Frequently Asked Questions

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How do we hear?

You’ve heard the term “sound wave”. This is the term for all forms of vibration that travel through air, liquid or solid objects. These vibrations are all around us and they translate into the sounds we hear. The vibrations are lead into our ear canal via the external part of the ear, and make their way to the eardrum, causing it to vibrate. The three bones on the other side of the eardrum, in the middle ear, are moved by this vibration. The third bone in the series, the stapes (sta-PEES), sends vibration into the fluid-filled inner ear, the cochlea (coke-lee-a). When this fluid begins to vibrate, it stimulates tiny hair-like cells lining the cochlea. These cells change this physical movement into electrical signals that are in turn transmitted to the brain. The brain then interprets them. Different cells respond to different frequencies or pitches. If any of this integral system is damaged or malfunctions, hearing can be changed or even lost.

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How do I protect my hearing?

Exposure to loud sounds may cause temporary or, ultimately, permanent hearing loss. Protecting your ears from loud sounds is the most important thing you can do to protect your hearing. We measure sound in decibels. Sounds that we never dreamed could hurt us can be damaging our hearing. Repeated exposure to sound at 80 decibels or greater, such as lawnmowers, power tools, or rock music, usually results in gradual noise-induced hearing loss. A single exposure to an extremely intense sound such as a gunshot or a firecracker can cause immediate severe, permanent hearing loss. Loud sounds affect your hearing because the hair cells of the inner ear and sometimes even the auditory nerve fibers themselves are destroyed. And they can’t be repaired or restored. To protect your hearing, wear hearing protection devices whenever you will be exposed to loud sounds. Such devices come in a variety of forms, from earmuffs to custom fitted ear plugs. All are available at our office. It is never too late or too early to start protecting yourself from permanent hearing loss.

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What are the signs of hearing loss?

In the U.S., approximately twenty-eight million Americans experience hearing difficulties. People often are made aware of their hearing loss from the reactions of others. The following questions may help you decide whether you may have a hearing loss:

  • Do you often ask others to repeat themselves?
  • Do you hear but have difficulty understanding words?
  • Do friends and family seem to mumble or talk too quickly?
  • Is it especially difficult to understand conversation in background noise?
  • Do you turn up the radio or TV louder than others prefer?
  • Do you have ringing in your ears?

The best way to determine the actual extent of damage is to have your hearing evaluated by a certified clinical audiologist. Please call our office to schedule your personal hearing evaluation!

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Why is a hearing loss evaluation necessary?

A hearing evaluation is necessary to understand your type and degree of hearing impairment. An audiologist is the professional who specializes in evaluating and treating people with hearing loss. After obtaining some information about your general health and, in particular, your hearing concerns, you are put into a sound proof booth. While wearing a set of headphones, you will be asked to listen to a series of tones at different pitches. Some of the tones may sound loud and clear, others very soft. You will be asked to respond whenever you hear one of the tones, even if it is barely audible. You may also be asked to repeat some words. The result of this testing is a graph, called an audiogram. From the audiogram, the audiologist can determine if you have a hearing loss, and whether hearing aids would be appropriate. If testing shows that medical intervention is necessary, the audiologist would refer you back to your family doctor.

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What are the types of hearing loss?

Basically, there are two types of hearing loss. Conductive hearing loss occurs when the eardrum and/or the bones of the middle ear don’t function properly to conduct sound to the cochlea (the inner ear). Ear infections, abnormal bone growth, or ear wax buildup can cause conductive hearing loss. Sensorineural (sen-so-ree-NU-ral) hearing loss is permanent damage to the inner ear and/or the auditory nerve. It is commonly caused by exposure to excessive noise and the normal aging process. It may also occur due to head injuries, reactions to certain prescription medications, high blood pressure, or be present at birth due to a variety of factors. Sometimes, both types of loss are present at the same time, resulting in a mixed hearing loss. Presbycusis (press-ba-CUE-sis) is the term for hearing loss associated with aging. Usually occurring after age fifty, hearing acuity declines gradually every year. Initially, people don’t realize their hearing is changing. But this type of loss interferes with the clarity of speech and often makes people intolerant of loud sounds.

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What is “ringing in the ears” – Tinnitus?

If a sensation of noise occurs in the ear when no external sound is present, you may have a condition known as tinnitus (tin-NITE-is). Although often referred to as “ringing in the ears”, tinnitus can be any persistent sound including hissing, buzzing, chirping or roaring. The sound may be constant and can change in pitch or loudness. There are numerous physical causes for tinnitus, such as middle ear infections, a ruptured eardrum, or a build-up of wax. If the audiologist finds a treatable medical condition is responsible for the tinnitus, your doctor can recommend therapy ranging from a simple course of antibiotics to surgery. Most commonly, however, tinnitus is associated with noise-induced hearing loss or presbycusis (press-ba-CUE-sis) – the loss that occurs in people over 50 years of age. Many people have been mistakenly led to believe that there is nothing that can be done to alleviate this annoying problem. Actually, since hearing loss is usually present as well, hearing aid use can often effectively mask the ringing. Sometimes a special hearing aid called a masking device can cover up the stressful noise with a more pleasing sound. Do not hesitate to mention the presence of tinnitus to the audiologist. You don’t need to suffer needlessly as there are many viable options for relief.

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How do I get help?

Do not be ashamed or reluctant to let others know about your hearing problem. Many times this will help explain to someone why your behavior seems to be a withdrawal from social situations where hearing problems can be exaggerated. Approximately twenty-eight million Americans have hearing loss and the great majority can be helped through medical or audiological means. In many situations you can help improve communication between yourself and others by asking people to do three simple things:

  • 1) get your attention before they start to speak
  • 2) face you so that you can make use of visual cues and gestures
  • 3) have them speak slower, not louder.

You can’t always control others or the environment, however. Ultimately, your hearing loss is your concern. And when you need it, an audiologist is the professional to turn to for help. They have the training and the knowledge to recommend an appropriate course of action. Please call our office to schedule your personal hearing evaluation!

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What is an audiologist?

An audiologist is the professional who specializes in evaluating and treating people with hearing loss. Audiologists have masters or doctoral degrees from accredited universities with special training in the prevention, identification assessment and non-medical treatment of hearing disorders.

They are required to complete a supervised full-time internship and pass a demanding national competency examination prior to being professionally certified to practice audiology. By virtue of their graduate education and comprehensive training, audiologists are the most qualified professionals to perform hearing tests, dispense hearing aids and know when to refer patients to physicians when medical or surgical intervention is necessary. Audiologists are vitally concerned that every person realizes the benefits of good hearing. Your first step in treatment of a hearing problem is a hearing evaluation by a certified clinical audiologist.

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How do hearing aids work?

All hearing aids have four major components: a microphone to pick up sound, an amplifier to make sounds louder, a receiver or speaker to deliver the amplified sound into the ear, and a battery to supply the power. The older, analog style circuits will usually have a user operated, manual volume control. The newest digital technology has an automatic volume control. Some aids offer the option of a remote control to change volume. Whether analog or digital, all hearing aids can be fine-tuned to your particular hearing needs. Please call our office to schedule your personal demonstration of the newest hearing aid technology.

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What questions should you ask your provider?

Be sure to ask the audiologist any questions you have about your hearing loss or hearing aids. There is no “best hearing aid”. A good audiologist will help you decide what is best suited to your needs. You need to look at a host of factors from the actual hearing loss, to your physical ability to handle the aids (and their batteries), as well as cost and cosmetic concerns. You should feel comfortable with your decision, understanding why the audiologist is recommending a particular style or circuit. Ask about how to clean and care for them. Ask about the advantages of wearing hearing aids in both ears. Ask about ease of use. Ask about the correct use of batteries. You should be thoroughly versed in their use before starting to wear hearing aids. Your audiologist is your advocate for getting the most out of your investment.

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What are the different types of hearing aids?

There are four major styles of hearing aids. In-the-ear aids fill up the whole bowl of the ear, but lie flush within it. Canal aids are smaller and fit deeper in the ear canal. The new completely-in-the-canal aids are deeply inserted within the canal, often with minimal visibility in the outer ear. Behind-the-ear aids rest behind the ear and channel their sound through a tube connected to an earmold that fits in the outer ear. The style of hearing aid appropriate for your hearing loss will be determined by you and your audiologist. The audiologist will also choose from a variety of circuits from the most conventional, analog type to the newest digitally programmable and 100% digital sound processors. Some have manual volume controls, some have the option of a remote control and some have no user controls at all, and are fully automatic. Again, there is no “best” hearing aid, only what is most appropriate for you and your hearing loss.

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How do you select the right hearing aid?

The results of your hearing evaluation will be the major factor in your hearing aid selection. Generally, the smaller hearing aids which fit part way or completely into the ear canal will usually work quite well if you have mild to moderate hearing loss. The in-the-ear or behind-the-ear models can be used for mild to severe hearing loss. For profound hearing losses, powerful behind-the-ear models are necessary. Although appearance is important, hearing is more important. Do not put too much emphasis on the cosmetic appearance and make sure that you select a model that suits your particular hearing needs. Your audiologist will help you come to a decision you can both accept, weighing audiologic needs, cost, and cosmetic concerns.

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What is binaural hearing with two aids?

Binaural (bi-naw-ral) is the use of both ears to gather sound information. A concept we often take for granted, using both ears to hear is very important. Binaural hearing is required to discern from which direction sound is coming. Because good communication depends upon reliable information, the information supplied to your brain must be accurate. Clinical studies have shown that binaural hearing aids increase auditory comprehension by helping the ears get the necessary information from both ears to the brain. When the ears work together, listening is less stressful and clarity is enhanced. “Stereo” enables us to understand speech better, especially in the presence of disturbing background noise. The use of one hearing aid, turned up in noisy situations, only makes the sounds louder, not clearer. By having a hearing aid in both ears, the amount of information is increased without increasing the volume. Using two hearing aids is much closer to the natural hearing we take for granted.

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What are the realistic expectations?

The most critical factor in anyone’s successful transition to wearing hearing aids is the understanding and acceptance of realistic expectations. Hearing aids – regardless of brand or type of technology – can never replace normal hearing in all listening situations. The degree of benefit obtained through hearing aid use can vary greatly from person to person. Resist the urge to compare yourself to others. Hearing aids will not eliminate background noise. It is normal to have more difficulty understanding speech in noisy environments. There are things you can do, however, to increase your speech comprehension. In difficult listening situations, normal hearing listeners rely on visual cues (i.e. lip reading), and focusing greater attention on the speaker. As a person’s hearing deteriorates, utilizing all the available information – auditory and visual – is even more critical when faced with less than optimum listening environments. In the end, hearing aids should allow you to understand speech more clearly, with less effort, in a variety of listening situations.

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What about different listening situations?

Since different locations and situations produce many different listening conditions, it is impossible, even at the current level of technology, for hearing aids to adjust perfectly to every situation. Some hearing aids can be tuned and preset for different environments, but not for every situation you may encounter. Getting the most out of your new hearing aids means acquiring new skills, most importantly, relearning how to listen. Retraining the brain to use what it can now hear takes effort and time. Start slowly with familiar voices and familiar environments. Realize that even in your own home you will need to reacquaint yourself to common sounds – running water, the hum of the refrigerator, your doorbell ringing. Getting your attention before starting to speak, talking face-to-face so you can use visual cues, and minimizing distracting background noise (turning down the TV or rolling up the car windows) all help. Lastly, relax. Don’t expect to hear and understand every word. Consistent, conscientious use of your hearing aids pays off in the long run – opening up a whole new world to enjoy.

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What about radio, television and movies?

It is very frustrating to go to a play or movie and not be able to follow the crucial hushed conversation, which often contains some of the most important dialogue. Many commercial theaters are striving to better their facilities for the hearing impaired. Often you can rent headsets that have their own separate volume controls and are part of either an FM or Infra-red transmission system. These large area Assistive Listening Devices significantly improve what is called the signal to noise ratio. This simply means that the signal – usually speech – is easier to hear and therefore understand in relation to the level of the noise – anything that’s interfering with the speech signal. These systems are often seen in churches or other large meeting places. They are also manufactured for home television and radio. A transmitter plugs into the TV or radio and sends the signal to the headset receiver. And as in the movie theater it is wireless. The speech signal is enhanced and clear. Friends and family can set the TV at a comfortable volume and you can adjust the volume on your headset for your needs. Many of these systems are purchased through our office as gifts – for the giver and the receiver.

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Can I still talk on the telephone?

The telephone can become quite frustrating for the person that wears hearing aids. Often feedback, or whistling, of the hearing aid itself interferes with phone use. Sometimes just learning how to reposition the handset will help. Some hearing aids have a telecoil switch which activates a special pick-up for the phone. Some people prefer to remove their aids entirely for phone use. Special amplified phones or separate handsets with amplifiers and volume controls can be installed. Fortunately the phone lines themselves, whether fiber-optic or digital-cellular, have improved clarity tremendously. If your hearing loss is very severe there are devices to make the phone ring louder or the lights to flash when the phone is ringing. TDD’s (telecommunication devices for the deaf) are also in widespread use for those who can no longer hear well enough over the phone. Most government and large business offices offer TDD communication link-ups. Nowadays there should be no reason to allow the telephone to isolate you from those you wish to contact.

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How do I prevent damage to my hearing aid?

Hearing aids are fragile, electronic devices. It is important to learn how to care for them properly to avoid unnecessary damage. Always remember to turn off the volume and open the battery compartments when you remove them from your ears. Never get in the shower or the swimming pool with them on. If the aids get wet, even from excessive perspiration, dry them as quickly and thoroughly as possible. If moisture damage has been a problem for you, you can purchase an inexpensive dehumidifier from our office to store the aids in it over night. Never apply hair spray when wearing your hearing aids because it will damage the microphones. Be careful not to drop or knock them against hard surfaces. The outer casing can crack and the internal components can be disconnected, necessitating factory repair. Simple repairs can be done in our office by the audiologist. More significant damage may require sending the hearing aids to the factory that made them. We recommend periodic cleaning and checking of all hearing aids to ensure that they function optimally for you.

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How do I clean my hearing aids?

You should perform regular maintenance on your hearing aids, just as you would any other electronic device. Inspect the aids daily, because they can pick up oils and waxes that can block their effectiveness. Do not use water or other liquids such as alcohol to clean them. All hearing aids regardless of style or complexity need to be cleaned in a similar manner and all come with tools to be used for this purpose. Make sure the audiologist reviews cleaning techniques and you understand what to do and not to do with these tools. You should see your audiologist at least once every six months for a professional cleaning. Little problems can be detected before they become big ones and your hearing aids can and should be kept in top performing condition.

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How do I protect from wax?

The part of the hearing aid that is in the ear canal will be exposed to earwax. For in-the-ear styles, earwax can damage the mechanical components of your hearing aid because it can build up in the receiver and cause it to malfunction. A behind-the-ear hearing aid is not similarly affected because only the plastic earmold is in the ear canal. However, earwax can plug up the earmold of a behind-the-ear aid and can completely stop the sound from ever getting to your ear. It is recommended that you remove earwax from the devices daily, regardless of whether you wear an in-the-ear or behind-the-ear style. Problems caused by earwax are the number one reason for all hearing aid repairs. You should be given a kit that includes a wax pick and a brush when you are fit with your hearing aid.

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What are the tips about hearing aid batteries?

The tiny battery in your hearing aid must power a microphone, amplifier and a speaker. Battery sizes can vary with the size and style of the hearing aid, and battery life depends on the size of the battery and the strength and complexity of the circuit. Average battery life can range anywhere from 3-4 days to 3-4 weeks. A hearing aid battery, like any battery, may develop corrosion on its contacts. This is why it is smart to leave the battery compartment open when not wearing your aids. You must be sure to place the battery in the aids correctly. If it is installed upside down, the hearing aids will not work at all. Stuck batteries and broken battery doors are a common sight in our office. If this happens to you, don’t try to pry the battery out yourself. You often do more harm than good. Our audiologists have lots of experience – and the right tools to do the trick. One word of caution – all batteries contain caustic chemicals that can be dangerous if swallowed. Dispose of all batteries properly in the trash, and don’t leave them out for young children or pets to get into.

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Is there a troubleshooting checklist?

The first thing to check when your hearing aid is not transmitting sound at all is to make sure the sound outlet is not plugged with wax. Get out your cleaning tools and clear the pathway. If that seems OK, next check the battery. Make sure the battery is inserted properly. If you have a battery tester, test the battery to be sure it is good. Replace the battery if necessary. Intermittent or distorted sound could be a battery problem, a wax problem or a contact problem. A whistling sound could mean that the hearing aids are not fitting or inserted properly, or the sound transmission is blocked by ear wax in the ear canal. This should be checked by a clinical audiologist. If you try your best and still can’t figure out what’s wrong or how to fix it, please stop by our office. Surprisingly, most hearing aid problems are minor and can be repaired quickly and easily right in our office.

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What is new hearing aid technology?

Digital technology has changed the world and how we communicate within it. From its use in satellites in space to its overwhelming success in personal computers, telephones, and compact disc players, it has revolutionized how we process sound information. For the person with hearing loss, the new 100% Digital Signal Processing and Digital Programmability available in hearing aids represent the most sophisticated technology available today. These instruments contain a tiny computer chip capable of utilizing separate circuit paths to independently process millions of calculations per second. The biggest advantage for most hearing aid wearers is improved clarity of speech, even in the presence of background noise. Digital hearing aids have automatic volume controls. If your hearing or listening situations change, they can be re-programmed in a few minutes in our office. Call our office for your demonstration of this new revolutionary hearing aid technology.