Support Group for Cochlear Implant wearers

This is just a quick post regarding Hear Peers, a support group for cochlear implant and bone conduction hearing aid users. I learned about them because I have recently begun fitting bone conduction hearing aids. I don’t fit cochlear implants myself. If you’re interested in a cochlear implant or need your implant reprogrammed, I would contact the Cochlear Implant Center at Stanford University. If you want to meet others in Santa Barbara who have hearing loss, hearing aids, or cochlear implants you can go to the Hearing Loss Association of America’s Santa Barbara Chapter meetings.

Why do people hate their hearing aids?

Uff. Occasionally a person comes in a dismisses the entire profession of audiology and it bums me out. The person was mad that I didn’t just sell a hearing aid without including all the office visits. They felt those should be separate. I could see that it really didn’t matter what I said. They just saw me as a shyster.

It’s kind of like being mad at an orthodontist for charging you $6,000 for a bunch of wires and thinking their education isn’t really that important.

I think the thing that helped the most when I said, “Treating hearing loss isn’t just slapping on a hearing aid.” You spend an hour choosing the aids. You spend an hour or two fitting them. And then you spend an hour educating patients and family about how hearing works. And then hearing changes and you have to fine tune it some more. And the ear canal changes, so you have to change the shell or the dome. And then wax gets in the speaker, the wire breaks, the bluetooth gets disconnected…. People come in all day for follow up. I have to emphasize to patients that they’re not bothering me. That’s just how it is with hearing aids. They need regular checkups and tweaks. If I charge for all these little maintenance visits, people don’t come in. This is why so many people hate their hearing aids. Not enough testing, fine tuning, education, or follow up.

As an aside, I was told once that a dispenser said that audiologists and dispensers take the exact same test to get their state license. True. But like I tell my kids, a certificate or associates degree teaches you how to do something. A university degree teaches you how things work, in depth. That way if something weird happens, you have half a chance at figuring out why and how to fix it.

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.

Signia (Siemens)

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.

How to Clean Your Ears

Eek! There’s a spider in my ear!
My brother called one night because it felt like he had a spider in his ear. First of all, it turns out it wasn’t a spider. It was a little seed. He had been helping on the farm and suddenly it felt like something was moving in his ear. He went to urgent care and they said they couldn’t help him and that he should go to the emergency room. Removing things from an ear canal with a curette or water is something that most doctors do routinely, so that was odd, but whatever. He tried to rinse it out in the sink. That didn’t work and usually it doesn’t because the stream of water is too wide to actually circulate in the ear. A shower head is more likely to work.

Using an Ear Wash Kit
I recommended he try an ear wash kit from the drug store and I gave him one recommendation: Use body temperature water or it will make you dizzy. I also gave him two tips: Pull your ear back to straighten out the ear canal, and place the tip of the bulb in the top of the canal so the water can circulate. What finally worked was straightening the ear canal. This is possible because the outer 1/3 of the ear canal is cartilage while the inner 2/3 is bone. Straightening the ear canal helps the water circulate. Also, the reason a little seed can feel like a spider is because jaw movement causes the cartilaginous part of the canal to change shape a little, so whatever is in the ear canal can move when you smile, open your mouth, or even tilt your head.

Straightening the Ear Canal
To straighten the ear canal, you pull up and back on the ear. You can see how it’s done at 1 min, 10 seconds on this video:

One final tip. Don’t do this if you know you have a hole in your ear drum. If you have pain or it doesn’t work, go see a doctor.

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.

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