1.  What is an Audiologist?

An audiologist is a practitioner who has a masters or doctoral degree in audiology. Audiology is the science of hearing. In addition, the audiologist must be licensed or registered by their state (in 47 states) to practice audiology.

In the field of audiology, the master's degree has been the accepted "clinical" degree for almost 50 years. However, the profession is undergoing a transition to a doctorate-level degree as the entry-level requirement to practice audiology. The Au.D. (Doctor of Audiology) is the clinical doctorate degree and is issued exclusively by regionally accredited universities and colleges.

2.  How do hearing aids perform in background noise?

Virtually all patients wearing hearing aids complain about background noise at one time or another. There is no way to completely eliminate background noise.
When you had normal hearing there were still times when background noise was a problem. It is no different now, even with properly fitted hearing aids! The good news is there are circuits and features that help to reduce (or minimize) background noise and other unwanted sounds. In fact, there are research findings that demonstrate that digital hearing aids with particular circuit and microphone options can effectively reduce background noise.
Many early digitally-programmable (and even some digital) circuits, which claimed to reduce or eliminate background noise, actually filtered out low- frequency sounds. This indeed made the sounds appear quieter, however, not only was the background noise made quieter, but so too, was the signal (the speech sound).
Newer ways to reduce background noise are based on timing and amplitude cues and other noise-processing strategies, which 100% digital hearing aids can incorporate. These methods work, but are not perfect. Directional microphones are available and are useful as they help to focus the amplification in front of you, or towards the origin of the sound source. Directional hearing aids can offer a better signal-to-noise ratio in difficult listening situations by reducing a little bit of the noise from the sides or behind you. In most 100% digital hearing aids, the noise control features help make noise more tolerable, but do not completely eliminate the noise.
The best and most efficient way to eliminate or reduce background noise is through the use of FM technology.

3.   Do I Need Two Hearing Aids?
Basically, if you have two ears with hearing loss that could benefit from hearing aids, you need two hearing aids. It is important to realize there are no "normal" animals born with only one ear. Simply stated, you have two ears because you need two ears. If we try to amplify sound in only one ear, you cannot expect to do very well. Even the best hearing aid will sound "flat" or "dull" when worn in only one ear.
There are many advantages associated with binaural (two ear) listening and importantly, there are problems associated with wearing only one hearing aid -- if you are indeed a candidate for binaural amplification.
Localization (knowing where the sound came from) is only possible with two ears.  Using both ears together also impacts how well you hear in noise because binaural hearing permits you to selectively attend to the desired signal, while "squelching" or paying less attention to undesired sounds such as background noise. 
4.  What can I realistically expect of my hearing aids?
Hearing aids work very well when fit and adjusted appropriately. They amplify sound! You might find that you like one hearing aid better than the other. The left and right hearing aids will probably not fit in exactly the same way and they probably won't sound exactly the same. Nonetheless, hearing aids should be comfortable with respect to the physical fit and sound quality. Hearing aids do not restore normal hearing and are not as good as normal hearing. You will be aware of the hearing aids in your ears. Until you get used to it, your voice will sound "funny" when you wear hearing aids. Hearing aids should not to be worn in extremely noisy environments. Some hearing aids have features that make noisy environments more tolerable, however, hearing aids cannot eliminate background noise.

5.  What can I do if I really cannot get used to the “plugged-up” feeling when I have my hearing aids in my ears?
When you wear hearing aids for the first time, you will probably notice your voice sounds funny! You will hear your voice amplified through the hearing aid. You may describe this sensation as feeling "plugged-up" or hearing your voice echoing. This is normal and will usually go away in a few days after you have given yourself a chance to get accustomed to your new hearing aids and learned to adjust the volume control. There are adjustments that the audiologist can do to relieve these symptoms, should these persist beyond the first few days of wearing your new aids.

There is a new technology called “open canal fitting” that may relieve the echoing effect of wearing hearing aids.  Talk to your audiologist to see whether you are a candidate for this new technology.

Audiological Services of San Francisco
3150 California, San Francisco, CA  94115
(between Lyon & Presidio)
Alice Leung Au.D., CCC-A

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