2005–2006 Scholarship Recipient

PAUL HIGGINS
USA STUDY TOUR 2006

Hello there to all Quota International members. I would like to start of by apologising profusely for taking so long to get a story to you but also to thank you from the bottom of my heart for funding my trip to the USA in 2006. It was surely money well spent, as you will see.

I am 41 years old and just recently completed my Master of Audiology degree. I have been conducting my own private hearing aid research for the past decade or so. I have three lovely children, 2 sons who are 18 and 17 respectively, and a 7-year-old daughter. My partner Tracy also has three children. I live in the beautiful city of Tauranga in the Bay of Plenty, New Zealand and currently work for Bay Audiology. My hobbies include fishing, reading, flying gliders (I am an instructor), and music – I am a professional drummer (teaching, performing and recording) and I’m an avid music history buff.

My Early Years

I first developed a hearing loss around the age of 4 that was believed to be caused by a severe case of measles. It started as a fairly mild loss then gradually got worse over time. At the age of 12 I took up playing drums (the very instrument not designed to preserve hearing!) and played my first professional gig at 14 with my college music teacher and others. From there I had a very interesting and varied musical career, performing and touring with a vast range of local bands and NZ icons including Hard to Handle, Hipshooters, Ritchie Picket, Suzanne Prentice and many others. As well as performing, I was involved in a number of recording studio and documentary projects, and won Producer of the Year and Album of the Year awards at the 1995 Bay of Plenty Music Awards.

During my teenage years I took up gliding and then went on to fly helicopters. Unfortunately my hearing loss became worse and there came a point where I was unable to continue with my commercial helicopter license. I was absolutely devastated and became depressed, angry and ‘lost’ for a long time and often turned to alcohol, which eventually had dire consequences on my marriage and health. One day whilst flying an American tourist over Mt Maunganui, he commented on what a great job I had. After explaining that flying gliders was only a hobby and giving him the sob story of my helicopter career ending, he mentioned he had an audiologist friend in Florida and how it was an exciting and growing profession because of the digital revolution. By the time we landed I knew this was what I was going to do with my life. The next day I drove to Auckland to check out the Auckland University audiology department. I met with Professor Peter Thorne who gave me the lowdown on what was required – I was looking at a minimum of 5 years fulltime study to gain a Bachelor degree, then a Masters in Audiology. At the age of 29 and already with 2 children and a multitude of debts, this was a daunting prospect. But I set my sights and counted down the days which turned into another 6 years before finally I started my Bachelor degree at Waikato University in 2003, majoring in psychology with studies in physiology, screen and media, linguistics, history, and business and marketing studies at summer school.

Prior to this, around 1998, I had also begun studying hearing aid technology and running solo trials of various hearing aid settings in my own hearing aids as I was very dissatisfied with the sound quality of hearing aids to date, especially the early digital aids which did not have the same resolution capabilities they have now and sounded absolutely dreadful. However, I soon discovered that no matter what the level of technology, sound quality could be maximised when set properly, just as one can set the graphic equaliser on a cheap stereo and get a point where it sounds okay, even though it may not rival a 200-watt home theatre system. The same is true with hearing aids. Hearing aid prescriptive procedures are generally based on averages obtained in research trials. However, through experimentation I discovered that I was consistently able to obtain far better results for myself and others who were working with me and eventually I was able to pinpoint a set of averages based on a range of hearing loss types that, to me and the people who were trying these settings, sounded much better and had just as good and in many cases superior speech intelligibility than anything currently available.

In 2003, I met with the manager of Bernafon at that time (Ken Bozeman) who was very supportive of my pursuit and kindly supplied me with a new technology of hearing aids called Symbio, which utilised a channel-free compression system. These aids were fantastic, far and away the cleanest and clearest signal reproduction I had heard in hearing aids but unfortunately many audiologists just did not seem to be able to get their heads around the fact that there were no channels to contend with and did not embrace this technology to the degree that they perhaps could have. A lot of ground was covered in my trials using the Symbio aids. I wrote an article on this technology which Bernafon released and to this day those who know this technology well and use it properly will testify to its quality. I would like to mention at this point how grateful I am to Bernafon for their on-going support, in particular Fiona Birchall (now with GN Resound), Adam Kraska (Australia) and current NZ manager Maurice Du Toit.

It was around this time (2003) that my prescriptive procedure averages were becoming excitingly very consistent. But it was still in its infancy and there was a lot to learn. On top of this, I was now at university and trying to get my head around computer programmes, statistics, and a lot of other scary things. My investigations slowed down quite bit but in 2006 but when I began my Master of Audiology degree, my motivation for the hearing aid prescriptive procedure ignited again and I was fortunate that year to win several scholarships, including being one of the AMP scholarship winners that recognises excellence in projects that benefit others in a wide variety of settings. At this point I would also like to acknowledge my gratefulness to the Dillon Trust in Tauranga who helped fund some of my university fees, the Blue Lagoon Charitable Trust in Tauranga who helped with accommodation costs, and of course Quota International in Australia/New Zealand who helped fund my trip to the USA to further investigate my prescriptive procedure.

USA 2006

My trip to the USA was a life-changing experience. I visited world-renowned hearing aid researcher Mead Killion, president and founder of Etymotic research in Chicago. This man and his company have over 30 world-wide patents for many hearing technologies, including the legendary K-Amp hearing aid, and the insert tips that virtually every audiologist uses now when testing hearing. I was told that this guy sometimes eats audiologists for breakfast and does not suffer fools gladly, and that if I did not impress him in the first 5 minutes I would be out the door (a staff member at Etymotic told me this after my arrival). So my first approach was some psychology since he was apparently a very well acclaimed jazz pianist and classical violinist, and I was also a musician. His very first words to me were ‘So you’re a drummer, are you? You like jazz? After answering ‘yes’ to both questions, he said ‘Righto, you’ll do’ and we then began our meeting by going out to lunch! While we were sitting around outside eating, a 747 flew overhead very low and very loud. I asked Mead and Tim Munroe (Etymotic software engineer) if that noise was close to being painful. They replied ‘yes, why?’ From there I explained that my approach to the prescriptive procedure was based on two basic things – first, I always used normal hearing people for comparisons, and I always start from loud to soft. For example, when I was developing my formula, I would ask normal hearing people to tell me when a stereo for example immediately became uncomfortable. I would only do this once for a few seconds, and it was never at dangerous levels that would cause damage to hearing.

I discovered very often that people who wore hearing aids reached an uncomfortable loudness point much sooner wearing hearing aids than they did without them. For those not involved in hearing research or studies, this may seem to be obvious. But studies have shown many hearing impaired persons judge loud sounds around the same levels as normal hearing persons. There is a phenomenon known as ‘loudness recruitment’ which is basically an unusual growth of loudness that those with sensorineural hearing often have. But this is often misunderstood. It refers to the fact that these people have a much smaller dynamic range from soft sounds to loud. But at more intense levels, around 90-95 dB SPL approximately, loudness judgment tends to be approximately the same as normal hearing people, although there are of course exceptions and also those with very severe/profound loss are a different matter.

Mead Killion and I discussed this at great length, and is one of the reasons why the K-Amp hearing aid was so popular with sound enthusiasts and musicians, because it reduced gain (volume) at loud levels in a manner than was vastly different to the majority of other compression-based hearing aids, which often result in distortion at high levels. As well as this, many prescriptive procedures tended to, and still do, provide inappropriate amounts of gain at not only loud levels, but at medium and soft levels too. The balance is wrong in my view. And this in a nutshell is the basis behind my formula – to provide amplification in a manner that is as close to what normal persons experience. Nothing irritates me more than patients describing their hearing aids as ‘sharp and tinny’, and sounds like Niagra falls when they go to the toilet, and clinicians telling them this is normal and they will get used to it – their brain will adjust because they haven’t heard high frequency sounds for a long time, etc. I must stress at this point that I do not blame

clinicians, this is what they know and have been taught, and the vast majority of them are not hearing impaired and do not wear hearing aids. In fact, I admire many of them who do a great job considering it’s like driving blind for them.

There is definitely some truth to the fact that people will take time to adjust to hearing these sounds again yes (auditory deprivation), but my point is hearing aids do not have to sound tinny and sharp if the are set properly in the beginning – granted, they can be given less amplification overall to begin with which can then be increased as they become used to hearing sounds around them, but sharp and tinny at the outset? No! It’s all about proper frequency response shaping from the beginning and taking into account the small physical size of the hearing aid components such as the microphone and receivers (speakers). Most hearing aids can be optimised to a degree, and my formula simply seeks to provide a rich, bright but warm environmental soundscape from the outset, or at least move toward that if the ‘first fit’ doesn’t quite achieve this, as remember these procedures are based on averages only.

I have been doubted, knocked back, ridiculed and frowned upon by some of my peers in this industry, mainly in New Zealand; after all, who was I to suddenly appear and challenge the existing commercial (a key word) formulae based on ‘empirical’ research?

Believe it or not, I even had one person tell me I was full of it, and that no such formula of mine existed! But by the same token, I have had tremendous and encouraging support from a number of internationally acclaimed hearing researchers and audiologists, and many hearing aid users, which at the end of the day is what counts.

I must also stress that I’m absolutely not knocking good, solid research and that I do have a great respect for validity, something that was instilled strongly in me during my time at Auckland University. But people do need to remember that all research that results in a commercial offering may not always agree with another offering. Hearing technology, and all the things that go with it, including prescriptive formulae, is big business these days and manufacturers and researchers are scrambling for first place. Indeed, the DSL v. NAL prescriptive procedures debate is legendary, and they are vastly different from each other. My research at present has nowhere near the ‘scientific validity’ as say NAL-NL1, a common prescriptive procedure developed in Australia and used world-wide. But this does not make my method any less effective in the real world on real patients. The proof is in the pudding, as they say, and it was the results I achieved with internationally acclaimed bass player Jerry Scheff that really gained attention and further boosted my confidence in what I was doing.

Jerry Scheff

When I was in the USA meeting with Mead Killion, I had 6 days spare in between meetings, so at my own expense I flew to Memphis to visit Elvis’ Graceland and to jam with some blues bands on Beale Street. I was also scheduled to visit the St Thomas hearing research centre but alas they were on a summer break and the person I had organised to visit with was suddenly called away out of town.

I then went on to Nashville via bus to visit legendary drummer Ronnie Tutt, who’s credits include Elvis Presley, Sammy Davis jnr, Roy Orbison, Johnny Cash, Billy Joel, Neil Diamond, and hundreds of others. While we were sitting around with his family on 4th July waiting for it to get dark to watch the fireworks display, Ronnie asked me if I thought I would be able to help Jerry Scheff with his hearing loss, and I said I would certainly give it a shot. Jerry’s credits are also incredible and include Elvis Presley, Bob Dylan, The Monkees soundtracks, John Denver, Elvis Costello, and again hundreds of others. Incidentally, his son Jason is the lead singer and bass player for the band Chicago.

We met up several months later in Sydney when they were doing the Virtual Elvis show, where Elvis is on the big screen and the band are playing live onstage re-performing the music along with Elvis, absolutely unreal, I had tears in my eyes when the concert started because I never thought that in my lifetime I would ever get to see Elvis and his concert band, who were and still are my main music heroes, playing live. Elvis on record is one thing, hearing his voice through thousands of watts in a stadium is another – it gave me the shivers. A long time friend of mine went with me and though not a big Presley fan as such, he appreciated who he was, and he too was overwhelmed and had tears.

Before the show we had dinner with the band, then had a discussion with Jerry about his hearing loss. I could tell then that it was pretty severe. We made plans to meet, and a year later on Dec 4 2007 he flew to New Zealand to spend a week with me. I managed to get some sponsorship from Bay Audiology, for whom I’m currently working and also had a special set of aids made in the USA by America Hears specifically for music performing that contained a technology known as ADRO (Adaptive Dynamic Range Optimisation), which was the topic of my dissertation at Auckland University and achieved significant results in favour of ADRO. Bay Audiology also supplied two sets of aids from Siemens for Jerry’s everyday use, including the new Nitro Power CICs (completely in the canal). I applied my formula to all these aids.

Whilst I was confident of my formula to date, I was very nervous when Jerry arrived. This guy had been to audiologists around the world including Los Angeles, London, and Edinburgh, and he was still very unhappy with the sound he was getting. Now he had flown all the way from Scotland and it was my turn – yikes! When we got to the airport car park, I handed him the Siemens canal aids and explained that this was just a first fit of my formula to get us going and be able to at least converse (he was having tremendous trouble hearing me, and I’m loud). He put them in and straight away said ‘Oh wow man, what a sound! This is what I’ve been looking for, man! (He is an old hippy at heart and talks like one too). Knowing how much scope I had left to fine-tune if needed, I was incredibly relieved and ecstatic at the same time. For the record, his hearing loss was overall very severe/profound, with his high pitches being around 95 – 105 dB thresholds.

A few days later we performed together in Tauranga at a private gathering to test the music aids, which were built with extra large speakers in them. They were in the ear aids too, but bigger than the Siemens ones. The day started with a couple of guitar players jamming while Jerry watched, and gave me the thumbs up for the sound. Then more players were added and finally the whole band with a rhythm section played full volume. Still clear sound with no distortion in his aids. Then came the moment I had waited all my musical life for – Jerry got up to play with us. Words cannot describe the feeling I was experiencing, jamming with my bass hero and seeing his face light up when he started to play. He told me later he had not heard so clearly for years, and had never been able to wear hearing aids on stage. He made a speech at the end of the jam acknowledging how this visit had changed his life. And all this was captured on DVD. It was surely my proudest moment. The next day his wife (an accomplished film producer) rang me from Scotland and she was crying. She said she had just had a conversation with Jerry on the phone, and it was the first phone conversation they had ever had. In a later email Jerry described a similar situation where he and his wife were talking after he returned to Scotland and she became tearful, telling him it was the first time they had been able to converse freely, face to face, without making adjustments to compensate for the hearing loss. When Jerry and I were driving back to Auckland, he suddenly turned to me with tears in his eyes and said ‘Do you realise what you have done for me man? You’ve given me my life back’. Again I was stunned. On the way to Auckland before I picked him up I was listening to him on the car stereo playing with Elvis live at Madison Square Garden, marvelling at his beautiful playing, and now, a week later, he was sitting in my car telling me I had just changed his life. It was the most surreal and emotional week of my life.

There is still more research for me to do before I reach the stage of my formula being available commercially. An American and an Australian company (whom I cannot name at present) are currently keeping an eye on the research with the view that if the official results are the same as my unofficial trial results, then they may possibly purchase it as their proprietary formula to use in a new line of hearing aids. I am just about to apply for ethics to make my research official as such, and it is all a very time-consuming process, especially since I’m now working full time. But I’m in no hurry and, at the end of the day, whether it becomes commercially available or not, I can still use it to benefit patients that I see. And that’s what it’s all about.


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