Good fit, trial period critical for effective hearing aids

Daily Press (Newport News, Va.) (MCT) - For some, the sound is that of crickets chirping, for others it's bacon frying, or even a high-pitched ringing sound.

These inside-the-head noises are symptomatic of tinnitus, a side effect of damage to the nerve endings in the inner ear and its accompanying hearing loss. Ironically, such hearing loss may also involve a heightened sensitivity to loud noises, says audiologist Deborah Minnis.

She's explaining the basics of sensorineural hearing loss to a group of 50 at a free seminar at Sentara CarePlex Hospital in Hampton, Va. Everyone over the age of 60, she notes, has some loss, usually at the high-pitched, high-frequency range. Many can be helped by the use of hearing aids.

As the only hospital-based audiologist in the Hampton region, Minnis has the luxury of recommending hearing aids to those who need them on the basis of need and fit.

"Our key message is rehabilitation, not retail," she says, explaining to the group that her salary is not dependent on the sale of any assistive devices.

As an audiologist she holds a doctorate involving several years of study beyond undergraduate training.

Yet, the only requirement for a state license as a hearing-aid "specialist" _ they sell the bulk of devices in the retail market _ is a high school diploma.

"We all know people who have hearing aids in their dresser drawer," says Minnis. There are several reasons that people purchase hearing aids, then don't wear them, she says. Among them are unrealistic expectations, poor fit and the noises that result, discomfort from wax buildup, and issues with the dexterity necessary for putting them in place and changing batteries.

In the audience, Beatrice Holmes, 57, fits the mold.

She paid $4,000 for hearing aids a couple of years ago. They're now tucked in her pocketbook.

"They would 'ring.' I would hear myself chewing _ I'd hear everything but what I wanted to hear," she says.

Likewise, Rachel Feller of Yorktown, Va., now in her 80s, gave up wearing hers a decade ago, but she's more concerned with solving the pain her husband, William, is experiencing from an aid he's been using for three months.

Then there's Ken Beachum, 76, who drove from Toano, Va., to learn about the latest models. He's wearing an older pair of in-ear devices which he notes are effective in church, for example, but don't help him in social situations when there's background noise.

The newer technology, as Minnis explains, is increasingly helping to diminish unwanted feedback and ambient noise while providing the desired amplification.

Hearing aids aren't cheap and they're not covered by Medicare or by most private insurance companies.

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Digital, programmable styles vary in cost from about $1,000 for an "entry level" model to $3,000 for the best sound processing available.

They may look identical, but the essential difference is in the sophistication of the electronics used.

Minnis reassures, though, that there are many effective ones that fall in the middle price range.

The least expensive are just microphones, others have microchips that process sound. That's where Minnis' expertise comes in.

After administering a hearing evaluation, Minnis programs each device to the individual using a Bluetooth programmer with a Noah link. It transfers live data to a computer so she can determine the best outcome. "It's like testing glasses. I can ask what works best for them as they're trying it," she says. "With wireless I can even walk them down to the cafeteria and test it there in a different environment. It's really fine-tuned."

She recalls that when the first programmable hearing aids came out a decade ago, audiologists went overboard. You could have a program for every situation, one for the bowling alley, one for the restaurant, and so on, and the wearer had a push-button switch to choose. "We quickly realized you don't want a zillion programs and that one really good program was better," she says.

The hospital carries half-a-dozen brands of "world-class" hearing aids, all from companies involved in cutting-edge research.

At the meeting, Sandra Davis, a representative of Oticon, demonstrated its latest model, the Delta, a tiny triangular open-ear device that comes in a palette of 18 zany colors. Forget the flesh-colored lump with the visible on/off switch that blocks the entire outer ear, in this open-fit model, the amplifier with two tiny built-in microphones literally disappears behind the ear, while a wire, almost like a wisp of hair, holds the receiver in place near the ear drum.

"There's no stigma any more. Now you're high-tech if you have something colorful in your ear," says Minnis.

For those who need hearing aids in both ears _ Minnis emphasizes the importance of balanced hearing, "otherwise you may be able to hear a pin drop, but you won't know where it is" _ these actually communicate wirelessly with one another.

"In the old days it was really hard for people to adjust the volume appropriately in each ear," says Minnis. "With these, they're constantly scanning for sound and adjusting, blocking background noise and amplifying speech."

For first-timer Linda Mitzel, 69, of Hampton, exploring hearing aid options accompanied by her husband Bob, the seminar was reassuring. She was also impressed by the Delta's design and its ease of installation. "It's amazing, it's so small. I put it on in just a few seconds," she says.

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Here's a sampling of the questions and answers from the audience:

Q: What is the life span of a hearing aid?

A: Six to seven years, though some may last as long as 12 years.

Q: Is there a trial period?

A: Yes, 30 days is standard.

Q: How long does a battery last?

A: Anywhere between a week and two weeks; the larger batteries last longer. They cost a little less than $1 each and are available at any store with a pharmacy.

Q: How moisture-proof are they?

A: More than they used to be. Some have a "nano-coating" that's designed to be water-resistant and lasts 10,000 touches.

Q: Can I wear them with glasses?

A: Yes, they fit really close to the ear; but there may be a problem if you wear reading glasses and are constantly removing and replacing them.

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© 2008, Daily Press (Newport News, Va.).