Dr. Abonso: My goodness, what expectations you have! No, you won't be able to hear like a 17 year old. Former surgeon general Dr. Koop says that's one expectation you'll have to give up.

Suspicious Consumer: How does he know?

Dr. Abonso: He's been wearing hearing aids himself for years, quite successfully.

Suspicious Consumer: So he didn't get his 17 year old hearing back, even with hearing aids?

Dr. Abonso: No. In about a year, though, hearing aids with super-directional microphones should be available. Perhaps with those he will be able to understand conversations in noise as well as young people do. But there is more to hearing than hearing in noise. How about music?

Suspicious Consumer: I want to know what to expect about hearing in noise.

Dr. Abonso: OK, but I love music: I direct a choir, you know. Anyway, you have only a mild-moderate hearing loss and should do quite well with your new hearing aids.

Suspicious Consumer: What does "quite well" mean? Can you put numbers on it?

Dr. Abonso: Yes. I see you have good hearing aids; your dispenser didn't give you a pair of those old-fashioned, narrow band, crummy-peak-clipping hearing aids such as unenlightened dispensers do. That bought you at least 10 years of auditory youthening. There's a number for you.

Suspicious Consumer: "Auditory youthening?" "Youth-ening??" Is that a word?

Dr. Abonso: It wasn't until I used it.

Suspicious Consumer: The number you gave me doesn't help me very much.

Dr. Abonso: I'll be more serious. Without hearing aids, in order to understand people in noise you probably needed to have them speak up, twice as loud as the noise. Numerically, you probably needed what's called a +9 dB signal-to-noise ratio.

Suspicious Consumer: What do normals need?

Dr. Abonso: Amazingly enough, they can understand conversations even when the desired talker is almost buried in the noise. In numbers, a -5 dB signal-to-noise ratio is all that is required: The noise can be half again louder than the talker.

Suspicious Consumer: So what can I expect with my new hearing aids?

Dr. Abonso: You got them from a competent hearing professional, so your hearing aids should allow you to understand conversations when the talker is as loud as the noise. Numerically, this represents a 0 dB signal-to-noise ratio. That's not back to normal, but it is about two-thirds of the way back to normal from your unaided hearing. It's also a lot closer to normal than we used to be able to achieve with hearing aids. With the old hearing aids, you could expect to hear much worse than normal with the ...

Suspicious Consumer: I know, I know, the old fashioned crummy spike chopping aids.

Dr. Abonso: Peak clipping.

Suspicious Consumer: Thanks for giving me numbers. Is it really that simple?

Dr. Abonso: No. With a mild-moderate hearing loss, you already hear loud sounds quiet well with your own ears, so you shouldn't expect your hearing aids to improve your hearing for loud sounds. The improvement comes for the quieter sounds that you were missing. In most restaurants, for example, you should hear much better. (In loud noise with your hearing aids, you should hear just as well with them as without them. That's a big improvement over the old narrow band peak clipping hearing aids. With those you could hear loud sounds better with the aids removed.)

Suspicious Consumer: Is there a way to check how I'm doing in noise compared to young people?

Dr. Abonso: Yes, there is a new 24-minute test described in an article in the September 1993 issue of the Hearing Journal. It compares results with good and not-so-good hearing aids. The article also discusses some useful distinctions that FDA Commissioner David Kessler, MD didn't make when he appeared on TV.

© 1993

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