Hearing Loss Help  

by Neil Bauman, Ph.D.

A lady asked:

If one likes one’s hearing aids perfectly fine, does one really need to try different kinds? I’ve been reading the hearing aid forums, and I feel almost embarrassed that I went to the audiologist, bought very expensive hearing aids, and headed out into the world. I’ve worn contact lenses for thirty years and have never once cost compared different brands, or tried multiple brands to see if there’s a difference, unless I was having a specific problem. Did I make a mistake?

Think of it this way. Say you were buying your first car. You go to the Ford dealership (since it is nearby) and let a salesman talk you into a particular model. You take it for a test drive, decide you are perfectly happy with it, and buy it.

What you’re asking is, “Did I make a mistake?” The only way you’ll ever know is to shop around. You may find that another make or model of car has a feature you particularly like, and now you wish you hadn’t been so hasty.

That is why it is better to shop around first—test drive various makes and models so you get a feel for what suits you the best.

Hearing aids are much like that. You may have lucked out and got an excellent fit for your hearing loss—and thus shopping around won’t find you a better fit. That’s ok. The thing is, you are happy and can hear under most conditions.

However, you’ll never know if another make or model of hearing aid would have sounded more natural, or would have compressed loud sounds better, or was not as susceptible to wind noise, or had controls that were easier to use, etc. unless you have tried them. Thus it is wise to shop around before deciding on a specific hearing aid, even if you just try 2 or 3 other hearing aids.

Did you make a mistake? If you are happy with your hearing aids and they work well for you, I’d say not. However, you possibly could have made an even better choice if you had shopped around. Next time I recommend you shop and compare before you buy. Many audiologists carry several lines of hearing aids so you can try them right there in her office.

by Neil Bauman, Ph.D.

You don’t want to be taken in my ads that claim you will hear well with the latest hearing device. NewsChannel 5 ( WTVF) recently wrote a story that begins:

If you’re having trouble hearing, you might be tempted to buy a new product called the Loud ‘N Clear.

It promises to help you hear better and even hear things you might not ordinarily be able to.

But, can the Loud ‘N Clear really do all that its ads claim?

NewsChannel 5 Investigates put it to the test, and consumer investigator Jennifer Kraus found the answer is… Click here to read the rest of this story.

This expose’ is itself a bit misleading. It asks whether you can hear across a street, or what people are saying in a crowded room with lots of other noise, etc. The answer to that is no, the Loud ‘N Clear can’t do that, but surprise, neither can my fancy hearing aids. You have to have realistic expectations of what hearing aids and assistive devices can and cannot do for you. One thing they won’t do is restore your hearing to normal. In quiet situations you can expect to hear much better, but in noise, or in groups, you will still find that you typically miss a lot.

You see, there are two factors in hearing loss. First, obviously, since you have lost some hearing, you need a device to make sounds louder—and hearing aids and other devices can do that without any problem. However, they cannot fix the second factor that also accompanies hearing loss, namely, poor discrimination.

In other words, speech may be loud enough for you to hear people talking, but you may still miss a lot of what they are saying because your ears can’t hear many of the high-frequency speech sounds that give speech much of its “intelligence”.

In noisy situations you can’t rely solely on devices or hearing aids unless you can get the microphone right up to the speaker’s lips. (This is why FM systems work so well in these situations—you have the remote microphone right at the speaker’s lips.)

Trying to hear a person talking through noise and at a distance just isn’t going to work, whether you are using your “big buck” hearing aids, or the Loud ‘N Clear, or any other assistive device unless you have a remote microphone at the speaker’s mouth. That’s just the way it is.

by Neil Bauman, Ph.D.

A lady explained:

If someone has an automatic t-coil on their hearing aid, they will have problems hearing on their cell phones if they want to do so in t-coil mode. They will need a magnet glued to the phone’s earpiece in order to activate the automatic t-coil.

I don’t have a t-coil switch on my digital hearing aid. As a result, for a year, trying to hear on my cell phone was horrible. I couldn’t put a magnet next to the earpiece to kick in the t-coil because it was a flip-phone and it wouldn’t close otherwise.

I just brought a new cell phone—not a flip phone this time. I glued a magnet next to the earpiece and the t-coil kicked in properly. I can hear great now!

You have just exposed one of my chief complaints concerning automatic t-coils—they need a manual override when using them with devices that do not provide a strong enough magnetic field to activate them. This includes devices such as cell phones, neckloops and room loops.

It’s a shame that after paying the big bucks for your hearing aid, you still have to fool around to make the automatic t-coil work with your cell phone. Your work around is great—you just have to find a small magnet that’s powerful enough to activate your automatic t-coils and then glue it to the right place on your phone so it will activate when you hold the phone up to your ear (hearing aid). That’s a pain.

I don’t like, or recommend, automatic t-coils unless they have a manual override. With a manual override, you don’t have to fool around with a magnet. You just manually put your hearing aids into t-coil mode. Then they will work with your cell phones and neckloops and room loops too.

With your automatic t-coils, you can’t hear via your t-coils when using loop systems unless you stick magnets to your hearing aids to activate their automatic t-coils. That’s another pain. (Also, you need to have those magnets with you at all times so you have them when you need them.) Furthermore, you can’t glue the magnets to your hearing aids because you have to remove the magnets when you are finished with the looped device so your hearing aids will return to microphone mode again. Otherwise, you won’t hear a thing until you do. What a pain!

It’s so much better to insist on a manual t-coil, or an automatic t-coil with a manual override. Then you never have to fool around with magnets on your phone or your hearing aids. As you can tell, I’m solidly for “pain-free” listening.

by Neil Bauman, Ph.D.

A man asked:

Which is better, hearing aids or cochlear implants?

The true answer is “It depends.” You see, it’s not hearing aids or cochlear implants, rather its typically hearing aids first and then, when your hearing aids no longer significantly help you hear, its time to see about getting cochlear implants.

If hearing aids can significantly help you, you are typically not eligible for cochlear implants. However, when your hearing aids no longer significantly help you, its time for you to investigate getting cochlear implants.

To be eligible for cochlear implants, as a rule of thumb (and the rules keep changing), the hearing in your better ear has to be severe or profound, your word recognition has to be under 40% and hearing aids cannot significantly help you.

Incidentally, some new research has revealed that getting a cochlear implant in your worse ear and wearing a hearing aid in your better ear can produce better directionality of sound, better understanding of music and speech and more natural sounds than getting two cochlear implants—at least in some people. Therefore, the answer to your question may be—get one of each if you are eligible.

by Neil Bauman, Ph.D.

A man wrote:

I would like to know if my audiologist has given me the right information. She has told me that I cannot use an open fit or slim tube hearing aids because my hearing loss is too bad. I am using Phonak BTE aids now. They are not open fit or slim tube aids.

I looked at your February 7, 2009 newsletter with links to many different hearing aids and I saw a half dozen or so that appear to be able to be used for severe to profound hearing loss.

I would like to go to newer technology hearing aids that aren’t as visible. Thanks for any help you can give me.

You audiologist is probably right. The open fit and slim tube models are designed for people with the milder to moderate hearing losses. For severe and greater hearing losses, these hearing aids have two problems. One is they do not have enough power, and two, if they did have enough power, they would cause feedback.

The big problem is getting the power you need without getting feedback at the same time. The manufacturer has fitting curves that show whether your hearing loss will work with their aids. Your audiologist has access to these, so you need to trust his/her judgment.

I’d love to have open fit hearing aids myself—but every audiologist I’ve talked to about it has said the same thing—my hearing loss is too severe. It’s not fair, is it? But that’s the way it is. Trust your audiologist in this.

by Neil Bauman, Ph.D.

A lady explained:

Last night, all of a sudden my ear began itching so I took my hearing aid off and with my little finger I was scratching in my ear canal. When I put my hearing aid back on, it started to give feedback all the time. This morning I’m still getting enormous feedback when I put my aid in. It’s driving me crazy. What can I do?

There are two likely causes of your feedback. The good news is they are both easy to fix.

When you were scratching your ear, you likely dislodged a piece of wax (or other debris) and either one of two things happened.

One, the dislodged wax is now blocking your ear canal, so when you put your hearing aid in, the wax butted up against the hole in the ear mold, basically blocking it. The result is feedback. It’s basically the same thing as your hearing aid squealing when you cup your hand around it. This is not as true of modern aids that have feedback suppression.

Two, when you put your hearing aid on, you pushed the wax into the hole in the ear mold—again causing the feedback.

The first thing to check is your ear mold. If any wax is blocking the hole, clean it out. That should fix your problem.

If the ear mold hole is clear, then you likely need to clean out your ear canal. When we wear hearing aids, the body’s natural action to work wax and anything else in our ear canals out over time is prevented by the ear mold. Thus, each time we put in our hearing aids, we push wax further into the ear canal until it completely blocks it.

Therefore, it is a good idea to have your ears regularly cleaned out to prevent this from happening again in the future.

Epilogue: This lady went to her ear doctor, and he found her ear canal was completely plugged with wax. Cleaning out her ear canal instantly solved the feedback problem.

by Neil Bauman, Ph.D.

What will they think up next? Did you ever want to change the settings on your hearing aids, but felt embarrassed, and didn’t want to be obvious about it? That is where a remote control comes in handy. I loved to be able to do this with the remote that came with my old Widex Quattros. I could change programs, adjust the volume, or turn on or off the T- coils or microphones, even if the remote was in my pocket. No one had a clue that I was doing that.

Now Starkey Labs, the makers of Starkey hearing aids has come up with these features, but with a new twist. Their new “S” Series hearing aids have a cool feature built in called T² technology.

With T² technology, your cell phone can double as a remote control. T² technology allows you to use your cell phone (or any touch-tone phone for that matter) to conveniently switch memory settings, adjust the volume, or mute your “S” Series hearing aids.

To learn more, click on Starkey “S” Series hearing aids, then click on “View Features” to learn a bit about the T² technology and other features of these new hearing aids.

If controlling your hearing aids via remote control is something you always wanted, and you are “married” to your cell phone, maybe the new Starkey “S” series is something you might want to investigate.

by Neil Bauman, Ph.D.

A lot of people think that t-coils and loop systems are a relatively new invention. I’ll bet you’ll never guess just how long t-coils have been available in hearing aids.

If you’re like most people, you probably guessed some time in the 1970s or 1980s. If you guessed that, you’d be way off base. In actual fact, the first hearing aid to have a t-coil was a vacuum tube table model that Tel-Audio came out with back in 1936!

Two years later, in 1938, Multitone of Great Britain produced their model VPM (vest-pocket model)—the first wearable hearing aid with a t-coil. Here in the USA, it took until 1946 before RadioEar produced their Multipower “Phonemaster”, the first American hearing aid with a t-coil. Since the 1950s, t-coils have been standard features on a number of hearing aids.

As some of you may know, I am the owner of the largest on-line hearing aid museum in the world.

Recently the museum acquired a Sonotone Model 200 transistorized body-style hearing aid made in 1956 with a built-in t-coil. That is nothing unique. But what was unique is that it came with a small loop pad that you could hook up to your TV and so listen to your TV via this loop pad. (I’m not aware of any other of these loop pads still in existence!)

You hooked the loop pad to your TV by simply clipping two alligator clips to the TV’s speaker wires. Then you set the loop pad down beside you and placed the body of your hearing aid on the loop pad and turned the mic/t-coil switch to the t-coil position.

If you’d like to see this Sonotone 200 hearing aid set on the loop pad, it is shown on the 11th picture down. Cool isn’t it? (For more information on this loop pad, click on the “Sonotone Miniature Loop Pad” link beside this picture.)

Compare this antique loop pad to a modern loop pad that is in use today. (Scroll down to the 4th picture.)

 by Neil Bauman, Ph.D. 

A man wrote:

I just bought the MaxIT bluetooth neckloop and recently tried it in my 2003 Honda Odyssey van. The electrical interference from the engine was so loud that I couldn’t use it. As the engine went faster the sound got louder.

I then tried the MaxIT in my 1996 Toyota Rav 4 with no problem, as least at idle. Otherwise it has worked fine. As you probably know, the use of the device in the car is important to eliminate background noise while riding in the car. Thanks for any help you can provide.

What you are hearing is mostly ignition noise caused by the spark plugs firing. Unfortunately some vehicles are electrically “quiet” and others are very “noisy” as you just discovered.

About 30 years ago when I was an active radio amateur, we “hams” had to cope with the same interference to our mobile radios. Fortunately, we knew a few tricks that largely eliminated it. You can do the same. (You’d think they would do this in all modern cars, wouldn’t you?)

The first thing to do to eliminate this interference is to replace the spark plug wires with special high-resistance spark plug wires. That was often the primary fix. Also, we’d put a capacitor across the alternator and that fixed the alternator “hash”. A good garage mechanic with a specialty in electrical stuff should be able to eliminate, or at least greatly reduce, this interference to an acceptable level.

I’ve heard from numerous people who want to use their t-coils in their cars—and to their dismay, their cars produce a lot of interference. Incidentally, don’t blame the neckloop. It isn’t picking up the interference. It’s the t-coils in your hearing doing that. You just notice it when you are using assistive devices such as the MaxIT neckloop because otherwise you have your aids in microphone mode.

Magnetic interference is one thing all hard of hearing people should take into consideration when buying a car. Sit in the car, start the motor and with your hearing aids in t-coil mode see whether you can hear any interference and if so, how bad it is. If it is too noisy, look for another car, or you could have a bargaining point to have the dealership correct the problem (at no extra cost) before you buy the car.

by Neil Bauman, Ph.D.

A man asked:

Could you provide sources or websites that rate hearing aids? I’m getting conflicting input from audiologists, ads, and hearing impaired folks. Where can I find an impartial source that rates hearing aids that address my profound needs?

I’m not aware of any source that actually rates hearing aids—giving their pros and cons including their reliability, how well their t-coils and other features work under real-world conditions, etc. such as you would find in Consumer Reports articles. It’s a great idea, but nobody is doing it.

There are a few sites that make lists of some hearing aids and may list some of their main features, but these lists do not contain any indication of how well these features work, or whether they are basically a bunch of hype. There are a couple of sites that from their names, sound as if they do exactly this, but when you go to them, they don’t. It’s just a “come on” to get you to their site.

The best (and most complete) lists I have found are on the Hearing Review website. They list a number of selected features for each hearing aid so you can compare their features, etc. The listings also include a colored picture of each hearing aid listed.

Every month or two, for the past several months they have listed another class of hearing aids. So far they have only listed behind-the-ear (BTE) hearing aids. They have broken them down into three classes—Conventional BTE aids, Thin/Slim Tube BTE aids and Receiver-in-the-Ear BTE aids.

These reports are well worth perusing if you are in the market for new aids. You’ll have a good understanding of what is out there and their relative features. Note: not all makes/models of hearing aids are included, but it gives you a good start.

Here are the details and links to each report.

Power BTEs  (February, 2009) 10 pages

Conventional BTEs (January, 2009) 21 pages

Thin/Slim tube BTEs (November/December 2008) 11 pages

Receiver in the Ear (RITE)/Receiver in the Canal (RIC) BTE aids (October 2008) 11 pages

ITEs [Inside the Ear] Hearing Aids (March/April 2009) 12 pages

The above lists do not give prices, but if you want to get an idea of hearing aid prices, check out Ahearingaid.com’s website. They list their prices for the most popular makes and models of hearing aids. This will give you an idea of the relative prices of the various hearing aid models and whether they will fit into your budget.

Now comes the question, “Which is the best hearing aid for me?” The best hearing aid for you depends on many factors. Some of them are subjective, so only you can make the decision, while others are objective, and your audiologist can choose those for you. For example, your audiologist can tell you which aids have enough power for your hearing loss, but only you can determine if the sound produced by these aids seems “good” to you. Furthermore, only you know which features are important to you.

Once you’ve narrowed your choices down to a short list of hearing aids that have the features you want, and the power and type that your audiologist knows you need, how do you make your final choice?

The surprising answer is that when it comes right down to it, your satisfaction with any of these hearing aids will depend, not so much on a specific hearing aid, or its features, but on the skill of the person programming it to your specific needs.

Therefore, ultimately you want to purchase a hearing aid that your audiologist has had lots of experience successfully programming, and knows how to program it for your specific hearing needs. That was the conclusion of Dr. Mark Ross, a man I highly respect because of his common-sense understanding of hearing loss, both as a highly-regarded professional in the field, and also as a hard of hearing person. (Mark has had a hearing loss for as long as I’ve been alive—which means we’ve both lived with our hearing losses for 60+ years now.)

He recently wrote an article called “Revisiting the Perennial Question: What is the “Best” Hearing Aid” in the January/February 2009 issue of Hearing Loss magazine. It is well worth the read.