Treatments

What hearing aids can’t do?

Hearing aids cannot

• grow new hair cells
• restore the normal function of a damaged hearing system
  • Humans are born with 15,00 hair cells in each cochlea.
  • Hair cells detect sound and transfer the signal to the brain.
• Human damaged hearing cells can not regenerate themselves the same as
• our damaged teeth do not regrow back

Only birds and amphibians can regenerate hair cells throughout their lives.

prevent or improve hearing loss from the organic condition make speech sound B/P, T/D, K/G, F/V, S/Z. more distinct

Hearing loss can be compared to vision loss in when a person has damaged or scratched the retina of their eye. The dead area of the retina makes holes in their visual field. These holes stay the same with or without glasses. The dead-area of damaged hearing cells makes a dead area in the frequency regions of hearing. If outer hearing cells are damaged, you won’t be able to hear the difference between sounds b/p, d/t, f/v etc. with or without hearing aids.

“Hearing is a communication sense for receiving speech, vision is just an environmental sense which helps us navigate the physical world”.

How hearing aids help?

All hearing aids have the same basic technologies as all vehicles have tires, batteries, and brakes. However, regardless of technology level or brand, signal classification systems, multiple channels of compression, complex noise reduction algorithms, automated directional microphone technology, and types of wireless capabilities are significantly different.

Hearing aids altered the sounds that enter the damaged auditory system. A practitioner finds the best combination of signal processing, manipulating these sounds for the best use of the remaining capabilities of the client’s auditory system. Modern hearing aids no longer simply make sounds louder or more audible. They represent the real-world dynamic acoustic landscape, reduce steady-state noise like refrigerators, computer fans noise and reduce listening effort.

Hearing aids help you to hear better by:

• Making sounds louder (amplification of sounds)
  • Environmental sounds can be perceived as soft, comfortable, and loud. Hearing aids have different fitting methods to increase soft, comfortable, or loud sounds for individuals with hearing loss, but when hearing aids imitate these sounds, they are still perceived as soft, comfortable and loud to listeners. That is achieved by amplifying soft sounds a lot, and loud sounds a little. For example, for people with mild loss, only soft sounds will be amplified.  
  • Making speech louder than background noise (Increasing speech-in-noise Ratio), partially separating speech from noise. HAs can identify the type of noise and reduce the amplification of that frequency. Improving SNR leads to reduced listening effort.
    • Every hearing aid uses two basic methods to deal with background noise: a directional microphone system which consists of two microphones on each hearing aid. When the directional microphone system is activated, the hearing aid focusses to the direction of sound pick-up forward to the interest. This means you hear loudest from the direction you are looking at, while sounds next to and behind you are suppressed
    • Noise reduction systems analyze sound and determine if it consists of unwanted sounds. Noise has a steady sound and loudness doesn’t fluctuate over time (fan, water flowing). Speech sounds are changing in loudness all the time. The difference in loudness fluctuation allows hearing aids to differentiate between speech and noise.

Most consonants are not voices but:

• have a noise quality
• have a period of silence
• involve the nasal cavity

It’s very challenging to separate them from noise with basic methods. Every manufacturer implements their own new innovations in hearing aids to improve SNR.

• Sound classification:
  • Acoustic signals can be divided into 3 categories: speech, music and noise. Hearing aid can change its mode of operation to process signals in different categories in different ways.  For speech, the hearing aids promote mild and low frequencies. Low frequency signal is a strong component of music and hearing aids can generate a full sound. For noise, hearing aids constantly modify and repeatedly increase and decrease pulsed sounds of noise.
• Reducing tinnitus
• Reducing listening fatigue because with hearing aids the brain uses less energy to understand speech.

Dramatically improving hearing in wind noise:

• Improving phone use by allowing you to hear landline calls in both ears
• Improving Landline Phone use with T-coil
• Assisting with Single Sided Deafness
• Hand-free mobile phone usage, access to remote microphones and better television enjoyment.

Hearing aids communicate with one another, improving sound localization and enabling the user to control both devices with a single touch to one device or remote control. Bluetooth streaming to the hearing aids from almost any sound source (including radio, TV, FM, smart phone, laptops, tablets, computers, dedicated sound systems, etc) provide a realistic dynamic acoustic landscape.  

Manufacturer combines and implements these technologies and features in its own unique ways.

Levels of Hearing aids technologies

Living with hearing loss means constantly managing the noise.

Electronic chips.

All digital hearing aids have chips just like computers. A chip is a small circuit board with all of the electronics on it. The electronics provide the functions of the hearing aids. 

Most hearing aid manufacturers use one chip for an entire line of products and program them to be an entry-level hearing aid for one client, medium or premium hearing aids, for the other clients. That means they activate and deactivate the features depending on the level of technology the hearing aid will be sold at.  

They perform the same in the most common listening situations, and different in more complicated listening situations with a lot of background noise. The entry and premium levels of hearing aids work the same in a quiet room but different in a restaurant with a lot of noise.

Premium level

Uses edge-cutting technology reducing noise in a more complex sound situation, like having a party with your friends in a noisy restaurant.

Deliver the best speech clarity

Deliver the most natural sound

Mid-Level

As a middle level. It works well in a quiet environment but not the best in a noisy environment. It has basic noise reduction but lets you better adjust sounds in each frequency group.

Entry-Level 

The entry-level cannot manage noise very well. This level of hearing aids is good for communication in a quiet environment. It also works better for people who have the same amount of hearing loss across all frequencies because this technology doesn’t let you adjust individual frequencies, but rather a small group of frequencies together – low, medium and high.  

Technology levels and the difference in advanced features

Hearing aid amplified sounds based on frequency from 250 to 8000 Hz. The frequencies are divided in groups we call channels. Hearing Aid’s software have handles to control the channels. Depending on the level of hearing aids, we can adjust small or little groups of frequencies.

For example, a 3-channel hearing aid may treat all sounds 250 Hz-1000 Hz as a low-frequency channel: 1000 – 3000 Hz as a mid-frequency channel, and 3000- 8000 Hz as a high-frequency channel. More channels (up to 12) give more precisely identification, processing and adjusting of the sounds.

Noise reduction (up to three types)

Directional mic (wide or narrow-angle)

Fixed – not alter the sound around but pick up best in front.

Adaptive – follows the one loudest noise behind you as it moves

Multi-band – follows to multiple sound sources behind you, suppressing them

Super Beam forming – form a four-microphone array. Provide maximum pick-up sound in front and maximum suppression behind:

• Frequency lowering
• Feedback control
• Own voice detection
• Motion deduction
• Data login
• Wireless connectivity (Android, iPhone, both or none)

Extra comfort

Premium level hearing aids have some features providing extra comfort and make adaptations to  hearing aids much easy and faster.

One or two hearing aids?

Better Sounds

When you wear two hearing aids, you will need 2-8 dB less gain than with one hearing aid. That means you decrease the problems with squealing (feedback) because you get less gain.

Hearing Loss Prevention

Clients with symmetric hearing loss who only wear a single hearing aid, slowly losing the ability to understand speech in the unaided ear due to a lack of brain stimulation.  

Localization

Two hearing aids grants the ability to localize sounds relatively the same as people with normal hearing.

Our brain recognizes the difference in loudness and time arrival of sounds

Loudness: high pitch sounds coming from one side of the head, lose up to 15 dB when they reach another ear.

The time: sounds reach one ear faster than another ear. That is how we know where the sounds come from.

When a person wears only one hearing aid, other people don’t have raise their voice anymore, but now instead speak softer. Hence, there is less audibility in the unaided ear.  A hearing aid in one ear causes a mismatch in timing. Over time, the brain starts to ignore the weak sound from the unaided ear. There is no localization anymore.

Speech in Noise

When you wear two hearing aids, the sound is combined which means the speech becomes a minimum of 3 dB louder than noise. For that reason, 2 hearing aids improves speech understanding in noise by 20%. The same as your headphones, the sound is much better with two headphones compared to only one. 

Hearing Aids Can “TALK” To Each Other

Two hearing aids can wirelessly share full-audio signals which help to focus on a source of speech and significantly improve understanding of speech in background noise.

How long is the treatment?

Hearing aids will be matched to your “wants and needs”.

As a clinic independent from manufacturers, we have the privilege to promise you that our choice of hearing aids for you will be prescribed solely based on your needs only and are not influenced by manufacturers’ benefits.

We make sure that your hearing aids will solve all of your problems and any additional costs of advanced features equates with increasing the benefits.

Because each brand has pros and cons, to avoid misleading/misrepresenting their performance, appearance, benefits, elements, or use; we will be carefully discussing:

• • Health issues
  • Degrees of hearing loss
  • Speech tests results
  • Cognitive and memory skills
  • Ability to understand Speech in Noise
  • Previous history amplification if applicable
  • Any physical dexterity and vision problems can affect the ability to handle hearing aids successfully
  • Level of social interaction
  • Acceptance to new technology, phone, apps and accessories
  • Your occupation
  • Your daily activities
  • Your expectations

Selecting, applying, and getting used to wearing hearing aids take time and patience.

It takes a minimum 120 days to feel significant improvement: to hear the whole spectrum of sounds and most importantly, high pitch consonants like SH, TH, S and F.

• • Because each clients’ hearing loss is a special case, we will give you as many appointments as they need:
  • A guide on how to train your brain to learn new artificial sounds.
  • Developing the confidence to live your life to the fullest with hearing aids
  • Developing skills to perform daily activities with confidence and comfort while avoiding complications.
  • Learning how to use your hearing aids in work and in leisure.
  • Learn about room acoustics and how sound can be distorted in some situations.
  • Learn how to position themselves to facilitate lip reading.

Here is a blueprint of the treatments you may undergo.

2nd appointment – beginning of a mandatory trial period (45 min)

A properly programmed hearing aid will be delivered to you at this appointment

Part 1. Fitting

• Instructions on Insertion and removal of hearing aids
• We will show you how to operate hearing aids for their best performance
• We will make sure that your aid is compatible with your cell phone and cordless phones and that the T-switch is enabled. 
• You will know how to use a phone and apps
• We will show you how to care for and maintain your hearing device in the best condition.
• Counselling; wearing scheduled, expectations etc.
• Providing self-help literature

Part 2. Validation

We will perform a REM test to confirm the appropriate amount of gain provided by hearing aids for soft, comfortable and loud sounds. Verify that hearing aids optimize speech understanding and speech quality

4th appointment – the end of the mandatory trial period (30 min)

• Discuss your experience & adjustments if needed
• Move to the next level up adaptation (software)
• Counselling on using assistive listening devices for TV, talking in a car, for hand-free access to your cell phone etc.
• QuickSIN test to demonstrate how your hearing aid with directional microphones improves speech understanding in noise
• Hearing improvement will be documented using subjective tests

6th appointment (6 months) if needed (30 min)

• Discuss your experience & adjustments if needed

7th appointment (12 months) (60 min)

• Annual check-up.  Electro-acoustic hearing aid test
• Hearing evaluation. Adjustments if needed

How to be ready for the test

Do not come if you are sick or in pain. Active allergies, colds, sinus/ear infections can all cause fluid in the ear and as a result, temporal hearing loss. The test results will be inaccurate. Please see your family doctor to treat the symptoms.

If you suspect you have built-up earwax, please visit your family doctor.  We need to see at least 30% of your eardrum, to perform the test.

Try to rest before the test and avoid loud sounds because the test takes a lot of concentration by listening and responding to different sounds.

Give your ears 10 hours rest before taking a hearing test in case you worked in a noisy environment.

Take your S/O with you. We can help both of you to overcome the challenges involved with hearing loss, and find the best treatment based on your stories of how hearing loss impacts your relationship.