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.

Audiology Extern Week 2

I. Am. Pooped.

Week 2 of clinic was a busy one. The week consisted of regular clinic on Monday, Tuesday and Wednesday, training in the nursery for hearing screenings, SIGN CLASS on Wednesday for 2 hours after clinic, and a Symposium all day Thursday, Friday and Saturday.

I was finally trained in the nursery! I am responsible for doing the hearing screenings on the newborns one morning every week. They are so tiny I feel like I'm going to break their necks turning their heads to get to their ears! We test all the babies born the day before. I love it so far. It's a nice way to start the day. The testing itself is pretty simple. We hook up the babies and the computers do the rest of the work. I just hope I don't mess up the paper work. My favorite part of the week was Sign class! I was told about this class the week before and I mentioned to the Audiology director that I was interested in taking it. She hooked me up! K-Mo and I will now be attending Sign class every Wednesday from 4:30-6:30 for FREE! I love it. This is only a beginner class and I've already taken 2 beginner classes in the past, so the material is mostly a review for now. When this class ends, there will be another class offered at the intermediate level, and another one after that at the intermediate 2 level. As the current extern, I am able to take all 3 classes at no charge! I can't wait to improve my signing skills! Since the class is comped for me, I am in charge of helping out a little during class. There is a boy in the class who wears a cochlear implant and Engligh is his second language, so K-Mo and I take turns typing everything that is said during class as he follows along to help him understand. The rest of the week was the Marion Downs Hearing Symposium. The Symposium mostly consisted of topics related to pediatric audiology. I was excited to meet Marion Downs herself, as well as many other well respected individuals in the Audiology world. It was also especially fun to meet the man who is the voice of the recorded NU-6 and BKB-SIN speech tests! Once I found out he was the voice of the recordings, I was immediately reminded of Joey from "Friends" when he thought it would be a cool job to be the voice on the answering machine (Anyone recall this episode?... "You have 2 new messages...").

Week 1 in the Real World

was awesome!!! I have been at clinic for over 1 full week now. Monday morning started off with a short orientation, some paperwork, meeting a ton of people whos names will take me forever to learn, and a few observations. The rest of the week I continued to meet more of the staff, did more observations mixed in with some hands-on clinic, received my badge, got a mini tour of the buildings on campus I should be familiar with, and learned more about the requirements and opportunities I have here at the Marion Downs Hearing Center. The Highlights: 1) Finally meeting the Director of the Audiology Department - she is every bit as wonderful as I expected her to be. 2) Getting to know K-Mo a little better - we have so much in common and are becomming fast friends. 3) Meeting and getting to know the 4th year extern who's about to leave us and some of the 3rd year students - since they've been around UCH longer than K-Mo and me, they've been very helpful showing us the ropes. 4) Getting my badge - this allows me special access to the 4th and 5th floors of the hospital where the nursery and NICU areas are for screening the newborns! 5) Training in the nursery - the testing is easy, but there is a ton of paperwork to keep straight. 6) Experimenting with an E-Scope - an electrical stethoscope that a special patient brought in. This patient is a doctor diagnosed with stage four lung cancer and is kicking it's butt so far! Unfortunately, the chemo has taken a toll on his hearing and he needs an amplified stethoscope to hear his patient's heartbeat. It came with headphones, which work great, but it is also compatible with his bluetooth capable hearing aids! We need to order a special cable to make it work with the bluetooth, and then he should be all set! It was fun experimenting with the new technology! I ended my first week scooting out a little early on Friday for a trip back to Ohio for a wedding! More to come on the wedding weekend festivities soon.

A New Era

My last FREE weekday has officially come and gone. To make sure I made the most of it, Boyfriend and Baby C took me out for a surprise day trip to the Denver Aquarium! Around noon, we headed out and took the light rail into downtown Denver and walked to the Aquarium from there. It was a long walk, but alas, we made it. It took about an hour to get through, and we had a late lunch at the Aquarium Restaurant afterwards. before heading back. My overall take on the Aquarium is 1) It was a TERRIFIC way to spend my last free day. 2) Their food was delicious and in a sweet looking room with a huge fish tank with sharks along one wall. 3) Not as spectacular as the aquarium in Chicago or Dallas, but still very enjoyable!

The following Monday, July 12 marked my first day as an Audiology Extern at the Marion Down's Hearing Center at the University of Colorado Hospital!!! A new era has begun - I am now a working woman! Eight years out of highschool, I could not be more excited to be out of the classroom and into the workforce. The only thing that would make it better is if the work actually included a paycheck.

In a nutshell, for those of you who have no idea what an Audiologist is, it is a professional who specializes in diagnosing and treating hearing and balance disorders. At the hospital where I am carrying out my externship, I will be exposed to pediatrics through geriatrics, diagnostics, hearing aids (and numerous manufacturers), cochlear implants, vestibular (balance) testing including VNG, rotary chair and posturography, electrophysiology, newborn hearing screenings, etc. I will also be responsible for presenting at Grand Rounds every first Thursday of the month and coordinating Team Clinic every second Friday of the month (I will explain these better in a future post). Yikes! I feel very overwhelmed, but also extremely excited and lucky to be here.

My first day was pretty much what you would expect: orientation, paperwork, meeting the staff, and observing. I met most of the Audiologists already (there are 13!). They have been great so far and they maintain a very friendly and comforting atmosphere in the department. The best person I've met so far is my fellow Audiology Extern, K-Mo!!! We actually met the night before our first day so we would show up Monday morning at least [sort-of] knowing one person. She is awesome, we get along great, and we actually have a lot in common!

Day 1 is officially done and I am happy to say I am not afraid to go back tomorrow!