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Hearing Aid Issues: Experience Matters!

I have been a professional in the hearing aid industry for 30 years. I have researched hearing aid technology and I've questioned patients. I've read all the hype and I have spoken with other professionals in this industry and profession.

Below are some myths, thoughts and personal opinions. I would like to share these with you, to help you make your way through the sometimes confusing issues related to hearing aids and related topics.

1. If you are a previous hearing instrument user, try to really think about whatever it was that you LIKED about your previous hearing aid -- and order it on the new hearing aid! If you had a volume control, and you like being able to manually adjust the loudness, make sure you order a volume control on the new aid. Many professionals believe previous hearing aid users will miss the volume control if that function is completely automated! I believe that if you liked having control of the loudness, you should insist on a volume control -- even on your digital hearing aid.

Of course, for some people the automatic control of loudness is a welcome relief too, and that can be accomplished using digital circuitry. I recommend you not dismiss the volume control option, simply because digital hearing aids can adjust loudness.

2. Digital is better! OK, this is a half-myth. Making a hearing aid digital actually does make many things better, but for other issues - it is of little consequence (see point 3 below). Even digital hearing aids have a microphone and a receiver, just like analog (early technology) units, and the goal of the hearing aid is still to make sounds louder. Of course, what happens between the entry point of the sound (the microphone) and the exit point (the receiver) is very different in a digital circuit! Digitizing the sound signal allows the circuit to better manipulate and process the sounds. For example, digital circuits create virtually no distortion of the sound and digital hearing aids offer better control over frequency shaping. In other words, if you have a high frequency hearing loss, digital hearing aids can be adjusted to deliver to your ear, fairly specific high frequency sounds. Digital control also allows more things to happen at one time, such as the implementation of directional microphones (helping you to pay attention to sounds from a particular direction) while using noise reduction circuitry (to eliminate and reduce some background noises) while automatically reducing or eliminating feedback!

3. Despite the advances of digital hearing aids, it is important to appreciate that the ear itself is often the "rate limiting factor." In other words, if the ear does not hear clearly, if the ear distorts sounds and does not transmit the sounds clearly to the auditory nerve and the brain - even the best digital circuit will not make the sounds clear! In other words, despite the fact that the digital hearing aid is capable of transmitting a wonderful signal -- some ears simply will not hear clearly with any technology! Your hearing healthcare professional is your best resource for this issue. You'll want to ask about your speech discrimination score, which is also called the word recognition score, to get a better idea of what you can expect with digital hearing aids.

4. Manufacturers have been able to significantly reduce no-charge in-warranty repairs and have recently reduced digital hearing aid costs. Hearing healthcare professionals can electronically adjust digital circuits in-the-office and can create hundreds (if not thousands) of custom made circuits in each digital hearing aid. In-the-office adjustments and circuit changes are vastly preferable to all parties; the manufacturer, the hearing healthcare professional and the patient!

5. There are many digital programming protocols and they are each unique. Although there are standards in the industry for measuring sound and producing hearing aid circuits and for other issues, the "fitting" parameters and software vary with almost each manufacturer, and sometimes they vary by hearing aid model too! Although the variation allows individual differences and amazing customization, the hearing healthcare professional needs to be "up to speed" on all of the different programming issues, for each hearing aid they fit. This means the time (and money) spent learning to adjust and fit hearing aids is very significant. In essence, each program requires it's own study time and mastery. Although the standard is often free service on hearing aids purchased in that office, I think a "fee for service" is warranted and makes sense. In fact, if we charged for services on an hourly basis, rather than bundling the fees into the product costs, perhaps the price for digital hearing aids would drop a little more!

6. Rather than reading glitzy ads with lots of promises, I believe patients are best managed by a common sense approach. Only purchase instruments with a trial periods! Do not believe that simply "new" is better! Do not believe that "digital" will solve all your hearing problems. Realize that you get what you pay for! The attraction of a low price fades away long before the dissatisfaction of poor quality is forgotten! Don't try to replace the two ears you were born with one hearing aid -- we were not designed to hear with one ear, and although some people get by that way, binaural hearing (hearing with two ears) is ALWAYS best, whenever it is possible. You would be surprised how many people try to wear one hearing aid, and they complain and complain that the sound isn't what they were hoping for! Duh! Realize that hearing aids sold over the Internet are a potential nightmare for the purchaser trying to find a professional to adjust them and realize that in many states it is illegal to purchase hearing aids through the mail!

7. Choose a practice with professionals and office staff you enjoy spending time with. There is a lot to learn about hearing aids and there is a lot to learn about hearing. If you think you're going to just stick the hearing aids in your ears and that everything will be fine, you're probably mistaken! It takes time, energy and follow-up. You need to find a professional you are comfortable with, as you will likely have a long term relationship with this person. Choose a professional who will give you a selection of hearing instruments to choose from including various prices and options to fit your personal needs, your cosmetic needs, your financial needs and of course, your hearing loss!

8. Please do not expect your hearing aids to solve all hearing problems. Remember, you have reading glasses, sun glasses, and protective eye wear too. They all serve a different purpose. It's almost the same with hearing. Your hearing aids are essentially for conversational speech in a good listening environment. This means that you may need, and would probably also benefit from additional items called assistive listening devices (ALDs) for specific situations like TV and telephone usage. Also, FM systems are fantastic, and I encourage you to explore all of these options with your hearing healthcare professional.

9. Batteries. Hearing aid batteries are like gas for your car. They make it all work. Don't buy cheap, old or weird batteries. Go with the names you know and trust. It matters!

I hope the above items are useful for you and your loved ones. Healthy hearing choices are important and they need to be made with the guidance of your hearing healthcare professional in order to make the best personal decisions for your specific situation.

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