Ask the Hearing Expert

May 2012 Article

Hey there,

May is “Better Hearing Month” and as such I thought I would take the opportunity to answer the most asked question that is asked by our clients, “Why do Hearing Aids cost so much”?

This is the number one question that I get asked in our clinic on a daily basis. The answer is not simple, nor is it short, but I will try to explain it by breaking it down into the areas involved in the cost of a hearing aid.

The first part of the process is the research and development investment that is made by the Manufacturer before they ever sell a hearing aid. You are paying for the expertise of a group of highly educated Engineers and research Audiologists to design and evaluate prototype hearing aids, refine them and bring them to market. These Professionals deserve and command a fairly high salary to do what they do.

From research and development we move onto the manufacturing process which is no longer a low tech activity. As the technology in the hearing aids has become more complex so has the manufacturing process. The use of automated computer controlled manufacturing requires a huge investment to start with, that is only recovered over many years and tens of thousands of hearing aids. This equipment is all operated and maintained by highly skilled Technicians who are also well paid. (Have you had your refrigerator or computer worked on lately … it’s not cheap!)  All the hearing aids produced must meet the government standards of the country for which they will be produced. In most cases, to reduce the costs incurred from import taxes and duties, the companies will set up manufacturing facilities in the countries that they are doing the most business with. This produces jobs for that country but more initial investment is required… again.

The next step is marketing, getting the word out to everyone that the Manufacturer possibly can. This includes the advertisements to the end user through tv, print, internet and various other medias. But it also includes education and training of the people like me, that will ultimately be fitting the hearing aids on the end user/customer, you.

That brings us to the hearing aid clinic and all the costs of running it. We have the usual: salaries, a physical store front, specialized equipment for testing hearing, more specialized equipment for fitting of the hearing aids, utilities, advertising, insurance, re-investment etc. On top of these costs, the hearing aid clinics as well as the Manufacturers incur costs for returned hearing aids, trial periods and loss and damage insurance all of which are subsidized heavily by both parties.

So… now you have the explanation. What’s next?

You’ve made an appointment at A&E Hearing Care to have a hearing test and consultation. I’ve tested you, explained your hearing loss and answered all your questions except one. We have reached the point at which you ask me, “How much it is going to cost to treat my hearing loss?” and I tell you… but instead of looking at me and asking, “Why do hearing aids cost so much?”, because I’ve explained the costs involved and you understand them, you will be able to simple ask “Are there any government programs to help purchase my hearing aids?”, which I will have the answer for in my article next month… Is there any financial help for purchasing hearing aids?

Best regards,

Andrew Clark-Marlow RHAP, BC-HIS

 

 

April 2012 Article

We all see patients who report dizziness that affects the quality of their lives. If the vestibular system in one ear has a problem or disease, the balance signals from the ears may no longer be equal and the patient may experience vertigo. These patients need guidance and warnings to avoid falls.

Dizziness is not fatal, but its symptoms can be especially problematic. When people start experiencing vertigo, their intuition tells them not to make any sudden movements and to move slowly. They reduce their daily activity, like not getting up to get a drink. They sit in fear of their vertigo, but this restriction of movement is the exact opposite of what is needed to retrain the balance system. People can relearn the skills needed for balance and be taught how to deal with vertigo attacks.

Patients don’t like the idea of purposely making themselves dizzy. They would rather take a pill to make the vertigo go away. Unfortunately, many popular medications like Antivert that suppress the nervous system may delay rather than help rehabilitation. Balance-training exercises teach patients how to deal with vertigo, and the exercises work best if the patient’s neural responses are not muted with medication.

Dangerous Fall

When dealing with a dizzy patient or any patient not stable on their feet, be aware of the danger of falling. People with vertigo and balance instability need physical security in all directions because they could fall backwards.

Years ago, my mother fell and broke her hip. Some of my family members didn’t take her condition seriously so a family friend who is a nurse sent us an article saying the mortality rate for those with a broken hip is quite high. Initially, I didn’t believe that, but I researched the topic and found I was wrong. Sadly, not long after, we lost Mom. Elderly bones tend to be brittle, not flexible. Many seniors have osteoporosis without being aware that their skeletal system is approaching dysfunctional. People with broken hips are often confined to wheelchairs, and exercise tends to be painful. Without exercise that strengthens the skeletal structures, bones tend to heal slowly and the patients’ physical and mental state deteriorates rapidly.

We need to counsel all patients about the dangers of falls but particularly those with balance problems. We also need to be sensitive to their condition, being gentle and not aggravating their problems by swinging them around in the chair when looking at their ears or hearing aids.

Below is an example of a dizziness handout I give to patients who are at risk for or are already experiencing dizziness or vertigo. Feel free to use it when you council patients regarding the need to relearn balance. These patients need medical management and you should make sure the patient is going to physical therapy for the problem.

Best regards,

Andrew Clark-Marlow RHAP, NBC-HIS

Information for Patients with Dizziness

If you have a balance disorder as a result of an ear problem you should know:

1. The ears work together to create balance. The ears send a balance signal to the brain, and the brain compares the two signals. Normally these signals are the same. Vertigo is triggered when the balance signals are unequal, such as when one ear sends a strong signal and the other a weak one.

2. Sedating medications do not help the healing process. Medications like Antivert (meclizine), Valium (diazepam), and some antihistamines suppress the vestibular and central nervous system. This delays the healing process because the medication reduces the neural response as the brain tries to balance the two signals, and delaying rehabilitation makes balance problems worse.

3. The ears need to learn to work together. Some patients do not want to move because they are afraid of creating vertigo, but this is a mistake. The brain needs to relearn how to coordinate the balance signals from both ears. The more often the brain deals with the signals from the ears, the quicker the dizziness problem will be resolved. When the brain learns how to coordinate the signals from both ears, balance results.

4. Balance exercises help. Vestibular rehabilitation is a series of instructions and exercises to help your brain adjust to a weak ear signal. Remember, professional ice skaters and ballerinas learn to spin rapidly without getting dizzy. Rehabilitation classes help patients adapt to the signal imbalance coming from the ears.

5. You do not have a life-threatening disease. Dizziness, vomiting, and nausea are not fun, but they are not dangerous and your condition is not life-threatening. You can learn to suppress and control vertigo, so they disappear altogether.

 

March 2012 Article

It’s March, that means one more real month of winter, with any luck. With the approach of spring it would be good to hear the birds again. For many people with hearing loss the only birds they can easily hear around central Alberta are crows, magpies and blue jays. These birds are loud enough and annoying enough to be heard, by even people with moderate hearing loss. The smaller more pleasant sounding birds are a different story. Their songs are soft and don’t carry as far, so the pleasure of their song can be lost. Hearing aids can in many cases bring back the song of the bird. Being fit with an appropriate pair of hearing aids for your hearing loss, can have you enjoying the birds as well as conversations. Notice that I wrote appropriate “pair” of hearing aids. Human beings are “bilateral” meaning “two sided”, we are set up to use, ”two”, as in hands, feet, eyes, legs, arms, lungs, etc. Our bodies and brains are pre-wired this way.

Many clients see us for their initial testing and diagnosis and are shocked when we prescribe two hearing aids. I will hear from the client that their friend only wears one. Well chances are that the friend either has single sided hearing loss or they are ignoring the recommendations of their Hearing Professional. You do not see people wearing a monocle; they wear a pair of glasses. The reason for this is we have binocular vision. The brain processes what each eye sees and then combines the information. Much like the eyes, the ears send the sound signal to the brain separately, from one side and the other, then combines the signal to make sense of it. Wearing two hearing aids vs. one gives us the added benefits of:

•            Speech will sound clearer

•            Better understanding in noise

•            Your ability to locate sounds will improve

•            Listening is easier

•            Less volume is needed to understand

•            Improved focus in noisy situations

•            More confidence communicating

•            Better sound quality (ever listen to stereo vs. mono)

All of these factors are a product of what researchers’ call ‘Binaural Fusion or Binaural Summation”, this happens in the upper brain. Essentially 1 plus 1 does not equal 2, it equals 2.3 and we get a boost in the perceived sound over what we started out with. This gives us better sound quality, thus better speech understanding.

The latest research shows that clients’ who wore two hearing aids vs. clients’ who wore only one hearing aid were less tired at the end of the day. This left them more energy to enjoy life.

If you have any questions concerning two hearing aids vs. one hearing aid, or you want to check how you are hearing, gives us a call or email

aa.a-ehearing@shaw.ca.

Best regards,

Andrew Clark-Marlow

RHAP, NBC-HIS

 

 

February 2012 Article

Hearing loss is the most common physical disability in the industrialized world. More than 50% of the population over the age of 70 years suffers with a treatable hearing impairment. There are various tell-tale symptoms that can help an individual or their family and friends to determine the presence of a hearing loss. We have compiled a list of 11 questions regarding the main symptoms of hearing loss. If you or someone you are close to answers yes to 3 or more of these questions… then it is time for a hearing test.

The questions are as follows:

1.            Do people seem to mumble when they talk?

2.            Have you been told that you speak too loudly?

3.            Do you hear, but have difficulty understanding?

4.            Do you have trouble listening in a church or theatre?

5.            Do you experience ringing or buzzing in your ears?

6.            Do you often ask people to repeat something they’ve said?

7.            Do you find telephone conversations becoming more difficult?

8.            Do you sometimes miss hearing the doorbell or telephone ring?

9.            Does your family complain that you play the radio or TV too loudly?

10.          Do you have difficulty hearing when the speaker is not facing you?

11.          Do you have difficulty hearing in a group situation or noisy environment?

After answering these questions, if you have questions of your own, please call, visit or email our office to find your answers.

Call 403-347-2202 or toll free 1-877-347-2202, email: aa.a-ehearing@shaw.ca or drop by 4 – 6715 – 67 Avenue Red Deer, Alberta.

The article next month will explain why two hearing aids are generally better than one.

Until then stay warm and take care.

 

 

January 2012 Article

Happy New Year!!! The celebration is over but with all the noise and stress of the holiday season, many of us have an unwanted byproduct to remind us of the fact that we have been busy… Tinnitus! Tinnitus is an annoying sound usually ringing or hissing that we hear in our head, quite often after being in noisy environments or in stressful situations (i.e. time with the In-laws). Although there are many different causes of tinnitus these two situations are reported to be triggers for tinnitus. I looked for the definition of tinnitus and The Better Hearing Institute describes it as follows:

Tinnitus (Ringing in the Ears)

Richard Tyler, PhD – The University of Iowa. Dr. Tyler reports; Tinnitus is the perception of a sound that has no external source. Some of the more common sounds that patients have reported are: ringing, humming, buzzing and cricket-like. It can be constant or intermittent and is heard in one ear, both ears or in the head. Tinnitus can originate in the middle ear (behind the eardrum) or in the sensorineural auditory system.

Causes of Tinnitus

Tinnitus is usually accompanied by hearing loss, and sometimes accompanied by an aversion to loud sounds called “hyperacusis” (when moderately loud sounds are perceived as very loud). Some 50 million North American adults suffer from tinnitus (it can also affect children). For approx. 12 million, the problem is severe enough that it impacts their everyday life. Because tinnitus can be a symptom of a more serious disorder, it is important to have an appropriate health evaluation, from a hearing health professional (Hearing Aid Practitioner or Audiologist) or physician (ENT).

Treatments for Tinnitus

For most tinnitus sufferers, there is no cure. There is no pill or surgery that has been shown to eliminate tinnitus in scientific studies that have been replicated and accepted by the healthcare community. There are some important exceptions to this. Some forms of tinnitus, particularly middle-ear tinnitus, can be treated. Sometimes a medication can cause tinnitus, and stopping or changing medications can eliminate the tinnitus (check with whoever prescribed the medication).

There are two broad categories of treatments that help people adjust to their tinnitus.

Counseling; Counseling can be beneficial with thoughts and emotions, hearing, sleep and concentration. One example of this approach is Tinnitus Activities Treatment, which includes individualized collaborative counseling in each of these areas.

Sound Therapy; Many tinnitus sufferers report that the presence of background sound reduces the prominence or the loudness of their tinnitus. The background sound can be present in the environment (e.g. fan noise, ticking clock). There are sound generating devices that produce pleasant background sound (e.g. raindrops or nature sounds). Additionally, wearable maskers or sound generators are available that produce a ‘shhh’ noise (these can also be combined with hearing aids). The use of hearing aids improves communication, reduces the stress associated with intensive listening, and also can partially mask the tinnitus. Some hearing aid manufacturers have introduced melodic sounds that match brain wave patterns, this helps to relax the user, thus reducing the stress related to the Tinnitus. Music has also been found to be very effective in non-wearable (e.g. stereo systems) and wearable devices such as an iPod or other personal listening device.

Self-help Books

There are also some excellent self-help books available, both online and at your local library. If you, or someone you know, suffers from Tinnitus and wants to explore your options you should contact a Hearing Health Professional as soon as possible.

Happy New Year and Be Well,

Andrew Clark-Marlow,   RHAP, BC-HIS

 

December 2011 Article

Every day, we experience sound in our environment, such as the sounds from television and radio, household appliances, and traffic. Normally, we hear these sounds at safe levels that do not affect our hearing. However, when we are exposed to harmful noise/sounds that are too loud or loud sounds that last a long time—sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensitive structures, called hair cells, are small sensory cells that convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back.

What sounds cause NIHL?

NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by continuous exposure to loud sounds over an extended period of time, such as noise generated in a woodworking shop.

Sound is measured in units called decibels. On the decibel scale, an increase of 10 means that a sound is 10 times more intense, or powerful. To your ears, it sounds twice as loud. The humming of a refrigerator is 45 decibels, normal conversation is approximately 60 decibels, and the noise from heavy city traffic can reach 85 decibels. Sources of noise that can cause NIHL include motorcycles, firecrackers, and small firearms, all emitting sounds from 120 to 150 decibels. Long or repeated exposure to sounds at or above 85 decibels can cause hearing loss. The louder the sound, the shorter the time period before NIHL can occur. Sounds of less than 75 decibels, even after long exposure, are unlikely to cause hearing loss.

Although being aware of decibel levels is an important factor in protecting one’s hearing, distance from the source of the sound and duration of exposure to the sound are equally important. A good rule of thumb is to avoid noises that are “too loud” and “too close” or that last “too long.”

What are the effects of NIHL?

Exposure to harmful sounds causes damage to the hair cells as well as the auditory, or hearing, nerve (see figure). Impulse sound can result in immediate hearing loss that may be permanent. This kind of hearing loss may be accompanied by tinnitus—a ringing, buzzing, or roaring in the ears or head—which may subside over time. Hearing loss and tinnitus may be experienced in one or both ears, and tinnitus may continue constantly or occasionally throughout a lifetime.

Continuous exposure to loud noise also can damage the structure of hair cells, resulting in hearing loss and tinnitus, although the process occurs more gradually than for impulse noise.

Exposure to impulse and continuous noise may cause only a temporary hearing loss. If a person regains hearing, the temporary hearing loss is called a temporary threshold shift. The temporary threshold shift largely disappears 16 to 48 hours after exposure to loud noise. You can prevent NIHL from both impulse and continuous noise by regularly using hearing protectors such as earplugs or earmuffs.

Scientists believe that, depending on the type of noise, the pure force of vibrations from the noise can cause hearing loss. Recent studies also show that exposure to harmful noise levels triggers the formation of molecules inside the ear that damage hair cells and result in NIHL. These destructive molecules play an important role in hearing loss in children and adults who listen to loud noise for too long.

What are the symptoms of NIHL?

When a person is exposed to loud noise over a long period of time, symptoms of NIHL will increase gradually. Over time, the sounds a person hears may become distorted or muffled, and it may be difficult for the person to understand speech. Someone with NIHL may not even be aware of the loss, but it can be detected with a hearing test.

Who is affected by NIHL?

People of all ages, including children, teens, young adults, and older people, can develop NIHL. Approximately 15 percent of North Americans between the ages of 20 and 69—or 26 million North Americans—have high frequency hearing loss that may have been caused by exposure to loud sounds or noise at work or in leisure activities. Recreational activities that can put someone at risk for NIHL include target shooting and hunting, snowmobile riding, woodworking and other hobbies, playing in a band, and attending rock concerts. Harmful noises at home may come from lawnmowers, leaf blowers, and shop tools.

Can NIHL be prevented?

NIHL is 100 percent preventable. All individuals should understand the hazards of noise and how to practice good hearing health in everyday life. To protect your hearing:

Know which noises can cause damage (those at or above 85 decibels).

Wear earplugs or other hearing protective devices when involved in a loud activity (special earplugs and earmuffs are available at hardware and sporting goods stores).  Custom made hearing protection is available through your licensed hearing health professional.

Be alert to hazardous noise in the environment.

Protect the ears of children who are too young to protect their own.

Make family, friends, and colleagues aware of the hazards of noise.

If you suspect hearing loss, have a hearing examination by your hearing health professional.

Next month I will write an article regarding tinnitus and its causes and treatments.

 

Have a good month, stay warm!

 

October 2011 Article

Hi there folks, another month has crept by and we are just experienced the best weather that I can recall… so enjoy because winter is coming. With winter most of us will be spending more time indoors. Each indoor environment poses a different set of problems for a hearing aid user. You can combat these problems by using some basic strategies to help the hearing aid do the best possible job it can.

Keep in mind, the primary job of the hearing aid is to reproduce sounds in such a way as to augment the remaining hearing that you have. Or, in other words, to take what you have and make it better. Today’s hearing aids are getting better all the time, what with all the options that are available such as:

• Automatic multiple directional microphones which zero in on speech signals

Multi-channel circuits for more accurate tuning of the hearing aids

• Speech weighted noise reduction to help quell non-speech like noises

FM signal attachments for FM radio wave signal processing

• Speech analyzing circuitry to enhance the speech signal in all situations

Bluetooth connectivity to receive discreet electronic signals from sources such as TV, Telephone, Cellphone, Ipods/Mp3 players, microphone transmitters or just about any compatible Bluetooth signal you can think of.

These are all options that can make the speech signal better and reproduce sound in such a way as to make it clearer for the user and they make a big difference. The user of the hearing aids can make an even bigger difference if he/she is proactive in how they approach their own hearing challenges. Just by sitting in the front of any meetings whether it is business, school, Church etc., you give yourself a much better chance of understanding. Now that seems simple enough but I ask my clients where they sit at meetings and a great many of them sit further back in the room and struggle to understand what is being said.

Asking a person that hears well, whether or not they can hear in a given situation is fine but who cares! If you can’t hear or understand then change the situation…

Move closer, stop the person speaking and have he/she slow down and repeat or rephrase, and explain why. Most speakers want to be understood and will accommodate you if they know there is a problem. Change your position in the room so that there is less noise around you from air systems, pop machines, people or any other source of noise that is causing you not to understand what is said. Contrary to the statement “I can’t hear in background noise”, that is exactly where you want the noise, behind you. Face the source of speech and have noise behind you. In that way you will let the directional microphones on your hearing aid do their job. The microphones will switch to the front to better receive the signal from the source. All that you have to do is give them the help they need, to do their job, by positioning yourself properly. This works particularly well in restaurants. Try to be seated so that you face the people you wish to talk to and the majority of the restaurant is to your back.

Hearing and understanding in noisy situations, takes practice and patience. Easing into tougher environments with the proper attitude of, “maybe I won’t understand all of what is said, but let’s see how well I can do”, will serve much better than wearing your hearing aids occasionally only when you go out into noise because that is where you have the most trouble! It takes practice!

An excellent hearing drill is to turn on the TV to a show or channel that you know you can understand and sit at your normal distance from the TV. Now, take another speech source such as a radio, talking book, computer or a person reading out loud. Have the distance from you and the volume the same but behind you. For twenty minutes per day for one month, listen to the TV for five minutes then turn around and listen to the other speech source for five minutes. If you do this consistently, every day for the month, you and the people around you will see a difference in your ability to understand in noise as well as your ability to concentrate in noise. It works, so try it and see for yourself. You paid a lot for those hearing aids so why not get the most out of them. A little effort can make a massive difference in how well you do. Good luck with your practice and if you have any questions you can email me at aa.a-ehearing@shaw.ca or call and make an appointment for a consultation.

Next month I will write about noise induced hearing loss, how to prevent it and what can be done after exposure. Take care and enjoy the warm fall weather.

Andrew Clark-Marlow   RHAP, BC-HIS

 

 

September 2011 Article

Hi there folks, another month has crept by and we are just experienced the best weather that I can recall… so enjoy because winter is coming. With winter most of us will be spending more time indoors. Each indoor environment poses a different set of problems for a hearing aid user. You can combat these problems by using some basic strategies to help the hearing aid do the best possible job it can.

Keep in mind, the primary job of the hearing aid is to reproduce sounds in such a way as to augment the remaining hearing that you have. Or, in other words, to take what you have and make it better. Today’s hearing aids are getting better all the time, what with all the options that are available such as:

• Automatic multiple directional microphones which zero in on speech signals

Multi-channel circuits for more accurate tuning of the hearing aids

• Speech weighted noise reduction to help quell non-speech like noises

FM signal attachments for FM radio wave signal processing

• Speech analyzing circuitry to enhance the speech signal in all situations

Bluetooth connectivity to receive discreet electronic signals from sources such as TV, Telephone, Cellphone, Ipods/Mp3 players, microphone transmitters or just about any compatible Bluetooth signal you can think of.

These are all options that can make the speech signal better and reproduce sound in such a way as to make it clearer for the user and they make a big difference. The user of the hearing aids can make an even bigger difference if he/she is proactive in how they approach their own hearing challenges. Just by sitting in the front of any meetings whether it is business, school, Church etc., you give yourself a much better chance of understanding. Now that seems simple enough but I ask my clients where they sit at meetings and a great many of them sit further back in the room and struggle to understand what is being said.

Asking a person that hears well, whether or not they can hear in a given situation is fine but who cares! If you can’t hear or understand then change the situation…

Move closer, stop the person speaking and have he/she slow down and repeat or rephrase, and explain why. Most speakers want to be understood and will accommodate you if they know there is a problem. Change your position in the room so that there is less noise around you from air systems, pop machines, people or any other source of noise that is causing you not to understand what is said. Contrary to the statement “I can’t hear in background noise”, that is exactly where you want the noise, behind you. Face the source of speech and have noise behind you. In that way you will let the directional microphones on your hearing aid do their job. The microphones will switch to the front to better receive the signal from the source. All that you have to do is give them the help they need, to do their job, by positioning yourself properly. This works particularly well in restaurants. Try to be seated so that you face the people you wish to talk to and the majority of the restaurant is to your back.

Hearing and understanding in noisy situations, takes practice and patience. Easing into tougher environments with the proper attitude of, “maybe I won’t understand all of what is said, but let’s see how well I can do”, will serve much better than wearing your hearing aids occasionally only when you go out into noise because that is where you have the most trouble! It takes practice!

An excellent hearing drill is to turn on the TV to a show or channel that you know you can understand and sit at your normal distance from the TV. Now, take another speech source such as a radio, talking book, computer or a person reading out loud. Have the distance from you and the volume the same but behind you. For twenty minutes per day for one month, listen to the TV for five minutes then turn around and listen to the other speech source for five minutes. If you do this consistently, every day for the month, you and the people around you will see a difference in your ability to understand in noise as well as your ability to concentrate in noise. It works, so try it and see for yourself. You paid a lot for those hearing aids so why not get the most out of them. A little effort can make a massive difference in how well you do. Good luck with your practice and if you have any questions you can email me at aa.a-ehearing@shaw.ca or call and make an appointment for a consultation.

Next month I will write about noise induced hearing loss, how to prevent it and what can be done after exposure. Take care and enjoy the warm fall weather.

Andrew Clark-Marlow   RHAP, BC-HIS

 

September 2011 Article

Hello readers, finally we have a bit of heat and the rains have subsided. It has been some different kind of summer, weather wise. With the dryer hotter weather there will be some challenges when it comes to taking care of your Hearing Aids. So far this summer daily cleaning of your hearing aids should have been easy enough and would have included an inspection of the microphone openings as well as the receiver bore/wax guard area/ear mold sound bore (speaker or sound opening). These areas should be brushed lightly, daily, to ensure no debris becomes lodged in the openings. Debris can either partial obscure or in some cases fully obscure the sound travelling to the hearing aid or the ear canal. Along with the visible inspection and cleaning of the sound inlets and outlets, a general light brushing of the battery holder and hearing aid case should be performed. Generally if this cleaning is done daily the hearing aids will operate very efficiently with very few repairs. If the weather does get hotter, you may find that the hearing aid has some moisture in it. This is normal from your body’s perspiration. To combat this, your hearing aid professional can introduce you to a “dry aid kit”, which is a device that acts as its’ name implies. You put your aid in it and it dries the moisture out of the hearing aid system.

General Maintenance

The different styles of hearing aids will need slightly different maintenance. This is maintenance that should be performed by a hearing aid clinic, about every three or four months and is in addition to the daily cleaning schedule.

BTE: “Behind the ear” hearing aids need to have the hook as well as the ear mold tubing checked regularly. The tubing is a soft porous silicone material that stiffens over time and needs changing. This can cause poor sound transfer, physical discomfort and possible damage to the hook or the case of the hearing aid. The ear mold can also be disinfected at this time in a micro sonic bath. The case should be checked for damage and performance. Any filters on the aid should be inspected and changed if necessary.

ITE: “In the ear” hearing aids will need the microphone openings and sound bore checked and cleaned as needed. Wax guards/filters should also be changed as needed. A general disinfection with a sani- wipe should also be performed.

HYBRID: “Hybrid hearing aids” need a combination of the BTE and ITE maintenance as they share components of both styles. Depending on the parts present, the performed care will vary. The same schedule should apply, every three to four months.

Any time that you feel that the performance of your hearing aid is not up to par you should let you hearing aid professional know. They can perform an electro-acoustic analysis to ensure that the instrument is operating within the manufacturer’s specifications. This will tell them whether or not the instrument needs an electronic repair or something else is at fault and needs to be addressed.

If you feel you have cleaned your hearing aids and they are still not performing as they were previously, call your hearing professional and have them check the aids (we can’t fix it if we don’t know about it).

This months’ article is like our summer… a bit short!

Next month I will write about strategies for better hearing aid performance. Enjoy the summer… finally!

Take care,

Andrew

 

 

August 2011 Article

Wow it is coming up to the end of July as I write this addition of Ask The Expert on Hearing. Last month I said I would write about the different types and styles of hearing instruments/hearing aids, their applications and the pros and cons of each one.  First I will explain a bit about the hearing aid circuitry. Hearing aids originally had circuits that would amplify sound on a slope to try to match the hearing loss being treated. The problem with this linear (straight line) type of amplification was that, loud sounds were too loud, soft sounds were too soft and normal sounds were just right. Thus the user was forever adjusting the volume trying to achieve a comfortable level to match the volume of the surroundings that he/she was in at any given time. So the volume control was usually the first part to fail, as it was used quite a bit. Then came various loudness suppression circuits both manually and digitally control. These circuits were an improvement over the linear hearing aids but were still limited by an analogue (non-digital) circuit that was easily overwhelmed by the large amounts of information that needed to be processed to understand speech, particularly in the presence of background noise. This would require a new type of circuit to be developed and computerization has allowed that to happen. Over the past ten to fifteen years, there has been an integration of digital technology to control the function of shaping the sound processed by the hearing aids. This type of amplification control, allows the hearing professional the ability to program the hearing aids very finitely with the use of a computer. Now soft sounds are amplified to comfortably audible level, while loud sounds are suppressed to a loud but comfortable level and normal sounds as well as the loud and soft sounds are shaped for the best clarity possible.

Along with the digital circuitry, we have seen a switch in how hearing aids are being attached to the body. Generally speaking for a long time you either had an “In The Ear” (ITE) or a “Behind The Ear” (BTE) hearing aid.

The ITE hearing aid is made by taking a silicone impression of the outer ear and ear canal. This is shipped to the laboratory and a hard shell casting is made of the ear impression. The electronics are housed inside this casting. The size of the hearing aid is determined by the hearing professional and the client using the hearing loss and impression as a guideline to decide. Those sizes are as follows:

CIC – a “completely in the canal” hearing aid that can barely be seen and fits the deepest in the ear canal of any style hearing aid. It is very discrete, but is limited by the degree hearing loss and the shape of the canal of the perspective user. No controls are available on this style of hearing aid. New high power CIC hearing aids are now available, so this type of hearing aid is becoming more flexible than previously. Do to the depth of the fitting this type of hearing aid is more susceptible to moisture related break downs.

ITC- the “in the canal” aid is slightly larger than the CIC and depending on the ear canal size can now start to accommodate both inner and outer controls, such as an external volume control or an internal remote control interface.

HS/ITE –“half shell and in the ear” aids fill either the bowl of the ear in the case of the HS or the entire outer ear cavity in the case of the ITE. These hearing aids are very common and can accommodate more internal and external controls, such as telecoils and Bluetooth interfaces.

 

BTE- “behind the ear” hearing aids are the most versatile hearing aids. The electronics are housed in a hard casing that is placed on top of and behind the ear, hooking where the top of the ear meets the cheek bone. The aid is then coupled to an ear mold via silicone tubing or plastic thin tube. Sound travels from the BTE through the tube into the ear mold and into the ear canal. The ear molds can be custom made in the same sizes as the ITE hearing aids, as well as pre-molded silicone molds for instant in office fittings . BTE hearing aids come in a variety of sizes and colours. These aids can accommodate the widest variety of ear canal sizes as well as the different degrees of hearing loss from mild to profound.

Hybrids- these are the newest aids and can be ITE’s with a remote microphone or a BTE with an in the canal receiver/speaker system. This last hearing aid style known as; a “RIC” (receiver in the canal), a “CRT” (canal receiver technology” or a “RITE” (receiver in the ear). They all have the hearing aid housed in a casing like a BTE and a speaker system attached via a plastic coated wire. These hearing aids are widely used because of their comfort and flexibility for fitting a wide variety of hearing losses and ear shapes very effectively.

These are the main hearing aid styles and types if you have any questions about whether a style or type of hearing aid is right for you contact your hearing health professional. Next month I will write about hearing aid maintenance. Take care.

Andrew Clark-Marlow   RHAP, NBC-HIS