Month: December 2022

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Disabled Brown Woman

Hi everyone! I hope you are doing well, and that the sub-zero temperatures haven’t dampened your spirits. Recently, I have been thinking about how my disability intersects with my race and sex, and how this shapes both my experiences in the world and how other people perceive me. I thought I might write up my musings, and do some research at the same time.

In sociology, intersectionality theory refers to the existence of multiple sociopolitical identities that contribute to a person’s experiences of discrimination and privilege (Crenshaw, 1989). I am a deaf woman of colour, and these identities alter the lens through which I navigate the world.

#Desiabled – created by Chronically Brown to empower disabled South Asians

As a member of multiple communities, it can make it harder to fight for your voice. In particular, disability is hardly recognised in South Asian communities. There is a real need to uphold our reputation such that it is so common to not speak out about physical disabilities, let alone mental illnesses. A research study conducted by the University of Surrey found that South Asian people are 4x more likely to develop a physical disability compared to our white counterparts (Williams, Cox and Cooper, 2020). This is worrying for multiple reasons. If we are stigmatised for not fitting the mould and for speaking out, then who do we go to when we need support?

I am lucky to have parents who have always stood up for me, building up my confidence and encouraging me to ask for help. Still, there are moments with extended family where I have felt it might be better to wear my hair down so they don’t remember that I wear hearing aids. Still, I find myself not talking to my grandparents about the difficult parts of my day, the sadness I felt when I couldn’t hear my friends, the mental health struggles. Still, I try and minimise the pain I might cause by talking about my struggles.

Much of the world lives in a natural state of ignorance. The ‘normal’ person is not taught to be curious about disability and racism. Most people are able to move through the world every day, without needing to understand how much harder it is to move through when the world is set up against us. My white counterparts can watch news reports of the high rates of morbidity and mortality in BIPOC communities during the pandemic, without having to live through the impact of this.

I think about the dangers I face as a deaf brown woman. Often, I walk outside without my hearing aids so I can listen to music. I try to be as aware of my surroundings as I can without my hearing to rely on. Yet, as hard as I try, this has its limits. I feel much more vulnerable to the darkness, knowing that I am perceived as a woman of colour. Why must I keep my hearing aids on for my safety when I deserve to listen to music and walk outside as much as anyone else? I find myself wearing baggier clothes and taking on a more assertive stance. I keep my hearing aids in, and try not to speak another language on the phone. I try and minimise all the parts of my identity that make me vulnerable, and yet, why should I do this? After the murders of Sarah Everard, Sabina Nessa and Zara Aleena, how can I afford not to do this?

So where do we go from here?

I think it’s so important that we listen to people and understand how systems of oppression affect us differently, learn from this, and advocate for others when we can. The disability community is large, and yet, accessibility is largely centred around cis white people. I have barely scratched the surface of how race and disability intersect, and even then, my experience is one small part of a multitude of experiences. We must centre the voices of disabled people of colour. We must be curious about other people’s experiences. We must listen.

Here is some reading if you would like to find out more about the intersection of disability and race:

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To hear or not to hear!

Stethoscopes! They were the bane of my life in Year 4. In Cambridge, the first three years of our course are pre-clinical, with very little clinical exposure and many, many essays… Come Year 4, we are thrown in at the deep end and suddenly I needed to know where the heart and lungs were! Towards the end of my third year, I knew I had to start looking into amplified stethoscopes when I tried a friend’s normal stethoscope and I realised I couldn’t hear their heart (or mine!)

Looking for answers, I emailed many people in the Clinical School, my university’s Disability Resource Centre (DRC), my current audiologist at Cambridge and even my paediatric audiologists from Guy’s and St Thomas’ Hospital, London. Everyone was really lovely and tried their best to help, but I was surprised at how little information there was on amplified stethoscopes, and how confusing it all was. I wanted to write a blog post to compile all the research I did.

I had several factors to consider, which you may too:

  • How severe is your hearing loss – what level of amplification might you need? – I could not hear with a normal stethoscope.
  • What brand of hearing aids do you have? – I had Oticon Engage hearing aids, but halfway through this process, I switched to Oticon Sensei Pro hearing aids (causing some further confusion!)
  • Wireless connection (Bluetooth) or wired to your hearing device? – I use a wired option.
  • If wired, do you want earphones, headphones, or hearing aid shoes? – I use shoes.
  • What is your budget? Are you able to apply for funding from your university or place of work? – I was able to apply for funding from my university Disability Resource Centre and my college (Gonville & Caius College)

Stethoscope

I did some research, and I found out about the Thinklabs One Digital Stethoscope, which I had seen other health professionals recommending on Facebook groups and online. Their stethoscope claims to exceed the amplification of a regular stethoscope by 100x, addressing the needs of health professionals with hearing loss.

Thinklabs One Digital Stethoscope (https://www.thinklabs.com/)

Their website has a page specifically for people with hearing aids. They explain how their stethoscope can be used with a table summarising how it can be used with different types of hearing devices (click here).

Wired options

Wired options give a more robust connection, and potentially a better sound quality than wireless Bluetooth options. This would potentially give the user more security in knowing they have not missed any important heart or lung sounds. I have BTE (behind-the-ear) hearing aids, so from the above table, I could use either on-ear or over-ear headphones. Thinklabs recommend Beats Executive headphones, but these are quite expensive. However, for me, I knew I did not want headphones over my hearing aids. I have always found them to be very clunky and uncomfortable over my hearing aids, and the sound quality was never that good anyway.

Alternatively, I could have used earphones connected to my stethoscope. With my level of hearing loss, earphones usually transmit enough sound for me to take most phone calls and listen to music. However, I thought earphones would not be a good option for me as I would have had to remove my hearing aids to use them and this would mean I would miss any other sounds happening in the room, including anything the patient may say.

Wireless option

Apart from wired options, I also had the option to use streamer devices to deliver sound directly to my hearing aids, such as the Roger Pen. This is a portable microphone that can wirelessly transmit sound in noise and over distance. This would however require me to wear my hearing aids, Oticon shoes, and Roger receivers, allowing me to wirelessly connect to the stethoscope. With this option, I would not have to connect anything at the time of use, as it would all be automatic. The Roger Pen could also be useful in other situations such as lectures or conferences.

Roger Pen (https://www.phonaknhs.co.uk/assistive-device/roger-pen/)

At the time, I had Oticon Sensei Pro hearing aids. This brand requires FM9 shoes to be put attached to the bottom. At the time of research, the pricing for all of the equipment was as follows on Connevans (after VAT relief for disabled customers):

  1. Thinklabs one digital amplified medical stethoscope = £444.00
  2. Phonak Roger pen Ruby microphone transmitter = £510.00
  3. Two Oticon shoes FM9 for ear level receiver = £21.84 x 2 = £43.68
  4. Two Phonak Roger X receivers (type 02) for Oticon hearing aids = £510 x 2 = £1020.00

This would come up to a total of £2017.68, and I found this to be too expensive for me, especially as my college (Gonville & Caius) and the Disability Resource Centre at Cambridge were both helping me fund my stethoscope.

My first purchase – Oticon Sensei Pro hearing aids

Alternatively, the cheaper option was to have direct input leads that connect my hearing aids (and shoes) to the stethoscope. This is, admittedly, more clunky to carry around in hospitals compared to a wireless option, like the Roger Pen. I would also need to attach the direct leads to my stethoscope each time I need to use it, requiring me to take my hearing aids out very briefly. At this time, I still had Oticon Sensei Pro hearing aids, but I would need another type of shoe (Oticon AP900 shoes) for the direct input leads. At the time of research, the pricing for this was as follows on Connevans (after VAT relief):

  1. Thinklabs One Digital Amplified Stethoscope = £444
  2. 800mm binaural V direct input lead = £21.50
  3. Two Oticon audio input shoes AP900 = £22.75 x 2 = £45.50 

This came up to a total of £518.95 with delivery, and this is the option I went with!

My updated (and last!) purchase – Oticon Engage 105 hearing aids

A few months later, however, my hearing aids had been upgraded to Oticon Engage 105, which has Bluetooth function. This was amazing as I could now stream music directly to my hearing aids! However, with regard to my stethoscope, the equipment I had would no longer work with my new hearing aids. I wanted a new option that would require me to buy the least amount of equipment.

After lots of research and help from my audiologists, I found out that I would need the Oticon AP1000 shoes. These would however require me to replace the battery drawers of my hearing aids using the Oticon Corda Hearing Aid Service Tool. This replacement drawer has it own specific shape and size to allow the AP1000 shoe to connect to the Engage 105 hearing aids. Luckily, my audiologist was able to send me a service tool that I could use, but otherwise, I could have bought it here. Therefore, finally, at the time of research, the pricing for the new equipment was as follows on Connevans (after VAT relief):

  1. Two Oticon audio input shoes AP1000 = £22.75 x 2 = £45.50
  2. Two battery drawer shoe adaptor = £10 x 2 = £20

This came up to an additional £73.40 with delivery, so that I could use my stethoscope with my new Oticon Engage 105 hearing aids. I then just had to replace the battery drawers using the service tool, where I found instructions online (click here!)

Finally, I had everything!

I hope this helps you in finding the right stethoscope for you. I would recommend reaching out to as many sources of support as you can, your audiologist, your university/work, Occupational Health, your supervisors, and even me! All of this research took a long time for me, and I could not have done it alone. All information was accurate at the time of purchase, around a year ago, so please make sure you double-check any of the details before you buy a stethoscope for your own hearing device. Be especially careful with buying the correct shoes, and finding out whether your hearing aid battery drawer needs replacing (but your audiologist should be able to help you)! Finally, do try and apply for funding as you should not have to pay for needing reasonable adjustments for your work.

Well done for getting this far! Thank you for reading, and I hope it has been of some help!

Ashna x

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Clamouring towards me

Hi, I hope you are doing well, and defrosting by a warm heater somewhere. It was International Day of Persons with Disabilities on 3rd December, first coined by the United Nations in 1992. I am not sure I did anything in particular to mark the occasion… other than letting myself relax in bed and rest without guilt.

I had a spare 10 minutes today so I wrote this short poem, and maybe the feeling of being lost in (mis)communication might resonate with you.

I saw her across the room, and instantly it began
Her eyes lit up, and words spewed out of her mouth
The letters stumbled upon one another, all jumbled up
Clamouring towards me as fast as they could
This, and that, and everything in between
Colours, emotions and the mundane in-between
Alas, as the words inched closer, they bounced off me
Falling to the ground and disappearing
She did not notice though, her mind was still unloading
And it did not take me long to piece together why I could not switch on
Of course, my hearing aids were not switched on!
She did not notice though, her mind was still unloading
And surely, it would be unkind to stop her now!

Just an untidy ramble of thoughts, no Rumi here!

Ashna x

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Leading the way

I was interviewed by Caius! Have a read through for me rattling on about deafness and medicine…

I wanted to write about my experiences as a deaf medical student, and I wanted to build up something that I would have wanted when I was younger. This was one way I could give back.

Source: Leading the way

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