Download 8-20-2009 Brad Ingrao - Hearing Loss Association of America

Chat Transcript
“What should I expect from my audiologist
or hearing instrument specialist?"
Guest Speaker: Brad Ingrao Au.D.
August 20 2009 at 9 PM (EDT
Moderator
Good evening. Our topic tonight: “What should I expect from my audiologist or hearing
instrument specialist?"
Our program this evening will be moderated throughout the next hour. We will first answer any
questions sent in advance, and then you may type in your questions below and click “ask”. We
will do our best to answer all of your questions.
Our Guest Speaker is Dr. Brad Ingrao filling in for Mark Ross who could not be with us this
evening.
Brad Ingrao, Doctor of Audiology, and has presented and been published in journals and trade
magazines internationally on the topics of earmold technology, computer automation and
integration and accessibility for individuals with hearing loss. Dr. Ingrao is currently a Clinical
Supervisor and Lecturer in the Doctor of Audiology program at the University of Maryland,
College Park.
Dr. Ingrao has been a guest speaker in the HLAA chat room before and we are fortunate to have
him with us again tonight. Welcome Dr. Ingrao
Dr._Ingrao
Thanks Toni, it's a pleasure to be here. Dr. Ross wanted me to express his regrets for not being
able to be here due to a family medical situation. HLAA is near and dear to him.
Moderator
Thank you Dr. Ingrao. Ok. Let’s get to the questions right away.
Jim Grennan asks:
How can we who insist on hearing as best possible, or best affordable, urge the use of facilities
that provide assistive devices such as museums, live theatrical plays, etc? How can we get
facilities that provide assistive devices for hearing advertise the availability of such devices?
Dr._Ingrao
I'll post Dr. Ross's original answer to this question as I can't do better myself. :-)
Many of these places are required by the ADA to provide assistive listening systems.
Unfortunately, too few consumers utilize them when they are available and when they are not,
too few make a direct approach to management to ask that they be provided. I’ve tried the direct
approach a number of times and it does work. When the request is made on behalf of some
HLAA chapter the import is greater. The Center for Hearing and Communication in NY
(formally the League for the Hard of Hearing) hosted a consumer group (called ABC) who were
very effective in this regard.
Andrea Shah asks:
What is the best way to teach a child to not be ashamed of their disability? How do you answer
questions from other children regarding a hearing loss? It is very hard to explain to a young
child. They just get looked at as different or weird.
Dr._Ingrao
Another of Dr. Ross's answers
It’s been years since I personally have been faced with this issue, but it still comes up and still as
important as ever. As far as I know there is no one perfect answer. I think one important key is
self-acceptance and building self-esteem in some way (sports, academics, extra-curricular
activities, etc.) Trying to get the point across that everyone is different in some respect. But since
this is not an area that I’ve dealt with in recent years, my suggestion is that you contact your
school’s educational audiologist or speech-language pathologist and ask them for their advice.
I’m sorry that I can’t be more helpful.
Dr._Ingrao
As the parent of a Deaf child, let me add that I also made sure my son had lots of exposure to
both deaf and hard of hearing folks which helped him a lot.
Mike Corso asks:
Are you fitting your patients with the BAHA by Cochlear and how is the outcome with them? I
think it is a great device for SSD people so much going on in the bone conduction tech. today.
My son and I had the surgery and I should be getting my new BP100 that is taking over the
Divino in the beginning or middle of Aug. Thank you for your time. Mike Corso
Dr._Ingrao
Dr. Ross's answer will be up shortly, but let me add that clinical outcomes are available from
Cochlear.com
.
Dr._Ingrao
Dr. Ross said:
I’ve been retired from clinical work for years now and what I know about the BAHA is what I’ve
been reading about it for years. I have used bone-conduction hearing aids many years ago, that
worked very well (with some comfort issues), and the BAHA is clearly an improvement. But
subject candidacy is still a key. But since your son and you had the surgery, I consider you the
expert! Please let me know how you make out. Do you have a conductive component to your
hearing loss?
George H Stair Jar asks:
I currently wear 2 BTE Hearing Aids. I am ready to get another pair of hearing aids. My hearing
is too severe for the small things that go into your ears. I do not like earmolds because they cause
my ears to get scabs & dermatitis according to my ENT Doctor. Do you have any suggestions for
the type of hearing aids that I should look for?
Dr._Ingrao
Once again, I can't do better than Dr. Ross... His answer to George's question: If your loss is “too
severe” then I suspect you’re not a candidate for a BTE with non occluding earmolds. Though I
think that it may be worth trying with an aid with an effective feedback management system.
There are also earmolds that use non-allergenic materials that may be more benign to your ear
canals. Somehow, however, you have to get the sounds into your ear canals (it doesn’t sound like
you are a candidate for a BAHA). Good luck and don’t give up.
Suma Kote asks:
Dear Dr. Ross: I am 55 years old, have cochlear otosclerosis with severe progressive hearing
loss. I have been advised to have CI, by otologists. I was advised to make sure I have great
audiology team for after CI rehabilitation & that is the most important fact in choosing where to
get the surgery done. Could you comment on what I should look for when meeting the CI
audiology team? I am sorry if I deviated from your topic of the day. Also would the audiologists
be able to help me use stethoscope via CI? I am a physician internist.
Dr._Ingrao
Dr. Ross sent in a great multi park post. Here is part one: The CI centers I know of all have
guidelines that describe their services, follow up schedules, etc. I’ve always trusted my instincts
on meeting prospective medical providers, of any kind, and I think you are probably in a better
position to do this than I am. Insofar as using a stethoscope with a CI, I am appending an excerpt
of an article written for Audiology Online that answers your query better than I could. I hope that
you find this helpful.
An excellent resource for support and information is a non-profit organization called Association
of Medical Professionals with Hearing Losses (AMPHL). Their website has a stethoscope link
that can be accessed from their homepage at www.amphl.org. The direct link is
www.amphl.org/stethoscopes.php. You will find information about using various assistive
listening devices to couple the cochlear implant processor with a "specialty" stethoscope.
A stethoscope with direct audio input capability (DAI) such as Cardionics' E-Scope II allows one
to connect the stethoscope to their cochlear implant processor and/or hearing aid with a patch
cable or inductive accessory such as a silhouette or neckloop. There is also a device available
that can augment what you are hearing with visual readouts of heart/breath sounds used in
conjunction with a PC or PDA. More information about Cardionics products can be found at
www.cardionics.com/stethoscopes/
Barbara L. Chertok asks:
Please tell the viewers what the difference is between a certified audiologist and a hearing
instrument specialist?
Dr._Ingrao
A certified audiologist is a Hearing Care Professional who holds the Certificate of Clinical
Competence (CCC-A) from the American Speech-Language Hearing Association
(www.asha.org). This requires at least a Masters Degree (changing to a Doctorate in 2012) from
an accredited university, completion of 1820 hours of clinical practicum, and the completion of a
national exam.
Minimum qualifications for Hearing Instrument Specialists are determined by state law, however
additional training and certification are available from the National Board for Certification in
Hearing Instrument Sciences (http://www.nbc-his.com/home.htm) and the American Conference
of Audioprosthology (http://ihsinfo.org/IhsV2/Education/028_ACA.cfm) offer additional and
comprehensive training and certification for Hearing Instrument Specialists.
It is important to note that for the majority of patients, it is less important WHO fits their hearing
aids, than HOW. If any of the above follow well researched and peer-reviewed best practices
including speech in noise testing and Real Ear Measurement, then it is reasonable to expect good
outcomes regardless of the degree or certification of the practitioner.
Cynthia Harmon asks:
Is there any research or other information on the best way for an audiologist to approach
programming when a patient is wearing a hearing aid on one ear and has a cochlear implant for
the other (i.e. have both devices on during programming or only do one at a time)?
Dr._Ingrao
Bimodal patients are still quite a challenge for Hearing Health Care practitioners. Many expert
hearing aid fitters are not versed in cochlear implant mapping and vice-versa. I am not aware of
any specific research that supports one method over the other; however, I predict that as the
number of implant recipients’ increase, this will require more research and creative crosstraining.
Joanne Karpowitz asks:
I have completed the Peer Mentoring training program at Gallaudet. When I speak with many
persons in their 70's & 80's with adult onset hearing loss I discover that they have purchased two
ITE aids that they keep in their pockets. Many have arthritis and find the ITE difficult to handle.
As clients they are not satisfied customers and feel disappointed and cheated by their
audiologists. BTE aids were never suggested to the client, nor was the possibility of beginning
the journey with only one aid. Please explain why you think this is the case. Thank you. Joanne
Karpowitz
Dr._Ingrao
Joanne, There is, unfortunately, no way for me to answer your question, as I am not in the offices
where this occurred. I can say that while I do understand your point of a slower journey, clinical
research strongly supports binaural amplification to maximize understanding of speech in noise,
aid in localization and to ensure that impaired ears do not atrophy and lose the ability to
maximize benefit from amplification at a later date.
Lisa Matthews asks:
I was born with sensorinueral hearing loss. I currently have a moderate to severe loss. It is a
cookie bite type of loss and I do suffer more in the mid-high frequencies. I am finding it very
difficult to find a hearing aid that works for me. Besides having a cookie bite loss I also have
very tiny ear canals and there is a slight bend in the right ear. What is your advice when dealing
with these types of obstacles? I do not wear aids currently as I gave up on my last ones several
years ago. Fortunately, I am a good lip reader and do not work outside the home so I am able to
function in a majority of situations. I would like to be able to use the small BTE's that are on the
market right now but I am worried about the molds or ear domes being uncomfortable in my tiny
ears. Thanks!
Dr._Ingrao
Lisa, Current hearing aids should be able to handle the cookie bite nature of your loss as most in
the “mid level” and certainly “premium” digital ranks have multiple frequency channels which
your Hearing Care Professional can adjust to meet your needs.
As for your small ears, it should be possible to make a custom earmold and use it with a “thin
tube” BTE. We make earmolds for infants all the time, so it’s certainly within the realm of
possibility. I’d contact your Hearing Care Professional and set up an appointment to investigate.
Don Hutchinson asks:
What do you think of the quality of hearing aids like the Bell & Howell Silver Sonic and the
Sonic Ears.
Dr._Ingrao
Don, these products are not hearing aids, but rather “personal amplifiers” (according to the
FDA). I haven’t personally analyzed them, but based on what I have seen, they are very simple
amplifiers with non-custom ear couplings. As such, they will be a “what you hear is what you
get” solution and will not offer much, if any, ability to customize to your loss. It would not be in
your best interest to pursue ANY amplification for a hearing loss without seeing a qualified,
licensed Hearing Care Professional.
David Heuvelman asks:
Will my hearing aids ever function like natural hearing? I have tried 4 different styles and
manufacturers, and none will help understand conversation in a crowded room. Background
noise is amplified to an extreme, and also the frequencies are distorted.
Dr._Ingrao
David, unfortunately, the answer to your question is no. No artificial hearing system (hearing
aids, ALDs, cochlear implants) will restore normal hearing.
The second part of your statement may be helped with an Assistive Listening System which can
improve the quality of the signal and make it more prominent relative to background noise.
Unfortunately, the distortion you hear may be an indication that your hearing loss is beyond the
capabilities of hearing aids. Discuss this with your Hearing Care Professional and see if you
might be a candidate for a Cochlear Implant evaluation.
Bob Norfleet asks:
In a quiet office, my Audiologist makes a Hearing Aid adjustment, and asks "does that sound
better?" Never does because I am not used to the tone/volume/ switch setting and so on. I say "I
will try it out" and maybe come back in a few weeks, in its unbearable. It is there better way?
Dr._Ingrao
Bob, in fact there is a better way. Current Best Practices recommends Real Ear Measurement
and/or Speech Mapping to verify that hearing aids do the following: 1) Make quiet speech
audible 2) Make average speech and other sounds comfortable 3) Prevent loud sounds from
becoming uncomfortable
These systems can also verify that directional microphones and noise reduction systems are
functioning appropriately.
Judith Shaw asks:
I have a profound sensorinueral hearing loss and wear Phonak Supero Bycross. I've had for 5
years. I started looking for a new hearing aid and tried the Naida (the most powerful one) by
Phonak and the Unitron 316. Neither one had enough power for me even though on paper they
should have had enough. Is the new digital technology different than my current aid? I was told it
was linear whatever that means. Could you explain or tell me what is the most powerful BTE
hearing aid is for profound deafness? Thank you.
Dr._Ingrao
Judith, linear means that the hearing aid amplifier does not use compression. Nearly all current
digital aids, even those made for profound losses, have the ability to use this to some extent. If
you are used to little or no compression, then most aids, including the two you mentioned, can be
set by your Hearing Care Professional to be more linear.
Your Hearing Care Professional may need to contact the manufacturer for some assistance in
doing this, as it’s not the typical way these aids are programmed. Also, ask your Hearing Care
Professional to check and make sure your earmolds are optimized. I prefer the Continuous Flow
Adapter tubing system for most of my patients, especially those with profound losses.
Joan Raphael asks:
Is there ever going to be a hearing aid mold that is comfortable but doesn't have enormous
feedback? I'm wearing earmolds that are not as big as the usual ones since I tend to get sores in
my ear from the pressure. But now it squeals almost nonstop. It drives everyone, especially me
nuts!
Dr._Ingrao
Joan, this is my area of particular interest. Earmolds that are ACCURATE are both comfortable
and prevent feedback for the majority of folks. Unfortunately, when the earmold lab sees that
feedback has been a problem, they often build-up the impression to the point that it loses the
precise anatomical features of your ear canal.
Ask your Hearing Care Professional to request “minimal buildup – no dipping” with your next
earmold. Also ask to try out Comply Canal Tips as an alternative.
Allen Warren asks:
It seems to me that the correct fitting of hearing aids is the most important thing for the patient.
Without it the results are minimal. Do you think "Real Ear" measures should be given to all
patients routinely during every hearing aid selection and follow up appointments. This seems like
it's the best way to get a proper fit.
Dr._Ingrao
Absolutely. Current best practice documents from leading professional associations specify Real
Ear with speech or speech-like signals for all fittings.
Cynthia Harmon asks:
What type of testing should be done to assess improvement in hearing function after a hearing
aid fitting (before vs. after the aid). At what intervals post fitting would such testing be
appropriate?
Dr._Ingrao
Cynthia, as stated above, Real ear Measurement is strongly recommended. In addition, a good
objective and subjective self report such as the Abbreviated Profile of Hearing Aid Benefit
(APHAB) and the Client Oriented Scale of Improvement (COSI) should be completed pre-and
post fitting (about 4 weeks out).
I also advocate speech in noise testing (HINT or Quick SIN) before and after hearing aid fitting.
These measures should be repeated whenever new hearing aids are fitted, or when additional
technology like an ALD is added to the mix.
Michael Spiegel asks:
Is there a cell phone dispensing co. that will blend their cell phone with the customer's particular
hearing loss? I seem to hear better with a cell phone than I do with a land phone. Better is not
quite good enough. It just seems that the cell phone needs "fine tuning" adjustment for my
particular hearing loss, which is a sensorinueral hearing loss. Do cell phone companies have
CONVENTIONS---if so, when & where.
Dr._Ingrao
Michael, This is coming in the not too distant future, however if your hearing is impaired enough
to need this feature, I would recommend seeking evaluation and treatment from a qualified,
licensed Hearing Care Professional, as you likely can benefit from assistance in other areas of
your life.
All the cell phone carriers are exhibitors at HLAA's convention, which is a GREAT place to
check out the best new technology.
Karen Runge asks:
My hearing loss is single-sided due to vestibular schwannoma resection 5-years ago in one ear
and am having mild-hearing loss in the good ear. Recently during a hearing exam I was
diagnosed with Tulio syndrome as the low-tone part of the test had me falling off the chair and
feeling sick. Not much has been discussed with me as to how to live with the vertigo caused by
sound, mostly with low tones. There are many places I can no longer go to without risking
falling (grocery store, restaurants, movies, motor cycles passing by on the street). I have come up
my own remedy with a total sound blocking ear plug, but one audiologist said I could be setting
myself up for hyperacusis. This is a double edged sword, but I'd rather not deal with the vertigo
as I am already balanced challenged due to the resection of my vestibular nerve. What do I do?
Will my hearing loss increase faster than normal for a 53-year-old?
Dr._Ingrao
Karen, I would have to agree with your audiologist regarding your use of an earplug; however
that does not mean you need to suffer. There are two well established treatment programs for
hyperacusis that your audiologist should be able to research. One is called Tinnitus Retraining
and the other is called How to Manage Your Tinnitus from NCAR in Portland.
I wish I could answer your second question, but we have no crystal balls. Have your hearing
tested every 6 to 12 months and stay in contact with your audiologist. If you haven’t done so
already, join the Acoustic Neuroma Association for support and resources.
Elisa Williams asks:
When did Audiologists add the practice of dispensing hearing aids? Why are audiologists getting
into the dispensing of hearing aids when there are already hearing aid dispensers?
Dr._Ingrao
Elisa, in the mid 1970’s the prohibition on audiologists dispensing was lifted. We do it because,
like Hearing Instrument Specialists, audiologists are full service Hearing Care Professionals.
It's really not as important what kind of professional one sees, but that they ask the right
questions. The HLAA consumer checklist is a great way to do this.
Moderator
For those wishing to download the Consumers Checklist may do so here:
http://www.hearingloss.org/learn/docs/HLAAHearingAidChecklist_4-14-2009.pdf
Cindy Johnson asks:
When I pay $5,000 for hearing aids, what am I paying for? Certainly the plastic and parts don’t
cost all that much?
Dr._Ingrao
Cindy, you are correct. The “parts” do not cost nearly that much, however it takes much more
than parts to bring a hearing aid to market. Research and development of the processing chip,
fitting software development, warranty service, marketing, training and sales all enter into the
equation of the price the hearing care professional pays.
Then their professional time, follow-up service, overhead, marketing, etc. are added to come up
with the total price you pay.
Anthony Ferack asks:
1) I expect the audiologist to know how to program these digital aids. After 3 visits, I finally told
them to 'open them up'. These do not perform as well as my old analogs. Why?
2) Why are we users that liked the analogs referred to as "power freaks"?
Dr._Ingrao
Anthony, I can’t speak to your audiologist’s specific expertise with your hearing aids, but to be
fair, current hearing aids are quite complex, as are the fitting programs. There are certain
parameters which are hidden to the hearing care professional, so it’s possible that your
audiologist know what to do, but isn’t directly able to based on the software.
Analog hearing aids were often much more “linear” than current digital aids. This resulted in a
perception of more loudness. The trade off was that often, then aids provided too much or too
little amplification.
Current aids use compression to amplify differently based on the input sound. The down side for
an experienced analog user is that it seems too soft, muffled, not “open.”
The name “power freak or junkie” comes from this difference. The good news is that with some
cooperative work, you and your audiologist should be able to find a happy medium.
Dario Williams asks:
What questions should I be prepared to answer when I visit my hearing aid dispenser? I want to
be sure I have well prepared answers.
Dr._Ingrao
Dario, it’s important and helpful to report the following: 1. History of surgery or medical
problems resulting in hearing or balance changes 2. Family history of hearing loss 3. History of
loud sound exposure 4. History of tinnitus, ear pain or dizziness 5. Having a good idea of which
*specific* situations you have difficulty hearing and understanding
In addition, the checklist Toni just linked to is a great way to keep organized
Denise Pruitt asks:
I have profound hearing loss in one ear due to otosclerosis and recently got my first hearing aid.
The programs worked very well for me until I had a direct audio input program put in for me to
listen to my MP3 player and audio books in stereo. Since then, my regular programs (everyday
listening and noisy room listening) just don't seem the same. They are muffled and not crisp in
language recognition. Adjustments don't seem to do much good. Do I need to let the quality of
the MP3 suffer in order to have better every day hearing? The tech messed with the treble and
the bass for the MP3 player to sound better and I'm afraid it has removed sounds for my other
programs. Thank you, Denise
Dr._Ingrao
Denise, without knowing the specifics of your hearing aid and MP3 player, it’s difficult to know
for sure, but I suspect that there may be a defect in the hearing aid. Usually, changing one
program does not affect others like this, so I would recommend having the practitioner send the
aid, boot, DAI cord and MP3 player in to the manufacturer to be evaluated.
Tiffany Warren asks: What is a reasonable Trial Period for new hearing aids and can they ever
be extended?
Dr._Ingrao
Tiffany, minimum trial periods are set by state law, but usually average 30 to 45 days. Hearing
Care Professionals may, and often do, extend these us to a maximum of 60 days. Beyond that,
their ability to return the aid to the manufacturer is compromised.
Doreen McCarthy asks:
I have 2 BTE aids ,I have had many and I have an issue with NONE of them really helping me
all that much ,I also notice that when I remove them I can hear better and louder BUT cannot
understand what is still being said ....... very unsettling ?? What can I do as I am NOT able to get
a CI?
Dr._Ingrao
Doreen, without more specifics, it’s not possible to give a definitive answer, however, I’m
suspecting that your hearing aid-earmold system may not be optimized for the acoustics of your
ear canals. Ask your Hearing Care Professional to perform Real Ear Measurement, particularly
looking at the “insertion loss.” A minor modification in the shape of the sound bore of the
earmold may help.
I would also recommend that you discuss Assistive Listening Technology and aural
rehabilitation with your Hearing Care Professional.
James Chasse asks:
Hearing aids are produced to allow different "programs" for different circumstance. Within each
program the aids are sold to allow many channels (frequency) adaptations for the user. Prices
vary somewhat with higher numbers of response potentials. But when the tests are shown me
they always have less frequency variation than channels (e.g. 250-500-1k-4k-8k Hz [5
frequencies]). What is the value of having 5 programs vs. 4 or 9 and what is the value of 16
channels vs. 8?
Dr._Ingrao
James, the frequencies of the hearing evaluation allow your Hearing Care Professional to get a
ball-park idea of your hearing sensitivity. The frequency resolution of the test procedure relates
to the organization of the cochlea.
Nearly all hearing aids now use digital sound processors (DSP’s) that are more sophisticated than
our audiometers, both in frequency resolution and features.
While there isn’t a lot of good data to say more channels equals better hearing, more channels do
allow for finer separation of sound for advanced features like feedback control and noise
cancellation.
Hearing aid programs, are, as you said, designed for different listening environments. These are
based on your situational needs rather than frequency distribution.
It all comes down to your needs. If most of your listening happens in two conditions and your
hearing loss is gently sloping and mild, then two programs and 4 channels might be ideal.
If, on the other hand, you need to listen in 6 distinctly different environments and have a steeply
sloping severe loss, then you may need 6 programs and 8 or more channels to effectively meet all
of your needs.
Janis Moore asks:
I first acquired hearing aids in 1997. I am still using the original earmolds. I still have the
original (1997) Phonak hearing aid in my right ear. It has been whistling for years. I usually have
to turn the volume down quite a bit to make the whistling go away, which is definitely not
satisfactory. It has been sent back to the factory at least once for repairs. 1 How often should a
person have their earmolds replaced?
Dr._Ingrao
I usually recommend a new mold every two years, or when feedback is present
Janis Moore asks:
For several years the HOH-savvy people with whom I have spoken (including other audiologists)
have suggested that new earmolds might help resolve the whistling problem. I have discussed
this with my audiologist numerous times, including the fact that the volume increases
substantially in BOTH hearing aids when I press the earmolds into my ear canals; however, he
has never agreed to make new earmolds for me.
1. Do I have the right to insist that my audiologist make new earmolds?
2. My earmolds are hard plastic. Is there a material which might work better?
Dr._Ingrao
1. YES!!! You're the "boss of your hearing loss" Seriously, the audiologist works for you. Be
prepared to pay for new molds, but by all means get what you need.
2. Actually, there isn't any good data to suggest that the material itself affects feedback control or
sounds quality. ACCURACY of the fit does both.
Stephen1949:
I would like to know of any particular manufacturer or website where I can get descriptions and
prices for hearing aids.
Dr._Ingrao
HLAA has the Consumer Guide to Hearing Aids which covers this.
.
Moderator
The Consumer’s guide to Hearing Aids is available at http://www.hearingloss.org/bookstore
jmg2525
What is Real Ear Measurement? Thank you.
Dr._Ingrao
Real Ear or REM places a small probe microphone in the ear canal and another "reference" mic
outside. Then the hearing aid is placed in and turned on
Then the output of the hearing aid is adjusted to match targets based on your hearing loss. It
takes less than 15 minutes to do REM on two hearing aids and I recommend it for all fittings and
adjustments.
Bob_R
What is "real ear" that you keep talking about?
Dr._Ingrao
This is the same as the REM I just mentioned. It's also called "Speech Mapping" or "Live Speech
Mapping"
LMastree
You keep mentioning all these special tests that audiologists are suppose to do to insure the best
adjustment for HA's. How does one go about finding an audiologist that does all these tests? I
have seen many in S. Florida and none of them do what you are suggesting. It's very frustrating!
Dr._Ingrao
ASHA, AAA and IHS can help you find professionals in your area. If you call or email them and
ask, they can tell you what tests they provide.
Joe
Dr Ingrao, My earmolds get impacted with cerumen frequently. Is there a way I can clean them
myself?
Dr._Ingrao
Yes, you can carefully separate the tubing from the hook on the hearing aid. Then soak the mold
in warm water, then blow it out with an air blower (available from your hearing care
professional) and let dry. Then replace the tube on the hook.
jmg2525
My Oticon Synchro hearing aids are 5 years old and can no longer be insured by Oticon. I went
to another insurer and am paying almost $600 to insure for loss or damage. What is your advice
on getting insurance for 5 year old aids? They still work for me.
Dr._Ingrao
Hard to say. If you've never had a loss or damage claim yet, it might be worth the risk to drop the
coverage. An out of warranty repair will run you between $200 and $300 so you might want to
just take the gamble.
boblawrence
I was just implanted for a CI. Turn on will be Sept. 14th. what is the normal time between
turning on and the first revisit for mapping?
Dr._Ingrao
That's really outside the scope of this chat. Please consult your CI center for that information.
Tonyf
You mentioned atrophy when amplifying sounds. How would I know when this is happening?
Dr._Ingrao
You really wouldn't. Your test results for speech discrimination will reveal a decrease in speech
understanding over several audiograms.
evickery
Could you discuss the benefit of REM vs. Sound Field Evaluation for post-fitting verification?
Dr._Ingrao
Sound field really isn't appropriate for current hearing aids. These aids have multi-level
compression which simply can't be assessed by a pure tone or narrow band noise.
AAA and ASHA recommend REM as the preferred verification method for both adults and
children.
cindync11
I'm considering returning to school for my Au.D, but I'm just now learning about hearing
instrument specialists. I'm sorry I missed part of your earlier discussion on the difference
between the two - would you please comment on the difference in career path for each?
Dr._Ingrao
The primary difference is the focus. An Au.D will have a wider scope of practice including more
diagnostics and therapy.
A Hearing Instrument Specialist will focus on hearing aids and assistive devices as their primary
focus. It really depends on your goals and how much time you can spend in school.
Either path will prepare you to address the needs of people with hearing loss, just to differing
degrees.
Bill_Tedrick
I have a lot of ear wax that interferes with my hearing aids. Is there a recommended procedure to
reduce ear wax that interferes with hearing aid?
Dr._Ingrao
You really need to consult your hearing care professional or primary care practitioner to evaluate
your specific wax condition.
Tonyf
$200 - $300 for a repair. Is that the price for all the types of aids (canal, ITE, BTE)?
Dr._Ingrao
Yes that's about the range for an out of warranty repair. That repair will then be warranted for
between 6 months and one year depending on the product and manufacturer.
Moderator
I am afraid we have come to the end of our hour. There is no more time for questions. Thank you
Dr. Ingrao for joining us today it is always a pleasure having you.
Dr._Ingrao
Thanks for all the great questions. I always love HLAA-ers for that! Have a great night folks!
Moderator
For those wishing to download the Consumers Checklist may do so here:
http://www.hearingloss.org/learn/docs/HLAAHearingAidChecklist_4-14-2009.pdf
The Consumer’s Guide to Hearing Aids can be purchased at www.hearingloss.org/bookstore
A transcript of this chat will be available tomorrow at www.hearingloss.org
Next chat is schedule for September 10th, 2009 9:00 p.m. Eastern Daylight Time
Topic: Hearing Aid Compatible (HAC) BlackBerry Smartphones: HAC, Messaging, & More!
Speaker: Dave Dougall, Accessibility Program Manager, Research in Motion Limited (RIM)
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