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Now Hear This...


by Doc Holliday

Do you sometimes think that your TV sound system has deteriorated into a stream of muffled words? Is it more difficult to clearly hear the person at the other end of telephone conversations? In restaurants and at social events, do you suspect that people are speaking in muted tones?


Chances are that the problem has little to do with your TV, your mobile phone, or the voices of others and everything to do with your declining ability to hear. And you’re not alone. One in three people over the age of 60—and more than half of those older than 75—suffer from age-related hearing loss. Presbyacusis (to give it a medical name) is the most common cause of hearing loss in older people. Experts have yet to determine exactly why.
It is thought that most people develop presbyacusis because the nerve cells of the inner ear (the cochlea) become damaged and less effective. It is usually a gradual process, often over several years. In most cases, both ears are affected equally. That damage may result from a number of factors:


  • Arteriosclerosis: hardening and narrowing of the blood vessels that supply blood to the cochlea.
  • Heart disease, high blood pressure or diabetes.
  • Exposure to noise over the years.
  • Stress.
  • Exposure to certain types of medication or chemicals.
  • Smoking.
  • Being overweight.
  • Hereditary factors.
  • Osteoporosis.


There is little you can do to prevent age-related hearing loss, and there is no cure for the ailment. The remedy: hearing aids.


Modern Aids

Many who are hard of hearing snub the idea of wearing hearing aids, perhaps conjuring memories of unsightly devices in the ears of their grandfathers who constantly diddled with the old-fashioned contraptions to up the volume or eliminate background noises. In this age of digital technology, though, hearing aids are vastly improved. They are far smaller, virtually invisible, customised to the user’s needs and easily adjusted. Furthermore, most contain a microcomputer that is much more sophisticated in responding to noise in the environment, so you don't get feedback and echoes.


Like an excellent stereo sound system, these new hearing aids filter out background noise, clean up and clarify the sound quality, and automatically adjust the volume. They are computer-programmed to match the nuances of each person's hearing loss. The advent of the directional microphone is the ultimate solution to hearing well.


Before opting for a hearing aid, it’s important to ascertain that you do, in fact, have a problem and that a hearing aid can fix it. Step one is an exam by an audiologist—if only to ensure that the culprit is not simply wax build-up or an infection. Then a hearing test will help determine whether hearing aids will help, and what type will best suit your needs. That is, you may want a simple hearing aid to hear the TV better, in which case appearance isn't an issue. On the other hand, if your life includes noisy restaurants and bars, church services and socials, business meetings and conventions, etc., you may prefer a less conspicuous device offering more flexibility for these different environments.


Types of Hearing Aid

Nearly all hearing aids today are digital—as opposed to analog. That doesn't necessarily mean expensive. Digital hearing aids are now available in every price category.


Where the hearing aid is worn—behind or inside the ear—is determined by its size. People with more severe hearing loss often need a larger size to accommodate the added circuitry and wires. In-the-ear models are just that. They fit completely in the outer ear and are used for mild to severe hearing loss. These can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback. Behind-the-ear devices are connected to a plastic ear mold that fits inside the outer ear. These are intended for those with mild to profound hearing loss. They must be perfectly fitted or there can be feedback. Some behind-the-ear models can be linked with Bluetooth cell-phone technology so can hear directly from your mobile phone into the hearing aid. It cuts out background noise.


Another option is the canal device, customised to fit the size and shape of the ear canal. It is intended for those with mild to moderately severe hearing loss. Because of their small size, canal aids may be difficult for the user to adjust and remove; they, too, may be damaged by earwax and draining.


Other than digital hearing aids, which range in price between 40,000 and 80,000 baht, there is always the lower-priced alternative of the traditional analog device. Computer-programmed analog hearing aids today are slightly more sophisticated, since the audiologist can create more than one program (so you’re not limited to "all-the-time" and "noisy environment" settings); you can change it via a remote control to suit your environment. They sell for about 25,000 baht and higher.


Whatever you choose, recognise going in that no hearing aid can eliminate background noise entirely, but they are getting better.