Common Questions About Hearing and Hearing Loss

Q: I hear some voices very well, but struggle with others. Does that mean that I need hearing aids?

Often the onset of hearing loss is gradual, making it difficult to notice small decreases over time. Usually family members notice hearing loss first, so listen to your family’s input.

Hearing loss often occurs in the higher frequencies first, so female voices and children’s voices are noticeably harder to hear, especially in background noise. So you feel like you still hear okay because you hear everything when it’s quiet. There are enough redundancies in speech for you to “fill in the blanks” temporarily when hearing loss first occurs. But the sooner you start wearing hearing aids, the better your quality of life becomes. If you deprive yourself of the benefits of hearing aids, then the hearing nerve will deteriorate more rapidly making it more difficult to process speech information. It is similar to a muscle that is not used that will atrophy. “If you don’t use it, you lose it!” The same is true for the hearing nerve. When it is not stimulated or deprived of sound for a number of years, it makes wearing hearing aids less beneficial later on. I see this often among those in their 80’s and 90’s who have finally decided to try hearing aids after living with hearing loss for 20 or more years.

Hearing loss also causes isolation from social situations often without the individual realizing it, which can lead to depression, or decreased cognitive and memory skills. So if you are having trouble or your loved ones think you are, it is important to have your hearing tested.

Q: Once I lose my hearing, can it ever be normal again or restored to normal with hearing aids?

Sensorineural hearing loss is a permanent type of hearing loss with damage in the cochlea (the hearing mechanism in the inner ear) and/or the hearing nerve, so normal hearing can never be restored, even with a hearing aid. If it is a conductive hearing loss, it involves the efficiency of the sound as it is being transmitted (this occurs in the outer and middle ear), and as long as you can overcome the decrease in volume, you should be able to correct the loss to normal. However, conductive hearing losses can often be medically treated, in which case, hearing aids will not be necessary. A mixed hearing loss is a combination of conductive and sensorineural.

Hearing aids will help all of the above-mentioned hearing losses. The level of benefit will depend on the severity of the hearing loss, the speech understanding, the complexity of the listener’s environment and most importantly, the patient’s motivation.

Q: I have been told by some of my friends and former coworkers that if I worked around noise, I can file a hearing loss claim for help with hearing aids. Is that possible?

If your hearing loss is determined to be caused from working around loud noise, then yes, the state, the federal government, or the insurance company that covers your employer may authorize hearing aids if your hearing loss claim is accepted. It is a process, however, and it can take three months to three years to get a claim approved depending on the circumstances, your work history, and the years of exposure. If you have been retired for several years, or have not been exposed to noise on the job for several years, there may be a statute of limitations in place that will limit the time you have to file a claim.

Your hearing loss will indicate damage to the high frequencies. We recommend a hearing evaluation by an audiologist to help determine if filing a claim would be beneficial. The audiologist will refer you to an appropriate physician to initiate the claim.

Q: My husband needs hearing aids, but he doesn’t think he has a problem. How can I help motivate him? The television is too loud and is driving me out of the house!

I think it would be helpful to contact an audiologist who is not going to pressure your spouse into buying hearing aids. Just tell the audiologist or receptionist that he does not seem ready to try them and then he/she will know how to approach him with information.

Then have your husband come in just to have a test. Let him know that it will simply tell him how he is hearing. If need be, contact his physician and ask him/her to support the recommendation.

All bases are then covered for him to have a hearing test and have his hearing loss explained to him in a way that gives him as much information as he can absorb. I recommend that you attend the appointment with him. Then the audiologist can give both of you information and literature to discuss and review later. As a result, he won’t feel pressured into making a decision. He can feel in control of making his own informed decision after giving it some thought. If that alone does not work, you can utilize other family members as a resource to help him understand the impact his hearing loss has on those around him. Sometimes children and grandchildren are the best motivation for taking that step into wearing hearing aids.

Q: How do loud sounds damage hearing?

When a sound is loud enough to damage your hearing, it damages the cochlea in the inner ear. The cochlea is a bony, fluid filled sensory organ shaped like a snail shell that has tiny hair cells that represent the frequencies that we hear similarly to the keys on a piano. High pitches or high frequencies are represented on the basal end or the outermost area and are damaged first by noise-induced hearing loss because they are closer to the noise source. The low frequencies are represented on the apical end of the cochlea and are the last to be damaged by loud noise exposure.

Noise-induced hearing loss is preventable so it is important to protect your hearing. A good rule of thumb to use is the following: If you have to shout to hear someone standing an arm’s length away from you, you are probably being exposed to a noise that is too loud and you should be wearing hearing protection. Wearing hearing protection is sometimes a hassle, but we see people everyday that would gladly go through the hassle, just to have their hearing back.

Q: I wear hearing aids, but sometimes in church or in movie theaters the sound is just too loud. That really bothers me. Why is that?

Frequently when people have a hearing loss, they have a reduced dynamic range of hearing. That means that the level at which that sound becomes audible, the level between comfortable and uncomfortable is a much smaller range than it is for someone with normal hearing. Generally, the longer you have hearing loss, the more sensitive you become to loud sounds, or the narrower your dynamic range of hearing is. This is called recruitment.

If you are in a situation that is too loud, you should mention it to the coordinators of the event. If they cannot make adjustments to the sound, you may need to turn down your hearing aids if possible, or take them out. Sometimes just taking one out is helpful. If the sound still bothers you, see your audiologist for an adjustment to make your hearing aids more comfortable in loud environments.

Q: How often does a person need to replace their hearing aids?

This is different for everyone. Some people keep their hearing aids for three years before replacing them and others replace them after seven years or more. The average life of a hearing aid is five years; however, in the last three years, improvements in digital technology have been so great that some people feel the need to replace them more frequently in order to keep up-to-date so as not to miss out on the important sounds of life. The prices have also decreased giving more people the opportunity to take advantage of good technology at a lower price.

As a hearing aid ages, the receivers and microphones have a tendency to break down from moisture, wax and dry skin. When the components break down, the hearing aid either won’t work properly or it may not work at all. Then it has to be repaired. When repaired, it makes the aid more vulnerable to future repairs because all the tiny connections wear out over time.

Q: What is the latest in hearing aid technology?
There are many exciting new advances in hearing aid technology and it continues to rapidly change all the time. We are able to fit devices that are smaller, lighter weight, and more comfortable than ever before.

The sound quality and noise reduction capabilities of hearing aid technology have also improved significantly resulting in many tears of joy in our office when family members can reconnect with one another after sometimes years of being unable to.

For the tech-savvy individuals, there are hearing aids that communicate directly with specific phones to provide hands-free, communication access sent to both ears simultaneously for phone and audio streaming. This can also be accessed with certain tablet devices to stream audio for music and movies. This has been life changing for improving access to information in our fast-paced world for those with hearing loss.

Q: How can I encourage my husband to come in for a hearing test when he feels like he doesn’t have a problem?
Well this is a difficult question. Sometimes it is helpful to have other family members who are noticing the problem assist by providing their observations to your loved-one. We cannot always motivate the unmotivated but you can share the isolation that you feel when you try to talk to your husband and he does not respond or asks you to repeat things routinely. You may have to point out how often you have to repeat what is being said to him.

Many people have negative thoughts when they think of hearing aids and this may be his struggle too. It is usually related to an experience of the past, perhaps with a parent or grandparent. The truth is that hearing aids are so much better than they ever have been resulting in life-changing, positive experiences for those who are brave enough to seek help. Encourage him to stay engaged with those precious children, grandchildren or even great grandchildren. He will be glad that he did.

Q: I have purchased hearing aids at a big box chain to save money. I don’t wear them. Do you offer something different?
Yes, we offer patient-focused care. We want to ensure that you have a positive experience and we work hard to achieve that. First, we do extra testing that gives us a more real-world picture of the struggles that each patient is experiencing. Then we utilize superior technology. Technology is great but it is also important to take the time to listen to the individual needs of each patient and set the hearing aids up to meet those needs. We take the time to do that gradually through a follow up process. People have very different lifestyles and communication demands. People also have very different hearing losses from one to another. Some people may frequently spend time in meetings, or need to talk on the phone while in the car traveling for work, while others may live a quiet, slower-paced lifestyle. We take the time to learn and discover these needs and our patients benefit.

Q: I only wear my hearing aids when I ‘m going somewhere where I think I need to them. What’s wrong with that?
If you are looking for reasons not to wear your hearing aids, you will find them, but the reality is that you are not doing yourself or your loved-ones any favors by doing that.

When we fit hearing aids, we set them to where they are comfortable the first day and then gradually give your brain time to adjust all the new sounds that you are not used to hearing before gradually bumping up the settings again. This is a very important part of reintroducing input to the brain that has been missing. The brain has a remarkable ability to adapt to these changes over time, putting these new sounds into your everyday soundtrack of life. This is part of a positive follow up care experience.

If you are only wearing hearing aids part-time, and they are set up to your targets, your brain will feel bombarded by the sound each time you wear the hearing aids and you will become easily fatigued resulting in the desire to remove them again. Then the pattern of dissatisfaction begins again.
So we recommend going back through a gradual fitting approach. It is a much more pleasant process and your family and friends will appreciate your efforts.

Q: Why is there such a range of prices for hearing aids?
Great question! The answer may vary depending on who you ask, but I will speak for my own office pricing.

I hear people often discussing how difficult it is these days to receive remarkable and consistent customer care. I too have felt this way about some of my consumer experiences. People say, “No one wants to help you once you have purchased something. Manufacturers don’t want to repair or maintain their goods in this disposable society. They just want you to buy another one.”

Well we don’t feel that way at Nilsson Audiology. Included in the purchase price of your hearing instruments, there is a maintenance plan, which will vary depending on the level of technology you choose based upon your listening lifestyle and your budget. This includes the initial fitting and all the adjustments, batteries and warranties for loss, damage and repair for a set time period. This is valuable because if something happens to your hearing aids, you need service right away. Some plans cover those services for three years.

Cleaning the instruments and visual examinations of your ears are free for the lifetime of the instruments you purchase from us. This keeps them in good working order. We like to perform this clean ad check every six months or sooner when needed. We love our patients and we enjoy providing exceptional customer care because we truly value our patients meeting and maintaining their hearing goals. So my answer is that hearing aids, in some cases, may cost less up front offering very little follow up care and support or you may consider investing in yourself with a little more up-front commitment in price and have good care when you need it.

Q: My health insurance says I have a benefit plan through a separate company. What does this mean?
Hearing benefits for insurances are changing as rapidly as healthcare. There are third-party companies now managing hearing benefits from afar disassociated with the insurance company itself. These third-party companies dictate to providers which manufacturers that they can work with and what levels of technology they can fit. There is not a one-size-fits-all approach to hearing healthcare. Each patient has unique needs, but yet we see this approach happening.

These companies reimburse very little to providers advertising a “discount” to the patient, which perhaps may be a small discount when in reality these third-party “managers” are making sure that their company is well compensated when they are not having any direct contact with the patient.

These companies require prior authorizations before ordering and repairing instruments creating longer wait times to the patient with more “hoops to jump through” for providers. If you have received hearing aids through one of these “benefit” plans and are dissatisfied, let your insurance company know. My concern is that this limits patients from positive hearing care experiences and, in some cases, they may give up using hearing aids all together. This can result in isolation from loved-ones and in atrophy of the hearing nerve. If you don’t voice your concerns, your insurance company will never know to change, and in my opinion, exceptional quality care will become increasingly difficult to come by.