fitting – Climb to the Stars

So Many Failed Fittings [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

Again and again, when I talk about my hearing loss and my role as Open Ears editor, people tell me about their relative, acquaintance, or friend who has hearing loss of some degree, got hearing aids, but never wears them. This is a well-known problem in the industry, of course. I haven’t done checking out the existing research on the topic, but after an umpteenth discussion — and a failed fitting in my history — I do have a few thoughts to share.

If I go back to my personal experience, there was a major difference between my first (failed) fitting and the one that got me wearing hearing aids on a daily basis three years ago: the first time, I was sent home with “perfectly tuned” hearing aids and that was it. In my memory (though it might be failing me), no follow-up appointment. The second time, I was sent home with barely amplified hearing aids and clear follow-up instructions.

Of course there are other differences. I was 13 at the time, 25 years older at my most recent fitting. Technology had evolved. I’d had time to accept the fact I have hearing loss. As a teenager, I was “told to go”, whereas as an adult, I made my own decision.

But I can’t help but think that sending newly fitted people home with hearing aids on “full blast” is a bad idea for a first fitting. Everything I know about habituation and resistance to change screams against doing that. Baby steps is usually what it takes for lasting change, rather than huge sweeping revolutions. Remember those new year resolutions you never keep? Yeah.

Have you been fitted with hearing aids that stayed in a drawer, or do you know somebody in that situation? I’m curious as to what other people’s hypotheses are regarding the reasons for all these failures, I have to say.

Musings on Fitting Strategy (and Pricing) [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

Since my last visit to the Phonak headquarters I keep mulling on the conversation I had with Solange about fitting and pricing strategy. We know hearing aids come in different price ranges, and the benefits they provide to the wearer change as you move up in technology. These variations in price are not isolated to a specific piece of hardware or software, but reflect the overall experience the wearer receives when using them in more complex listening environments. And that, ultimately, is what we pay for, as hearing technology users: a better life experience.

This reminded me a lot of all my musings on value-based pricing as an independent professional. What is the service I’m providing worth to my client? What is the better life and communication experience that the hearing aid brings worth to the hearing impaired person?

The question of how much we value our new hearing leads to another issue: we usually don’t know how good it could be. People with hearing loss often don’t really measure how bad it is — we can’t hear what we can’t hear, right? When it’s always been there, or it’s very progressive, how are we to know how much easier a hearing aid could make our lives?

Solange kind of shocked me (in a good way) by telling me that when she was a practicing audiologist, she would always fit her clients with the best available solution first, regardless of price. Yes, price is important and budget is often a limiting factor. But how do you set a budget for something when you have no idea how much impact what you’re getting is going to provide? Fitting with the best available solution provides a baseline for “how good it can be”.

This is completely different from how I approached things. I wanted to spend as little as possible. I mean, of course I wanted hearing aids and was willing to pay the price, but I didn’t want to pay 10k when 3k might do. So, we started out with an entry-level solution. It was great! It was astounding! Even at 8dB below my ideal settings according to the manufacturer (hardly any amplification, really), I was hearing better than I’d ever heard before. Two weeks after my fitting, if you had given me the choice between going back to a hearing-aid-less world or keeping what I had, I would have kept those hearing aids with that insufficient setting without any hesitation.

As weeks went by, and we increased amplification, and the initial wonder wore off a bit, and I started noticing things that “could maybe be better”, I started wondering what a more expensive hearing aid might do for me. So we went one step up. And it was slightly better. And I ended up buying the second pair.

But today, I still don’t know how good it could be. Is what I have as good as it gets? How good would it be, and how would my life experience be improved, if I had the highest-end solution available for me? Who knows, maybe it would be so incredibly better, beyond all my imagination, that I would be willing to pay way more for it than what I initially intended — just like I ended up spending unbudgeted money on a pair of skis this winter because they make me feel 20 years younger when I’m on the slopes? And maybe it wouldn’t, and the small increase in quality of experience would not be worth the higher price for me — and that would be fine. At least I would know that what I’m hearing now is as good as it reasonably gets for me.

I Don’t Hear Very Well [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

“I don’t hear very well.” This is what I’d been saying since I discovered, age 13, that I didn’t hear very well. “I don’t hear very well.” My hearing was checked, I was given the verdict “yeah, so you have some hearing loss, we’re going to give you hearing aids”, and sent to an audiologist to be fitted. They took some measurements, filled my ears with pink stuff, and next time I went there I left with a rather big pair of skin-coloured inside-the-ear aids.

They felt uncomfortable, I could hear background noise, the world was too loud, and girls at school made fun of me. I wore them two days, maybe three, then put them back in their box, never to be taken out again. I decided that it wasn’t that bad after all to “not hear very well”, and that I would cope.

And I did, for the next 25 years.

Steph Audiogram

In 2012, after a couple of years of “getting there”, I finally decided to get fitted again. My brother had got hearing aids a few years before and what he told me of the process and the changes in his life really encouraged me. (We have similar hearing loss, hereditary.) I shared some of my thoughts on my blog right after getting my hearing aids (“A Week With My Superpower”) and a month or so later (“More About Hearing Aids…”).

Nearly two years later, my hearing aids are part of my life, and I wonder why I waited so long. I still end up saying “I don’t hear very well” every now and again, but now I can add “I’m not wearing my hearing aids just now,” or “Even with hearing aids, I don’t hear as well as you.” The impact is different!