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September 2010 Iowa COMPASS News A Program of the Center for Disabilities and Development Iowa’s information and referral service on disability services, assistive technology (AT), AT funding resources, and AT legal advocacy. Have you Heard? It is estimated that nearly 31.5 million Americans had a hearing loss in 2004. That’s about 1 in every 10 people. The number of people with hearing loss increases with age. That means that 1 in 3 people over 65 have some level of hearing loss. As the baby boomer generation ages those numbers will double. Hearing loss is and will become an even greater issue as we age. However hearing issues can occur at any age, with 1 in 6 children being born with congenital hearing loss (present at birth). New studies show 20% of all teenagers may have acquired hearing loss to the ever increasing use of ear buds with mp3 players. A hearing impairment is the degree of loss of loudness or pitch outside the normal range. You can have a slight hearing loss but not have any problems with every day life. On the other hand, we may all have trouble hearing when it’s noisy or when there are a lot of people talking at once. People with more severe hearing issues can feel isolated from others and from daily activities. There are two main types of hearing loss. The first is called conductive hearing loss. This involves the outer or middle ear. With this form of loss sounds may seem muffled and the loudness of certain sounds may be affected. People with this type of loss have problems with lower frequencies or particular vowel sounds. Causes can include wax buildup, infection of the middle ear, punctured ear drum, or malfunction of the ossicular chain (three tiny bones) in the middle ear. Treatment for these is medical or surgical. The most common form of hearing loss is sensorinureal hearing loss or nerve deafness. This is from damage to the hair cells or nerve fibers in the inner ear. This distorts and diminishes the loudness of sound. This type of loss means a person will have problems with understanding speech (especially in noisy situations), and understanding consonant sounds (high frequency). Causes for this type of hearing loss include birth defects, head injuries, ear infections, some medications, illnesses with high fever, exposure to loud noises, or long-term exposure to noise. These cannot be treated medically or surgically but are most likely helped with hearing aids. However, a hearing aid does not restore your hearing. Have a hearing loss? If you are worried about your hearing, start with your own doctor to have a basic test done or get a referral to an audiologist to get a complete and thorough hearing evaluation. Audiologists are qualified to diagnose and treat hearing loss and other sensory issues. They will also be the ones to evaluate and fit you for hearing aids or other hearing devices if needed. An audiologist has a graduate level degree. They should have a Certificate of Clinical Competence (CCC-A) from the American Speech-LanguageHearing Association (ASHA). They also should have state licensure, registration, or school certification where required. Ask yourself— do I have: Ringing, roaring, or buzzing in one or both of my ears? The TV turned up so loud others don’t like it? No interest in a conversations when two or more people are talking? To ask people to repeat what they said? Difficulty understanding speech? Problems understanding because voices are muffled or dull? Problems listening when there is other noise or in groups? Inconsistent response to sound? People looking at me funny when I answer them? Problems socializing? Frequent ear infections? Family or friends who tell me I can’t hear? Sudden drop in hearing in either one or both of my ears? Dizziness/lightheadedness/spinning sensations? Balance problems or unsteadiness? If you answer yes to these, you may want to see your doctor. Some Great Links! The American Speech-Language-Hearing Association (ASHA) - www.asha.org/ American Tinnitus Association—www.ata.org/ The Centers for Disease Control—www.cdc.gov/ Hearing Loss Association of America— www.hearigloss.org/ (used to be Self Help for Hard of Hearing) Are there hearing aids in your future? Approximately 24.1 million people with hearing loss do not own a hearing aid or device. About 12.5 million people own hearing aids, and 11.1 million people actually use them. Many people think there is a stigma against wearing hearing aids, but the stigma is against admitting there is a hearing problem in the first place. Most people don’t want to listen to family and doctors who tell them they may have a hearing problem and need to think about getting hearing aids. However, as the numbers show, once a person decides to get them, they will use them. Barriers to using hearing aids can include the design, fit, and price. However, overall customer satisfaction is 77%, which places hearing aids in the top third of products and services in the United States. Even though hearing aids do not restore hearing, they can help 95% of people who have hearing loss. There are no one-size-fits-all hearing aids. Every hearing loss is individual and different. These are factors you should consider when looking at hearing aids. How is my dexterity? Hearing aids are becoming increasingly smaller. The smaller they get, the smaller their batteries and controls. If you have physical limitations with fine motor, control this may be an important factor in selecting hearing aids. Do I wear glasses? The behind-the-ear aids can get in the way when you wear glasses. There are special eye-glass styles available or the smaller, in ear styles. What is my level of hearing loss? That can impact the type of device you should purchase. What type of environment am I in more—quiet or noisy? How often am I in groups? Do I listen to a lot of music? Different types of devices can help you adjust to different surroundings and improve sound quality. Do I travel a lot in the car? Wind noise can cause problems with some types of devices. Do I spend a lot of time on the phone? Feedback noise can be a problem with some hearing aids. It may also depend on the type of phone you use and what devices or options are available on the phone. Some phones are adapted to hearing aid users. Also consider whether you like using blue tooth devices when talking. Does it matter if other people see my hearing aids? If you want to be discrete then consider smaller aids that fit in your ear canal and are programmable so you don’t have to make adjustments while wearing them. Am I active? In the canal aids are more secure so you have less risk of losing them and may reduce the sound of wind noise. How much are they? Hearing aids can run from $80 (for the new disposable) to $6500 for a high tech pair. Should I just get one or two? Discuss this with an audiologist. You might only have one ear affected by hearing loss. But, if both ears are involved and two ears are better than one, than so are two hearing aids. The benefits include better sound quality in noisy settings, improved balance, the ability to hear farther distances, and a reduction in the strain from hearing. My hearing aids are driving me CRAZY! It takes time to get used to your hearing aid. It doesn’t happen over night. If you are patient and give yourself a chance, you can adjust. Getting comfortable will depend on your age, health, level of hearing loss, how long you’ve had your hearing loss, and your level of determination. Many people say they get used to their aids in about a month. Some sounds may sound strange to you at first, especially your own voice. Don’t worry! This is normal. You can get used to this by reading out loud. At first you really notice back ground noises—those noises we’ve learned over time to tune out. With a hearing loss, you’ve not only tuned them out, they have gone away. With a hearing aid those noises get amplified and can be irritating. It will take time to tune those noises out again. Focus on the sound you want to hear. If you have multi-programmable devices, adjust the settings until you get the one that works the best for you. You may have a hard time following a conversation, especially when you’re in a group. Other conversations will creep in and may over power yours. Focus on the person you’re talking to and watch their mouth—that might help. When you are in public at a concert or lecture or show, sit in front and watch the presenter’s or performer’s face. Also remember that with the advent of the ADA (American’s with Disabilities Act) public buildings, such as theaters, churches, and conference rooms, will probably have what is called assisted listening devices. These are systems to help people with hearing aids hear the event better. Call ahead to see what they offer. Always talk to your audiologist about adjusting your hearing aid and if you have any questions or concerns. Remember: Give yourself time to get used to the hearing aids— don’t wear them all the time at first. Start by only wearing them around your family and friends. Don’t wear your hearing aids in noisy places. Slowly increase your wearing time. Don’t set the volume too high. Don’t force yourself—take breaks, especially if you are tired or frustrated. Iowa Lions Hearing Aid Bank Collects Used Hearing Aids Send used hearing and surplus batteries to: Iowa Lions Hearing Aid Bank Rhoda Bender, Coordinator 310 N 4th Street Marshalltown, Iowa 50158 Phone 641-752-4337 Email: [email protected] Devices and Definitions There are many types and styles of hearing aids. Here are a few definitions on various devices available. First, there are two types of hearing aids available: Analogue Aids—these convert sound waves electronically and can be either conventional or programmable. Conventional aids amplify all sounds equally whereas programmable aids can be set for different environments. Examples will include conversations versus theater. Some devices allow for multiple settings. Digital—these aids transfer sound to digital code, change it and retransmit it back by using mathematical calculations. They duplicate the sound and produce a high quality sound that is extremely accurate. Many believe they have revolutionized hearing. They are more expensive then analogue aids. There are 4 basic styles of hearing aids on the market: Behind-the-Ear—Also known as BTE, they come in a number of styles from simple ones that form around the ear, to smaller devices that hide behind the ear connecting to the ear with tubing . They can last a long time and can produce a lot of power. In the Ear—ITE hearing aids are used most often by those who have a moderate hearing loss. Again, it will depend on the individual whether they will fit. They do not work for everyone. In the Canal—Or ITC aids fit inside the ear but are larger and slightly more visible then CIC devices. Completely in the Canal (CIC)—these aids are extremely tiny aids and are the most invisible. They fit down inside the ear canal. They don’t work for everyone. It will depend on each person’s fit. Disposable—many of you may have seen ads for disposable hearing aids. They are available only online and are worn until the battery dies at about 400 hours or approximately one month of daily use. You then throw them away and get new ones. They are small and hide behind the ear. They are not In-theCanal devices but they are digital. They cost around $80 for a single aid or $160 for a pair. One of the claims with these devices is that you don’t need an exam. They try to be one-size-fits-all, which means they won’t work for everyone. There are no sound adjustment options and the only change you can make to the fit is moving the tub. They can work in some situations, particularly if you are worried about losing your hearing aid, for temporary situations say when you are traveling or are away from home, if you do lose a device. You might even give them a try (they do offer trial periods) to see what it’s like to have a hearing aid and how they work for you. Remember, this would not be how a specially-fitted and tuned hearing aid would sound or work. For the best results, go to a licensed audiologist to get a thorough exam. They can help you get the best fit and adjustment for your hearing aids. For your information Songbird Hearing Inc makes the Flexfit Disposable Hearing Aid. Go to www.songbirdhearing.com/ for more information. They also manufacture two other hearing aids, the Flexit, which allows tip replacement, battery replacement, and volume control. It uses standard 312 hearing aid batteries. This is not a disposable hearing aid and costs 199.90 plus $14.95 shipping and handling. Their second non-disposable hearing aid is the Ultra which their smallest hearing aid, offering feedback cancellation, noise reduction, additional sound boost, 6 replacement batteries all at a cost of $299.90 each plus $9.95 shipping and handling. Hearing Aid Resources and Links Here are some resources and links you might look into as you think about purchasing a hearing aid. Not all information on the internet is unbiased. Some of these resources are maintained by companies who provide either hearing services, hearing devices, or both. Remember, when looking at anything online, consider the source of the information. Consumer Reports offers a comprehensive hearing aid report through their Consumer Reports Health site. To access that site it will cost you $19 annually or $4.95 monthly. This is separate from purchasing a subscription to the regular Consumer Reports site. However, you do not need one to get the other. You can access a report they wrote about the process they went through to conduct this report in 2009. Go to their Hearing Aid Guide at www.consumerreports.org/health/healthy-living/homemedical-supplies/hearing/hearingaids/overview/hearing-aidsov.htm?INTKEY=195BHE0. One thing they said was that they found “a fragmented and confusing marketplace and had difficulty sorting out good hearing-aid providers from less-capable ones.” When you go to the above link, you’ll see the reports on the left. Those with CRH in their title are only accessible with a subscription. Even so, there are a number of links available to all readers to guide you through the process. For a quick, free review go to Hearing Aids Review: The 4 Leading Brands (Siemens, Beltone, Starkey, and Phonak) at www.hearingaidresearch.info/. For a fairly comprehensive site with information on hearing loss, types of devices, and specific manufacturers go to Hearing Aids 101 at www.hearingaids101.com/. They do not sell products. When reading the articles, be aware that after the first sentence, the links you are seeing are ads. Scroll down past the ads for the rest of the information on that subject. Another interesting site from a center in Indiana is The Hearing Center Online at thehearingcenteronline.com/. Hearing Planet offers a free guide called Buyer’s Guide to Hearing Aids that provides more detailed information on hearing loss, explanations on hearing aids and how they might help, and a comparison chart on various models. Hearing Planet is a company that provides hearing services through clinics in the US. They also sell a variety of hearing aid models. You can see their website at www.hearingplanet.com. Go to www.hearingplanet.com/hearing-aid-guide-st2.php to download the guide. Before you download you will need to complete a short form. You are asked to provide your name, email address, phone number, and state. If you do this, our best guess is that you will be contacted by a Hearing Planet representative for sales or services. How do I pay for hearing aids? Hearing aids can be very expensive. There is a source in Iowa that might be able to help you. The IowaAble Foundation provides flexible loans for adapted devices, including hearing aids. They are customized to fit your needs. Check them out at www.iowaable.com. Iowa COMPASS Center for Disabilities and Development University of Iowa Hospitals and Clinics 100 Hawkins Drive, Room S. 295 Iowa City, Iowa 52242-1011 Phone: 800-779-2001 Fax: 319-384-5139 Email: [email protected] Iowa COMPASS News is published bimonthly through the Iowa Program for Assistive Technology. Iowa COMPASS is a project of the Center for Disabilities and Development, Iowa’s University Center for Excellence on Disabilities. CDD is a component of the University of Iowa Children’s Hospital. No endorsement of products or services is intended. Support for Iowa COMPASS is provided by: Center for Disabilities and Development Iowa Program for Assistive Technology Iowa Department of Human Services Iowa COMPASS 800-779-2001 (toll-free) 877-686-0032 (toll-free, TTY) 319-353-8777 (local) www.iowacompass.org