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Jeff Lane Audiologist

Accessorize Your Hearing

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Fortunately, there are a wide range of accessories compatible with current hearing aid models.

Technology is constantly evolving, often at a rapid pace, with the goal of improving and simplifying the experience of the user. If you buy a new phone, you get a pair of wireless earbuds. Hearing aids are similar. While modern hearing aids can significantly improve a wearer’s quality of life, some situations could still be improved with the addition of an accessory such as listening to someone behind you while hiking or catching all the information at a meeting. Fortunately, there are a wide range of accessories compatible with current hearing aid models.

Remote Microphones

Remote microphones are a wonderful solution for improving communication between individuals. Let’s say that a hearing aid user is going on a tour. The tour guide will likely be at a distance from the user or often turned away. Obviously, this makes hearing the tour guide much more difficult for the person with hearing loss. Remote microphones eliminate this frustration by delivering the speaker’s voice directly to the hearing aids. The talker can be far away (typically 60 to 80 feet) or even turned away, and the user will still hear them perfectly clearly. Plus, it is all done wirelessly! And the microphones are small, meaning they are convenient to wear.

Also, they are fairly versatile. They can be used in the car, while hiking, in a restaurant or at home with the two individuals in different rooms. They’re also great for loved ones with very soft voices. Typically, remote microphones are designed for listening to a single talker, meaning they are not ideal for group situations. However, this also means that remote microphones are very affordable.

Roger Technology

Before proceeding, it should be noted that Roger technology is specific to Phonak hearing aids. However, it is unique and beneficial enough that I felt it warranted inclusion. Roger technology is similar to a remote microphone, but far more advanced. First, it can be used in virtually any situation. It can be worn by an individual, or it can be placed on a table to hear multiple talkers. When listening to multiple talkers, it can either be automatic or manual. When automatic, it will adjust its directionality to amplify whoever is currently speaking. Or, the user can select which directions it wants the device to focus on. For example, if you only want to hear in front and to the left, you can designate that and the device will ignore everything else.

Another advantage is that Roger technology can actively cancel out background noise and increase the volume of the desired signal. Thus, you would have a much more favorable signal-to-noise ratio than with a regular remote microphone. Studies actually show that individuals with hearing loss can hear better than those with normal hearing in noisy situations when wearing hearing aids and Roger. While it does cost more, it is a wonderful solution for those who struggle to hear in noise.

Television Streamers

One of the first things a patient tells me during their hearing test is that they have to blast the TV in order to understand what is being said. Having properly fitting hearing aids will automatically help. But TV streamers can make it sound even better! Again, since the signal is being beamed straight to the aids, it eliminates the need for the sound to travel over distance and through other aural clutter. Another nice feature is that the actual TV volume isn’t affected, so other people can still hear the TV at a volume that is comfortable for them. Unfortunately, TV streamers can’t improve the sound mixing of a program or make British accents any easier to decipher.

Remote Controls

All hearing aids have buttons that allow you to adjust programs. However, this may not be the best option for some wearers. If someone has arthritis or neuropathy, they may not be able to press the button. A person with memory loss may not be able to remember where the button is or its purpose. In these situations, a remote control can be very handy. It is easy to handle and very clear on its operation. For those who want to be more discreet, there are applications for the phone that can act as a remote control as well.

To be clear, accessories are not required to use hearing aids. But for those who need or want a bit more assistance, they are worthwhile. As always, let your hearing care professional be your guide. QCBN

By Jeff Lane, Au. D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Using VR in Tinnitus Management

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Recently, researchers have looked to fractal tones for use in sound therapy.

The second most frequent request I receive from patients, after improved hearing, is to make their tinnitus go away. While tinnitus is not dangerous, it can certainly diminish sufferers’ quality of life. Unfortunately, there is no known cure for tinnitus. Instead, the focus is on mitigating the impact on daily life. Studies show that amplification, sound therapy, dietary modifications and cognitive behavioral therapy (CBT) are all effective forms of tinnitus management. But are there any new tools to add to the arsenal? Perhaps! Researchers are beginning to explore the use of virtual reality (VR) in helping tinnitus patients, and the initial results are promising.

Sound Therapy

Sound therapy refers to the practice of having tinnitus patients listen to relaxing sounds to lessen the perceived annoyance caused by the tinnitus. Common stimuli can include white noise and nature sounds, such as waves. They are often presented through hearing aids. The stimulus sound masks the tinnitus; the brain focuses on the stimuli, rather than the bothersome tinnitus. It’s similar to putting on your headphones while trying to complete an assignment so you are not distracted by the noises around you. Sound therapy also promotes relaxation, which has been shown to reduce the perceived loudness of tinnitus.

Recently, researchers have looked to fractal tones for use in sound therapy. Fractal tones sound like wind chimes or singing bowls, which most people find inherently relaxing. However, their real benefit is their unpredictability. Because they do not follow a predictable pattern, the listener listens more passively, which promotes a more relaxed emotional state. Studies have shown that fractal tones can be as or more effective than other types of sound.

Virtual Reality

When hearing the words virtual reality, most people likely imagine video games or online communities. However, studies have shown it to be useful in the medical field as well. It can be used to help manage acute and chronic pain. It can also help with mental health conditions such as anxiety. Scientists believe the therapeutic benefit stems from VR’s effect on our limbic system, which helps to control emotional states and reactions. Since the limbic system is believed to be involved in our perception of tinnitus, VR offers an intriguing pathway to relief. Indeed, one study showed VR to be as effective as CBT in addressing tinnitus.

Happy Marriage

So, sound therapy and virtual reality have both proven themselves viable options for managing tinnitus. But what happens if the two are combined? Is the benefit even greater? Fortunately, we have an answer. A. K. Deshpande, et al. (2022) performed an experiment to explore this exact hypothesis.

The authors gathered 20 adult participants with tinnitus in one or both ears. They excluded those with head, neck or spinal injuries, or those who already had a tinnitus masker active in their hearing aids. They then had the participants undergo two treatment paradigms. One involved a session using a commercially available sound therapy in isolation. The second involved those same participants undergoing the sound therapy in conjunction with VR. The VR involved wearing goggles which presented different nature scenes. Each session was performed one week apart, with the order of the sessions (VR first or second) being randomized.

After each session, the effects of the therapies were determined using three self-assessments. However, for our purposes, we will focus on two: tinnitus loudness and Tinnitus Functional Index (TFI). Tinnitus loudness is the perceived intensity of the tinnitus. The TFI measures the perceived negative impact of the tinnitus on the person’s daily life. Both paradigms (sound therapy only and sound therapy with VR) were shown to help lower both the tinnitus loudness and TFI scores. However, there was a statistically significant difference between the two, which favored the inclusion of VR. In other words, the authors showed that combining the two therapies did make them more effective.

These results are obviously quite exciting. Audiologists have a possible new tool in the fight against tinnitus! However, anticipation must be tempered. As the authors discuss, their experiment did not study the long-term effects and efficacy of their treatment. Also, the setup was entirely experimental and designed solely for the study. There is no commercially available, self-contained device that you can buy to replicate this specific treatment. But such significant results in early experiments are encouraging. Contact your local audiologist to discuss currently available treatments and keep an eye on the horizon. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Dr. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Understanding Your Results

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By possessing a greater understanding of your results, you can feel confident in the decisions being made.

The first step on any hearing health journey is undergoing an examination. This exam provides you and the audiologist an understanding of your current state of hearing and allows for proper recommendations to be made. The findings are presented in a report called an audiogram. An audiogram contains both a written section and a graph. While the audiologist does review the audiogram during the appointment, it can sometimes be difficult to remember or fully grasp how to interpret your results. Proper interpretation is imperative, as it empowers you to be an equal partner in treatment.

Hearing Thresholds

Hearing thresholds are presented graphically on the audiogram. The x-axis of the graph (left to right) represents frequency. Frequency is interpreted by humans as pitch, with increasing frequency corresponding to increasing pitch. Pitch increases from left to right along the x-axis. Thus, the left half of the audiogram would represent bass, while the right half would be treble. An average exam will test frequencies between 250 and 8,000 Hz. While human hearing can detect frequencies above and below this range, these are the most important for daily communication.

The y-axis (top to bottom) represents intensity as measured in decibels hearing level (dB HL). On this scale, 0 dB HL does not represent the absence of sound, but rather the quietest sound that the average adult can hear. Intensity is interpreted by humans as loudness. A higher decibel level corresponds to a louder sound. Quiet sounds are at the top of the graph, while very loud sounds are at the bottom of the graph.

Your ears function both as combined and independent systems. A such, the audiologist will want to test the respective performance of each ear. The hearing thresholds for the right ear are represented by circles or triangles, while the left ear thresholds are Xs or squares. Hearing thresholds are the quietest sound you can hear at a given frequency. For example, the right ear threshold at 1k Hz may be 20 dB HL. This would mean that at that specific frequency, the right ear can hear the sound when it is 20 dB HL or louder, but not below that level. This will hold true for the threshold of each respective frequency. 20 dB HL is considered to be the cut-off for normal hearing, with 21 dB HL and higher representing increasing degrees of hearing loss.

Speech Understanding

Another main component of a hearing exam is speech testing. Speech test results may be found in numerical form in a box typically located at the bottom of the page. Two main speech tests are typically performed. The first is the speech recognition threshold (SRT). It represents the quietest level at which you can understand speech 50% of the time. The SRT mainly functions as a way to verify accuracy within the test battery. A measurement that is more relevant to daily communication performance is the word recognition score (WRS). Your WRS represents how well your brain can interpret speech sounds and is reported as the percentage of words repeated correctly. When measuring the WRS, the words are presented at a loudness level that is easy for the patient to hear. A high WRS means you can understand words well, while a lower WRS means that the brain has difficulty interpreting the speech sound due to distortion in the auditory system

Relationship Between Thresholds and Speech Understanding

One important concept to understand is that your hearing thresholds and ability to understand speech are not necessarily correlated. Better hearing thresholds do not always mean a better WRS, nor do worse thresholds always mean a worse WRS. Indeed, two individuals may have the exact same hearing thresholds, yet drastically different abilities to understand what is being said. What then, influences your WRS? It all has to do with the frequency filters in your ears. Each speech sound has a different fundamental frequency. Sounds like “shh” have a higher frequency than “oo” would. When sound is picked up by your ears, it is sent through specially designed filters to help separate out all the speech sounds. As more damage occurs to the auditory system, those filters become less precise and overlap with each other. Thus, “shh” and “oo” may appear to your brain to be coming from the same filter and it has difficulty distinguishing them.

While many factors are taken into account when deciding treatment, test results are a main one. By possessing a greater understanding of your results, you can feel confident in the decisions being made. QCBN

Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

How to Care for a Loved One with Hearing Aids

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Hearing care professionals are always willing to repair or clean hearing aids. Even calling with a simple question is always welcome.

According to the Labor of Bureau of Labor Statistics, 16% of the population provided eldercare between 2017 and 2018. Combine that with one in three people over the age of 65 having a hearing loss, and there is a very good chance you are or will be caring for someone with hearing aids. Hearing care professionals will diagnose the hearing loss and fit the devices. But, once fit, a majority of the daily use and maintenance falls to the wearer. Or, by extension, the caregiver. It is therefore prudent to know how to properly care for hearing aids.

Daily Care

First, take comfort in knowing that hearing aids are more durable than they appear. This isn’t to say one should play catch with them, but, given the proper respect, the aids will hold up just fine to daily life. Perhaps the most important thing is to not get them wet. Modern hearing aids have the highest IP ratings (resistance to dirt and water). This means they can withstand moderate amounts of sweat, rain, and snow. Humidity is also tolerable, although it is recommended that a specially-designed dehumidifier be used. However, if a hearing aid gets soaked (shower, swimming, washing machine), it can cause damage. Bottom line: hearing aids are water resistant, but not waterproof.

It is also important to clean the hearing aids. If the microphones get clogged or there is too much wax on the portion inside the canal, the sound will be diminished. Luckily, cleaning hearing aids is simple. A dry cloth or tissue can be used to wipe off any debris, while a brush can be used to keep the microphone ports clear. Ask the provider if you are unsure of the microphone location. In the case of receiver-in-the-canal (RIC) hearing aids, it is acceptable to clean the domes with soap and water. Just be sure to remove them from the hearing aid first and allow them to try completely before reattaching.

One should also be conscious of pets. Animals, particularly cats and dogs, are attracted to hearing aids. Unfortunately, they are not very gentle and can often cause significant damage. If the aids are not being worn, place them in a container out of reach of any critters.

Putting on Hearing Aids 

It is possible that, because of vision or dexterity difficulties, the patient may not be able to put the aids on independently. Here are the best methods for putting hearing aids on somebody else, based on style:

RIC: Hook the aid over the ear. It should sit on top of the ear, between the skull and pinna, with the wire running down the front of the ear. Grab the wire near the dome and gently insert the dome into the canal. Gently push until it settles into place.

Behind-the-ear (BTE): These types of aids will have an earmold, which is custom-molded to the patient. Thus, the mold can be easily inserted and then the hearing aid can be swung over the ear.

In-the ear (ITE): These aids are custom-molded and are contained entirely within the ear. Insert the aid with the battery door facing outward.

Most hearing aids will have indicators to identify the proper ear: red is right and blue is left. If there are no color indicators, the proper ear can usually be determined by holding up the aid and examining the orientation.

Special Considerations

It is possible that the individual being cared for is not always with the caretaker. Perhaps the loved one resides in a nursing home. In this case, the staff can be trained to assist with the hearing aids. Initial training can be done, along with written reminders. When visiting a loved one, the staff can be asked to provide updates on hearing aid use.

Another possibility is that the loved one is sick. If they are admitted to a hospital, it is probably best to hold onto the aids for them, as aids can often become lost in such an environment. The hearing aids can be placed on the patient during visits with family of the doctor, but should be stored at home. If they are transferred to hospice care, it is probably okay to leave the hearing aids with them as a hospice is a less hectic environment.

Caring for a loved one can be challenging. Remember that it does not have to be done alone, even with hearing aids. Hearing care professionals are always willing to repair or clean hearing aids. Even calling with a simple question is always welcome. QCBN

By Jeff Lane, Au. D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Making Sure Hearing Aids Work for You

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The hearing aids fit by audiologists are also on the cutting edge of technology.

As audiologists, our main goal is always to improve our patient’s safety and quality of life. Typically, this is done through the fitting of hearing aids. Surveys have shown that one major barrier to accessing hearing aids is cost. In an effort to help address this barrier, Congress recently granted permission for hearing devices to be sold over the counter. Now it can be even more challenging for patients to know which option best suits their needs. Fortunately, you do not have to figure it out all on your own.

Technology

Now that hearing aids can be sold over the counter, it can be expected that there will be a huge increase in available products. A couple have already been revealed in stores like Walmart. A few patients have asked me if the technology is any good. Honestly, it’s too early to say for sure. But the concern would be that all of this technology is unproven. There is no data to say how well they perform or how long they’ll last.

A major benefit of seeing an audiologist is that you know the quality of what you are receiving. The brands they fit have published studies that verify that the devices provide the benefit they claim to. A lot of these studies are performed by independent researchers, meaning the results are objective. They have also been around for decades, meaning the products have been put through their paces and shown their durability. Your audiologist will have the experience and knowledge to help pair you with devices that will best suit your needs.

The hearing aids fit by audiologists are also on the cutting edge of technology. Not only do they amplify, but they have filters that help reduce background noise and ease communication. They also have an array of accessories, such as remote microphones, to help you hear in crowds or at distance. Can’t make it into the office? No worries! Most hearing aids can be adjusted remotely. And given that hearing aids have different performance levels, these features are often available at a very competitive price.

Reliable Support

Deciding which hearing aids to choose can be overwhelming. And once you are fitted with a pair, there can be a steep learning curve. After all, most people don’t even think about hearing aids until they need them. That’s why it is so valuable to have someone to support you along your journey. Audiologists have a treasure trove of knowledge and real-world experience dealing with all manner of hearing aid issues. No difficulty or question is too small or silly. We love to help!

At the fitting, the audiologist can measure the output of the hearing aid to ensure it is as accurate for your hearing loss as possible. Over-the-counter hearing aids do not have a verification system in place. Also, it looks like a lot of over-the-counter models are designed to be set up through a smartphone application. This is definitely convenient, but may not work for those who do not have a smartphone or are uncomfortable using one. After programming them, the audiologist will review how to use the hearing aids and answer any and all questions that arise, ensuring that you are confident in operating them when you walk out the door.

But of course, technology doesn’t always work as intended. The sound quality may be good in one area, but bothersome in another. The hearing aids may somehow malfunction and need to be repaired. Or they may simply need cleaning with tools too small for someone to see or manipulate. All of these things can be addressed by the audiologist. Simply call them or walk in, and they can get you back up and running. Audiology offices provide peace of mind that help is always on hand. Any hearing aid you receive from an audiologist will have a multi-year warranty, meaning repairs are often free!

Friendly Faces

Most audiology offices are small and local. This means that they have a consistent staff through the years. The providers know you and your history. You don’t have to worry about learning new faces every time you need help. Plus, you can trust that the audiologist is going to make recommendations that best suit your particular needs.

When it comes to amplification, anything is going to be more helpful than nothing. So, if over-the-counter hearing aids are the best option at the time, go for it. Just don’t discount the value of exploring all your options. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Accessorize Your Hearing

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To be clear, accessories are not required to use hearing aids. But for those who need or want a bit more assistance, they are worthwhile.

Technology is constantly evolving, often at a rapid pace, with the goal of improving and simplifying the experience for the user. If you buy a new phone, you get a pair of wireless earbuds. Hearing aids are similar. While modern hearing aids can significantly improve a wearer’s quality of life, some situations could still be improved with the addition of an accessory – situations such as listening to someone behind you while hiking or catching all the information at a meeting. Fortunately, there is a wide range of accessories compatible with current hearing aid models.

Remote Microphones

Remote microphones are a wonderful solution for improving communication between individuals. Let’s say that a hearing aid user is going on a tour. The tour guide will likely be at a distance from the user, or often turned away. Obviously, this makes hearing the tour guide much more difficult for the person with hearing loss. Remote microphones eliminate this frustration by delivering the speaker’s voice directly to the hearing aids. The talker can be far away (typically 60 to 80 feet) or even turned away, and the user will still hear them perfectly clear. Plus, it is all done wirelessly! And the microphones are small, meaning they are convenient to wear.

Also, they are fairly versatile. They can be used in the car, while hiking, in a restaurant, or at home with the two individuals in different rooms. They’re also great for loved ones with very soft voices. Typically, remote microphones are designed for listening to a single talker, meaning they are not ideal for group situations. However, this also means that remote microphones are very affordable.

Roger Technology

Before proceeding, it should be noted that Roger technology is specific to Phonak hearing aids. However, it is unique and beneficial enough that I felt it warranted inclusion. Roger technology is similar to a remote microphone, but far more advanced. First, it can be used in virtually any situation. It can be worn by an individual, or it can be placed on a table to hear multiple talkers. When listening to multiple talkers, it can either be automatic or manual. When automatic, it will adjust its directionality to amplify whoever is currently speaking. Or, the user can select which directions it wants the device to focus upon. (If you only want to hear in front and to the left, you can designate that and the device will ignore everything else.)

Another advantage is that Roger technology can actively cancel out background noise and increase the volume of the desired signal. Thus, you would have a much more favorable signal-to-noise ratio than with a regular remote microphone. Studies actually show that individuals with hearing loss can hear better than those with normal hearing in noisy situations when wearing hearing aids and Roger. While it does cost more, it is a wonderful solution for those who struggle to hear in noise.

Television Streamers

One of the first things patients tell me during a hearing test is that they have to blast the TV in order to understand what is being said. Having properly fitting hearing aids will automatically help. But, TV streamers can make it sound even better! Again, because the signal is being beamed straight to the aids, it eliminates the need for the sound to travel over distance and through other aural clutter. Another nice feature is that the actual TV volume isn’t affected, so other people can still hear the TV at a volume that is comfortable for them. Unfortunately, TV streamers can’t improve the sound mixing of a program.

Remote Controls

All hearing aids have buttons that allow you to adjust programs. However, this may not be the best option for some wearers. Those who have arthritis or neuropathy may not be able to press the button. A person with memory loss may not be able to remember where the button is or its purpose. In these situations, a remote control can be very handy. It is easy to handle and very clear on its operation. For those who want to be more discreet, there are applications for the phone that can act as a remote control as well.

To be clear, accessories are not required to use hearing aids. But for those who need or want a bit more assistance, they are worthwhile. As always, let your hearing care professional be your guide. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.