American Hering & Balance

Learn How To Avoid
The Most Common Mistakes
With Hearing Aids
In 3 Easy Steps!

When it comes to better hearing,
it pays to be selective
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The Right Way to Clean Your Ears


Anatomy of the ear
Blausen.com staff. “Blausen gallery 2014″.

That there is a right way to clean your ears suggests that there is a wrong way, and in fact, there is a very wrong way. The wrong way is customary, and it breaches the first rule of cleaning your ears: don’t insert foreign objects into your ear canal. That includes cotton swabs and any other item that will probably only press the earwax up against the eardrum, potentially causing irritation, temporary hearing loss, or eardrum damage.

So what should you be doing to clean your ears under normal circumstances? In a word: nothing (I hope you weren’t looking for something more profound). Your ears are built to be self-cleaning, and the regular movements of your jaw move earwax from the canal to the outer ear. If you attempt to remove it, your ear just produces more wax.

And earwax is essential, as it contains protective, lubricating, and antibacterial properties. In fact, over-cleaning the ears leads to dry, itchy, irritated skin within the ear canal. Therefore, for the majority of people the majority of of the time, nothing is required other than normal showering to clean the outer ear.

But notice that we said MOST of the time, because there are times in which people do generate an excessive amount of earwax or excess earwax impacts the eardrum. In situations like these, you will need to clean your ears. Here’s how:

Cleaning your ears at home

We’ll say it again: don’t insert any foreign objects into your ear canal. You can irritate the delicate skin of the canal and can end up perforating your eardrum. This means no cotton swabs and absolutely no ear candles. (Speaking of ear candles, in 2010, the FDA released a warning against using them, declaring that no scientific evidence supports their effectiveness and that their use can trigger major injuries.)

To properly clean your ears at home, take the following methods:

  1. Purchase earwax softening solution at the drugstore or make some at home. Directions for making the solution can be found online, and the solution often includes the use of hydrogen peroxide, mineral oil, and glycerin.
  2. Pour the solution into your ears from the container or by using a plastic or bulb syringe. Tilt your head to the side and let the solution to work for 5-10 minutes.
  3. Empty the fluid out of your ear by tilting your head slowly over a container or the sink, or you can use a cotton ball pushed against the outside of the ear. (I know it’s tempting, but again, don’t push the cotton ball into your ear.)
  4. Flush out your ears with lukewarm water using a bulb syringe to free any loosened earwax.

When not to clean your ears at home

Cleaning your ears at home could be unsafe in the presence of an ear infection or a perforated eardrum. If you encounter any symptoms such as fever, dizziness, ear pain, or ear discharge, it’s best to speak to your doctor or hearing specialist. Also, repeated attempts at self cleaning that are unsuccessful may suggest a more severe congestion that will require professional cleaning.

Medical doctors and hearing specialists apply a variety of medicines and devices to rapidly, thoroughly, and safely remove excess earwax. The solutions tend to be more powerful than the homemade versions, and tools called curettes can be inserted into the ear to manually remove the wax.

When in doubt, leave it to the professionals. You’ll get the peace of mind that you’re not causing damage to your ears, and symptoms can subside within minutes of a professional cleaning. In addition, underlying problems or hearing loss can be identified and corrected by a professional.

If you have any further questions or wish to set up an appointment, give us a call today! And remember, if you’re a hearing aid user, you’ll want to get a repeated professional checkup every 6 months.

The Surprising Statistics Behind Occupational Hearing Loss

It’s common to think of hearing loss as an inevitable problem associated with aging, or, more recently, as a consequence of the younger generation’s regular use of iPods. But the numbers reveal that the greater problem may be exposure to loud noise at work.

In the United States, 22 million workers are subjected to potentially destructive noise, and an estimated 242 million dollars is expended every year on worker’s compensation claims for hearing loss, according to the National Institute for Occupational Safety and Health (NIOSH).

What’s more is that higher rates of hearing loss are found in progressively noisier professions, revealing that exposure to sounds over a certain level steadily increases your risk for developing noise-induced hearing loss later in your life.

How loud is too loud?

A study performed by Audicus revealed that, of those who were not exposed to work-related noise levels above 90 decibels, only 9 percent struggled with noise-induced hearing loss at age 50. In contrast, construction workers, who are routinely exposed to sound levels as high as 120 decibels, experienced noise-induced hearing loss at the age of 50 at a rate of 60 percent!

It appears that 85-90 decibels is the threshold for safe sound levels, but that’s not the complete story: the decibel scale is logarithmic, not linear. That signifies that as you raise the decibel level by 3 decibels, the sound level nearly doubles. So 160 decibels is not two times as loud as 80—it’s about 26 times louder!

Here’s how it breaks down: a decibel level of 0 is hardly noticeable, normal conversation is about 60 decibels, the limit for safety is 85-90 decibels, and the death of hearing cells takes place at 180 decibels. It’s the area between 85 and 180 that leads to noise-induced hearing loss, and as would be anticipated, the vocations with increasingly louder decibel levels have increasingly higher rates of hearing loss.

Hearing loss by occupation

As the following table displays, as the decibel levels connected with each profession increase, hearing loss rates increase as well:

Occupation Decibel level Incidence rates of hearing loss at age 50
No noise exposure Less than 90 decibels 9%
Manufacturing 105 decibels 30%
Farming 105 decibels 36%
Construction 120 decibels 60%

Any profession with decibel levels above 90 places its workforce at risk for hearing loss, and this includes rock musicians (110 dB), nightclub staff (110 dB), Formula One drivers (135 dB), airport ground staff (140 dB), and shooting range marshalls (140 dB). In every scenario, as the decibel level increases, the risk of noise-induced hearing loss grows.

Protecting your hearing

A recent US study on the frequency of hearing loss in farming found that 92 percent of the US farmers surveyed were exposed to harmful noise levels, but that only 44 percent claimed to use hearing protection equipment on a per day basis. Factory workers, on the other hand, tend to conform to stricter hearing protection regulations, which may explain why the incidence rate of hearing loss is slightly lower in manufacturing than it is in farming, despite being exposed to similar decibel levels.

All of the data point to one thing: the significance of protecting your hearing. If you work in a high-risk job, you need to take the right precautionary measures. If avoiding the noise is not an option, you need to find ways to decrease the noise levels (best accomplished with custom earplugs), in addition to ensuring that you take frequent rest breaks for your ears. Reducing both the sound volume and exposure time will minimize your chances of developing noise-induced hearing loss.

If you would like to talk about a hearing protection plan for your particular circumstances or job, give us a call. As hearing specialists, we can provide custom-made solutions to best protect your hearing at work. We also offer custom earplugs that, in addition to defending your hearing, are comfortable to wear and can preserve the natural quality of sound (in contrast to the muffled sound you hear with foam earplugs).

Finding Financial Assistance for Your Hearing Aids

Hearing Aid Financing

The adage “you get what you pay for” is certainly true of hearing aids, and while modern-day hearing aids are engineered to be more effective than ever, they’re not exactly inexpensive, either.

Fortunately, modern digital hearing aids, while not cheap, ARE becoming more budget friendly, in the same way that the majority of consumer electronics are becoming more affordable (A 20-inch high-definition TV cost $1,200 in 1999; it costs just $84 today). And when you think about it, we have a tendency to spend considerably more cash on things that simply do not improve our quality of life to the level that a pair of hearing aids can.

Let’s say, for instance, that a pair of hearing aids costs $5,000. Presuming the hearing aids last 5 years, that is equal to a monthly price of only $83.33 per month. Most people spend more money on their cable television bill, and that’s why the majority of our patients readily admit that while the upfront cost seems large, the monthly cost, relative to the benefit they receive from healthier hearing, is more than worth the money.

The question is, would you be willing to devote less than 100 dollars per month to have better conversations and relationships with your family and friends? Most people would, and that’s why so many people choose to purchase hearing aids.

But once you decide to purchase hearing aids, what are your methods for paying for them? In spite of conventional beliefs, you have a range of potential options.

Financing options for hearing aids

The initial mistake people make is assuming that no financial aid is possible. Although acquiring assistance can be frustrating at times, there are in fact quite a few resources that you should inquire about before making a decision to hand over a full cash payment. The following are some of the steps we suggest taking:

  • Start by consulting your private insurance provider. While private insurance varies by company and by state, many people discover that their private insurance supplies some type of assistance with hearing aids.
  • Look into using a medical flexible spending account. This is a special type of account you can use to put aside money (pre-tax) to pay for out-of-pocket medical expenses.
  • Check your Medicare and Medicaid benefits. This is not the most likely way to help pay for hearing aids, but Medicare and Medicaid do provide benefits in certain limited circumstances.
  • Call your local VA office if you’re a veteran. Veterans may obtain benefits that can help partially or completely pay for hearing aids. Check with your local VA office for more information.
  • Search for charitable organizations that offer hearing aids or financial help. If you meet the financial criteria, there are numerous charitable organizations that supply hearing aids or financial assistance for hearing aids. We’ll provide some resources for you in the next section.
  • Check your state’s vocational rehabilitation program. If hearing aids are necessary for work, your state may help you pay for them through its vocational rehabilitation program.
  • Consider financing your hearing aids. Numerous programs exist, including CareCredit, which works like a credit card but is exclusive to healthcare services.

Additional resources

There are far too many options and resources to list, and many programs are specific to the state you reside in or to the specific organizations you’re affiliated with. Therefore, instead of browsing a long list of resources, it’s best to search for programs specific to your state or situation. For instance, carrying out a Google search for “hearing aid funding in ” or “hearing aid assistance for veterans” will most likely supply some worthwhile results.

You might also want to check out the list of financial resources from the
Better Hearing Institute
and the Hearing Loss Association of America, both of which list programs by state and include lists of several charitable organizations.

If you’re still not positive where to start, or are having a hard time finding information, don’t hesitate to give us a call. We can point you in the right direction and can help you find the financing option that works best for you. Your hearing is worth it—call us today!

When Should I Get My Hearing Tested?

In most cases, people are unaware that they have hearing loss. It develops so slowly that it’s usually undetectable, and on top of that, most family doctors do not regularly test for hearing loss at the yearly physical exam.

Bearing in mind these two realities, it’s no surprise that most people first realize they have hearing loss by being informed about it from close friends or family members. But once people confront you about your hearing loss, it’s very likely already relatively advanced. Considering that hearing loss gets worse over time—and cannot be totally recovered once lost—it’s critical to treat hearing loss at the earliest opportunity instead of waiting for it to get bad enough for people to notice.

So when and how often should you get your hearing tested? Here are our suggestions:

Establish a Baseline Early

It’s never too soon to consider your first hearing test. The sooner you test your hearing, the earlier you can create a baseline to compare future tests. The only method to assess if your hearing is becoming worse is by comparing the results with previous tests.

Although it’s true that as you grow older you’re more likely to have hearing loss, keep in mind that 26 million people between the age of 20 and 69 have hearing loss. Hearing loss is widespread among all age groups, and being exposed to loud noise puts everyone at risk regardless of age.

Yearly Tests After Age 55

At the age of 65, one out of every three people will have some degree of hearing loss. Given that hearing loss is so typical around this age, we advise once-a-year hearing tests to ensure that your hearing is not deteriorating. Remember, hearing loss is permanent, cumulative, and essentially undetectable. However, with yearly hearing exams, hearing loss can be discovered early, and treatment is always more effective when carried out earlier.

Consider Personal Risk Factors

According to the National Institute on Deafness and Other Communication Disorders, “approximately 15 percent of Americans (26 million people) between the ages of 20 and 69 have high frequency hearing loss due to exposure to noise at work or during leisure activities.”

If you have been subjected to loud work environments or activities such as music concerts or sporting events, it’s a good idea to have your hearing tested. It’s also a good idea to get a yearly hearing test if you continuously expose your hearing to these conditions.

Watch for Signs of Hearing Loss

As we noted earlier, the signs and symptoms of hearing loss are often first observed by others. You should set up a hearing test if someone has recommended it to you or if you experience any of these signs or symptoms:

  • Muffled hearing
  • Difficulty following what people are saying, especially in loud settings or in groups
  • People commenting on how loud you have the TV or radio
  • Avoiding social situations and conversations
  • Ringing, roaring, hissing, or buzzing in the ear (tinnitus)
  • Ear pain, irritation, or discharge
  • Vertigo, dizziness, or balance problems

Don’t Wait Until the Harm is Done

The bottom line is that hearing loss is common among all age groups and that we all live in the presence of several occupational and everyday risk factors. Seeing that hearing loss is hard to detect, gets worse over time, and is best treated early, we suggest that you get your hearing tested regularly. You may end up saving your hearing with early intervention, and the worst that can happen is that you find out you have normal hearing.

Understanding Your Treatment Options for Tinnitus

Nearly 45 million Americans suffer from tinnitus, which is the perception of sound where no outside sound source exists. This phantom sound is typically identified as a ringing sound, but can also materialize as a buzzing, hissing, whistling, swooshing, or clicking.

The first thing to recognize about tinnitus is that it’s a symptom, not a disease. As a result, tinnitus may signify an underlying health condition that, once cured, cures the tinnitus. Earwax accumulation or other blockages, blood vessel conditions, select medications, and other underlying disorders can all trigger tinnitus, so the first step is ruling out any ailments that would require medical or surgical treatment.

In most cases of tinnitus, however, no specific cause is found. In these cases, tinnitus is presumed to be caused by destruction of the nerve cells of hearing in the inner ear. Noise-induced hearing loss, age-related hearing loss, and one-time exposure to very loud sounds can all cause tinnitus.

Whenever tinnitus is induced by nerve cell damage, or is connected with hearing loss, tinnitus oftentimes cannot be cured—but that doesn’t imply that people must suffer without help. While there is no definitive cure for the majority of instances of chronic tinnitus, numerous tinnitus treatment options are available that help patients live better, more comfortable, and more productive lives, even if the perception of tinnitus persists.

Here are some of the treatment options for tinnitus:

Hearing Aids

The majority of cases of tinnitus are associated with some type of hearing loss. In patients with hearing loss, less sound stimulation reaches the brain, and in response, investigators believe that the brain changes physically and chemically to accommodate the lack of stimulation. It is this maladaptive response to sound deprivation that results in tinnitus.

Tinnitus is aggravated with hearing loss because when ambient sound is muffled, the sounds associated with tinnitus become more noticeable. But when hearing aids are utilized, the amplified sound signals cause the sounds of tinnitus to blend into the richer background sounds. Hearing aids for tinnitus patients can then render multiple benefits, such as improved hearing, increased auditory stimulation, and a “masking effect” for tinnitus.

Sound Therapy

Sound therapy is a wide-ranging phrase used to identify several approaches to making use of external sound to “mask” the tinnitus. After some time, the brain can learn to recognize the sounds of tinnitus as unimportant relative to the competing sound, thereby minimizing the intensity level of tinnitus.

Sound therapy can be delivered through masking devices but can also be provided through specific hearing aid models that can stream sound wirelessly using Bluetooth technology. Some hearing aid models even connect with compatible Apple products, including iPhones, so that any masking sounds installed on the Apple devices can be delivered wirelessly to the hearing aids.

The kinds of masking sounds utilized may vary, including white noise, pink noise, nature sounds, and music. Sounds can also be specifically programmed to match the sound frequency of the patient’s tinnitus, delivering customized masking relief. Seeing that each patient will respond differently to different masking sounds, it’s imperative that you work with a knowledgeable hearing professional.

Behavioral Therapies

Numerous behavioral therapies exist to help the patient deal with the psychological and emotional components of tinnitus. One example is mindfulness-based stress reduction, in which the individual learns to accept the ailment while developing beneficial coping methods.

You may have also heard the term Tinnitus Retraining Therapy (TRT), which blends cognitive-behavioral therapy with sound masking therapy. With Tinnitus Retraining Therapy, people learn to establish healthy cognitive and emotional reactions to tinnitus while using sound therapy to train their brains to reclassify tinnitus as trivial, so that it can be deliberately ignored.

General Wellness

Along with the more specific sound and behavioral therapies, patients can engage in general wellness activities that have been found to lessen the severity of tinnitus. These activities include healthy diets, frequent exercise, social activity, recreational activities, and any other activities that contribute to improved health and reduced stress.

Drug Therapies

There are currently no FDA-approved medications that have been demonstrated to cure or relieve tinnitus directly, but there are drugs that can treat stress, anxiety, and depression, all of which can make tinnitus worse or are caused by tinnitus itself. In fact, some antidepressant and antianxiety medicines have been shown to furnish some relief to patients with severe tinnitus.

Experimental Therapies

A flurry of encouraging research is being carried out in labs and universities internationally, as researchers continue to seek out the underlying neurological cause of tinnitus and its ultimate cure. Even though many of these experimental therapies have shown some promise, remember that they are not yet readily available, and that there’s no guarantee that they ever will be. People suffering from tinnitus are encouraged to seek out current treatments rather than waiting for any experimental treatment to hit the market.

Here are a few of the experimental therapies currently being tested:

  • Repetitive Transcranial Magnetic Stimulation (rTMS) delivers electromagnetic pulses into the affected brain tissue to lessen the hyperactivity that is believed to cause tinnitus.
  • Transcranial Direct Current Stimulation (tDCS) is another means of delivering electromagnetic pulses into the hyperactive brain tissue that is believed to cause tinnitus.
  • Deep Brain Stimulation (DBS) is comparable to the preceding therapies in its use of electromagnetic energy, the difference being that DBS is an invasive procedure requiring surgery and the placing of electrodes in the brain tissue.

Other medical, surgical, and pharmacological therapies exist, but the results have been mixed and the dangers of invasive procedures oftentimes outweigh the benefits.

The Optimal Treatment For Your Tinnitus

The best tinnitus treatment for you is based on several factors, and is best determined by a certified hearing specialist. As your local hearing care experts, we’ll do everything we can to help you find relief from your tinnitus. Book your appointment today and we’ll find the personalized solution that works best for you.

Getting the Most Out of Your Hearing Aid Batteries


Hearing Aid Batteries
Zinc-air-battery-types by Marc Andressen is licensed under Attribution CC 2.0

You could make a strong case that the most critical component of your hearing aid is the battery: without it, nothing else works, and if it fails, your hearing fails with it. In this short guide, we’ll provide you with everything you need to know about hearing aid batteries so that you can get the most out of your hearing aids.

How Hearing Aid Batteries Work

Hearing aids take a particular type of battery called zinc-air batteries. Each one has a sticker that covers tiny holes on the top of the battery. When the sticker is removed, air enters the battery through the holes, resulting in a chemical reaction that activates the zinc and makes the battery live. Once the battery is live, it begins discharging power and reapplying the sticker will have no effect in conserving its life.

Hearing Aid Battery Types

Zinc-air hearing aid batteries come in four standard sizes, labeled with standardized number and color codes. The four sizes, from biggest to smallest, are:

  • 675-blue
  • 13-orange
  • 312-brown
  • 10-yellow

Each hearing aid uses only one of the sizes, and your hearing specialist will inform you which size you will need. Bear in mind that the numbers and colors above are manufacturer independent, but that manufacturers sometimes add additional letters or numbers to its packaging.

Hearing Aid Battery Life

Hearing aid battery life is reliant on a multitude of factors. Many patients get up to one week of life out of a battery if they use the hearing aid for 12 or more hours a day, but this will differ based on:

  • The size of the battery – bigger batteries have a longer life.
  • The magnitude of hearing loss – More severe hearing loss demands additional power.
  • Hearing aid features – wireless capability, noise reduction programs, and multi-channel processing, for instance, call for more power to operate.
  • Temperature – hot and cold temperatures can diminish battery life.

Your hearing specialist will talk about all of this with you, and can help you find the right balance between hearing aid performance and battery life.

How to Lengthen the Life of Your Hearing Aid Batteries

You can very easily extend the life of your hearing aid batteries with one basic trick. Immediately after you remove the sticker to activate the battery, wait 5-7 minutes before placing the battery into your hearing aids. By removing the sticker and laying the battery flat side up for several minutes, air is able to properly activate the battery before you start using it, which lengthens its life.

A few other tips:

  • Keep the batteries away from coinage, keys, or other metal items that could short the battery.
  • When the hearing aid isn’t being used, turn it off and store it with the battery door open. If you don’t plan on using your hearing aids for an extended period of time, remove the batteries completely.
  • Unopened batteries can last for years; still, newer batteries are preferable because each year that goes by decreases the life of the battery.
  • Store your batteries at room temperature. This advice is so crucial that the next section is devoted to the subject.

How to Store Your Hearing Aid Batteries

There’s a dangerous myth out there advocating that storing your batteries in the refrigerator extends their life. This is not only incorrect; it produces the opposite result!

The reasoning behind storing your batteries in the refrigerator is that the cold temperature will slow the release of power. While this may be technically true, the amount of power you will save will be minimal, and the undesirable effects of moisture will produce far greater negative consequences.

Storing zinc-air batteries in a cold environment permits micro condensation to form in an on the battery, causing corrosion and a high risk of premature failure. Therefore, for ideal performance, simply keep your batteries away from extreme hot or cold temperatures and store at room temperature.

Maintaining Your Hearing Aid Battery Supply

Once you confirm how long your batteries last, on average, you’ll want to keep a month’s supply. If your batteries last 1 week, and you use 2 batteries (1 for each hearing aid), then you’ll end up using about 8 per month. Simply set 8 as your reorder target, and once you reduce your inventory down to 8, order an additional pack. Alternatively, you may want to look into the cost savings linked with bulk buys and maintain a supply that lasts longer than one month. If you’re not sure, we are more than happy to help you set up a strategy and will handle all of your hearing aid battery needs. Just give us a call!


Have any other questions? Speak with one of our hearing specialists today!

6 Ways to Save Your Hearing

The World Health Organization reports that 1.1 billion people are at an increased risk for noise-induced hearing loss, caused by exposure to excess sound levels from personal audio devices and noisy environments such as clubs, bars, concerts, and sporting events. An projected 26 million Americans already suffer from the condition.

If noise-induced hearing loss occurs from direct exposure to extreme sound levels, then what is deemed as excessive? It turns out that any noise more than 85 decibels is potentially dangerous, and regrettably, many of our daily activities expose us to sounds well above this threshold. An music player at maximum volume, for instance, reaches 105 decibels, and law enforcement sirens can hit 130.

So is hearing loss an unavoidable outcome of our over-amplified life? Not if you make the right decisions, because it also turns out that noise-induced hearing loss is 100% preventable.

Here are six ways you can save your hearing:

1. Use custom earplugs

The best way to prevent hearing loss is to avoid loud noise entirely. Of course, for most people that would lead to resigning from their jobs and ditching their plans to watch their favorite band perform live in concert.

But don’t worry, you don’t have to live like a recluse to conserve your hearing. If you’re exposed to loud sounds at work, or if you plan on going to a concert, rather than avoiding the noise you can lower its volume with earplugs. One possibility is to buy a low cost pair of foam earplugs at the convenience store, understanding that they will in all likelihood create muffled sound. There is a better option.

Today, several custom earplugs are available that fit comfortably in the ear. Custom earplugs are molded to the curves of your ear for optimum comfort, and they contain advanced electronics that lower sound volume symmetrically across frequencies so that music and speech can be heard clearly and naturally. Speak with your local hearing specialist for additional information.

2. Keep a safe distance from the sound source

The inverse square law, as applied to sound, says that as you double the distance from the source of sound the intensity level of the sound drops by 75%. This law of physics may possibly save your hearing at a rock concert; instead of standing front row adjacent to the speaker system, increase your distance as much as possible, balancing the benefits of a good view against a safe distance.

3. Take rest breaks for your ears

Hearing injury from subjection to loud sound is influenced by on three factors:

  1. the sound level or intensity
  2. your distance from the sound source
  3. the amount of time you’re exposed to the sound

You can lessen the intensity of sound with earplugs, you can increase your distance from the sound source, and you can also limit your cumulative exposure time by taking rest breaks from the sound. If you’re at a concert or in a recording studio, for instance, make certain to give your ears periodic breaks and time to recuperate.

4. Turn down the music – follow the 60/60 rule

If you regularly listen to music from a portable music player, make sure you maintain the volume no higher that 60% of the maximum volume for no longer than 60 minutes per day. Higher volume and longer listening times enhance the risk of irreversible damage.

5. Purchase noise-canceling headphones

The 60/60 rule is very difficult, if not impossible to abide by in certain listening conditions. In the presence of very loud background noise, like in a busy city, you have to turn up the volume on your MP3 player to hear the music over the ambient noise.

The remedy? Noise-cancelling headphones. These headphones can filter out ambient sounds so that you can enjoy your music without breaching the 60/60 rule.

6. Arrange for regular hearing exams

It’s never too early or too late to book a hearing test. In addition to being able to determine present hearing loss, a hearing exam can also establish a baseline for subsequent comparison.

Because hearing loss develops gradually, it is difficult to notice. For most people, the only way to know if hearing loss is present is to have a professional hearing examination. But you shouldn’t wait until after the damage is done to schedule an appointment; prevention is the best medicine, and your local hearing specialist can offer customized hearing protection solutions so that you can avoid hearing loss altogether.

The Psychology of Hearing Loss

If we genuinely want to understand hearing loss, we have to understand both the physical side, which makes hearing progressively more challenging, and the psychological side, which includes the lesser-known emotional responses to the loss of hearing. In concert, the two sides of hearing loss can wreak havoc on a person’s total well being, as the physical reality renders the loss and the psychological reality prevents people from addressing it.

The numbers tell the story. Even though virtually all cases of hearing loss are physically treatable, only about 20% of individuals who would benefit from hearing aids use them. And even among those who do seek help, it takes an average of 5 to 7 years before they book a hearing test.

How can we explain the massive discrepancy between the opportunity for better hearing and the widespread unwillingness to obtain it? The first step is to recognize that hearing loss is in fact a “loss,” in the sense that something invaluable has been taken away and is ostensibly lost forever. The second step is to figure out how individuals generally react to losing something valuable, which, courtesy of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand exceptionally well.

Elizabeth Kübler-Ross’ 5 stages of grief

Kübler-Ross observed 5 stages of grief that everyone coping with loss seems to pass through (in remarkably consistent ways), although not everyone does so in the same order or in the same time period.

Here are the stages:

  1. Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferred reality.
  2. Anger – the individual acknowledges the loss but becomes angry that it has happened to them.
  3. Bargaining – the individual responds to the feeling of helplessness by seeking to regain control through bargaining.
  4. Depression – understanding the weight of the loss, the individual becomes saddened at the hopelessness of the situation.
  5. Acceptance – in the last stage, the individual accepts the circumstance and exhibits a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the recovering of control over emotions and actions.

People with hearing loss progress through the stages at different rates, with some never getting to the final stage of acceptance — hence the discrepancy between the potential for better hearing and the low numbers of people who actually seek help, or that otherwise wait several years before doing so.

Progressing through the stages of hearing loss

The first stage of grief is the most difficult to escape for those with hearing loss. Because hearing loss advances slowly through the years, it can be very hard to recognize. People also have the tendency to make up for hearing loss by cranking up the TV volume, for example, or by forcing people to repeat themselves. Those with hearing loss can remain in the denial stage for years, saying things like “I can hear just fine” or “I hear what I want to.”

The next stage, the anger stage, can express itself as a form of projection. You may hear those with hearing loss state that other people mumbles, as if the issue is with everyone else rather than with them. People remain in the anger stage until they recognize that the issue is in fact with them, and not with others, at which point they may proceed on to the bargaining stage.

Bargaining is a form of intellectualization that can take various forms. For example, people with hearing loss might compare their condition to others by thinking, “My hearing has become much worse, but at least my health is good. I really shouldn’t complain, other people my age are coping with real problems.” You may also come across those with hearing loss devaluing their problem by thinking, “So I can’t hear as well as I used to. It’s just part of aging, no big deal.”

After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may enter a stage of depression — under the mistaken presumption that there is no hope for treatment. They may persist in the depression stage for a period of time until they recognize that hearing loss can be treated, at which point they can enter the last stage: the acceptance stage.

The acceptance stage for hearing loss is surprisingly elusive. If only 20% of those who can benefit from hearing aids actually use them, that means 80% of those with hearing loss never reach the final stage of acceptance (or they’ve reached the acceptance stage but for other reasons decide not to act). In the acceptance stage, people recognize their hearing loss but take action to correct it, to the best of their ability.

This is the one positive side to hearing loss: distinct from other kinds of loss, hearing loss is partly recoverable, making the acceptance stage easier to reach. Thanks to major improvements in digital hearing aid technology, people can in fact strengthen their hearing enough to communicate and engage normally in daily activities — without the stress and frustration of impaired hearing — permitting them to reconnect to the people and activities that give their life the most value.

Which stage are you in?

In the case of hearing loss, following the crowd is going to get you into some trouble. While 80% of those with hearing loss are stuck somewhere along the first four stages of grief — struggling to hear, damaging relationships, and making excuses — the other 20% have accepted their hearing loss, taken action to improve it, and rediscovered the joys of sound.

Which group will you join?

A Short Biography of Raymond Carhart, the “Father of Audiology”

Raymond Carhart

Most people are surprised to hear how young the discipline of audiology really is, and just how recently its founding father established the profession. To put this in perspective, if you wanted to find the founding father of biology, for instance, you’d have to go back in time by 2,300 years and read through the The History of Animals, a natural history text composed in the fourth century BCE by the Ancient Greek philosopher Aristotle.

In contrast, to find the founding father of audiology, we need go back only 70 years, to 1945 when Raymond Carhart popularized the term. But who was Raymond Carhart, and how did he come to produce a separate scientific discipline so recently? The story starts with World War II.

World War II and Hearing Loss

One of history’s most reliable lessons tells us that necessity is the mother of invention, signifying that challenging scenarios prompt inventions aimed at relieving the difficulty. Such was the case for audiology, as hearing loss was coming to be a bigger public health concern both during and after World War II.

Indeed, the primary driving force behind the progression of audiology was World War II, which resulted in military personnel coming back from combat with extreme hearing problems caused by direct exposure to loud sounds. While many speech pathologists had been calling for better hearing assessment and treatment all along, the multitude of people affected by hearing loss from World War II made the request impossible to ignore.

Among those calling for a new profession, Robert West, a respected speech pathologist, called for the development of the speech pathology field to include the correction of hearing in 1936 — the same year that Raymond Carhart would graduate with a Doctor of Philosophy degree in Speech Pathology, Experimental Phonetics and Psychology.

Raymond Carhart Establishes the New Science of Hearing

Raymond Carhart himself began his career in speech pathology. He received his Bachelor of Arts degree in Speech and Psychology from Dakota Wesleyan University in 1932 and his Master of Arts and Doctor of Philosophy degrees in Speech Pathology, Experimental Phonetics and Psychology at Northwestern University in 1934 and 1936. Carhart was in fact one of the department’s first two PhD graduates.

Following graduation, Carhart became an instructor in Speech Re-education from 1936 to 1940. Then, in 1940 he was promoted to Assistant Professor and in 1943 to Associate Professor. It was what took place next, however, that may have changed the course of history for audiology.

In 1944, Carhart was commissioned a captain in the Army to head the Deshon General Hospital aural rehabilitation program for war-deafened military personnel in Butler, Pennsylvania. It was here that Carhart, in the context of helping more than 16,000 hearing-impaired military personnel, popularized the term audiology, designating it as the science of hearing. From that point forward, audiology would divide from speech pathology as its own distinctive research specialty.

At the end of the war, Carhart would go back to Northwestern University to develop the country’s first academic program in audiology. As a skillful professor, he guided 45 doctoral students to the completion of their work, students who would themselves become notable professors, researchers, and clinical specialists throughout the country. And as a researcher, among innumerable contributions, Carhart developed and enhanced speech audiometry, especially as it applied to calculating the efficiency of hearing aid performance. He even identified a distinct pattern on the audiogram that indicates otosclerosis (hardening of the middle ear bones), eponymously named the “Carhart notch.”

Raymond Carhart’s Place in History

Of history’s founding fathers, the name Raymond Carhart may not be as well known as Aristotle, Isaac Newton, Albert Einstein, or Charles Darwin. But if you wear hearing aids, and you know the degree to which the quality of life is enhanced as the result, you might place Raymond Carhart on the same level as history’s greats. His students probably would, and if you visit the Frances Searle Building at Northwestern University, you’ll still see a plaque that reads:

“Raymond Carhart, Teacher, Scholar, and Friend. From his students.”

Questions to Ask Your Hearing Specialist Before You Buy Hearing Aids

Question Mark

When it’s time to purchase a car, the majority of us know exactly what to do. We conduct some research, compare options, and compile a list of questions to ask the dealership. We do this so that by the time we’re ready to visit the dealership, we have an idea of what we’re looking for and we know which questions to ask.

When it’s time to choose hearing aids, in contrast, many people don’t know where to get started. Even though the process is comparable to buying a car, it’s also in many ways more complicated (and probably not quite as fun). It’s more complicated because each person’s hearing loss is unique and each pair of hearing aids needs customized programming. If buying a car was like this, it would be like you bringing it home and having to install the transmission yourself.

Fortunately, you don’t need to know how to program your own hearing aids, but you do need to know the questions to ask to ensure that your hearing specialist covers all bases, correctly programming the most appropriate hearing aids for your requirements and lifestyle. In this way, producing a list of questions to go over with your hearing specialist is the single most important thing you can do prior to your hearing test.

But which questions should you ask? Here are 35 to get you started off, broken down by category:

HEARING LOSS

Specific kinds of hearing loss require specific kinds of treatment. The more you understand your own hearing loss, the better you’ll be able to compare hearing aid options. You need to know what type of hearing loss you have, if it will get worse, how soon you should treat it, and all of your treatment alternatives.

Questions to ask:

  • What kind of hearing loss do I have?
  • Do I have unilateral or bilateral hearing loss?
  • Can I have a copy of my hearing test?
  • Will my hearing loss get worse as time passes if left untreated?
  • Will hearing aids enhance my hearing?
  • How much of my hearing will hearing aids regain?
  • What are my other options besides hearing aids?

HEARING AID STYLES AND FEATURES

Hearing aids are sold in numerous styles, from several producers, armed with numerous features. You need a organized way to narrow down your choices to assure that you get the best hearing aid without wasting money on features you don’t need or want.

Questions to ask:

  • How many different kinds of hearing aid styles do you offer?
  • Which hearing aid style is most beneficial for my needs and lifestyle?
  • Which digital features would be beneficial to me, and which could I do without having?
  • What are telecoils and directional microphones and do I need them?
  • Do I need Bluetooth compatible hearing aids?
  • Do my hearing aids need to be professionally programmed?
  • Do I need one or two hearing aids, and why?

HEARING AID PRICES, FINANCING, WARRANTIES, AND TRIAL PERIODS

The total price of a pair of hearing aids often includes the professional fees associated with custom fitting and programming, along with several other services or accessories. You want to ensure that you understand what you’re receiving for the price, if financing is available, if insurance will help, what the warranty protects, the length of the trial period, and if any “restocking fees” apply to the end of the trial period.

Questions to ask:

  • What is the total price of the hearing aids, including professional services?
  • Do you provide any financing plans?
  • Will my insurance coverage help pay for hearing aids?
  • How much will my hearing aids cost me per year?
  • Do the hearing aids have warranty coverage?
  • How much do hearing aid repairs cost after the warranty has expired?
  • Are repairs completed at the office or somewhere else?
  • If my hearing aids have to be sent out for repairs, are loaner hearing aids supplied?
  • Is there a trial period and how long is it?
  • Is there a restocking fee if I return my hearing aids during or after the trial period?

HEARING AID OPERATION, CARE, AND MAINTENANCE

Your hearing specialist should explain to you how to care for, clean, and control your hearing aids. To make certain that nothing is forgotten, make sure all of these questions are answered:

Questions to ask:

  • How do I operate my hearing aids?
  • How do I use hearing aids with telephones and other electronics?
  • Can you show me how to use all of the buttons, features, and settings for my hearing aids?
  • What are environmental presets, and how do I access them?
  • Do I need a remote control, or can I use my smartphone to operate the hearing aids?
  • What batteries do I need, how long will they last, and how do I replace them?
  • How should I clean and store my hearing aids?
  • Do I need to come back for follow-up visits?
  • How long will my hearing aids last?
  • Do I need to update the hearing aid software application?
  • Do I become eligible for future hearing aid upgrades?

YOU’RE READY TO SCHEDULE YOUR HEARING TEST

Ok, so purchasing a pair of hearing aids may not be as enjoyable as shopping for a new car. But the quality of life you’ll obtain from better hearing might very well make you more happy, as you’ll reconnect with people and appreciate the intricacies of sound once again. So go ahead and schedule that hearing test — your new pair of hearing aids are waiting for a test drive.