Questions and Answers
Ask an Audiologist
Answers to the most frequently asked questions
What is earwax and how can I avoid earwax problems?
The skin lining the ear canal contains hair follicles and glands that produce oil and earwax. The earwax (cerumen) lubricates the skin and traps dust and foreign particles. It may also prevent infection of the ear canal. The wax is a colorless, watery secretion that dries and turns darker in color when it mixes with dust particles and dead skin cells.
Cerumen normally migrates out of the ear canal naturally die to movement of the ear canal when talking and chewing. Some people produce excessive amounts - or the wax does not fall out naturally - and need to have earwax removed. Over-the-counter eardrops and a syringe (with body temperature water) can be used to dissolve the wax, but don't do this if you have a perforated eardrum. Some people need to have earwax removed regularly with eardrops, irrigation or suctioning. Note: The use of Q-tips is not recommended, as this often pushes wax further into your ear or scratches the ear canal.
Who are Audiologists?
Audiologists are university trained and hold a Masters Degree or Doctorate in Audiology and/or Communication Disorders.
Is getting a hearing aid all I can do for a hearing loss?
No. Some forms of hearing loss can be treated surgically or with drugs. Your hearing test results will help determine how best to appropriately address your hearing loss.
Can everyone with a hearing loss benefit from hearing aids?
Audiologists refer to hearing loss as being sensorineural. This describes pathology in two areas: sensory and neural. The sensory cells, known as hair cells, are located in your cochlea. The eighth cranial nerve carries the sound to your brain through a complex neural pathway. People whose hearing loss is predominately "neural" in nature may not be able to understand speech no matter how comfortably loud the speaker. Your complete audiologic examination will determine the degree and kind of sensorineural hearing loss you have.
Are there other options besides hearing aids?
Assistive Listening Devices (ALDs) amplify sounds from telephones, TVs, alarm clocks and fire alarms. Our clinic carries a variety of products our patients have found useful. Some devices can even be used in theaters and movies!
What can I expect from a hearing aid?
At a minimum, your hearing aids must be comfortable. After a few days, you must be able to wear your hearing aids for long periods without noticing you are doing so. The audiologist will closely monitor your initial fit. You are going to hear some things you have not heard for a long time. That is part of the process. Your brain will acclimate and your hearing aids will be fine tuned during this acclimation process. Success is due in large part to understanding this process and working with the audiologist to meet your needs. Expect 2-4 office visits during the initial adjustment process. We ask all our patients to return to the clinic once or twice a year to be sure their hearing aids' performance is optimal.
What do hearing aids cost?
Prices vary by the technology and size. Depending on the type of hearing loss and each individual's specific needs, the most appropriate hearing aid will vary from person to person. It is the audiologist's job to recommend the most appropriate device for each individual, while providing the options necessary in meeting an individual's financial requirements.
Will my insurance pay for this?
Medicare, Medi-Cal and most insurance companies cover hearing evaluations recommended by your doctor. Our office works with all parties to provide you help with your insurance needs. However, it is best for you to contact your insurance company personally, and ask what their hearing aid coverage is for your particular policy.
What hearing aid is best for me?
First, answering this question without your hearing test results and without the chance to meet you and better understand your lifestyle is difficult. These technologies are currently available to help with hearing loss:
• Conventional Instruments (analog)
Some manufacturers are phasing out production of conventional instruments. This technology lacks the circuitry to effectively compress loud sound, and cannot be tuned as precisely to an individual's hearing loss as programmable or digital instruments. However, it can be used effectively in quiet situations.
•Programmable Instruments
Programmed by a computer, these instruments allow greater flexibility and fine-tuning capacity. Most of the technology used in programmable hearing aids uses analog conventional circuits that are set and controlled by a computer.
•Digital Instruments
Digital hearing instruments represent the most advanced technology available today. These instruments actually contain a computer chip programmed by a computer. This offers the best method available on the market to match a particular hearing loss with the most prescriptive amplification needed. Complete flexibility and amazing fine-tuning capability are among the many benefits. The processor separates the incoming sound into bands and channels, and processes each band and channel independently. Digital hearing instruments utilizes separate circuit paths to independently process thousand bits of sound information per second to aid in the recognition and suppression of some of the noise that interferes with speech.
•Directional Microphone Technology
Most hearing instruments hear everything around you equally well. With directional microphone technology, available in both programmable and digital hearing instruments, you are able to suppress noise coming from behind you. Some digital instruments include very sophisticated D-mics (directional microphones) that can seek out the noise behind you and help to suppress it. At present, the smallest sizes are unable to accommodate the extra microphone and circuitry.
If I have hearing loss in both ears, can I get by with just one hearing aid?
The majority of patients with hearing loss in both ears choose to be fitted binaurally for the following reasons:
• Better balance in hearing
Two hearing aids allow you to hear comfortably without having to continually position one ear to catch the words of the speaker.
• Better sound quality with less power
Because sound presented to both ears is louder than the same sound at the same intensity to one ear only, the volume on two instruments can be set lower than if you use only one instrument. This is more relaxed, comfortable and less stressful.
• Better ability to localize sound
The ear closest to the sound receives the information microseconds earlier than the ear further away. This allows the brain to discern where the sound is coming from. For example, it can help you judge the location of an oncoming car you cannot see.
Why are we called the Paradise Hearing and Balance Center?
When you are healthy, you keep your balance because a coordinating center for balance in your brain called the brainstem is continually sorting out the input it receives from at least three sensory systems - your eyes, your muscles and joints and your inner ear vestibular system. In response to the input, your brain sends messages to your eye muscles to allow clear vision as you move and to your body muscles to allow you to sit, to stand, to walk, even to turn cartwheels and still maintain your balance.
Your inner ear vestibular system provides the most important input to your brain - information about changes in your head position with respect to gravity. The objects you see around you and the surfaces you touch or stand on may be changing continually. The sensory input your brain receives from your senses of vision and proprioception may be in conflict with one another (for example, when you are standing next to a moving bus and you feel as though you are moving, too). In these instances the brainstem places highest priority on the input it receives from your vestibular system. Your vestibular system is providing information about the only unchanging point of reference available to your balance system, the force of gravity.
Under normal circumstances, balance control takes place on an unconscious level. When a conflict from the normal sensory input occurs the brain reacts on a conscious level and usually produces a sensation of dizziness. Dizziness is not an unusual occurrence. After lower back pain, dizziness is the second most common complaint heard in a doctor's office. 42% of the adult population reports episodes of dizziness or vertigo (spinning) to their physicians.
Unfortunately, half of all patients with this condition do not find the reason for their symptoms and only a third receives beneficial treatment. That's because dizziness can have many causes and pinpointing the exact reason for the condition and providing effective treatment can be difficult. As an Audiologist I am specially trained and experienced in determining if the inner ear vestibular system may be contributing to symptoms of dizziness or a balance problem.
Helping doctors and their patients pinpoint the causes of dizziness and finding effective cures is why we are the Paradise Hearing and Balance Center.
We hope this information is useful to you. Please call (530) 872-5500 and make an appointment for your hearing test and consultation. We, at Paradise Hearing & Balance Center, look forward to learning how we can find the best solutions for your hearing needs.
Deborah Touchette, Au. D., CCC-A