The Sound of Science Sophisticated Technology – Changes the Way Hearing Aids Work

About a year ago, a man made an appointment to see Jeffrey Halls after he returned from a hunting trip.

“He told me he sat on a perch in a tree for days without any luck,” Halls, co-owner of Baystate Hearing Aids in West Springfield, recalled. “Then, he looked down and saw two deer right beneath him. He hadn’t heard them moving through the woods, and that prompted him to seek help for his hearing loss.”

This story is typical of what he hears from customers, he went on, adding that the man knew his hearing had declined, but like many people, failed to address the problem until it affected an activity he loved.

Statistics from the Hearing Loss Assoc. of America show that 48 million adults in the U.S. suffer from hearing loss. It is the third-most-common physical condition after arthritis and heart disease, and although most people associate the condition with aging, 65{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Americans with hearing loss are under age 65, and the majority are in the workforce.

But most people wait five to seven years to seek help. Experts say some think their hearing loss is not advanced enough to do anything about it, while others, working with outdated information, don’t want to be seen wearing a hearing aid.

Indeed, today’s hearing aids have kept up with advances in technology, and some are so small they are almost invisible to the eye. There are a wide variety of styles to choose from and a vast array of programs that are coupled with the computer chips inside them. In fact, many automatically adapt to different physical settings and have Bluetooth connectivity.

“People often avoid seeing a specialist about their hearing loss because they think a hearing aid will make them look old. But a hearing loss is more obvious than today’s hearing aids,” said audiologist Susan Bankoski Chunyk, who owns Hampden Hearing Center in East Longmeadow.

James Caldarola agrees. “People are surprised at the size and clarity of the hearing aids available today, and with Bluetooth, they work better with phones and TVs than they did in the past,” said the co-owner of Baystate Hearing Aids. “Hearing aids can’t restore a person’s hearing, but they can make it a lot better. And since most hearing loss is gradual, many people aren’t aware of what they could be missing.”

Chunyk explained that a person who is gradually losing their hearing may not notice they have stopped hearing environmental sounds, such as crickets chirping or the click of a directional signal in a car. “But family members, friends, and co-workers may notice the person is having trouble understanding them.”

People often compensate for the problem by talking more loudly to the person with the hearing loss or repeating themselves.

But it’s not a good solution, and ignoring the problem can lead to other health issues, including dementia.

“Mild untreated hearing loss doubles your risk for dementia, moderate untreated hearing loss triples it, and severe untreated loss makes dementia five times more likely,” said Chunyk. “In addition, research shows links between untreated hearing loss and depression, anxiety, poor self-esteem, fatigue, isolation, and loneliness.

“It is important to act sooner rather than later because better hearing improves every aspect of a person’s life,” she went on. “But, unfortunately, only 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people with hearing loss ever seek help.”

However, the problem is growing and is now linked to a variety of health conditions. “New research shows hearing loss is twice as common in adults with diabetes, smokers, and people with heart disease,” she told HCN. “It is also common in people with kidney disease.”

Hearing loss can be hereditary or related to aging, occupational noise, or frequent use of earbuds with the volume turned on high. “In many of these cases, it is preventable,” Chunyk said, adding that using earbuds for extended periods of time with the volume turned up can be dangerous.

Caldarola said there is a need for increased awareness about hearing loss along with the technological advances that make today’s hearing aids comfortable to wear and smarter than they were in the past. “Some people don’t think they have a loss because they can hear things far away or can hear some sounds very well. But we recommend that people over the age of 40 get tested every two or three years,” he said.

Most hearing aids sold in the U.S. are digital, and are a vast improvement over older analog models, which were difficult to adjust and amplified background noise as well as speech. Today’s models respond to noise in the environment, so people don’t have to experience problems associated with feedback and echoes.

“Today’s hearing aids are all digital, which allows us to customize them to make sounds clear and natural,” Caldarola said, explaining that people hear over a range of sound, which involves tone and pitch.

Chunyk concurred. “Thirty years ago, we used to adjust hearing-aid settings with a tiny screwdriver; this limited the range of possible adjustments,” she said. “But today’s digital instruments are programmed via the computer, which makes the adjustments more precise and personalized to an individual’s needs. The newest hearing aids are sleek and discreet, so they are less visible and more comfortable to wear. In fact, some people who get them are so excited about how small they are that they take them out and show them to their friends.”

The new devices are also adaptable. “In the past, if someone got a hearing aid and their hearing changed, they were forced to get a new one. But today, we can reprogram a hearing aid in minutes,” Halls said.

A hearing test will determine whether a person will benefit from a hearing aid, and if it can make a difference, they will be shown models that meet their cosmetic preferences and lifestyle needs.

“Not all hearing aids are the same,” Chunyk said. “We pick a category that is appropriate for mild to moderate hearing loss or a severe degree of loss. There are also super-power or ultra-power aids for people with profound hearing loss.”

Halls said people hear over a spectrum, which includes high to low pitch. “The ability to hear high pitches makes speech clear,” he explained, adding that the newest hearing aids will allow people to hear sounds such as a bird chirping outside their window, although the pitch may sound a bit different than it does to people without a hearing loss.

Hearing aids are classified by the U.S. Food and Drug Administration as medical devices, but many people confuse them with over-the-counter models that can be purchased at retail stores or via the Internet.

“The over-the counter models are simply sound-amplifying devices,” Chunyk noted, adding that she has patients who have told her they purchased them, then threw them away because they didn’t help.

“Hearing loss is not just about volume; more often, it is about clarity, which can only be addressed with professional help,” she continued, adding that, although most hearing loss cannot be treated medically, hearing aids can do a lot to restore hearing.

“Technology has gotten smarter and smarter,” she went on. “Since 1996, there have been big breakthroughs every few years, and although hearing-aid technology doesn’t change as frequently as it does for iPhones, there have been big changes in computer chips, which allow them to process sound better and more automatically and allow the hearing aids to be programmed to respond differently in different acoustical conditions.”

For example, some have a feature that allows them to automatically adjust to a quiet place or noisy setting.

“If the person is in a quiet room, the hearing aid will go into surround-sound mode,” said Chunyk. “But if they walk into a noisy restaurant with competing noise, the instrument will activate directional microphones which automatically focus forward and reduce sound from the side and back so the wearer can hear the person in front of them.

“At the same time, there is noise-reduction circuitry inside that will recognize a voice and focus on it, while reducing everything else,” she continued. “Older hearing aids often required people to push a button to make changes, but today’s models do it automatically with more precision.”

Another major improvement is the reduction of feedback. “Older styles used to give off a high-pitched squeal if a person hugged someone or did anything that blocked the aid,” Chunyk told HCN. “But today’s technology controls feedback much more effectively.”

These high-tech hearing aids come in many styles, but many factors go into choosing the one that is right for each individual. “Part of the selection process is knowing what the person’s preferences are for sound and what type of environment they are in every day,” she explained. “The needs of a very active person are different than someone who is home all the time just watching TV.”

Today’s hearing aids work well with other electronic devices. “There is connectivity between hearing instruments and mobile phones, land lines, and televisions,” Chunyk said. “For example, one manufacturer makes a model that allows a person to wear a small device around their neck that is paired with their cell phone. When the phone rings, they push a button on the device, and it streams the sound to their hearing aid through a microphone. If there is too much background noise, they can hold the streamer close to their face to eliminate it.”

Caldarola noted that Bluetooth technology has resulted in hearing aids which automatically cue into a phone. “In the past, people had to push a button to hear on the phone, but now many models are automatic and have features that reduce background noise without manual intervention, so speech is more intelligible,” he explained.

Other accessories include lapel microphone clips that can be put on another person’s collar in a place like a noisy restaurant. “It sends the person’s voice to the hearing aid,” said Chunyk, adding that several manufacturers have hearing aids that are made to be compatible with iPhones and work through free apps.

However, there is a lot to know about purchasing a hearing aid, and Caldarola and Halls offer the following advice:

• Ask people who wear hearing aids where they got them and if they were happy with the service;

• Ask about the seller’s return policy and if they can repair hearing aids on the premises;

• If you have been fitted with a hearing aid and experience a problem, ask for help in resolving it. Most people need several visits before the settings reflect their preferences;

• Ask if additional features can be added later on, like Bluetooth or a remote control; and

• Ask about any additional costs that will be charged after you purchase the hearing aid.

Halls said fitting a hearing aid is a process. He and Caldarola advise clients to wear a new device for a week, then return so adjustments can be made. “Sometimes it takes several visits to achieve a goal.”

In some instances, they have had to go to the person’s home to solve the problem. For example, one woman who complained her refrigerator sounded too loud discovered it was too loud and she needed a new one.

But in many cases, hearing aids can be fine-tuned. “We can add a program for golfers that will eliminate wind noise,” Halls said, citing one example.

Ringing in the ears can also be masked. But people need to be realistic, because hearing aids have limitations, and some situations may continue to be problematic, such as hearing a person who talks rapidly, mumbles, or speaks very softly. “In these instances, even with a hearing aid, it can be difficult for the person to understand 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of what is being said,” Caldarola said. “It’s unrealistic to expect to restore hearing to the way it was when a person was 16 years old.”

But hearing aids have internal memories, and experts can tell how often it switches from one mode to another, which helps the fitter to make adjustments.

Caldarola has two patents for hearing aids, and his latest model is called the Micro-Air. It is suspended in the ear canal, and what sets it apart from other instruments is that it allows natural sounds to pass through the ear canal while amplifying the frequencies that the person who wears it is missing. The result is the elimination of background noise and echoing which plagued many people in the past.

Such advances will continue, and technology has come so far, there is no reason why people should shy away from the thought of visiting a hearing specialist.

“More than 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people with hearing loss could benefit from a hearing aid,” Caldarola said. “If the loss starts affecting your life, it’s time to get checked.”