<p>Month ago took my 84 year old mother to costco to replace her 6 year old inner ear canal hearing aids,</p>
<p>ENT And audiologist did test in their office,
Costco offers
90 day trial period, and she has gone in to have some calibrations tweaked.</p>
<p>She now has $1800 ( Rexton which is made by Siemens)for pair behind the ear, and loves them. </p>
<p>Ear wax issue- I asked the hearing aid person at costco to check my moms ears for wax, because she had two issues in the last two years. </p>
<p>He immediately suggested she go back to ENT for removal, which she did and will have to be monitored every three months- so heads up about the ear wax issue.</p>
<p>@Consolation – success with hearing aids depends in large part on the willingness of the user. If your mother does not want hearing aids and does not feel she needs them, you and all the audiologists, hearing aid dispensers, an ENTs on the planet won’t be able to talk her into them. A lot of family members hope their parent or spouse will be “delighted” when they finally hear, but after not hearing well for a long time, their brain has adapted and it can take a while to re-learn how to listen again. Plus, it is not like putting on a pair of glasses. In most cases of age-related hearing loss, there is damage at the sensory level (compare to missing retinal cells in the eye) so the signal might not be clear. It can be a struggle. Just wanted to warn you that the hearing aid user really has to want it to make the most of it.</p>
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Many persons are quite concerned with the appearance of hearing aids, particularly younger persons (I realize the person described in the OP is not young). For example, my audiologist mentioned recently fitting a SoundLens for a teenage girl with a moderate to severe loss. The most important factor by far for her was the device being near invisible. It was much less important that the device give the best possible hearing improvement and/or have a good margin to support worsening hearing loss in the future.</p>
<p>@Data10 – I can understand the cosmetic and fitting in concerns of a high school student, but don’t you think being able to hear well is important in school? So you don’t miss stuff and fall behind? You can’t put an FM system on a SoundLens. I guess if it is between that and nothing, it is better than nothing, but I would question the thinking of an audiologist who would prescribe an aid that underamplifies for a student especially. Just a sad statement on the stigma of hearing loss. </p>
<p>This is getting really off-topic, but SoundLens is a specialty product that won’t even fit in many people’s ear canals, period, and especially if it needs to be designed with a powerful, and therefore, larger, speaker.</p>
<p>Starkey’s website says the Soundlens supports up to a moderate-severe hearing loss. While it wouldn’t have the directionality tech found in some larger models, it still has quite advanced tech (it is only sold in their high technology levels), and will likely do an excellent job for improving hearing for those with moderate-severe loss and less.</p>
<p>If Starkey is like other companies I have worked with, then I’d expect that they support a wide variety of ear canal sizes and desired amplifications by making custom builds that are different sizes and/or fit in different locations of the ear canal than standard. For example, I once ordered a Nano Virto Q from Phonak. The Nano is supposed to be much smaller than a standard CIC, yet the hearing aid I received was notably larger than my existing standard CIC (from Siemens). In cases like this, it’s my understanding Starkey would be able to build a model with similar performance that was smaller than either Phonak or Siemens.</p>
<p>I am not saying SoundLens is not advanced. It does not have wireless communication or directional microphones like larger hearing aids, but in part it does not have to, because it uses the outer ear shape for that. </p>
<p>Look (or listen – I have worked with Starkey, have toured their production facility, and had a job where I looked very closely at ear canal shapes. If a size 10 battery won’t fit in your ear canal, neither will a hearing aid built around it. That is about as simply as I can spell this out. The companies you list who make deep canal hearing devices will all tell you that, and will give you a tool for measuring an ear impression so the audiologist can tell the patient before ordering the device if it is likely they will be able to build it. Otherwise, it would be sad to build up someone’s hopes of a tiny device if their ear can’t accommodate it. In a prior job, where I worked on a digital ear canal scanner (substitute for taking silicone impressions), I have worked with several major hearing aid companies, so know pretty well, better than than average audiologist even needs to know, what the dimensional requirements are for these types devices. And as for your size differences, it could also have to do with the individual modelers who designed your custom devices, or the depth of the impression taken (though I would hope that would not be the issue). </p>
<p>By the way, I heard from one of these major manufacturers that the very deep devices aren’t nearly as reliable because of earwax.</p>
<p>And apologies to Consolation for the thread diversion!!</p>
<p>I have no specifics, but my 84yo father just got his fourth pair and we finally have a winner! I haven’t seen him since he got them, but I know this is the first set that’s over the ear. The other pairs he never stayed with, complaining about this and that. One thing I do know is that they won’t work if you don’t wear them! Phone conversations are so much nicer – no yelling, no repeating and no frustration from either of us.</p>
<p>I find it had to believe that anyone would have their elderly parents fitted with a hearing aid without first being examined by a physician AND a qualified doctor of audiology. Why object to the input from both practitioners? Consumer reports agrees. </p>
<p>Hearing loss is a medical condition. The evaluation for this condition is a covered benefit by medicare and most other insurance companies.</p>
According to postings by Soundlens owners on hearingaidforums.com, when the inner ear canal is too narrow, they make a model that fits further out than pictures in the pamphlets, in some cases to the point where it is essentially a CIC, much like my earlier Nano experiences. Nevertheless, it still is a smaller sized alternative to Phonak, Siemens, and similar in these cases.</p>
<p>Why wouldn’t someone need to see an ENT if they have age-related hearing loss? Well, because hearing loss with advanced age is really, really common and there are actually ENTs out there who will say that they do not want to see a case of age-related hearing loss, if an audiologist pre-screens and determines that to be the case. There is not much the ENT will be able to do except reinforce that hearing aids are the only treatment.</p>
<p>@Data10 OK, Soundlens is smaller. It is supposed to fit beyond the second bend whereas nano goes at the second bend of the ear canal. The components (microphone, battery, chip, speaker) will still have to fit in either case. Ear canal geometries vary greatly among people. Some are straight, some bendy, some skinny, some wide. That is the last I will say on it.</p>
<p>In the first place, I am not “having” my mother fitted with a hearing aid. She is a very independent-minded adult.</p>
<p>She has delayed and delayed doing anything about her hearing issues, largely because she doesn’t want to spend the money, but she is fully aware of the constraints that it puts on her life (mostly in terms of dealing with her affiars via phone). The fact that she could go to Costco, which was easy and familiar, had something to do with her decision to move forward.</p>
<p>Medicaid pays for an examination by an ENT only with a referral from a primary care doctor. My mother, believe it or not, does not HAVE a primary care doctor, per se. When she needs something, she goes to a walk-in clinic in her town. Not only is she very healthy and extremely fit for her age, but she does not have balance problems.</p>
<p>Personally, I would be perfectly happy if she would go to an ENT and associated audiologist, and wouldn’t care a bit if she paid for it completely out of pocket. But my chances of getting that to happen are slim to none. I’d rather she go to Costco than wait until I could get her to make up her mind to see someone else.</p>
<p>@Consolation – just to warn you about what happened to my mom. She got a hearing aid from a hearing instrument specialist and the person who fit her overamplified by a lot! She got headaches, returned them, and was scared off from hearing aids for several years, but later found someone more competent and now has them. She wears them when going out only, not around the house. I try to act as indifferent as possible, though I think she should wear them more consistently.</p>
<p>Consolation, if your mother is on Medicaid as you stated, she should see a medicaid hearing aid provider. They can fit her with hearing aids for free in most cases. That is how the Medicaid system works her in Florida.</p>
<p>If your mother has Medicare, then she would not need a referral to see an ENT for evaluation of her hearing loss. The medical evaluation and audiometry are all covered under Medicare. She would not need a primary care physician referral. I hear repeatedly from elderly patients that they are much more comfortable about their hearing issues and options after talking it over with the doctor.</p>
<p>Dstark, there are some fine digital hearing aids that actually self adjust to different ambiant noise. They do not have volume controls that the user adjusts.</p>
<p>In my opinion, these are a very good option. If the ambiant noise gets louder…or softer…the aids adjust.</p>
<p>Consolation, you would be surprised at how many hearing issues have a medical issue that can either be resolved, or can make fitting a hearing aid that will work difficult. Even with the elderly, it is wides to rule out medical issues before investing in a hearing aid.</p>
<p>@thumper1 Just curious if you can give some examples of such issues, especially the one about fitting the aid. By the way, usually either a medical clearance signed by an MD or a waiver signed by the patient is required before purchasing a hearing aid. And mnm111 where I work, patients on medicare need an order from their PCP to get a hearing test to be covered by medicare. I believe this is true in general.</p>
<p>LBowie, it is true that a physician needs to order the hearing test in order for it to be covered by Medicare, but the ordering physician does not need to be the PCP. Any physician can order this test and it will be covered by Medicare.</p>
<p>We often have oncologists order hearing testing prior to and during chemotherapy. Infectious disease physicians will often order hearing testing when they prescribe ototoxic antibiotics. Neurologist order audiometry as part of an evalation for dizziness. I can think of several others.</p>
<p>Sure, but the point is it requires an order. Your earlier post, read quickly, made it seem like the test was covered by Medicare without a referral.</p>
– I have worked with Starkey, have toured their production facility, and had a job where I looked very closely at ear canal shapes. If a size 10 battery won’t fit in your ear canal, neither will a hearing aid built around it. That is about as simply as I can spell this out. The companies you list who make deep canal hearing devices will all tell you that, and will give you a tool for measuring an ear impression so the audiologist can tell the patient before ordering the device if it is likely they will be able to build it. Otherwise, it would be sad to build up someone’s hopes of a tiny device if their ear can’t accommodate it. In a prior job, where I worked on a digital ear canal scanner (substitute for taking silicone impressions), I have worked with several major hearing aid companies, so know pretty well, better than than average audiologist even needs to know, what the dimensional requirements are for these types devices. And as for your size differences, it could also have to do with the individual modelers who designed your custom devices, or the depth of the impression taken (though I would hope that would not be the issue). </p>