who specializes in Deafness and Autism, and a parent and a patient advocate. We go with them to each appointments and make note of their concerns for their child and their goals for their child's future. Over lunch, we all meet in the conference room to discuss the children seen in the COMPASS clinic and review the findings of the morning appointments. Then, at the end of the day, we all get together again to review the findings of the afternoon appointments. Finally, K-Mo and I write up the recommendations from each professional seen that day and get it to the child's family in the next week. By the time we're done, we get to start preparing for the next one!

So... it's a lot of work, but this clinic is pretty awesome. I learned so much in only a single day, and the families who need it had the opportunity to have their child cared for in a more well-rounded fashion and they get all of their questions answered. The day itself can be overwhelming, but the families leave feeling truly grateful! I still can't believe how much I learned during this clinic. I am thinking about using the little guy I accompanied for my next grand rounds project, so you will probably hear all about him in the near future.

Weekend Update

The Milwaukee Brewers were in town, so we had to hit up a few of the games! We left as soon as I got home from clinic on Friday and headed for the lightrail. For $7.00 round trip, it sure beats dealing with traffic and paying for parking downtown. We made it to our seats (in the nose-bleed section) just in time for the game to start. It was a good game, but unfortunately, Brewer's lost. Coors Field is a nice ball park though. All the seats are angled towards home plate and the Rockie's fans are civil! Of course the random "Brewer's suck!" comments are expected, but that was the extent of the hassling we got from the home team fans.

Sweet hat some girl we met at Swanky's made.

On Saturday, we went back for more! Another night game, and another ride on the lightrail. This time the Brewer's walked away with a WIN! Ready to celebrate, we headed to Swanky's! Swanky's is a sweet Packer bar just down the road from Coors Field. There was Packer paraphernalia everywhere, and it was packed with Brewer fans after the game, AND some Brewer's themselves. None of them were familiar to me though (in other words, they were not the hot shots). We had a fantastic waitress who served me what might be the greatest drink ever... a dreamsicle. So delish, and they were on special... so I had several! Probably the most awesome part of Swanky's is their "No Brett Favre" rule. They took down all things Brett Favre related from their wall and no Brett Favre jerseys are allowed. HA! There was actually a guy there who was wearing a Favre jersey, and they made him turn it inside out in order to enter. What do you think? Best rule ever? I think so too!

We won! Go Brewers!

Finally, on Sunday, I did nothing (with the exception of driving to T-Bell for some greasy awesomeness), and it was wonderful! The Brew-Crew did have one more afternoon game, but we are too poor to do 3 in a row I guess.

The "don't walk" sign we saw on the way to/from the game

(I know... inappropriate... but also kinda funny)

Anyone else do something fun this weekend?

Pet Peeves

Earlier this week, I discovered that I have 3 huge pet peeves when it comes to clinic. I have experienced each of these many times before, and they weren't that frustrating. But this time... they were back to back to back. Patient #1: The literal clicker This is the patient who when you say "click the button every time you hear the beeps" ACTUALLY does one click for every beep heard. Normally, I present about 3 beeps in a series, and the patient clicks the button one time demonstrating that he/she heard it at that level. This patient hears the 3 beep series and click 3 times very fast. Beep, beep beep --> "click, click, click" Beep, beep beep --> "click, click, click" Beep, beep, beep --> "click, click, click" Patient #2: The uncontrollable clicker This is the patient who can not stop clicking the button, even when no stimulus was presented. Many patients have a hard time with this since they often mistake their tinnitus (ringing in their ears) for the tones or beeps I present. Therefore they think I'm presenting a tone so they respond, even though I never played the beeps. Usually a simple reminder to only click the button when they're sure they heard the beeps and not the ringing in their ears is enough to get the clicking under control. Well, not this time. I reminded this patient 4 times.... 4 TIMES... to try and control her clicking. No change. It may have been one of the longest puretone checks I have ever done. It went something like this: Beep, beep beep --> Click.............................. click..................,,,....... click................................................

....................... click ................................click ..................................................ckick ................click Beep, beep, beep --> click .........................click ..................click ...................................................click Get the idea? How am I supposed to know what is a true response and what was a click that coincidentally came just after I presented the beeps? Patient #3: The let me tell you how to do your job patient Really? You went to school for 8 years to study ears/hearing aids/etc too? No, I didn't think so. You gotta love the patients that come in complaining that their hearing aids aren't working or their earmolds don't fit right and tell you exactly what they think you should do about it. Individually, these patients are not that bad. But having each of these scenarios 3 patients in a row makes a girl want to scream! Thankfully, I got through them all and had the patient leaving happy and satisfied. What are your work pet peeves?

Grand Rounds

Every month, the Audiology Dept. at my hospital holds grand rounds. Grand rounds is every 1st Thursday of the month during the lunch hour (lunch is provided!). All the audiologists, neurotologists (our ENT doctors are neurotologists), and residents are invited to attend, while the 4th year Audiology externs (K-Mo and myself) present interesting cases to them. Basically, the presentation consists of choosing an interesting case study (typically a patient presenting with an uncommon disease or disorder), and supplementing it with research articles or books sharing information about the disease/disorder and supporting the care or treatment given to the patient. For my first one, I choose to present on Otosclerosis! Otosclerosis is a common form of hearing loss in adults. It is essentially a bony growth in the otic capsule (the bone surrounding the inner ear) and results in the fixation of the stapedial footplate (part of the 3rd tiny bone, aka "stirrup", of the middle ear) in the oval window (the opening leading from the middle ear to the inner ear). This prevents the ossicles (3 middle ear bones) from vibrating, and transporting sound from the middle ear to the inner ear resulting in a conductive hearing loss (a loss which may be correctable by surgery and is not related to the hair cells in the cochlea). In more serious cases, the bony growth can grow into the inner ear, ossifying the cochlea and resulting in sensorineural hearing loss. This type of hearing loss can not be corrected with surgery. Throughout the presentation, the audiologists and neurotologists chime in with lots of discussion and questions. I will admit it. I was scared. It is a very intimidating environment. But, all in all, a very good experience. K-Mo and I both present every month and we learned a lot from the process, the research and especially from the enticing discussion that took place. One down, eleven to go!

Last week

...was not the best. I was pretty much sick the whole week, so everything I did was a bit of a blur. But, I still managed to go in everyday and not get anybody else sick (knock on wood). Nothing too exciting happened this week, but here are the highlights.

1) I had my first "go" at the hearing screenings in the nursery all by myself. All my babies were very well behaved and sleepy - just the way we like them. We (myself and the volunteers) tested 7 babies and 4 of them passed their screening. The other 3 were referred on one ear and will need to be screened once more before being discharged from the hospital. We have a high volume of non-English speakers at this hospital, so I was thrilled about not having to make an attempt at using the language translator phones.

2) It was the last week for the exiting 4th year student. She has been terrific! She trained me in the nursery, gave me the low down on team clinic or "compass clinic" and on what's to be expected of us at grand rounds. She has introduced me to a lot of wonderful people, and the list goes on and on. We will miss you!!!

3) Boyfriend took me on another surprise trip! This time we went to the Rocky Mountain Nation Wildlife Refuge. It is not too far from our place, near the airport. Basically, it's a 2 hour tour around the refuge on a bus looking for wildlife. Not the most exciting trip, but not a bad way to spend a Saturday morning either. The 2 hour tour is free and we got to see a bunch of wildlife! Including, but not limited to: deer, bison, hawks, water fowl, a cute raccoon family (I know, I hate raccoons too, but they they were honestly kinda cute) and hundreds and hundreds of the most adorable prairie dogs! It was humorous to watch all the people on the bus get unbelievably excited to see birds and bunnies and raccoons. Don't they ever look outside their windows at home? A pleasant, relaxing trip overall.

One of the coons from the raccoon family! See kinda cute... for a coon.

My favorite picture of the prairie dogs. They're kissing!! Just before I took the picture they were hugging too. So adorable.