Firstly we need to ask ourselves, how do we hear? We hear with a combination of both our ears and our brain. Sound enters our body via our ear canals (for the majority of people), gets converted into mechanical energy in our middle ear via our ear drum and ossicles (3 small bones in the middle ear) which in turn creates fluid movement in the cochlear at specific locations corresponding to the frequencies present in the sound. The cochlear then converts this mechanical energy into an electrical signal that gets sent to our brain (the auditory cortex) via our auditory nerve. It is then up to our brain to process and interpret these sounds so that they become meaningful to us. Unfortunately, a hearing loss can occur anywhere along this pathway and can sometimes involve multiple locations. For example, a person may simultaneously have a perforated ear drum (conductive hearing loss) and cochlear damage (sensorineural hearing loss). This will both attenuate and distort sounds entering the auditory system. Alternatively, you may have a person who has a combination of a cochlear loss and due to ageing, is unable to process sounds as efficiently in the brain. Even with hearing aids, this kind of person may still struggle particularly in noisy situations.
So what can you do? Our brain is a muscle so the more you use it, the better it gets at doing a specific task. If hearing aids have been prescribed to you, the most important thing you can do to get the most out of them is to WEAR them as often as possible. This will provide the hearing parts of the brain with regular stimulation to the important speech sounds required for speech understanding. The more the brain engages with these sounds, the better it gets at extracting meaningful information from them. As an audiologist, I often get asked by people 'how often should I wear my hearing aids as I am home by myself during the day and I only really need them when I go out?' Well, my response is that if they want to hear well with their hearing aids when they need them, they should wear their hearing aids when they don't need them. Even a few hours during the day (particularly when watching TV) will only help.
The next thing to do is make sure the sound leaving the hearing aid and travelling down your ear canal is not interfered with by wax. Wax can prevent sound from cleanly travelling down your ear canal and hence will reduce the effectiveness of your hearing aids. The easiest way to manage wax is to use a few drops of olive oil in each ear once a month (some people may need to use more and apply it more often). Hearing aid users tend to have a higher propensity of wax occlusion problems owing to the fact that they have something in their ears which interferes with the ear's natural self-cleansing mechanism. Therefore, often olive oil by itself will not be enough to clear the wax. The safest, gentlest and most effective way to remove wax is to get a trained clinician to use gentle micro-suction which is what Comfort Clean Ear offers. This is the preferred approach used by Ear, Noise and Throat Specialists for a reason. Wax can also get into the hearing aids so it is also important to be vigilant with cleaning them. Its a good idea to brush all over the hearing aids including the microphones which may become blocked with dust. Some hearing aids even come with their own wax management systems in the form of wax guards which need to be changed every couple of months. If you have not been shown how to do this, ask you audiologist next time you se them. Comfort Clean Ear can help with this too. Just bring in all you hearing aid accessories with you to your next appointment with us. At the end of the day, not having clean ears or clean hearing aids is like getting dental work done on your teeth but then not brushing them or keeping them clean.
Finally, the last thing needed to get the most out of your hearing aids requires some assistance from others. Your family and friends need to understand that the best way to communicate with you is by gaining your attention first, reducing their distance to you and to make sure they are facing you when they speak. In noise, most hearing aids are designed to focus towards the front which means to hear at your best in these situations, make sure that most of the noise is behind you and the person you want to hear is in front of you. I have to stress here that even once all that I have said is applied, for some individuals with a hearing impairment they will still find it difficult in the more demanding listening environments like a restaurant. Sometimes the distortional aspect of ones hearing loss (which can include auditory processing issues) is just too great for hearing aids to overcome. More sophisticated hearing aids certainly have a greater chance at providing assistance but one does need to have realistic expectations. It may even be difficult for people with 'normal' hearing. Some environments are just too demanding. I know I struggle hearing my wife sometimes (maybe not enough) in the car especially when travelling at fast speeds. For some people, remote microphone systems are the only viable way to provide auditory information in the form of speech directly from the source via a remote microphone to their hearing aids when the listening situation becomes too complex.
And thats it!!!
I hope by reading this post, you have a greater appreciation about the intricacies of our ears and the way we hear as well as the role hearing aids can play to help reduce the impact of hearing loss. Stay tuned for our next post.