One in Five People Who Needs a Hearing Aid Actually Wears One
Story originally appeared on page D1 of the Sunday Republican on Nov. 3, 2019. Written by Anne-Gerard Flynn.
Audiologist Susan Bankoski Chunyk of Hampden Hearing Center in East Longmeadow thinks that is unfortunate.
She has been fitting people with hearing aids for more than 35 years and says today’s technology has something for just about everyone’s hearing loss.
She said aids now are smaller and can be regulated more discretely and that the computer chips inside them recognize different sound types and can be programmed to adjust volume accordingly as well as to meet an individual’s specific hearing needs.
Bluetooth technology allows for direct streaming of sound into the ears from smartphones and other devices and, she adds, always improving applications from manufacturers enable those phones to act as remote controls in adjusting volume and sound in a variety of settings as well.
“Sometimes people have the idea that there is nothing that can be done for them. They might feel their hearing is not bad enough or they might feel like their hearing is so bad that nothing can be done,” Chunyk said.
“Sometimes I find they were told 40 years ago, hearing aids won’t help you. If there is anyone who heard that, that is not true today. The technology can fit a wide range of hearing losses from mild to profound and, if it gets to the point where hearing aids don’t do the trick, we refer people for a cochlear implant and they can have that and that technology continues to get better, too.”
Efforts to address hearing loss from damage to the inner ear date back centuries, but small, one-piece devices with microphones to catch sounds, amplifiers to enhance and send them to a speaker and molds in the ear to channel the sound date back to around 1950 with the first fully digital hearing aid introduced at the end of the 20th century.
Today’s aids all come with a computer chip that can be programmed with the use of computer technology for an individual’s specific needs.
“The traditional type that features an aid behind the ear has been updated with the new digital technology,” Chunyk said.
“They are all digital and have been for quite a while now.”
She added, “It is all about how smart and how advanced is that computer chip that is in there.”
Bluetooth technology allows for wireless programming as well as streaming from smart devices.
“We can hook an individual’s aid up to their smartphone so the sound from telephone calls or from music and videos – any sound content on their phone – can go directly into their ears,” Chunyk said.
“So, you have basically turned the aids into wireless headphones but what makes the aids better in my opinion than the wireless headphones that you buy from the store is that the sound is custom shaped for what an individual’s ears need.”
She added, “They are finetuned specifically for their hearing.”
“The sound is being shaped for what the individual needs and they get the sound directly streaming and on top of this manufacturers’ apps turn the phone into a remote control to make adjustments. A lot of people have trouble on the phone. It is not a matter of hearing the phone, it is a matter of understanding the words. It is the clarity.”
Chunyk said all but the smallest of aids come with Bluetooth technology that allows the chip to use this wireless technology to be programmed from a computer. “We can program so much into the computer chip when it is hooked up to the computer wirelessly because there is Bluetooth technology and this allows us to give people what they need where they need it without overdoing it,” Chunyk said.
“There was a time when, if a person came in and had really good hearing for low pitches, for example, but not so good for high, we would say, ‘Go away and when your hearing gets worse, come back.’ This might have given the impression that the person did not need hearing aids, which was not necessarily true. We just did not have the technology to help them. Now, if someone just has a mild or moderate degree of hearing loss, they are struggling, especially in background noise, we have technology to help them.”
She called the computer chip “the ringleader that tells everything what to do.”
“With today’s technology, it will act differently depending on what sound is coming in,” Chunyk said.
“It knows the difference between speech and not speech. The chip can control what the components of the aid do to make that work right. It knows soft, medium and loud sounds and because we are programming the sounds through the computer software, we can say if it is a soft sound, we want this much power. We want very little or no power if it is a loud sound. We just want it to go right through. If it is average sound, give the person this much.”
Chunyk said that people will tell her they want an aid that “will make all the background noise go away.”
“Well, you don’t really want that and it can’t be done,” Chunyk said.
“But what we want to make sure happens is that the technology will do what it needs to do so that the background noise won’t overwhelm what you are trying to listen to. It is not a perfect situation. It is not what our brains and ears do naturally but every level of technology, every level of improvement makes it that much better.”
Chunyk said one type of hearing aid that has cornered a large share of today’s market has done so because the sound receiver is literally tucked into the ear.
“The style might look similar to the traditional behind the ear, but what is different is that the speaker part actually sits inside your ear. If you think of this aid as a public announcement system, the part in the ear is the speaker,” Chunyk said.
“It sits so much closer to your eardrum and this means sound does not have to travel down the tube to affect it. It is more natural. It also leaves the ear canal more open so people’s own voices sound good.”
Sound travels down a wire into the speaker as electronic sound after it is processed by the computer chip.
“The wearer can still use a toggle on the case of the aid to adjust volume or use a smartphone with an app to turn the phone into a remote control to adjust volume on the computer,” Chunyk said.
She added, “Through using an app you can adjust the volume, you can select among different programs.”
“Sometimes we will set up settings for music or a specific kind of listening situation like church or a classroom – some place specific where you spend time but are having trouble different from your general listening situation,” Chunyk said.
“You can have up to four different programs that you can select through the app and say, for example, ‘OK, now I am on my music program,’ and you can do all of that through the phone. You can make adjustments automatically.”
Chunyk said that she “recently had a woman who uses the receiver-in-the-ear style come in for her progress check.”
“The time before we paired her aid with her iPhone so she could stream phone calls hands free and during the progress check we paired her iPad because she said she wanted to do FaceTime with her family,” said Chunyk of the aid whose battery is rechargeable.
“The manufacturer has a new app that just came out and we went over all that and now she can talk directly to her family out on the other coast and have it stream directly into her devices.”
The use of what Chunyk called “real ear” or “probe microphone” measurements allow audiologists to ensure a hearing aid’s optimal amplifi cation for the individual using it.
This involves the placement of tiny microphones in each ear canal to measure the canal’s influence on sound with and without an aid. The test basically measures what is gained in terms of sound from the use of the hearing aid and what adjustments need to be made to match sound quality prescribed for the best benefit.
“Real ear or probe microphone measurements allow us when we first fit someone with an aid to adjust the aid’s settings where we think the person will be, but then make a physical measurement,” Chunyk said.
Audiologist Susan Chunyk of Hampden Hearing Center has been fitting people with aids for more than 35 years. She said computer chips turn today’s aids into smart devices.
“This sets up targets in the software that say, OK, this is how much we need at all these different pitches for soft, medium and loud sounds and we get as close to those targets as we can in programming the chip so we know for sure that is how they will get their best speech understanding.”
She added, “We basically tell the chip, this is what you do for this, this is what you do for that, and then that sets the default and the person can adjust the volume and if they come back and find they need fine tuning, then we adjust again.”
Chunyk said the need for physical measurement is based on the fact that “there is a natural resonance of sound in any ear where there is an increase in volume based on the size and shape of your ear canal.”
“There is a little peak,” Chunyk said.
“For humans it is in the area where speech information is. In elephants, dogs and ants, the peak is going to be different. By making that measurement with people we factor in the acoustics of their own individual ear canal and that makes hearing through the aid much more precise and also a lot more comfortable. We know we are delivering the best sound qualities so you don’t have to put so much more energy into listening.”
Chunyk added that most people need an aid in each ear.
“Most people have the same hearing in both ears. It does not make sense to fit one – we jokingly say if you had vision problems in both eyes would you wear a monocle – of course not,” Chunyk said.
“Your brain needs the sound from both sides to balance the sound, tell direction and that sort of thing.”
Chunyk said that the aids arrive from the manufacturer with “just a test program in them.”
“The manufacturer doesn’t know who the aid is coming to or what they need,” Chunyk said.
“We hook them up wirelessly and then we can program them and the person comes in and we measure it and fine tune. We teach them how to use it and send them home and when they come back, we usually do some fine tuning to get the sound to be more acceptable.
She added, “There is an adjustment period because your brain got used to not hearing a lot of environmental sounds and now that is all back.”
“You need to give your brain a chance to get acclimated to know what needs attention and what needs to be ignored,” Chunyk said.
She also said equating hearing loss with aging can delay some people in seeking help until lack of clarity at some life event brings someone to her for a hearing evaluation.
“I wish I could say the whole stigma with hearing aids has gone away but it hasn’t,” said Chunyk who works with audiologist Jennifer Lundgren Garcia.
“People still equate wearing one with being old. This is ridiculous because if you sit in my waiting room you will see that who needs a hearing aid runs the gamut.”
She added that during her more than three decades of being an audiologist she has seen “so many changes.”
“I remember when we made adjustments to a hearing aid with a tiny little screwdriver. We had a control on the face plate or behind a door on the back of the aid and would make an adjustment on what is called the potentiometer,” Chunyk said.
“We could make an adjustment over a very narrow range. We would do that and we would say, ‘How does that sound?’ It would be either good or bad and we would make another adjustment.”
“Now, because of the computer programming,” she said, “there are so many combinations of things that we can do that we can get where we need to be that much sooner in the process so people are satisfied.”