Do you find yourself or someone you know making these comments? If so, you’re not alone. More than 28 million Americans have hearing loss, many of them suffering the less-than-pleasant side effects involving the inability to follow conversations or tinnitus (persistent “ringing” in the ears) , either of which often times results in social withdrawal.

May is “Better Speech & Hearing Month” -- a time of year when we as hearing professionals reassess how well we are serving the needs of the hearing impaired and, more importantly, how we can improve our effectiveness and availability.

Drawing on our experience of 30 years of caring for people with difficulty hearing, the following article covers frequent questions and a few observations that we thought it might be worthwhile to share with you as you browse our site.

It often takes a good deal of time for one to address the reality of a hearing problem.

It is not pleasant to slowly realize that "I really just don't hear the way I should"

Many of us, once tested, show signs of a significant hearing loss and yet still feel that we “have no trouble hearing others”. This points out that it is important to define how well we “hear” versus how well we “understand” … two entirely different functions.

Let's look at the difference between "hearing" speech and "understanding" speech. To better grasp the "hearing" of speech, we need to better understand key frequencies or “pitches”. Some of the key “speech frequencies” are lower in pitch (a male voice) and some are higher in pitch (a female voice). Those speech frequencies that are lower in pitch mostly reflect sounds associated with a speaker’s voice or “voiced sounds.” If we can hear these lower speech frequencies, we will recognize that someone is trying to speak to us and will know to attend to that person. This is demonstrated by the fact that one may hear (but not necessarily understand) a lower male voice when a higher female voice would be missed.

The issue of "understanding" what others are saying (versus simply "hearing" them talking) is answered by how well or how poorly we hear the higher pitch speech frequencies. These softer, higher pitches offer us the clarity or, again, the “understanding” aspect of communication. The majority of us suffering from presbycusis (age-related hearing loss) often lose our ability to hear the higher speech frequencies first. Consequently, we feel we have no trouble communicating as we can "hear" that someone is talking to us but we can't understand what they are saying. This, of course, leads to inappropriate responses to questions and the inability to contribute meaningfully to conversations. Nothing could be more embarrassing. Unfortunately, noisy environments (like restaurants, movies, parties or meetings) make this situation even worse. This is because the background noise very effectively “masks” or drowns out those softer, higher frequencies that we need to "understand" the speech.
So it is that there are two parts to speech -- the "hearing" of it (which we may be able to do and therefore don't think we need a hearing aid) and the "understanding" of it (which is the piece we are missing and therefore need amplification).

In addition to age related hearing loss (due to a decrease in function of the nerve of hearing), there are other conditions related to the middle ear (referred to as conductive hearing losses). These often involve the tiny middle ear bones (the malleus, incus and stapes which are also known as the “hammer, anvil and stirrup”) or the middle ear (the space just behind the eardrum). Most of these middle ear disorders can be appropriately treated or managed medically or by surgery -- occasionally hearing aids are also helpful in these situations. Otosclerosis (a disease involving the small stapes bone in the middle ear) is often effectively managed with hearing aids.

Tinnitus ( constant ringing, buzzing, rushing or roaring in the ear) frequently occurs in conjunction with a hearing loss. In this situation, it is often possible to treat by using a hearing aid alone. Frequently, it is necessary to add a second circuit to the hearing aid which is known as a sound generator. This type of combination instrument is also a very effective treatment for tinnitus. These two types of treatment for tinnitus are part of the state-of-the-art treatment for this condition referred to as Tinnitus Retraining Therapy(TRT) which is thoroughly discussed in another section of this web site.

I'm now ready to try a hearing aid, but am practically cross-eyed over all the choices … what type of technology (analog or digital) … how big … how small … which are the best manufacturers?

During the first meeting with our team of hearing professionals your most recent hearing evaluation is reviewed in detail to determine which instrument would suit your hearing loss best. We need to know what you expect to get out of the hearing aid and how you expect to benefit from it -- what types of daily situations or listening environments make you most frustrated. We also need to know how challenged your hearing is on a daily basis in order to decide how complex the technology in your hearing aid needs to be. Technology ranges from baseline digital circuits, offering fine hearing clarity in most environments, all the way up to advanced, multi-channel circuits with directional microphones, providing you with optimal hearing and understanding in noisy environments. The instrument can be large (BTE- behind-the-ear) or small (CIC-completely in the ear canal) which is the least conspicuous. Sitting with our experienced team will very quickly “narrow the field” and help you get about the task of selecting the right technology to suit your needs.

Another commonly asked question is whether I need an aid in one ear or both ears? Most frequently, the best hearing improvement is gained through using two hearing aids. Less frequently, a single aid will provide the maximum benefit. All of our hearing aids are fitted on a free trial basis for approximately one month. Consequently, this question is frequently best answered by trying two hearing aids for a week or two and then removing one aid -- using a single aid for a week or two and deciding for oneself which is best.

It is important to remember that a hearing aid is only as good as it benefits the wearer. It is therefore me (the one buying the hearing aid) who should decide whether a given pair of hearing aids or a single hearing aid meets my expectations. This can always be achieved through the free trial process.

Hearing aids are custom made to the exact shape and size of the ear canal it will fit. The first step is the making of an impression of the ear canal which takes about five minutes. This is sent to the manufacturer of the selected hearing aid so that the portion of the hearing aid which fits into the ear canal will fit your ear canal perfectly. The finished hearing aid or hearing aids are then returned to us and you are notified to come to our offices for the final fitting. In every case, the first month is a free trial period during which the instrument may or may not need to be adjusted.

The hearing aid fitting process is not a simple straightforward process, but rather involves some of the "art of medicine".. We are integrating a complex piece of technology into an individual lifestyle … and EVERYONE IS DIFFERENT. Two people with very similar hearing loss will experience the same hearing aid in very different ways. One person may like the hearing aid to offer a very sharp, crisp, response with significant high frequency or high pitch gain; another person may find this sharp, “crisp” response too sharp or “tinny.”

One may be using the hearing aid around a conference table in a boardroom.

One may be at home alone most of the day.

One may work in a busy restaurant with significant background noise.

These are entirely different situations and require entirely different hearing aid settings and treatment goals.

In the process of fitting the hearing aid, technological skill and expertise is important -- but the "art of medicine" is indispensable.

I think the time has come for me to get a hearing aid -- but I need to ask some questions and get some advice without feeling obligated to buy an instrument.

After thinking about the advice, I have decided to get a hearing aid -- but I still need to ask questions and better understand the options without being, or feeling, pushed.

Having ordered the hearing aids and put down my money -- I look forward to having the aids fitted with the same degree of interest in my hearing problems as prior to my decision to purchase.

I look forward to the "thirty-day free trial period" as a time for me to freely decide whether the hearing aids truly benefit me. If not, I will feel free to return them for full refund.

We work hard -- day in and day out -- patient by patient -- to meet each of these assumptions -- in keeping with our mission statement:

"To treat each patient as we would wish to be treated if we were the patient.