By Linda S. Remensnyder, Au.D.
Doctor of Audiology
Hearing Associates, P.C. . . . Eliminating the Sound of Silence
755 S. Milwaukee Avenue, Suite 189
Libertyville, IL 60048
www.hearingdoc.com
Dear Mr. Burley:
I read with interest your column, On Your Side, in the September/October 2010 AARP.Org magazine. As you know, it focused on your reader, Mary Schofield, 88, of Slingerlands, New York who, in your own words,
got her hearing aids from Beltone. The salesman sold Schofield two hide-in-the-ear Invisa Touch 17’s—the kind busy execs worried about their appearance might choose—for $6400. The tiny batteries must be replaced every few days, not an easy task. Days after the purchase, Schofield fell ill and was hospitalized for weeks. When she resumed wearing the hearing aids, they weren’t fitting correctly . . . and the 45 day trial period had long since passed. (30)
I am a Doctor of Audiology, I have owned my practice for 30 years and I was written up in an end-of-the year similar newspaper column called The Fixer (December 27, 2009) that has considerable distribution. The article was about “Of These Good Guys” and I was honored to get national media exposure as being one of the Good Guys/Good Doctors.
Here is my take on what happened to the reader you presented in your column: As a Doctor of Audiology, I NEVER fit a tiny in-the-ear style hearing aid on an 88 year old and I give the patients I see the following reasons:
1. My job is to make you hear for the next 5-7 years. You may develop tremor, poor dexterity, or poor eyesight (macular degeneration is rampant in that age population), and I do not want to take the risk that you will not be able to manage this style of hearing aid long-term. Cleaning the tiny hearing aids requires good dexterity and eyesight and so does battery replacement of the diminutive batteries.
2. My job is to counsel you that when you are in your late 80′s, it is not surprising that you may experience some weight loss which is often secondary to ill health, hospitalization, or temporary placement in a rehab facility. Lose weight and your ear “loses weight” as well. You don’t just lose weight at your belt line; and the ear, being cartilage, loses its tonus and the hearing aid literally falls out of your ear and is prone to annoying “whistling” (i.e.–feedback).
3. My job is to inform you. Did you know that the ear (and the nose) continue to grow with age? Your ear will get larger and larger over time, especially in the 8th and 9th decades of life, and the aid will start to fall out and be prone to squealing even if you are healthy and maintain the weight you had when you ordered the instrument. The ear becomes like a “floppy fish” and the bowl of the ear gets larger and larger.
4. My job is to educate you. Did you know that the ears produce more cerumen (ear wax) with aging and ear wax is very adverse to the in-the-ear styles. That is why 100% of our patients over 80 get the behind the ear hearing aid style which uses an earmold that can easily have the ear wax visualized and removed without damaging the critical components of the hearing aid (the behind-the-ear style is safe tucked up above your ear where ear wax doesn’t migrate). Also earmolds are approximately $95.00 and can be remade inexpensively to accommodate changes in ear dynamics.
5. My job is to caution you about Murphy’s Law–what can go wrong will go wrong– and how it applies to aged ears. An interesting fact you may not know is that many aged ears have a tendency to have collapsing ear canals. The ear canal is like a funnel and it often has collapsing walls with aging thereby causing the hearing aid to be expelled from the ear canal contributing to chronic feedback. The only solution to this is a behind-the-ear style.
6. Most importantly, my job is to warn you that hearing often dramatically diminishes in the 8th and 9th decade of life. The in-the-ear styles have less reserve gain (power/amplification) than the behind-the-ear. Thus you are safer, long term, and insulated from purchasing more and more hearing aids over time.
Your reader’s problem is that she went to a retail store and did not get doctoring advice. The same thing happens at Costco and at Sam’s Club, where the salespeople only sell and do not manage hearing loss. One last comment: 95% of all hearing loss is not capable of being managed by an Ear-Nose-Throat physician (ENT). What does the ENT do after he looks into the ear, shrugs his shoulders, and says “No wax, no sign of infection”? He says ”Go get an audiologic evaluation by the Doctor of Audiology.”
Doctors of Audiology are truly the hearing health care providers and I do not support your magazine’s suggestion to “start with your doctor” first. The Doctor of Audiology’s audiogram and testing documents, for example, the probable presence of a brain tumor (8th Nerve tumor) and the magnitude of hearing loss secondary to ear fluid, which is not discerned by the otoscopic examination In fact, many medical doctors refer patients to me for cerumen removal.
You are in an incredible position to impact the future of your aging readers as they navigate through the hearing health care arena. I was also profiled on the Better Hearing Institute (BHI) Website (May 12, 2010) in their Audiologist Changing their Communities series, by providing Audiologic Rehabilitation Classes that empower patients to make the right decision about hearing.
Please contact me if any questions or concerns. Your reader’s complaint deserves my answer and your readers, as a whole, need education.
CALL 
