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Welcome to Peter Pearlman's question and answer forum! Each month, Peter will respond to hearing instrument questions and their associated fitting . Peter has been associated with hearing loss almost his entire life.  His father started Louisville Hearing Aid Center in the early 60’s.  After graduating  from the University of Louisville Department of Communicative Disorders, Peter joined the practice.  Peter served as Director of Audiology at Louisville Hearing and in 1989 became the CEO.   Peter left Louisville Hearing Aid Center in 2015 and now serves as Director of Audiology at Gould’s Discount Medical.  Peter has enjoyed providing hearing healthcare services for his patients over the last 34 years and looks forward to answering your questions.

We are open to your questions NOW!  Please use the website's Contact Us  or Post a comment links to send in your questions today! You can also email us directly at info@hearinglosskyhome.org. Next month, we will post Peter's responses . 

December 2016 Question And Response:

Your Question: Can you talk about programs, options and features that are available on hearing aids? How can a consumer become aware of them so they can more intelligently talk with the audiologist? How can one become a better consumer?

Audiologist's Response: Almost any hearing aid you purchase nowadays has the ability to put various programs in.  Think of a program in a hearing aid as a second or  even third hearing aid that responds to sound differently than the original hearing aid, to help you hear better in a different type of noise situation.   Many manufacturers have programs for speech in noise, outdoors, music etc…The question is how important  are programs when purchasing hearing aids?  The truth is most individuals do not need multiple programs with their hearing aids, especially with higher  technology hearing instruments.  Here are the reasons why..

Hearing instruments have become highly sophisticated electronically and are able to do more in different noise situations.  In the past, programs were very important in that they could change a hearing aids frequency response or microphone directionality in order to help an individual to hear in various noise situations.   Nowadays hearing aids have very fast computer chips which are able to look at the noise situation that an individual is in and make changes that allow them to hear and understand better without having to switch programs. 
Now,  with that said, there are times where I have had patients that have needed more than one program.  I have individuals for instance who attend a large number of roundtable meetings and find that keeping a hearing aid in directional mode helps them to hear in the meeting better.  I also have patients who work in very noisy situations who we have tried to build a special program for.   The important thing is that there are always exceptions to the rule and when there is one, we have to make a program for it.
 

So as stated earlier, almost all of the new hearing aids have the ability to put in extra programs.  Most of the time with the technology built into the new hearing instruments there is little need for an extra program but there are exceptions to the rule.

August 2016 Question and Response:

Your Question: Can you talk about ear molds? Over the years, I have had many types...some that fit well, some that itched, moved and caused blood blisters. I have hit on a good mold/fit several times but when I go to a different audiologist/H.I.S. I get an entirely different type of mold and it takes several efforts to get a good fit. How can I help this process? How can I repeatedly get a good ear mold and fit? (I don’t change my Hearing Professional lightly. However, moves, retirement, closed or sold offices, etc. forces the process.)

Audiologist's ResponseThis is a very good question without a very good answer. Earmolds, most especially for severe to profound losses, need to fit tight in the ear so that the patient does not have feedback problems. Let’s cover a few of the variables: 

(1) Itching may be one of the easier problems to solve. People who have itching problems with their earmolds may have an allergy to the material. If this is a problem , you need to talk to your professional about it. Earmold manufacturer’s have materials that are considered non-allergenic which can solve the problem. With that said however there are still times that no matter what material you use your ear still itches. An anti-itch cream may help. If it continues you may want to see your doctor.

(2) Fit is a more difficult question most especially with severe to profound losses.This type of loss usually requires a tight fitting earmold so that It minimizes feedback. With that in mind, the difference between a tight fit and a painful earmold causing blistering  could be very small. If you have an earmold you like, right down the style and the type of material that was used.That way if you go elsewhere or have a new professional you can request what you want.I wish there was something I could tell you to ensure a good fit, but honestly there is not much that you can do yourself to ensure a good fit.

June 2016 Question and Response

Your Question I went into the shower and forgot to take off my hearing aids. What should I do?

Audiologist's Response: First thing is don’t panic! Hearing instruments are much more water resistant than they were several years ago. They don’t sweat out as easily as the old hearing aids did and have much higher ratings when it comes to moisture protection. Many hearing aids today have an ingress protection marking of 68. For those of you who are truly interested I invite you to go to the following web site to read the nitty gritty details: https://en.wikipedia.org/wiki/IP_Code The bottom line is that electronics use to be listed as water resistant or waterproof without really defining what it meant. The IP code actually quantifies what the resistance is for the particular product. In the case of the number 68, the 6 indicates that the hearing aid would be dust tight and the 8 means that it could be immersed in 1 meter or more of water without leaking. This does not mean you can put your hearing aid under water or wash it under water!

So what should you do if you get your hearing aids wet? First, take them off and dry them off well. Secondly, any one who owns hearing aids should have some type of drying kit. You paid a lot for your hearing aids so you should protect them. Drying kits can be something as simple as a pouch with drying crystals in it which you put your hearing aid in at night, to some very sophisticated electronic machines to help keep your hearing aids dry. In either case, if you are good to your hearing aids they will be good to you and last you a good long time.

May 2016 Question and Response:

Your Question: What is the likelihood of an infant’s hearing screening failure being a false positive? 

Audiologist's Response: The best way to answer this is by citing an ariticle out of the journal of the Academy of American Family Physicians: 
“Universal newborn hearing screening produces a large number of false-positive test results. Both AABR and TEOAE can be influenced by motion artifact and therefore are more specific if performed on a sleeping child in a quiet room. The rate of false positives ranges from more than 30 percent for one-step programs using TEOAE to less than 1 percent with a two-step process, such as retesting a child before discharge if the initial test is positive. Despite these concerns, the consensus of multiple organizations that develop children's health guidelines is that the potential benefits of universal newborn hearing screening outweigh its adverse effects.  Currently, 37 states and the District of Columbia have enacted legislation requiring that hearing screening be performed on all newborns in hospitals and birthing centers”

March 2016 Question And Response

Your Question: How do I clean and take care of my hearing aid earmold?

Audiologist's Response: The first point I would like to make is that different types of ear molds require different types of care.   So the first question I would ask you is whether or not your earmold is for a behind the ear style (BTE) of hearing instrument, a receiver in the ear(RITE) style of hearing instrument, or a custom hearing instrument.  Lets take a look at each and see what type of care they require:

RITE (Receiver in the ear hearing instrument)
The first thing that you have to remember about this style of instrument is that there is electronics inside of the earmold that can be damaged.  This means that the earmold cannot be put into water to be cleaned.   The earmolds should be cleaned every night by wiping them off with a soft dry cloth to remove any body oils or earwax that may have collected during the day.  Many of these types of molds are also equipped with wax guards which keep the earwax from going down into the electronics.  Generally I would recommend that you use a soft brush to gently brush off the wax trap.  When  the wax trap becomes clogged, go ahead and replace it.  Some times these earmold’s do not come with wax traps.  Your hearing professional should provide you with some type of wax pick to help you keep the mold clean.

Custom Hearing Instruments(In the ear, Canal, Completely in the Canal)
The rule for cleaning this type of hearing instrument which is built into an earmold is the same as the rules for cleaning RITE hearing aids.  Wiping of these aids every night and following the other rules will help you to keep the instrument clean and working well.

Behind the Ear Hearing Instruments
Earmolds for this style of hearing instrument are different than for the other styles because there is no electronics built in to the molds.  It gives us some more leeway.  The initial rules are the same.  Wipe  the earmolds off every night to help keep them clean.  If earwax gets down into tube, remove the earmold from the hearing instrument being careful not to get them mixed up.  Run warm water (not hot) through the tube and on the earmold itself.   If there is a lot of earwax, you can drop them in warm  water with a mild soap and let them soak for a while. I personally like to use Dawn simply because it does such a good job of removing earwax.   IT IS IMPORTANT THAT THE HEARING AID IS NOT PUT INO THE WATER, JUST THE EARMOLD!!!  Rinse the molds off well and dry them off being sure to blow all of the water out of the tubes before putting them back on to the hearing instruments. DO NOT USE A BLOWDRYER TO REMOVE THE WATER FROM THE TUBE.  Earmold tubing can get hard and can crack  with age.  When this occurs, the tubing can be removed and a new tube can be inserted by your hearing professional.

Lastly, never use any chemical solvents or alcohol on your  earmolds.  These liquids can cause discoloration and make soft earmolds turn hard and shrink. If you have any questions your hearing professional can help answer those questions for you.

February 2016 Question and Response:

Your Question: I am having trouble with whistling when I am close to objects. I find car window to be especially bad. What do you recommend?

Audiologist's Response: Good question.  So first lets talk about that whistling sound which is called feedback. Anybody my age or a little older who listened to rock music can tell you all about those loud screeching sounds that were almost an art form for hard rock bands in the 60’s  and 70’s.  Great for rock music but when it comes to your hearing aids, not so great. Having worked with hearing aids for 34 years I can tell you that today’s hearing aids have little or no feedback compared to the old analog hearing aids that I first started working with.
 
Okay, so let’s talk about some of the causes of feedback. One of  the first things that your hearing professional will do when trying to rule out the cause of your feedback is to look in your ears.  An ear occluded with cerumen (earwax) is often the cause of excessive feedback in your hearing instruments.  This is one of the easier fixes because as soon as the cerumen (earwax) is removed the feedback goes away. We usually see a greater chance of feedback with those individuals who have a more  severe  type of hearing loss.  In the simplest terms, the stronger the hearing aid, the greater the chance of feedback. Some causes of feedback with these individuals include: loose ear molds, too large of a vent in the ear mold and lastly it may be time to change that tubing that has gotten hard.   Ruling these factors out your professional may also be able to isolate where the feedback is occurring with your hearing instrument and program it in such a way to reduce the feedback. Some of these issues may also be the cause for feedback in custom instruments. Today’s new open fit instruments can also suffer from some of the same feedback problems that the older style custom and behind the ear hearing aids have.  Sometimes a simple change of the dome will solve the feedback problems.  In addition, reprogramming the hearing instrument may solve the problem.
 
If you are having trouble with feedback when your head is next to a window or wall you might try to have your professional attempt to adjust your aid while your head is next to a wall.
 
Lastly,  you need to understand that the newest hearing aids on the market today are far less likely to have feedback problems.   The new anti-feedback  circuitry in today’s hearing aids does and unbelievable job in reducing the chances of feedback.   

January 2016 Question And Response:

Your QuestionWhat are the three or four things that are important for you to know or be able to provide to your hearing healthcare provider when you are looking for new hearing instruments?

Audiologist's Response: To answer this question it is important that we look at 4 separate issues:  The severity of the individuals hearing loss, their lifestyle, their individual needs, and lastly for some, cosmetic issues.

The most important process for a hearing healthcare professional when seeing a patient for new hearing instruments is the case history.   We need to know what communication difficulties you are having so that we can pick the most effective solutions.  I like to tell new patients before they come in for their appointment to take notes about where they are having problems prior to coming in. For example:  I have trouble hearing in meetings,  I can’t hear on the telephone, I can’t hear the minister, I can’t hear in groups.   These are all important issues. 

Sometimes selection of an instrument comes down to life style.  An individual who leads a very quiet lifestyle may not need to purchase a hearing instrument that has all of the bells and whistles to reduce background noise while a very active business person may need something much more active in background noise.  Today’s hearing aids also allow us to select other products in addition to hearing aids to allow patients to hear and understand better.  These devices include Bluetooth streamers that  can connect to telephones, televisions and even computers to help someone hear and understand better. 

Severity of hearing loss will always be a factor.  Sometimes with very severe hearing losses we can’t select a very small hearing instrument. There are other medical conditions that may also necessitate the selection of a different hearing instrument than the patient might want.  Or, as another example, selecting a rechargeable model for someone who has trouble changing batteries. 

The last issue is cosmetics.  Today’s hearing aids compared to even those from 20 years ago are amazing  in how little they show.  I rarely ever see that as an issue anymore but it still pops up once in a while.