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10 Totally Untrue Facts about Hearing



1 Ears are made of rubber.

2 Fish can hear in colour

3 Your ears continue to grow long after you die

4 Due to a virus, an entire colony of Fruit Bats in the outer Brisbane suburb of Indooroopilly was fitted with hearing aids. Furthermore, once a year, each bat has to be caught to have the batteries replaced.

5 Porcupines hear through their quills.

6 Walking around with your hands over your ears for 15 minutes every day prevents loss of hearing in later life.

7 Cats are born deaf.

8 In many societies, husbands communicate by listening.

9 Ear Wax (Cerumen) has the same street value as Heroin.

10 Before the invention of RADAR, rats were trained to listen out for incoming enemy aircraft.

O.K., one of the above is actually true….but which one?

Total Ear Hygiene is a new service offering the consumer safe and effective ear wax removal.

Clinics

There are currently three practices:

·      Ashgrove Specialist Medical Centre Suite 5a/21 Harry Street Ashgrove 4060.

·      Thursday and Friday.

·      299 Boundary West End 4101 & Alexandra Level 1 201 Wickham Terrace Spring Hill 4000.

·      All other days (including weekends).

·      The telephone number is 0402 650 500

I am also available to conduct home visits, both to private dwellings as well as nursing homes and other institutions.

Scope of Practice

The business is a specialist service, devoted to the health of the ear. It is not meant to replace the G.P., ENT specialist or Audiologist out with this scope of practice..

The practitioner is specifically trained to:

·      Assess the health of the ear canal.

·      Promote and educate the patient in best practice for the health of their ear.

·      Safely and effectively remove ear wax (Cerumen).

·      Prepare the ear for intervention and fitting of hearing aids by an Audiologist.

·      Report to Doctor or Audiologist

·      No doctor's referral required.

A bonus that I see for this practice is that it relieves the G.P. and ENT specialist of having to clean the ear canal (external auditory meatus), a practice which can detract from their other work.

Unlike a G.P. or practice nurse who would only do this type of work intermittently, this service offers a stand-alone professional intervention by a practitioner who has made it their specialist career. 

I understand that many G.P.s are now refusing to this type of intervention due to the time and risk of injury to the patient.

Offering a cheaper but specialist service to the patient without the additional cost an ENT specialist would incur, it also reduces the risk of a negative outcome to the patient as any procedure is carried out by a dedicated specialist.

The client does not require a referral from a doctor or other specialist and can simply call, either themselves or through a caregiver.

As some alternative therapies are available for rebate, I am hoping that this procedure, which is a clinical intervention, could gain the same credibility.

Pricing

The current cost for treatment, which involves examination and any wax removal is $75.
The procedure takes approximately 30 minutes.


Procedure

The treatment involves an initial Metabolic Study to determine a baseline physiological presentation. This involves taking base-line vital signs (Temperature, Pulse, Respiration and Blood pressure). Clients can present with a possible Otitis Externa or Otitis Media without realising. They can be referred to their G.P. for appropriate treatment before any procedure would take place by the Ear Hygienist.

The next step is an examination of both of the patient's ears.

This begins with an overall visual impression of the external ear (also known as the pinna or auricle).

Next, an examination of the ear canal is carried out.

Detailed, high definition photographs are taken via a Digital Otoscope. This records a permanent record of the ear canal at the time of the examination.

It is also used to compare the canal before and after any treatment.

Clients are offered the opportunity to have the photographs emailed to them, free of charge.

Method of Cleaning

I currently prefer using two techniques in my practice.

The first is the use of hand held instruments, wax curettes, also called Jobson Horne probes.

These are of different sizes and are used to manually remove ear wax from the ear canal.

The second is a Low Pressure Irrigation System.

This delivers water, at low pressure, through an applicator which is aimed towards the wall of the ear canal in order to gently remove wax which is too close to the Tympanic Membrane to remove manually.

Contrary to other practitioners, I do not use a Low Pressure Suction Method as a first line of treatment.
I have found the technique convenient but not as gentle as the irrigation method.
I have a machine available should I feel it to be clinically indicated.
Clinical indications can be; perforation of the tympanic membrane, a history of 'wall down' surgery or client preference and previous experience.

Clients who have impacted ear wax and/or where the tympanic membrane cannot be observed are offered softening agents to take home and use for a few days prior to having wax removed. They charged for one consultation and treatment only.

Education

As part of the service, clients are taught the most effective methods for looking after their own health in respect to their ear hygiene.

The object of Total Ear Hygiene is not to create a dependent clientele but to offer people the ability to make informed decisions regarding their hearing.

This is in a relatively simple format and can be verbal, as well as, handouts or information pointing to valid resources found on the internet.

The maxim, ‘Do no Harm’ is a major philosophy with Total Ear Hygiene.

My intention is to:

·      Relieve Suffering and Distress

·      Aid in the Return of Function

·      Promote Health and Hearing

·      Offer Support

·      Educate

·      Empower and Enlighten

·      Referral to an Appropriate Service Provider.

Documentation and Reporting

A suite of documents are completed for the clinical pathway the client will navigate.

·      Client Information (with Consent form)

·      Case History

·      Assessment

·      Treatment

·      Report to Referral Source   

With the client’s permission, a report detailing assessment, treatment and outcome can be sent to any preferred health care provider or specialist. This can include G.P., Audiologist, ENT Specialist or Key Stakeholder.

The mechanism of balance

Your ears are not just for hearing. They also contain a natural apparatus that tells you how your body is placed in space and what is happening to it.

Your vestibular system has two main components: the semi-circular canals, which detect rotation; and the otolith organs, which detect linear acceleration.

Each ear has three semi-circular canals, like little curved spirit levels (but with no bubble). Each canal is aligned to a primary axis of motion; pitch (up and down), roll (rotation)  and yaw (left and right). When your head moves, the fluid in the canals presses against tiny hairs, which transmit the sensation of movement to your brain. Most of the time you don't notice this.

The otolith organs are, essentially, tiny rectangular bones, one set oriented vertically, and one horizontally. As in the semicircular canals, tiny hairs detect inertia and send signals to the brain. Think of the otoliths as a bar of soap resting on a brush.

Your vestibular system helps your body balance, regulate its posture, and see clearly when moving. But it, and the proprioceptive signals that come from the skin and muscles, (the 'seat of the pants') are mechanisms designed for earthbound life, but can be easily fooled, especially in situations of flying.

 A modern passenger plane can have you all over the sky avoiding bad weather, and you’d never know. All you experience is some occasional turbulence and a safe flight to your destination. 

Referenced and adapted from the CASA Flight Safety On-line Magazine March 2014.

A quick Google search shows that there are thousands of articles on ear wax removal. With so much choice, making the right decision about the best way to have your ears cleaned can seem rather overwhelming.

The hard truth is:
You often don’t know if you’ve found a great method or person to remove your wax until they deliver. 

But never fear, here are some signs that will help you tell if you’re about to making the right decision about how your ear wax is going to be removed: 

1. They listen

Some ear wax removal professionals are so keen to tell you about their awesome skills or past clients that they forget to actually listen. You should feel comfortable talking to your ear wax removal practitioner and feel able to discuss your symptoms and history freely and in total confidence. 

2. They ask a lot of questions

A good ear wax removal specialist is curious and will ask you lots of questions, either on the phone or in the initial consultation. Expect to be become 'deep and meaningful' about your ears and your hearing. They will probably ask you lots of other things you’ve probably never thought about. 

3. They have experience

Good Ear Hygienists didn't come down in the last shower or pop up from a hole in the ground. Try to choose a ear wax removal hygienist with a track record, training and experience in the many different methods of ear wax removal.

4. They have a website

An Ear Hygienist's website says pretty much everything about how they approach their work.

• Is it professional?
• Do you like the tone?
• Do you find it answers your questions.

5. They Inspire confidence

 It’s important that you get a good ‘vibe’.  A trusting relationship with any professional is essential.

6.  They’re affordable but not cheap

Going for the lowest price isn’t necessarily the way to guarantee the best outcome for your health.

7. They are knowledgeable

They regularly complete training courses in their discipline and are actively willing to update their knowledge. Professional Development, for them, is not a chore. It's a guarantee of their ongoing skill and your safety, continuing good health and well being. They have a dynamic and contemporary knowledge of both ear health, as well as, the holistic needs of their clients. 

In the search for the best method of cleaning ears, I have combed the vast halls of libraries, surfed the many oceans of the internet and interviewed hundreds of individuals; friends, acquaintances and complete strangers.

The methods employed by our fellow man (and women) to remove the dreaded earwax (Cerumen, by it's proper name) can be clever, ingenious but ultimately a career move to loss of hearing, possibly irreversible.

The classic method, the Q-tip or cotton bud suggests a 'no-harm' technique.

Nothing could be further from the truth.

Everyone's ear canal is different in both length and diameter. Sticking a cotton bud into this canal will probably push the wax up against the ear drum making removal more difficult and you with increased loss of hearing. The more unlucky of us will have it penetrate the eardrum causing all sorts of unexpected surprises; pain, bleeding and loss of hearing. Time to pack away the stereo, won't be ending that for a while.

Other specialist tools are the common house or car key, just great for getting to those, difficult-to-reach places. Those with servants and/or a chauffeur have the added advantage of not having such fiendish devices at hand. If your driver or housemaid is suddenly hard-of-hearing, suspect the worst.

 My personal favourite is the top off of a particular French made ball point pen. This acts as a convenient scoop and makes penetration into the middle ear simple and easy to do. Vive Le France!

Yet more tools are purpose build ear wax excavation implements. These are used by differing cultures who find pen tops and car keys, passé. They have similarities to the tools used by professionals except they're being used by total amateurs. Long spiked things purpose built to cause pain and deafness in the wrong  hands.

The professional has the advantage of, well... being professional. 

They have several things to their advantage.

Your G.P., ENT Specialist or Ear Hygienist (this is where I come in), is on the outside looking in.

They are using specialist lighting, magnifying equipment and other high tech tools to see your ear canal and your other bits and pieces in glorious high definition 3D.

Many years of experience also tells them when to play and when to hold (in 'Hold 'em Poker' parlance).

Compacted ear wax can be down right painful. You can not only feel a loss of hearing, but as if half of you is somehow missing. Vertigo can also be a problem, try chairing that 'really important meeting' when you feel like you're looping-the-loop in a stunt plane.

You wouldn't reach into the toolbox for a pair of pliers if you had a toothache, neither would you plug yourself into the nearest wall socket if you felt a heart attack coming on. 

I probably shouldn't be giving you this advice, after all, your do-it-yourself enthusiasm could be keeping my colleges and me in a job.

Seriously, leave it to people who only use their keys to start their car.