Fequently Asked Questions
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.
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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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