If someone someday remarks that you must have rocks in your head, don't take offense. They're right.
And it's those rocks or ear crystals -- otoconia is the medical terminology -- that help human beings with their balance on a daily basis.
If those rocks get out of whack, it can cause moderate to severe dizziness or an imbalance that can be disconcerting.
For Dr. Alice Cellino, such a condition is right up her alley. An audiologist with the Columbus Speech & Hearing Center on Double Churches Road, she enjoys treating patients with what is known as "vestibular disorders."
Never miss a local story.
The Columbus native, who also specializes in pediatric audiology, is on the staff of the speech and hearing center founded by her mother, speech pathologist Susie Ford, back in 1978. Ford still practices there today.
Cellino, 32, grew up around the clinic and developed a comfort level and desire to help those who have a difficult time hearing the voices of loved ones or -- at this time of year -- Christmas carols and chatting happily at parties.
Audiology is a career that the U.S. Bureau of Labor Statistics projects will see "much faster than average" job growth through 2020. The U.S. already has about 13,000 audiologists, with 37 percent more needed, or about 4,800, by that year. The current median annual wage is $66,660.
Cellino caught the Ledger-Enquirer's ear recently, discussing her job, why she chose it and how people today are damaging their hearing more than they ever have.
How did your mother influence your career choice?
She would come home and tell me about patients she was seeing. It was fascinating to hear her stories of patients who had strokes and head injuries and rehabilitating them back to full capacity. I thought that was pretty heroic.
What do you tackle on the job?
It's a big field. It ranges from the diagnostic side, which is identifying hearing loss in babies who are only 20 weeks gestation to hearing problems in older adults who can easily respond to you. Then there's the treatment and rehabilitation side, and that's from hearing aids to cochlear implants to different augmentative communication methods to try to overcome a hearing loss.
There is another side of audiology, which is one of my favorites -- vestibular disorders. With your inner ear, you have two parts to it -- hearing and balance. Our job is to diagnose those problems and treat those problems. I enjoy the balance side. But we get to do it all and it's fun because you might have 15 different types of patients in one day.
Is vestibular disorders, or problems with the 'rocks' in your head, a common problem?
It's very common. In fact, dizziness and imbalance is the number one cause of doctor-related visits by the elderly in America. It is an enormous field and when you get older, often times, your body's ability to absorb calcium is really depleted. So those little ear rocks, the otoconia, can get in the wrong place and you just don't clear them like you used to and it can make you very dizzy ... It's estimated between 20 to 30 percent of all adults will have it at least once.
How do you treat that?
You can reposition patients' heads to actually roll the rocks from one involved semicircular canal back into the one that they should be in. That's called (benign paroxysmal positional vertigo). When it's not BPPV related, it's due to problems with not being able to visually track objects, which also makes you very dizzy. We offer a lot of exercises to help treat problems with the ear rocks.
But it's fun to figure out what's happening with the patients because, with most of audiology, you can get some immediate relief. It's just a neat challenge to help somebody, hopefully, by the time they walk out the door.
Does the Columbus-Phenix City area have a fair number of people with hearing problems?
It does. This is a great community to practice any type of medicine in. It has the population of a large town. You see a cross-section of people who are interesting and fascinating from a clinical standpoint. But it's also a small-town feel, so that if you need to collaborate with another professional, you can. And that's pretty unique.
On any given day you see a variety of cases?
I do. My personal specialty is children and then the vestibular disorders. You kind of get to pick and choose in any career what you really enjoy doing. I enjoy being a pediatric audiologist and also enjoy the balance part.
How does a typical day go for you?
We normally start at 8 and go all the way through to 6 o'clock, just seeing patients back to back. I see probably 10 to 20 patients a day. It varies. We also are the audiologists for Doctors Hospital and for The Medical Center. All well babies born at Doctors Hospital, we test within 24 hours of being born to make sure that their hearing is OK. It's called the Universal Newborn Hearing Screening Program. It's a national program and Georgia's a great participant. And, then, all of the sick babies, the neonatal intensive care unit babies born at The Medical Center, we do advanced testing on them. So we're in the hospitals every day.
So you're trying to catch hearing problems quickly?
Yeah, I think hearing loss may be one of the top two most common birth defects in all children in America ... We normally say between 1 and 4 percent (have problems), which is a lot when you consider how many babies are born.
Describe the process of treating the young ones.
You screen them in the hospital and that's how you identify potential problems. As soon as somebody fails a screening, we bring them into our office and we do diagnostic auditory brain stem response testing. What makes that really unique is you don't have to raise your hand when you hear the beeps, especially when you're a child. We actually put electrodes on you and sounds in your ears and we can measure activity of your nerves through those electrodes. That's how we know the baby is hearing or not. You can tell, one, if they're hearing and, two, what degree they are hearing. They didn't have this when I was a kid, so it's pretty new technology.
What other hearing issues do patients face?
Here at Fort Benning and the South in general, most people are exposed to loud guns and to tractors and to all kinds of farm equipment and general noise sources. So I think you see as much hearing loss today, even in the current young generation, as you would from any generation back to World War II. We are just a really noisy society. Hearing protection has come a long, long way and is amazingly effective. But most people just don't wear their earplugs.
Are you seeing more damage from portable music devices with ear buds, where the volume is turned up too high?
Oh, a ton of it. People love to do noisy things while listening to music, like mow their lawns or do something in a noisy crowd.
So they really have to turn their music up to hear the song over the background noise. It's just kind of a stairstep effect that by the time they can get (the music player) to where they can hear it, everything is way too loud.
Have you seen some severe cases?
Oh, yeah, in all ages. It's not at all uncommon now for young children 12 or 13 years old to have pretty significant hearing loss due to noise exposure.
Once hearing is gone, it's gone, or can it be improved or restored somewhat?
No. Once it's gone, it's gone. There are studies in the works focusing on how to rebuild those hair cells, but nothing that's approved yet.
What are the most common sources of hearing loss?
It really is just the overall long-term effects of a lot of noise exposure over years. It all adds up. You mow grass every Sunday and it's really loud. And you like to go shoot skeet. We see a lot of damage from hunters. We see a lot of damage even from loud trucks and stereo systems inside vehicles. It's just the cumulative effect of all of that. Rarely is it one specific incident that causes significant loss.
Why do you enjoy being an audiologist?
Hearing is a real quality of life issue. You can be totally bed bound and as long as you can still communicate with your loved ones, there is a lot of life left to share and enjoy. But when folks can't communicate, either through speech problems or hearing problems, that robs them of their relationships.
And I very much enjoy the satisfaction of being able to help somebody immediately. When somebody comes in with a hearing loss and they walk out with hearing aids and can hear, that's just precious. For children, when they come in and have significant hearing loss that would keep them from developing speech, we can put hearing aids on them, or cochlear implants, and they can develop speech at, hopefully, a normal rate.
What's the biggest challenge in your work?
The toughest part for me is occasionally seeing family members who are not supported and not vested into how hard it really must be to live with either a speech problem or a hearing problem. That makes it really tough on a patient.
So the best part of my job is when I come in and there's a whole family sitting there supporting a patient and we all work together and that person has maximum potential for getting over this and moving on with life the way that they want to.
But sometimes you get parents who aren't necessarily into all that their kid has going on and things slip through the cracks. That can be really tough to see somebody struggling because of a problem that I could help if I could get them interested.
Are speech problems often related to hearing?
If you're talking about a child, yes, because part of the big reason you have ears in the first place is to hear language and to be able turn around and, therefore, speak the language. In children, hearing and speech problems are just hand in hand. So we work very closely with a speech pathologist to make sure they're getting care for both receptive and expressive language development.
Aside from formal training and education, what does it take to be a good audiologist?
I think you've got to love people, and you've got to be willing to think outside the box and treat every person as an individual as they walk through the door. And you have to be a cheerful problem solver. People are coming to you for help and you have to give them help, whatever that looks like.