Fitting hearing aids is a process that requires a keen understanding of how each patient’s ears perceive sound. Audiologists have been trained through an intensive six-year curriculum to identify and provide remediation for hearing impairments.
Mail Order and Internet Hearing Aids
People have become accustomed to purchasing electronic equipment by mail or on the Internet. Is this a good choice to make when you are ready to buy hearing aids? Let’s review your options. You can select an audiologist to guide you through the procedure, purchase hearing aids by mail or purchase through a wholesaler on the Internet.
Audiologists prescribe the appropriate instruments and program those products to best serve your hearing needs. Audiological testing determines the degree of your hearing loss. Other factors tested for (such as loudness growth perception, loudness tolerance and the dynamic range of hearing) must also be considered when selecting and fitting hearing instruments. Programming the hearing aids using these parameters ensures you will be able to hear and understand speech in all listening situations. At the same time, the audiologist will make sure the loudness of the sounds you hear never overwhelms you. Your audiologist can make adjustments in many different sound environments, which assures that you will understand speech in all listening situations.
Mail order hearing aids are very inexpensive compared with the instruments you obtain from an audiologist. There is a good reason for this. The company selling the products to you will use no hearing testing information to select your instruments. They will provide devices that can be classified as “one size-one circuit fits all hearing losses.” Mail order hearing aids offer little benefit to you because they all have the same acoustic characteristics. They arrive at your door with three different sizes of rubber plugs (for small, medium and large ears) to fit your ear canals. The amount of volume provided is the same for every product, regardless of the degree of hearing loss you have. Additionally, some can actually cause your hearing loss to become worse because they do not limit loud environmental sounds like properly fitted hearing instruments do.
Imagine that you want to buy a pair of shoes. When you arrive at the store, the clerk hands you a size 12 D black tennis shoe. When you protest that this is not your size or the style you want, the clerk responds that this is what you get, because it is the only product they offer. Obviously, you would not buy the shoes. And, you should not accept “one-size-fits-all” mail-order hearing aids to treat your hearing loss.
The third alternative you have is purchasing digital hearing aids from an Internet wholesaler. The hearing aids can be the same devices that an audiologist will provide to you. So, why not purchase them from the Internet? You will save about $400 on the initial price as compared to purchasing from an audiologist. However, you will have to supply hearing testing data and earmold impressions that will add about $200 to your costs. So, your savings will be less than you thought.
When you receive your hearing aids, they’ll be programmed for your hearing loss. If they don’t sound quite right to you, you’ll have to send them back for reprogramming, hoping the wholesaler will understand how to remedy your complaint. Since he has little expertise in programming, it’s likely that you’ll have to send the aids back many times to begin to approach the proper correction for your hearing loss. In addition, you’ll have no use of the products while they are being re-programmed by the wholesaler.
Many people who have followed this road have come to me after months of frustration of mailing the aids back and forth. Once I have programmed their products correctly, they realize that they should have visited my office first, because they have saved neither time nor money buying hearing aids through the Internet.
There is an axiom that is true, especially in the hearing aid world: “You get what you pay for.” The perceived discounts you imagine will be realized when purchasing from a wholesaler will be overshadowed by the poor performance and frustration you’ll experience when you continually ship the products back to the seller for reprogramming or poor fit.
Additionally, be aware that all hearing aids will need service to maintain proper function over the years. Our office can often service your products in a few minutes, and we have the appropriate equipment to make certain that they are working to specifications. A mail-order company or wholesaler cannot service the aids, so you’ll still have to find an audiologist.
So, why waste time? Obtain your hearing aids from the hearing professional who has the training to understand and service all of your hearing needs—your audiologist.
Extended Wear Hearing Aids
Recently, you may have seen ads praising the virtues of new hearing aids that fit deep within the ear canal. These devices, called extended wear hearing aids (EWHAs), were developed in response to patient demand for a solution to hearing loss that is completely invisible. I agree that the deep placement of EWHAs makes them essentially unnoticeable, and the sound quality is acceptable. However, I have some serious concerns about the performance and potential side effects of this technology.
First, EWHAs have very limited fitting capablities. The patient’s ear canal must be of a certain size, shape and direction. Those with narrow, short or highly angled canals need not apply. Another drawback is that these instruments are only appropriate for those who have very mild hearing losses.
Patients wearing EWHAs may experience unintended medical complications. Measuring the ear canal for proper placement of the device requires that the fitter touch the eardrum lightly with a probe. It is not uncommon for this to cause a slight hematoma on the eardrum, or, in the worst cases, a perforation which requires surgical repair. In addition, EWHAs occlude the ear canal, creating a barrier that prevents air from circulating freely. This condition may cause moisture to accumulate in the canal, which in turn makes it more likely that fungal infections will develop.
Since EWHAs should not be removed and reinserted by the patient, battery replacement is not as simple as it is with conventional hearing aids. These devices are powered by a battery that lasts about two months. When the battery fails, the EWHA must be removed by a hearing care professional and replaced with a completely new device. This procedure is necessary six or more times per year.
The price of EWHA fitting is also a drawback. Currently, EWHAs cannot be purchased. Manufacturers offer them for lease at a cost of about $1,600 annually for one device and $3,200 for two. Therefore, patients must reinvest in the technology every 12 months in order to continue using the product.
EWHAs are in their infancy, but you should be aware that the hearing aid industry is working enthusiastically to advance this technology and to solve the problems outlined above. Only when they have evolved to meet higher standards will I offer them to my patients.