I received the report from Nolan's most recent hearing test in the mail today. The results look remarkably similar to the test results from Buffalo Children's last November, but they are still a change from the last hearing test at our normal audiologist's office (particularly for the left ear). The low frequencies are still a mixed loss, but everything above 1000Hz is sensorineural. His bone conduction scores have dropped by about the same amount that the air conduction scores have dropped, which indicates that the small new loss is sensorineural (inner ear loss) in nature.
For those who aren't familiar with audiograms, Nolan can't hear anything above the plotted lines when his hearing aids are off. Basically, he can't hear any speech at normal conversational levels with his aids off, though he can hear things like rock music, lawn mowers, and other loud things. With his hearing aids on, he gets most of what lies in the middle frequencies, but still misses out on the high and low frequencies (hearing aid adjustment issues).
Thankfully, the worst hearing is at 65dB (I thought I had seen a 70dB mark on the audiogram in the office, but he is still just moderately severe in the low frequencies).
His speech reception thresholds changed from 40dB in each ear to 45dB (right ear) and 50dB (left ear). His hearing aids are still set for a mild loss in the high frequencies, which explains why John Tracy was showing under-amplification in those frequencies. He has lost a bit in the low frequencies, too - he seems to lose a bit at one frequency (or in one ear), and the rest follow suit shortly thereafter. Fortunately, it is a very slow loss - it has taken almost four years to go from mild/moderate to moderately severe.
We will return on July 5 to confirm the level of loss and (finally) adjust his hearing aids to match the loss.