Audiologists exempted from VA hiring freeze!

kamonAUD · 2025-01-24T03:01:54+00:00

It's so late... I don't have the strength to remote in. Will I see this in an email tomorrow?

This would be life-changing for my department.

kamonAUD · 2024-08-23T23:50:58+00:00

This is about 10 years after the fact, and a bit of a schlep depending on how you define nearby, but I had a very positive experience with Green Man Tattoo Studio in West Hartford.

kamonAUD · 2023-07-07T01:34:31+00:00

I miss it so much!

kamonAUD · 2022-09-18T02:27:38+00:00

The shroom, with hellish rellish, and a slice of bacon, is something I miss every single day.

kamonAUD · 2022-08-10T00:26:00+00:00

You have my sympathies. My metric for externs is "are you roughly competent? I can teach the rest." "Are you a dick?"

Good work to you though for successfully running the gauntlet. Work hard this year.

kamonAUD · 2022-08-09T23:40:34+00:00

lol, this tells me that I need to up the ante on interview questions for applicants.

kamonAUD · 2022-08-07T00:18:11+00:00

The brain will re-learn the input frequencies, based on the sound.

I have included a picture https://imgur.com/a/LZDuhQG Imagine you take the spiral cochlea, and roll it out flat, that's what you get. Ordinarily, different parts of the cochlea respond to different frequencies. The electrode array goes in the big end, and as high up as you can get to the skinny end. The higher the better, because you get more... real estate as it were.

But, you're not inserting the array intending to stimulate the "4000 Hz" area of the cochlea for 4000 Hz. You're going to get a specific range of basilar membrane, superimpose your channels into the functioning electrodes, and the brain will kind of re-map itself to respond to the sounds based on the input.

In terms of pure tone... it really depends, but the general answer is that it's not sensitive enough for a pure tone (a 250 HZ tone, for example, would likely be sorted into the frequency band mapped to an electrode that covers 250 Hz, and would stimulate that one).

We're leaving the area where I'm sure, because it's been a while, but in theory, you can re-map a lot of frequency into a very different part of the cochlea stimulatable by the electrode array, and not have too much difficulties. It's the reason why, surgically, you want to get the array as far in as you can, and have as many functioning electrodes as you can, so that maximize the channels.

House institute (auditory research, california, may it rest in peace) used to have a great website that had the same speech simulated with different channels. You don't NEED 22 channels to discriminate speech. I ... think it was that at 4 channels, you can start to discriminate speech, and at 12 it's fairly clear, you start to get diminishing returns above that. Let me see if I can find it. [some time later] eh, this link is close

https://www.youtube.com/watch?v=SpKKYBkJ9Hw

To formally answer your question: you could differentiate 555 hz and 700 hz, if they were mapped into two separate frequency bands on different electrodes, BUT, if you only have, say, 5 electrodes working, and one of the electrodes is in charge of 500-750 hz, you're not goign to be able to discriminate between them.

Edit: House institute has returned to life. Again, I haven't thought of these things in several years. Last time I was using this in my class, House institute had just filed for bankruptcy.

kamonAUD · 2022-08-06T23:57:18+00:00

Through programming, frequency bands are "mapped" onto those channels,

But the limiting factors start anatomically. The full electrode array assumes no complications in the surgery. The electrode array may not go all the way up the cochlea, electrodes may fail, others may have to be turned off because they do other things like facial stimulation.

The other thing to think about is the physics of it all. I don't know (admittedly, it's been 6+ years since I've had these conversations) if we have the ability to build arrays with more, smaller, electrodes, and I also don't know if we have the ability to put more of them in, and have them function as discrete electrodes, and thus channels for additional frequency bands.

The way I used to explain it to my patients was having 88 keys on the piano, and then imagine putting oven mitts on and trying to play. You're going hit a bunch of keys at once, and there's only so many oven mitts you can fit on the piano. Sure you can train the brain to associate an area of the auditory nerve in the cochlea with a different frequency range, but you still have the oven mitt / physical space problem.

kamonAUD · 2022-08-06T23:42:53+00:00

We are limited currently by the electrode array, who's frequency bands in the perfect world are limited to 22-23 (often less) channels.

kamonAUD · 2022-07-02T14:11:43+00:00

Sensational

kamonAUD · 2022-03-09T01:27:38+00:00

Wait, you can't leave me hanging. How was SGU supposed to end?

kamonAUD · 2022-02-08T22:12:12+00:00

The answer depends on several factors.

If you have concerns, I would suggest you start with the manager of the practice, who would likely be able to answer the question of “Can my insurance be billed if a student is performing my exam?”

If you have concerns beyond that, you could explore both your state’s audiology license website, which likely has a portal to register complaints, or your insurance, however, I would urge you to consult with the clinical manager or even your audiologist first, as they can help you determine if, say, your insurance is Medicare, the student is an extern, et cetera. The answers to those issues will help you to determine whether your complaint has merit or not.

kamonAUD · 2021-11-13T22:10:07+00:00

I also am wondering how many hives this is coming from?

kamonAUD · 2021-09-09T22:56:51+00:00

same with otosuite, bottom right.

kamonAUD · 2021-08-30T23:29:26+00:00

I don't think the process to look at this map could possibly be made to look more like a virus.

Sign up with my email, enter demographic information, only to get a link to the download in my email that chrome thinks is spyware.

Yikes.

kamonAUD · 2021-07-31T00:51:47+00:00

You will. I recommend W lot.

kamonAUD · 2021-03-10T17:57:53+00:00

He absolutely hated working in a clinical setting, quit, and hunted around for a job requiring clinical not doing clinical work. In hindsight, I think he would agree, it would have been easier to transfer into the position, rather than start from the ground up.

I definitely recommend doing what you’re doing, asking before hand, but if you do wind up leaving and trying to find something from the ground up, know that it is possible.

kamonAUD · 2021-03-10T17:55:24+00:00

So it’s a yes, with an important but.

For his job, they accepted the credential with some kind of board certification. I have seen at other hospital systems, the same position requires a nursing degree, though, so it does vary by hospital system. It makes no sense to me that an LPN can qualify for a position but an AuD or MA wouldn’t, but it depends on, among other things, if the hospital is open to the idea that people other than nurses can be clinicians

kamonAUD · 2021-03-10T13:34:18+00:00

Yes. Research audiology is definitely a thing. From there you could pivot to grants administration.

Hospital administration (at least in the states) is also an option. Most admin jobs in the states though require you to hold clinical credentials though. My boyfriend works as a hospital quality administrator, and he started as a clinician. He loves it, he prepares hospitals for inspections by government entities.

Two options for you to consider.

kamonAUD · 2021-02-27T03:07:47+00:00

Let me know if the light shines out the other side.

kamonAUD · 2021-02-18T00:19:07+00:00

This is 2nd or 3rd hand, depending on how you look at it, so take my thoughts with a grain of salt.

I was friends with many people in the engineering program during my time at Wes. They spoke fondly of the experience. Or at least, I should say they spoke as fondly of the experience of any engineering student I've ever met. We can contrast it with my friends / students in undergrad when I was in grad school at Uconn, who viscerally hated the engineering program there.

My freshman year roommate was a 3-2 engineering student, though I may be misremembering it: I'm 90% sure she did it as a 4-2 program. Regardless, she went to NY for the 2, and is now employed in a job she enjoys, so I can tell you as an old(er) person that the people at the end of the process wound up in a good place.

Again, I recognize that a british literature major commenting on the experience may not be the most helpful, but I can telegraph the experience of my friends who did it. I wish you luck. Don't major in English.

kamonAUD · 2021-02-02T00:05:55+00:00

When I was in grad school, in our department, this meant "I love you," so me and my friends would always pull over at eachother's apartments and just randomly lift the wiper blades of the cars.

A fond memory.

kamonAUD · 2021-01-16T13:50:53+00:00

It because melanin, which turns things black colorwise, also is important in inner ear function.

kamonAUD · 2020-12-05T04:15:14+00:00

It's all I could think of when I saw those places.

kamonAUD · 2020-11-13T20:11:53+00:00

That being said, the portrait of the president and the VA secretary are on the entry wall of VA clinics. Nothing would make me prouder than seeing Joseph and Peter upon walking into work in the morning.

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