Preferred Hearing Care

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The landscape of digital hearing aids is quite competitive. New technology has created some real breakthroughs that directly benefit individuals with hearing loss. While there are several companies on the cutting edge of hearing device design, one of note is Siemens.

Since 1878 Siemens has been recognized as a word-wide leader in the design and production of hearing devices. 2010 marks a new chapter in their technology, as Siemens introduces Best Sound^TM technologies.

There are really three parts to BestSound^TM that make it noteworthy. We'll break down each in layman's terms so you can get an understanding of what the technology might be able to do for you.

SpeechFocus - individuals with hearing loss complain about one area more than any other - difficulty understanding speech. SpeechFocus was designed to make understanding speech easier and more natural. This new technology is unique in that it can amplify speech regardless of the direction it's coming from. For example, one trouble area is hearing speech from the backseat of a car. Older technology couldn't effectively deal with this type of speech. SpeechFocus works like a review mirror for sound making understanding speech in this environment possible.

FeedbackStopper - People who wear hearing aids typically want to make them as inconspicuous as possible. One of the sure-fire ways to let everyone know you are wearing devices is when they start to squeal and screech. FeedbackStopper is designed to anticipate feedback before it happens and eliminate it.

SoundLearning - Messing with settings on a small device can be a hassle. Especially if you have large fingers. SoundLearning was designed to learn your preferences in different listening environments and automatically adjust without a manual change of settings. Once you start wearing the devices and begin changing the setting depending on the listening environment, SoundLearning remembers your settings and will automatically adjust in the future.

Siemens is also working hard to ensure the best fitting of devices at the outset. They now measure various data to help eliminate the need for future adjustments.

While Siemens is not the only hearing aid manufacturer making strides in new technology. They are certainly a company to keep on your radar.

For more info, contact:

Preferred Hearing Care

3242 S National Ave

Springfield MO 65807

Phone: 417.889.5353

FAX:     417.889.5355

http://www.preferredhearing.com/

LGOODWIN@PREFERREDHEARING.COM

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Gus Mueller, Ph.D. Vanderbilt University, Nashville, Tennessee

Ruth Bentler, Ph.D. University of Iowa, Iowa City, Iowa

While the processing of modern hearing aids is complex, and computer programming is required to make some of the adjustments, the basic components that make them work has not changed. The basic function of a hearing aid is as follows:

• Sound waves enter through the microphone, which converts acoustic signals into electrical signals.
• The amplifier increases the strength of the electrical signal.
• From the amplifier, the signal is then transformed back to an acoustic signal by the receiver (a miniature loud speaker).
• From the receiver the signal is channeled intro the ear canal, either through a small tube or through an ear mold.
• A battery is required to power the hearing aid and enable the amplification process.

Many hearing aids also have user controls (e.g. toggle switch, volume control wheel, push button, or remote control) that enable the wearer to adjust a variety of hearing aid parameters, including:

• Turning the hearing aid "on" or "off"
• Changing the volume
• Switching to the telecoil
• Switching between omni- and directional-microphone settings
• Switching to a different pre-programmed memory

Styles of Hearing Aids

Hearing aids have been available in four styles: body, eyeglass, behind-the-ear (BTE), and in-the-ear (ITE). Included in the category of ITE hearing aids are in-the-canal (ITC) and completely-in-the-canal (CIC) styles (all shown in the figures below). While body and eyeglass style hearing aids were regularly used 40-50 years ago, they comprise only about 1% of all hearing aids marketed today. Instead, most individuals choose ITE (approximately 80%) or BTE (approximately 20%) style hearing aids. This transition in style, use, and preference is occurring for a number of reasons, including the reduction in the size of the components, durability, and cosmetic concerns on the part of the consumer.

The ITE style hearing aid fits directly into the external ear. The circuitry is housed primarily in the concha (external) portion of the ear. Due to the miniaturization of the component parts (including the microphone, receiver and battery), it is possible to make hearing aids small enough to fill only a portion of the concha (ITC) or fit deeply into the ear canal (CIC). All three of these styles have typically been considered to be more modern and cosmetically appealing. However, modern BTE hearing aids have become smaller and at times are less noticeable than some ITC hearing aids. Other features of in-the-ear instruments are as follows:

• More secure fit, and easier insertion and removal than with BTEs.
• Improved cosmetic benefits with smaller styles (CIC, ITC).
• Less wind noise in the smaller styles than with BTEs.
• Directional microphone technology available for most styles, excluding CICs.
• Deep microphone and receiver placement with CICs may result in increased battery life and high frequency amplification compared with other styles.
• All components are integrated into a one-piece shell, which may be easier to handle and operate than for BTE styles.

The BTE style hearing aid is housed in a small curved case which fits behind the ear and is attached to a custom earpiece molded to the shape of your outer ear. Some BTE models do not use a custom earpiece; instead the rubber tubing is inserted directly into the ear. The case is typically flesh colored, but can be obtained in many colors and/or patterns. Other features include:

• BTEs may be the most appropriate choice for young children, as only the earmold needs to be replaced periodically as the child grows and the ear changes in dimension.
• Typically, BTEs are the most powerful hearing aid style available, and may be the best option for persons with severe-to-profound hearing loss.
• FM and direct auditory input is routinely available as an optional or standard feature.
• Telecoil circuitry is often more powerful than with ITEs.
• Non-occluding earmolds may be used with BTE hearing aids, if a medical condition exists or if the patient reports a "plugged" sensation when wearing other hearing aid styles.
• Directional microphone technology available with most BTE styles and models.
• Larger battery sizes used in BTEs may be easier to handle than smaller styles for those with limited manual dexterity or vision deficits.

If you have specific questions Contact:



Lloyd Goodwin  BC-HIS



417.889.5353

LGOODWIN@PREFERREDHEARING.COM

www.PreferredHearing.com

In my humble opinion, I cannot think of a consumer product with such an impressive list of potential benefits as do hearing aids: greater earning power, improved interpersonal relationships, reduced discrimination toward the person with the hearing loss, reduced difficulty in communicating, less need to compensate for hearing loss, reduced anger and frustration, reduction in depression and anxiety, enhanced emotional stability, reductions in paranoid feelings, reduced social phobias, greater belief that you are in control of your life, reduced self-criticism, increased self-esteem, improved impressions of mental acuity, improved health status, greater level of outgoingness (e.g. extroversion) and greater likelihood of participating in groups. I challenge anyone to name a product or a service with this impressive list of benefits. When presented to a group of medical doctors, one prominent physician stated, "I was not aware of the seriousness of hearing loss and the potential for hearing aids to alleviate the problem. Every doctor in the world must be made aware of these findings!" -Lloyd Goodwin BC-HIS

There is nothing more important to the manufacturers of hearing aids and hearing healthcare professionals than your satisfaction with their product and services. Like any smart professional, they know that satisfied clients lead to repeat business and to positive word-of-mouth advertising for their products. The hearing aid industry is interested in delighting you, in meeting your needs and exceeding your expectations. The hearing aid industry is people-oriented in that it allows significant interaction and communication between the person with the hearing loss and the hearing healthcare professional to assure that they have done all things possible to meet your needs. It is important to emphasize that you have a roll to play in assuring your satisfaction with hearing aids. So I would like to offer some suggestions for optimizing the chances that you will be one of these delighted hearing aid wearers.

Simply stated, satisfaction is having your needs, desires or expectations met. Another way of looking at satisfaction is that you are fulfilled, based on a promise which may have come from the hearing healthcare provider, literature, a website, advertising or a mixture of these sources. You have very specific needs and the purpose of the hearing healthcare provider is to find out what your needs are and to meet them. Thus, during the process of rediscovering your hearing it is important to determine what your needs are, what outcomes you are looking for, and most importantly, how you’ll know when you’ve fulfilled your needs. Many people go into their hearing healthcare practitioner with a vague concept of their need: “I can’t hear,” or “It seems as if people are mumbling more,” or worse yet, “My wife says I don’t listen to her.” I believe you will have a more fulfilling hearing aid experience if you dig deeper to comprehend the impact your hearing loss has had on your life emotionally, behaviorally, mentally and socially. Write the issues down because they will become a roadmap for both you and your hearing healthcare professional. Also, many hearing healthcare professionals have assessment scales designed to help you understand problems caused by your hearing loss. Once you know your problems, you can better identify your expected outcomes. It’s your personal needs list and when it’s fulfilled it will bring a smile to your face and the faces of your loved ones. This list also becomes a contract between you and your hearing care professional. Identification of communication situations that cause you the most difficulty is a critical first step in solving your hearing loss problems. If you can describe difficult listening conditions, your hearing care provider can address the problems and develop strategies to help you manage them. If you need more information, ask for it. Some people want highly technical information about hearing aid systems and hearing loss, while others just want a brief overview of hearing aids and their function. Most providers will be happy you asked, and will give you information such as consumer literature, data sheets, brochures, videotapes and other types of instructional materials. Ask for clarification if you need it. Many complex concepts can be explained in an uncomplicated way.

Advanced hearing aid technology can now compensate for most hearing losses, but there are still millions of hearing aid candidates who are not ready to accept this fact. Is there a missing link? I think so. People with hearing loss are in different stages of readiness. At one extreme the individual is in denial about the hearing loss. If either a family member or a professional insists on hearing aids at this point, behavior is unlikely to change and most likely such a person would be dissatisfied if pursuing hearing aids. Individuals highly motivated to improve their hearing have an infinitely better chance of success with hearing aids. Such motivated people recognize their hearing loss and are open to change. They tend to seek out relevant information related to their hearing loss and the technology needed to alleviate the hearing problem. The most highly motivated hearing aid candidates have a willingness to discuss their feelings about their hearing problem and explore some hearing options that might be available to them. When they are fitted with hearing aids, they eagerly explore their new technology, discuss problems during follow-up visits with their hearing healthcare professional, and patiently learn to adapt to their technology.

The most important personality trait that one could possess is a positive attitude, not just toward the process of obtaining hearing aids, but toward life in general. Motivation is a key to success with amplification. This means a willingness to try hearing aids, adapt to new solutions, and keep frustration at a minimum when obstacles arise. If you view your circumstances as beyond your control, there’s a higher probability that you’ll be less successful in adapting to change, including hearing aid use. Hearing aid studies have shown that people who have a positive outlook on life do better with hearing aids. They have a positive self-image and believe they’re in control of their life. My recommendation is take charge and be determined to improve the quality of your life with today’s modern hearing aids!

It is human nature to want to keep your hearing aids as long as possible in order to maximize value. However, it should be kept in mind that hearing aids do break down over time, ear canals change in shape, and your hearing loss will change over time. In the research that I have conducted, customer satisfaction is at its highest in the first year of use (78%). After 5 years of use, satisfaction drops significantly to 58% and after 10 years of use even lower to 51%.     So, it’s important that you make sure that both the physical and audiological fit of your hearing aids is optimized for your hearing loss today rather than the way it was five, ten or fifteen years ago. I would recommend that you replace your hearing aids every four years; if your hearing aids are programmable you may be able to keep them longer since your hearing care provider can usually adjust them to the degree of hearing loss you currently have.

I have conducted extensive research across dozens of technologies. There is no doubt that customers are more satisfied with programmable technology. Advanced programmable technology allows the dispenser to adjust the hearing aid to your specific hearing loss characteristics with more precision. If the product does not meet your needs then the hearing healthcare professional can adjust the hearing aid at their location versus sending it back to the manufacturer for adjustment. This additional flexibility is worth at least 10% customer satisfaction points even with the budget-priced programmable product, because there is a greater likelihood that your needs will be met. The tools for fitting advanced technology hearing aids are also more advanced. For example, some manufacturers store hundreds of “real world” sounds in the computer and allow you to see how your hearing aids will sound in those situations. This tremendous feature allows the hearing aid dispenser to dynamically adjust the hearing aids based on your personal reaction to sounds. If you can afford advanced technology, do not hesitate to purchase programmable hearing aids. A second advanced feature to consider is directional hearing aids. They have either two or three microphones in them. Because of their design they are able to reduce annoying background noise and have been proven in both the lab and in the real world to improve your ability to understand speech in more difficult listening situations. I have conducted three studies on directional hearing aids. I found a 17% customer satisfaction improvement in two studies and a 26% improvement in another. The latter achieved a 90% customer satisfaction rating, the highest I have ever seen in a hearing aid. If you are an active person, then directional hearing aids will result in enhanced speech intelligibility in more listening situations. In these three studies conducted between 1996 and 2001, I found significant improvements in 100%, 93%, and 31% of listening situations measured. Compared to a 30% customer satisfaction in noisy situations for the average hearing aid, these directional hearing aids respectively had customer satisfaction ratings of 67%, 48% and a 49%. More studies are underway, but it is safe to say programmable directional hearing aids unequivocally should be the technology of choice where applicable.

Your goal is to purchase a hearing aid that never needs adjustments. It should graciously determine the volume you need and adjust its directionality by sensing if you are in quiet or a variety of noisy situations. If you have a completely digital hearing aid, when it comes across steady state noise like in an airplane cabin or around an air conditioner, it should improve your hearing comfort in these situations by making the sounds more tolerable. In addition, it should not give you feedback (whistling, buzzing or squealing) as it amplifies sounds around you. It should restore your ability to enjoy some soft sounds (e.g. leaves rustling, bubbling of a fish tank, etc) while sensing very loud sounds and making them comfortable for you (loud sounds should never be painful to your ears). While the industry has in principle developed automatic hearing aids, some people need to personally control their hearing aids. Research has shown, especially among experienced wearers, that some people (roughly a third) still need either a volume control, multiple memory switch (quiet versus noisy situation switch) or a remote control in order to control volume or to access different hearing aid strategies for handling different listening environments. Some people need control of their hearing aid for the following reasons: the automatic feature does not meet their needs in 100% of listening situations; psychologically the hearing aid wearer simply must have control of their hearing aids; or they are long-term hearing aid wearers who are used to a volume control and are therefore unwilling to part with it through habit. It is very important that you determine your needs with respect to control of the hearing aid. You don’t want to fiddle with your hearing aids every ten minutes but then again you don’t want to be frustrated because your hearing aids work well in most situations but not in 10% of your favorite situations (e.g. listening to soft music). This is an area that needs to be explored with your hearing healthcare professional.

One of the most important aspects of an enjoyable hearing aid experience is that you like the sound quality of hearing aids. So when you test-run your hearing aids, make sure that you consider the following dimensions of sound quality:

• Do you like the sound of your voice?
• Is the sound clean and crisp (sound clarity)?
• Is the sound too tinny?
• Does your hearing aid seem to plug up your ear and in fact muffle sound?
• Does it make some pleasant soft sound audible to you?
• Are loud sounds uncomfortable to you?
• Are your hearing aids natural-sounding?
• Does music sound pleasant and rich in texture?
• Does the world sound like you are in a barrel?
• Does your hearing aid whistle, buzz or squeal on its own?

 

  With today’s modern digital hearing aids, most of these problems should be solved. If you notice any of these problems during the trial run and in your follow-up visits, by all means talk to your hearing healthcare professional about these issues. Such professionals are now capable of adjusting your hearing aids to your satisfaction. The extent to which all of the possible sound quality issues can be resolved is of course, governed by the severity of your hearing loss. In other words, some types hearing losses are simply more conducive to restoration of rich sound quality in many listening environments while others are not.

Over the past ten years the hearing aid industry has reduced the size of hearing aids to near invisibility. People can now wear them with greater comfort and we’re finding very small CIC hearing aids have their distinct advantages such as on the telephone and in outdoor situations. Some people are concerned with cosmetics and prefer the least noticeable hearing aids, in the way that you might choose contact lenses instead of framed eyeglasses. The problem is that the smallest hearing aid may not be the most suitable hearing solution for you for a variety of reasons. Your specific hearing loss may require more power than available in CICs, you might not have the manual dexterity to manipulate them, or your ear canals may not allow them to be retained in your ears. Because of hearing loss stigma or embarrassment, many consumers come into hearing healthcare care offices and start off the dialog with, “I would like one of those invisible hearing aids that I saw on TV.” A likely response may be something like: “We carry invisible hearing aids, but I first need to examine your ears, measure your hearing loss, assess your lifestyle and manual dexterity and then discuss how your hearing loss is impacting the quality of your life. You may or may not be a candidate for these hearing aids.” If it is determined that you are not a candidate for CIC hearing aids and you still insist on buying them, the professional hearing healthcare provider will not fit you with the product because in essence they would be giving you the wrong prescription for your hearing loss.

Follow the instructions you are given during the initial stages of adjustment. These are designed to help in formulating realistic expectations of what to expect from your hearing aids. You may need a specific wearing schedule for hearing aids. One experienced in-the-canal hearing aid wearer obtained CIC instruments a few years ago. He was in his early 30s and had used hearing aids since he was a teenager. When he returned for his two-week recheck, he was asked how long he could wear the instruments in the beginning. He said that he could only use them for 15 minutes at a time. Within two weeks he was wearing them full-time and they were completely comfortable. Had he not been counseled that the deep insertion of the shell tip with CIC hearing aids may take extra time to fully adjust, he might have become discouraged and given up on that particular style of hearing aids. Be patient with yourself. If you have the best hearing aids for your hearing loss and your lifestyle, hang in there. Make sure you’re comfortable with the advice you’ve been given. Ask questions. Remember, your provider is your advocate. Satisfied hearing aid wearers are not shy when it comes to telling others about their success, but unfortunately, neither are the ones who are dissatisfied. No two people are alike, and it’s not a good idea to assume that if someone has had a bad experience, that all hearing aids are bad. You could very well be one of the overwhelming majority who has a good experience! There are many reasons why someone may not have been successful, so don’t project these conditions and improbabilities onto yourself. Also, do not expect someone else’s hearing aids to work for you. Would you wear their eyeglasses and decide whether you can be helped by glasses based on this experience? Be realistic. Hearing aids will not permit you to hear the flapping of hummingbird wings near a jet engine. Remember that it takes time to get used to hearing aids, especially if you’re a new wearer. Keep in mind that background noise is almost always part of your environment, and adjustment to it is required. In time, you will tune out many of these everyday sounds. It’s important not to become disappointed or frustrated while your brain begins to adjust to a whole new world of sound. If you’re an experienced wearer trying new hearing aids, understand that they might not sound like your old ones. Before you reject them, allow neural hook-ups in the auditory system to adapt to these new sounds. You just might find that you like this new sound better than the old one.

One of the common causes of hearing aid failure is that moisture and earwax fill up the receiver tubing of the hearing aid causing the hearing aid speaker to no longer function correctly. I strongly suggest that you purchase hearing aids with proven methods of keeping earwax out of the hearing aid. I have personally studied more than 90,000 hearing aid owners over a two-year period and determined that it is possible to reduce hearing aid repairs by 50% due to receiver failure by using a wax guard at the end of the hearing aids.