Colorado Academy of Audiology

Last weekend was the Colorado Academy of Audiology (CAA) Convention.  It was located in Breckenridge, CO.  I must say, that was one of the most gorgeous drives I have ever been on.  It started on Thursday and went through Saturday afternoon.  I had a great time.  I took a really great class that was 6 hours long on cerumen management (essentially an ear wax removal course).  The last 2 hours of it were hands on practice with all the different instrument options for removing wax. 



This dress in NOT as short as it looks - it's actually very appropriate... usually. 
And you should be looking at the fancy head gear anyways. 





Inserting the speculum (and as you can see the dress length looks better now)

 

The serious microscope - this is what our ENT uses to do wax removal

Cerumen management is a part of my scope of practice for audiology (at least in most states it is).  However, in my audiology program, we do not have a single class providing training on how to properly remove wax from the ear.  Yet, once I graduate, I am free to perform wax removal on my patients and say that I am a professional and licensed to do this procedure.  Is it just me or does that sound ridiculous to anyone else too?  Aside from being familiar with the anatomy of the ear and outer ear pathologies, what makes me any more capable of removing wax that the "average Joe" on the street without training?  Therefore, it was very important to me that I got into this class.  They only allowed 30 participants, but luckily I was one of them. 

There was only one down side to the class.  During the hands on section, we got to practice removing wax from the other people in the class.  We practiced on each other, but nobody in my group had enough wax in their ears to bother removing.  Needless to say, it is hard to practice removing wax from the ear when there is no wax in the ear to begin with.  But, because I took the class, my supervisors will allow me to start doing some wax removal in clinic, with their supervision of course.  So I will still get the proper hands on training I feel I should have before graduating! 

Surprisingly, this wax removal course was my highlight of the convention for me.  Since the course took most of the day, there were only a couple of lectures I got to see after it was done and the next morning I attended an interesting lecture by Chuck Berlin.  Thursday and Friday nights were both eventful.  They provided a couple of free drinks each night for some socializing.  On Friday night a bunch of us went out to downtown Breckenridge for a late night.  It was a great time!  It is a very cute city too, and of course the scenery was beautiful. 

Out in downtown Breckenridge with one of my favorites!



Sweet view from the ski resort the convention was held at



The colors are starting to change!

My Family Rocks!

My family rocks! 

My excitement has been building all week long for this past weekend to arrive.  Boyfriend has been hinting to me all week that something wonderful was going to happen.  I was given strict instructions to call him when I got to my car to come home after clinic on Friday.  From there I would be given further instructions.  I was instructed to go to Kohl's for 10-15 minutes to "look around for awhile and see if there's anything I like." From there, I was told to go to the grocery store for a 12-pack, some 7-up, and to pick up a little something for myself (I would be lying if I said the thought of us "celebrating" something that night never crossed my mind).  From there, I was told to call on my way home and Boyfriend met me outside to help bring the groceries in. 

When I walked inside, I immediately emptied my hands so I could throw my arms around MY DAD!!!!!  I walked in to find him hanging out in my kitchen!  Several hugs and kisses later, I finally made my way to the livingroom.  I could not believe my eyes when I saw GRANDPA sitting around the corner by the patio door!!!!  BEST SURPRISE EVER!!!! 



My reaction to seeing DAD!!!!!



G-pa came too!!!!!

Dad and G-pa have both had surgeries recently, so apparently they decided to come out here to visit before Dad had to go back to work!  Friday night we kept low key and just went out for a nice dinner.  On Saturday we went out to breakfast at a place called Rosie's that Dad really liked the first time he was here.  Then we went to the Coors Brewery.  We were able to take a modified tour that is shorter and uses the elevators so my visitors wouldn't over-due it on their legs. 

Coors Brewery

   

Harvest Moon



From there we did a little sight seeing and Boyfriend and I took them to see the beautiful view we had from the trail head of our most recent hike.   

 

Happiness!

 

Downtown Golden (and Down Denver in the distant background)

On Sunday we went to Garden of the Gods.  There was a part of the park we didn't go to the first time Dad was here and it didn't involve too much walking around so G-pa could handle it. 



Balanced Rock



G-pa!

We went to the US Air Force Academy on the way home.  We all know how much G-pa loves planes.  We caught one last dinner together and then I went back to the hotel with them to squeeze in a little more Dad and G-pa time before they had to go home in the morning. 

It was a FANTASTIC surprise!!!!!  LOVE YOU DAD and G-PA!!!  Please come again! 

Externship Update

I am loving my externship!  I the hospital, I love the Audiologists, I love the work atmosphere, I love the many awesome friends I've made through working ("working") here, and I love this city!!!!!!

The first month and a half of my externship was spent doing hearing evaluations and working with hearing aids for the most part.  The great thing about learning at this clinic is that we see a large variety of patients.  About one half day each week I found myself working with developmentally delayed patients who can be very difficult to test.  We also see a lot of interesting ear disorders that you wouldn't typically see at a smaller clinic as well as asymmetrical hearing losses.  Although I will have rotations in the different specialty areas of audiology throughout the year, I will continue to do hearing tests and hearing aid clinic part time the entire time I'm here in order to keep my foot in the door of some of the basics in audiology. 

About a month ago, I started my first rotation.... the vestibular (balance) rotation!  I was so excited to start this rotation because vestibular is the area of audiology that I think I want to do more with when I graduate.  I was also nervous though because I have not had much experience with vestibular testing before coming here.  Another bonus to this externship placement, is that they know that vestibular is an interest of mine, so they put me in it first and mentioned they will probably keep me doing at least one half day of vestibular testing each week for the rest of my time here so I don't "lose" anything I'm l learn during the rotation.  The last month or two of my externship I may be placed in it again to get me the most of what I want to do in audiology right before leaving.  The best news so far..... I am getting some very positive feedback on my performance so far in this rotation!!!!!  In the first week I was told I exceeded their expectations.  Now they are getting picky with the things they want me to work on and are merely "fine tuning" my testing and interpretation skills for VEMPs (Vestibular Evoked Myogenic Potentials) and VNGs (Videonystagmography).  I have only done the rotary chair test once and posturography once, so those skills still have a ways to go.  I also work in the BPPV (Benign Paroxysmal Positional Vertigo) clinic every Tuesday morning with one of the neurotologists.  I love this clinic.  If we suspect a patient has BPPV we schedule them for BPPV clinic instead of doing the full VNG evaluation.  If they are positive for BPPV then the neurotologist (with my assistance) does the modified Epley maneuver to get rid of the dizziness right away.  It is so much fun to "cure" the dizziness because this is the only type of dizziness we can cure! 

This past weekend I also helped out at the Hearing Health Fair put on by Cochlear.  I helped with the hearing screenings for a few hours, and then joined the UCH booth for a few more hours before going home.  Not the best way to spend my Saturday, but... I guess I'm already volunteering 5 days a week, why not throw in the occasional Saturday too! 

My most interesting/memorable patients so far: 
*A developmentally delayed patient who very much looks and acts like a developmentally delayed version of a guy I know in Wisconsin.  I haven't told this person I met the DD version of himself... he may not like it. 
*A patient without a middle or inner ear!  No eardrum or anything.  It looked like a long curvy tube that never ended. 
*A patient with the outer ear closed off.  Imagine the ear canal pinched off about half way in, before reaching the eardrum. 
*Fitting a "VIP" couple with a set of hearing aids each. 
*Trying to sell a set of hearing aids to a 14 year old girl who has never worn them before.  Once she saw them, she instantly decided she could hear "fine" and doesn't need any help.  Time to bring out the big guns because this girl's education would have suffered had she not gotten hearing aids. 

I'm sure there are some more interesting high points and interesting patients, but I can't think of any more right now. 

Coming up at the end of the month is the Colorado Academy of Audiology in Breckenridge!  Can't wait! 

Our Second Adventure

Boyfriend and I went on our second hike last weekend. My goal is to go on one hike every weekend. We'll see how long it lasts, but so far we're 2 for 2.

Mesa Trail

Boyfriend and I took off on Monday (Labor Day) morning for Eldorado Springs for our second hike. We stopped by the trail head to find out which trail(s) to follow. This area has a ton of trails that meet up with each other, so you can choose how many miles you want to hike and then find a combination of trails that will make it work for you. The main trail we followed was called the Mesa Trail, but we actually followed Homestead Trail up the foothill (What I consider to be a mountain the locals here call foothills. Apparently the mountains are the really, really big ones behind the foothills), met up with Mesa Trail and followed Mesa Trail back down.

The trail head warned us that we were in rattlesnake country. Prairie rattlesnakes to be specific. They apparently habitat in abandoned prairie dog holes. If we get bit, don't panic and seek medical attention immediately and "do not attempt to suck out the venom via another person's mouth!" I want to know who thought that would be a good idea!

In addition to rattlesnakes, there are also black bears and mountain lions in the area. A list of what to do should you come across one of these animals followed. It had crossed my mind that this may not be the smartest or safest place to hike, but the large number of people that seemed to be hiking in the area convinced me that the black bear and mountain lion sightings must be somewhat rare. Otherwise, I don't think the trails would have been so popular. So, on we went.

A view from the beginning of the trail leading into the foothill

Officially in the foothills, the trail continues upward

A view of "Devil's Thumb"

One of the many views along the way

View of the city from the peak of our trail. Other trails continue much higher up the foothill, but we're new at this, so we decided not to get too carried away just yet.

The trails we followed totaled a distance of about 3 miles. I give Boyfriend a props for putting up with my constant stopping along the way to take pictures. He was very patient. Finally, we made it back to the car. We looked back at what we had just hiked only to be surprised by....

Smoke! A wildfire had started off in the distance!

We were completely shocked to see a big cloud of smoke (I suppose most people would be). Our first thought was, "It's not supposed to storm today! Then we realized what was going on. I think we were in awe for a few minutes because neither of us had never seen a wildfire before, at least not in person and we never really expected to see one. Also, we had a view of the edge of that foothill for a good portion of the hike and the sky was bright blue with not even one cloud in the sky the whole time we were hiking. In fact, here is a picture of the same view maybe 20 minutes earlier...

Notice the clear blue sky - minutes later it would be filled with a huge cloud of smoke

It was another great day for hiking and another great trail! More to come later on the wildfire.

I leave you with one question that Boyfriend and I have been debating on since starting the trail. Would you rather come across a black bear or a mountain lion while hiking and why?

I would much rather come across a black bear, because they are not naturally aggressive unless provoked, startled, or if you are between a cub and it's mother. Otherwise, it they hear you coming they usually leave the area to avoid humans. Boyfriend, however, is on the side of the mountain lion claiming they'd be easier to fight against since they weigh so much less than a bear.

Happy Trails

One of the adventures I have been looking forward to most since moving to Colorado is hiking on the numerous trails Colorado has to offer. Finally, 2 weekends ago, Boyfriend and I got off our butts and took off early in the morning for our first hike!

Horsethief Falls

Our first trip was to Divide, CO. Divide is a small town about half an hour west of Colorado Springs. It took about 2 hours to drive there (which was completely my bad, it did not look like a 2 hour drive when I was looking at the tiny map on my computer), but at least the scenery was nice to look at. From the time we left the house to the time we arrived, the temperature had dropped approximately 20 degrees. We had gone up in elevation during the drive, but neither of us had realized just how much higher we actually were. We finally found the trail head which is a sign indicating the beginning of the trail and it provided information including a trail map, animals/plants we might see along the way, precautions, and rules/regulations of the trail.

The worth-the-drive view directly across the street from the start of the trail.

Wow. There are no words for how ridiculously worn out I felt only a couple minutes into the trail! The thin air in higher altitudes is no joke! I was huffing and puffing and feeling ridiculous for being so tired so early in the hike. At the same time, though, it felt great! I was out there, in the fresh air, in nature, taking advantage of all Colorado has to offer me and it was so beautiful! I think I've discovered one of my new favorite hobbies!

A couple minutes into the hike, lovin' nature

So, the trail started off pretty tough. It was labeled as a "moderate" hike. Luckily for us out of shape, not used to the thin air, new to hiking "adventurists", it was only a steep incline for about half the hike and then leveled off making the remainder of the hike nice and relaxing stroll through the woods. There were a couple of spots throughout the trail that gave some nice open views.

The first opening in the woods with a random pond

The second opening in the woods - beautiful!

The majority of the trail was alongside a tiny stream and it ended at a cute little waterfall! When I say waterfall, I literally mean and small amount of water, dropping only a couple of yards. But it still worth it to see. We were told by a coulple we ran into that where we were standing for these pictures taken below was approximately 10,000 feet above sea-level. We (I) putzed around for a while taking pictures before turning around and heading back to the car.

The very small white-ish "drip" in the middle of this shop is the waterfall

Close up of the waterfall with the sun peaking through the trees

It's been too long

I have been a very busy girl these days, so I have a lot of catching up to do. First order of business is to answer the question I asked last week. There may only be 2 of you awaiting an answer, but gal darn it you're going to get one!

Truth be told, there are a couple of acceptable ways to clean your ears. Many people have no need to do more than wipe off the outer portion of their ears with a towel or cloth. Wax naturally works its way out of the ear. Some wax is actually a good thing, as it helps protect your ears from bacteria and foreign particles. Many others, though, find it necessary to do more.

One way to clean out your ears is to use a baking soda and water solution. Mix about 1/2 teaspoon of baking soda with 2 ounces of warm water. For convenience, put the solution in a dropper bottle and put several drops into your ear. This will help soften the wax if it is hard in order to help it work it's way out of the ear better.

Another way is to drop hydrogen peroxide in your ears. Only drip a few drops at a time. It will tickle and bubble for a little while, and then tip your head to get the peroxide back out of your ear.

You can also purchase over the counter ear drops used to soften the ear wax to help it move out of the ear canal naturally.

*Warning: Do not use these methods if you suspect you may have a hole in your eardrum. If the drops get behind the eardrum, you would be at risk for infection.

Another option is to see you local ENT or physician for wax removal.

Do NOT use Q-tips people. I know, it is a ridiculously hard habit to crack, but it actually makes the wax situation worse. By using Q-tips, some wax is removed. The wax that touches the Q-tip comes out, but the rest of the wax is actually pushed deeper into the ear canal. This impacts the wax making it more difficult for the wax to work its way out on its own. If you "must" use Q-tips, only use it on the very outer portion of the ear canal to remove what has already working it's way out of the ear. Otherwise, try to steer clear and "don't put anything smaller than your elbow in your ear."

Also, to answer navyguy/navygirl's question: Will wearing ear protection all day do any damage to your ears?

Well, I am going to say, no. Of course I'm sure there are a few random people out there who would love to prove me wrong. At the worst, ear protection worn on a daily basis might stretch your ear out a little. Not a noticeable difference though. It would be no different than wearing hearing aids with a custom earmold for years and years. Occasionally, a new impression may need to be taken to be sure the molds or plugs are fitting well in the ear and are creating a good seal (due to the slight stretching of the ear). Also, you might notice ear wax builds up faster because there is something in your ear blocking the wax from working it's way out. Other than that, there is nothing to worry about. The benefits of custom ear protection is that it will always be inserted correctly in your ear, and therefore will always attenuate sound to the degree that it claims it will (the foam ear plugs actually attenuate sound better when inserted correctly, but when inserted incorrectly do a poorer job of attenuating sound).

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?