Steer for the deep waters only

Robert Day's thoughts on his photography, his writing and his business

Loud and clear

with 4 comments

I’ve worn spectacles since the age of six; so regular visits to the opticians have been part of my life for many years. Over time, this has become a more and more expensive business as my optical prescription has become more and more extreme. Discount opticians – Specsavers, Vision Express and similar – can’t help me because they make their money out of the 80% of cases who present with fairly straightforward prescriptions. Just to be difficult, I’m in the 20%. To be fair, I did try a discount optician when they first appeared on the High Street. It turned out that my prescription required lenses that they had to order in specially, so their price and order turnaround promises didn’t apply. This is what you get for being different.

Of course, I could have spectacles through the National Health Service – but the range of frames is limited  and there would be no option over the type of lens I could have. I really need two different prescriptions, so I have varifocals – two lens types in one optic. I’ve never asked, but I suspect that varifocals aren’t available on the NHS, meaning that I’d have to have two pairs of spectacles and keep swapping them over for different situations. Also, given the extreme nature of my prescription, my lenses are pretty thick – so I have top-end “thin” branded lenses, which I also doubt are available through the NHS. Even with the hi-tech thin lenses, mine resemble the bottom of a beer bottle in thickness, so again I dread to think what the NHS equivalents are like.

Last year, the opthamologist said that I needed a new pair of spectacles because of a change in ‘prism’ – the way that my eyes work together to  deliver stereoscopic vision (or in my case, not). The technology of opthamology is improving all the time, and there have been new tests introduced for prism in the past couple of years which give a far more accurate evaluation of the patient’s needs. However, I have one “lazy” eye – it works fine, but contributes very little to my overall vision field. So my stereoscopic vision is pretty poor – one reason why I was never much good at ball games when I was in school – and the tests for prism are actually measuring something which I hardly find myself experiencing in everyday life. So I had a new pair of spectacles last year that I found made almost no difference to my everyday vision. I was not impressed.

And then, as if I don’t give my opticians enough trade, the last time I went in, I was offered a free hearing check. Now, I’ve fallen foul of this before. It’s administered in the normal shop, and if there’s a lot of external noise, or other customers in the shop, the result is going to be pretty poor. Added to that, I have tinnitus, so the quieter tones in the hearing test require me to concentrate very hard to pick them out from amongst the continuous “noise” that the tinnitus gives me. This concentration can easily be broken if there are distractions such as other customers and conversations. So I ended up seeing the audiometrist at the beginning of the year as well as having my annual vision test.

The vision test, I’m pleased to say, resulted in no significant change in my prescription, though I was told that I have the beginnings of a cataract in one eye (though that won’t become a problem, all being well, for a good five to ten years). The audiometry was something else. I first had a full audiometric examination two years ago, when I was told that I have the beginnings of age-related hearing loss at the upper end of the hearing register. This came as no surprise to me. In my varied past, I spent five years working for the Social Security Industrial Injuries Unit in Birmingham. The area I covered included parts of the Werst Midlands where there had been a lot of engineering works, and so a lot of industrial deafness cases. Part of my job involved commissioning consultant audiometrists’ reports, having those reports interpreted by the department’s Regional Medical Officers, and sometimes dealing with appeals against the decisions on those industrial deafness claims, including writing the Secretary of State’s submission to the appeal tribunal. So I know a reasonable amount about audiograms, and I could broadly interpret the results as easily as the audiometrist. I had no cause to doubt the diagnosis.

Last year, the initial in-shop screening told me nothing I didn’t already know, but was administered on a good day when I was able to give good responses to the test. But this year, it was not a good day. So I ended up seeing the audiometrist again; and this time, the verdict was a lot of hearing loss at the 4 kHz level, almost to the stage of being defined, she said, as “profound”. The audiogram correspondingly showed a dramatic plunge of the trace to bear this out. Almost immediately, she was saying “We really strongly recommend that you consider being fitted for a hearing aid – or even two, so we can balance out the effect properly.”

The hearing aids on offer start at £450 each, these being the type that fits behind the ear. Once you start looking at types that fit partially or fully in the ear canal, the prices go up accordingly until you are looking at £1250 or more per ear. Other suppliers can also supply hearing aids at a range of costs – I have even heard the figure of £3000 per device mentioned!

It was the audiometrist’s eagerness to set me down the road to more and more expenditure that made me hesitate. Even £450 isn’t money that I can put together at the drop of a hat; and I found her enthusiasm rather off-putting, especially as the loss is in the sort of range where I would only really be missing top-end harmonics. I hadn’t noticed that I was missing conversations, altthough I do find the television often difficult to hear (mainly because the speakers on flat screens are on the back of the set and face the wall), and I have missed the odd conversation in the office (mainly because I sit with my back to everyone else and the test manager does tend to sometimes speak from behind his desk screens without standing up). But I consider that I still have hearing that is perfectly good for everyday purposes. So I thought I’d get a second, less biased opinion, and so I went to see my doctor, who in turn referred me to the local hospital hearing centre.

I went a couple of weeks ago. It was quite illuminating. I was shown into a proper consulting room which was properly soundproofed and away from the main circulating areas of the hospital. The audiometrist explained the test, and I let her, though I did have to warn her to expect some false positives becasue of the masking effect of tinnitus. She then proceeded to administer not only the normal audiometric tests, but also did something I’d not had done before, tests using a bone conduction headset – sound waves transmitted through the skeleton, especially the skull, play a surprising part in our hearing sense. The software the hospital had access to was able to integrate all the results including the bone conduction. They confirmed the diagnosis, as I expected them  to. But the audiogram I was shown was drawn up with a far shallower vertical axis, so the amount of loss at the top end didn’t look so dramatic. Also, the NHS audiometrist’s interpretation of how far up the graph the boundaries between “moderate” and “profound” hearing loss occur was rather different to the private one.

She then proceeded to offer me a behind-the-ear aid for each ear. Completely free of charge. And looking pretty well identical to the £450 base model that my opticians wanted me to shell out for.

My sister, who is older than I am, has also had hearing aids prescribed, though she doesn’t wear them all the time. She made the excellent point that if I bought a private hearing aid, I would have to buy all my batteries; whereas with the NHS aid, the batteries are also supplied free of charge. And if I used the aid full-time, the batteries would last about a week.

I’ve decided that I don’t want to have hearing aids just yet. I shall take advice from other friends I know who have them, and I shall take up any offer of further hearing screening tests to keep an eye on my ears. And if I do have an NHS aid fitted, I can always upgrade in future years if I find I’ve got more money than I know what to do with. (Ha!) In any case; I’ve paid tax into the system all my working life. Why should I go out and pay for something I’ve paid in for already?

They say that getting old is a full-time job, given the number of appointments and arrangements that have to be made for health reasons. Thinking of last year’s brush with prostate problems, I thought then that I was in the best place to have these problems assessed without having to worry about the bill – especially as if the results of all those invasive tests I had had not been so favourable, I would have been fast-tracked for treatment – again, no questions asked, no form-filling, no waiting for an insurance decision on whether the claim was allowable. My experience of the insurance industry over the past few years makes me relectant to have them involved in anything as important as my healthcare and treatment. This experience over my hearing, where I was able to directly compare public and private provision, has not changed my opinion.


Written by robertday154

June 14, 2018 at 10:51 pm

Posted in Uncategorized

4 Responses

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  1. As you say, “getting old is a full-time job”, and I, for one, greatly appreciate your comparison and view on what you have been through and found. They always say that personal recommendation is the best recommendation. Good on you Robert and keep well


    June 15, 2018 at 8:36 am

  2. Interesting !

    When I got my current frames, 30 years ago, I had the option of better frames if I paid the difference between the NHS allowance and the full cost. As I had a problem with perspiration corroding side frames, I opted for some titanium Air frames, which I am still using, albeit on my third prescription upgrade.

    Local opticians having the reputation of being dear, I send the prescription, which is for thin, fully coated photo sensitive trifocals, off to Zagreb, where it is cheaper. I think the last ones were about three hundred quid. A friend in the UK sends his to Hong Kong, where it is cheaper still !

    As to hearing, I think I’m still OK, although I picked up a behind the ear set in Lidl, for Eur10, on the basis that they could come in handy at some point !

    I don’t envy you the tinnitus.



    peter ellis

    June 15, 2018 at 11:39 am

  3. Another personal, insightful post.

    Now if we could just develop intelligence aids, a booster shot just before you vote so you don’t a) elect a moron like Trump or b) foolishly leave the EU largely because of concerns over immigration (let’s be honest).

    Write on, Robert…

    Cliff Burns

    June 15, 2018 at 3:57 pm

    • For some reason, today at work everyone wanted to talk Brexit, when normally the discussion would be about football. It’s not as if they’re normally very politically aware (though I’ve been trying my best to raise consciousness in the 18 months I’ve been there). But being an office mainly full of twentysomething IT specialists, you can guess what their opinion was. And although I don’t get, or do, patriotism, I got approval from my Polish and Nigerian colleagues for the opinion that “the best places in the world attract people from all over the world – End Of.” (Though the Pole commented that one of the attractions of living in the UK was the weather, which says things about Poland…)


      June 15, 2018 at 10:21 pm

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