Fequently
Asked Questions
•
How do I know if I have hearing loss?
• What are the most common hearing
aid styles?
• Getting accustomed to hearing
aids: What to expect and realistic expectations!
• What are digital hearing aids?
• Why does my voice sound funny
when I use my new hearing aids?
• Binaural Hearing Aids...Do I
really NEED TWO?
• What is ''background noise''
and how do I deal with it?
• How should I care for and maintain
my hearing aids?
• Please discuss hearing aid batteries.
• How often do I need to change
the batteries in my hearing aids?
• How long do hearing aids last?
• Does Medicare/Medicaid cover
hearing aids?
• Are hearing aids covered by
insurance?
• What problems might I experience
while adjusting to my hearing aids?
• What questions should I ask
before buying hearing aids?
• How much do hearing aids cost?
How
do I know if I have hearing loss?
Hearing loss occurs in most people as they age.
Hearing loss can be due to aging, exposure to
loud noise, medications, infections, head or ear
trauma, congenital or hereditary factors, disease
processes and other causes. The vast majority
of hearing problems do not require medical or
surgical intervention. Some 90 to 95 percent of
all cases of hearing loss can be corrected with
hearing aids.
There are some 31.5 million people in the USA
(as of 2005) with hearing loss. Hearing loss is
the single most common birth "defect"
in America. Approximately one third of all seniors
aged 75 years and older have significant hearing
loss. About 14 percent of all people aged 45 to
64 years have demonstrable hearing loss. Hearing
loss negatively impacts quality of life, personal
relationships and of course, the ability to communicate.
You may have hearing loss if...
You hear people speaking
but you strain to understand their words.
You frequently ask
people to repeat what they said.
You don’t laugh
at jokes because you miss the story or the
punch line.
You frequently complain
that "people mumble."
You ask others about
details of a meeting you just attended.
You play the TV or
radio louder than friends, spouse and relatives.
You cannot hear the
doorbell or the telephone.
You find that when
people look directly at you while they speak
to you, it makes it easier to understand.
If you have
any of these symptoms, you should see an audiologist
or hearing care professional to get an "audiometric
evaluation." An audiometric evaluation (AE)
is the term used to describe a diagnostic hearing
test, performed by a licensed professional. An
AE is not just pressing the button when you hear
a "beep." Rather, an audiometric evaluation
allows the hearing care professional to
determine the exact type and degree of hearing
loss, and it tells how well/poorly you understand
speech. Afterall, speech is the single most important
sound we listen to and the ability to understand
speech is extremely important. Your ability to
hear and understand speech in quiet and noisy
situations can be accurately tested by your hearing
care professional. The AE also includes a thorough
case history (interview) as well as visual inspection
of the ear canal and eardrum. The results of the
AE are also useful to the ear, nose and throat
doctor, in the event the audiologist refers you
for medical or surgical alternatives.
Written hearing tests, "dial a hearing test"
and other online hearing tests are not 100% accurate
and are not diagnostic, but they may be utilized
as screening tools. Screenings are usually free
and can be scored within seconds. Screenings may
help validate that a hearing problem exists.
Click Here to take our on-line hearing test
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What
are the most common hearing aid styles?
There are many styles of hearing aids. The most
common styles are listed below:
ITE: In-The-Ear units are often
the most comfortable, the least expensive and
the easiest to operate. They are also the largest
of the custom made styles.
ITC: In-The-Canal units are usually
more expensive than ITEs. They require good dexterity
to control the volume wheel and they are smaller
than ITEs.
MC: Mini-Canals are the size
between ITC and CIC. A mini canal is a good choice
when you desire the smallest possible hearing
aid with a tiny volume wheel.
CIC: Completely-In-the-Canal
units are the tiniest hearing aids made. They
require a "removal string" due to their
small size and the fact that they fit deeply into
the ear canal. CICs can be difficult to remove
without the pull string. CICs do not usually have
manual controls attached to them because they
are too small.
BTE: Behind-The-Ear hearing aids
are the largest hearing aids, often the least
expensive, and they are very reliable. BTEs have
the most circuit options and they typically offer
more power than custom made units. BTEs rest on
the back of your ear. They are connected to the
ear canal via custom-made plastic tubing; the
earmold. The earmold is usually custom made from
an ear impression to perfectly replicate the size
and shape of your ear.
PAC: Post-auricular-canal instrument.
This is a new hearing aid design which physically
separates the processor from the receiver/speaker.
This design offers comfort and acoustic options
as the tiny processor is placed behind the ear,
and the receiver/speaker is placed deep in the
ear canal.
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There are
two basic levels of hearing aid technology; analog
and digital.
1. ANALOG technology has been around for many
decades. Analog technology offers limited capability,
but is sometimes perfect for specific purposes.
2. DIGITAL technology is the most sophisticated
hearing aid technology. Digital technology gives
the audiologist maximum control over sound quality
and sound processing characteristics. As of 2005,
the OVERALL CUSTOMER SATISFACTION ratings of new
hearing aids (which are essentially 90 percent
digital) is 77 percent!
There is qualitative and quantitative evidence
that digital instruments outperform analog hearing
aids. Digitals are not perfect, but they are extremely
good -- However, not all digital hearing aids
are the same! Within the "digital" world,
there are better and lesser units...speak with
your audiologist to be sure you're getting the
right one for you. I ALWAYS recommend digital
hearing aids, unless there is a compelling reason
to recommend a specific analog product.
Many people ask about pricing relating to digitals.
It is important to know that thanks to the integration
of digital products across hearing healthcare,
better, faster, more reliable and less expensive
digital hearing aids are the "norm."
---Dr. Douglas L. Beck
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Getting
accustomed to hearing aids: What to expect and
realistic expectations!
GETTING ACCUSTOMED to your HEARING AIDS:
It takes time....People learn and adapt at different
rates. Some people need a day or two to learn
about and adjust to their hearing aids, most people
need a few weeks and others may need a few months.
There is no perfect way to learn about hearing
aids.
I usually recommend...
Wear your hearing aids for a few hours the first
day and add an hour a day the following day, and
the next, and the next, until you are wearing
hearing aids most of the day. Do not try to set
an endurance record! I recommend that you interact
with people familiar to you during your first
days with new hearing aids. Start in a favorable
listening environment (such as one-on-one conversations
in quiet) and work towards more difficult listening
situations. Let your friends and family know you’re
using your new hearing aids.
Please do NOT wear them to a cocktail party or
restaurant during the first few weeks, thinking
"this will be a good test!" It will
absolutely not be a good test – it will
be very difficult! You should not wear hearing
aids in noise until you are very accustomed to
them!
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What are digital
hearing aids?
The term DIGITAL is used so often today, it can
be confusing. When the term "digital"
is used when referring to hearing aids, it generally
means the hearing aid is 100% digital. In other
words, the hearing aid is indeed a "complete
computer". 100% digital hearing aids have
been commercially available since the mid-1990s
and they are wonders of modern technology. 100%
digital hearing aids can process sound using incredibly
fast speeds. Interestingly, most 100% digital
hearing aids have some analog components, such
as the microphone and the receiver. 100% digital
hearing aids transform analog information into
a digital signal and process the sound to maximize
the speech information you want to hear, while
minimizing the amplification of sounds you do
not want to hear.
Digital technology is tremendous and it allows
the audiologist maximal control over the sound
quality and loudness of the hearing aid. Importantly,
digital technology allows the audiologist to tailor
or customize the sound of your hearing aids to
what you need and want to hear. In summary, if
you want the best technology -- get 100% digital
hearing aids.
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Why
does my voice sound funny when I use my new hearing
aids?
When you wear hearing aids for the first time,
you’ll probably notice your voice sounds
funny! You’ll hear your voice amplified
through the hearing aid and some people describe
this sensation as feeling "plugged up"
or hearing your voice echoing. This is normal
and will usually go away in a few days after you
have given yourself a chance to get accustomed
to your new hearing aids and learned to adjust
the volume controls. However, there are adjustments
the audiologist can make to relieve these symptoms,
should they persist beyond the first few days,
or it they are intolerable and need to be addressed
immediately.
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Binaural
Hearing Aids...Do I really NEED TWO?
YES! Basically, if you have two ears with hearing
loss, and if both ears could benefit from hearing
aids, you need two hearing aids. I know you were
hoping to "get by" with only one hearing
aid, people tried that for decades and it simply
does not work very well.
In 2005, 86 percent of all new hearing aid wearers
are fit binaurally (both ears).
Here's why...
It is important to realize there are no "normal"
animals born with only one ear. Simply stated,
you You have two ears because you need two ears.
If you try to amplify sound in only one ear, you
cannot expect to do very well. Even the best hearing
aid will sound "flat" or "dull"
when worn in only one ear.
You do need two ears to tell where the sound is
coming from (localiztion). Localization is very
important for determining the origin of warning
signals, alerting sounds and of course, conversational
speech.
Using both ears together allows your central nervous
system (your brain) to better focus on, and process
sounds you want to hear (human speech) while more
or less "squelching" (ignoring) sounds
you do not want to hear (background noise). One
ear working by itself cannot do this very well.
The brain needs to compare and contrast loudness,
pitch and the phase (timing) of the sounds from
the two ears to make sense of it!
It's sort of like using your eyes. If you close
one eye, you cannot get depth perception. In other
words, if you were to close one, it becomes very
difficult to tell how far something is in front
of you. It is also difficult to read and you'll
find you get tired more quickly as you are straining
and working harder to make visual sense of the
world. Of course, if you had two eyes that were
far sighed, or two eyes that were near sighted,
you wouldn't even think about getting a monocle...and
that would be analogous to wearing one hearing
aid.
Assuming you have two ears that hear about the
same, you can do a little experiment at home to
better understand how important binaural hearing
is:
First, gently close just one ear, by simply pressing
the little fleshy part in the front of your ear
canal (the tragus) into your ear canal -- a little.
Do not apply pressure, do not hurt yourself. Just
close the ear canal to eliminate sound from entering
the ear. The idea is to close that ear for about
ten minutes while you watch TV or listen to the
radio or speak with your spouse. Then, after a
full ten minutes, remove your finger. What an
amazing difference!
Binaural hearing allows a quality of "spaciousness"
or "high fidelity" to sounds, which
cannot occur with monaural (one ear) listening.
Understanding speech clearly, particularly in
challenging and noisy situations is much easier
while using both ears. Additionally, using two
hearing aids allows people to speak to you from
either side of your head – not just your
"good" side!
People cannot hear well using only one ear. There
are studies in the research literature that show
that children with one normal ear and one "deaf"
ear are ten times more likely to repeat a grade
when compared to children with two normally hearing
ears. Additionally, we know that if you have two
ears with hearing impairment and you wear only
one hearing aid, the unaided ear is likely to
lose word recognition ability more quickly than
the ear wearing the hearing aid.
Bottom line...if you have two ears that can benefit
from hearing aids, fit both ears!
---Dr. Beck
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What
is ''background noise'' and how do I deal with
it?
Virtually all patients wearing hearing aids complain
about background noise at one time or another.
There is no way to completely eliminate background
noise.
Remember, when you had normal hearing there were
times when background noise was a problem. It
is no different now, even with properly fit hearing
aids! The good news is there are circuits and
features that help to reduce (or minimize) background
noise and other unwanted sounds. In fact, there
are research findings that clearly show that digital
hearing aids with particular circuits, FM options,
and directional microphones can effectively reduce
background noises. Please speak with your audiologist
about this.
Many early digitally programmable (and even some
digital) circuits, which claimed to reduce or
eliminate background noise, actually filtered
out low frequency sounds. This indeed made the
sounds appear quieter, however, not only was the
background noise made quieter, but so too, was
the speech sound.
Newer ways to reduce background noise are based
on timing and amplitude cues and other complex
noise processing strategies, which 100% digital
hearing aids can process. These methods work,
but are not perfect. Directional microphones are
available and are useful as they help to focus
the amplification in front of you, or towards
the origin of the sound source. Directional hearing
aids can offer a better signal-to-noise ratio
in difficult listening situations by reducing
the noise from the sides or behind you. In most
100% digital hearing aids, the noise control features
help make noise more tolerable.
The best and most efficient way to eliminate or
reduce background noise is through the use of
FM technology. Please speak with your audiologist
about this.
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How
should I care for and maintain my hearing aids?
More than 75 percent of all hearing aid repairs
are due to moisture and earwax accumulating in
the hearing aid. The vast majority of these repairs
are 100 percent preventable. It is extremely important
to clean the entire hearing aid every time it
is removed from your ear by wiping and brushing
it. To better protect your investment, use a DRY-AID
kit every night! Electronic dry-aid kits are the
best. They include a germicidal light that kills
most bacteria and other germs. They also have
desiccants to absorb moisture and fans to circulate
air around the internal components of the hearing
aid. Get in the habit of cleaning the hearing
aid after each use and keeping the hearing aid
in the dry-aid kit at night. The hearing aid is
electronic and moisture is the enemy! Preventive
maintenance is the key to trouble free, long life
from a hearing aid. A well maintained hearing
aid can easily last 5 to 7 years, maybe longer.
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Please
discuss hearing aid batteries.
All batteries are toxic and dangerous if swallowed.
Keep all batteries (and hearing aids) away from
children and pets. If anyone swallows a battery
it is a medical emergency and the individual needs
to see a physician immediately.
One question often asked is "How long does
the battery last?" Typically they last 7-14
days based on 16 hours per day use cycle. Batteries
are inexpensive, costing less than a dollar each.
Generally, the smaller the battery size, the shorter
the battery life. The sizes of hearing aid batteries
are listed below along with their standard number
and color codes.
Size 5: RED
Size 10 (or 230): YELLOW
Size 13: ORANGE
Size 312: BROWN
Size 675: BLUE
Today's hearing aid batteries are "zinc-air."
Because the batteries are air-activated, a factory-sealed
sticker keeps them "inactive" until
you remove the sticker. Once the sticker is removed
from the back of the battery, oxygen in the air
contacts the zinc within the battery, and the
battery is "turned-on". Since many of
today's automatic hearing aids do not have "off"
switches, removing the battery from the hearing
aid circuit, by opening the battery door, when
not in use, assures the device is turned off.
Zinc-air batteries have a "shelf life"
of up to three years when stored in a cool, dry
environment. Storing zinc-air hearing aids in
the refrigerator has no beneficial effect on their
shelf life. In fact -- quite the opposite may
happen. The cold air may actually form little
water particles under the sticker. Water is made
of oxygen and hydrogen. If the water vapor creeps
under the sticker, oxygen may contact the zinc
and the battery could be totally discharged by
the time you peel off the sticker! Therefore,
the best place to store batteries is in a cool
dry place, like the back of your sock drawer,
not the fridge!
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How
often do I need to change the batteries in my
hearing aids?
Batteries should be changed about every ten to
14 days. The exact schedule for changing batteries
depends on the amount of time the hearing aids
are worn and the power consumed over time. Most
new digital hearing aids have battery warning
indicators. Before the battery goes out, the hearing
aid will "beep, beep, beep" to tell
you you have another hour or two before the battery
fails. Using excellent, fresh batteries is important,
and changing batteries should take no more than
60 seconds.
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How
long do hearing aids last?
The most common repairs required by hearing aids
are based on dirt and debris blocking the microphones
and the receivers. In other words, the majority
of repairs required are sue to poor/low maintenance.
Your hearing healthcare professional will review
with you how to maintain your hearing aids, how
to keep them clean and dry, how to change batteries
etc. Nonetheless, if the hearing aids are well
maintained, generally speaking, they can last
5 to 7 years.
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Does
Medicare/Medicaid cover hearing aids?
In general, Medicare does not cover hearing aids.
In general, Medicaid does cover hearing aids.
However, each situation is different. It is always
a good idea to speak with your personal (Medicare/Medicaid)
representative that handles your account, to determine
your eligibility.
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Are
hearing aids covered by insurance?
Some insurers do cover hearing aids. However,
each situation is different! Even though a particular
insurer offers hearing aid coverage, you may or
may not have it available to you, based
on your individual policy. It is always
a good idea to call the insurance company and
speak with a representative to find out exact
coverage.
What problems
might I experience while adjusting to my hearing
aids?
All hearing aids require adjustments. Some common
problems that can be corrected in the office include:
"My voice sounds like I'm talking in a barrel,
my hearing aids whistle, my ears feel plugged-up,
I hear too much background noise..." All
of these common complaints/problems can generally
be addressed to the user's satisfaction using
new technology, better hearing aid circuits and
excellent clinical protocols.
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What
questions should I ask before buying hearing aids?
There are many questions to ask before buying
hearing aids. The first two questions are: Do
I have permanent hearing loss? And -- Who should
I see about this?
Some people have hearing problems caused by ear
wax, which can be removed by the professional.
Sometimes middle ear infections cause a temporary
hearing problem which can be eliminated after
medical treatment. Sometimes auditory processing
disorders cause hearing problems. If any of these
situations (or others) are present, your hearing
care professional will be able to recognize and
diagnose the problem and will manage or refer
you to best handle these situations! Before purchasing
hearing aids, a comprehensive diagnostic evaluation
should be obtained, by a state licensed hearing
care professional.
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How
much do hearing aids cost?
Hearing aid prices vary, depending on many factors.
Factors that influence price include...one versus
two hearing aids, aural rehabilitation programs,
warranty, services included, accessories, circuit
sophistication, telephone coils, directional microphones,
insurance coverage and other factors too! Generally
speaking, a pair of hearing aids can cost anywhere
from $500 to $6000 depending on all of these services
and options. Please consult your hearing healthcare
professional (audiologist or hearing instrument
dispenser) to discuss these options and find out
what your final cost will be.
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