By Robert L. Martin
I am sometimes asked, “What about the hearing aids I see advertised in the newspaper or on the Internet?” The simple answer is “These hearing aids do not work.” To understand my answer, you need to know how hearing aids are fitted.
There are many critical stages to a hearing aid fitting. These include:
• making sure the hearing aid fits the ear well
• making sure the sound is comfortable at all times
• keeping the sound bore and microphone screen clean
• doing the fine-tuning (programming) so the hearing aid effectively reduces background noise
• programming the hearing aids so the cell phone signal (Bluetooth) is sent to both hearing aids, and solving the ten little problems discussed below.
These tasks are accomplished during a series of office visits. In my practice, we do the initial settings in week one, while advanced programming occurs during the week two and week four office visits.
I need to emphasize one point: A hearing aid is not a stand-alone, ready-to-work electronic device like a radio. Many features have to be fitted to the patient. A hearing aid is an adapted device like a pacemaker or artificial limb. The “product” is only one small part of the total package. The programming, care, and fitting are all critically important.
THE INITIAL VISIT
Hearing aids are fitted initially the day you get them. The audiologist or hearing instrument specialist checks the fit and the sound, and teaches you how to use the instruments. This is not an end fitting; it is just the start.
Hearing aids need to be re-adjusted after weeks and months of use. The practitioner intentionally sets the sound level low at first to help you get used to amplification. Many parts of the hearing aid fitting are done during follow-up visits. For example, additional tuning is typically needed after 6 to 8 months to bring the sound up to the desired use level.
A successful hearing aid fitting is not done by one person. It is the result of four “parties” working together. The four-part team includes: the patient, the practitioner, the family, and the factory support specialist. The patient and the family member (or friend) work with the audiologist or hearing aid specialist. Goals are established. A treatment plan is developed. The factory support specialist helps the practitioner solve technical issues; we often consult them for technical support.
A lot of love and care goes into a highly successful hearing aid fitting. Some of this “love and care” is low tech (teaching and helping); some is high tech (eliminating a feedback peak or allergic reaction). If any members of the four-party team are not involved, the results will probably fall short of the goals we set.
Hearing aids are not tough, durable, “bullet-proof” items like shoes or watches. They are delicate little devices that need “love and care” to keep them working well.
A busy hearing aid office will see two or three people every day who come in with hearing aid problems. Most are quickly resolved; some could even have been remedied at home.
Hearing aids need care, but in talking about the kind of care they need I like to use the word “love” instead of “maintenance.” Hearing aids make your life better by helping you hear and communicate well. In return, the care you give your hearing aids is the type of “love” you would give to your pet, a high-performance car, or a fine musical instrument. You take care of possessions that give you pleasure. You take care of your hearing aids because they take care of you and make your life better.
When you purchase hearing aids, you purchase the hearing professional’s time, skill, equipment, and support. A quality hearing aid office makes its staff available to you, so problems get resolved quickly. With hearing aids, batteries need to be changed, ears need to be cleaned, and patients need to be instructed and re-instructed on proper hearing aid use.
I use a questionnaire called the TELEGRAM developed by Dr. Linda Thibodeau at the University of Texas. The TELEGRAM asks patients about hearing at home, on the job, at school, in church, and at parties and meetings. It also asks consumers about hearing while using their cell phone and landline, while watching TV or movies, and hearing a smoke alarm, a doorbell, or an alarm clock.
When hearing aids are first fitted on a patient, the primary problem (e.g., hearing the spouse) is addressed. During later visits, other problems (e.g., hearing the doorbell, using the phone) are considered and the instruments are specially programmed to solve specific problems.
If hearing aids are purchased from an anonymous web site or by phone and without any hands-on, in-person participation by a qualified expert, they usually end up in the consumer’s dresser drawer and the money they cost is wasted. This happens because there are numerous problems that patients encounter when they use hearing aids, and it takes only one problem to render the hearing aid useless.
The series of articles that follow this one will discuss a variety of common hearing aid related problems. But for now, I would like you to simply read the following list of 10 common problems. This list will help you appreciate the nature of hearing aids and better understand all the work and expertise that go into their successful use.
TEN COMMON PROBLEMS
(1) a dead hearing aid
(2) a plugged ear
(3) an obstructed microphone
(4) the hearing aid whistles
(5) the wearer cannot hear on the telephone
(6) the wearer cannot hear in a restaurant
(7) the hearing aid is uncomfortable
(8) the sound is distorted
(9) the instrument is difficult to insert or remove
(10) the most common problem leads to the patient making a classic comment: “I hear, but I don’t understand the words.”
A lot of little things can happen to a hearing aid to make it stop working. These problems can be called “bugs.” Experienced practitioners are good at getting the “bugs” out of hearing aids.
FINDING THE RIGHT PROFESSIONAL
If you are looking for a hearing aid professional, I suggest that you find someone with lots of experience. It takes many years to develop expertise. If possible, find someone who comes recommended by a friend or family member who has been helped by that practitioner.
Most importantly, find someone you can work with, someone you like, and are comfortable visiting. When you use hearing aids, you will see this person and their office staff many times. You want to be comfortable during these visits.
Let the professional figure out the instruments and technology. Your task is to find an experienced professional you enjoy working with. There are many wonderful instruments on the market, but don’t concern yourself with the “technical” aspects. Success comes from finding the right professional and working with the person until your hearing aids work wonderfully.