Realistic Expectations for the Hearing Aid User

REALISTIC EXPECTATIONS:

Hearing aids work very well when fit and adjusted appropriately. They amplify sound! You might find that you like one hearing aid better than the other. The left and right hearing aids will probably not fit exactly the same and they probably won’t sound exactly the same. Nonetheless, hearing aids should be comfortable with respect to the physical fit and sound quality. Hearing aids are do not restore normal hearing and are not as good as normal hearing. You will be aware of the hearing aids in your ears. Until you get used to it, your voice will sound “funny” when you wear hearing aids. Hearing aids should not to be worn in extremely noisy environments. Some hearing aids have features that make noisy environments more tolerable, however, hearing aids cannot eliminate background noise.

YOUR OWN VOICE:

When you wear hearing aids for the first time, you will probably notice your voice sounds funny! You will hear your voice amplified through the hearing aid. You may 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 control. There are adjustments that the audiologist can do to relieve these symptoms, should these persist beyond the first few days of wearing your new aids.

GETTING USED TO HEARING AIDS:

People learn at different rates. Some people need a day or two to learn about and adjust to their hearing aids, most need a few weeks and some may need a few months. There is no perfect way to learn about hearing aids. I usually recommend you wear the hearing aids for a few hours the first day, and add about an hour a day for each day that follows. Do not try to set an endurance record. Over a period of time you will lengthen the amount of time that you wear the aid. Eventually you will wear the hearing aids most of your waking hours. It is recommended that you interact with those people you are most familiar with during your first few days. Start off listening with your hearing aids in a favorable listening environment and work towards more difficult listening situations. Let your friends and family know that you are using your new hearing aids.

Helpful Steps to Learning to Use a Hearing Aid:
# Use the aid at first in your own home environment.
# Wear the aid only as long as you are comfortable with it.
# Accustom yourself to the use of the aid by listening to just one other person – husband or wife, neighbor or friend.
# Do not strain to catch every word.
# Do not be discouraged by the interference of background noises.
# Practice locating the source of the sound by listening only.
# Increase your tolerance for loud sounds.
# Practice learning to discriminate different speech sounds.
# Listen to something read aloud.
# Gradually extend the number of persons with whom you talk, still within your own home environment.
# Gradually increase the number of situations in which you use your hearing aid.
# Take part in an organized course of aural rehabilitation, see your audiologist to learn about these courses.

PHYSICAL FIT:

One concern with all new hearing aids is the physical fit. Hearing aids need to be comfortable, not too tight and not too loose, they should fit just right. Do not wear the hearing aids if they cause any discomfort or irritations. Do call your audiologist to schedule an appointment time to remedy the problem as soon as possible. Do not wear them if they are uncomfortable. For more information and a free hearing consultation with a LHS(licensed hearing specialist) please reply to this with your question or visit our website at www.absolutequalityhearing.com for full contact information.

Hearing Aids in the Presence of Background Noise.

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 still 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 demonstrate digital hearing aids with particular circuit and microphone options can effectively reduce background noises.

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 signal (the speech sound).

Newer ways to reduce background noise are based on timing and amplitude cues and other noise processing strategies, which 100% digital hearing aids can incorporate. 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 a little bit of the noise from the sides or behind you. In most 100% digital hearing aids, the noise control features help make noise more tolerable, but do not completely eliminate the noise.

The best and most efficient way to eliminate or reduce background noise is through the use of FM technology.

How do I know if I have Hearing Loss?

Hearing loss occurs to most people as they age. Hearing loss can be due to the aging process, exposure to loud noise, certain medications, infections, head or ear trauma, congenital (birth or prenatal) or hereditary factors, diseases, as well as a number of other causes. In the year 2001, there are some 28 million people in the USA with hearing loss. Hearing loss is the single most common birth “defect” in America. Hearing loss in adults, particularly in seniors, is common.

You may have hearing loss if…

• You hear people speaking but you have to strain to understand their words.
• You frequently ask people to repeat what they said.
• You don’t laugh at jokes because you miss too much of the story or the punch line.
• You frequently complain that people mumble.
• You need to ask others about the details of a meeting you just attended.
• You play the TV or radio louder than your friends, spouse and relatives.
• You cannot hear the doorbell or the telephone.
• You find that looking at people when they speak to you makes it easier to understand.

If you have any of these symptoms, you should see a hearing aid consultant t to get an “audiometric evaluation.” An audiometric evaluation (AE) is the term used to describe a diagnostic hearing test, performed by a licensed hearing aid specialist. An AE is not just pressing the button when you hear a “beep.” Rather, an audiometric evaluation allows the audiologist to determine the type and degree of your hearing loss, and it tells the audiologist how well or how poorly you understand speech. After all, speech is the single most important sound, and the ability to understand speech is extremely important. The AE also includes a thorough case history (interview) as well as visual inspection of the ear canals and eardrum. The results of the AE are useful to the physician should the hearing aid consultant conclude that your hearing problem may be treated with medical or surgical alternatives.

Written hearing tests, “dial a hearing test” and other online hearing tests are not particularly accurate and are certainly not diagnostic tests, but may be utilized as screening tools. These screenings are usually free and can be scored within a few seconds. Written hearing screenings may point the patient (or consumer) in a particular direction and may help validate that a hearing problem may indeed exist.

Therefore, we have designed a written hearing screening to provide you with some general guidelines about your hearing ability. It is free and it may offer you insight regarding the likelihood that a hearing loss is present. If you would like to take the written hearing screening, Click here.

Are two hearing aids better than one?

In most cases, it’s better to have two hearing aids. Wearing two (binaural) hearing aids allows more information to reach your brain and makes it easier to hear speech against background noise. You’ll have more balanced hearing with two hearing aids, preventing the need to turn your head toward the sound if you’re wearing only one. And wearing two hearing aids means neither of the devices needs to be turned up as loudly as when you’re wearing just one. That should prevent some feedback. Still, financial limitations or other problems may prevent some people from wearing two hearing aids. Talk to your audiologist about your options.

How we hear?

The human ear can be functionally divided into four main sections: the external ear, the middle ear, the inner ear, and the hearing processing centers of the brain. All four parts work together to conduct sounds from outside the head to the brain and to process it. This article will explain the function of each part of the hearing system. The hearing mechanisms of the brain (central processing centers) will not be discussed in this article because of the extreme complexity.

The External Ear

The external ear has two parts: the “PINNA” which is the outside portion of the ear that is visible on the side of the head, and the “EXTERNAL AUDITORY MEATUS” (ear canal) that extends from the pinna to the “TYMPANIC MEMBRANE” (abbreviated TM and is commonly referred to as the eardrum).

The pinna is mostly skin and cartilage with some muscular attachments to the back (allowing some talented folks to wiggle their ears). The pinna collects and directs sounds down the ear canal. The twists and folds of the pinna enhance high frequency (pitched) sounds and also help us to determine the direction of the sound source. Sounds coming from the front and sides are slightly enhanced as they are directed into the ear canal while sounds from behind are slightly reduced. This helps us to hear what we are looking at while reducing some of the distracting background noise coming from behind. Cupping the hand behind the pinna provides small additional amplification to sounds coming from the front because it effectively enlarges the sound collection surface area of the pinna.

The external auditory meatus is a small, twisting, tunnel-like “tube” that connects the pinna to the tympanic membrane. It is about one inch in length (2.5 cm) and has a diameter about the size of a pencil eraser. The walls of the ear canal are sensitive to touch and there is even a cranial nerve branch that passes just below the back canal wall surface. If the ear canal is touched near this nerve, many people will react by coughing (Arnold’s reflex). The outer half to two thirds of the canal is surrounded by cartilage and contains glands that produce “CERUMEN” (ear wax), while the inner one third to one half is surrounded by bone. The ear canal has a natural resonance that typically boosts sound pitches around 3000 “HERTZ” (abbreviated Hz. and is the same as cycles per second) by approximately 10-15 deciBels. Cerumen serves useful purposes in the ear canal that are discussed in a related article on cerumen management.

The Middle Ear

The middle ear consists of an air-filled space between the tympanic membrane and the inner ear that contains three tiny bones linked together that connect the tympanic membrane to an opening into the inner ear. It also contains tiny ligaments and muscles that support and adjust tension of the bony chain.

The TM is a concave shaped layer of membrane at the end of the ear canal. Sounds travel down the ear canal and strike the TM, causing it to vibrate. These vibrations are then transferred through the “OSSICLES” (the tiny bones previously mentioned) to the “COCHLEA” (inner ear). The first bone is the “MALLEUS” (hammer) and is attached to the inside surface of the TM. The second bone is the “INCUS” (anvil) and the innermost bone is the “STAPES” (stirrup). Sound sets this whole structure into vibration and the footplate of the stapes vibrates within the oval window opening of the cochlea, transferring sound energy to the fluids and tissues of the cochlea.

There is a small tube that connects the middle ear space to the back of the throat and is known as the “EUSTACHIAN TUBE.” This tube is normally closed but opens momentarily with yawning, swallowing, etc. This periodic opening maintains equalization of the air pressure between the middle ear and the outside air pressure. This pressure must be equalized for most effective transfer of sound through the middle ear. If it becomes unequal as in relatively rapid altitude change, the sudden opening of the Eustachian tube produces a “pop” and improved hearing because pressure balance is restored.

The Inner Ear

The inner ear is comprised of two functionally separate sections: The “VESTIBULAR” or balance part and the cochlea, which is the hearing part. These two parts are interconnected and each serves its own vital function.

The purpose of the vestibular portion is to help us sense acceleration/deceleration of both rotational and linear motion and to sense head position in relation to gravity. Equally important, it is part of a reflex arc that makes it possible for us to maintain sharp visual focus with the many small and rapid motions of the head that occur as we engage in walking, riding, chewing, etc. Vestibular function is described in more detail in another article so will not be covered in further detail here.

The cochlea is a coiled canal in the dense bone tissue of the skull. The shape of this canal somewhat resembles a snail shell and houses three fluid-filled membranous canals extending its full length. The central canal houses the “ORGAN OF CORTI” which is comprised of specialized cells and their supporting tissues. Vibratory energy propagated through the fluid produces deformation of the organ of Corti, in turn resulting in shearing forces on tiny tufts of “hairs” or cilia extending from the upper surfaces of the “hair cells.” This shearing action triggers an electro-chemical signal that travels upward through the auditory nervous pathway which passes through the internal auditory canal to the brainstem and then upward to the auditory processing centers in the temporal lobes of the brain. This is a simplified description of a fascinatingly complex activity that ultimately results in “hearing.”

Finding a good LHS or Licensed Hearing Specialist is a task in itself also you need to find someone who is very well educated in audiology. In addition to testing hearing, audiologists can also work with a wide range of clientele in rehabilitation (cochlear implants and/or hearing aids), paediatric populations and assessment of the vestibular system.