By Melissa A. Papesh and Stephanie R. Pesa
This article is a part of the September/October 2017, Volume 29, Volume 5, Audiology Today issue.
Case History
A male veteran (MV) in his early 50s recently presented to a Veterans Affairs (VA) audiology clinic stating that he had noticed a substantial decrease in his hearing ability following his military service. The MV served in the Navy and in the Army National Guard for a total of 32 years, which included many domestic and international service missions. While deployed to Iraq, he was exposed to a total of three bomb blasts, the most severe of which occurred approximately six years prior to presenting in the VA audiology clinic.
During this incident, the MV was in a military convoy that struck an improvised explosive device concealed in the roadway. The blast exposure left him with a traumatic brain injury (TBI), as well as ruptured discs and vertebrae throughout his spine, a broken nose, permanent damage to his right arm and knee, and loss of multiple teeth. For this encounter, he was awarded a medal for exemplary service in combat. At the time, he was seen in the VA audiology clinic, he had previously undergone cognitive rehabilitation treatment through polytrauma and speech language pathology services for concerns related to cognitive difficulties.
His additional medical diagnoses included post-traumatic stress disorder (PTSD), anxiety, obstructive sleep apnea, chronic headaches, type 2 diabetes mellitus, sensitivity to light, colitis, chronic knee and back pain, hyperlipidemia, weakness and numbness of the right arm, and coronary heart disease. An intake interview revealed that his primary auditory complaints included difficulty hearing in noise and in the presence of multiple talkers, difficulty understanding on the telephone, problems paying attention to people speaking, and confusing similar-sounding words.
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