Cochlear Implants (CIs) are often touted as the cure for deafness. This may be true, but success varies. Typically, I recommend an evaluation for a CI if word discrimination is very poor and the individual has significant hearing loss,
1) If the individual cannot benefit from hearing aids.
2) If the individual is interested in pursuing additional evaluation.
3) There are contraindications such as risk for heart problems, stroke and general health of the individual.

Age should not factor in this decision. Typically, extensive audiology testing and a consult with an ear, nose, throat physician (ENT) is necessary to determine candidacy. Insurance coverage is important since the out of pocket cost is estimated at $50,000-$100,000.

The process of fitting a CI involves surgery that generally lasts two to three hours. The device itself has two parts: the microphone/processor and the receiver/electrode array. The mic/processor looks like a large hearing aid and transmits the sound to a magnet (the circular disk) that sits above the ear. The receiver/electrode array receives the signal. The electrode sends a stronger signal to the auditory (hearing) nerve. To receive the signal through the electrode, the inner ear is partially or wholly destroyed by the electrode array itself. The CI surgery is not reversible. Many people with CIs wear their regular hearing aids on their other ear, to receive some sound awareness when the CI is removed.

The success of the CI varies on the age of the individual being implanted, their experience with sound in general, how long it has been since they have heard any sound, how dependent they are on sound, the structure of their inner ear, and how willing they are to learn to hear sound and use the device. Programming the device may require several follow ups over the first few years. Losing the processer (the hearing aid portion) is a major loss and costs several thousands of dollars to replace it.

An adult CI patient generally has greater success if they recently lost their hearing and used hearing aids faithfully throughout their adult lives. However, for the individual who has grown up using sign language, never uses their hearing aids, CIs would likely provide less benefit—perhaps only some sound awareness. Some of the success is also dependent on how healthy the hearing nerve is. For example, the individual who has one “dead” ear and one ear that has a severe hearing loss, the CI would likely be implanted in the better since the auditory nerve is likely more healthy.

For young children, it is desirable to implant very young to give that child experience with sound during the critical stages of learning speech and language, less than two years old. Many of these recipients have positive results, however it is difficult to determine what the level of success each child will obtain. It is generally agreed that the child will hear better with the CI than with hearing aids alone.

If you think you might be a CI candidate, call your physician for a referral and receive audiologic testing at Parker Audiology.

Can I Wear Only One Hearing Aid?

When it comes to the question of whether or not you can wear only one hearing aid, ask yourself this question. Would you only get one lens for your pair of glasses if you had vision loss in both eyes? Most people would get a full pair of glasses to help them see better, so why not have two hearing aids to help you hear better?

Technically, you can just wear one hearing aid, and in a few cases, that is exactly what is recommended. Those cases usually are for those with one normal hearing ear and one with hearing loss. When your audiologist recommends two hearing aids, it is usually because you have hearing loss in both ears. The use of two hearing aids will help you in many ways; one way is to help you to have the ability to locate where sounds are coming from better. Our brains work to locate sounds using different signals from our ears. Our brains can tell when the sound reached each ear and most importantly which ear it reached first. By doing this, it can locate where a sound is coming from in your environment. If you had a hearing loss in both ears, but only wore the one hearing aid, your brain is getting signals that may not make sense and might direct you to the wrong location. Two hearing aids will allow the brain to function normally during this task.

Another way you benefit from wearing two hearing aids is by hearing better in noise. When the brain is hearing from all around you equally, it can filter out some of the noise in the room. By doing so, it can then pick up the speech nearest you and help focus your attention to that speech. This allows you to hear and understand the speech better and carry on a conversation, even in a noisy situation.

Two hearing aids can also provide you with a natural boost of loudness. When we hear equally with our ears we don’t need sounds to be as loud to hear them. When people only wear one hearing aid, the sound level is usually increased by an average of six decibels. With two hearing aids that level can be brought down and possibly be more comfortable for you.

Along with the natural boost in hearing, you are also having a more pleasant listening experience and feel more balanced. With two hearing aids, you are not straining as much to hear the sounds and speech in your environment. This makes listening to family and friends easier and you can concentrate on them rather than to each word they are saying and wondering if you understood them correctly.

We were made with two ears and feel more natural when we hear from both ears equally. The way our ears pick up sounds and deliver that message to our brains helps us understand speech, locate sounds and are aware of our environments. With only one hearing aid with hearing loss in both ears, it will be more difficult to know exactly where the car you hear in the parking lot is coming from. Two hearing aids can also provide an overall safe feeling for the user.

Overall, two hearing aids will help you locate sounds, hear better in noise, give you a natural boost in sound, make listening more pleasant and give you a sense of balance between your ears. Even though we know that two hearing aids will perform better than one alone, some people just feel more comfortable with one. Discuss the differences with your audiologist to figure out what would work best for you.

The topic of hearing loss is more than a feel-good Hollywood script. Marlee Matlin has portrayed many roles for deaf individuals, which have increased public awareness of hearing loss (West Wing, Children of a Lesser God). Recently, a new TV show, Switched at Birth, has gained a larger national audience which will begin Tuesday, January 3, 2012 at 7 p.m. This ABC family show will highlight the cultural and practical experiences of a young woman who was switched at birth and developed significant hearing loss early in life.

Hearing loss (not deafness) is actually more common than people think. Hearing loss is one of the most common
birth anomalies, affecting three to six out of a 1,000 (http://www.asha.org/public/hearing/disorders/children.htm). In fact, 60 percent of those with hearing loss are under the age of 65 years old. One of the most common comments I receive is, “I notice my friend/family has hearing loss. How do I get them here to get tested?” When the individual finally arrives in my office, they are often shocked when they realize how much others have noticed their hearing difficulty in a variety of situations. They often state they hear normally except for their spouse. Listen to your family—they spend time with you and have your best interests at heart.

If “Huh?” is your favorite response to everything said to you, this holiday season, consider giving your family the gift of improved listening ability. With today’s technology, hearing (dis)ability can be viewed, or made invisible, at the discretion of the user. Normal hearing people use huge, heavy Bluetooth devices in their ears. By contrast, the hearing impaired use easy, comfortable, sophisticated, invisible hearing instruments, which can receive phone (Bluetooth) signals. Often, my normal hearing visitors are jealous when they see the capabilities of current hearing instrumentation.

In essence, with the newer, smaller technology, hearing does not have to be the big problem it once was. My greatest success has been the gift of telephone conversations and quiet TV-listening. Small hearing instrumentation can invisibly allow business meetings to flow more easily in the conference room. With a little extra help from a tiny external microphone, restaurant listening can continue with less background noise to confuse the conversations.

Do not look “old” or “forgetful” because of your favorite response (“Huh?”). Whether you are working or simply trying to get along in your life, do not underestimate the value of improved hearing. Make an appointment in my office and see what new technologies have to offer for you.

Communication is a two-way street: the talker and listener each have a responsibility. The talker must speak loudly and clearly, and present their ideas in an orderly way. The listener’s job is to pay attention and speak up if something is not understood. If one person does not perform their job, then the message gets mixed up. Hearing aids make the job of listening much easier. In some cases, other assistive devices can work with your hearing aids to further remove background noise.

Remember, if there is something you can do to improve your listening situation, you will feel more involved and active in your life. It may help to frequently (and nicely) remind the other person to speak a little differently. Or, you can be a gracious listener and provide cues that you understood the other person. Most of the time, the simple suggestions below can help.

For the normal hearing person:

1. Get the other person’s attention. If necessary, tell them what the topic is before talking about it.

2. Turn off background noise, such as TV or radio, shut the door, etc.

3. Look at the other person. Make sure they can see you.

4. Smile and talk slowly. Shouting distorts. If necessary, “chunk” your phrases. For example, “Today…. I am going…. to the store…..to buy some…milk.”

5. Rephrase rather than repeat. Say the message more slowly.

6. Hearing aids do not replace normal hearing. They amplify your voice and remove extra noise, so you do not have to shout. They make listening easier, but not normal, for the user.

For the hearing impaired:

1. Try to improve your listening situation. It is not your fault you cannot hear well. However, you can make it easier for others to talk to you. Ask others to talk louder, slower, clearer, look at you, turn off the TV, get a little closer, etc.

2. Communication habits are hard to break. Nicely remind others frequently how to speak, even if it is every 30 seconds. Again, the speaker’s job is to make themselves heard.

3. Look at others when they talk! Their facial expressions offer good information and can help you understand.

4. Respond when others talk. Say, “OK,” nod your head, ask questions, etc. Others may not know if you heard them or not.

5. If you have hearing aids, wear them as much as possible, even if it is quiet in your home. If there is a problem, take charge. See your audiologist, speak out, get a second opinion, ask others to help you. Hearing aids often require adjustments over time.

There is no such thing as a one-size fits all hearing aid. If you are honest and willing, help is available.

Why do digital hearing aids sound so different than my analog hearing aids?

New digital hearing aids have computer technology that processes the sound. With this technology, your audiologist is able to tailor the sounds and your comfort levels to your specific hearing loss. This cannot be done with analog hearing aids.

The difference between analog and digital hearing aids starts with the microphone on your hearing aid. The sound is initially received through the microphone where distortion and noise are added to the sound. This is done because the microphone is noisy. With analog hearing aids, the sound with the added distortion and noise is passed on to what you are hearing. This makes you feel that you are hearing more sound than you do with the digital hearing aids.

With digital hearing aids, the distortion and noise are added from the microphone, but the sound is then cleaned up before it is sent to you. After the sound is cleaned of as much of the noise and distortion as it can be, it is sent to the amplifier. At the amplifier is where the hearing aid decides how much power to add to the sound in order for you to hear it. The sound is then sent to the receiver or speaker unit, where it is cleaned up again. This point is also where the hearing aid checks for feedback or whistling and works to cancel it before it ever begins. Through this process, the hearing aid is changing levels of the sound for your particular hearing loss, making sounds comfortable and speech easier to hear, especially in noise.

That all makes digital hearing sound great, but why do you still not like them? There are two categories when it comes to digital hearing aid users, new users and previous analog users. With new users to hearing aids, they often don’t like their digital hearing aids due to improper fit. Sounds may be too loud or even overwhelming. At that point, they need to see their audiologist and have the hearing aids adjusted to be more comfortable for them. Even though the computer programs the hearing aids for the user’s hearing loss, it is not always exactly right. It is expected to make adjustments for each individual user. Sometimes it takes a few different visits to get the sound exactly right or even changing manufacturers. Each manufacturers sound quality is just a little bit different. Another reason a first time user of hearing aids may not like them is because of unrealistic expectations. Hearing aids are meant to help you hear better not return your hearing to your original quality. This is also a time to work with your audiologist to find what works the best for you.

For those switching from analog to digital, it can be a challenge. Over time, we learn what we like and
dislike. For example, many people may not like a certain food when they are young, but learn to like it when they are older. It is something we all call developing a taste for it. The same thing applies when switching from analog to digital hearing aids. Sometimes, it needs to be a slow introduction to the new sound quality and the different sounds your brain is going to hear. Your brain has become used to hearing sounds and speech in a particular way, and it can be hard to change that. When you put your first pair of digital hearing aids on, they may seem to have a brighter sound quality and may be overwhelming. Because of this, you may instantly not like them. At this point, there is one of two mistakes that can be made. You could tough it out and try to get used to them or you could give up.

Toughing it out may actually make you dislike them more. This is because you are hearing way too much way too fast. And your brain cannot handle the overload of different sound quality and all the different sounds it hasn’t been hearing. And giving up on the hearing aids doesn’t help anyone. The longer you wait to switch to digital hearing aids, the harder the transition will be.

What can be done to help make the transition easier? You and your audiologist will work together to help you transition as easily as possible. The first thing to do is to tone the hearing aids down to be comfortable for you. Many times, this includes taking away some of the higher pitches you haven’t been hearing. Then over time, gradually start to introduce more sound through small adjustments. This may take several visits ,so make sure you are comfortable with your audiologist as you will be spending a lot of time together.

Another reason analog users don’t like digital hearing aids is because of the noise reduction. You are used to hearing all the noise around you. In the beginning, your audiologist may turn that feature off, but then later slowly add it in after you have become accustomed to how the hearing aid sounds.

One feature of the digital hearing aids that people like is the feedback cancellation. Most digital hearing aids are able to almost eliminate feedback. Some feedback will still be normal, but not nearly what it is like with the analog hearing aids.

When you are ready to transition from analog to digital, or would like to try it again, contact your
audiologist and discuss what would work best for you. The most important thing to remember is that you will need time and patience to make a successful transition to digital hearing aids.

What should you do if you have sudden hearing loss?

Many people with sudden hearing loss realize it when they wake up. It may occur in one ear or both, but it is more common in one ear. There is not always a known cause to why your hearing suddenly disappeared. There are two different types of sudden hearing loss, conductive and sensorineural.

Conductive sudden hearing loss is in the middle ear or canal. Many times you will feel “plugged-up.” This can be caused by the common cold, a middle ear infection or fluid build-up. This can be handled by your family physician. If you have a sudden hearing loss due to a blow to the head or a loud noise, you need to see an ear specialist immediately.

Sensorineural sudden hearing loss is considered a medical emergency. This is also when you might not notice the loss in hearing until you wake up in the morning. Others have reported hearing a loud “pop” before the hearing disappears, as well. When your hearing changes, you may also experience dizziness or vertigo and also tinnitus (ringing). You may also experience a feeling of fullness or even a headache.

If you have this occur, you need to see an ear specialist immediately, not your family physician. Your family physician is not prepared to help regain your hearing in this case. If there is a chance for your hearing to improve, you need to see an ear specialist as soon as possible. Ear specialists, like an ENT (Ear Nose and Throat) or preferably an Otologist, will know what to do to help you regain your hearing. When calling for an appointment, you need to stress that it was a sudden hearing loss, and that you need to be seen immediately. You may also be scheduled for a hearing evaluation at the same time.

If after the sudden hearing loss you do not regain any of your hearing, a hearing aid may be the next option. A hearing aid will help you hear better in background noise and help you locate sounds better. With sudden hearing loss with no known cause, it can be hard to accept the hearing loss, and it may take awhile before you are ready for the hearing aid.

An important thing to remember is to protect your hearing in your good ear. If you feel that you do fine with the one good hearing ear and the hearing impaired ear you want to make sure to protect the good hearing ear, even when you are mowing the lawn, snow-blowing or using a loud vacuum. You also still want to protect the ear with the hearing loss. There are several degrees of hearing loss, and you don’t want the hearing loss in the ear to worsen.

If you have questions about hearing aids, or how to protect your hearing, contact your audiologist. If ear plugs or muffs are not comfortable for you, there is custom made hearing protection.

Ear wax, or cerumen, comes from a specialized sweat gland (Sudoriferous glands) in the ear canal. Ear wax serves to lubricate and disinfect the ear canal. The mere presence of wax is usually beneficial, but having too little or too much wax can sometimes be problematic. Too much wax creates a physical blockage in the ear canal causing hearing loss. Too little can also cause problems such as itchiness, bacterial growth, and dry skin. Just the right amount of wax will discourage bugs from entering the ear, lubricates the skin and reduces the risk of an ear infection in the ear canal (e.g. swimmer’s ear).

Wax often begins as a clear liquid in the ear canal and has a sticky feel to it with an odor of earwax. It is most noticeable in the morning. As wax ages, it collects dirt and can change color, often becoming the caramel- brown color that we recognize. Wax can range in color and texture from a light, nearly white color to nearly black. Texture can range from a liquid to flaky dry skin-texture up to a hard rock-like texture. Ear wax is best left alone in most ears. However, if there is too much earwax, it will cause a physical blockage and hearing loss.

If you suspect you have wax build up, it is best to ask your physician on the proper way to remove it. It is imperative that you rule out having a hole in the eardrum prior to doing anything. There are over the counter removal methods that are effective for some people. These include debrox ear drops, which can are inserted into the ear to lubricate the canal and soften the wax. Debrox is particularly helpful for hard wax impactions. Miracell is another drop that can help lubricate and soften the wax in the ear. Bulb syringe and accompanying solution is another effective way of removing wax. This can be uncomfortable and may even cause temporary vertigo. Sometimes, it is helpful to simply use a washcloth to wipe your ear canal with a bit of gentle soap and water. This may cut down on the feeling of itchiness.

NOTE: Qtips are NOT advised, as they will “bulldoze” wax into an impaction. The farther the wax is pushed in your ear, the harder it is to get it out and more likely it will cause temporary hearing loss. QTips can also scratch your ear canal, increasing risk for bacterial infection.

Physicians and audiologists may have other suggestions for your particular wax issue as different types of wax can sometimes benefit from different types of treatment.

The content in this article is based on clinical observations and not on hard clinical research.

Are there hearing aids that will work with my arthritic hands?

When the feeling or dexterity in your fingers declines, it can be very difficult to manipulate small objects. Hearing aids are no exception. Even larger hearing aids can sometimes prove difficult to use if your hands are arthritic or numb. There are several different styles of hearing aids to choose from, and your audiologist can help you choose the style that will be easiest for you to work with.

Usually the custom hearing aids with larger batteries tend to be the most popular style when finger dexterity is a factor. Custom hearing aids are a single unit made from impression of your ear. They can have handles or notches added to them to give the patient something to hold on to when taking the hearing ad in and out. Small program buttons or volume control wheels are options patients can add to a hearing aid but can be quite difficult to use with arthritic hands. Most hearing aids can come with remote controls, which have larger buttons (similar to a small T.V. remote) that can control the volume or programming. They are simple to use and allow the patient to adjust the hearing aid without touching the hearing aid itself.

Changing batteries can also be difficult. Small tools with magnets on the ends can help take batteries in and out of hearing aids. Some companies are providing rechargeable batteries in certain hearing aids, so the patient only has to change batteries approximately once a year. The hearing aids simply sit in a charging box each night and are ready to go the next day.

Ask your audiologist which style would work best for you. Together you can select the right options and work on techniques that will help you use your hearing aid to the best of your ability.

Are You Connected?

This past year, hearing instruments have turned into entire sound systems, wireless cell phone listening systems as well as hearing devices for communicating with family and friends. The innovation has become quite simple to use and very integrated with television, radio, home phone and cell phone use. There are even microphones that can be given to family members to take away background noise in restaurants and family dinners.

Oticon makes a wonderful relay between hearing aids and other devices. The Streamer is small and integrates almost seamlessly with most audio-technologies. They also offer an Amigo which presents clarity and connectivity for those who need a little more power. The Amigo may be a little more expensive, but it is durable and worth every penny.

Hearing aid Rechargeable Batteries?

Rechargeable batteries seem to be a great idea for hearing aids, especially for those with poor hand coordination or poor vision. I have seen many battery systems come and go through the years with much frustration. The batteries often need to be replaced once or twice a year at a cost similar or sometimes greater than the over-the-counter hearing aid batteries. If the battery fails, troubleshooting of the hearing aids becomes far more difficult—is it the battery, battery recharger or hearing aid that is failing, or is it the patient’s handling of the entire system?

I have found the first system that I’ve been impressed with: Hansaton (Pronounced HANS-za-tone). They have a truly rechargeable fully encased battery system that is good for five years, guaranteed. They have had virtually no failures due to the battery or system itself. As with any hearing aid, wax is always an issue, and good maintenance is necessary for
optimal functioning

October News:

There will be some new products available in October. Please call our office at (563) 326-5441 to see if you are being left behind by technology.

How do you determine what hearing aid style a patient is going to get?

Hearing aids are available in several different styles. These styles range from hearing aids that fit completely-in-the-canal (CIC) to hearing aids that set behind-the-ear (BTE). Just as hearing aids styles are varied, so too, are the factors that determine what style(s) is/are appropriate for patients.

When deciding on hearing aid style, several factors come into play. One factor is the degree of hearing loss present. Generally speaking, the greater degree of hearing loss a patient has; the greater the need for a larger hearing instrument. With that being said, hearing aid manufacturing companies have made great strides in regards to the amount of power (volume) that can be produced by smaller hearing aids. However, when a large amount of volume is produced by small circuitry, there is greater risk for feedback (whistling). Therefore, larger hearing aids are still typically recommended for greater degrees of hearing loss.

Another factor that comes into play when deciding on hearing aid style is the patient’s ear status. Ear canals vary in regards to shape and size. Some individuals may have ear canals that are too small to appropriately fit a CIC hearing aid. Also, if individuals commonly have cerumen (wax) build-up or active drainage from their ears, a hearing aid that sets in the ear, may not be recommended due to increased risk of the hearing aid becoming plugged with cerumen or debris and needing to be sent for repair more often.

Some other factors include patient amplification history, patient ease of use, and patient preference. If an individual has worn amplification before and is familiar with a specific style, the same style may be recommended again based on the patient’s benefit and satisfaction with that particular style of hearing aid. Also, some patients find it easier to use and adjust in-the-ear (ITE) hearing aids. Therefore, if ease of use is a great concern for an individual, an ITE hearing aid may be recommended over a BTE hearing aid. Additionally, patient preference is an important factor in determining hearing aid style. Based on some of the other factors previously discussed such as degree of hearing loss or ear canal size and shape, some individuals may have limited choices regarding the hearing aid styles that are appropriate for them. However, if more than one hearing aid style is suitable for an individual, patient preference is a significant factor in determining the style of hearing aid fit on the patient.

Overall, there are several factors involved in determining hearing aid style. Hearing health-care professionals base their style recommendations on several, if not all, of the above mentioned factors. It is essential that patients have good communication with their hearing health-care provider to ensure that the style selected provides accurate benefit and results in patient satisfaction.