The student complained that even with her new hearing aid, she cannot hear everything her cardiologist tells her. He speaks too fast and with an accent, and he looks down when he talks, giving her no opportunity to augment her hearing aid by lipreading.
He has turned down her request that he bring in one of his staff to serve as a kind of interpreter, leaving her no choice but to bring her grown daughter along to every appointment.
Audiologist Kim Uccellini, teacher of a three-week class that UPMC offers new hearing-aid wearers every month, made a couple of suggestions: The student could write down what she hears and then read it back to the doctor to check for accuracy, or she could remind him that he is obligated to accommodate her needs under the Americans with Disabilities Act.
"Be your own advocate," Ms. Uccellini told the July class during its final session. That means being assertive. Not aggressive; not passive; but assertive. For example, she said, if a neighbor yells something across the yards at you and you can't hear him, ask him to come closer as you can't hear well. A passive response would be waving and nodding as if you'd heard him; an aggressive one would be something like yelling, "I've told you I can't hear well. Why can't you remember that?"
Being assertive is one of the most important lessons people who are hard of hearing can take away from the UPMC courses because getting a hearing aid -- or two aids -- is only a first step toward establishing successful communications with the wearer's world.
"Although you do much better with an aid, it's still not as well as when you had hearing," said Catherine Palmer, Ph.D., director of the Center for Audiology and Hearing Aids at the UPMC Eye and Ear Institute.
"The family still must make accommodations. You can't talk to them from another room, for example. It's hard for people to make these changes. In clinic we don't have time to go over those kinds of things. This class gives them time."
And at first, for perhaps two weeks, the wearer might feel as if his or her hearing has worsened, because the aid picks up background noise and other sounds the wearer hasn't heard for a long time. The brain must relearn how to ignore unnecessary noise and home in on what it wants to hear.
"Hearing happens here," Ms. Uccellini said during the first class, pointing to her ear. "Hearing understands here," she added, pointing to her brain.
The more the patient wears the aids, the faster and better the adjustment. "Part-time users never do well," Dr. Palmer said.
The three 1 1/4-hour sessions cover a wide range of topics: how an ear works, communication strategies for new hearing aid users and their significant others, how to use various hearing aid features, and communication strategies for difficult situations like restaurants and parties.
The regular teacher for the monthly classes, Ms. Uccellini delivers both technical information and common-sense advice with humor and enthusiasm.
She got the first class of the July series off to a good start with some basic rules for successful communication that she went back to in the final session:
• Face everyone you talk to so you can better read their lips.
• If you can't hear what someone said, don't smile and nod your head. And don't keep talking over others just because you can't hear them. Either of those actions can lead the speaker to think you're "aloof, standoffish, have a low IQ or no good social skills," Ms. Uccellini said.
Rather, she suggested the person who is hard of hearing should ask the speaker, "Can you repeat that or rephrase it?" or some equivalent response.
In the second class, Ms. Uccellini used a drawing of a restaurant to teach the best way to sit in order for a hearing aid user to hear and converse with the waitstaff and dinner companions. Some simple strategies:
• Go to dine early, before the big crowds arrive.
• Ask to be seated in a booth, which will keep you out of the hubbub in the middle of a room.
• Avoid seating near the entrance doors, the kitchen doors, the bar, and, if there is one, a piano or musical group. Those areas are where the noise levels are louder,
• Seek seating near a light source, which will permit better lipreading.
Hearing aid wearers are encouraged to bring their spouse or significant other to the classes with them.
"It helps you and your significant other understand hearing loss and how to make better use of the hearing aid," Ms. Uccellini said. "Both sides of a communication have to do a little bit of changing because hearing loss is permanent."
In the July class, the two students who are hard of hearing, who asked to remain nameless, had no spouses to accompany them to class. One brought the daughter who accompanies her to the cardiologist's office and who asked numerous questions about dealing with her mother's hearing loss.
A Port Vue couple who attended the inaugural hearing aid course, Mary and Bob Erkel, thought the classes were more beneficial to the spouse than the hearing-aid wearer.
"I always felt that the person wearing the hearing aid knew what was going on and that the class really was for those [who didn't and now] can appreciate the problems that the hard of hearing were having," said Mrs. Erkel, who wears two hearing aids.
After attending the course -- they were the only students -- Mr. Erkel said, "It helped me to understand the problems my wife had been having about hearing and how much improved her hearing was when she got the hearing aids."
Mrs. Erkel also said she gained an understanding of how her hearing loss might be a problem for her husband.
"I think it was," she said, "because I would continuously ask him to repeat himself," something her husband acknowledged sometimes got on his nerves.
The same held true for Dr. David Kennedy, 81, of Squirrel Hill, who took the course about nine months ago with his wife, Doris, also 81. She had just gotten her first two hearing aids a couple weeks earlier.
"She can't hear. I have to adapt to that and either speak louder or, sometimes, repeat things," Dr, Kennedy said. "[Before] I was upset about her not listening to me or not paying attention to me. That just cleared things up."
Mrs. Kennedy said the most important things she learned were to "wear them all the time and that you can't expect to hear everything."
The course is free to people who buy their hearing aids through UPMC and costs $100 for those who buy their hearing aids elsewhere. To register, call 412-647-2030.
Pohla Smith can be reached at firstname.lastname@example.org or 412-263-1228. First Published September 3, 2008 4:00 AM