Audio Engineer Turned Audiologist feat. Dr. Steven Taddei | Audiologist

The Hearing Matters Podcast discusses hearing technology (more commonly known as hearing aids), best practices, and a growing national epidemic - Hearing Loss. The show is hosted by father and son - Blaise Delfino, M.S. - HIS and Dr. Gregory Delfino, CCC-A. Blaise Delfino and Dr. Gregory Delfino treat patients with hearing loss, tinnitus, and Central Auditory Processing Disorder at Audiology Services, located in Bethlehem, Nazareth, and East Stroudsburg, Pennsylvania.

On this episode you will learn: 

• How a background in audio engineering positively influences Dr. Taddei's patient outcomes 
• The importance of real ear measurement (REM) 
• The difference between basic level hearing technology and premium level hearing technology 
• Dr. Taddie's "Why" 

On this episode we interview Dr. Steven Taddei.  Since childhood, he has been fascinated with sound and music. His interest grew into passion leading him to open a small recording studio and pursue a degree in audio production. Hungry for more understanding of acoustics and our perception of it, he obtained a doctorate in audiology. 

During his time in academia, he took every opportunity to learn from those around him. Some highlights include assisting in the construction of professional recording studios, conducting hearing sciences research in wind tunnels, and traveling abroad providing hearing services for orphans and low-income families. 

Since graduating with his doctorate in 2018, he has continued to explore his passions. He has been working as an audiologist at a non-profit. Simultaneously, he has been teaching audio production and hearing sciences at several universities. Further, he is the co-founder of an audio product start-up which just received patent approval. 

Regardless of his explorations in sound, he has remained inspired, eager to learn more, and grateful. As an audio engineer, he facilitates an artists’ vision and helps bring it to the world. As an audiologist, her works with the hard of hearing population exploring all options to improve quality of life. As an audio professor, he hopes to inspire students to find their passion and pursue it. 

We Heard You Have Some Questions? Let's Hear Em'!

E-mail: Blaise@faderplugs.com 

Transcript

Blaise Delfino: 0:06

Youre tuned into the Hearing Matters Podcast with Dr. Gregory Delfino and Blaise Delfino of Audiology Services and Fader Plugs. The show that discusses hearing technology best practices and a growing national epidemic hearing loss on this episode we have Dr. Steven Taddei all the way from Chicago Dr. Taddei, how are you?

Dr. Steven Taddei: 0:31

I'm doing great Blaise thanks for having me on

Blaise Delfino: 0:33

It is such a pleasure to have you on the Hearing Matters Podcast . You and I were connected through one of the audiology facebook groups and you are an audio engineer doctor of audiology you have a passion for sound can you just share with us your journey as an audio engineer because you have such a unique story you started as a musician, leading into audio engineer and now a doctor of audiology that is such a cool sequence of life events so share with us your experience as a musician, audio engineer and when did you start playing and editing music?

Dr. Steven Taddei: 1:11

Oh sure well thank you. Yeah it's been a fun fun kind of circuitous path but i was always in bands when i was younger and Ive always been drawn to music as most people are and in college i kind of picked up and switched over to audio engineering. Should back up actually started in game design which is a little known fact about wow so started off yeah my college degree in game design and kind of just being really creative in that realm. I found myself always going home to record my band and record other bands and I figured wait something's wrong here l should just do recording full time so I changed over and I did that in college and I really loved it and around you know senior year I started thinking about the future as people tend to do with that time and it kind of hit me like well I have to find a job once I once I graduate if I want a job. If you're not very familiar with the recording world you definitely have to kind of earn your stripes you know you have to you know find a studio to work at and there are the horror stories of being like a coffee runner and things like that and I didn't necessarily want to do that and I really liked hearing conservation and and the anatomy and physiology that I learned in college so I pursued my doctorate and I was fortunate enough to get into the only school I applied to since it was so last minute and I went through through school at Northern Illinois University, did a bunch of fun stuff there a bunch of fun research and graduated and I have now been practicing on the rockford rockford area ever since.

Blaise Delfino: 2:37

Steven, prior to this episode you and I had the chance to connect to have a great conversation. Do you feel as though that with your background in audio engineering, that absolutely has to positively influence your ability to program your patients hearing instruments and your patients are definitely you know receiving the benefits of you truly understanding sound, how it works, compression things of that nature?

Dr. Steven Taddei: 3:04

Yeah Ill definitely agree with you there Blaise. You know, one of the main things that we see when we talk about sound and hearing for with patients and pretty much anyone is you realize very quickly we don't have many words to describe sound. You know maybe we'll have resonance or something as quiet or something as loud, but outside of a few a handful of words we start going to other words like maybe that sounds tinny or sharp or soft sound. So a lot of these words we grabbed from the visual system or the tactile system and it's something you learned very very quickly in audio engineering just how to interpret maybe a client's needs or desires for a certain sound and then how to get that out of the speakers. And it's very similar within audiology where you have patients coming in and they might have certain complaints or certain suggestions, just personal preferences and then you have to interpret what they're saying and then make that again come out of speakers that are in their ears. In our previous discussion I mentioned too, Ive seen lots of students throughout the years and even some other audiologist and they'll they'll sometimes struggle in the early stages of understanding things like compression and what is equalization and how to all these stack together and make up all the digital signal processing that happens inside of hearing aid. And if you come from a background of audio engineering, you can have you know for example as you know you know one track for vocals and on that vocal track you can have an equalizer to maybe reduce some kind of negative sounds then you compress it and you have maybe another EQ to make it sound brighter and premiere, then you distort it a little bit to make it sound a little bit more aggressive, then you have a little bit more compression on it. So yeah having a background

Blaise Delfino: 4:40

That's the en ire vocal chain and thats o e track.

Dr. Steven Taddei: 4:44

One track on inside of a session that might have you know 50 tracks so it's not that hearing aids are simple by any means but it's more so understanding that language of how to manipulate sound and it definitely goes a long way to understanding and i think helping hopefully then outcomes.

Blaise Delfino: 5:00

You absolutely nailed that Steven, manipulating sound and having the understanding of how sound works. And you bring up such an interesting point in that, you know, we don't have many words that we can use to describe sound. And I want to go back to the audio engineering aspect of your life because you're implementing audio engineering every single day. Like you're working on different projects. I know you're working now with the hearing track or with third podcast and things of that nature. So you get to you get to work on different audio projects probably every single day. When you first started as an audio engineer, what do you think the hardest thing to learn was as an audio engineer?

Unknown: 5:46

Honestly, what I remember most is spending endless amounts of time trying to play some microphone, record, let's say a guitar and it wasn't sounding like what you would hear on a professional album, right? And then what I would do is me and my friends and other bandmates, we'd always all kind of pull our money to get a new microphone thinking this is it. A piece of gear, right, we've fixed it. Now we have the right mic, and then we we'd like re record our entire demo. And then it still didn't sound the same.

Blaise Delfino: 6:16

But the same mic placement?

Dr. Steven Taddei: 6:17

Yeah, same mic. It, I think that was the hardest thing. You know, the software, I started off with sonar. And I don't believe it's called that anymore. Now it's I think even called Studio One. But the software wasn't too hard to understand. It was more kind of that global understanding and how all of the technology we use, even the space that we're in the acoustics of it, the instrument itself, how all of that together, and just small micro little adjustments, that's what makes a professional sounding, you know, album or, or EP or whatever you have.

Blaise Delfino: 6:48

Absolutely. And to dovetail off that when we talk about audio engineering, because what's so interesting about our paths is our paths sort of parallel each other. You're an audio engineer, I'm an audio engineer, we've we've cut so many different projects, when you talk about that microphone placement and learning audio engineering and editing and understanding sound, the microphone placement, like guitars, right? And I learned just like you where, you know, dubbing the guitars and playing to that click track. And that's how you get that fullness of sound, you know, even even chants, chanting on a track, right. And when we were discussing prior to this episode, I asked you I said, you know, Steven, do you feel as though that having a background and you have a very unique background in audio engineering, does having a background in audio engineering help you program hearing aids? Share with us why you believe that having a background in audio engineering helps you to program hearing aids?

Dr. Steven Taddei: 7:50

Again, it just goes back to understanding what is possible within the world of acoustics. And then within our realm of understanding acoustics, if we go from the world around us sound is very, very complex. And it's bouncing around a room, almost like what we would see inside a mirror maze, right where you stand in the mirror maze, you bump into walls, because you can't see stuff. And that's what it's like with our hearing system with all the reflections around us. But our auditory system is just so advanced that it makes sense of all those crazy reflections. So once you go a step beyond that, you start interacting with our hearing system. We we call it psycho acoustics our perception of that sound. And I think understanding that understanding the digital signal processing in terms of what you would do for music, and then hearing aids are doing the same exact processes. It's the same thing. You have equalizers in there, you have compressors in there, and limiters. And again, you have to make it all fit out of two speakers. So that came very, very naturally to me. And even things like frequency response when we talk about real ear measures. You know, we do that all the time in audiology, we put little microphones inside people's ear canals.

Blaise Delfino: 8:58

Some of us right not all, not not everyone, but everyone should be.

Unknown: 9:04

There you go. You definitely should be putting little microphones in ears, taking measurements and seeing what the hearing aid actually sounds like and not just looking at what the computer screen is. And you can kind of think of it. And this is at least the way I think of it, Blaise. If you went to your doctor and they said okay, you have high blood pressure, let's say you have diabetes, right? They'd give you medication for maybe a change in your diet, lifestyle exercise. And then when you come back, they're going to check again to see if we've affected you know, the sugar in your sugar in your blood. Have we affected the blood pressure. So in my mind not doing real ear measures is kind of like if your primary care physician gave you medication for diabetes or high blood pressure and they said you feel better great. We're going with that we don't need to follow up anymore. So I we've kind of gotten on a tangent now about ruler measures, but

Blaise Delfino: 9:52

No this is good keep going. This is perfect.

Dr. Steven Taddei: 9:56

When we do those measurements, our goal is to make sure of course at the hearing aid is meeting certain targets a certain profile to make sure that you are hearing speech sounds as good as possible. So there are, of course, always limitations. So we do things like that within audio engineering too. So that all came naturally for me. Honestly, the hardest thing though, was, I would say, interacting with someone on a personal level and understanding that I knew the tech side of it. But there's this whole other realm of being able to, you know, be personable and, and work with people in a good way and understand and listen to them and read body language and all that.

Blaise Delfino: 10:30

Its the empathy part of it, right? Because you understand the DSP, the digital sound processing behind it. And now this patient is telling you, well, it sounds tinny. But thats simple for you to understand, because you're an audio engineer, and you're like, oh, okay, I know the high frequencies, probably between two and four, maybe six to eight. Yeah, I'll bring those down. And automatically, you know how to make those adjustments. I want to just dovetail off your comments about real ear measurement, because what I think is so fantastic, is that we have patients calling our office and they're actually asking, Hey, do you guys do real ear measurement? And of course, we say, Yes, we have been doing real ear measurement for years. And unfortunately, not enough hearing healthcare providers are implementing real ear measurement. Steven, can you let our listeners know what real ear measurement is, and why it's so important. And it's okay, if we go off on a tangent because this is something that is really important in the industry specifically now, because hearing aids are only as good as the individual who is fine tuning them.

Dr. Steven Taddei: 11:37

Yeah, and I completely agree with you just said about, it's how the hearing aid is the hearing device is programmed. So to start it off, before you are fit with any type of hearing instrument, you should have a hearing test. And what the hearing test is going to do is tell you and the you know, the hearing care professional that you're working with, it's going to give them what is your hearing profile. And then when we look towards hearing aids, we want to make up for that. Were basically providing some type of correction factor. So as you mentioned before, if there is a high frequency hearing loss, what we're going to do with the hearing aid then is we're going to try and provide amplification to make up for that high frequency hearing loss. It's kind of the stands between what is left, what is the fidelity of your hearing system. And then what are we capable of doing with the technology that's available. So to get to real ear measures, what we are doing in a nutshell is we are trying to verify that they're giving an appropriate correction factor for you. And it's a very fun, I find it a very fun and exciting process doing it because everyone's ear canals are different size, a different shape, the size of their head, their body, it's all different. And all that goes into this crazy equation of how things sound to us. So for real ear measures I mentioned before, we're going to put some microphones inside your ear canals. And we're looking for a portion of it where there's a really strong resonance, where we're really getting a good sense of how things sound at the point of roughly your eardrum. And we take different measurements with your canal open with your ear canal plugged up or occluded as it's called. And then we turn the hearing aids on and hearing aids always have a an algorithm that they are going to do providing the correction factor based on you know, your hearing loss. And those are called targets. And there are there are there are lots of different fitting algorithms that we use. So what we're doing is we're going to present different speech sounds, take measurements inside your ear canals with the hearing aids on and just see how closely we are meeting that prescription that target that we're supposed to be hitting. And ultimately the goal of that in a nutshell, all the science behind it, we're just trying to make sure that the hearing aids are providing you with the appropriate amount of speech sounds so that when you go about your life, you can almost forget about the hearing aids and they're providing as much of a benefit as possible an improvement in quality of life as much as possible too.

Blaise Delfino: 13:49

Steven, I'm sure you have a blast conducting real ear measurement, because let's be honest, it's like it is graphic equalization. It absolutely is graphic EQ and to be able to show the patient as well, this is target. This is where you hear without the hearing instruments. This is where you hear with the instrument turned on and where it thinks you should be. And these are your corrections. Our patients always say oh my gosh, this is it sounds so much clearer right? And the goal of a hearing aid is not to make everything louder. It's to make speech clearer, right to decrease that overall listening effort and increase that overall speech under standing. Now, Steven, you work with a lot of patients throughout the week conducting real ear measurement, helping individuals and patients start their journey on their new hearing world. Now, as an audio engineer, you need to ensure that your hearing is protected. How important is it for individuals to protect their hearing? You know, I would say it is probably one of the most important things. This is something I get on a soapbox on all the time Blaise, you know when we look at hearing loss obviously the prevalence of it is far too much, it's skyrocketing. And when we look at permanent cell damage, permanent its called sensory neural hearing loss what we find is that in almost all cases there is some tie with sound or noise exposure which means that one of the number one causes of permanent cell damage is preventable and i always feel like i need to repeat that when i when i mentioned it's kind of a crazy fact that one of the number one causes of permanent hearing loss is completely preventable. And what that means is as a society we do not understand the implications of loud noises or music and then even as a field with hearing care providers and professionals I don't think we're necessarily doing as much justice as we could to educate people on how they can be protecting their ears and it doesn't have to be crazy it's not like oh no you can't drive with your radio cranked in your car anymore. It's a matter of it's a two sided coin that's how loud is the sound you're listening to and then how long are you going to be exposed to it. So it's very similar to sun exposure, right if you're going to be let's say on let's say we're in California, right somewhere nice and warm and sunny and if you're going to be on the beach for five minutes probably don't need to put on you know suntan lotion but if you're going to be there all day and it's sunny you really need to make sure you're applying suntan lotion on regular basis and that's what we see with our hearing system. You need to make sure you are protecting your ears when you're exposed to loud sounds and then simultaneously hopefully limiting your exposure to those hazardous levels. I think it's something that there needs to be a lot more focus on and just general awareness and I think many people are afraid that being hearing conservation conscious means that they like can't go to concerts anymore, they can't go to bars, they can't listen to loud music and the best recommendation I have and I say this all the time is if you can get a set of earplugs that has a key chain with it you will make your life so much easier. If you can get a key chain put it on your car keys no matter where you go you will have hearing protection with you. I don't think any of us want to be that you know that person like oh hang on, I need to grab my earplugs before we go to the bar or something. It's no one wants to think like that so if you just have them with you all the time you don't know when you always don't know when there's going to be loud noises so it's important. Steven, you remind me when I was about 21-22, I went out with a couple friends, there was a group of us. There was loud music and there I am I put my earplugs in they were foam earplugs. They were foam yellow earplugs and honestly I did not care because I think a lot of individuals when we talk about hearing conservation and how important it is. How important it is to protect your hearing you got to get to the point and Im sure a lot of individuals will say people are going to look at me, I'm going to be the odd one out. Listen I was like 22 out with a group of friends, I wore the foam plugs sticking out of my ear, I looked like shrek, but I didn't care you know why cuz I did not have that ringing in my ears the following morning. And Steven, when we talk about hearing loss essentially being preventable, right. We have the ability to prevent hearing loss by utilizing hearing protection, limiting exposure, things of that nature. There's different co-morbidities you know that are concomitant with untreated hearing loss such as cognitive decline or dementia of the alzheimer's type, cardiovascular disease, depression, anxiety things of that nature so you see it as Im an audio engineer, I need to protect my assets and those are your ears and your overall hearing to continue to do what you love and how many musicians do you know, Steven, and maybe your age or a little bit older who are younger and present with hearing loss and play music and that's going to affect their career.

Dr. Steven Taddei: 18:48

Yeah there there's many of them and what I will say is it actually surprises me because I know quite a few. I'm still in contact with quite a few bands that I recorded back in the day, just general friends. And even for some of the people who come into the clinic now and it does seem as though some of those stigmas as you were mentioning are going going away. I think people are realizing you know that that the noise exposure that you have and kind of that rock and roll lifestyle it's just not worth it. And we're seeing a lot more people who are professionals within the field coming out and acknowledging the fact that I am having to stop this thing that I love, music Ive devoted my entire life, my career, to music and now music hurts because of the injury that Ive caused to my my hearing system as a result of 20-30-40 years of loud sounds without exposure. So as I said I do think those stigmas are starting to change and some of the younger people that I Im at least in contact with.

Blaise Delfino: 20:31

That's incredible to hear I mean it really is. And to dovetail off that Steven, what's so promising is here what we've seen at Audiology Services is a couple of months ago we had this wave of musicians coming in for in ear monitors and i was like what's going on here well they were all in the Same band. So it started with one scheduling with us, took their ear impressions. And, you know, they were fit with IEMS. And it was so cool to see, you know, because obviously it being a musician myself, I said, listen, I'm going to conduct a complimentary hearing screening, we're going to do the full 250 to 8000. I'm not skipping any of the frequencies here, because being a musician, you need those frequencies. And it was just so uplifting to see. And they were all younger musicians between the ages of 22 and 35. So that was the coolest thing to see. Absolutely. It really is. What would you say to your patients who were hearing aids? Right? They have residual hearing. And they go to a concert that might be loud. What would you recommend to those patients who have residual hearing, maybe find themselves going to loud concerts, things of that nature? What should they do?

Dr. Steven Taddei: 21:40

So that's a great question. I did want to at least comment on what you said before. And I don't know if it's just like praise your voice. But thank you for doing a hearing test on those musicians that came in, right because that sets a baseline so that they understand where their hearing sits before they start using in ear monitors, because ear monitors aren't in of themselves hearing protection, they have to be used properly. So by giving them a baseline, you give them this gift where they can then measure in six months to a year if they get their hearing tested again, are they still damaging their hearing? Is it working or not? And I think that is something that is very often overlooked. So it's great that it's great that you're doing that for but

Blaise Delfino: 22:16

Thank you, Steven, thank you.

Dr. Steven Taddei: 22:17

That's awesome to hear. It really is. So to get back to your question. Yes, people have hearing aids. And then let's say they go to a concert or they're exposed to loud sounds. Generally what I tell them is hearing aids, they're programmed to not go loud enough to damage your hearing. But they are not going to be a hearing protection device, that kind of a slightly confusing thing. They they're not going to damage your hearing themself. But if you have like a jackhammer go off next to you. They're not going to prevent that jackhammer from damaging your hearing. So I always make sure that people understand what I mentioned before, it's noise exposure, or music exposure, how loud is it? How long and in many cases, I recommend that people take off their hearing aids, put them in a case and in their pocket, and they if they know they're going to a concert, they should have that case with them, and then put in hearing protection devices that are designed for music or whatever they are going to be exposed to. So that's another thing that we haven't talked about yet, right? There's there's so many different types of hearing protection devices, we relate it back to the vision system, you know, I see people wearing like Rolly foamy, those yellow foam plugs that you mentioned, and they'll wear those when they go to, let's say, a bar or just a general small concert. And that's kind of overkill. It's almost like wearing a welding mask to try and block the sun out of your eyes when you're driving. Yeah, it's it's speaking with someone who's familiar with a hearing care professional, and making sure that you're using appropriate hearing protection device, if you're going to music, there are ones that are designed for music, to keep things sounding exciting and musical so you can enjoy it. If you're doing something in industrial world with you know, woodworking any power tools, there are devices that are specifically made to help protect your ears for that. So, you know, there's just so many great devices out there now, in pretty much every every kind of avenue of hearing and hearing protection is no exception.

Blaise Delfino: 24:08

Well, Steven, we're excited to hook you up with a pair of fader plugs to try those out the world's first adjustable custom earplugs, we're gonna get you set up with those. And, Steven, when you talk about all of the different types of hearing protective devices, there are also different types of hearing aids. Now, as an engineer, audio engineer, you have a passion for fidelity, high quality audio. That being said, you have a great appreciation for the different hearing technology levels that are available. For example, there's less expensive hearing aids, and there's more expensive hearing aids. Now, what is the difference? And why do most patients do extremely well with advanced to premium level technology as compared to maybe the basic level technology?

Dr. Steven Taddei: 24:56

Sure, and that's a great question. I think most people when they consider hearing aids, that's probably the number one question that they have. So all accompanies what they do is their hearing aids take into account a certain frequency range from low to high frequencies. And generally that's around 250 hertz up to around 7000-8000 hertz, I think is pushing it for for most companies still, depending on your hearing loss, and they take that range, and they split it into a certain number of slices. So if we were going to, if we're going to look at it think of we take your hearing, and we split it into eight cookie cutter slices, and that's what we have then to adjust in the clinic. We have eight channels to adjust for your hearing loss, 8 channels to adjust for background noise to make changes in the future as you get used to them in a climatized to them. So that's akin to an entry level device where you have to six to eight channels as they're called. As you go up in technology level the hearing aids kind of open up and they give us more channels so we go from eight channels to maybe 10 to 12 I think 15 is around what they max out here in the states. I think if you go overseas they actually have more channels that are available but so we're talking about maybe maybe 8 to 15 channel differences so you can imagine it means the hearing aids are a little bit more specific. They give you know us in clinic more options to make adjustments there are more fine tuning points to follow the configuration of your hearing profile should it be a more kind of zigzag or complicated path and then there are more areas to try and locate background noise and reduce it. It's really really complicated there's lots of science behind it. My mind is kind of torn a little bit, Blaise, when I look at this because I want to follow best practices as best as possible like we were talking about real ear measures and real ear measures are best practices when you look at some of the research that is out there. Some research not performed by the hearing aid companies and there was a recent one relatively recent i think was in 2017 by I believe it was Johnson and Cox and they sought to answer this exact question you know when you'd have people fit with entry level devices vs. the most expensive devices, do people perform better? And if I if I recall correctly it showed the results show that not everyone performs better going with the most expensive device so honestly, Blaise, I generally don't fit the most expensive devices that are out there and it's not something that I tell patients like no you can't be fit with the most expensive ones. I generally have a conversation with them like we are right now and then let them know yes in theory you will hear better with the more expensive ones but, it's hard to quantify of course, right? Its really hard to quantify how much better.

Blaise Delfino: 27:38

To dovetail off that Steven, we always say here at Audiology Services, we have different levels of technology for every lifestyle and for every budget, truly. And we know that the higher level technology the technology that's more expensive does have greater ability to reduce and filter out background noise as compared to a basic or you know entry level hearing instrument. And premium level and advanced level technology allows us the hearing healthcare provider to make appropriate adjustments especially when we're conducting real ear measurement. When we talk about speech in noise scores, how important is it to test speech and noise scores and how does this allow you the clinician to make a strong recommendation with regard to the level of technology they should go with?

Dr. Steven Taddei: 28:28

Oh that's a great question and for people listening Im sure they've had this thought too and Im sure you've heard of Blaise in clinic. And someone will come and you'll test their hearing you do different speech tests and quiet and then they'll say but this is this isn't the real world right they say in the real world there's there's other background noise and that's where I struggle. So what we do then is we try and emulate these complicated situations and with speech and noise tests you're getting a clean signal. Like let's say my voice right now and then there is background noise that's introduced and depending on the test basically the ratio between my voice and the background noise is shifted to a point where you can just barely make out the words clearly and what that does for us clinically and diagnostically is it tells us basically what is the fidelity of your hearing system. And this is where it starts getting a little bit more interesting, when we look at your hearing and processing because you can have two people with the same exact hearing loss. One person let's say they do let's say they can repeat 96% of the words in quiet and let's say they have a very mild signal to noise ratio loss let's say they meet maybe need something like a five decibel signal to noise ratio and then you can have someone else again with the same exact hearing loss and maybe they only repeat 70% of the words in quiet and then they have a very very significant signal to noise ratio loss meaning maybe they need the speech twice as loud, or more, than the background noise. And what that does diagnostically, it gives us more of a sense on how you might benefit from noise reduction algorithms within hearing aids, directional algorithms within hearing aids, and then also how much you might benefit from wireless technologies such as microphones which are truly going to be the best option to improve a signal to noise ratio in a noisy situation. But you know it there's a lot that goes into it you know you have to take into consideration your hearing loss, the configuration of their hearing loss, the you know the monetary constraints that might be there as well the cognition of it, and as you mentioned lifestyle, so there's so much that goes into this decision.

Blaise Delfino: 30:26

Steven, there is so much that goes into the hearing aid recommendation and it's sort of like that checklist, absolutely. Like for example, when you talk about the cognitive aspect, well also what is your vision like, what is your dexterity, do you need a custom rechargeable, which you know which level so as as an audio engineer, you're always thinking of okay how do I EQ this? But then as a hearing healthcare professional and doctor of audiology, when you are having this consultation you are constantly thinking of okay what is going to be the best technology for this patient? What is going to allow them to communicate effectively and efficiently with their loved ones, friends, family in crowds things of that nature. Absolutely, absolutely. So Steven why is it you do what you do as an audiologist?

Dr. Steven Taddei: 31:17

That's a that's a really good question

Blaise Delfino: 31:19

What is your why?

Dr. Steven Taddei: 31:20

You know there's there's a lot. There's the the desire to just kind of geek out about technology all the time. Right, that's that's a big part of it a big part of it as well is as I'm sure you know it's it's quite a miraculous kind of chilling experience when you have someone who comes in and they're they're struggling throughout their life just basic stuff even with like watching television. And then fast forward a month and they're coming in and there's a smile on their face and they've mentioned that you know the tv's down, they're not fighting with their spouse as much, they're able to get back out and enjoy their life. You can have a really profound effect on people's lives, helping them hear better and I think anyone within the world of you know hearing sciences, they would agree that is definitely something that's right on the top of list and why they do it. We're able to hear before we're even born right 16-18 weeks gestation our brains are developing and starting to understand sound. And then as we kind of age through life, we start losing sound and that's a whole nother discussion too but to be able to hopefully bring back then that connection to loved ones to just even simple things like hearing the birds chirp that you know you and I, we take for granted to be able to hear the turn signal in our car. All these goofy kind of nonsense sounds in our world, but they all make the magic of what is actually hearing so in the long winded answer

Blaise Delfino: 32:37

You know, Steven, I love that why and I like to ask that question on the Hearing Matters Podcast because I don't feel as though it's asked enough today, right? When we interviewed Dr. Liz White, you know what makes you happy it's things like that as a clinician. You are helping individuals every single day and thank you for the dedication to our industry and everything that you've done and continue to do you know working with the hearing tracker that's the coolest thing helping patients on and throughout their journey to better hearing. It's incredible to be able to connect with you to talk about hearing healthcare. Steven, before we sign off do you have anything else that you wanted to to mention?

Dr. Steven Taddei: 33:19

You know for anyone out there who has questions, what I will say is there are such fantastic resources like you know like the Hearing Matters Podcast. There are wonderful facebook groups or wonderful clinics out there I want you to shamelessly plug and say you know the Hearing Tracker Podcast, but there are people who are trying to help and provide that information. so nowadays with with technology with information so much of the field is moving itself to trying to give people the agency the autonomy to understand these very complicated topics, so that they can then make informed decisions about their hearing health which isn't just a miraculous movement in within sciences medical sciences anyway everywhere so

Blaise Delfino: 34:01

Absolutely and Steven look at us, listen it's a friday evening, we're talking about hearing healthcare, talking about what we love, audio engineering. You're tuned into the Hearing Matters Podcast with Dr. Gregory Delfino and Blaise Delfino of Audiology Services and Fader Plugs. Today we had Dr. Steven Taddei from Chicago, he is a doctor of audiology and an audio engineer. Be sure to like us on facebook, follow us on instagram, and share that five star review on Apple Podcasts. Thanks for tuning into the Hearing Matters Podcast, until next time hear life's story.