Managing Hearing Loss Out of the Box. Michelle Pitts. What Hearing Aids and a Chicken Dinner Have in Common. Karl Strom. What If You Could Lease Your Hearing Aids? Shari Eberts

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Michelle Pitts with her husband Adam and their sons Elijah and Jack.

Out of the Box

The hunt for a successful hearing solution leads to greater self-knowledge and empathy. By Michelle Pitts

I have been struggling with my hearing for quite some time, but finally made the decision to do something about it now, in my early 40s.

Even though I work with individuals with disabilities, starting the process of treating my hearing loss feels like I’ve been thrown into a new world about which I know so little.

After my hearing test and official diagnosis, I was shown a few hearing aid models to choose a pair. Simple, right?

So I thought.

Over the course of a few minutes, my audiologist tried to explain the different technological features, colors, and brands available. I knew that agreeing to one of her suggestions would also be an agreement to thousands of dollars of my family’s healthcare savings. I felt guilty and sick to my stomach about spending this money if, God forbid, a bigger health emergency came up.

Making such a big purchase felt like rolling the dice. I still knew almost nothing about the hearing aid options and I felt like I wasn’t given enough clarity on the matter. With every hearing aid brand making similar claims about their technology, it’s difficult to be sure you’re making the right choice for your hearing loss.

Testing pairs of hearing aids wasn’t easy for me, either. “How’s that sound?” my audiologist would ask after putting them in my ears. And I’d just think, I have no idea! Only a few seconds have passed, and this is a quiet room with only one other person in it. Then I’d leave the office and everything sounded harsh, giving me a headache, and then I’d be at home having a difficult time understanding my kids.

I tell myself, So maybe this will be harder than I expected, with trial and error adjustments. And maybe I need to do some of my own research to find the best technology for my ears.

I dug into the technology offerings from each brand using their data sheets, only to find that often the features I desired were not available for my preferred style of hearing aid. And back to square one I’d go.

Eventually I discovered an exceptionally helpful internet forum. It contains users’ personal experiences with various aids, technology information, links to data sheets, and definitions of technical terms.

One of the terms I came across on the forum was a “cookie bite.” Someone wrote in a comment to another user, “Since you have a cookie bite, it’s more difficult to fit you with hearing aids. You need to find a very well-trained audiologist to handle your type of hearing loss.”

What’s a cookie bite? I wondered. Down the internet rabbit hole I

When some people who have hearing loss won’t wear their hearing aids, chances are their devices don’t fit right, they are uncomfortable, or they are incorrectly programmed for their hearing loss—or any combination of these reasons. If this is you, please know that things can be much better after your audiologist works with you to adjust your hearing aid programming so you can hear better.

went—and found that a cookie bite is a midrange frequency hearing loss, and the audiogram is shaped like a bite taken out of a cookie.

Wait a minute! I grabbed my audiogram, and lo and behold, I have a midrange frequency loss. So what does this mean?

Midrange frequency loss is a type of sensorineural hearing loss that is genetic. It is present from birth, but usually isn’t severe enough to be noticed until someone is in their 20s or 30s. The midrange is where sounds like speech and music occur. Usually hearing loss is more prominent in the high frequencies or the low frequencies, like what my parents and my brother have.

Learning more about my hearing loss has prompted significant recent revelations about my life, too. Now I know why I have such a hard time understanding speech sometimes. I see why I miss a lot of lyrics in music and dialogue in movies.

I can even remember being at a wedding reception in my 20s when someone asked me, “Isn’t this your favorite song?” All I could hear was the thump of the bass. I was pretty amazed that they could hear the song, and they were pretty amazed that I couldn’t. I think that was one of the first times I started to question if I had a problem.

I usually have to turn the radio down in my husband’s car or tell my kids to lower the TV volume because I can’t handle the noise. Noise drives me crazy, and sometimes I think I’m turning into my mother. But now I know that it’s actually loud high frequency and occasionally low frequency sounds that drive me crazy, because these correspond to my hearing loss. And I can pretty much forget about being able to understand someone if there are multiple, competing sound sources.

While I’ve wanted to throw in the towel several times on the whole hearing aid business, I have been working with my audiologist to help me find a pair that will work for me, in part by using real ear measurements, a way to directly measure the sound that hearing aids produce in the ear canal.

Now I can understand when some people who have hearing loss won’t wear their hearing aids. Chances are their hearing aids don’t fit right, they are uncomfortable, or they are incorrectly programmed for their unique hearing loss—or any combination of these reasons—and they can’t hear right. If this is you, you should know that things can be much better after your audiologist works with you to adjust your hearing aid programming.

I’m learning to advocate for myself while also better understanding what my clients experience, so that we can overcome our challenges together.

My clients often come in and don’t know what services are available for them or what technologies are available that can help them. These things can change their lives, but sometimes service providers don’t take the time to educate their clients or don’t keep up to date themselves. I try to make sure I pass along any of this information because I too have experienced the difficulties of navigating a disability.

Michelle Pitts is an instructor for vocational rehabilitation with the state of Tennessee. After primarily working with people with vision loss, Pitts’ role has expanded to include people with all types of disabilities who are seeking to enter or re-enter the workforce through vocational rehabilitation.

Share your story: Are you new to hearing aids? Tell us your hearing loss journey at editor@hhf.org.

Support our research: hhf.org/donate

help What Hearing Aids and a hearing with Chicken Dinner Have in Common aids By Karl Strom Hearing aids can cost thousands of dollars for at 56.9 percent of respondents). One issue: many reasons: the research and development “There’s no single standard across the country that goes into advanced hearing aids, the for whether hearing aids are covered by health associated professional investments and service insurance,” the report says. costs, the relatively small number of hearing As a result, hearing aid financing is aids manufactured, the demand for customizable becoming more common. Ask your hearing hearing solutions, and more. However, the care practice if hearing aids can be purchased advent of personal amplification products, using low- or no-interest monthly payments. Big Box options, and straight-to-consumer Some financial services companies offer hearing devices have made price sensitivity long-term, low-payment financing options an even larger issue. that you can apply to hearing aid purchases. To illustrate why hearing aids dispensed (You can also explore using a health savings or by audiologists are more expensive than if flexible spending account to save on taxes.) purchased online, Washington University in Hearing care professionals are increasingly St. Louis clinician-researcher Michael Valente, carrying a wider selection of hearing aid Ph.D., uses the example of buying a chicken products, including more economy and basicdinner three different ways: 1) a $5 grocery level hearing aids. They are also unbundling store frozen chicken; 2) a $10 cooked rotisserie their prices and may offer optional service chicken; and 3) a $30 chicken cooked and served packages as add-ons, to separate out and reduce in a nice restaurant. the overall “device cost.” necessary associated costs. Numerous studies show that hearing aid price, while certainly not the only factor, remains second most important reason for not adopting hearing aids (after “Can manage without one” You may be able to purchase amplification Numerous studies show that hearing online (a precursor to the Food and Drug Administration’s eventual over-the-counter aid price, while certainly not the only factor, remains a major obstacle in hearing aids category) on your own or even at a hearing provider with the provider fitting the device and charging for fittings and/or followobtaining appropriate hearing care. ups. The provider may also give the option of applying all or part of the device cost toward It’s the same meal, but you must do more The bottom line is that financing options and work for the least expensive option, while the lower-priced hearing devices are available and most costly is served to you on a platter. There can be viable solutions. Just ask your provider is value and benefit in a hearing aid fit with best and if needed, ask more than one. And then go practices, but that value and benefit comes with ahead, treat yourself to dessert afterward. a major obstacle in obtaining appropriate Karl Strom is the editor of the hearing care. According to hearing aid website hearing professionals journal Hearing Tracker, the average price of a hearing The Hearing Review, from aid is about $2,500. which this article is adapted. A July 2020 survey by senior resources For more, see hearingreview.com. website Senior Living shows that cost For references, see (38.2 percent of survey respondents) is the hhf.org/winter2021-references. the purchase of a traditional hearing aid later on.

What If You Could Lease Your Hearing Aids? By Shari Eberts

The growing popularity of auto leasing makes sense to me. You get the benefits of ownership without putting all the money down. You enjoy the use of the car while you pay over time. Leases also often include regular maintenance and if something breaks or goes wrong, repairs are usually covered too. For time-consuming repairs, a replacement car may be provided. After a few years, your lease ends and you are free to swap into a newer model with all the latest bells, whistles, and safety features. Or you can choose a different brand of car altogether. You have ultimate flexibility.

What if you could do this with hearing aids? Here are some issues to consider.

Hearing aids are often custom fit. Hearing aids are highly personal items, typically custom-made to fit your specific ear—especially those worn in the ear canal. This could make them hard to repurpose for another user. But, there is the growing popularity of open-fit, behind-theear models. Even when used with custom ear molds, the behind-the-ear devices are fairly standard and could likely be repurposed for another user quite easily.

Complexity may temper ease of upgrade. Hearing aids are highly sophisticated devices, programmed to meet your specific hearing challenges. Things sound differently through each pair of hearing aids, so it often takes time and energy to get used to them. Swapping to a new pair every two or three years may not be desirable.

Hearing loss can also change over time, making a different type or brand of device more appropriate. This would make the flexibility of a lease attractive, but it could also add complexity if the lease was tied to a particular manufacturer.

Industry structure would need updating. Sometimes old hearing aids are collected and repurposed for markets in developing countries, but less so in the U.S. Given the high price of hearing aids, a used-device option—assuming they can be reprogrammed and updated with fresh ear molds—could be an exciting new market especially for first-time users put off by the typical cost.

Today, a few alternative hearing aid purchase models do currently exist. For example, Phonak’s Lyric hearing aids are sold as a subscription, although the “rental” is paid annually and the cost can compare to buying a new device. Hearing loss can change over time, making a different type or brand of device more appropriate. This would make the flexibility of a lease attractive, but it could also add complexity if the lease was tied to a particular manufacturer.

Audicus, an online hearing aid company, offers a “membership model” option. Users pay a nominal monthly fee entitling them to hearing aids, batteries, insurance, and the ability to upgrade to new devices every 18 months. Another new entrant, Whisper, recently launched a subscription model product that includes ongoing care from a local audiologist, regular software upgrades, and a three-year warranty.

Telehealth is becoming more prevalent with COVID-19 health practices in place, and some audiologists already offer financing for hearing aids. It could be time to consider a leasing model option as well.

Shari Eberts serves on the Board of Trustees of the Hearing Loss Association of America and is a past chair of HHF’s Board of Directors. A version of this originally appeared on her blog, livingwithhearingloss.com.

Share your story: Are you new to hearing aids? Tell us at editor@hhf.org.

Support our research: hhf.org/donate