Episode 2 The Beginning of Hearing Health

The Transcript

Dale Johnson:   The Conversation Starts Here. It does every Saturday morning at this time on KFOR FM 103.3 1240 AM with Dr. Sandra Miller of Complete Hearing, because we care about your hearing. I’m in the radio business, Dr. Miller. After all, I got to have people listen to me.

Dr. Miller:           That’s right.

Dale Johnson:   I need people with good hearing health. That’s what we talk about every Saturday morning on The Conversation Starts Here. Complete Hearing, at 44200 Pioneer Woods Drive . You’ll find them on the just north and east of 70th and Pioneer.

Dale Johnson:   Dr. Miller, last week we learned about you, and the fact that you came here from North Dakota, been here a number of decades.

Dr. Miller:           Yes.

Dale Johnson:   What brought you into the field of hearing health? When your teacher asked you, you’re sitting in class, “Sandra, what do you want to be when you grow up?”

Dr. Miller:           “I want to be a airport administrator.”

Dale Johnson:   Never heard that answer.

Dr. Miller:           That ties nowhere to hearing health in any stretch of the imagination.

Dale Johnson:   No.

Dr. Miller:           Eventually, of course, like a lot of college students, I changed my major probably three times. Public relations was one of my majors. I think it’s because I love people, and I love to interact with people. But I took a class that just went into the health care side, Introduction To Communication Disorders. It was just really tied into speech pathology, and hearing, and assessing patients. I thought, “That is definitely for me.”

Dr. Miller:           Just like every other person who has maybe a mentor, you end up having that one professor who strikes a chord with you. Dr. Kevin Fire, I know you’re not listening, because he still lives in Grand Forks, North Dakota, but he said to me, “Sandra, I don’t know if you can be an audiologist. You talk too fast.” For me, I get really excited, and I do start to talk super fast. For me, my husband tells me, “So you have to talk slow and loud every day, right?” And I said, “Yeah, pretty much.” But I don’t mind, because I just really enjoy and love what we do. But he really struck a chord in me.

Dr. Miller:           I love the diagnostic part of audiology, and trying to figure out what the problem is. Every patient is so different, and then being able to find a really great solution. I can tell you, for being an audiologist for 25 years, the relationships you establish with your patients is long term, just like any other medical provider. I really am connected to a lot of my patients. Sometimes they say, “Sandra, we’ve known each other for 10, 12, 15 years,” and I think, “Am I really that old?” is kind of what think. But super grateful to have the longevity in the practice we have had, and just am grateful to go to work every day and have it be rewarding.

Dale Johnson:   I wanted to be an architect.

Dr. Miller:           Oh yes.

Dale Johnson:   I went to take a tour of the learning, it was a tech school back at the time. We walked through the accounting department. I went to sleep. I had no desire to be in accounting, but the second teaching area was the campus radio station. I’m looking at them, and they’re in jeans and t-shirts, and they’re playing rock and roll, Dr. Miller. I said, “I could do that.”

Dr. Miller:           I love that.

Dale Johnson:   “Where do I change my intention?”

Dr. Miller:           Where do I change my intentions? Isn’t it fun to find something you’re passionate about?

Dale Johnson:   Yeah, yeah. It really is.

Dr. Miller:           That’s one of my favorite things too.

Dale Johnson:   I’m a why person and you’re a why person.

Dr. Miller:           Mm-hmm (affirmative), yeah, absolutely.

Dale Johnson:   I like to know why something is happening to me, or why this happened, so that I can better understand it. That’s important to you, and it’s important to understand to help your patients.

Dr. Miller:           Absolutely. A lot of times I think my patients, when they come into the practice, there’s very much about, they don’t understand how their health is tied to their hearing. So a lot of times, they might say, “Really? I have high blood pressure, and that could be tied to this?” Or, “I’ve had heart disease,” or, “Diabetes really is tied to hearing loss?” There’s correlations to the health, I think, that people don’t understand, and understanding the why, or that it could come from childhood. It could come through adolescence. It can come through so many different avenues. Trying to pinpoint where exactly it came from is very important.

Dale Johnson:   You’ve mentioned smoking.

Dr. Miller:           Mm-hmm (affirmative).

Dale Johnson:   We’re still a smoking society.

Dr. Miller:           I have a hard time believing that.

Dale Johnson:   I do too.

Dr. Miller:           Yeah. And now that we have e-cigarettes …

Dale Johnson:   E-cigs.

Dr. Miller:           … or vaping, these things that are out there now that are so not good for any general part of your health. But when you think about how it’s tied to your auditory system, very much that smoking restricts the blood flow. What happens is when we restrict the blood flow to the inner ear, it’s just like your eye. Think about when you restrict the blood flow, that’s not good, because it makes those hair cells that are inside your inner ear, they don’t get the amount that they need. It can be damaging to the hearing long term.

Dale Johnson:   So if someone comes in, and they fill out their form, and there’s smoking, that could be a trigger. That could be a road that would lead you to better find out why a person is losing their hearing.

Dr. Miller:           Exactly, exactly. We see, when people have heart disease, there’s a certain pattern that will show up in their hearing tests that we go, “You know what? Have you had some heart disease in the past?” Is this an indicator that there might be something going on? So the audiogram that we do is not just specific to, “Do you have hearing loss?” but what other things do we see that could be happening within the system? It’s very diagnostic.

Dr. Miller:           When we talk about you, I think one question your listeners may have is, what’s the difference between me getting a hearing screening versus having a diagnostic evaluation? People don’t understand that.

Dr. Miller:           I want you to think about a screening being, “Oh, let’s see. Do you have 2020 vision or not?” Okay, it’s pass fail. When you come in for a screening, if somebody screens your hearing, they’ll play a sound for you, and do you hear it or not? That’s screening.

Dr. Miller:           When you have a diagnostic test, we figure out, is it outer ear, middle ear, inner ear. Is it central? Where does it come from? Then we need to decide is it something that needs to be treated medically. 10% of our patients need to have an antibiotic or surgery. There is a small population that actually benefits from going to a medical physician to have something looked at. But 90% of our patients actually, if they do have hearing loss, needs some type of that we can provide.

Dale Johnson:   Antibiotics. There are medications that can help me hear better?

Dr. Miller:           Mm-hmm (affirmative). Well, think about if your hearing loss is caused by a middle ear infection. That would be one situation [crosstalk 00:06:09] where an antibiotic would be helpful. What we sometimes find is that people have benign tumors that grow along their auditory nerve. We always send a referral out to one of our ear, nose and throat physicians to say, “Hey, we’re finding something you need to medically look at.” There’s things that can happen to the middle ear where the bones can get fixated, and that can be surgically treated. But I don’t think people realize it’s such a small portion. It’s maybe 10% of the people who come in with hearing loss actually can be referred out for a medical treatment in terms of surgery or medications.

Dale Johnson:   I want to circle back. You mentioned that you may find something that is creating the reason for their hearing loss, and you will refer them to a doctor or a surgeon in that particular field?

Dr. Miller:           Exactly.

Dale Johnson:   Go there. That that seems an odd relationship, to have someone in the hearing profession going to someone referring a patient to a surgeon.

Dr. Miller:           Yeah. What you want to think about audiology, definitely, is we are a medical provider. We joint work with other medical professions. There’s times when what we’re doing, we don’t have the solution and we need to definitely refer out, especially when it’s something medically that needs to be looked at.

Dr. Miller:           If it’s medically warranted that we need to refer on, we need to make sure that we’re making the appropriate referral. We work with all the ear, nose and throat physicians in Lincoln. So, okay, we’re going to refer you to Dr. Tesmer. We’re going to refer you over to ENT specialties. Depending on where the patient would like to go, we have relationships with those offices to say, “We are finding something medically that needs to be looked at to ensure this person either can be treated medically or they need to be medically cleared.” That means a medical physician is looking at this to say, “You know what? Medically, we’re not going to do anything. It’s appropriate to put hearing aids on them at this point in time.”

Dr. Miller:           But medically, it’s important that we partner with those physicians, that we are working together as a team. We never want to go outside of our scope of practice. That just means if we see something that needs to be referred out for, we do that.

Dr. Miller:           We also work with Dr. Thedinger in Omaha. He’s a neuro-otologist. So when we see things where we think it’s even beyond something that needs to be really medically looked at in terms of specifically to the ear, that’s maybe beyond what an ear, nose and throat physician would do, sometimes we refer them to the ENT, and the ENT may refer them to him.

Dr. Miller:           We have a nice referral basis going that is necessary. It’s so necessary when it comes to doing a diagnostic test, so you know exactly what’s going on. Because if you’re just having a hearing screening, or the test is not complete, we don’t know where the hearing loss comes from. Medically, if it’s something that needs to be addressed, we’d definitely have to make the referral.

Dale Johnson:   You see children also.

Dr. Miller:           We do. Children definitely. It’s back to school time now. I know we do screenings in school for sure. We always think, “Well they had their newborn screening when they were born. Do we need to ever do this again?” Absolutely. I know they are doing it in the school system every so often. I saw a patient this week. I think he was a freshman. They were talking about, “Oh, I think I have this every other year,” but they stop doing it once they get to high school. Our encouragement is, again, to always have it reassessed. LPS in Lincoln has a great system in terms of making sure we’re getting our kids screened, and that’s important.

Dr. Miller:           Our kid population at Complete here is a little bit smaller. We do see a more of an adult population. But we see kids from everything from hearing screenings for school, custom protection to go swimming. If kids have tubes in their ears, they want to not get water in the years over the summer, so we do make custom earplugs for them. That’s another place we go. Sometimes kids are speech delayed. We want to rule out is this hearing loss or not. Sometimes they’ll fail the newborn screening. We are definitely a center where people will come, and we’ll get them rescreened, and make sure they pass their newborn screening. So we see them for a lot of different reasons.

Dale Johnson:   How young is a newborn screened for their hearing?

Dr. Miller:           They’re newborn. We want to see them within the first three months. We like to see them within two weeks of them being born, so that they get rescreened. Typically when they leave the hospital they will attempt screening multiple times. If they don’t pass, they’ll end up going back to the pediatrician, and they end up referring to us for a reevaluation.

Dale Johnson:   Dr. Sandra Miller from Complete Hearing every Saturday morning. It’s The Conversation Starts Here.

Dale Johnson:   You’re big on community involvement.

Dr. Miller:           We are.

Dale Johnson:   That’s evident by going to your website, complete-hearing.com. One of the continuing events that got my attention, because I’m a coffee guy, is the Coffee And Conversation series you have every month.

Dr. Miller:           Yeah. We moved to our new location almost three years ago. We have this great conference room, and we thought, “What can we use this for besides staff meeting?” So once a month, we have something called Coffee And Conversation. It’s for you to come over. We talk about general health topics in terms of noise exposure, in terms of traveling with hearing loss, how to talk to a loved one who has hearing loss. We talk about how to take wax out of your ear. We review lots of different topics. Once a month, you come and have a cup of coffee, 30 minutes, it’s great. You get to see our office. You get to meet us. Not only that, you get to take the cup you drink from.

Dale Johnson:   You have cool cups.

Dr. Miller:           We have cool cups.

Dale Johnson:   You do have cool cups.

Dr. Miller:           So you should come have coffee with us, and you can take the cup with you.

Dale Johnson:   4200 Pioneer Woods Drive, northeast of 70th and Pioneer. One more municipal band series event.

Dr. Miller:           Yes.

Dale Johnson:   Complete Hearing has been sponsoring them all summer long, but we’re down to the last one.

Dr. Miller:           Yeah. I would tell you, we’re glad it’s cooled off, number one. We love music, and we know that our patients enjoy being able to hear well with music, but also we want to educate our patients about protecting your hearing in terms of … Municipal band, maybe not so much hearing protection, but when you think about going to concerts and what does that mean, we get that question a lot.

Dale Johnson:   Enjoyment.

Dr. Miller:           Enjoyment, number one, but also, “Do I need to protect my hearing?” number two. “I’m going to go to this concert, and is it going to be so loud I’m not going to be able to enjoy it?” We talk through those strategies too with our patients, but we’re so proud to sponsor that. I think it’s such a great thing for the community. Lincoln is one place where there is always something going on.

Dale Johnson:   Be there before 7:00 to get a good spot.

Dr. Miller:           There you go.

Dale Johnson:   And be here every Saturday morning at 9:30 or so for The Conversation Starts Here with Dr. Sandra Miller of Complete Hearing. Talk to you next week.

Dr. Miller:           Thank you.