“I wish this was just like getting glasses, you put them on the first day and just go,” stated a patient in my office recently.
So do I, my friend, so do I. My life would be so much easier if it was a simple prescription I could type into the computer and BAM! Perfect fit. The reality is, there is far more to the art of improving a person’s hearing than most people imagine.
Each patient is very different. Even the same hearing loss on the graph can be fit so many different ways. The size of the ear canal, the dexterity of the fingers, the sensitivity of the damaged nerve to accept the new sound, the length of time since the hearing was “normal” to the beginning of amplification use, the perception of your voice, the comfort in the ear, the curves or lack thereof in the canal shape…the list goes on and on.
I love the puzzle each patient presents. I take all the pieces they present to me and try to put together the perfect fit. I use the history of their hearing, the current issues they are experiencing, their lifestyle and needs, their ear size, shape, texture, skin type, their dexterity and if they have lost sensitivity in their fingertips or have severe arthritis.
We talk about where they are noticing difficulty, what is going on and how they currently manage it. Then I look at the test results for volume, pitch, variances across the pitches, their ability to understand speech in quiet and noise. After all that…the research and planning begins!
Once I have narrowed down what I think may be the best starting point, keeping it as simple as possible, I pick the device, the length and power of the speaker I will use, the type of ear coupling that will fit the loss as well as what will best fit that person’s individual ear, and the patient’s abilities to adjust. Will it be perfect? Probably not…at least not yet!
At the initial fitting, we check the perception of sound – how well can they hear others as well as hearing their own voice. How is the fit in the canal, the ease of insertion. Do I need a longer wire? A larger or smaller earpiece; maybe a custom one for better retention, easier for arthritic hands or finger numbness, more bass, more security, or for more power without whistling. The options are endless.
Now the experiment begins! Will they work with me to narrow down the best fit and sound? Will they wear it regularly over the next few weeks while I modify the sound and fit over time to get the best outcome? How well will they acclimate? I never passed “Mind Reading Class” in college, will they share what is happening and how they are doing in a candid fashion so we can work together to fine tune it?
When we feel the fitting is close to our goal, then do the in-ear measurements of sound pair to what our targets are in the real-ear measurements?
It takes time and communication for your Doctor of Audiology to fine tune specifically to you. You just can’t get the same care and right fit when it is programmed and sent to you in the mail. You certainly aren’t going to have the personalized care and fitting from a box on a shelf.
What is your hearing worth? It is priceless.