Try making a list of those aspects of the job that you can still do well and those that may cause you difficulty because of the extent of your deafness. This list may provide a clearer picture of whether or not you can still do the most important parts of the job. Bear in mind that if you have done the job for a while, you are likely to have skills and experience, and a knowledge of the firm's methods of operation, that would be costly for your employer to lose.

On the other hand, you may now have serious problems using the telephone, discussing your work with individual colleagues or customers and taking part in meetings and other types of group discussion. If these activities form a significant part of your job, you will need to tackle these problems.

The evidence of the Stories suggests that there are several ways of reducing your involvement in telephone calls:

• encourage colleagues and customers to use email or fax as their main means of communication with you;
• arrange for a colleague to make and receive telephone calls for you and to pass on messages;
• where answering telephone calls is an inescapable part of your job (e.g. on a Help Desk), modify the job so that the telephone work is transferred to another member of staff, and you take on a different area of work to offset the work transferred.

Alternatively, you could encourage your employer to buy you special equipment to help you use the telephone. If you still have a small amount of hearing enhanced by hearing aids, you may be able to use an amplified telephone effectively. If you gain no benefit from hearing aids, a textphone linked to Typetalk (see Organisations for Other Technical Aids) will enable you to have telephone conversations with hearing colleagues and customers, although at a much slower pace than telephone calls between two hearing people.

If your job involves frequent face-to-face discussions with individual colleagues or customers, you may feel apprehensive about how to cope unless you have a natural flair for lipreading; but there are several things you can do that will help:

Taking part in meetings, conferences and other kinds of group discussion is probably the most difficult thing to do if you are profoundly deaf. If attendance at these events is not a crucial part of your job, you may want to arrange for a colleague to raise any issues which you want considered and then report back to you on what was discussed and decided.

If, however, you do need to take part, try to persuade your employer to get you a suitable technical aid and/or support worker. If, for example, you still have some hearing amplified by hearing aids, a radio microphone is likely to prove useful. This can be linked to your hearing aids and passed round to whoever is speaking at a meeting or conference. Another approach is to install a loop system in the room where the meeting is going to take place. Once the system is switched on, your hearing aids will pick up the voice of anyone who speaks in the room.

If you are unable to follow speech at meetings even with the use of a radio microphone or a loop, you should consider using a speech-to-text system, such as Palantype. With this system a highly trained operator will type all that is said into a specially designed keyboard, linked to a portable computer where you can read the words on the computer screen as they are being spoken. The system is very flexible; it can be used for one-to-one discussions, business meetings with small groups or at large public meetings and seminars. (Where these meetings involve several deafened people, the text is projected on to a large screen rather than a small computer screen).

The speech-to-text operators can be hired for any of these types of meeting; but as there are very few of them, they are in great demand, and you will need to book them well in advance. (The operators will bring their own keyboards and computers, but not large screens or projectors).

A slightly different approach is to hire a support worker to help you rather than rely wholly on technical aids. Lipspeakers and notetakers can be hired for interviews, meetings and conferences. A lipspeaker repeats what speakers are saying but without making any sound. Because the lipspeaker is trained to speak clearly, you may find it easier to follow what is being said by watching the lipspeaker than by watching the speakers themselves, who may be difficult to lip read. But if you are not a good lipreader, you may find it hard to follow even the lipspeaker. In that case a professional notetaker is likely to be more useful.

A professional notetaker has been specially trained to record the points that speakers are making for you to read as they go along and to leave you with their record at the end of the meeting or conference. To keep up with the flow of speech the notetaker acquires the skill of writing down a short summary of what is being said rather than every word. So the notes you see will enable you to keep pace with the main points being made.

As with speech-to-text operators, there is a heavy demand for lipspeakers and notetakers that far outweighs the small number available; so book them well in advance of when you need them.

If you are a manager working with a team of staff who report to you directly, communicating with them effectively is likely to be a key part of your job; but because you are the manager, you should be in a strong position to organise the conduct of one-to-one discussions and team meetings to suit your own needs.

If you can no longer hear environmental sounds, you may not hear the alarm if there is a fire practice or an actual fire,a bomb alert or other similar emergency. So you will need to be provided with some other form of alarm such as a flashing overhead light, a vibrating pager or even a Hearing Dog. To meet the requirements of the Health and Safety at Work Act, your employer must provide you with an alternative, which you find effective, to a sound-based alarm.