Hearing amplifiers vs. hearing aids - any experiences?
January 15, 2018 7:39 AM   Subscribe

I have moderate hearing loss in my right ear, mostly high frequency. This was discovered when I was a little kid, and I'm 47 now. It has gotten worse over the years and has made social and professional situations difficult. I am currently trying a set of Otofonix amplifiers, both ears and want opinions on these vs. "real" hearing aids. More details inside.

What I find online is vague, and probably lots of paid promotional reviews and affiliate marketing sites, and lots of stuff that seems sort of predatory towards older folks on the internet. Many reviews on Amazon state that they are just as good or nearly as good as $3000+ aids.

Anyone have experience with audiologist hearing aids vs. hearing amplifiers? My set cost around $700 and do seem to improve my hearing. But I am still wondering if my specific conversation impairments are improved. I'm currently unemployed, so business-social type of interactions are really limited. And then right after I bought them I came down with a cold, so my ears got intermittently plugged. I'm 95% done with the plugged ear issues now.

TL,DR: You are not an audiologist. Opinions from people who have tried both amplifiers vs. "real" hearing aids, please?
posted by jeff-o-matic to Health & Fitness (6 answers total) 13 users marked this as a favorite
My poor hearing is likely genetic, and not diagnosed until I was 40. I have found it extremely difficult to do research, esp. comparisons between brands and types. The industry seems to be pretty closed. I'd go to a library and see if Consumer Reports has any useful info. Hearing aids are pretty profitable, and you should be able to try them out with no obligation.
posted by theora55 at 8:08 AM on January 15, 2018

I am an audiologist who specializes in hearing aids and hearing aid outcomes. I'm not your audiologist. I agree with you that the hearing aid industry is a bit of a black box and I wish there was more transparency and information for people.

Hearing aids and personal sound amplification products (PSAPs) both do similar things in theory: they make sound louder so that it is audible to you. The biggest difference is that a hearing aid is programmed specifically for your hearing loss while a PSAP is not. In other words, a hearing aid is going to amplify high frequencies for you differently than it does low frequencies. An audiologist will actually put a microphone in your ear canal and measure what comes out of the hearing aid to ensure it is set appropriately for you.

That's the biggest difference - but there are others as well. Hearing aids have a variety of advanced processing algorithms, some of which work very well and some of which work less well. Hearing aids have very advanced compressive capabilities and they use this to attempt to preserve the dynamic range for you even though your dynamic range is reduced due to your hearing loss (i.e. the output of the hearing aid fluctuates as a function of the input level in a non-linear way). Hearing aids also use the four microphones (two on each ear) to provide directionality, so they don't amplify all sound around you equally. This is useful in noisy places where your hearing aids will try to sort of zoom in on the person you are talking to and turn down the noise around you. Directionality and compression work very well, and the research shows us that it benefits people in the real world. Hearing aids have a variety of other algorithms that attempt to improve listening in certain environments that work less well, but do work to some degree. These include things like noise and wind reduction. Hearing aids also have very advanced feedback management that has allowed for people like you to get hearing aids with very tiny earpieces, so low frequencies can come into your ear naturally while the hearing aid amplifies high frequencies.

There are 6 big hearing aid manufacturers that make pretty much every hearing aid in the world, and their hearing aids are mostly more alike than different. They all do the aforementioned processing, they just have slightly different ways of going about it. Research has revealed time and again that outcomes are not really different for people between brands. These days the big differences between brands are bells and whistles types things - which will connect to your iPhone, which can hook up to your ITTT channel and so forth.

Each manufacturer makes a number of technology levels of their hearing aids. It's the same chip but with more features and processing as you go up in level (and price). It's kind of like when you buy a car and there's the base model and then the fancier versions - the engine is the same but one has heated leather seats or whatever. As you go up in tech level, you usually get more processing algorithms, more automatic features, the audiologist has access to more fine tuning. Research has not shown that higher technology levels result in more benefit or better outcomes. I have patients who do amazing with the basic level and patients who do terribly with the most advanced level.

Hearing aids are expensive. They are fairly advanced computers. It's easy these days to look at your $600 phone and wonder why hearing aids are $5000. But hearing aids are medical devices that have to process a tremendous amount of signals, do it incredibly fast, while using very little power, and also being smaller than a dime. It's a tall order, really. Also, most audiologists still bundle their costs, so when you pay $5000 you get the hearing aids but also years of service, programming, follow-up care, etc.

I get asked this question a lot and here is my bottom line: yes, proper hearing aids programmed appropriately by a knowledgeable audiologist will be much better than a PSAP (make sure your audiologist performs real ear measures). But there are diminishing returns. You'll notice a much larger difference in benefit between the PSAP and the basic level hearing aid than between the basic level and premium level hearing aid.

I will add one final important bit - those PSAPs are unregulated devices, and the output of many of them is not known and is not controlled. One of my jobs is to make sure the hearing aid is not so loud on my patients that it exacerbates their hearing loss. So use those PSAPs with caution.

As always I am happy to answer any other questions, either here or via MeMail. Hearing loss is a difficult condition that a huge number of people face (it is the second most common condition among older people), and yet few people talk about it openly. Hearing aid marketing is atrocious and misleading. It is hard to find good information.
posted by Lutoslawski at 8:42 AM on January 15, 2018 [44 favorites]

Also, most audiologists give you a trial period, usually a month, to try the hearing aids with no purchase obligation. In some states this is required by law.
posted by Lutoslawski at 8:49 AM on January 15, 2018 [1 favorite]

For someone who has moderate hearing loss and limited income, I would recommend MDHearingAid. These are real FDA registered hearing aids, unlike the Otofonix, which is not FDA registered.

The MDHearingAids are better than most of the expensive hearing aids from 5 years ago and don't have all the fancy bells and whistles of the latest expensive ones, but at a fraction of the price. They have several program settings for various conditions.

If you have typical age related moderate hearing loss, you might find that these will improve your life immensely.

The hearing aid industry really is a scam. More than half the retail price of hearing aids, thousands of dollars, goes to the dispenser or audiologist who may spend a few hours with you.

Again, if you have severe hearing loss, you should see a professional audiologist, preferably not one associated with retail sales. But for moderate hearing loss, off the shelf FDA registered hearing aids should be fine.
posted by JackFlash at 9:58 AM on January 15, 2018 [3 favorites]

My hearing loss is similar to yours, and in the same ear. We're close in age. Also, I have moderate-to-bad tinnitus. I recently saw an audiologist who fitted me with an Oticon hearing aid. I had several appointments, with a fitting & tuning service similar to the one that Lutoslawski described, and subsequent follow-up. I was also referred for an MRI to eliminate vestibular schwannoma as a cause.

It's made a huge difference to me. My tinnitus hasn't gone away, but it's probably 30-50% better. I hear voices much more clearly - including my own, which means I no longer have to raise my voice so that I can hear myself. That has really improved my comfort level in conversations. It's still hard for me to hear clearly in noisy environments, but I'm no longer nodding & smiling, while essentially guessing what anyone else might be saying.

When I originally presented to my GP, I had to push past a certain amount of resistance before I got a referral, because my hearing loss wasn't obviously disabling. I'm glad I did so, because my hearing aid has really significantly helped me.

I can't compare other devices, never having used anything else. Also, this is in the UK so I didn't have to pay (other than via my taxes). But, maybe an additional data point.
posted by rd45 at 11:13 AM on January 15, 2018 [1 favorite]

More than half the retail price of hearing aids, thousands of dollars, goes to the dispenser or audiologist who may spend a few hours with you.

Nah, you don't just "spend a few hours with them." You build a relationship with an audiologist. I can stop by nearly anytime for tweaks, new tubes, questions, troubleshooting. He'll look in my ears to see if the problem is the aid or wax buildup, and for a minimal charge he'll clean the wax out. Hearing aids have warranties and the audiologist will take care of the return if it cannot be repaired in house, plus give you a loaner while you're waiting. His office handled the insurance stuff for me. So no, it's not like a salesperson you never see again.

Yes, they are expensive, but I personally can't put a price on, you know, being able to actually communicate with the people around me. Socializing and work would be virtually off limits and I may as well become a hermit.

If amplifiers are enough for you, great! You're definitely saving money. But if you're still having trouble, it's worth it to get an ear exam.

Since you're unemployed, check if your state provides subsidies for low income folks to get hearing devices.
posted by AFABulous at 1:11 PM on January 15, 2018 [3 favorites]

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