Author Topic: Have to have hearing in both ears! Looking for suggestions just in case!  (Read 6931 times)

ANER

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Hey all,

Recently diagnosed with a 1cm AN and have seen several Doc's. So far we have decided to go watch and wait.  Seeing as these thing typically grow and I may eventually need surgery to remove my AN, is there a way to "fix" SSD.  My career requires some hearing in my AN ear, meaning I have to have good hearing in the non AN ear and something in the other one.  I also know that surgery carries the risk of SSD.  My question is; Is there a way to fix SSD enough so that I can carry on in my profession?  Will the hearing aid options cover any/all complications with surgery?
 To  be specific these are the requirements "The medical evaluation shall minimally include audiograms performed in a sound-treated booth compliant with the most recent version of ANSI S3.1 (Criteria for permissible ambient noise during audiometric testing) with equipment calibrated to the most recent version of ANSI standard S3.6 (Specification for Audiometers). If a booth is unavailable, the test room sound pressure levels should not exceed those specified in the Federal OSHA “Audiometric test rooms” standard (29 CFR 1910.95, Appendix D).

1.   Category A medical conditions shall include:

Hearing deficit in pure tone thresholds in both ears, the deficit in each ear averaging 35 dB HL or worse at 500, 1000, 2000 and 3000 Hz,

Candidates failing the Category A pure tone threshold standard and who still wish to be considered for appointment will be required to have follow-up examinations that include:
 
full audiological examination, including speech reception threshold (SRT) and speech discrimination testing (NU-6 word lists) in both ears individually,

AND

full otological examination.

In order to pass they must demonstrate:

Pure tone thresholds in better ear indicating average hearing deficit at 500, 1000, 2000, and 3000 Hz to be lower than 35 dB HL,

AND

Performance score of 80% or better on the speech discrimination test in the better ear.

HEARING AIDS:
Initial hearing examinations must take place unaided. 
Candidates who cannot pass the initial examination should be referred to a licensed audiologist for the follow-up examination.  Candidates may use hearing aids for the follow-up examination.  Candidates using hearing aids must pass the follow-up examination based on sound field-testing, using the criteria listed above.

2. Category B medical conditions shall include:

a. perforated tympanum,
b. auditory canal - atresia, severe stenosis, or tumor,
c. severe external otitis,
d. auricle - severe agenesis or traumatic deformity,
e. mastoid - severe mastoiditis or surgical deformity,
f. Meniere's disease, labyrinthitis or any disorder of equilibrium,
g. otitis media,
h. any other hearing disorder or ear condition that results in an individual not being able to safely and effectively perform the job of police officer. "


« Last Edit: November 10, 2015, 02:12:50 pm by ANER »
Diagnosed 10/22/15  11-8-7mm
Watch and Wait as of 11/9/15
Had a ride in the MRI on 5/2/16 with no new growth.
Riding this Watch and Wait Train until May 2017.

CHD63

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Re: Is there a way to fix SSD?
« Reply #1 on: November 10, 2015, 02:21:54 pm »
Hi ANER .....

Maybe I am not reading your post carefully enough but I am not quite certain what you are asking, nor what your career (employer??) requires.

If you are asking is there a cure for being single side deaf, the most likely answer is "no" unless you are experiencing temporary hearing loss due to swelling or some other condition affecting the auditory nerve.

If you are asking if a hearing aid will enhance hearing when one is not totally deaf, the most likely answer is "yes" if you have good speech discrimination.

Following my first AN surgery (via retrosigmoid approach), I retained approximately 20% of my hearing and still retained 100% speech discrimination.  My Widex hearing aid boosted the volume nicely and I was able to hear adequately in my AN ear.  Following my second surgery (via translabyrinthine approach), I automatically lost all hearing in my AN ear.  However, my doctor implanted the abutment in my skull behind my ear for my Oticon Medical Ponto Pro bone-anchored hearing system at the same time.  This means I can hear sounds coming from my AN side but they are bone-conducted to my only hearing ear.

I do not know what your career is.  Do you have to have hearing in your ear or only need to be able to hear sound from all directions?

Best thoughts.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

rupert

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #2 on: November 10, 2015, 05:13:07 pm »
Unfortunately, you will have to make some hard decisions down the road.  When?  nobody really knows.   AN's are notorious for damaged hearing.  Hearing usually diminishes over time regardless if treated or not,   and the odds are that your hearing will be gone at some point in the future.  You have been diagnosed so at least you know what you're dealing with and it won't just creep up on you which happens to a lot of people.  Keep up regular MRI's , hearing tests and dialogs with your doctor to keep on top of the situation.  Good luck.

ANGuy

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #3 on: November 10, 2015, 09:53:00 pm »
The way I am reading the requirements, you only need good hearing in the good ear. 

Also, the requirement is for "appointment".  If you are already on the job, the requirements could very well be different in light of the American's with Disabilities Act.  Are you on the job now, or are you trying to get on?
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

alabamajane

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #4 on: November 11, 2015, 09:54:21 am »
It appears from the last line that you are a police officer,,
Your question seems to be can you "fix" SSD. Yes, to a degree,, you can get a   BAHA hearing device implanted which will give you hearing on AN side through routing an external processor to the "good" ear. You don't get much directionality but you can hear sounds/conversation from SSD side. You may also be able to use the CROS hearing aids instead.

Perhaps one of these devices would meet requirements of your medical exam.
Hope that helps some,, just my opinions,,

Good luck,,,
Jane
translab Oct 27, 2011
facial nerve graft Oct 31,2011, eyelid weight removed Oct 2013, eye closes well

BAHA surgery Oct. 2014, activated Dec. 26

ANER

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #5 on: November 11, 2015, 03:54:58 pm »
Yes.  Been a Cop for 15 years and am currently a Sergeant. I believe I only need to pass a pure tone audiogram.  The medical standards I got were from the State's website for initial appointment.  The Doctors have said that they have a 65(ish%) of saving my hearing through surgery.  I am currently watch and wait for a few reason; 1) my hearing is currently within normal limits, 2) I have to research ways to overcome this potential obstacle, 3) Mine is still small so we might as well kick the can down the road for six months and see where we are at. 
« Last Edit: November 11, 2015, 03:57:15 pm by ANER »
Diagnosed 10/22/15  11-8-7mm
Watch and Wait as of 11/9/15
Had a ride in the MRI on 5/2/16 with no new growth.
Riding this Watch and Wait Train until May 2017.

ANGuy

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #6 on: November 11, 2015, 09:16:02 pm »
Yes, you are back on track with your thought process with this latest post.  Since you are already on the job, you have different standards to meet and you have protections available to you.  This stuff isn't always clear cut, but the Americans with Disabilities Act generally requires that your employer make "reasonable" accommodations.  Would it be "reasonable" for a single-side deaf person to work in the record bureau?  What about all of the admin jobs that could be done by someone with one good ear?  They'd have a pretty hard time kicking you out the door I would think.  You might not want to work inside, but you do what you have to do.  You could very well work the road with one bad ear if you want if they have to accommodate you in that way too. 

Then too there are the disability pensions available to you.  It depends on the state, some really suck, and some are great.  I can tell you from personal experience, there is life after The Job if you pension out.

As for watch and wait, that is another good point you make.  Right now, you are not disabled.  After treatment, you might be.  You have 15 years on, how many more to make your regular pension?  Monitoring your condition for 5 years to make 20 and a pension isn't a bad idea at all.

I am a big proponent of WW for people like you and me so you won't get an argument from me on that point. 

Based on your first post, I said to myself "This guy needs to take a deep breath".  It looks like you did just that.  Having an AN could definitely screw up some aspects of your life.  Or, it might just be a big, annoying, speed bump that will eventually be a minor issue.  There is no perfect way to predict how it will go.  So, the best thing to do is just what you are doing.  Get info about AN's, come up with short, medium, and long term plans, and plan for worst case scenarios and how it would change your life.

FWIW, we had a Lt that had one of his legs amputated below the knee due to illness and he was moved inside where he finished his career.
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

PaulW

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #7 on: November 15, 2015, 06:39:21 pm »
Unfortunately as a police officer in active duty I suspect you will need to actually hear in both ears. If you become SSD you will lose your ability to locate the direction of sound.
This of course would potentially put you at risk in a dangerous situation.. eg unable to locate an approaching attacker etc..
There are solutions like BAHA and CROS but they do not restore your ability to locate sound direction much, if at all...
With your size tumour you have three options, there is no guarantee with any of them, and the chances of any of us having great hearing in 10 years is also not great..

However please consider the following...
Please be aware of different ways of measuring hearing preservation... Some will quote Any Testable Hearing... Versus the ability to have useful hearing.. (Class A and B Hearing)

If you chose surgery there is a reasonable chance that you will lose your hearing immediately, but if you do get past the first 12 months there is a good chance it will not alter.
If you chose watch and wait or radiation you are at risk of losing your hearing over time but you wont lose it immediately.
W&W or radiation may give you a few or many extra years of active duty, although radiation can be tough on balance for many, which might also stop you from active duty for a while

Good hearing, small Acoustic Neuroma under the age of 55... Hearing preservation quoted as 93% at 6 Years post Gamma Knife in one study with over 300 people in the study

Have a read no easy answer..


http://www.ncbi.nlm.nih.gov/pubmed/25434946

http://www.ncbi.nlm.nih.gov/pubmed/25790873

http://www.ncbi.nlm.nih.gov/pubmed/25077326
http://www.ncbi.nlm.nih.gov/pubmed/25077306


 

 
10x5x5mm AN
Sudden Partial hearing loss 5/28/10
Diagnosed 7/4/10
CK 7/27/10
2/21/11 Swelling 13x6x7mm
10/16/11 Hearing returned, balance improved. Feel totally back to normal most days
3/1/12 Sudden Hearing loss, steroids, hearing back.
9/16/13 Life is just like before my AN. ALL Good!

james e

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #8 on: November 18, 2015, 01:15:30 pm »
I was a cop in the 70s and 80s. I am SSD now but not back then. There is NO way I could be a street cop and be SSD. I cannnot determine the source of sound. This morning I went into a gun store where I normally deal and they know my name there. Someone  called out my name to say good morning and I could not locate them in the store. They were  standing behind me.

I was involved in 3 shoot-outs in my career. One of them was an attempted assination on me in a druggy neighborhood. You have to be able to locate the source of sound. I knew right away where the gunman was.

Detective work might be okay. Any inside work like dispatch or records can work. If you are on a good size department, you are probably safe after 15 years. Best of luck to you.

By the way, I just got a supoena for a homocide I investigated 39 years ago. I can still testify.
James

Ugne3030

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #9 on: November 20, 2015, 05:58:22 pm »
I too am a retire gumshoe. I was able to get one of my young football coaches on the job this past year. We talk a lot and when asked I share my thoughts about things-it is a brave new world out there. With all the current events in Paris translating over to our countries, (we shot a terrorist-my department shot a terrorist/person with a bomb last week) being able to hear with both ears in my humble opinion is a must. My youngest daughter sometimes calls me from my a room in our house and I can't even locate her. Can you imagine driving a black and white and having to locate a small child or go after an armed suspect. Hearing is everything. I had my 3 cm AN out in Feb and even thou I have remarkable balance, and SSD I am working as a teacher now. It is not the same but the pay is the same. I am still fatigued and even with my cros aid, I find my mind works harder to concentrate and have no ability to locate someone calling me. I could not image what it would be like working the job again. Do I miss it, oh yeah but I think if you watch and wait or as for light duties - transfer to records, Ident, recruiting etc they would accommodate you. We will pray for the best outcome for you and your family.

ANER

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #10 on: November 21, 2015, 08:24:36 am »
Unfortunately as a police officer in active duty I suspect you will need to actually hear in both ears. If you become SSD you will lose your ability to locate the direction of sound.
This of course would potentially put you at risk in a dangerous situation.. eg unable to locate an approaching attacker etc..
There are solutions like BAHA and CROS but they do not restore your ability to locate sound direction much, if at all...
With your size tumour you have three options, there is no guarantee with any of them, and the chances of any of us having great hearing in 10 years is also not great..

However please consider the following...
Please be aware of different ways of measuring hearing preservation... Some will quote Any Testable Hearing... Versus the ability to have useful hearing.. (Class A and B Hearing)

If you chose surgery there is a reasonable chance that you will lose your hearing immediately, but if you do get past the first 12 months there is a good chance it will not alter.
If you chose watch and wait or radiation you are at risk of losing your hearing over time but you wont lose it immediately.
W&W or radiation may give you a few or many extra years of active duty, although radiation can be tough on balance for many, which might also stop you from active duty for a while

Good hearing, small Acoustic Neuroma under the age of 55... Hearing preservation quoted as 93% at 6 Years post Gamma Knife in one study with over 300 people in the study

Have a read no easy answer..


http://www.ncbi.nlm.nih.gov/pubmed/25434946

http://www.ncbi.nlm.nih.gov/pubmed/25790873

http://www.ncbi.nlm.nih.gov/pubmed/25077326
http://www.ncbi.nlm.nih.gov/pubmed/25077306


 

 
Paul,  I hadn't really even considered GK up until this point.  I have a phone consult with the House Clinic on Tuesday and I am gonna also now do a follow up with Dr. Heilman from Tufts. Thank You.
Diagnosed 10/22/15  11-8-7mm
Watch and Wait as of 11/9/15
Had a ride in the MRI on 5/2/16 with no new growth.
Riding this Watch and Wait Train until May 2017.

ANER

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #11 on: December 27, 2015, 08:32:54 am »
ANGUY
The way I am reading the requirements, you only need good hearing in the good ear. 

Also, the requirement is for "appointment".  If you are already on the job, the requirements could very well be different in light of the American's with Disabilities Act.  Are you on the job now, or are you trying to get on?

I believe you're right. I do only need hearing in one ear.  I didn't give your comment the scrutiny it deserved and after re-reading the requirement a bunch more times it seems as though one sided hearing is "good enough". Thank you for your comment!
Diagnosed 10/22/15  11-8-7mm
Watch and Wait as of 11/9/15
Had a ride in the MRI on 5/2/16 with no new growth.
Riding this Watch and Wait Train until May 2017.

arizonajack

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #12 on: December 27, 2015, 01:25:37 pm »
I have a phone consult with the House Clinic on Tuesday and I am gonna also now do a follow up with Dr. Heilman from Tufts. Thank You.

This is not a put-down of House, but House always recommends surgery because that's their stock in trade.

I suggest that you consult with AN facilities that do both surgery and radiation, like the Barrow Neurological Institute in Phoenix:

https://www.barrowneuro.org/specialty/acoustic-neuroma/

3/15/18 12mm x 6mm x5mm
9/21/16 12mm x 7mm x 5mm
3/23/15 12mm x 5.5mm x 4mm
3/13/14 12mm x 6mm x 4mm
8/1/13 14mm x 5mm x 4mm (Expected)
1/22/13 12mm x 3mm (Gamma Knife)
10/10/12 11mm x 4mm x 5mm
4/4/12 9mm x 4mm x 3mm (Diagnosis)

My story at: http://www.anausa.org/smf/index.php?topic=18287.0

ANER

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #13 on: January 09, 2016, 09:22:28 am »
I have a phone consult with the House Clinic on Tuesday and I am gonna also now do a follow up with Dr. Heilman from Tufts. Thank You.

This is not a put-down of House, but House always recommends surgery because that's their stock in trade.

I suggest that you consult with AN facilities that do both surgery and radiation, like the Barrow Neurological Institute in Phoenix:

https://www.barrowneuro.org/specialty/acoustic-neuroma/


I agree surgeons want to do surgery, radiologists want to do radiation.  In the end it's up to me. Due to my relatively young age I am more prone with what I have read to go with a surgical approach.. Whoever, prior to any treatment I will seek out a radiation oncologist to get their opinion!
Diagnosed 10/22/15  11-8-7mm
Watch and Wait as of 11/9/15
Had a ride in the MRI on 5/2/16 with no new growth.
Riding this Watch and Wait Train until May 2017.

mcrue

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Re: Have to have hearing in both ears! Looking for suggestions just in case!
« Reply #14 on: January 10, 2016, 04:43:31 am »
That's not necessarily always true. A surgeon at House suggested radiation (at another facility) would also be a decent option for me. And a prominent radiation oncologist recommended I have microsurgery instead of cyber knife radiation treatment.

However, I do agree your theory holds true for most cases.


I have a phone consult with the House Clinic on Tuesday and I am gonna also now do a follow up with Dr. Heilman from Tufts. Thank You.

This is not a put-down of House, but House always recommends surgery because that's their stock in trade.

I suggest that you consult with AN facilities that do both surgery and radiation, like the Barrow Neurological Institute in Phoenix:

https://www.barrowneuro.org/specialty/acoustic-neuroma/
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

 


anything