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Wednesday 16th January 2013

I have a degree of hearing loss. I was going to write ‘I suffer from…’ but the truth is I don’t find it so affecting as to cause any real suffering. What I have is some high frequency loss in my left ear.

When I was working at the Alnwick Garden I did find it a bit of a nuisance so, in 2007, I paid for a hearing aid. In 2008, my name, finally, reached the top of the NHS waiting list and I received an NHS aid.

Last year, when I happened to be at the local hospital I asked about review procedures and was told I was due for a retest. You would think that the audio clinic would have an automatic recall process but, it seems, it relies on ‘don’t ask, don’t get’. If you don’t think to enquire about a retest they won’t call you in for one.

Luckily, the wait for a retest was only a few months, not the 12-18 months for the original test, so I went and was re-assessed. The test found deterioration in my hearing though I think that may have quite a lot to do with the ‘improved’ testing procedure meaning I could hear quite a lot of external noise because the fully sound-proofed testing enclosures have gone.

The nurse/technician said the loss was enough to be flagged up to the ENT clinic and I would get an outpatient appointment. That has now arrived and is the reason for me talking about my hearing in this blog.

Included with the appointment was a form for me to complete headed ‘Patient List of Current Medicines’. It asks for details of both prescribed and OTC medicines and says ‘Remember to include…herbal or homeopathic remedies’.

Hypericum androsaemum, St John's wort

I’m pleased that the form asks about herbal remedies. Some of these, take Hypericum androsaemum, St John's wort, for example, are well-known to cause interactions with prescribed medicines so it is important that any doctor who might be about to prescribe something new knows what the patient is taking.

More importantly, though I suspect quite likely to be missed, is the matter of supposed herbal remedies that have a history of being adulterated with known pharmaceuticals in order to try and convey some efficacy to an inert plant extract. This item by Edzard Ernst¹ refers to a study published last July² that raised serious concerns about very damaging conditions that could be precipitated by using adulterated ‘natural’ remedies. And that’s without considering the unpleasant problem of contamination also found.

What would be useful would be if someone reviewed these patient medicine lists and looked for any herbal remedies with a record of adulteration or contamination in order to offer advice to the patient but I doubt if a hard-pressed NHS is going to do that.

The other thing I question is the inclusion of homeopathic ‘remedies’ on the form. When my wife received one of these forms, last year, I raised a complaint with the hospital and, eventually, received the usual weasel words about not endorsing homeopathy but needing to know what patients are taking. Again, this would be useful if the hospital had the resources to talk to any patient who listed a homeopathic substance to make sure that this wasn’t being taken in place of medicine but, since those resources don’t exist, it is hard not to see this as an acceptance that homeopathy can have a physical effect from the substance itself.

Having made one complaint and received no satisfaction I don’t see the point of doing so again but I refuse to let the matter pass completely unremarked. So, the only item I’ve written into the column headed ‘Name of Medicine’ is ‘water’.

References

1. Contamination and adulteration of herbal remedies  Edzard Ernst  12/01/2013
2. Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews (abstract) European Journal of Clinical Pharmacology, July 2012