My new crusade – raise awareness about noise

Communications is by far mostly verbal. Aside from the visual aspects (screen image, video/film, body language etc.), information is mostly spread verbally/auditory. Think about how much information exchange that takes place verbally in these arenas: education, court system, politics, entertainment, family, parties and so on and so on.

The last year or so I have engaged in voluntarily work, such as sitting on boards for the housing cooperative in my community (where I live) and for HLF Oslo (hearing association in Oslo, a subgroup of the national HLF) much like the HLAA.

On the HLF Oslo board I have been designated a role much like a CCO or PRO, in a political aspect, that is. A political interests spokesperson for HLF Oslo. Now, I admit, I have a lot to learn (which is part of why I want to do this Smilefjes  ). One of the issues we are talking about working on is noise.

One aspect that is amazingly neglected in these aforementioned venues of auditory communication is acoustic noise. (it is amazing when you think of it, really! It takes very little resources, and the gains would be HUGE!)

Please take a little time to look at this, it explains it so well:

Why architects need to use their ears

In the Queue of my life, no 44 – (Part 5 of 7)

Secretary of State Sundsbø: – The responsibility lies on Health South-East .

Secretary of State, Dagfinn Sundsbø (SP, Centrum Party) in the Department for Health and Care says to Din Hørsel taht the department have been briefed about the situation for CI-surgeries in the region of Health South-East. – There has been concerns for the difficult situation at Rikshospitalet. We’ve been informed that illness among staff has been a large contributor to the currently difficult situation. But we strongly believe Rikshospitalet will be able to turn this around and that they are doing whatever is possible in order to maintain the set number of CI-surgeries for 2008.

He tells us that the development of the situation are closely monitored via follow-up meeting throughout the fall of 2008. – Health South-East has a clear understanding and acceptance of the demand set by the department as for how many surgeries shall be performed this year, he says.

According to the State Secretary, the Rikshospitalet are working at a project for increasing the surgery capacity by means of eliminating the needs for putting CI-patients into beds post-procedurally. – That project has a high priority and is expected to be implemented some time in October. The Otolaryngology department has drafted a plan for treating more patients. The plan is being finalized and is currently being studied by the hospital management, he says.

Sundsbø says that the reason of the unfortunate situation that has unveiled, is caused by a number of unfortunate coincidences. The Otolaryngology section had a heavy burden of illness, and also had trouble recruiting new staff for compensation. Reduced number of beds available to the section will be compensated by the establishment of the “one-day treatment” project, he says to Din Hørsel. – We’ve also been informed that another problem area is the pre-qualifying CI-examination capacity, Sundsbø tells.

108 patients are currently waiting for CI at Rikshospitalet. [my comment: at current rate the 108th patient has to wait more than 2 years]

In the Queue of my life, no 44 – (Part 4 of 7)

Rikshospitalets goals for CI operations in 2008 will not be met.

As of September 1st, Rikshospitalet has performed 25 CI operations on adults. – We will not be able to achieve the goal of 100 operations for 2008, Rikshospitalet says in a statement.

The former health-minister Sylvia Brustad (labour party), ordered Health-South-East (Helse Sør-Øst) to perform 100 CI operations on adults. Despite the warned budget cuts at the Otolaryngology-section at Rikshospitalet last winter, the State Secretary Rigmor Aasrud from the Health and Care Department (HOD) stated in February 2008 that the order for 100 operations remained valid.

For all the adult patients in line for CI examination to decide medical eligibility, waiting to get back to working life, this is a very meager comfort when the summer turns into autumn. Leader for section for hearing, chief medical officer, Marie Bunne, says to Din Hørsel that they only managed 25 operations on adults so far this year. She does not deny that the hospital is in a very difficult situation on the background that the order was for 100 operations. – We do our best, but we will not be able to meet this order, she states.

Can not reach last year’s capacity

Last year the Otolaryngology-section carried out 50 new operations on adults. – Given the present situation, we have great challenges exceeding that number, she informs. Her analysis of the situation is that the hospital has been given an order without the needed resources. In order to fulfill the order, the section need an increase in the resources of 33 percent. – We have the countrywide responsibility for operating CI into children. They are given the highest priority, and we are able to operate all the children, Bunne says. The Rikshospitalet has a capacity of 150 operations per year. Included in this figure is also re-surgeries and some number-two implants. Bunne informs that the hospital faces huge challenges in respect of reaching this capacity after the budget cuts earlier. The Otolaryngology-section had no reduction in number of positions, but the capacity for CI-surgeries are directly related to the fact that the hospital are saving the number of beds and operating rooms available, she informs us. This fact disables us from reaching our normal capacity, the chief medical officer states.

Medical priorities

The Otolaryngology-section also receives other patients that are prioritized before adult CI-surgeries. – Cancer patients and people with chronic destructive ear infections. The chief medical officer makes a point of the follow up post surgery. In many ways the patients become life-time clients with needs of controls and support when problems arise. The Otolaryngology-section faces an accumulated amount of patients that has received CI and need regular follow-up. – If nothing is done with increasing the budget frames in accordance to this increase in demand, our ability to help new CI-patients will most certainly decrease.

The section leader is not happy about the situation Rikshospitalet faces on the subject of new CI surgeries for adults. – We are forced to make painful medical priorities given the extremely tight budgetary situation, she says. She continuously reports status at the section and what resources the section is in possession of. – The hospital management are aware of the contradictions between resources and the formerly requested results, she states.

Staff willing to sacrifice leisure time for shorter CI-queues

The section leader has a few short-term strategies that might improve the situation a little. – By the end of the year we will perform some CI-surgeries as “day-surgeries”, meaning that the patients won’t spend a night at the hospital after the surgery. The knowledge around CI surgeries are now so solid that the medical staff thinks it is about time to run a trial for this “CI day-surgery”. But this will in best case scenario mean that the hospital will be back to “normal” operating capacity (my comment: i.e. 50 surgeries, still only 50% of capacity as ordered by health minister). It is not the lack of will on our part, she continues. The section has very dedicated staff. – We could have been able to reduce the waiting time a little by performing CI surgeries as “projects”, Bunne informs us. In clear text it means that the staff are willing to use their leisure time to perform surgeries. – Such a solution demand that further funding are released, she says. The chief medical officer has herself taken initiative for investigating the possibility if resources from the “faster back to work”-fund can be release to such a project…

In the Queue of my life, no 44 – (Part 3 of 7)

…article continues…


Invest in my health

The health bureaucracy system has grown into a monster that seemingly no one is able to really control. The health care costs money, we all know that. But now I have cost the society more money in welfare benefits than a surgery on both ears costs, and I still have to wait another year. I lack words in an attempt to describe how pointless and Kafkaesque I think this whole situation is, he says resigned,

He observed the budget cuts at Rikshospitalet last spring with disbelief. Cutbacks on bed-days and OR time has direct effect on the capacity for CI-operations.
– My point in this mess is about the dividend between what we as a nation invest in health and what is being used for welfare benefits. In my case the state bleeds money totally unnecessary. To illustrate the pointlessness of it: this money could have been spent on further increase in CI-surgical capacity, improving after-surgery-support capacity or more cancer treatments at the hospital! It is a vicious circle: the more you save on health, the more money leaks into the welfare and the less BNP we are able to produce. My opinion about this is that it is an example of irresponsible management of the taxpayers money, Ulf says.

Ulf challenges the authorities to think of everybody who waits in health-queues as valuable customers to the hospitals and for the society.
– If our hospitals don’t have capacity to operate, it is about time we allow immediate treatment in other countries. The capacity is there. Economically we save money, no matter what.

In the Queue of my life, no 44 – (Part 2 of 7)

article continues…

Psychological burden

Ulf is a part time dad for an 8 year old boy.
– It is demanding for me as near deaf to be single dad for an active toddler which is very communicative. For me it developed in an unhealthy direction where I problematized the whole situation and got psychological problems. I “buried” myself in problems and developed insomnia-issues.
– Sleeping disorders are often closely related to one’s general well being, he says. He his grateful for the existence of “Center for hearing and psychological health” at Gaustad in Oslo. This center saved me, he says.

Has a dream

The big dream is to get CI on both ears.
– Next step is that I hope to be able to realize a career and get up someplace where I can make a difference.

I feel I have so much inside me and that I have a good grasp of the world around me. I believe I could make an impact someplace. In order to accomplish such a dream, I am totally dependant of the tool an advanced CI-implant represents, he says.
– In regards to my relationship to my 8 year old son, it is a dream that I have more surplus in order to stimulate him further in the direction of knowledge and activities. I simply hope I can become a better father, he says.

He fears that the dream of simultaneous bilateral CI remains just that; a dream. Today there is only children that automatically has a right to get bilateral CI. For economic reasons most adults only receive unilateral CI and the burden of proof is on him, in order to prove that he will benefit better from two rather than one CI. This provokes the 36-year old.
– If you develop bad eyesight on both eyes, would you be happy to have to document that you need glasses on both eyes? – It’s just plain outrageous, Ulf states.

In the Queue of my life, no 44 – (1 of 7)

Hard of hearing Ulf N. has been in line for eligibility-examination for CI (Cochlea Implant) for 18 months. That is very expensive for the state.

The IT-expert burdens the welfare services approximately 30.000 euros per year. In the 18 months he has waited the welfare costs are the equivalent of a simultaneous CI surgery on both ears. Today he is defined as deaf.
– With CI it is a well documented chance of me getting back the ability to understand speech and to be able to get back to a regular job, Ulf says. The waiting is long. It doesn’t only sap the welfare funds of money, but it also takes it toll on him as a human.

Total cost may become 100.000 euros in welfare benefits

Ulf has been waiting since January 2007. When Din Hørsel visit him in his apartment, the calendar shows 26. of august 2008. He still has a long wait ahead of him. He visited Rikshospitalet the day before and got word that he is now number 44 waiting for that all-important operation. He has received a guarantee for treatment which expires January 2010.

– If I get the surgery just as the guarantee deadline is up, I have received welfare benefits equivalent of 4 single-ear CI operations! Add into the calculation the lost tax-income for an IT-expert in productivity, costs for psychologist and other health-services, you don’t need to be a social economist to understand that it is horribly expensive for the Norwegian state  to have people with highly-sought-for skills beneficiaries of welfare.
– as a society it is an economical catastrophe! We are saving ourselves into the poorhouse, so to speak! [my comment: this statement references to the budget cuts in hospitals throughout Norway] It is utter madness that medically disabled are not treated quickly in order to get us back into work. – On a human level it is a constant state of emergency, he states.

Has something to offer in work-life

hcp_logo_168px telenorlogoIn 2006 Ulf had to cease practice in his professional life. He was then working for Telenor, the worlds fifth largest telecom-company. He had been there almost two years in a Telenor in-house program for disabled persons – Telenor Open Mind. – I worked as a trainee in the top management of the Norwegian Business division. To me it was fantastic and gave me a much needed confirmation that I have skills to offer in the work-life, Ulf tells us. After a long period of adjustments with fewer meetings and eventually days with home office, he suffered the exhaustion syndrome. He had to take the consequences of it and stop working.
– It wasn’t anything wrong with me mentally, it was my declining hearing that made me exhausted, he says.


…to be continued ….

Status update IV – early autumn 2008 – part 5 of 5

The mental aspect

After a continuous rise of mental health throughout 2007 and the beginning of 2008 I think it is good in one aspect to get a setback. Life contains both ups and downs and what defines people is how they deal with both. I did a good job on the upside, and now I want to do an even better job on the downside. I owe it to myself, my son, my family and all my supporters out there.
My psychological therapy started in 2006 after a full breakdown. At first it was about getting myself up on my feet, and then I needed to learn to walk.
This down period I’m into now, told me one thing clearly: I need to learn to walk on my own. I have become somewhat dependant to the psychological therapy, which can not be good in the long run. So the goal for me now is to start detaching from the whole therapy thing. Time to think about throwing away the crutch.

I’m still afraid of the CI-procedure and what will mentally happen to me during the fight for bilateral which I expect will end in a clearly defined NO.
(I know I’m pessimistic, but to me this is the reality I need to face: it is not common procedure these days to get simultaneous bilateral CI in Norway. I don’t want to raise my expectations, because I know the disappointment will be difficult to bear. I’d rather fight the bilateral fight, and then become positively surprised if I manage to argue well with the deciding bodies of the political and medical bureaucracy. So the process of detachment from therapy starts now, with a goal of ending it sometime next year. I don’t go there every week, so I have a good starting point in that manner.

Political development

Things will happen this autumn and winter. I think I will save the details about that for later more detailed posts. But I think it will be interesting and maybe a little bit exciting. I can tell you this much: I have been interviewed about the whole “waiting for CI”-thing, and it will be published some time next month, I think… Will of course translate this article from Norwegian and post it here for you all to read. Hope it stirs up some debate, that is for sure!