3 years ago, Tasmanians did not have much choice when it came to having their ears cleaned or dewaxed. They could either risk getting their ears damaged by self treatment and pharmacy options, risk getting their ears syringed at their GP clinic often after having to come back for multiple appointments or having to wait months upon months for an ENT appointment for safe microsuction to be administered. As an Audiologist working at a Audiology Clinic in Devonport back in 2015 having come across from Melbourne, I was aghast at the lack of options my patients had. What hit the nail on the head for me was when one of my patient refused to wear their hearing aids due to a desire not to have his ears syringed by his GP. I felt bad for him and other like him that there wasn’t really any practical alternative to syringing which I already knew was not the safest procedure around (read my blog about this here). Being the kind of clinician that goes above and beyond the normal call of action, I decided to bring Microsuction Earwax Removal to Tasmania.

The Birth of Comfort Clean Ear

In February 2016, I took my young family across to Melbourne on the Spirit of Tasmania and embarked on a 3 week odyssey getting trained in the microsuction way. It was rigorous training and at first I felt that it was a mistake to have come all this way and how I was not going to be able to learn this skill. But with a bit of grit and determination, having practised on over 100 REAL “brave” patients, the skill was cemented. ​ A few weeks later, Comfort Clean Ear was born in Devonport – the first Microsuction Earwax Removal Clinic in the whole of Tasmania in the history of Tasmania. The first patient I saw was at a home visit in Ulverstone. Since then, Comfort Clean Ear has serviced the needs of almost 1500 Tasmanians from all over the apple isle.

A New Nurse

In May 2017, well respected Registered Nurse Heather Grainger came on board to help see patients in Launceston at the Launceston Medical Centre (aka Launceston Health Hub). Being a very caring human being, Heather approached me to see if it was possible for her to see patients in St Helens. She noticed that we had a lot of patients driving huge distances to get their ears cleaned and she wanted to make it easier for them. I agreed and Heather now conducts appointments in at St Helens GP Clinic every 5-6 weeks.

Heather also noticed that not everyone can or is able to physically come to an appointment at a GP clinic due to physical limitations. Heather therefore conducts home visits as well as nursing home visits for all patient in Devonport and Launceston. Our patients have been very grateful for this service.

Microsuction earwax Removal Clinics in tasmania

If you need your ears cleaned and are living in Tasmania, then you now can go to professional earwax removal clinics in Hobart, Launceston, Devonport, Ulverstone, St Helens and now……..wait for it……….

Heather will now be seeing patients at Somerset Medical Centre. That’s right, if you are living in the north-north west of the state, you will be able to be seen in Somerset for all your earwax removal and outer ear infection needs.

Outer Ear Infections – Otitis Externa

At Comfort Clean Ear, we don’t just clean ears with wax build up. We often see patients with infected debris either bacterial or fungal. When this is the case, quick and decisive treatment is recommended which includes cleaning the ear and applying topical drops prescribed by your doctor. When cleaning is not administered first, the medication is not as effective which is why microsuction ear cleaning clinics like Comfort Clean Ear are really providing amazing help for patients with these infections. Waiting times to see an ENT can be up to 6 months if not longer. Waiting times to see our clinician is sometime only a few hours and at most a few days. We are extremely flexible and also work out ways to see you sooner if necessary and wanted.

Conclusion

Tasmanians have heaps of choice and options now for save earwax removal when only 3 years ago, this was definitely not the case.  If you would like quick and effective ear cleaning without the mucking around of going to your GP or waiting months to see an ENT, give us a call on 1300 380 060 or book an appointment online today. Let us rejuvenate your ears and provide the gift of hearing.

Well as far as looks are concerned, fireworks definitely look amazing. Sound is a different kettle of fish and is what this article is concerned with. In recent times, researches and Audiologist alike have raised the profile of the need to protect one’s ears from excessive loud noise. If you have ever been to a rock concert you will know what I’m talking about.

In fact research shows that any sound from about 85 decibels and above will start to damage our ears. As the level of sound increases above this level, the accumulative damage occurs over a shorter period of time. In other words, 100 decibels of noise exposure will do the same damage as 85 decibels over a shorter period of time. So the question I hear you asking yourself: will the fireworks display damage my hearing?

Well firstly, if you are concerned, the easiest way to still enjoy the night’s festivities is to bring along some plugs (which you can get from the chemist) or to put in your ears just before the strike of midnight.

The best thing to do (too late for tonight) but to get custom ear plugs made from an Audiologist which can attenuate sound by up to 30-40 decibels across all frequencies.

​The truth of the matter is yes, fireworks are loud enough to do damage to the fine structures of your inner ear including the finite number of inner and outer hair cells within the cochlear. Distance is a HUGE part to play and the greater the distance the less damage you can expect.

The World Health Organization says that hearing loss from loud noise (or noise induced hearing loss) is reaching epidemic proportions in wealthier nations and recommend that adults avoid sounds louder than 140 decibels of maximum sound pressure.

Fireworks and firecrackers can exceed 150 decibels. As we just mentioned, sounds from about 85 decibels will start doing accumulative damage although louder sounds will do instant irreversible damage to your ears.

Here are a few more tips to protect your hearing tonight:

• Try to find a vantage point that is at least 100m from the fireworks display (the greater the distance the better).
• Wear hearing protection throughout the fireworks display (and at the night club afterwards).
• Protect children’s’ ears including young infants (for the earlier fireworks displays).

For more information about hearing loss, please visit this website here. There is also a website that can tell you if your current lifestyle is doing damage to your hearing at knowyournoise.nal.gov.au

Wishing everyone a healthy and awesome 2019,

keywords: noise induced hearing loss, custom ear plugs, fireworks, tinnitus, ringing ears, unsafe noise, NYE

Related: Why Microsuction is The Best Way To Remove Earwax

This might be the case for say soft wax. But what happens when the earwax is like a hard rock which is often the case when we see our patients? In our humble opinion, water could be more destructive than beneficial. Why I hear you ask?

Well let’s take two recent examples of patients in the last two days. Everyone knows that in the Summer the perfect place to go is the swimming pool to cool down. In Australia, swimming pools are packed to the rafter on hot days not to mention our beaches.

In the last two days, we have had 2 patients that went swimming and only after after going swimming did their ears become blocked and the need for treatment become necessary. In both cases these patients had dry hard rock-like wax in their ears. So what’s going on?

My hypothesis is that despite the excessive wax in each of these patients’ ears, there was probably still a (ever so small) gap between the earwax and the wall of the ear canal. Large enough for even a small drop of water to block. Hence the instantaneous blocked feeling these patients felt upon immersing themselves in the swimming pool.

Back-up a minute. You’re probably asking well if water is so bad for the ears, why do GPs use water syringing to dislodge earwax? Well the simple answer is they shouldn’t. A study published by the RACGP (Australia’s Head GP Association) admitted that syringing carries several risks and should only be administered under certain conditions several of which that will be mentioned below.

It also mentioned the astonishing fact that 1 in 5 medico-legal cases involving GP malpractice is do to problems arising from water syringing. If this no warning signal to the dangers of water syringing then you are braver than me.
​
Water that can become trapped inside the ear canal can give rise to outer ear infections that can be both bacterial and fungal in nature. For some, this can mean months of prescribed ear drop use, avoidance of water in the ears (so no swimming ) and hearing problems that can make anyone lose their mind.

In summary, use water in your ears for earwax at your own peril. Whilst for some this may be a quick way to remove wax, for many, it will just push the wax further in or even worse, give birth to an infection. We can never be too sure of the sterility of the water.

If you would like to have your ears Professional Cleaned using Quick, Safe, Precise & Gentle Microsuction Earwax Removal, then look no further than Comfort Clean Ear, your Tasmanian Earwax Removal Specialists.

keywords: microsuction, earwax removal tasmania, earwax removal devonport, earwax removal launceston, safe earwax removal, water syringing

• Olive Oil
• Waxol
• Audiclean
• Earol – olive oil spray
• Ear Clear  – wax removal syringe
• ProEar from  Miracell

Given its natural abundance and ear wax softener that is preferred by us at Comfort Clean Ear. We will be starting with every day olive oil. Stay tuned…..

​We are very pleased to be joining the Launceston Health Hub who are in the process of building a state of the art medical hub bringing together different medical expertise in the one building.

The Royal Australian College of General Practitioners (RACGP) have recently put forward some guidelines for GPs to take note of the next time they need to decide whether to prescribe antibiotics or not. This is especially important given the rise in concern of anti-biotic resistance.  Dr Lynn Weekes, NPS MedicineWise CEO says “Using antibiotics when you don’t need them can contribute to bacterial resistance, both in the individual and the community…the more antibiotics we use, the more chances bacteria have to become resistant to them and as a result they will lose their power.” The RACGP instead recommend a ‘wait and see’ approach as the majority of ear infections in children resolve by themselves.  If symptoms worsen or don’t improve with time, then antibiotics (assuming the infection is bacterial) may then be warranted.  Interestingly, antibiotics do not reduce the pain associated with ear infections and may even have adverse effects like diarrhoea. Therefore, in the initial 24-48 hours, an analgesia like a paracetamol may be prescribed by the GP.  As a parent, it can be very tempting to accept a quick fix to a medical issue involving  your child. But what the RACGP are suggesting is to have this conversation with your GP to determine whether antibiotics are indeed necessary.

At Comfort Clean Ear, we do not just remove wax. Often we are asked to remove and clean debris resulting from infection of the ear (bacterial and fungal). We are then asked to paint on prescribed drops onto the infected area to ensure they work more effectively if and when they are actually required. This is akin to cleaning up a wound before applying some ointment  like when your child falls over and grazes their knee. So next time your child needs to have ear drops with anti-fungal or  anti-bacterial properties administered, get Comfort Clean Ear to do it. This has the  potential to  expediate the healing process.

Following on from this survey, Comfort Clean Ear, a new dedicated professional ear wax removal service that has started operating in the North-West Tasmania. Comfort Clean Ear removes ear wax using gentle micro-suction technology under direct observation. This is the same safe, gentle and dry technique used and preferred by ENTs and is much more effective at removing impacted wax.  Where the syringing method is contra-indicated or for those patients where syringing has not been a pleasant experience, Comfort Clean Ear provides a safe, timely and practical alternative for your patients who may otherwise need to wait excessive periods to see an ENT.

Similar wax removal clinics have integrated well on mainland Australia and have been well received by GPs, Audiologists and ENTs alike.  They have helped improve clinical efficiencies by not wasting GPs’ precious time in the medical appointment removing wax, by allowing ENTs better use their time to manage more important ear related problems as well as reducing the need to bring a patient back for another appointment due to wax occlusion for Audiologists.

A link to AMA Tasmania’s latest Online Newsletter can be found  here which supports the establishment of Comfort Clean Ear.

Summary of Survey Results:

Q1. Have you ever removed wax from a patient’s ear?
– 83% answered yes

Q2. If wax removal is not the prime reason for a patient’s appointment, how much of the appointment time is taken up by the wax removal procedure?
– 50% of respondents said that wax removal on average took up between 20-33% of the appointment time

Q3. When would you not perform wax removal as part of your appointment even though it has been requested?
– 66% of respondents would not perform wax removal if present otitis externa or evidence of ME pathology

Q4. What method do you or other colleagues use for wax removal at your medical practice?
– 100% of respondents selected ear syringing

Q5. Are you aware of patients refusing to receive wax removal as a result of their aversion to the syringing method?
– 33% of respondents said ‘yes’

Q6. Have patients ever complained of pain during the syringing method?
– 33% of respondents said ‘yes’

Q7. Have you ever failed to unblock an ear full of wax and if so, what’s the frequency?
– Everyone said ‘yes’ but it doesn’t happen that often.

Q8. If available, would you refer your patients to have wax removal performed by specially trained Nurses or Audiologists who possess skills in safe wax removal using the same techniques ENTs use (micro-suction and curettes)?
– 66% of respondents said yes. The other 33% said they would at least offer their patients the option.

Q9. Do you think such a service (that is already offered in most major cities on mainland Australia), if provided outside the GP appointment, would serve as a valuable way to improve clinical efficiencies for GPs?
–  66% of respondents said ‘yes’

Q10. Given access to ENT services for public clients requires lengthy waiting periods, do you think a wax removal service provided by Audiologists and/or Qualified Nurses would be a more timely and practical alternative for safe wax removal for patients who choose not to have wax removed via the syringing method?
– All respondents agreed with the assertion.

Firstly we need to ask ourselves, how do we hear? We hear with a combination of both our ears and our brain. Sound enters our body via our ear canals (for the majority of people), gets converted into mechanical energy in our middle ear via our ear drum and ossicles (3 small bones in the middle ear) which in turn creates fluid movement in the cochlear at specific locations corresponding to the frequencies present in the sound. The cochlear then converts this mechanical energy into an electrical signal that gets sent to our brain (the auditory cortex) via our auditory nerve. It is then up to our brain to process and interpret these sounds so that they become meaningful to us.  Unfortunately, a hearing loss can occur anywhere along this pathway and can sometimes involve multiple locations. For example, a person may simultaneously have a perforated ear drum (conductive hearing loss) and cochlear damage (sensorineural hearing loss). This will both attenuate and distort sounds entering the auditory system. Alternatively, you may have a person who has a combination of a cochlear loss and due to ageing, is unable to process sounds as efficiently in the brain. Even with hearing aids, this kind of person may still struggle particularly in noisy situations.

So what can you do? Our brain is a muscle so the more you use it, the better it gets at doing a specific task. If hearing aids have been prescribed to you, the most important thing you can do to get the most out of them is to WEAR them as often as possible. This will provide the hearing parts of the brain with  regular stimulation to the important speech sounds required for speech understanding. The more the brain engages with these sounds, the better it gets at extracting meaningful information from  them.  As an audiologist, I often get asked by people ‘how often should I wear my hearing aids as I am home by myself during the day and I only really need them when I go out?’ Well, my response is that if they want to hear well with their hearing aids when they need them, they should wear their hearing aids when they don’t need them. Even a few hours during the day (particularly when watching TV) will only help.

The next thing to do is make sure the sound leaving the hearing aid and travelling down your ear canal is not interfered with by wax. Wax can prevent sound from cleanly travelling down your ear canal and hence will reduce the effectiveness of your hearing aids. The easiest  way to manage wax is to use a few drops of olive oil in each ear once a month (some people may need to use more and apply it more often). Hearing aid users tend to have a higher propensity of wax occlusion problems owing to the fact that they have something in their ears which interferes with the ear’s natural self-cleansing mechanism. Therefore, often olive oil by itself will not be enough to clear the wax. The safest, gentlest and most effective way to remove wax is to get a trained clinician to use gentle micro-suction which is what Comfort Clean Ear offers. This is the preferred approach used by Ear, Noise and Throat Specialists for a reason. Wax can also get into the hearing aids so it is also important to be vigilant with cleaning them. Its a good idea to brush all over the hearing aids including the microphones which may become blocked with dust. Some hearing aids even come with their own wax management systems in the form of wax guards which need to be changed every couple of months. If you have not been shown how to do this, ask you audiologist next time you se them. Comfort Clean Ear can help with this too. Just bring in all you hearing aid accessories with you to your next appointment with us. At the end of the day, not having clean ears or clean hearing aids is like getting dental work done on your teeth but then not brushing them or keeping them clean.

Finally, the last thing needed to get the most out of your hearing aids requires some assistance from others. Your family and friends need to understand that the best way to communicate with you is by gaining your attention first, reducing their distance to you and to make sure they are facing you when they speak. In noise, most hearing aids are designed to focus towards the front which means to hear at your best in these situations, make sure that most of the noise is behind you and the  person you want to hear is in front of you. I have to stress here that even once all that I have said is applied,  for some individuals with a hearing impairment they will still find it difficult in the more demanding listening environments like a restaurant. Sometimes the distortional aspect of ones hearing loss (which can include auditory processing issues) is just too great for hearing aids to overcome. More sophisticated hearing aids certainly have a greater chance at providing assistance but one does need to have realistic expectations.  It may even be difficult for people with ‘normal’ hearing. Some environments are just too demanding.  I know I struggle hearing my wife sometimes (maybe not enough) in the car especially when travelling at fast speeds.  For some people, remote microphone systems are the only viable way to provide auditory information in the form of speech directly from the source  via a remote microphone to their hearing aids when the listening situation becomes too complex.

And thats it!!!

I hope by reading this post, you have a greater appreciation about the intricacies of our ears and the way we hear as well as the role hearing aids can play to help reduce the impact of hearing loss.  Stay tuned for our next post.