Note from Tammy: There is so much information out there about hearing aids and no shortage of questions. It can be very difficult to muddle through all the information to figure out what are the best hearing aids for you.  Our research tells us that people wait on average 7 years to get a hearing aid after they’ve been told they need one. I believe this is, in part, due to the overload of information. Hopefully, I can help clear a few things up!

Digital Hearing Aids vs Analog Hearing Aids

Q: My friend has an analog hearing aid but when I ask around all I hear about are digital hearing aids. What does it mean to have a digital hearing aid? How do I know which is best for me? – Adam from Billings, Montana

A: Almost all hearing aids produced today are digital. If you look at the evolution of hearing aids they started out as analog circuits. However, over the years the digital hearing aids have taken over. Having a hearing aid be “digital” indicates a more sophisticated circuit as well as a more flexible circuit. It also means that it can be programmed (and reprogrammed) according to your hearing loss. Your friend’s analog hearing aid is likely quite old.

So, for the most part you are only going to see digital hearing aids available anymore. And as I said earlier, this is good news for the consumer!

Bluetooth Hearing Aids

Q: I hear about Bluetooth in hearing aids. Is this something I need? Is it hard to use? – Amber from Austin, TX

A: Bluetooth can be a wonderful assistive device to help in various situations. Bluetooth devices can be hooked up to your car, phone, television or computer as long as that particular device is Bluetooth compatible as well. So, Bluetooth-compatible hearing aids could allow you to hear phone conversations through your hearing aids. . . they could allow you to hear your television through your hearing aids. . . they could allow you to hear music through your hearing aids.

Now, to your latter question. . . how hard is Bluetooth to use? This depends on how comfortable you are with the technology and how comfortable you are with the devices you are trying to hook it up to. Often times you will be tasked with handling most of the setup as it is difficult for a clinician or manufacturer to keep up with the thousands of phone, car and computer models. If you enjoy gadgets and have a little time and patience to get everything set up then Bluetooth can be incredibly helpful to you!

Open Fit and Receiver-In-The-Canal (RIC) Hearing Aids

Q: I started researching hearing aids and see open fit hearing aids and also receiver-in-the-ear hearing aids. What’s the difference and how do I know which one will work for me? – Cathy

A: These hearing aids are very similar. Both have the main part of the hearing aid sitting behind your ear with a small, thin tube going into the ear canal which anchors the hearing aid. They are both considered to be an “open fit” because the small tube (with a small tip on the end) is the only thing in the ear.

An open fit simply means that we don’t have a traditional, more bulky earmold anchoring the hearing aid in the ear. . . the ear is more open versus being closed off as it might be with a traditional earmold. The advantage of an open fit (whether it be a traditional open fit or the receiver-in-the-ear) is that it provides a more natural sound and is more physically comfortable.

The difference between these two is in the piece that goes in your ear. In the traditional open fit (the one we call open fit) the piece that goes in your ear is nothing more than a hollow tube with a plastic tip on the end. With the receiver-in-the-ear/receiver-in-canal the receiver of the electronics in the hearing aid is actually going in your ear. The tube that connects the larger part of the hearing aid has a very thin wire within it that connects to the receiver that is covered by the ear tip on the end.

So, it’s a little tricky. They are both considered to be an open-fit but we only call the one an open fit. The advantage of the receiver-in-the-ear is that it can fit a more severe hearing loss.

If you’d like to submit a question to Dr. Tammy Flodmand please send it to [email protected]

by Tammy Flodmand

9 responses to “Ask the Audiologist: Hearing Aid Basics Part Three

  1. I have a profound hearing loss in the high pitches with some near normal in the lower pitches. I have been wearing a hearing aid that moves the high pitch sounds to low pitch to enable me to make out words more clearly. I have 20-30% ability to make out words without aids. This is a trial to see if these aids help at all and so far they seem to. However, my brother who has total loss in one ear and 75% loss in the other has become an expert in hearing aids and he is upset with my audiologist and the brand of hearing aids. I have already purchase two other sets of hearing aids that have failed me. I cannot afford to keep buying. I was feeling pleased with these but my brother says the brand is not recommended by his Dr. audiologists nor does he feel my audiologist is competent with only a CCC behind her name. I am wondering what would be a guess as to what would be good for me.

  2. Correction: Send hearing tests to [email protected]

  3. @Karl: In essence you do have this with the new digital hearing aids. They are programmed to give you more/less bass and treble where you need it. Most people need less bass and more treble.

    sr waterman: The aBlue is an open fit while the aNote is a receiver-in-the-ear. You can send your hearing test to

    @Eleanor: The smaller the hearing aid the less power it can put out. So, the type that go in your ear put out significantly less power than a hearing aid that goes behind-the-ear. If your hearing loss is too severe then you won’t get enough benefit from the in-the-ear.

    @Brian: Unfortunately, Medicare does not cover the cost of hearing aids at this time .

    @Edith: I’m not sure why the hearing aid wouldn’t have helped you. Having a hole in your eardrum should not preclude you from getting benefit from a hearing aid. We could certainly look at your hearing test and make recommendations for you!

    @Steve: Thanks Steve! Echo (aka occlusion effect) is a common issue. Try putting a smaller tip on the piece that goes in the ear and see if that helps. The less blocked up your ear is the less likely you are to experience the echo. If that doesn’t work we can reprogram for you to minimize that sound.

  4. Enjoy your emails, informative is good. I am a new user with two Bt Anotes. Sometimes I get an echo mode going that seems to last a bit. I’ve turned them down and still have the reverb/slight echo going. Seems to be there no matter which programI run. Am I doing something wrong?

  5. I sent an email last week saying that, two years ago, I went to an ENT while on vacation to have some wax removed. A few months later, back home, I went to my ENT and he noticed a hole in my left ear drum. I told him about the wax removal while I was on vacation and how I
    Was feeling a hearing loss. With the help of an audiologist, I tried using a Phonak V for one
    Month and it did not help at all. Do I need a different type of hearing aid? Can you please answer this question and make a suggestion. Again, many thanks. Edith Pollner

  6. Does Medicare typcially help cover the cost of hearing aids

  7. I was told that I could not be fit with an open fit receiver in the ear because my hearing loss was too severe. I have small hearing canals, but would like an all in the ear Aid, because the tube that connects behind the ear often bothers me and hurts. It hurts mostly when I wear glasses or sunglasses.

  8. the difference betwieen a note and a blue . recently i had ahearing test. how do i tend it to you does both a note and a blue have receiver in ear?

  9. why can’t I have a hearing air with volume, bass and treble adjustments. Actually this works for me with an old fashioned radio and no hearing aid..

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