Audiologist’s Journey Living with Hearing Loss: Interview with Dr. Nashlea Brogan

Welcome to This Week in Hearing. I’m Gael Hannan, a hearing health advocate. I’m a writer for Hearing Health Matters and others publications. I’m the author of two books, including Hear & Beyond: Living Skillfully with Hearing Loss with Shari Eberts And I’m also a speaker on living the best possible life with hearing loss. Here’s something the younger me would never have considered possible. An audiologist who also wears hearing aids. How would that person with hearing loss be able to assess my hearing loss? Let’s find out this week. I am delighted to be speaking with Nashlea Brogan. she’s from Sarnia, Ontario, and Nashlea is an experienced audiologist with a 19 year career. It’s marked by her dedication to assisting those with hearing loss and tinnitus. great. Don’t get me going on tinnitus. As a founder and a leader of a successful hearing care practice, she prioritizes innovative, patient focused care and plays a vital role in helping bring along new hearing care professionals. You sound exactly what my favorite audiologist would be, but I’m across the country, so I’ll just have to stick with the ones I’ve got. That’s great. Welcome. Thank you. Yeah okay, tell me about your hearing loss. as much as you like, but tell me about your hearing loss, and then I want to know what came first. I will. I’m a very open book, so I share my journey. so I was born with normal hearing, and when I was in junior high, I started noticing I was having trouble. And my parents took me for a hearing test when I was 14. And at that time, I was diagnosed with a very slight hearing loss, but not enough for hearing aids back then. But this is in the 1990s, before digital, and the audiologist told my mother at the time that I was going to have a progressive hearing loss. And that was it. And I went home. I continued through high school. I competitively danced all across Canada, played several musical instruments, and had all marks in the 90s. But I didn’t know that the bell rang in the school between every class, so I had no idea there was a bell. And people would say, Nashlea, you’re always daydreaming, or you’re such a snob. Right? And we didn’t know at that time that I was basically losing my hearing more and more. so when I was 18, a month after I graduated from high school, I went to a different audiologist and a different ear, nose, and stroke specialist, and I was fit with hearing aids, and she became my mentor I left for France four weeks later to live with the french family for a year. And I was fit with behind the ear hearing aids, and my hearing loss was progressively changing at this point and I wasn’t very happy. Now, my audiologist at that time said, you have to stimulate your brain because someday you’re possibly going to need cochlear implants, so you have to wear your hearing aids all the time Nashlea. And I did follow that advice, but when she wanted me to get an FM system, I was like, no, I am not wearing a box. And when I would go back and visit her every year when I came home from university, she’d be like, you should be an audiologist. And I was doing a biology degree and psychology degree, and I was like, no way. And I ended up going to Africa for pre medicine. But I was in the OR and the doctor was working, and they wore masks, and I realized that I could never work in a hospital because they’re treating me like I’m stupid because I can’t hear what they’re saying. So I came back from Africa kind of crushed. But then I went home to see my audiologist, and she gave me the article by Mark Ross, and she gave me his article. And at that time, I was in my fourth year of psychology and biology, and I’m like, I want to study audiology. I want to study how people cope with hearing loss. Like, why am I struggling so much to accept this? So at that time, we were giving me different size hearing aids. I got digital hearing aids, the first in North America. and then I was going to, I spent a year and another audiologist, Dennis Hirx, he mentored me for a year, and I started researching how people cope with acquired hearing loss. This point, I’m losing all my hearing. I graduate, get into audiology, and that was a whole story. That could be a whole podcast. if you want to talk about my experience, training to be an audiologist, because they were so worried about my ability to test. Exactly. And that would when I sort of think about having an audiologist with hearing loss, how can they test, how can they hear the little things that you need to do? And I am assuming so much of it is automated now. but it was something that I would have worried about, but I would have said, could I have someone else? that’s fascinating. So I actually would like to hear more about that process that you talked about becoming an audiologist. So I do have actually, and it’s interesting. I do have different students in audiology across Canada now who reach out to me, and actually one recently in the states with hearing loss. And they have the same concerns I had in 1999 and 2000 23 years ago, was there isn’t actually having a hearing loss. Being an audiologist really doesn’t stop you from doing anything, because a lot of the stuff that is more difficult because of your hearing loss are just technical things. So whether it’s an assistant helping you or a secretary helping you, a big part of being an audiologist is counseling, treatment planning, having conversations they don’t rely on. And the machine, the equipment, like every time a person presses the beep, the button, when they hear the beep, the equipment lights up. You can still see. You can put an FM system in the sound booth. If you’re doing word discrimination, you can have them point to a picture. you can also use an assistant to score. so what I realized as I was training, but they were hard on me, it was a hard three years. I would say the hardest point in my entire career was training to be an audiologist. what I didn’t realize, and I tell every future audiologist that’s now who has a hearing loss, because there’s usually about one a year in the canadian programs, who has a hearing loss is that you have superpowers, and your superpowers are going to come into play when you become a clinician that are very hard to train someone for. so getting around the technical issues, you can get around them, but then teaching a person to connect with another person is very powerful in understanding their journey. And this is what I really would like to talk about, because it is so important for that connection, and that’s something that I know we’re on the same page with. As a recipient of hearing care I need to have that connection with my audiologist, and it’s something that the consumers with hearing loss say that we’re not getting this, and it’s individual to everyone. I have seen the change, and I would say out of all the audiologists that I’ve had through my many years of life is that almost all audiologists, they’ve been passionate about what they do, and I’ve liked working with them, but there have been times when it’s been less than successful. So tell me how your hearing loss makes you a better audiologist sitting across the chair to chair meet you. How are you a better care person for me than if you didn’t have hearing loss? I truly understand their fears. it’s an acceptance journey, and even myself, I’m still going through this journey. I mean, I received two Cochlear implants. On both, I wear bilateral Cochlear implants, and so I eventually lost all my hearing, and even when I got implanted, hadn’t talked on the telephone for ten years. So I understand what it’s like to be scared of the treatment not working or the process to have an ear mold changed in your ear to hurt that first week, but you have to put it in, but you don’t want to put it in. to take them out every night and be like. Because I always say treatment is, like, on and off, on and off. I don’t want to go every night to take it off. We’re built to hear, I think, 24/7 so I think, as an audiologist, it just allows me to understand their fears, and then it also allows me to understand what happens in the real world. So we do all this stuff with hearing treatment, and then we send them out into the real world, and, I mean, wind and noise and just the day to day, and then with the public, it’s understanding that journey, right? Because that’s where I think, when I was trying as an audiologist, I was privileged to be able to try every manufacturer’s brand. I mean, I was even at Western as a student. They would send me every brand, every premium hearing aid on the market. I got to demo and try. I still did, right up until I cochlear implants. But no matter what hearing aid it wore or what level it was or anything, I had to leave my office and go out and sit in a restaurant or get in a car or try to hear my children when they were really young. so I think that that allows me to connect with the patient because I understand the process, what I call the treatment journey. I understand holistically that there’s their fears and their limiting beliefs, and then there’s what they’re coming to me with and then what I’m telling them, and then also what they lead the office with. Because once you start hearing treatment or you give a person hearing aids or they change different brands or an upgrade it all starts over again, I don’t think. It’s not like I used to hate getting new hearing aids. I mean, it’d be like, oh, I got to get a new ear mold, and I got to get a new buttons. I don’t think that’s where it’s understanding that you’re changing a person’s whole life, right from morning to night. It’s very different than just putting glasses on. It’s a very much more transformation. And cochlear implants were a whole new identity. So I felt like I went from normal hearing to completely deaf. So I had this hearing impaired identity. Then I got implants, and now I have a cochlear implant identity, which means every night when I go to bed, I have no hearing at all because I have two cochlear implants. Or if I’m getting a shower or a bath, it’s just like, it’s a different thing. So the identity of wearing hearing aids is very different identity to wear cochlear implants in terms of what you experience in your environment. Just the feeling, the sensation, the environmental awareness if I’m sleeping. I did it as a joke, and I didn’t do it on purpose, but it was kind of funny. A few weeks ago, I fell asleep with an eye mask, like a sleep mask on, like a bedtime mask. And my 14 year old daughter didn’t. She came home at 09:00 at night, and I was sound asleep. And didn’t she jump on me when my eyes were covered but my implants were out. I’ve never been so shocked awake, and it was like electric shock woke me, and I almost had an anxiety attack. And I’m on the ground, and I’m thinking, don’t ever wear one of those masks again to block out the light because I didn’t realize I was cutting off all my senses. Even listening to that story, I felt a mild panic. It would be just out from nowhere, like a It’s fascinating to talk about identity, and I did not fully realize that you were a bilateral cochlear implant recipient. And that’s interesting. You talk about identity and so, clearly, you talk about your identity as a hearing aid user, as a cochlear implant recipient. is it really identity? I’m just wondering, when you say identity does that mean with the community, or it’s just here I am. This is what makes up me now. Yeah. To me, it’s more sense of self. So I’m referring to how I feel as a person. then your identity with the community, I mean, that’s a whole different identity. So that’s another identity, because, I mean, at the same time that I was adjusting to losing my hearing and my self acceptance and who I was and what I was, then there’s your identity with other people. So I think that’s like, almost two different ones, because one can be going really well and one might not be going really well either. Yeah, that’s an interesting point because I’m bimodal myself, so hearing aid and cochlear implant. And we read about people with hearing loss who feel caught between two worlds in terms of identity in the hearing world. And I have a slightly different take on that, the hearing world. I don’t feel that I’m separate from the hearing world because I don’t even think that’s a thing, really. It’s just another adaptation, a bit of the identity that we have as a person as opposed to the community. although I do identify with people with hearing loss, because I know instinctively they’ll understand who I am or what I experience. And it’s kind of what we’re talking about. It’s fascinating. And people have very different views on that. Temper can start to Because it’s important for people to have that identity. And when they feel that they don’t, we might say, well, clearly you are a hearing aid user, but they haven’t adapted to that yet. The way you’ve talked about and it’s really important topic. And there’s another level to that was, I am extreme extrovert. Like, I’m an extrovert. I love people. I get my energy off of people. and my hearing loss robbed me of that. And it wasn’t until I was given back my cochlear implants in both ears that that self identity I actually turned into, literally a very unhappy introvert where I was fearful and didn’t enjoy social situations, conferences, I couldn’t speak on stage, even though that was my dream, because my hearing loss with my hearing aids, it was just getting to a point where it was really difficult. And then the transformation with both my cochlear implants and being an extrovert and that. So I guess for me, the self identity is I’ve gone from being an extrovert to an introvert back to being an extrovert again, where I feel much more confident with who I am as a person as an audiologist. And I actually have an audiologist identity is I really try to be careful how I tread with the hearing identity world because as a clinician and a hearing professional, I have to respect all views. And, I mean, that was big in our clinical training, is I have to respect the deaf community, and I have to respect the different words we call ourselves, the different things audiologists are supposed to respect it all. So I try to always be very careful navigating those words because I don’t want to. As an audiologist, I have patients who are deaf, and I have patients with implants, and I have patients who sign, and I have patients who. So I have to respect all their different I try not to get involved in what they, if that makes. Sense, like as a clinician, and it does. And identity is something, it’s a topic that it’s ongoing and it’s individual. So you’re right, this is another whole podcast. I’m very keen to know. So with your life experience and your hearing loss journey you’re bringing that to your interactions with your clients. And how do you share that with other professionals? when you are helping new professionals come into their career, how can you actually share the wisdom that you have? Because this is something about patient centered care, client centered care that is making all the difference for people like me. And as you say, it’s a little hard to be taught, but it can be. How do you do it? well, part of it, actually. When I started it last year, that was my mission. So when I started posting on my instagram last year, of my followers, most are audiologists. Even on my LinkedIn, like 90% are audiologists and hearing professionals. So when I was, for example, in Mexico last year, and I was with a large group of audiologists, and I was going to the beach, and I had my little Claire bag and I had my dryer and I had my ear gear, and they looked at me. My friend, who’s been an audiologist for 1415 years, she’s under practice, she said, I didn’t know that you would have to do all that just to go to the beach. And I said, I can’t even walk in the sand and sit in the chair without all this stuff in case I have to take them off and make sure they’re secure. and then I have my waterproof covers for my implants. I mean, I had it all, and I think I was trying to start to change what they see happens outside the clinic. So the realities of, like, when I go exercise or when I go golfing or I go biking or I’m going into a meeting for them to see what actually happens. And I think that’s what’s missing in audiology, is that we don’t get any education on the real world. It’s all in the sound booth, in a test box, which is very important. Very important. I’m huge on diagnostics. But then we need to, obviously, have conversations with our patients on how to live with their hearing loss successfully, how to be confident in their decisions they make when they’re going on an airplane or an airport. I mean, I travel a lot. I fly every few weeks. Every single airport is different. It is. Flying with hearing loss is something else. And you’re right. Unless when they talk, they being all the other audiologists that aren’t you when they’re talking with their clients about that life, it’s really theoretical, because they haven’t gone through it themselves, and they haven’t gone to a restaurant with their clients. And these things can all be learned. You can read about them. especially this time of year, we’re inundated with articles on how we, the people with hearing loss, how to survive the holiday season, because it is challenging. but still, unless you’ve gone through that. and I’m not suggesting that audiologists need to go live with their clients for a week, but I would suggest that they go to a hearing loss conference a consumer conference, to really get an added perspective. What do you think about that? And I think they need to be around people with hearing loss outside of the clinical environment. So that’s basically what you said. So, like, when I’m traveling with audiologists, or the audiologists who are watching me on Instagram post my videos and I’m talking about it, and it’s being outside a clinical environment where they’re just seeing what other people. How they’re adapting to it. Because I don’t think, like you said, a conference is a great idea, because they don’t get to see that. they don’t get to experience. What. We say happens in clinic, and then what happens in theory and then what happens in practice is usually two different things. so, yeah, no, I think that’s a great idea. And it’s something, to be honest with you, it’s something like, just because I got my cochlear implants and now I’m getting confident. More speaking. And it was this may. It was my first time ever speaking on stage my entire life. I was excited. I’m building up the confidence to speak to my peers about it, but it’s obviously hard, because if you’re not speaking on evidence based practice or science, which I love, I’m very into that. But it’s hard to get up as an audiologist and preach to my peers about, you should be aware of this. You should be thinking about this. So it’s trying to, how do we open up the conversation without people getting their backs up or thinking that you’re telling them what to do? And that’s the challenge of it from their healthcare providers. And yes, their main function is health care. But the same thing is they still need to be able to either direct people to the resources, teach them about it, have a way to identify who needs what help. These things actually could be brought into the clinical world. It’s just figuring out how to do it in 2023. I totally agree with you. my co author, Sherry Eberts, and I since our book was published a year and a half ago, have been speaking together at a number of hearing care professional convention conferences. And at most of them, and I would say all of them, we were approached afterward by saying, this is the first time that we have heard the consumer voice at our conference, and what you’re saying. So Canadian Audiology association, I’ve spoken there several times, but still they go, oh, it’s that new perspective. And it’s not even new. They know it. But just having someone there, a consumer, saying, this is how your clients can live more skillfully with hearing loss. And you’re right. The challenge is not to say this is what you need to do, or definitely not. You’ve been doing it all wrong. And there’s another way, because I fully appreciate the challenges of what you as hearing care professionals need to get across in limited time. And that’s why an ongoing relationship, giving the information at appropriate time, being there for them, establishing trust, which is a huge thing. but I think it’s wonderful that you have added this new layer to what you do professionally. And I have noticed that you’ve been really reaching out to consumers as well, in a different way. Not just you should get your hearing aid chat, come in and get a hearing aid. and you posted something yesterday, and I meant to look this up ahead of time, and I took a picture of it. Something you said, you were really reaching out to consumers. Tell me why you’re doing that more and why you’re doing it. So we go back to my beginning when I wanted to be Mark Ross’s article. And when I came to western university, Ontario, I was from Nova Scotia, and I was interested in doing rehabilitation and nothing knocking rehabilitation. But I think that’s the reason why audiology is kind of like we’re stuck in the past. So it has its place in audiology, but the problem is that a lot of hearing care professionals and audiologists don’t do anything extra because it’s either you’re doing oral rehab or you’re not doing anything. And I think there’s a whole world in between that can be, especially in 2023 with Zoom and Facebook groups. And I think the world is wide open now to change the conversation. I think connecting with people like life coaches does and fitness coaches with mindset, and you’re not alone. And let’s talk about all the benefits of treating your hearing and loss. Increased independence, relationships, intimacy. We’re not just talking about hearing better, we’re talking about connecting better, being more intimate. so I feel like in 2023, we can start teaching audiologists that it doesn’t have to be an eight week oral rehab program. And I know that’s like, I love it. I think it’s great. But what you said, what doesn’t connect with today’s clinical practice is that it’s almost like you’re either most places now just don’t do anything. So you don’t do zero. Right now, the definition is, did I do a real ear measure? Like, that is like the gold standard or speech and noise test. We do that, but can we just do a little bit more? Can we talk about mindset and say to the patient, did you go into the living with a hearing loss Facebook group? Did you read this book? Maybe? Did you follow this person on social media? And then what we’re doing is we’re kind of transferring the patients then to groups and communities where they might identify with something and then start learning together and connecting and growing on their journey. And I think that’s in 2023 with, like, zoom in 2024 online video training. There’s just so many possibilities that it doesn’t have to be. It doesn’t have to be. I’m going to do, like, oral rehab or no oral. Does that make it very much makes sense. in our book, Sherry and I one of the. Through lines in our book here and beyond we had both come to this realization prior to working on this, but when I changed my goal from wanting to hear better to wanting to communicate better, that changed everything. And for both of us. And that is one of the biggest mind shifts. It took the mindset, making that shift to an actionable mindset that helps us live more successfully with our journey. I’m never, ever going to be able to hear like I used to. Well, I’ve had hearing loss all my life, but I’ve never even with technology. So I hear the way I hear. I can communicate with you. That’s wonderful. but I need more, and I’m doing more. I’m communicating because I’m streaming through here. captions the modern age of technology that allows us to communicate better and using all visual cues that quite often people don’t realize that we’re doing, like the subtle, it’s a good example. People say, well, I don’t like seeing the subtitles down there because they’re distracting. Well, we found, research shows that especially with the pandemic, more and more people are using captioning and they realize it’s a fluid process. Just like when I’m speech reading you, I’m not just staring at your lips, I’m watching your face and I’m watching what’s the context? The same thing with subtitles. The brain can do these things very quickly, but it’s communicating is what we need to have people embrace more, not just hearing, but communicating. And that’s where you switched your mindset. So that’s where I say, like, the modern way of audiologists and healthcare providers learning to address their patient needs might not be, oh, do they need this program? It might be, do they need a change in their mindset? Do I got to give them some tools or connect them with the community? So we just don’t talk like that. in clinical audiology, we don’t talk like that. Like when I announced this week that I was going to start having my monthly living confidently with the hearing loss workshops in sarnia via Zoom, the audiologist I talked to said, I used to run four week workshops, or I used to run, but I’m like, no, these are just, you can come to one, or you can pop into one. Six months from now, maybe there’s going to be one on traveling, or there’s going to be one on working with your spouse and intimacy and communication, maybe one applies to and one doesn’t apply to. And I think that’s really key in terms of changing the field and how audiologists think is that not every person with hearing loss needs the same thing. Exactly. So have you started these? so I’m having my first insarnia December 20, and then the last Wednesday of every month, I’m going to have an in person insarnia. But then in the new year, I’m going to have zoom so people can zoom in and watch. and then I’ll have someone answer one of my team answering questions via the zoom while they’re watching it. And what I’m going to try doing, which has always been my goal I started a year ago, was how do I create an online with my expertise and background? How do I create this? Living with the hearing loss. So I called it living confidently, combining both, like the life coaching I’ve learned courses with the mindset approach and audiology. and that’s what I’m starting next year. And let’s talk about intimacy. This always throws audiologists. I’ve had patients say to me when I take my devices out and I go into the bedroom with my husband in the evening and they’re like, they said that to you? And I’m like, yeah, they would bring that up in the appointment because they were in a safe place. I think this is great. And you could suggest to them, I suggested it to the hearing husband that I have, but he would not wear glow in the dark lipstick to help with lip breathing at night. but those are important things. And lately, when I’m doing workshops for different groups around North America, people tune in from all over. And I’m saying that because what you’re doing, once you get it going, if other people can tune in to benefit from this please let me know and if I can help you in any way, I would be pleased to do that. so here it is, folks. You’re hearing it right here. It might be a little bit of collaboration. That would be amazing. It would be wonderful. Yeah. we’re running short of time and it’s been a free ranging conversation with the wonderful nationally brogan and an audiologist who has hearing loss herself. And extremely inspirational because you are walking and talking exactly what I believe in. and what I’m very passionate about. And it’s just been a pleasure to talk with you and for you to share these things with us. I’m sure you’re a wonderful inspiration, I’m not sure I know, to be an inspiration to other audiologists and to people with hearing loss as well. So keep doing what you’re doing and maybe next year we’ll tune in again, we’ll have another chat and see how some of your courses and your outreach is going along. So thank you so much for joining us today. Thank you for having me. You’ve always been inspiration for me and your book and everything you’re doing, so it’s amazing. So thank you so much too for having me.