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Subject :  When you go to buy an aid
posted by azureblue on Sun Nov 21, 2010 9:31 am
When you buy an aid from a dispenser, most of the time, they factor in post fitting office visits. This is why quotes from dispensers are so high - they add in office time for post fitting, which more or less amounts to half of the aid’s cost. I have no disagreement with that, as long as the money is earned. I would be glad to pay $6K+ for a pair of aids, if I knew that they would be set correctly for my loss and hearing situations, after just a couple of visits. Time and stress has its price, and I will gladly pay for expertise and experience. Much like going to a doctor, with an illness, and he or she examines you, find the illness, prescribe the pills, and ask for you to come back to make sure that the pills work. And you, as the patient, expect the doctor / audiologist to be knowledgeable and have the proper equipment to address your needs. You, as a patient, should also expect your medical appliance to function correctly the first time, whether it is a hearing aid or a pacemaker.

I have said this before on this board and will say it again: BEFORE you buy hearing aids from a dispenser, make certain they know how to use the software, adjust the aids, have the proper test equipment, and will commit to doing what ever it takes to get the aids set correctly, including calling the manufacturer, until you, the wearer, are happy. So BEFORE you buy the aids, make sure you are comfortable with the person selling the aids and their expertise. Do not accept platitudes. You must be active about this and ask direct questions, and want direct answers. You will be with them for a while, and you need to know before you put down you money if you will be able to establish a good patient / care giver relationship. As always, caveat emptor.

The settings that are put into your aids at the factory is an approximation of what they think would work best for best speech recognition. Not fidelity. Not music. Just boost and compress the speech frequencies. And it is a guess. Why? Because there are many other factors that come into play when you wear you put in your aids - resonances in the ear canal and variances in the components and earmold and venting all affect the sound. And the graph that they use on the software that is supposed to represent your settings, is only an approximation. The only way to get a good setting for your aids is by the dispenser using a hearing aid analyzer Real Time Measurement (REM) machine to check the settings for your aids from the very beginning. This machine listens to the aids while they are in your ear, and prints out a graph for the audiologist the use to alter the hearing aids’ settings. This is a first step, and it must be followed with real world sound tests, like listening to music at real world levels, a phone, conversation with background noise, a ride in a car, etc. I have been through this and can say from personal experience that the REM test will get you in the ball park, but it takes real world testing to get t right. With the advances in hearing aid CPUs and design, a hearing aid is now a high fidelity amplification device, not a narrow purposed speech amplifier.

But let’s back up one more step up the chain- the hearing aid makers themselves-- if the hearing aid makers preprogrammed the aids correctly to begin with, none of this mess would happen. What should happen is the aids should arrive 90% “there” and the dispenser should hook you up to a REM tester, make some fine tunings, then let you listen to some real world sounds, make a few more tweaks, then set a follow up appointment, knowing that you will a few days need to adjust to the aids’ sound. The process should not take more than four follow up visits, ideally speaking. I think it is arrogant for the HA makers to make an aid that is not correctly programmed, and expect an audiologist to figure out what is wrong and fix it. This is unfair to the audiologists and us who wear aids. An audiologist should be focused on you, the patient, not being put into a very uncomfortable position of having to figure out why the aids are not working properly.

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