Are ALDs Only for People Using Hearing Aids?
What is Tinnitus?
How do I know if I have Hearing Loss?
What Can I expect When Choosing Hearing Aids?
How Should I Maintain My Batteries?
Am I Candidate for Middle Ear Implants?

Q: Are ALDs Only for People Using Hearing Aids?
A: No. People with all degrees and types of hearing loss ? even people with normal hearing can benefit from assistive listening devices. Some assistive listening devices are used with hearing aids; some are used without hearing aids.

Q: What is Tinnitus?
A: Tinnitus is an abnormal perception of a sound reported by a patient but is unrelated to an external source of stimulation. Tinnitus is a very common disorder affecting over 50 million people in the United States. It may be intermittent, constant or fluctuant, mild or severe, and may vary from a low roaring sensation to a high pitched type of sound. It may or may not be associated with a hearing loss.

Q: How do I know if I have Hearing Loss?
A: Hearing loss can be due to the aging process, exposure to loud noise, certain medications, infections, head or ear trauma, congenital (birth or prenatal) or hereditary factors, diseases, as well as a number of other causes. Recent data suggests there are over 34 million Americans with some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime. People with hearing loss compensate often without knowing they have hearing loss.

Common signs of hearing loss include:

You hear people speaking but you have to strain to understand their words.
You frequently ask people to repeat what they said.
You don't laugh at jokes because you miss too much of the story or the punch line.
You frequently complain that people mumble.
You need to ask others about the details of a meeting you just attended.
You play the TV or radio louder than your friends, spouse and relatives.
You cannot hear the doorbell or the telephone.
You find that looking at people when they speak to you makes it easier to understand.
You miss environmental sounds such as birds or leaves blowing.
If you have any of these symptoms, you should see a hearing professional to have an "audiometric evaluation." An audiometric evaluation (AE) is the term used to describe a diagnostic hearing test performed by a licensed hearing professional. An AE is not just pressing the button when you hear a "beep." Rather, an audiometric evaluation allows the hearing professional to determine the type and degree of hearing loss, and tells the professional how well or how poorly you understand speech. Speech understanding testing shows the professional how successful amplification may be for your hearing loss. The AE should also include a thorough case history (interview) as well as visual inspection of the ear canals and eardrum. Further tests of the middle ear function may also be performed. The results of the AE are useful to the physician should the hearing professional conclude that your hearing loss may be treated with medical or surgical alternatives. Result of the AE are plotted on a graph referred to as an audiogram. The audiogram provides a visual of your hearing test result at various frequencies.

Q: What Can I expect When Choosing Hearing Aids?
A: Realistic Expectations for the Hearing Aid User
Hearing aids work very well when fit and adjusted appropriately. They amplify sound! You might find that you like one hearing aid better than the other. The left and right hearing aids will probably not fit exactly the same and they probably won't sound exactly the same. Nonetheless, hearing aids should be comfortable with respect to the physical fit and sound quality. Hearing aids do not restore normal hearing and are not as good as normal hearing. You will be aware of the hearing aids in your ears. Until you get used to it, your voice will sound "funny" when you wear hearing aids. Hearing aids should not to be worn in extremely noisy environments. Some hearing aids have features that make noisy environments more tolerable. However, hearing aids cannot eliminate background noise.
YOUR OWN VOICE: When you wear hearing aids for the first time, you will probably notice your voice sounds funny! You will hear your voice amplified through the hearing aid. You may describe this sensation as feeling "plugged up" or hearing your voice echoing. This is normal and will usually go away in a few days after you have given yourself a chance to get accustomed to your new hearing aids and learned to adjust the volume control. There are adjustments that the audiologist can do to relieve these symptoms, should these persist beyond the first few days of wearing your new aids.
GETTING USED TO HEARING AIDS: People learn at different rates. Some people need a day or two to learn about and adjust to their hearing aids, most need a few weeks and some may need a few months. There is no perfect way to learn about hearing aids. I usually recommend you wear the hearing aids for a few hours the first day, and add about an hour a day for each day that follows. Do not try to set an endurance record. Over a period of time you will lengthen the amount of time that you wear the aid. Eventually you will wear the hearing aids most of your waking hours. It is recommended that you interact with those people you are most familiar with during your first few days. Start off listening with your hearing aids in a favorable listening environment and work towards more difficult listening situations. Let your friends and family know that you are using your new hearing aids.
HELPFUL STEPS TO LEARNING TO USE A HEARING AID: Use the aid at first in your own home environment. Wear the aid only as long as you are comfortable with it. Accustom yourself to the use of the aid by listening to just one other person - husband or wife, neighbor or friend. Do not strain to catch every word. Do not be discouraged by the interference of background noises. Practice locating the source of the sound by listening only. Increase your tolerance for loud sounds. Practice learning to discriminate different speech sounds. Listen to something read aloud. Gradually extend the number of persons with whom you talk, still within your own home environment. Gradually increase the number of situations in which you use your hearing aid. Take part in an organized course of aural rehabilitation. See your audiologist to learn about these courses.
PHYSICAL FIT: One concern with all new hearing aids is the physical fit. Hearing aids need to be comfortable, not too tight and not too loose. They should fit just right. Do not wear the hearing aids if they cause any discomfort or irritations. Call your audiologist to schedule an appointment time to remedy the problem as soon as possible. Do not wear them if they are uncomfortable

Q: How Should I Maintain My Batteries?
A: Hearing Aid Battery Information
All batteries are toxic and dangerous if swallowed. Keep all batteries (and hearing aids) away from children and pets. If anyone swallows a battery it is a medical emergency and the individual needs to see a physician immediately.
One question often asked is "How long does the battery last?" Typically they last 7-14 days based on a 16 hour per day use cycle. Batteries are very inexpensive, costing less than a dollar each. Generally, the smaller the battery size, the shorter the battery life. Hearing aid battery sizes are listed below along with their standard number and color codes.
Size 5               RED
Size 10 (or 230)  YELLOW
Size 13              ORANGE
Size 312             BROWN
Size 675             BLUE
Today's hearing aid batteries are "zinc-air." Because the batteries are air-activated, a factory-sealed sticker keeps them "inactive" until you remove the sticker. Once the sticker is removed from the back of the battery, oxygen in the air contacts the zinc within the battery, and the battery is "turned-on". Placing the sticker back on the battery will not prolong its life. Since many of today?s automatic hearing aids do no have "off" switches, removing the battery at night assures that the device is turned off. Zinc-air batteries have a "shelf life" of up to three years when stored in a cool, dry environment. Storing zinc-air hearing aids in the refrigerator has no beneficial effect on their shelf life, in fact, quite the opposite may happen. The cold air may actually form little water particles under the sticker. Water is made of oxygen and hydrogen. If the water vapor creeps under the sticker, the oxygen may contact the zinc, and the battery could be totally discharged by the time you peel off the sticker! Therefore, the best place to store batteries is in a cool dry place, like the back of your sock drawer, not the fridge

Q: Am I Candidate for Middle Ear Implants?
A: In order to be fit with a MEI (or a binaural fitting), one requires a purely sensorineural hearing loss. Since MEIs are better at generating mid and high frequency gain than low frequency gain, the optimal hearing loss should be sloping. Many MEIs can be digitally programmed or are in fact digital. With the extra control that these technologies afford, other sensorineural configurations can be fit. I doubt if any new hearing aid users would be MEI candidates. Although the various surgeries are not complicated, they can be lengthy (up to 3 hours) and like any surgery, can be traumatic. A MEI candidate is therefore one who has tried conventional hearing aids and was unsuccessful either because (1) they were not able to obtain as much high-frequency amplification as required, or because (2) the occlusion effect (Vagal response) could not be resolved to the satisfaction of the patient. While the cosmetic issue is important, I am not convinced that this should be the primary deciding factor, given that CIC hearing aids can be made quite small with the newer technology.

There was a panel session, chaired by myself and Dr. Jon Spindel, at the 2001 AAA meeting in San Diego. In addition, part of the August 2001 issue of Hearing Journal was dedicated to this topic, with myself and Jon as co-editors.