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Over the Counter Hearing Aids

NPR covered over-the-counter hearing aids back in 2017. Since then, politicians have passed legislation that provides access to these new amplifiers. NPR, like the politicians, dismissed the audiology profession without talking to an unbiased expert in the field – not a doctor and not someone who sells hearing aids. Ruth Bentler at University of Iowa would have been a good choice. Todd Rickets at Vanterbilt would have been another.

The only way I’ve thought of to concisely explain what audiologists do is to compare them to orthodontists. You might ask why a bunch of wires cost $6,000. They’re just wires. It’s because they don’t help much if you don’t have an expert, with 6-8 years of education, custom fit them and fine tune them over time. Audiologists require at least 8 years of education.

I’m glad these amplifiers are out there, but they’re only appropriate for a limited group of people. I tell patients to try it out, but keep your receipt. I guess you could compare them to something like Invisalign knockoffs that you get on Amazon or at the drug store. They’ll work for a few people with slightly crooked teeth.

One last thing. The NPR podcast inferred that you have to spend $5000 on a pair of hearing aids. The $5000 ones can have a lot of benefits, but the quality of the fitting is at least as important as which hearing aid you get.

What really needs to happen is for legislators to come up with policies that help enforce competence and ethics. There are problems with both of those in this field. How you legislate something like that, I don’t know. That’s their expertise.

Costco Hearing Aids

I’ve gotten a lot of questions lately about the difference between me and Costco and why Costco’s hearing aids are so much less expensive.

Well, partly it’s because they buy a limited number of models from a limited number of manufacturers. So they buy in bulk. I can get any hearing aid from any manufacturer (except a couple of proprietary companies). I like that because they don’t all make the right hearing aid for everyone. I spend a lot more time keeping up with technology than they do, but it’s worth it. Here are some examples of hearing aids and why I might choose them.

Some people won’t wear hearing aids because they think it makes them look old. So, I can choose Phonak Titanium or Signia Styletto. Some work in an environment with lots of people and noise. So I have Oticon OPN S. Some people need rechargeable batteries. So I have a lot of options, but usually I think ReSound Quatro. I have people with deafness on one side and might try a CROS hearing aid. I’ve been trying Signia Nx for that lately. I have people with profound hearing loss and I’ll usually choose Oticon Exceed. Some people need to answer their Android phone, hands free, so I get Phonak Marvel. Starkey Livio Ai has fall detection, heart rate monitoring, and language translation. Widex Evoke has a great tinnitus masker.

I can also change manufacturers for things like earmolds. I’ve switched between companies like Westone, Starkey, ReSound, Oticon, Emtec, and Microsonic because quality can vary over time. They also have their own specialty. Microsonic is excellent at children’s earmolds and Westone is great at musician’s monitors.

Also, I’m an audiologist. They are usually hearing aid dispensers. While I’ve met dispensers that are stellar and audiologists that aren’t, audiologists have an advantage of graduate school education. The focus is different. Audiologists are trained to think of treating hearing loss, and that includes more than hearing aids. Sometimes it doesn’t include a hearing aid at all. A liberal education teaches more than how to do something. They teach why. So when you get unexpected results, you have half a chance of figuring out the why and how to fix it.

A few random things that come to mind: I take insurance and I work for free in Starkey’s Hear Now program. Costco’s ReSound hearing aids are locked – meaning only Costco can program or fine tune them. And, finally, I hope you enjoy this video, because it circles back to my first example of patients who think hearing aids make them look old.

Which Hearing Aid is the Best?

I get asked this question a lot. I see Consumer Report testing and audiologist Youtube videos that rank the hearing aid manufacturers. My answer is, For who? The best hearing aid manufacturer depends on who it’s for. There’s a problem with ranking manufacturers because it’s not a toaster we’re talking about here. I will say that there are a lot of excellent manufacturers that I work with. There is a lot of competition between them. They all have a specialty they focus on from year to year. They generally come out with something significantly improved every 5 years or so.

Call me if you’re wondering which manufacturer would be best for you and why. I’m big on education. 905-881-2620

Here’s a little homework though:
1) Read Consumer Reports’ buying guide .
2) Check out the major manufacturers listed below.

Oticon
ReSound
Phonak
Signia (Siemens)
Starkey
Widex

Mail Order Hearing Aids: Eargo

Patients sometimes ask me about Eargo mail order hearing aids. As with anything, there are pros and cons. I couldn’t put it any better or more thoroughly than an audiologist from Arizona, “Doctor Cliff”. Check out this video summary. I tell my patients to go ahead and try it. Just keep your receipt and know that, just like with real hearing aids, the law requires that you be given a 45 day trial period.

Aural Rehabilitation: Hearing Aids Aren’t Enough

“I know that you believe you understand what you think I said, but I’m not sure you realize that what you heard is not what I meant.”

Robert McCloskey

Think about how a physical therapist treats someone with a knee injury. They might use a knee brace, but they always give the patient a series of exercises, and the exercises change slowly as their patient gets stronger. Treating a hearing loss is similar because a hearing aid is just an aid. It’s not enough. Sometimes it isn’t even appropriate.

Aural rehabilitation is something audiologists do to help hearing impaired people overcome a hearing handicap. Audiologists do a little bit of it whenever they test hearing or balance. It’s also part of helping someone get used to a hearing aid. It includes diagnosis, counseling related to hearing loss, education on assistive technology, learning communication strategies, giving information on community and non-profit resources, speech perception training, and instruction for family members. The communication strategies can include things like sign language and lip-reading.

Aural rehab is relevant for the 14% of adults who have a hearing loss, but it’s also relevant for an even larger group, family and friends of people with hearing loss. I am currently developing a series of 6 aural rehabilitation classes. It may be offered at SBCC Adult Education, at a retirement community, at the Hearing Loss Association of America meetings, or at a public library. We’ll see. I’ll announce it when the dates are set. Call or shoot me an email if you’re interested.

audiologyhome@protonmail.com
805-881-2620

Technology in Hearing Aids 2019

I made a presentation the the Hearing Loss Association of Santa Barbara. They’d asked me to talk about the latest technology. Here’s a summary.

Helpful New Technology:

1) Help in noise:
– Faster sound processing
– Wireless connection between hearing aid via 2.4 gHz, near field magnetic induction

2) Bluetooth:
– To find lost hearing aids
– To remotely control hearing aids
– To hear cell phone calls, TV, or a remote microphone through hearing aids without a lot of extra devices.
– Stream tinnitus masking apps from your phone or tablet

3) Rechargeable batteries

Important Old Technology:

1) Telecoil for use in looped theaters like the Granada, Lobero, and Arlington

2) Directional microphones for help in noise

Fancy New Stuff That Doesn’t Improve Hearing:

1) Hearing aids that can be adjusted remotely

2) Hearing aids that translate languages

3) Hearing aids that monitor exercise like a FitBit

4) Hearing aids that start the coffee or tell you when you get an email