[sasi] Is This True?

[Jeremy Congdon]

Here is a basic explanation of hearing loss, and after that a basic
explanation of hearing aids and cochlear implants. 

Sound makes your eardrum vibrate, and the vibration moves through three tiny
bones in your middle ear, then to your cochlea, which is a spiral like a
snail shell or a cinnamon roll.  Your cochlea is filled with fluid and lined
with hair cells of different lengths.  The different lengths of tiny hairs
respond to different frequencies or pitches of sound.  When different hair
cells respond to different frequencies, they stimulate the auditory nerve to
send sound messages to your brain.

There are two major types of hearing loss:  conductive and sensorineural.
Conductive hearing loss, which is less common, is caused by problems with
your eardrum, ear canal, or the bones in your middle ear.  Sensorineural
hearing loss is when the outer and middle ear are working fine, but there is
not enough response to sound inside the cochlea itself.  When people get
older, they naturally lose some hair cells in the cochlea, usually the
smallest ones, which respond to high-pitched sounds.

Hearing aids all do the same basic thing, which is to amplify sounds so that
they will stimulate the cochlea more strongly.  Analog hearing aids
basically amplify all sounds.  Digital hearing aids are more expensive, but
also more flexible, because they can be programmed to amplify more in the
specific frequencies that a person has the most difficulty hearing.  Hearing
aids are not like glasses, because they don't correct the problem of hearing
loss.  Even with the right hearing aid, it's still going to be harder to
hear in noisy situations, for example.  But hearing aids can help many
people to increase their ability to use their remaining hearing effectively.

Cochlear implants work differently from hearing aids.  They use a tiny
series of electrodes to substitute for the missing or defective hairs in the
cochlea.  Instead of the hairs stimulating the auditory nerve, the
electrodes do it.  The electrodes receive their instructions from a cochlear
processor, which looks a lot like a behind-the-ear hearing aid.  It has a
microphone and a computer chip that controls how the electrodes stimulate
the auditory nerve.  The sound a person gets from a cochlear implant is
different from what they get from normal hearing or a hearing aid, and
learning to use this new kind of hearing requires significant therapy with
an audiologist.

When people lose their hearing, the first step is to try hearing aids.  When
hearing aids can't provide enough help, then the next step might be a
cochlear implant, if a person is a candidate for that.  Many people can use
cochlear implants, but it isn't an option for everyone.  For example, I have
a severe-to-profoud hearing loss, but I can't benefit from a cochlear
implant because I have a third, much less common kind of hearing loss called
auditory neuropathy.  That means that my auditory nerves (between my
cochleas and my brain) are not working properly.  I can hear a lot of sound,
but it's very distorted, and I have a lot of difficulty understanding speech
and recognizing the sounds I hear.

Now, for the issue of money:  Most insurance does not cover hearing aids.
However, cochlear implants are often covered.  When I bought my first pair
of hearing aids, I had to cash out my pension from my job in order to pay
for them.  But I'm glad I did.  It's very important to think not only about
money, but about which hearing aids will really help.  If you buy less
expensive hearing aids only because they're cheaper, then it's a waste of
money because you won't wear them and they won't be useful to you.  You
should only buy the hearing aids that will work with your individual hearing
loss.

And Ruth and Scott are absolutely right:  you need to find an audiologist
who will listen to you.  An audiogram does not describe real life, so don't
let anyone tell you what you "should" be able to hear based on the numbers.
Find someone who will take you seriously when you say what you can hear and
what is difficult for you.  Get a trial period of at least a week or two
with any hearing aids that your audiologist recommends.  During that trial
period, take notes about what was easier to hear and what was harder, and
when you were comfortable and when things were too loud.  Could you use the
controls and change the batteries comfortably?  The audiologist should use
that information when deciding whether it's better to adjust the current
hearing aids or whether it would be better to try a different kind.  Anyone
who just pushes you to buy hearing aids without listening to your questions
and priorities is going to be just as unhelpful down the road, too.  You
don't want to be stuck with an expensive hearing aid that sits in a drawer
because it's more trouble than it's worth.

Sorry for such a long message!  I hope some of this information is useful.

Jeremy