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Hearing Aid FAQ's
Frequently Asked Questions About Hearing Aids
How do I determine if I am a candidate for a hearing aid?
The critical variable is whether you experience difficulty hearing or are having increased stress and strain in your daily function. Amplification may simply relieve the strain of hearing, as opposed to making sounds louder or even improving your understanding of speech. However, this alone can be a very significant benefit. You must ask yourself whether you find you are becoming stressed or fatigued after a day of straining to listen. Ask yourself whether the ability to hear, but not understand, is adequate for your needs. Unselfishly examine whether you are becoming a burden to your family and friends, even if you do not personally recognize difficulty hearing.
Why do hearing aids cost so much?
There are many factors that determine the cost of hearing aids. A pair of quality hearing aids will cost between $1000 and $6000. Some of the reasons hearing aids cost so much are:
1. They are sold in relatively low volume as compared to stereos and other electronic equipment.
2. The amount of time and money spent by manufacturers on research and development is considerable. One manufacturer claims to have spent over twenty million dollars developing a single model.
3. They are very customized to each individual. They cannot be mass produced.
4. The amount of time spent by an audiologist with a patient is very significant. Data indicate that an average of five direct contact hours is spent during the first year a patient receives hearing aids. This time is critical for new users, particularly to assist during the acclimatization process. Mail order or budget clubs can afford to sell hearing aids at lower prices because the electronic components often are inexpensive and the hearing aids themselves are often placed on the user with minimal (or in the case of mail order) no instructions or fine tuning adjustments. Furthermore, the patient may be charged for every return visit, including minor tubing change and adjustments. Thus, in the long run the patient is likely to pay as much or even more. Additionally, the minimum amount of training required for a dispensing audiologist is a Masters degree while mail order or discount centers are often staffed by sales people having minimal technical training. Audiologists, like consumers, are concerned about keeping the cost of hearing aids affordable. The reality is that communication is one of the most important skills humans have. So if wearing hearing aids allows you to resume normal activities and communicate with loved ones, the cost becomes a lot more justifiable.
How much time is needed to adapt to a hearing aid?
While each person's experience will vary, hearing aids may allow a person to experience certain sounds they had never heard before (or at least for some time). Relearning takes place in the central auditory nervous system and not in the ear itself. Recent experiments suggest that a listener's ability to comprehend speech may continue to increase over a period of several months when wearing a new amplification system. This process is termed acclimatization. The more that you wear the hearing aid, the faster this process may occur. It is important to wear your hearing aid for the full trial period before deciding whether you will be keeping the hearing aid to allow for this adjustment process.
What should users of new hearing aids realistically expect?
When wearing hearing aids:
1. Your hearing in quiet environments (one to one communication watching TV, etc) should be improved.
2. Your hearing in moderate background noise should be improved.
3. Your hearing in background noise is NOT going to be as good as your hearing in quiet.
4. Your hearing in loud background noise should be NO WORSE than without the hearing aids.
5. Soft speech should be audible, average speech should be comfortable; loud speech should be loud, but not uncomfortable.
6. Your earmolds should be comfortable.
7. Your own voice will sound different to you.
8. There should be minimal feedback when the hearing aids are properly seated in your ears.
9. You may hear sounds you have not heard for a while (like footsteps or the refrigerator humming). This is not abnormal.
Be patient. It requires time to adjust to hearing aids. Your listening skills should improve gradually as you become accustomed to amplification.
Hearing aids WILL NOT restore your hearing capabilities to "normal" or to pre-existing levels.
Why does my voice sound so odd to me when wearing hearing aids?
Some hearing aid users report that they feel as if they are in a barrel or experiencing an echo when talking. This is called "the occlusion effect." Normally, when your ear is unblocked and you are speaking, you hear yourself both through the air traveling through your ear canal, (air conduction) and through vibrations that you create in your skull and ear canal (bone conduction). When your ear is occluded or blocked, however, air conduction transmission is reduced and bone conduction perception enhanced. Try this experiment. Hum aloud and then alternately plug and unplug one ear while humming. Notice how the sound changes pitch and loudness in your plugged ear? This happens because the vibrations are blocked from their usual escape route. Most new users adapt to this effect and it isn't a problem.
Why do hearing aids amplify so much noise and make sounds too loud, but not clear enough?
Among the most frequent complaints voiced by hearing aid users are that noise is amplified too much and that certain sounds become too loud for the user to bear. Some modern hearing aids contain sensors that allow the hearing aid to detect sounds exceeding a certain loudness level, and then self-adjust to reduce the amplification (gain) for those sounds. Unfortunately, because noise is comprised of many of the same frequencies as speech, it is virtually impossible to "shut out" noise without also adversely affecting the quality of the speech signal. The good news is that audiologists have learned to utilize modern technology to measure and control the maximum sound intensity reaching your ear. If sounds (speech or noise) exceed either the saturation level (maximum level the hearing aid can amplify without distortion) or your personal loudness discomfort level, distortion or discomfort will be the result. Modern hearing aids utilize technology that allows for adequate gain for soft sounds while minimally (or not at all) amplifying loud input signals. Concerning background noise, new techniques using multiple microphones within the same hearing aid aids are improving the listener's ability to function in noisy environments. With regard to clarity, even the most sophisticated hearing aids' ability to clarify speech is limited by the degree of inner ear and/or central auditory nervous system distortion.
What can I do about the whistling (feedback) produced by hearing aids?
There are two types of acoustic feedback: that produced internally from the hearing aid - indicating a device in need of repair; and the more common external feedback produced by a leakage of amplified sound out of the ear canal and back into the microphone of the hearing aid. Feedback that occurs when the hearing aid is being inserted or removed or when your hand is cupped near the device is common, and does not necessarily signal the need for action. If however, you experience feedback when you speak, chew, yawn or change position, you need to consult your audiologist. Feedback is more likely to occur in smaller hearing devices because the microphone is closer to the area at which the sound comes out into the ear. So, a behind-the-ear style may be less likely to produce feedback than in in-the-canal style device. If excessive feedback is a problem, your audiologist will work with you to find a solution.
Recently some manufacturers have introduced digital feedback reduction. With this technology, feedback is sensed by the hearing aid and canceled by means of a new signal generated by the hearing aid itself.
How often must hearing aids be replaced?
Generally speaking, hearing aids should last for at least five years. The need for new hearing aids may occur if a patient's hearing status changes, but with the availability of programmable and digital hearing aids, changes can be made in the audiologist's office and should reduce the need to order new hearing aids merely because of changes in hearing status.
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