What Did You Say?

(2 of 2)

Then there's the vanity issue. "I have a real love-hate relationship with my hearing aids. I wear them because I need them. But they're clunky, they're ugly, they look prosthetic," says Battat of SHHH. "I'm longing for Calvin Klein to start designing hearing aids." Many people who have tried hearing aids before the technology surge of the past 10 years found the discomfort and embarrassment of wearing them outweighed the benefit they provided. Bad experience can be contagious as well. "In audiology we say that if someone likes their hearing aids, they tell five people," says Rezen. "If someone hates their hearing aids, they'll tell 20."

Much attention has been paid to improvements in miniaturization. But smaller is not necessarily better. The tinier the aid, the more difficult it is to manipulate the controls and change the batteries. In addition, smaller aids--which fit in the ear, in the canal, or completely in the canal--simply can't pack the power of larger, behind-the-ear or body-aid models.

How hearing aids work is far more important than how they look. Traditional analog aids are technologically the simplest--and the least expensive. They enable the user to adjust the volume of incoming sounds. The newer, programmable analog aids are pricier, but they can be digitally programmed--and reprogrammed as hearing loss progresses--to accommodate individual patterns of hearing loss as well as different listening environments. Fully digital aids offer the greatest flexibility and precision. But the more expensive digitals are not necessarily better for everyone. "Digital aids have gotten a lot of press, but there's little hard research that they're better than the others," says Laurie Hanin, director of audiology for the League for the Hard of Hearing in New York City. "Some people prefer the sound quality of digital aids and feel they help with understanding speech in noisy situations, but many people do very well with conventional analog aids."

Even after a hearing aid is selected, programmed and fitted, a good audiologist will urge patients to return for adjustment and counseling. "Fitting hearing aids is a process, not an event. They're not like a pair of shoes or glasses, where you put them on and walk out," says audiology professor Rezen. "You have to go back and give the audiologist feedback so that they can adjust them. And hearing aids take learning; they take getting used to."

Even the most sophisticated hearing aids cannot restore perfect hearing. In particularly difficult conditions, many people find assistive listening and alerting devices helpful. In her determination not to be sidelined by her profound hearing loss, New Yorker Ruth Bernstein, 67, has become a gadget guru. The lamps in her living room, office and bedroom are wired to flash when the phone rings or the doorbell buzzes. Her telephone has a receiver with a powerful amplifier. Though theaters are required to lend listening systems to hard-of-hearing customers, Bernstein has purchased her own infrared unit. She's also bought a personal fm unit for lectures: the speaker wears a small microphone, which transmits via radio waves to a receiver connected to a loop Bernstein wears around her neck, which sends the signal to the telecoils in her hearing aids. She uses a caption decoder on her television, attends captioned theater performances and asks people to e-mail her messages rather than leave them on her telephone answering machine. Perhaps the most difficult listening environment is a noisy party or restaurant gathering, where many people are talking at once and the clatter of dishes adds to the cacophony. To reduce the background noise and focus on the conversation at hand, Bernstein uses a tiny direct-audio-input microphone connected by wire to her hearing aids.

Though hearing loss remains largely irreversible, it need not be the crippling disability it once was. The advice from hearing experts is loud and clear: There's help out there for those who seek it. And anything that helps you hear is a sound investment.