 The Clarinet BBoard
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Author: john brush
Date: 2007-05-03 09:55
I wonder how many clarinettists on the BB suffer from high frequency hearing loss? Three years ago I bought a pair of digital ITE (In the ear) hearing aids which were programmed to help this, but found they were useless when playing the clarinet. They totally distorted the sound produced by the instrument, I believe, because the microphone is sensitive to bone transmission through the head. (For the same reason, when eating, an annoyingly loud crunching noise was heard). Also they were uncomfortable to wear,and they gave a kind of boxed in feeling, due to the fact that they shut off the ear almost completely.
National Health hearing aids don't seem to be much better. However, recently I have tried out a pair of digital Siemens Centra hearing aids, which are BTE (behind the ear) and they suffer from none of these problems. They are also very discrete and difficult to see, and though expensive, allow me to play my clarinet without any problems. They do not change the character of the sound I hear, including normal listening, and I find them comfortable and easy to wear all day.
There are probably other types available which are similar, but I thought this information might be useful to BB readers. Now when playing in an orchestra, there is a good chance I can hear what the conductor says. I am delighted with these aids, and they have the bonus of being adjustable by means of a neat little transmitter unit held in the hand.
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Author: Don Berger
Date: 2007-05-03 13:19
Thank you,John B, for the Siemens Centra info, I may need some "help" before long. I have a Good Friend who is seeking better H A's now, and will mention it tonite at our comm. band practice, where a number of our "oldsters" have hearings problems. We are "somewhat helped" by a P A system for singing rehearsal and elect. keyboard use. Here in the "wilds" of Oklahoma !, we have a Siemens mfgrg facility, however for the making of instrumentation for pet. and chem. plant use, which I helped develop/invent earlier in my career. Don
Thanx, Mark, Don
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Author: sdr
Date: 2007-05-03 14:24
There are over 400 makes and models of hearing aid on the market. Shopping for a hearing aid is like shopping for a car – all the cars have 4 wheels, a motor, and a steering wheel; all the hearing aids have a microphones, an amplifier, some bandpass filters (akin to a graphic equalizer on your stereo), and a speaker. But, you can by the economy model or the model with leather upholstery and a sunroof. These may both be excellent machines, but one has no frills and the other has all the bells and whistles. Same with hearing aids. If you think you might have a hearing loss, see an otolaryngologist (ENT) for an audiogram and ear check-up. If you are a candidate for a hearing aid, consider going to a hearing aid center, not a storefront franchise. The center will carry a range of instruments from reliable manufacturers that cover all the features and price points. If you go to a franchise dealer, you are at greater risk of having a saleperson push you to buy their “top of the line” instrument even if it may not be the best for you. To sell hearing aids in most states you need a high school diploma and a $25 hearing aid dealer license. You are more likely to get good care if you go to a licensed audiologist with a Master’s Degree in Audiology to be your hearing aid specialists. All 50 states in America now have laws that anyone wishing to sell you a hearing aid must provide a minimum of a 30 day money-back trial (unless you make the mistake of signing away this right by not reading the fine print on the sales contract).
Nowadays virtually all hearing aids used digital signal processing technology. I doubt any companies are making analog aids any more. The digitals are much cheaper to manufacture but they garner a greater retail mark-up at the point of sale because they are “digital” (Woo! Woo!). Hearing aid dealers also charge a premium for smaller aids (In the Canal “ITC” vs. In the Ear “ITE” vs. Behind the Ear “BTE”) despite the fact that BTE are almost always superior in every important regard – they are easier to handle, they last longer, they sound better, they are better cosmetically. This last point, cosmetics, deserves special comment. I am a firm believer that a small plastic housing colored like your hair and sitting in the crease behind your ear with only a thin clear plastic tube into the ear is far less noticeable than a chunk of pink plastic filling your ear. In considering any cosmetic downside of hearing aids, you must weigh them against the “cosmetic” aspects of the hearing loss: not knowing when to laugh at the punchline, misunderstanding a question and giving a ridiculous answer, and generally appearing to be “out of it” in any conversation or group. Unfortunately, in our culture anyone with gray hair (or no hair) who is a little “out of it” is assumed to be senile, not hard of hearing. I personally would rather wear the hearing aid and let people draw the right conclusion.
Finally a note about acoustics. The most common forms of age-related hearing loss, as well as acoustic trauma hearing loss, exhibit preferential loss of high frequencies (above 1500 Hz) but tend to spare lower frequencies. When you completely occlude the ear canal, you preferentially block low frequency sound. Thus, with an ITC or ITE hearing aid, you are actually blocking out your best hearing and substituting the tinny electronic sound of the aid. With a BTE and vented earmold you are allowing normal low frequency hearing and supplementing it with amplified high frequency sounds – an effective hybrid solution to the high frequency hearing loss.
-sdr
Oh, and BTW, if you have two aidable ears, you are probably better off with two hearing aids. The eye doctors don't sell many monocles anymore either.
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Steven D. Rauch, MD
Assoc. Prof., Otolaryngology
Harvard Medical School
Mass. Eye & Ear Infirmary
Tel: 617-573-3644
Fax: 617-573-3939
Email: steven_rauch@meei.harvard.edu
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Author: ariel3
Date: 2007-05-03 17:32
If you have just read Dr. Steven Rauch's reply - read it again ! It is the most beautifully, clearly written advice on the fitting of hearing aids I have seen.
I have worn aids for 50 years - way back when audiologists were not permitted to dispense (sell) hearing aids. Of course, hearing aids at that time were much simpler instruments.
The most important first step is your choice of an audiologist - an individual with a masters or doctors in audiology. This person most usually dispenses not only one particular brand of hearing aid, but will provide the best instrument for you from several manufacturers.
A good audiologist will work with you to help you hear in ALL hearing situations. In my particular case (severe bilateral nerve loss) I wear the Phonak BTE. I have 5 programs (actually use 3). I enjoy my clarinets more than ever and continue to enjoy my ensemble playing. My audiologist is one of my biggest fans.
Gene Hall
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Author: Brenda Siewert
Date: 2007-05-03 18:27
So, is it better to try to get by without hearing aids as long as possible? I am having some pretty dramatic hearing loss the last 5 years and still hear fine to play. I don't hear conversations very well, but really don't want to go to hearing aids yet because I've heard many stories like this one. It seems it would be possible to take them out for playing and then put them back in when you're done. ariel3's story sounds like it might be possible to find them that work for both.
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Author: bill28099
Date: 2007-05-03 18:53
When I started relearning the clarinet I had an awful time as my right ear was down over 50%, left is pretty normal. Unfortunately for most of us the right ear feeds the left brain which in turn runs your fingers so any hearing loss can be detrimental to learning. I had a check up with an MD ear specialist and he confirmed the loss. A test that I took on the internet was within 5% of his results. After scouting around for an aid I again turned to the internet, did my research and bought an appropriate new brand name behind the ear hearing aid off of the unmentionable site at 1/5 the retail cost. Then had an appropriate earmold made ($50). After tinkering with the 3 pots I seem to have something that serves me well. However, sitting in front of trumpets and pipe organs can be shocking but it's a hoot to eaves drop on all those individuals gabbing behind you.
The frosting on the cake was although my insurance company saved a bundle and reimbursed me for the aid they bounced the shipping costs as a non medical expense.
I don't recommend my approach but given that I'm a electronics engineer by profession figured I could figure out hearing aids. At the moment I'm using a single channel digital aid that does not require a programmer, someday I'll get one those and purchase a really high tech aid whether I need it or not. Dr. Rauch's advice is right on given my personal experience.
A great teacher gives you answers to questions
you don't even know you should ask.
Post Edited (2007-05-03 19:26)
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Author: ariel3
Date: 2007-05-03 23:29
Yes, Brenda, I am glad that you mentioned this concern - being able to program an aid or aids for a person to use for both music and speech alike. This, however, requires two different program modes that the user can switch back and forth as necessary. Music and speech sounds require entirely different amplification to assist the wearer. Voice recognition demands emphasis on a limited spectrum of frequencies in the vocal range, whereas music demands a full range of the frequency spectrum. All of this is adjusted to supplement what the person is "missing". Another factor is the use of sound compression to "level out" the sound to make it easier to hear speech.
This sound sound compression is not usually desired in the music mode.
There are also other programs that can be added such as a telephone coil program, etc.
It is all so very amazing. And a so much for the need of a dedicated professional to help you make the correct choice.
I have to say that I do not feel that I am missing a thing in one of the things that is so dear to me.
Gene Hall
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Author: Simon
Date: 2007-05-04 02:27
Hi all,
I am glad this topic has been raised. I have a similar problem as far as hearing loss is concerned, however my hearing deficiency is in the mid range frequency in the order of about 40% in both years and is a familial. My curve is "U" shaped.
Can someone please explain how this affects me learning and what steps I acan take other than a hearing aid to help me cope with this. I mainly play by ear. I must admit it does take me alot longer to grasp things and fast passages. I also suffer from tinitis.
I would appreciate any suggestions.
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Author: sdr
Date: 2007-05-04 02:28
Some interesting issues about hearing aids and hearing rehabilitation are coming up in this thread. I am provoked to write some more:
Some "high end" hearing aids now offer multiple filter pre-sets -- something like setting the different radio channels on your car radio. Each setting (done for you by your dispensing audiologist, or by using factory default settings) is supposed to optimize your hearing in different acoustical environments. For example, speech in quiet, speech in noise, music, etc. Some "demanding listeners" and technophiles love this and find it to be a great help. Other people just want an on-off switch and a volume control. The situation is somewhat analogous to your microwave oven -- it has settings to roast a turkey, bake a pie, make popcorn, and defrost a TV dinner, but you probably just use it on "High" for 30 sec to reheat your cup of coffee. So, do you want to pay for all those other features?
When all is said and done, hearing aids are just amplifiers -- they make sounds louder. However, not all cases of hearing loss are due solely to loss of loudness. When we test hearing, we measure threshold (the softest sound you can hear at each test frequency, going up by octaves from 250Hz-8kHz) AND we measure hearing clarity (a.k.a. Word Recognition Score or Discrimination). Discrim is measured by having a voice (preferably from a high quality CD recording) read single syllable words (consonant envelope with a vowel in the middle; "You will say: CAT" "You will say: MIT" "You will say: BUT") and the test-taker repeats them. The audiologist scores the percentage of words repeated correctly. Normal persons score above 90% when the words are delivered at a loudness of 40dB above your threshold. Threshold and Discrim (loudness and clarity) are analogous to the volume and the tuner on a radio. Many people who lose hearing lose BOTH loudness and clarity. If you lose significant clarity, turning up the volume will not solve your problem. It's like turning up the volume on a radio station with bad reception -- you hear MORE, not BETTER. If you have a hearing loss of both loudness and clarity, hearing aids are still helpful to correct the deficiency of loudness, but they will not restore "normal" sound reception because of the degraded clarity. Unless the dispensing audiologists explains this and patients "recalibrate" their expectations, the patients are often very disappointed that their $6K investment ($3K/ear) sounds so crummy.
If you have a hearing test showing that you are a candidate for amplification, there is no benefit in postponing acquisition of hearing aids. Use of aids does not accelerate hearing loss nor foster dependency on the aids. However, once you use the aids and realize how much you've been missing, you will probably want to use them more often. Hearing aids are not bolted to your head. You use them when you want and take them off when you want. Once you have them, you have an option that was absent before you got 'em.
-sdr
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Steven D. Rauch, MD
Assoc. Prof., Otolaryngology
Harvard Medical School
Mass. Eye & Ear Infirmary
Tel: 617-573-3644
Fax: 617-573-3939
Email: steven_rauch@meei.harvard.edu
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Author: SimpsonSaxGal
Date: 2007-05-04 04:03
I, too, have hearing aids. I've had my current set (Phonak 91 ITEs) since sophomore year in high school (I'm currently a junior in college). My biggest mistake in getting these was getting almost the cheapest and simplest type my audiologist offered. They're kind of a pain in the butt, but I've grown to accept them. These ones are getting a little old... I've had a few mishaps with them, including dropping one and rocking my dorm chair over it (just broke a piece of plastic off, creating a hole in the casing. It has been slightly staticky since). The thing I probably dislike most about these is the amount of static while doing anything with music. Some of it I can ignore. I've noticed that certain pitches seem to be worse. I will definitely keep those Siemens Centras in mind. I imagine I'll be getting a new pair within the next two years. My hearing loss is mostly in the low frequencies, with the right ear being significantly worse than the left.
Kimberly Karwath
Bb, Bass, and Contrabass
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Author: stevensfo
Date: 2007-05-04 06:27
-- "I don't hear conversations very well, but really don't want to go to hearing aids yet because I've heard many stories like this one." --
I've always had a problem with hearing what people are saying to me if there's a lot of chattering going on around, often even if they're quite close.
My hearing tests were always fine and I read that some people have something like.... "cocktail party syndrome". Anyone heard of this?
So I can hear fine, but simply find it difficult to distinguish words directed at me from the background noise. Extremely irritating!
Steve
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Author: sdr
Date: 2007-05-04 14:17
Re: "Cocktail party syndrome" -- difficulty discriminating voices in noise.
Your ears collect the sound, but all the analysis is done by the brain. Here's the vision analogy: If you are looking for your friend and he's the only one in the room, he's easy to spot. If you are looking for your friend at the basketball game and he's sitting in the bleachers with 18,000 other people, he's hard to spot. Finding him is a pattern recognition task -- separating one specific face from a sea of similar ones. Hearing your friend's voice in a noisy restaurant is the exact same task --- discriminating his voice from a sea of similar ones, with overlapping frequency and loudness. This is a challenging task when the ear is normal. It is even more difficult if the ear does not collect all the sounds (try the vision task with dark glasses on). I am sure you have had the experience of reading something, getting all the way to the bottom of the page and realizing you don't know anything you just read. You are not going blind -- you just didn't capture the info as your eyes ran over the page. This is a central processing issue in the brain, probably due to lack of attention, fatigue, stress, etc. We do the same thing with hearing. In fact, that is the difference between hearing and listening.
-sdr
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Author: stevensfo
Date: 2007-05-04 14:32
-- "This is a central processing issue in the brain, probably due to lack of attention, fatigue, stress, etc." --
This happens even when I'm concentrating and wide awake. In fact I often try to lip read as well in order to make out what they're saying.
In my last test, I had the typical middle age decrease in the upper frequency range, but no other problems.
Perhaps I'm just not meant to go to parties?
Steve
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Author: Bruno
Date: 2007-05-04 18:32
Okay. It had to happen, right?
Two guys meet on the street. First Guy says, "Man! I just bought a new hearing aid! Is it wonderful! I can hear a pin drop a block away. Cost more than the other brands but it's worth every penny."
Second guy: "Really? Great! What kind is it?"
F.G. "It's a quarter to four."
B/
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Author: sdr
Date: 2007-05-04 20:23
"This happens even when I'm concentrating and wide awake. In fact I often try to lip read as well in order to make out what they're saying.
In my last test, I had the typical middle age decrease in the upper frequency range, but no other problems."
In my previous post I was referring to people with normal hearing who have trouble discriminating voices in noise. People with high frequency hearing loss ALL have this problem. In speech, vowel sounds tend to have there energy in lower frequencies and consonants have theirs in higher frequencies. As you lose high frequency hearing you are preferentially clipping out the consonants. Think about what you do when you want to listen to NPR on your car radio --- you turn down the bass and turn up the treble. It is the crisp consonant sounds that lift a voice out of the background. If you have high frequency hearing loss, you basically hear the bass and not the treble, so the voices are lost in the background. There is no good fix for this -- hearing aids are only partially helpful in noisy environments because they don't know what you want to listen to. You should find quiet restaurants instead of noisy ones.
-sdr
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The Clarinet Pages
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