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Are You Hearing Challenged?

By Penny Allen, Washington State Chapter Coordinator
Self Help for Hard of Hearing People

Eventually you’ll get fed up with everyone nagging you to get your hearing checked and do something about it. Hopefully you’ll do it before you create worse problems than nagging.  Untreated hearing loss results in marital conflicts, anger, resentment, isolation, depression…the list goes on.   If you hear people talking but don’t understand what they’re saying, that’s often your first indication of a hearing loss.
 

Where do you start?

You should make an appointment to see an ENT (Ear, Nose and Throat specialist), because your family physician is not trained in this area.   An ENT will want to rule out any medical problem, like a tumor. Sometimes it’s a simple matter of wax blockage in the ear (but don’t count on it).  Most likely you’ll be astounded to learn that he can’t do anything about your hearing loss or even tell you why you have it.  He will probably smile, shake your hand, and matter-of-factly leave you with these four crushing words, “You need hearing aids.”  Just remember—it’s not terminal.

The ENT will refer you to an audiologist, who will seat you in a soundproof booth and test your ability to recognize everyday words at different volumes, as well as to hear tones at varying frequencies. The results are recorded on a chart called an audiogram, which gives a “picture” of your hearing and helps to determine what kind of hearing loss you have.  Frequently a first audiogram will show a mild hearing loss.  This is not a time to jump up and down with joy and forget the whole thing.  Being told you have a mild hearing loss is akin to your dental hygienist telling you that you have periodontal disease.  Do something about it right away! The people who have the most trouble adjusting to hearing aids are the ones who wait the longest before wearing them.   The longer you wait, the longer it will take to retrain your brain to understand—and yes, it really has a lot to do with the brain.
 

Where do you buy hearing aids?

Although an ENT will refer you to an audiologist, you can also buy hearing aids from a hearing aid dispenser. An audiologist is a Masters or PhD level professional who is certified by the American Speech-Language and Hearing Association in evaluation, rehabilitation and diagnosis of hearing loss and hearing aid dispensing.  A hearing aid dispenser, sometimes called a hearing instrument specialist, is state certified through a series of classes to provide hearing testing and hearing aid dispensing.  The distinction doesn’t necessarily dictate the price, however.  This is one product where prices vary widely for no apparent reason—even in the same town. For purposes of this article, I will refer to either person as a “provider.”

You want to purchase your hearing aids from someone who is reputable—possibly a person who is recommended by the ENT, or better yet, by someone else you know who wears hearing aids and is satisfied. Forget shopping mail order, because of some serious potential problems and lack of  follow-up service. Mail order sales of hearing aids are illegal in our state anyway.  I recommend not doing business with anyone selling only one brand of hearing aid, even if it’s a great hearing aid.  No single hearing aid is suitable for all types of hearing loss, and you’re taking potluck that it will work for you. A good business will have several makes and models from which to choose and will provide full aftercare service. Never purchase hearing aids without first having an audiogram.
 

Are today’s hearing aids better?

Absolutely! Hearing aids produced more than six or seven years old amplified all sounds equally and were no help at all in noisy environments. Newer technology allows different sounds to be amplified separately, and loud sounds can even be suppressed, resulting in much better comprehension.  Hearing aids today can have multiple programs, multiple microphones, and remote controls.  Unless you’ve had your head in the sand, you’ve probably heard all the hoopla by now about the new 100% digital aids.  Digital aids are touted to provide superior sound quality and much finer tuning to your individual hearing loss.
 

How do you know what to buy?

You simply have to rely on the expertise of your provider to help you choose the best hearing aids for your particular hearing loss and lifestyle at a price you can live with.  However, based upon my own experience and my work with other hard of hearing people, I would like to make some suggestions.  I don’t believe you need to get the most expensive hearing aids on the market in order to hear better, but I do believe you should try to do better than conventional aids.  Although digital aids are the latest rage, people with severe to profound hearing loss or poor speech discrimination may not be able to tell the difference in sound quality and may do just as well with high quality analog aids (which are also less expensive).  Studies have shown that multi-microphone aids provide better comprehension in noisy situations, as opposed to single-microphone aids.  I can attest to that, and this is one feature I wouldn’t want to be without.  I also wouldn’t want to be without a strong telecoil.  Many people are not even told about a telecoil, or else they’re told that they don’t need to worry about it. If you have more than a mild hearing loss, you should insist upon a strong telecoil.  You will hear better on the telephone and will be able to access assistive listening devices. There is also some controversy about the use of a volume control.  For the most part, this is not a standard feature of the all-digital aids.   I, personally, can’t imagine not having a volume control, and I believe it is important for anyone with a severe to profound hearing loss.
 

What is a trial period?

Your provider is required by law to issue a purchase agreement or contract for your hearing aids. It should contain all conditions of the transaction, and specify a length of time you can try your hearing aids before you become the permanent owner.  It should inform you of your rights to cancellation and refund.  It should include your warranty, which is your basic agreement with the manufacturer, and is also be backed by the provider. It should spell out what free services will be provided and for how long. You will have at least a 30-day trial period on your hearing aids. This is really not a trial to decide whether or not you need hearing aids—your audiogram already determined that.  It’s a trial to confirm or deny that these specific aids are right for you.  You need to work hard with your provider to get you “up and running” so you can make an informed decision on whether they are the hearing aids you want to live with.  If you don’t, you may get stuck with aids that don’t meet your needs.  During this time you will also want to develop a good rapport with your provider.  If you don’t feel a “connection”—for whatever reason—give back the hearing aids, go to someone else, and start over.  You want someone working with you who is caring, treats you with dignity and respect, and listens to your concerns about any hearing-related problems. You are dealing with far more important issues than simply buying hearing aids.
 

What is follow-up service?

Very rarely are hearing aids optimally adjusted the first fitting, or the second, or even the third.  Often the earmolds are too tight and hurt, or they’re too loose and you experience feedback (squealing). You may hear fine in the quiet of your provider’s office, but once you get out into the real world, you may not. You need to work with your provider and not throw up your hands in despair when something isn’t quite right, which it most likely won’t be initially. A commitment to return for check-ups and refinements to recently purchased hearing aids is so important for your success as a hearing aid user.
 

What are realistic expectations?

Because of all the money you are spending on the latest technology (and especially all that seductive advertising!), you will naturally expect miracles from your hearing aids. The truth is that hearing aids won’t give you perfect hearing, and they certainly won’t eliminate background noise—normal hearing people can’t even eliminate it! The more severe your hearing loss, the more you will need to rely on speechreading skills and assistive listening devices. The secret to getting good results from your hearing aids is to wear them every waking moment after an initial breaking-in period (except for bathing, of course). Many people, especially those who live alone, seem to have a harder time adjusting to hearing aids because they wear them only for conversation.  Even if it’s only you and your cat, you need to wear them or you’re doomed to failure.

I can’t think of anyone who has jumped up and down shouting, “Oh, goody!  I can’t wait to get hearing aids!”  Most of us want to spend as little money as possible, pick out the most inconspicuous aids, and get the whole thing over with quickly.  The reality is (generally speaking) that the more money we spend, the better the aids will be; the larger the aids we get, the better we’ll hear; and the longer we take with follow-up appointments, the greater our success will be. Yes, hearing aids are very expensive, and your insurance probably won’t cover much of the cost.  Medicare, unbelievably, won’t cover any of it—no matter who you are. You’ll just have to resign yourself to leaving less money to your kids.  No doubt your kids would probably rather you spend it on hearing aids anyway. Better hearing is better quality of life now—for both you and them.   Put your hearing first, and the rest will follow, including ridding yourself of the nagging about your hearing problem.   Now you understand what it means to be hearing challenged.

Reprinted with permission of the author. This article originally appeared in the Washington State Association SHHH Newsletter Fall '99 (Vol. 7, No. 1). Visit WASA-SHHH at http://www.wasa-shhh.org.