Edna Holt, confined to a world of silence by profound hearing loss, liked to sit by a large window and watch the birds.
But from isolation and depression, she was able to progress to a point at which she could actually hear the birds chirp. And now -- with a little patience and detective work -- she can even carry on a limited conversation with family members and friends.
For five years, the 84-year-old resident of the Riverview Nursing Home in Essex had been able to communicate with people only by writing notes.
She had lost most of her hearing during World War II while working at Glenn L. Martin aircraft factory in Middle River. Over the years her hearing worsened until only 5 percent remained in her left ear.
"She operated a drop hammer -- a kind of stamping machine -- at the plant," said her daughter, Irene Heinerichs, 55. "They made planes there and it was very noisy. Every penny of my father's insurance money was spent on hearing aids. The last time I took herto a specialist he said it was hopeless. It was nerve damage."
Then speech pathologist Susan E. Rowe entered Holt's life. Rowe said she was looking for patients at Riverview and other nursing homes "who had left their hearing aids at the nurses' station or had tucked them away in their nightstand," because they had given up on the possibility of hearing again.
With the assistance of a colleague at the Maryland Hearing Aid Service, she said, she introduced Holt to a combination therapy that is not widely used but seems to be particularly effective for people who have lost all, or almost all of their hearing.
It involves a "body aide," an enhanced hearing aid with enlarged microphones, and aural rehabilitation and therapy, which increases the patient's listening skills and speech production.
"The main idea, which is difficult to accomplish in the geriatric population, is to get them calmed down and to prove to them how much they can hear," Rowe said.
The therapy focuses on lip reading and the concept that those with severe hearing loss don't have to understand everything. They need only understand key words or ideas in order to participate in a conversation with another person sitting or standing close by in good light.
Holt's treatment involved three to four sessions a week for three months, Rowe said.
In an interview a few days ago, it took a few minutes for Holt to establish a connection with a reporter. But in true detective style, she quickly picked up on the clues.
Soon, Holt was revealing even more than expected -- noting for example, that "I like everything that comes out of the water, even eels, which I love."
She zeroed in on key words in the conversation, such as "age," "children," "food," "husband" and "married," and was able to build from that. The conversation flowed for about 15 minutes. Her eyes sparkled and she appeared happy.
"You look great, Edna," was the reporter's opener.
Holt, who is recovering from her second stroke in a year, replied, "But I feel terrible."
Asked how old she is, she replied, "too old," before she finally admitted to 84 years. She volunteered that she had three daughters and one son, 13 grandchildren, 24 great grandchildren and five great great grandchildren.
She related that she and her late husband, a police officer, were 17 when they married Dec. 24, 1924. Her father's people were all German; her mother's, French.
As for the food at the nursing home, she said: "I don't like the same thing every night of the week. I feel like throwing it out the window. Butif they gave me fish every night, that would be just lovely."
Rowe said the body aide actually represents early hearing aid technology that produces extremely high sound amplification.
It never became popular, she said, because people could easily see the 1-by-3-inch black box that hangs from a cord around the wearer's neck and connects via a tube to a
custom-made mold in the ear.
Nor is aural rehabilitation therapy new, she said. But the two together can produce astonishing results.
"People just don't seem to know that this combination therapy is a workable tool for people who have given up," Rowe said.
Rowe, who works for Henning and Cole Therapy Associates in Cockeysville, said the body aide costs about $200, while Medicare will pay for 80 percent of the cost of aural therapy.
Rodger C. Henning, a partner in the firm, said, "This woman had spent thousands and thousands of dollars for hearing aids that did not work. The body aide and aural therapy combination were cheaper and it worked."