WHAT TO EXPECT
MAXIMUM HEARING AID BENEFITS
For years, studies have shown that hearing aids are clearly associated with improvements in the social, emotional, psychological, and physical well-being of people with hearing loss in all hearing loss categories from mild to severe. Specifically, hearing aids can improve quality of life in the following areas:
- Improved communication (e.g., reduced listening strain & fewer listening errors)
- Improved personal relationships
- Greater sense of control over life’s events
- Improved mental and emotional well being
- Increased physical activity
- Increased social participation
It is important to understand, however, that achieving maximum benefit from your hearing aids usually requires time, commitment, and patience. For new and experienced hearing aid users alike, the clinical fitting process, as well as your ability to become comfortable with unfamiliar sounds, takes time. Relearning to use seemingly new sound information effectively, occurs gradually over a period of weeks and sometimes several months. The following information is designed to help you know what to expect from your new hearing aids, work through the initial adjustment period, and, ultimately, achieve maximum hearing aid benefit and satisfaction.
EVERYTHING NEW SEEMS STRANGE UNTIL WE BECOME FAMILIAR WITH IT!
It is important to realize that most of us have lost our hearing gradually over a period of many years and become rather accustomed to abnormal hearing. As a result, initial use of hearing aids can be somewhat surprising. Many people with hearing loss wait far too long before getting hearing aids and have often forgotten that we live in a world rich with sound. This is why voices, music, and environmental noises may seem quite loud the first few weeks when wearing new hearing aids. Over time, not only will our perception and tolerance of seemingly new sounds change, but actual physiological changes in the brain will occur along the central auditory nervous pathway resulting in greater listening comfort and more effective sound processing. Expect these changes to occur gradually over time.
Each person and each hearing loss is different. Therefore, the fitting and adjustment process is never exactly the same for any two people. In fact, to those clinicians paying close attention, most fittings are quite dissimilar. Some people wear their hearing aids continuously as soon as they are fit. Others wear the hearing aids for only a few hours the first day and increase wearing time gradually during the first couple of weeks. You should wear your new hearing aids as long as it is reasonably comfortable to do so. If they should initially feel or sound especially bothersome, give your ears a rest by turning the volume down or removing the aids and try to increase the volume or wear the aids again a few hours later. It is important to realize; however, that if you want to get the most benefit from your hearing aids, you must wear them as much as you can within the limits of comfort and convenience. With practice and patience, you should eventually feel comfortable wearing your hearing aids in most listening situations.
Here are some issues to keep in mind as you learn what your hearing instruments can and cannot do for you:
Expect benefit: Expect your hearing instruments to provide benefit to you during the trial period. Your ability to understand speech should be improved in the listening situations important to you. This is what you hoped for, and you should expect this benefit. If you do not experience an improvement, then work with your audiologist to see if the instruments can be adjusted to meet your specific needs. Not everyone will receive the same degree of benefit from hearing aids. Whether your goals will be easy to achieve or not depends on more than the amount of hearing you have left. It also depends on the appropriateness and quality of your hearing aids, the strength of your desire to hear again, your willingness to trade old hearing habits for new ones, and your audiologist's hearing aid programming, fitting and teaching skills.
Restore normal hearing: No matter how technically advanced, hearing instruments cannot restore your hearing to normal. Hearing aids work by amplifying sound in order for damaged ears to detect sounds that would otherwise be missed. Hearing aids do not restore normal hearing, and they cannot compensate for distorted hearing caused by severe inner ear nerve damage.
Types of hearing instruments: Not all hearing instruments perform the same with every type of hearing loss, but most hearing aids emphasize certain parts of the sound spectrum. For example, most provide high frequency (high pitch or treble) emphasis since this is the area most frequently lost by those with hearing impairment. As a result, your aids may sound “sharp” or “tinny” until you get used to hearing high pitch sounds again.
Fit and comfort: Since you are purchasing custom hearing instruments, you should expect the fit to be comfortable. The physical fit of hearing aids is very important. Your two ears are shaped differently, and the left and right hearing aid will probably not feel exactly the same in both ears. They should not fit too tight or too loose. Hearing aids usually feel “snug” in the ears until you get used to them, but they should not cause irritation or pain within the ear when properly inserted. If your hearing aids are uncomfortable, ensure that they are fully inserted each time you wear them. If soreness persists, please call the office immediately.
Sounds: Hearing instruments should allow you to hear softer sounds (e.g., perhaps a child's voice, soft speech, or footsteps) that you could not hear without amplification; this is part of the enjoyment of hearing instruments. In general, loud sounds should sound loud but comfortable; while very loud sounds that are uncomfortable to people with normal hearing may also be uncomfortable for you. If loud sounds are uncomfortable, the maximum output of the hearing aids may have to be adjusted by your audiologist.
Whistling and feedback: It is normal for hearing instruments to squeal or whistle when you are inserting them into your ear if you do not have an automatic power-on delay, a volume control, or a switch to turn them off. If your aid frequently squeals after proper insertion, then most likely you have an inadequate fit or wax build-up and should contact your audiologist.
Noise: Most hearing loss occurs gradually as noise and age damage the delicate hearing nerve (hair cells) over time. As a result, people with hearing loss unknowingly become accustomed to living in a quiet world… often for decades. With longstanding hearing loss, we literally can't remember how loud life really is. Meanwhile, we "get by" while our family and friends work to kindly repeat words, speak louder than normal, tolerate loud TVs, etc…. With gradual loss, we usually don’t even recognize most of the sounds that we’re missing.
As a result, the fundamental goal of any successful hearing aid fitting is to amplify speech to a comfortable loudness level. We cannot understand the sounds of speech unless we are once again able to first hear the sounds of speech. Unfortunately, hearing aids cannot simply amplify only the desirable sounds of speech and music without simultaneously amplifying undesirable noise. Even if science could separate such sophisticated sounds (extremely complex and always changing), one man’s noise is often another man’s music.
Replacing “long lost” background sounds suddenly, as with hearing aids, may be initially disturbing. Since many of us spend so much time in background noise, it takes a couple of months to truly begin to adapt to hearing much more sound rather abruptly. As a result, it usually takes weeks to begin to ignore noise at the subconscious level. Ignoring sounds is an acquired ability, and a lot of noise is simply too loud for anyone to ignore.
If noise continues to bother you beyond a few weeks, discuss the problem with your audiologist. It’s important that your aids are programmed (adjusted) properly to at least get the best chance to hear sounds you want to hear above the loudness of unwanted background noise. Directional microphones are still the only technology that consistently demonstrates improved speech understanding in noisy environments (forget other hype you may have heard). Depending on your unique hearing impairment and the type of hearing aids you purchased, it is sometimes beneficial to remove the aids in extremely noisy environments.
Your Own Voice: With hearing loss, we cannot hear our own voice normally. Hearing aids amplify everything including our own voice. Often this is an advantage because many people with hearing impairment tend to talk louder than normal in order to hear and monitor the sounds of their own speaking voice. When you wear hearing aids for the first time, you may notice your voice sounds louder and/or different. As you begin to hear your voice amplified through the hearing aid, it may sound plugged-up or muffled, raspy, hoarse, sharp, or even a bit like an echo. This is normal and will usually subside in a few days after you have given yourself a chance to get accustomed to your new hearing aids. There may be adjustments that the audiologist can make to relieve these symptoms should they persist beyond the first few days of wearing your new aids. Because your mouth is very close to the hearing aid microphone and the ear, your own voice, will usually sound louder than that of a person who is several feet away.
Telephone Use: Unfortunately, hearing aids have a tendency to squeal or “feedback” when using the telephone. Fortunately, many hearing aid users can use the telephone well without the hearing aid. Others may hear well with an amplified telephone or a phone equipped with a loudspeaker. If you experience squealing on the phone, try holding the phone at different angles or different distances from the hearing aid. In some cases it is imperative that the hearing aids be equipped with a telephone switch. If you cannot communicate effectively on the telephone, contact your audiologist. Many hearing aids today can be paired with cell phones effectively allowing phones to be heard in both ears simultaneously while eliminating squealing/feedback.
I can hear but I can’t understand: It is difficult to understand speech in a noisy environment even when hearing aids are functioning properly. Most often, hearing loss is caused by damage to the hearing nerve. Damage to the hearing nerve reduces our ability to distinguish subtle differences between tones, loudness levels, and subtle timing (e.g., duration, pause, onset timing, etc…) cues of speech. As a result, even when the sounds of speech are amplified to a comfortable loudness level, the person with severe inner ear nerve damage may find it difficult to differentiate sounds of speech. Under these circumstances, hearing aids make sound loud enough, but the efficiency of the hearing aids is limited by the listener's inability to hear speech clearly. With time and practice, however, our ability to distinguish sounds of speech typically improves as does our speech understanding. For additional information, See "LISTENING STRATEGIES" under the "COMMON TOPICS" menu above.
Eye Glasses: It is not reasonable to expect hearing aids to work like eye glasses. When you use eye glasses for the first time, you usually see the difference right away. Most vision problems are caused by a mechanical problem with the lens or cornea. Once a corrective glass lens redirects light to the undamaged nerves in the retina, our vision is immediately restored. With hearing aids, because the hearing loss is usually caused by nerve damage, it takes time for the auditory neural pathway and the brain to adjust to new sounds.
Your friend's hearing instrument: Do not expect your friend's hearing instrument brand or style to work for you. Their hearing is different than yours, as is the size and shape of their ears, their personal listening preferences, tolerance for loud sound, vision, dexterity, etc…. Today’s hearing aids are custom built and programmed to fit only a single ear, a single hearing loss, a single person.
Satisfaction guarantee: Expect to be satisfied with your hearing instruments. Expect your quality of your life to improve with proper hearing aid use. Expect a 60 day trial period to return your hearing aids for a refund should they not provide adequate benefit. For persons who return their hearing aids, most companies will retain a non-refundable fee for services rendered. Most people need several weeks to become fully acclimated to new aids. Never purchase a hearing instrument that does not give you sufficient benefit.
Helpful Steps to Learning to Use a Hearing Aid:
1. Use the aids at first in your own home environment.
2. Wear the aids as much as you can within the limits of comfort and convenience.
3. Teach yourself to use the aids by listening to just one other person such as a spouse, neighbor or friend.
4. Gradually extend the number of persons with whom you talk, still within your own home environment.
5. Gradually increase the number of situations and environments in which you use your hearing aids.
6. Do not strain to catch every word.
7. Do not be discouraged by the interference of background noises... it happens.
8. Practice locating the source/direction of the sound by listening only.
9. Increase your tolerance for louder sounds.
10. Practice learning to discriminate or distinguish different speech sounds.
11. Develop a good and ongoing dialogue with your audiologist. Once you’ve begun to adjust to new sounds, talk to your audiologist about the sound quality and the loudness of sounds with your hearing aids. The more information the audiologist has, the better he/she can adjust your aids properly for you.
Be patient with yourself. If you’ve purchased the best hearing instruments for your hearing loss and your lifestyle, hang in there. Make sure you're comfortable with the advice you've been given, and ask questions. Remember, your audiologist should be your advocate. Be realistic. Hearing instruments may not enable you to hear the clock ticking while the refrigerator is running. Remember that it takes time to get used to hearing aids, especially if you're a 1st time wearer. Keep in mind that background noise is almost always part of our environment, and adjustment to it is required. In time, you will once again be able to tune out many of these everyday sounds and noises. It is also important to remember that people with normal hearing are frequently bothered by noise as well.
It's important not to become disappointed or frustrated while adjusting to a seemingly new world of sound. If you're an experienced wearer trying new hearing instruments, understand that they probably shouldn’t sound like your old ones. Give yourself time for 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.
I’m on your side, and I will to do everything within the limits of my ability to help you hear as well as possible. I want you to feel comfortable with your hearing aids as well as my services. I want you to get the most life out of your new hearing aids. Please feel free to call anytime with questions, comments, or suggestions. If I can't answer your call, I normally respond to all voice messages within 24 hours.
Sincerely,
Dr. George Zenker