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    Hearing Aids from A to Z

    Helen Keller, both deaf and blind from early in life, said that if she were given the chance to recover one of these two senses, she would choose hearing because it would keep her in the intellectual company of those she loved. Hearing is a vital sense so often taken for granted-until we begin to lose it. This article is written for those of you who might be braving new waters, exploring hearing aids for the first time, or others who may be experienced hearing aid wearers seeking additional information to adjust better. In either case, there are a number of things you should expect when using hearing aids, and some things you should not. When you understand what you can and cannot expect form hearing aids, the challenges in your life will be that much easier to face and surmount.

    Anticipation. The average American anticipates getting hearing aids for seven years before taking action by seeking a health care professional. This is not good news! This represents years of procrastination and communication difficulty, not just for you, but also for your spouse, children other loved ones and friends. The good news is that you can look forward to marked improvement once you make the decision to proceed. Hearing aid technology is constantly evolving but it is up to you to take advantage of it so you can begin to overcome the barriers of hearing loss.

    Benefits. Hearing aids offer many benefits. While not perfect, they can bring about significant improvement. Programmable analog instruments provide excellent assistance and digital instruments offer audiologists additional modification capability to improve performance in many different situations. Depending on your loss, multiple microphones may significantly improve discrimination and localization in both noisy and quiet situations. Speak with your audiologist about options that will best offer you help.
    Choices. Today's technology offers a wide range of choices for most people with hearing loss. Hearing aids can be tailored to address many of your needs. There is an array of circuit and microphone choices, as well as styles and sizes of hearing aids to choose among. The smallest aids are barely visible, depending on the ear canal. However, if you want the best possible hearing, it is in your best interest to listen to the advice of your audiologist when it comes to size and benefits. You may need to make some size/benefit tradeoffs to get the best possible results.

    Dissatisfaction. It is important to recognize that dissatisfaction with hearing aids is most often associated with personal issues of motivation. If you are not very motivated to use hearing aids, you are more likely to be dissatisfied. If you are getting hearing aids to appease your loved one, you're basing the right decision on the wrong reason. You need to come to grips with the fact that you need and want the help they offer. The support and understanding of your loved ones is a critical element in satisfaction. They want you engaged in their lives and that is hard to do successfully if you miss much of the verbal interchange typical of human relationships. Both you and your loved ones must realize that hearing aids alone can't get you to where you want to be. However, using the instruments and working together, your communication will be significantly improved. Your audiologist is an important ally in getting the most out of your hearing. 

    Emotions. There are a number of emotions one experiences as a result of untreated hearing loss. If you do not seek help you may experience some of these. They include depression and anxiety, anger and hostility, frustration and embarrassment, lower self-esteem, increased feelings of isolation, resentment, paranoia, and avoidance. You must ask yourself, "Is it worth having these negative feelings because I am putting off what is necessary and in my best interest?" It is well documented that use of hearing aids produces significant improvement in eliminating these destructive emotions.

    Feedback. There are two areas of feedback worth consideration here. First, get feedback from those who love you about what they think you should do regarding your hearing loss and acquiring hearing aids. Maybe someone close to you can make a recommendation regarding a trusted professional you can consult for professional advice. The second area of feedback pertains to what happens when you wear hearing aids. The "squealing" you hear is known as feedback. It is something that can occur with any hearing aid or amplification device. It does not impair the function of a hearing aid, and is actually a way that many wearers use to tell if their battery is good. There are times with more highly powered hearing aids that undesirable feedback may occur; for example, on the telephone. There are ways to eliminate or diminish this. Ask your audiologist.

    Guilt. Some people pursue hearing aids out of sheer guilt. They're tired of hearing their loved ones tell them how miserable it is living with someone who refuses help. To a large extent, this might be true. You must know by now that your hearing loss affects the people around you. If guilt gets you into an audiologist's office for help, which isn't so bad, you can expect that this guilt will be resolved as you go through the necessary steps to improve your hearing function.

    Hearing again. This will eliminate the guilt associated with putting off the inevitable. It may be quite the challenge for you to slip out of your quiet world, make necessary changes and enter the noisier world! For some, old habits die hard. But once you reawaken to how easy communication can be, with the strain to hear gone (or greatly diminished), you will surprise yourself with how nice it is to rejoin your hearing world.

    Ill fitting. Although you will undoubtedly be conscious of the presence of hearing aids in your ears-just as you were conscious of a new sensation associated with wearing glasses for the first time, a new pair of shoes, etc., they should fit comfortably. If you have discomfort, you need to inform your audiologist. It is very easy to remedy this by modifying the shell. Discomfort in the ear should be no issue at all.

    Jokes. Okay, you already know about missing the punch lines! If you had perfect hearing for low frequencies, some high frequency hearing loss in both ears, less than optimal vision, and heard a punch line at five feet told by a woman while standing around moderately loud noise, you would likely misunderstand enough of it to only laugh politely. If you cannot hear, new acquaintances especially will not know this. When your hearing loss is not known to others, they will draw false conclusions. They may think you're not interested in them, or not paying attention, or you've had a stroke, suffer from poor memory, perhaps some dementia, or a host of other problems.

    Knowledge. The more educated you are about what to expect regarding your hearing aid experience, the more accepting you will be about hearing instrument limitations. Hearing aids are very good, but they are not perfect! Read brochures and books about hearing aids. Remember, successful hearing aid use does not mean hearing everything you hope to hear. It means hearing much better than you otherwise would hear. Hearing aids do not restore normal hearing. Even with the best hearing aid technology, hearing aids perform their poorest in the presence of competing noise. Think of your hearing aid experience in terms of a scale. On one side is knowledge. The more knowledge you have about your experience, the more realistic your expectations. 

    Limitations. There are two potential limitations with hearing aids: the physical hearing aids themselves, and their effectiveness during use. Hearing aids have certain limitations that may require you mastering new challenges. Keep in mind they are electrical devices housed in a warm, humid environment-your ear. Moisture, heat and electricity are not a good mix. It can result in occasional breakdown even if you properly care for them. Their effectiveness should pleasantly surprise you but you shouldn't expect the impossible. While it is everyone's wish that wearing hearing aids will resolve all hearing problems, the reality is that hearing aids cannot possibly solve all hearing challenges. Normal hearing doesn't permit this either. There may be some sounds that are occasionally too loud, others too soft. Finding the right balance requires a skilled audiologist to fit the hearing aids. Even then, you may have to endure some frustrations. It will require adapting to an imperfect world. Yet, it's worth repeating that no one who gets used to hearing aids prefers not using them. Take the challenge. Work with them. It gets better over time. 

    Maintenance. Some people don't like brushing their teeth. Yet, it has to be done. Daily hearing aid maintenance should include handling them carefully, keeping them away from pets, and avoiding all airborne chemicals like aerosols (deodorants, perfumes, hairsprays). Hearing aids are not moisture resistant, so keep them away from saunas, pools, and showers. You must conduct your own maintenance program to assure their optimal performance. There are four simple nightly rules before retiring to bed: (1) wipe off the hearing aid with a handkerchief or other soft cloth that will not shred, (2) inspect for wax and remove it if you find it, (3) brush the faceplate (the surface facing out of the ear) where the battery door and microphone are housed (this removes fine particles that can collect), and (4) open the battery door overnight to save power, and store aids in a container designed for moisture reduction. This will reduce the chances for breakdown. You will quickly discover that flossing takes more time.

    Noise. The most challenging acoustic environment for hearing aids is noise. Yet, this is something you can often control. Manipulate your acoustic environment. Control where you sit. Seat yourself preferentially away from noise. Consider facing corners or padded walls, or closer to objects that absorb or block sound-like tall plants or pillars. At social gatherings, rather than mingle through the crown, remain more on the periphery and, if possible, let people come to you and face away from the crown while conversing with them. If you have better hearing in one ear, direct the better ear toward the conversation when around noise. You can expect to hear better when you take charge of your acoustic environment. 

    Patience. Be patient. The average person requires up to four months of hearing aid use before feeling really comfortable with them. Give it time. Be optimistic. You can make it happen.

    Questions. Ask them! Ask your audiologist. It's best if you keep a diary, logging as many positive and negative experiences as you can. Be specific about the problems you experience. Don't just report that you didn't hear the sermon well at church. Report on where you sat, who was speaking, how large the facility was, were others saying they had trouble, was anything blocking your path, did the speaker use the microphone correctly? The more information you give to your audiologist, the more effective he or she will be in addressing your questions and offering you solutions. 

    Rumors. Don't trust them! You'll hear how magnificent your brother-in-law's first wife's father is hearing now with the "Cure-It-All-Master-Sound-Grabber-Aid" before he accidentally ran over it with his truck. Or maybe you'll hear horror stories from your neighbors who were trying to decide which to buy-new digital hearing aids or a Mercedes. Keep it all in perspective. Find an audiologist through a reliable source, perhaps from friends pleased with products and services provided by their audiologist. Find someone who has years of service, a high level of knowledge, and is empathetic to your needs. Believe far more in your own experiences than the rumors.

    Stigma. Some people believe there is a stigma to wearing hearing aids. The truth is, hearing loss is more noticeable than hearing aids.

    Tinnitus. Some people report that their tinnitus (ringing or other sounds in their ears) is reduced or temporarily gone while using hearing aids. Perhaps it's wise not to expect this, but enjoy it if it happens. 

    Underrated. It is this audiologist's opinion that hearing aids are the most underrated medical device used in America today. Millions of Americans are not benefiting from amplification, much of it out of ignorance, rumors, myths, and lack of professional support. The most trusted and reliable source-physicians-unfortunately know little about hearing aids and, therefore, only infrequently make appropriate referrals for them. You don't have to be one of these statistics if you take it upon yourself to seek hearing healthcare help. More than 90 percent of all hearing losses fit with hearing aids are "nerve loss." 

    Victory. You certainly spend a lot of money on other people, especially those you love. Do not begrudge making the investment of hearing aids in yourself. You can succeed in overcoming most obstacles. Make a difference to yourself. Hearing monitors your environment for a full 360 degrees, twenty-four hours per day.

    Worry. Remember that Jamaican song that played throughout America some years back? "Doooon't worryyyyy! Beeeee Happy!" It's rock solid advice. We spend more time worrying about what we want to do (or not do) than the time it takes to achieve it.

    Xenophobia. The fear or aversion to things we don't understand or know is natural. If you know little of hearing aids and how they can improve your life, they may fall into this category for you. However, as you gather information and move forward in obtaining and using hearing instruments, they will become important friends that you can't bear to be without. It has been said that hearing aids are miniature electroacoustic devices one puts off getting until 10-15 years after they really started needing them, but can't part with for 15 minutes when they need to be serviced. 

    You. Expectations are all about you! There is little doubt that hearing loss has taken its toll on relationships. Because of you, relationships can begin to heal once you address your hearing problem. An inner sense of calm will likely enter your world starting with you and emanating to all relationships around you. By getting hearing aids, wearing them, and letting the experience speak for itself-you make meaningful changes in the world around you. The strain to hear will be significantly diminished. The arguments and issues over not hearing well are gone. Silly sounds you once thought were meaningless-like stirring ice in a glass-the click of the automobile turn signal, or the whining of your dog, bring you back into the world you had lost. You'll become more oriented in your new hearing world, listening to some forgotten sounds. Birds. The wind. Rustling leaves. With the effective use of hearing aids, one thin you can expect is more joy in your life. 

    Zigzagging. If you decline helping yourself through amplification, your path will be one of zigzagging through high-level emotions that could be currently tormenting you and your loved ones. Without hearing aids, you can expect to live without trusting what you hear because you may never know for sure if what you hear is truly what is said. Enduring these uncertainties in not necessary. No one can help you until you are willing to help yourself. Seek the advice of an audiologist. 

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