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Frequently Asked
Questions:
1) Your hearing in quiet environments 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 never uncomfortable. 6) Your earmolds should be comfortable. 7) Your own voice should be "acceptable" to you. 8) There should be no 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 normal. Be patient. It requires time to adjust to hearing aids. Your listening skills should improve gradually as you become accustomed to amplification. It is not possible for hearing aids WILL NOT restore your hearing capabilities to "normal" or to pre-existing levels.
How much time
is needed to adapt to Hearing Aids?
Why do Hearing
Aids cost so much? 1) they are sold in relatively low volume (i.e. approximately 1.7 million hearing aids for some 30 million hearing impaired) are sold per year, as compared to several million stereos; 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) the amount of time spent by an audiologist with a patient is very significant. Data indicate that an average five direct contact hours is spent during the first year a patient receives hearing aids. Actually, with the newer digital and programmable aids this time is significantly more, to allow for adjustments to the hearing aids as the patient becomes accustomed to it, and needs change. This time is critical for new users, particularly to assist during the acclimatization process. Additionally, the minimum amount of training required for a dispensing audiologist is a Masters degree. Audiologists, like consumers, are concerned about keeping the cost of hearing aids affordable. The reality is, 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.
Why do
Hearing Aids amplify so much noise and make sounds too loud,
but not clear enough?
What can I
do about the whistling (feedback) produced by Hearing
Aids? 1) properly reinserting the hearing aid or earmold; 2) remaking the earmold (or in-the-ear shell); 3) plugging, or reducing the diameter of any vents (holes); 4) reducing the amount of high frequency gain, (typically an unacceptable trade-off because of the resultant loss of high frequency hearing); 5) altering the sound by means of filters in the hearing aids or changes in the way the devices are programmed; 6) adding a "canal lock" (a piece of plastic) to better hold canal hearing aids in place so they don't work their way out of the ear canal as you chew. 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.
What are
Multi-channel (Multiband) Hearing Aids?
What are
Digitally Programmable Hearing Aids? 1) Flexibility: changes in hearing can easily be accommodated, as with unusually shaped and fluctuating hearing losses. 2) Multiple Programs: It is often useful to be able to change the hearing aid characteristics depending on the environment one encounters. With these hearing aids, you can change program with the touch of a button or a remote control. 3) Advanced Compression Circuitry: Most hearing impaired people suffer from an abnormally rapid growth in loudness perception. This is why some hearing aid users complain that they can't hear soft sounds, but when sounds are made just a little louder, they are much too loud for comfort. Therefore, hearing aids are designed so that they will amplify soft sounds more than they will amplify loud sounds. This is called compression. Compression works almost like an invisible finger reaching up and changing the volume control so that soft sounds are made loud enough to hear and loud sounds are turned down so that they don't become uncomfortable.
What about
the new Digital Hearing Aids?
Why does my
voice sound so odd to me when wearing Hearing
Aids? 1) keeping the ear as open as possible; 2) reducing the amount of gain (amplified volume) in the low frequencies; and/or 3) using an earmold that fits very deeply into the ear canal so that it contacts with the bony rather than the soft cartilaginous portion (to reduce vibration). 4) With the newer programmable and digital hearing aids, we can often correct this problem acoustically by changing some of the parameters within the chip.
What
determines the style of Hearing Aids I should wear? 1) The shape of your outer ear: deformed outer ears may not allow for wearing of BTE styles. 2) The depth of the depression near the ear canal (technically called the concha): if your ears are very shallow there may not be adequate space for certain ITE model aids. 3) The ear canal size and shape: certain ear canals may be too narrow or shaped in a manner such that ITC or CIC hearing aids will either not go in easily, or may fall out too easily. 4) Manual dexterity: not only is the removal and insertion of canal style hearing aids difficult for some people, but some individuals are unable to insert the battery or manipulate the volume control. 5) Wax in the ear: some people build up large amounts of earwax, or may have extremely moist ear canals that require adequate ventilation. For these people ITC, or even certain full size ITE aids may not be appropriate. 6) Draining ears or ears otherwise having medical problems may not be able to safely utilize hearing aids that completely block the ear canal. For these ears, it is vital to allow ventilation so hearing aids that do not fully block the ear may be required. Sometimes, BTEs that are connected to earmolds that have large vents (openings to let air pass through) are useful. Hearing related factors include: 1) The shape of the audiogram (hearing test); individuals who have hearing loss for certain pitches (frequencies) but not others, (for example those who hear the low frequencies fine, but have a high frequency hearing loss) may be better served by systems that do not fully block the ear canal. 2) Degree of loss; currently, severe and profound hearing losses are best served by BTE style aids. This style may also minimize the likelihood of feedback (whistling). 3) The need for special features such as directional or multiple microphones and/or the use of a telecoil (a small magnetic loop contained in the hearing aid that allows for better use with telephones or assistive listening devices), may dictate the preferred style . 4) Acoustic feedback (whistling) occurs when the microphone is close to the loudspeaker. BTE aids have a clear advantage over the smaller ITE or ITC aids because feedback is less likely to occur. While you may feel that you will only wear an inconspicuous device, check the appearance of a small or mini-BTE aid coupled to the ear with an open earmold. A mini-BTE aid connected to the ear with an open earmold may be less conspicuous than most ITE and many ITC aids. Most importantly, discuss the pros and cons of different styles with your audiologist.
How often
must Hearing Aids be replaced?
How do I
determine if I am a candidate for Hearing Aids?
Is it really
necessary to wear two Hearing Aids, or can I get by with
one? 1) Better Hearing in Noise: An individual's hearing in noise can be improved if the signal reaching each ear arrives at a slightly different moment in time. This is technically referred to as phase. When the brain receives slightly different, yet still audible signals at the two ears, it has the ability to cross-correlate and process the primary signal (usually speech) better than if the signal is received monaurally; 2) Improved Signal versus Noise Level from Optimizing Position: Sound loses intensity (loudness) when it travels across the head. This occurs mostly for the high frequencies which are the most important for understanding of consonants, such as /s/, /t/, /f/, and /sh/. If you have a hearing aid on only one ear, say the left one; and the person you wish to hear is speaking to you from the right side, the consonants may be decreased by nearly 20 decibels by the time it gets to your aided ear. Unfortunately, noise in the room may occur from any or all directions, so while the noise level is not decreased, the speech level is. Wearing two hearing aids ensures that the speech sounds will not be diminished any more than necessary because of your position in the room. 3) Improved Localization Ability: We determine where a sound is coming from on the basis of a) the relative time in which the sound arrives at each ear, b) the relative difference in loudness at the two ears, and c) the relative difference in the pitch of the sound at the two ears. When there is a large difference in hearing between two ears (as might occur when a person with similar hearing in both ears only wears one hearing aid) the brain cannot make use of these subtle relative differences and their ability to locate sounds may suffer. 4) Possible Deterioration of the Unaided Ear: We hear in our brain, not in our ears. The ultimate goal of hearing aids is not just to send sound into the ear. It is also essential to retrain the central auditory system in the brain. While it is uncertain whether hearing sensitivity (ability to hear soft sounds) will decrease if your ear is not stimulated adequately, research now suggests that there can be changes in the way in which your brain processes sound when it is "starved." Thus, providing stimulation may be important in preserving your auditory potential.
What are
Assistive Listening Devices (ALDs) for TV, Telephones and
Theaters? It would be ideal to have the sound produced at the source transferred directly to the listener without losing any intensity. It is usually impractical to ask the speaker to move closer to the listener's ear. One way of achieving this effect is with direct audio input, in which the speaker holds a microphone that is hard wired to the hearing aid itself near his mouth. Many hearing aid wearers are reluctant to ask the speaker to do this. An alternative approach is available through infrared transmission, FM transmission, or inductance loop transmission. These systems are currently used in many theaters, concert halls, houses of worship and households. One of the best uses is for television listening. The portable transmitter (usually smaller than most cable boxes) and microphone are located near the TV loudspeaker. The sound picked up by the microphone is then transmitted in the same intensity to a receiver worn by the listener. These devices can transmit with minimal distortion over a considerable distance (up to 50 feet). ALDs are becoming increasingly common in public places, due to the legislative enactment of the Americans with Disabilities Act. Other non-wearable devices that assist the hearing impaired listener include telephone amplifiers, vibrating alarm clocks, TV closed caption decoders, inexpensive personal hand held or body borne amplifiers, visual alarm systems, and TDDs (telephone devices for the deaf).
How are
directional and multiple microphones used?
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