About Hearing

What is hearing loss?

Hearing loss typically means an individual cannot detect particular sounds compared to those without a hearing loss.

What are the early symptoms of hearing loss?

Missing everyday sounds like birds singing, difficulty following conversations in noisy situations, intolerance to loud sounds, finding yourself swapping the ear you hold the phone to in order to hear better, trouble hearing the T.V, radio, etc or keeping them at very high volume than normal, finding difficulty in understanding female voices, asking words to be repeated, etc. Although you may not experience all of the above symptoms, still if you do think you have a problem with some of them, you should get your hearing evaluated as soon as possible.

Why treat hearing loss?

When hearing loss occurs, reactions to the situation vary. Living with an unaddressed hearing loss can often lead to social isolation, we feel tired just trying to live our everyday day lives in the same way we once did when we could hear. Sometimes a loss of hearing can affect us both mentally and physically, if we isolate ourselves it could lead us to missing out on our activities and our interactions with our friends and family, we may feel lonely and left out. It is important to break this negative cycle and get your hearing assessed if you recognize this pattern. The earlier you begin to address your hearing loss, the better the chance of being able to retain many of the recognized "sound pictures" that our brain learns and stores from birth that help us quickly "get the picture" of a situation.

Types and causes of hearing loss:

There are many kinds of hearing loss, but most fall into two categories:
Sensorineural or Conductive.

Sensorineural hearing loss

This is the most common type of hearing loss. Sensorineural hearing loss is caused by damage to the tiny hair cells in the ear that help transmit sound to your brain. These can bend or break due to

• Exposure to very loud noises
• Genetic disposition
• Virus infections in the inner ear
• Certain medical treatments such as chemotherapy and radiation
• Head injury
• Age

The effects are almost always the same – it becomes harder to distinguish speech from noise, certain high-pitched sounds such as birdsong disappear altogether, people seem to be mumbling and you often have to ask them to repeat themselves.
Sensorineural hearing loss is permanent and can't be corrected medically, but a hearing aid can almost always help.

Conductive hearing loss

This is caused by any blockage that prevents sound reaching the inner ear. This might include:

• A build-up of earwax
• Fluid in the middle ear
• Unusual bone growth in the middle ear
• Middle ear infections
• Small holes in the eardrum

Conductive hearing loss is not necessarily permanent and can often be corrected medically or surgically.

Mixed hearing loss

It is possible that you may suffer from both types of hearing loss. This condition is called mixed hearing loss. Mixed hearing loss can be helped with surgery and a hearing aid.

Other factors associated with hearing loss

Discrimination loss:
Having a hearing loss does not simply mean the inability to hear loudly enough. Some people may also have great difficulties hearing within a specific and narrow frequency region. This can result in what is known as "discrimination loss"; one can hear speech but not understand it. Discrimination loss means that some speech sounds cannot be perceived by the ear and brain, making it difficult to distinguish between words and speech sounds - particularly those that are placed close to each other.
Your hearing care professional can measure speech recognition (in percent) to find out if you have a discrimination loss. The percentage of correctly identified test words is called the "speech recognition score". This represents the difference between a perfect score of 100 percent and the score actually obtained.

Tinnitus

Tinnitus is not a disease, but a symptom resulting from a range of underlying causes. When you suffer from tinnitus, you perceive certain sounds that are generated by the nervous system of the ear and brain. The cause of tinnitus is not fully known and at present no medical treatment exists that can cure it. The sounds are often characterized as hissing, ringing, buzzing, humming or the like.
A large variety of methods exist to deal with tinnitus, the most common being the use of hearing aids or various sound generators, various types of psychological approaches, therapies etc. Widex, a hearing aid manufacturer for example, offers hearing aids with a Zen system which can aid in the management of tinnitus.

Degrees of hearing loss

It's a fact that 1 out of 6 people over the age of 50 have trouble hearing and require some help with amplification of sounds. Hearing loss ranges from mild loss to moderate, severe and to profound.
This scale shows different levels of hearing loss (HL).
Normal hearing (<25dB HL)
Mild (26-40dB HL)
You have trouble hearing or understanding soft speech and whispers, or speech over background noise
Moderate (41-55 dB HL)
You have trouble hearing or understanding regular speech up close or regular speech in a quiet office environment
Moderately severe (56-70 dB HL)
You have trouble hearing or understanding everyday conversations or a telephone ringing
Severe (71-90 dB HL)
You can only hear loud sounds such as very loud speech, sirens or a door slamming
Profound (90+ dB HL)
You have trouble hearing sounds such as a motorbike or power tools
The degree of hearing loss is an important factor when choosing a hearing aid. Not all hearing aids will suit all degrees of hearing loss. Read more about this in the Hearing Aids section.

The audiogram

An audiogram is a visual representation of your hearing. During the hearing test, your hearing healthcare professional will plot the results into the audiogram.
This is a typical audiogram for a person with normal hearing:

And this is a typical audiogram for a person with age-related hearing loss:

Your hearing healthcare professional uses the data from your audiogram to determine if you might benefit from hearing instruments or if other medical treatment may be appropriate.

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How to choose your hearing aid?

Hearing loss typically means an individual cannot detect particular sounds compared to those without a hearing loss.

• Your Audiogram and hearing loss patterns and type
• Your life style and noise environment around
• Your expectations from the hearing aid
• Your needs and preferences
• Your budget

There is no fixed formula for choosing a hearing aid. A lot depends on the counseling given to you by your hearing aid specialist. Please remember that a hearing aid has to be tried and tested for you before you choose to buy them. Two hearing losses of two individuals might be identical, but it is quite probable that the same hearing aid might not suit one of them. Hearing aids are very subjective and hence, any comparison between manufacturers, fellow hearing aid users, technology, etc is irrelevant. It is a trial and error method. Even after few months of buying one, you may need to visit your hearing aid supplier for fine-tunings of your hearing aid. The approximate time frame for getting used to hearing aids may vary between 1 to 3 months depending upon the technology(how advanced) the hearing aid you have chosen is and your adaptation period

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Hearing Aids And Types

A hearing aid is a highly sophisticated communication device.There are many different types of hearing aids, just as there are many forms of hearing loss but they share five basic components. All of them work on amplifying sounds to enhance particular hearing range problems.

The design can vary but the overall effect is to empower you to live your life to the very fullest.

How a hearing aid works?

• Microphone picks up sounds
• Sounds are analyzed by the processing chip
• Processed sounds are sent to the amplifier
• Amplified sounds are sent to the loudspeaker
• Sounds are transmitted by the loudspeaker into the inner ear where they are transformed into electrical impulses
• Impulses are picked up by the brain where they are processed.

Behind the ear hearing aids are shown above

The classic behind-the-ear model (BTE) is the choice if you have a severe hearing loss or if you have very small ear canals, which makes it difficult to fit an entire hearing aid into your ear.All the electronic components of a classic BTE model are located in a housing placed behind your ear.A slim plastic tube with an earmould in the end directs the amplified sound from the hearing aid into your ear. Manual controls for volume and program change are placed on the top side of the hearing aid for easy user access.
Depending on the model, BTE hearing aids can moreover often be fitted with an open fit solution. This means that the ear-tip is made with compensatory measures so as to optimize the sound processing.

An in-the-ear hearing aid (ITE) is shown above

An in-the-ear model (ITE) is suitable if you have a mild to severe hearing loss. The ITE has all its electronic components contained within a plastic shell moulded to fit your ear. The ITE model is placed in the ear canal, but with the faceplate still visible in the concha of your ear. The size - as well as the visibility - of the ITE depends on your degree of hearing loss and the shape of your ear canals. The ITE comes with optional user controls for program and volume change on the outside shell plate.

Completely Inside the Canal (CIC) hearing aids are shown above

The CIC is the smallest model in hearing aids and is especially suitable if you have a mild to moderate hearing loss. It is a custom made shell that contains all the electronic components. The shell is placed deeply in the ear canal, making the hearing aid almost invisible. A CIC therefore has a big aesthetic advantage: No one can actually see that you are wearing a hearing aid. For easy everyday removal, the CIC has a small extension cord attached to the outside. A CIC model works fully automatically.

Receiver inside the Ear (RITE) hearing aids are shown above

The receiver-in-the-ear (RITE) model is a newer development in hearing aids and is suitable for mild to severe hearing loss.
Compared to a classic behind-the-ear (BTE) hearing aid, the receiver of the RITE (the loudspeaker) is placed in the ear-tip instead of in the housing, thereby reducing its size.
The RITE model consists of three parts: The housing, which sits behind the ear, and a thin earwire connecting the housing to the receiver. The receiver is placed in the concha of the ear.
The RITE model is a very discreet, and yet powerful hearing aid, which works fully automatically

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Tips For First Time User

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Take a tour of Hearing

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Analogue vs Digital Hearing Aids

We live in a world where there are a lot of ailments. The sufferers cannot be left at the mercy of God.  There are certain ailments which can be managed by modern technology. There are hearing aids to help patients suffering from hearing ailments. All hearing aids perform a similar function of improving the hearing of the sufferer. They act as a hearing amplifier. The two most common types of hearing aids are analogue and digital hearing aids. They are different in the way they process and amplify the sound.

Analogue hearing aids work on a simple principle. A small microphone picks the sound. It converts it into an electrical signal and by passing through a loudspeaker, the sound gets amplified. Here the electrical signal gets converted into an increased sound which is then impacted on the eardrum. Digital hearing aids also work on the same principle. The only difference is they amplify the sound digitally.

The loudness of the sound can be easily increased and decreased in digital aids. These can be programmed like a computer. They are the best help to compensate for any range of hearing loss by setting up the frequencies. They can eliminate background noise and can make the sound much clearer.

Different people have different choices. Some patients prefer analogue aids over digital.  Analogue hearing aids amplify the sound naturally. They amplify the background noise too which everybody listens to in their daily life. These aids are cheaper as compared to digital ones.

Whether you are facing difficulty in hearing, suffering from severe hearing loss, or have a minimal hearing loss, hearing aids can help you overcome these issues.  Analogue or digital hearing aids - the choice is yours. But one thing is for sure, there is no reason for anyone to suffer from hearing ailments now. These gadgets are there to help you out.

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Expectations from a Hearing Aid Instrument for first time users

Expect lot of new sounds

In due course of hearing loss, many people don't hear (or hear very less) everyday sounds like traffic noise, noises in the house (like fan, utensils, noises coming out of the window) etc. The moment they put on Hearing Aids, suddenly all the noises begin to appear. At first, they might think it's the hearing aid noise. But it is the environment noises that the users have first get used to. It may take days or even months for the brain to accept and get used new level of sounds. Once, the brain learns to ignore these sounds then users can expect better hearing. Patience, persistence, constant use and willingness of the user to enjoy/experience new sound are the key to getting used to the hearing aid.

Expect unnatural sound quality

Many users are under the impression that the moment they put on the hearing aids, things would be back to normal what they once were. Unfortunately, not even the best of hearing aids can reproduce natural ear like sound quality. Hence, users might feel their own voice sounding different than before. The physical presence of ear mould or sound outlet inside the ear itself creates a new sound altogether. The sound of chewing food, etc may too sound loud at first.

Tips for first time hearing aid users

• Start by wearing the instruments at home for two weeks. Start by wearing them for 4 hours per day, say two hours in the morning, one in the mid day and one hour at night. If you are having binaural (for both ears) hearing aids, then wear them together
• Notice the sounds that you haven't heard for long time. Like sound of the fan,
• roadside noise, utensils, mixer, grinder, sound of water flowing, etc.
• Do NOT try to understand hard at what people talk to you. You MAY NOT hear everything in the initial few weeks. Relax and let the body and brain get used to the sounds.
• Ask people to talk one at a time.
• Ask people to catch your attention, for example, by tapping on your shoulder before they speak to you.
• Ask people to talk slowly and clearly instead of raising their voices.
• Ask people to avoid smoking or eating while talking.
• Keep good eye contact with the speaker, or make sure that you can at least see their face well.
• Move closer when listening to someone at a distance.
• Look for keywords - understanding becomes easier when you know the topic.
• Be early for meetings so you can pick an optimal listening position.
• Prepare yourself for plays, performances, meetings or the like by looking into the story or the topic before you go.
• Give people occasional feedback to reassure them that you are following what is being said.

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