Five Things 3

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Publication brought to you by

1How toavoid costlymistakes

By Dr. David J. DeKriek, Au.D.

Youve had the self-realization of

hearing loss.You have also realized

the fact that you need to do something

about it. Your family and friends have

probably known for years. Now what

do you do? Talk to friends, look for

ads in the newspaper, research online?

Where do you go? Whom do you see?

What should you ask? How do you

make sure you are getting the best

DEAL? We will get to the answers of

these questions soon enough.

In my many years of patient care I

have seen and heard it all, everythingfrom people buying hearing aids

online that were actually stolen

property to the patient who bought

hearing aids through the mail and the

hearing aids never worked.

I have found that many consumers

are confused, if you start looking

online (which I do not recommend),

you have to sort through many

different websites many of which

have one goal in mind... To sell you

hearing aids, thats it.

They could care

less about the care,

education and

follow up

that is

required for a successful hearing aid

tting that can improve the quality

of life for all who wear them. There

are many different styles, models,

and manufacturers to choose from.

Artesia

Shoemaker

N

Five Things You MUST KnowBEFORE Buying Hearing Aids

CONTINUED ON 4

SeeFIVE THINGS

13079 Artesia Blvd.,

B-104

Cerritos, CA. 90703

Dr. David J.

DeKriek, 562.275.3602

In-depth background

and interview with

Dr. DeKriek Au.D.

I started my interest in audiol-

ogy when I had a friend who was in

his grad program studying audiology.

He asked me if I would be a subject

for one of his studies. I had some

free time so I agreed. His study was

on auditory brain stem response. He

did some testing on me and I found it

very interesting. He suggested that I

look into the career.

At rst I didnt really think that

was a reasonable suggestion but as

I became interested in it, I did start

studying it. Later I entered the gradprogram myself. That was at Cal

What consumers need to knowState, Los Angeles. I got my Mas-

ters degree in Audiology and started

practicing immediately. I did that in

a couple of different clinics. I latergot my clinical doctorate of audiol-

ogy thru the University of Florida.

After graduation, I was imme-

diately hired by a manufacturer for

Starkey Laboratories. They had me

on staff as a support audiologist and

as a eld rep going out into local of-

ces discussing different products

and answering questions for the au-

diologist.

In January of 2008, I made the de-

cision to open my own ofce in Cer-

ritos, California and Fidelity Hearing

Center was born.

Since then I have been focusing ongetting my name out in front of peo-

ple and trying to set my ofce apart

from the local ofces that are also in

the area. The way that I have been

doing that is by focusing on quality.I dont have any gimmicks that I

have in my ofce, I dont have off

or anything like that. I dont believe

in doing that, I think it is bad for the

industry and it is misleading for the

consumer or the patient. So my of-

ce is pretty straight forward. When

someone comes into my ofce I tell

them, after testing them, I tell them

what they can hear, what they cant

hear, how I expect that to effect them

and usually if there is a family mem-

ber present they agree and say Yah,

that is the difculty that we are hav-

ing.So then I can make a recommen-

Hearing Matters The community guide for healthy hearing

Hearing MattersBrought to you by Fidelity Hearing Center-Cerritos

Advertising supplement


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Fidelity Hearing Center - 562.275.36022 HEARING MATTERS www.hearingmatters.com

2009 ECNG, Inc. Reproduction prohibited unless permitted.

I was virtually stone deaf.

So I started checking out

whether theres some kind

of hearing device that would

help me, and I believe by divine

guidance. I was directed to Dr.

DeKriek. I was impressed by

the physical setup, all his new

equipment, and his obvious ex-

pertise.

He fitted me with an aid and

has, progressively, either im-

proved or replaced the aid I had,

so that now I can hold a conver-

sation one on one with people

without them having to shout at

me. I dont believe I would have

gotten this kind of service any-

where else. He cares about his

patients, so I carry his business

cards with me.

I totally endorse the work of

Fidelity Hearing Center and Dr.

DeKriek.

What are patientsmost pressing

concerns?Misinormation

I have patients who come into my

ofce who have heard many stories

regarding hearing loss.

They are misinformed and dontunderstand necessarily what problem

they have or how to address it; how

to x it. Many of them have gone to

doctors who said, Well you have

a hearing loss that cant be treated.

Its permanent hearing loss and there

is really nothing that we can do.

Inaccurate. Almost every hearing

loss can be treated and be treated

effectively and can be treated fairly

quickly so that within a week or so,

those patients can be hearing much

better than they have for many years.

Efects o

hearing lossA third reason is people really

dont understand how their loss of

hearing affects them. Certainly the

family members are aware but a lot

of times when

someone has

hearing loss they dont know how it

is affecting them. I go over hearing

loss with the patient and use some

specic examples with their family

members to show them the things

they are missing. The patient is

able to see the reaction his family,

friends, and co-workers can have

rst-hand. The patient was likely not

aware of the hearing loss affect, it is

very frustrating for them.

So we not only want to x your

hearing but also x the commu-

nication with your family, friends

and coworkers so that everybody is

happier.

Incorrect

productTypically they buy a product

that isnt the very best for them as a

person. There are many hearing aids

that treat different types of hearing

losses. They are exible, but you

have to be aware of other features

that maybe should or shouldnt be

present for that individual patient.

For example, if a patient has

a very tiny hearing aid, it is more

convenient they change the battery

themselves and place it back in their

ear. If I have a patient that is 35 or

45 years old, its not a problem. If

I have a patient who is in their 80s

and 90s with limited dexterity, we

must consider that in the hearing aid

tting process.

Another factor to consider would

be volume control that maybe that

patient shouldnt have. Its actu-

ally very common for me to have

patients not setting the volume

appropriately. Their family is usu-

ally perplexed because they see thehearing aids in the ears and do not

understand why they are not wor-

king correctly. The user, for wha-

tever reason, is turning the volume

down to a point where he cant hear

or maybe turning it up to a point

where it is too loud and it whistles

and it causes him discomfort. This

is another factor to consider when

prescribing hearing aid.

Frequently, I have patients who

come into my ofce and have bought

a hearing aid with features that they

are completely unaware of (and pro-bably charged more for that feature).

I thoroughly explain every feature

on any hearing aid I recommend.

Will I get ripped

of?I also have patients come into my

ofce who have been to corporate

type stores and have been told they

need these very expensive hearing

aids and that is really the only thing

that is going to afford them

hearing again. In reality those

very expensive hearing aids

are marked up articially.

So a pair of hearing aids at

that store might regularly sell

for $5000, their initial price is

$10,700 and then they apply

discounts to bring them

down to $5000.

You couldnt go and buy

a car and have it start at

$20,000 and then get a bunch

of discounts down to $10,000.

That just doesnt make sense.

Interview with Dr. David DeKriekIt either means they were ripping

you off in the rst place or that

they are giving you something for

far less than it is worth and they

wouldnt be able to maintain the

business.

There are more and more pa-

tients who are going online and

seeing hearing aids advertised

for as little as $79 a month or

think they can buy hearing aids

on Ebay. Thats because they see

hearing aids as a commodity rather

than a specialized product. Patients

believe they can buy hearing aids

much like reading glasses.

Thats unfortunate (and illegal)

that they are available in this man-

ner. Hearing aids are regu-lated and in many states,

California included; it

is actually illegal for

people to sell hearing

aids thru the mail.

But there are uns-

crupulous

people out

there who

sell mail-

order hea-

ring aids; the

purchaser is

unaware ofthe illegality.

Hearing

aids are

not a com-

modity, a

patient must be appropriately t, the

hearing aid must adjusted for their

specic hearing loss, and the patient

must return for periodic adjustment.

None of those things can take

place over the internet.

Adapting to hearing aids is not

an easy thing. It requires working

with someone who can direct youand provide the appropriate changes

at the right point in time. If someo-

ne purchases hearing aids from my

ofce, the rst setting works well for

them. But in 4-5 months, the audi-

Should I buy

online?

tory system will adapt and change

and become more effective using the

hearing aid so the hearing aid needs

to be tuned and adjusted for them.

Again, none of those things can

take place over the internet.

Also if people are exposing

themselves to different environments

and hearing different typesof noises we want to be

able to ne tune the

hearing aid to lter

those noises so

they are not as

troublesome and

the hearing aid

sounds comfor-

table.

Again, none

of those things

can take place

over the inter-

net.The hearing

aid tting is not

a product driven

type of service or transac-

tion. Its a service driven type of

Delight E. Macias

PATIENT TESTIMONIAL

Patient Bill Westra bought a pair of CE

200 hearin aids and loves them.

Arthur Mojica

Hope Kerr

transaction.

If you go to an ofce that knows

what they are doing vs going to an

ofce where they dont know what

they are doing, the exact same hea-

ring aid can have two different types

of outcomes. So it has nothing to do

with the quality of that hearing aid.It has to do with the quality of the

service that you are getting. Going to

an expert makes all the difference in

the world.

There are no experts on EBay.


3/8

Fidelity Hearing Center - 562.275.3602www.hearingmatters.com HEARING MATTERS 3


Is hearing aidsatisaction on therise?

Yes it is true. Most hearing

aid wearers have an improvedquality of life once they have

begun to wear hearing aids.

Consequences of untreated

hearing loss were analyzed and

evaluated in a major study of

older (50+) hearing

impaired adults and

their close fami-

ly members and

friends.

As hearing aid

wearers repor-

ted, relationshipimprovements

and stronger

sense of in-

dependence.

Families of hearing aid wearers

were even more likely to report

improvements. Social interac-

tion for many also improved.

Among those with more severe

hearing loss, hearing aid wearers

were 25% more likely to partici-

pate regularly in social activities

then non-wearers. Non-wearersreported greater depression, and

isolation. Comparing hearing aid

wearers to non-wearers found

that the non-wearers were less

likely to participate in social

activities, and more likely to

report depression, anxiety, and

paranoia.

Older non-wearers were more

likely to agree with the state-

ment, people get angry withme usually for no reason. This

study debunks the myth that

untreated hearing loss in older

adults is a harmless condition.

How well a person hears affects

his or her sense of well-being.

Unfortunately many

have allowed themselves

to remain in denial and

buy into their vanity barriers.

This only separates them

from real life, and often

freezing them from

the wonderful

spontaneity of

life and simple

everyday connections with im-

portant loved ones. They often

become more separated and lo-

nely with time as they and their

hearing loss begin to age. Their

own made up explanations con-

clude, My hearing is not bad

enough. I can get along with-

out one It would make me feelold. Or, Im too embarrassed

to wear one. The plain truth is,

a hearing loss is more noticeable

then a hearing aid! Hearing is a

wonderful thing. There are those

who havent quite come clean or

admitted yet what price they are

paying for their hearing loss.

What type o doctorwould yourecommend topatients?

They most certainly should go to

an audiologist. The more educationsomeone has about hearing, or any-

thing for that matter, the better they

will be able to assess the problem.

An audiologists is also required

to learn other things that affect com-

munication; things related to anato-

my and physiology.

Audiologists receive education

on Pharmacological aspects and how

drugs might interact with hearing.

They are educated on psychology

and how hearing loss affects our

interaction with family and how weinteract with the world. Audiologists

are much better prepared to deal

with people and their hearing loss;

not just a hearing loss independent

of that whole person.

Some audiologists have even

greater expertise in some areas.

Board certied audiologist receive

higher education and other more

specic requirements. This type of

certication assures patients that au-

diologists have the most up-to-date

education and will be able to provide

that current knowledge and current

expertise when evaluating hearingloss.

These doctors are required to stay

current. Many ofces dont have

even an audiologist much less a

board certied doctor of audiology.

What should apatient look orwhile in a

doctors ofce?

When I perform a hearing test I

first start with an otoscopic exami-

nation of the ear. I look at the outer

ear and then examine the inner ear

canal. I have a screen that the patient

can look at during the entire exami-

nation called a video-otoscope so

they can see exactly what I see.

I explain to the patient what we

are seeing and if I see any kind of a

problem I can point it out. If every-

thing looks great and healthy then I

point that out and I say, See every-

thing looks just the way we want it

to.

After the otoscopic exam, I as-

sess the movement of the eardrum

to make sure there is no restriction

or fluid. These symptoms can be

treated and might resolve the hearing

loss.

After these exams I will use a

more traditional hearing test us-

ing tones and beeps. I have a soundproof booth and utilize insert

earphones so that patients are not

affected by any kind of external

noise. My equipment is calibrated

and I use air conduction headphones

so my patients can be tested in a

normal hearing environment. I also

use a bone vibrator which helps me

assess the nerve independent of the

ear drum.

What are personal

listening situations?When a patient does decide ok

Ive got the right professional, I have

done the tests, the explanations were

very clear; how do personal listening

situations apply to the selection of a

hearing aid with your patients?

I always ask my patients, where

do you have the greatest difficulty?

Exactly why did you come in today?

If they tell me the greatest dif-

ficulty they have is at work or on the

phone, then I want to make sure my

solution is that I provide adequate

improvement for those problems.

If their difficulty is mostly hear-

ing their spouse then I make sure I

provide a hearing aid to help with

that and I will also ask them to bring

in their spouse for conversation.

In my view, a hearing aid should

be flexible enough for the patients

lifestyle.

If a patient is exposed to a very

diverse acoustic environment; -ex-

posed to a very quiet environment at

home and then a very noisy environ-

ment at work- then we want a hear-

ing aid that will allow themto make changes and have

different programs set up for

those different environments.

If I have a patient who

wants ease of use and conve-

nience, I want to know that

so I tailor my recommenda-

tion to what is going to be

easiest for them and provide

them with the best satisfac-

tion aside from the acoustic

qualities.

I made an appointment

after my husband noti-ced I was not hearing

the heart monitor on our exer-

cise equipment beep. I thought

it didnt work but

he could hear it

just fine.

I had my hea-

ring tested. I

found that I had

nerve damage in

both ears.It was

devastating for

me. I felt I was

way too young

for this and it

just hit me hard.

I went to see Dr. DeKriek for

a second opinion. He tested me

and found the same diagnosis,

but he made things simple and

clear and was very, very patient

with me.

Dr DeKriek was such a great

listener and was so sensitive to

me, helping me feel comfortab-

le with the hearing loss I have.He showed me what my hearing

really could be like, and helped

me create a whole new hearing

transformation.

The day I was

fit with my new

hearing aids, it

was amazing. The

sound was crisp.

I couldnt believe

how many sounds

I had been mis-

sing! It seems to

get better every

time I come in

and he adjusts them. I cant

imagine going back to my old

way of hearing. I feel like a

new person. I would recom-

mend them to everybody who

has a hearing problem.

Im very, very happy! He

will forever be my doctor.

PATIENT TESTIMONIAL

Anna Velez

Interview with Dr. David DeKriek

Patient Bill Westra bought a pair of CE

200 hearin aids and loves them.

Clara Rose Lipe


4/8



amount of amplication a hearing

aid can provide. In addition, if the

inner ear is too damaged, even large

vibrations will not be converted into

neural signals. In this situation, a

hearing aid would be ineffective.

Hearing aids work differently

depending on the electronics used.

The two main types of electronics

are analog and digital.

Analog aids

convert sound

waves into electrical

signals, which are

amplied. Analog/

adjustable hearing

aids are custom

built to meet the

needs of each

user. The aid is programmed by

the manufacturer according to the

specications recommended by your

audiologist. Analog/programmablehearing aids have more than one

program or setting. An audiologist

can program the aid using a

computer, and the user can change

the program for different listening

environmentsfrom a small, quiet

room to a crowded restaurant to

large, open areas, such as a theater

or stadium. Analog/programmable

circuitry can be used in all types of

hearing aids. Analog aids usually are

less expensive than digital aids.

Digital aids convert sound waves

into numerical codes, similar to the

binary code of a computer, before

amplifying them. Because the code

also includes information about a

sounds pitch or loudness, the aid

can be specially programmed to

amplify some frequencies more

than others. Digital circuitry gives

an audiologist more exibility

in adjusting the aid to a users

needs and to certain listening

environments. These aids also can

be programmed to focus on sounds

coming from a specic direction.

Digital circuitry can be used in all

types of hearing aids.

The whole research process can

become rather frustrating. I do

understand that you need to have the

right information before making a

decision, just try to make sure you

are getting it from a highly trained

professional, not a website that is

trying to sell you hearing aids.

Hearing aids are essentially all

the same, so the key is nding ahighly trained, experienced hearingaid professional that is right for you.

A hearing

aid is a small

electronic device

that you wear

in or behind

your ear. It

makes some

sounds louder

so that a person

with hearing loss can listen,

communicate, and participate more

fully in daily activities. A hearing aid

can help people hear more in bothquiet and noisy situations.

All hearing aids have three basic

parts: a microphone, amplier, and

speaker. The hearing aid receives

sound through a microphone,

which converts the sound

waves to electrical signals and

sends them to an amplier. The

amplier increases the power of

the signals and then sends them

to the ear through a speaker.

Hearing aids are primarily

useful in improving the hearing

and speech comprehension ofpeople who have hearing loss

that results from damage to the small

sensory cells in the inner ear, called

hair cells. This type of hearing loss

is called sensorineural hearing loss.

The damage can occur as a result of

disease, aging, or injury from noise

or certain medicines.

A hearing aid magnies sound

vibrations entering the ear. Surviving

hair cells detect the larger vibrations

and convert them into neural

signals that are passed along to the

brain. The greater the damage to a

persons hair cells, the more severe

the hearing loss, and the greater the

hearing aid amplication needed to

make up the difference.

There are practical limits to the

Allhearingaidsare thesame

Five thingsContinued from page 1

2

Choosinga hearingaidprofessional

When you do compare hearing

aids, the rst question is NOT

whether you want to get analog ordigital hearing aids. Or what brand

or style you are going to get or any

other question about hearing aids

themselves.

Hearing aids are essentially all

the same, so the key is nding a

highly trained, experienced hearing

aid professional that is right for you.

First, check the credentials of the

person. Are they an Audiologist?

They most certainly should be.

Audiologists have a Doctorate

or other advanced degree and

are highly trained to evaluate the

entire auditory system and performdiagnostic assessments to rule

out any medical issues that can

have serious

consequences.

A masters

level audiologist

has a ve-year

degree and

you will most

commonly see

M.S or M.A

behind their

name. A Doctor

of Audiology isa six-year degree

and they will have

Au.D. behind their

name. Two other

credentials that

you should look

for is a Board

Certication in

Audiology and a

Certication of Clinical Competency

from the American Speech and

Hearing Association (ASHA). This

certication is noted as CCC-A.

You are embarking on anadventure toward better hearing. You

need to select the professional you

are going to place your trust, your

money, your time and frankly your

hopes with carefully. This might be

something you have not given much

thought, but it may very well be the

most important decision you make.

You are going to be spending

time with this person for years

to come. It is important that it is

someone you feel very comfortable

around and someone with whom you

can communicate effectively. You

will need to trust this professional

to be able to open up and discuss

the difculties you have been

experiencing with

your hearing loss and

the communication

difculties it has

created for you.

Being open and frank

about the impact

your hearing loss

has on your spouse,

your family and

friends, as well as your

performance at work, is critical

to your success.

The person you select

should have the educational

background and the practical

experience you need, but

they also need to be a good

communicator and a great listener,

capable of translating your

experience into a technical solution

to resolve any issues that might

come up in the programming andtrouble- shooting of any problems

you encounter. They need to be

patient and committed to helping

you hear as well as you possibly

can. The last thing you want is a

professional who is delighted to sell

you hearing aids and then avoids you

if you need adjustments or coaching.

Do you trust them? Would you

feel comfortable referring your

friends to this person? If you can

answer yes to these questions you

are on the right track

Do a bit of research on the

professionals around you:

Ask for a referral from friends

you know who

have been

successful with

hearing aids. Did

they respect and

trust the person

they worked with?

Ask your

Primary Care

physician

which hearing

professional they

refer patientsto for hearing

loss and hearing

aids. Remember,

this person

reects either a

positive light or

a negative light

on the physicians

themselves;

normally they select other

professionals very carefully.

Make certain they hold a valid

audiology license, are in good

standing, and have no dubiouscomplaints against them. Every

state has a licensing board for

Audiologists. Check your states

web site for information.

If they have a business website

spend some time looking around.

Are they professional? Does what

they say about themselves and their

company t with what you are

looking for? Do they give you a

clear reason why you should select

them? What sets them apart from

the other professionals in the area?

Is their website an informationresource? (This will tell you if they

believe in patient education).

3

1. Check the credentials.

Are they an Audiologist?

2. Masters level audiologist

has a fve-year degree, M.S

or M.A behind their name.

A Doctor of Audiology is a

six-year degree, Au.D. behind

their name.

3. Two other credentials

that you should look for

is a Board Certifcation in

Audiology and a Certifcation

of Clinical Competency from

the American Speech and

Hearing Association (ASHA).

This certifcation is noted as

CCC-A.

Dr. DeKriek with patient Jim Richardson who

recently purchased Starkey hearing aids.

Patient Tom Vanderputten

purchased DE 1200 aids.


5/8



Purchasinghearing aids

It is important that you recei-

ve a written recommendation and it

should include the information below

at a minimum:

The manufacturer of the hearing

aid

The specic model of the hearing

aid

The price of the instruments and

any additional services

How long is the manufacturer repair

and loss and damage warranties

What their satisfaction guarantee is,

including any requirements you must

comply with, to return or exchange

the hearing aids

If you exercise your legal right to

return the hearing aids will any feesbe withheld

Should you decide to purchase

hearing aids and feel comfortable

with the professional and their ofce,

you should ask some additional ques-

tions.

Have the audiologist tell you

about their follow up policy. You

should have your rst follow up visit

within one week of your initial hea-

ring aid tting and several additional

visits during the adaptation period.

Depending on your hearing loss, this

adaptation period could be up to sixmonths in duration.

These visits should include de-

tailed discussion of your experiences,

the positive things you have experi-

enced as well as any areas of difcul-

ty. You should never feel like you are

bothering your audiologist and that

your comments and questions are tri-

vial. They are there to make certain

you are hearing as well as possible

and you are receiving the maximum

benet from your hearing aids.

Success iscontingenton a goodexam

Good experiences with hearing

aids are contingent on good data.

A complete evaluation is critical in

hearing aid selection as well as the

accurate programming of the inst-

ruments. Very few insurance com-

panies pay for the evaluation and

Medicare will only cover the exam if

referred by a physician and is not for

the purpose of tting hearing aids.

You need to get a complete exam

and you should be prepared to pay

for it. Expect to pay around $100

depending on your location.

You will see Free Hearing

Screening offers in advertising.

This test is a bare bones check

to see if you have a hearing lossand are a candidate to proceed to a

discussion of amplication. They

do not provide enough information

about your auditory system for a

successful outcome with hearing

aids. Free tests are never free. You

will either pay for them as an addi-

tional component of the total price

of the hearing aid or pay the price of

a high-pressure sales approach after

the test.

A complete Audiological evalu-

ation should include the following

components:Otoscopic Evaluation

A thorough examination of your

ear canals will identify any blockage

by debris or cerumen (earwax). If

a signicant amount of earwax is

present, your ears need to be clea-

red of wax prior to completing the

hearing testing. Some audiologists

provide cerumen removal and others

may refer you to your Primary Care

physician. A visual inspection of the

eardrum will also reveal any abnor-

malities, scaring or infections.

Middle Ear Evaluation

Most commonly referred to as

a Tympanogram. This evaluation

looks at the mobility of the eardrum

and the middle ear bones as well as

air pressure inside the middle ear.

This gives the audiologist informa-

tion on the integrity of the eardrum

and if any perforations in the ear

drum are present. Acoustic

reexes are also measured

with this test and give impor-

tant neurological information

about the hearing system.

Otoacoustic Emission

Otoacoustic emission

testing measures an echo reected

back as a sound is introduced into

the ear canal. This gives the audiolo-

gist valuable information about the

anatomy of the ear that is essentialfor suppression of background noise.

Audiological Evaluation

This portion of the evaluation

is what most people think of as a

hearing test. It is administered

in a sound treated room through

either insert or traditional earphones.

Eight or nine separate frequencies

are evaluated to identify the amount

of volume required for the tone to

be barely heard. This is referred

to as your hearing threshold. This

method of sound presentation is air

conduction testing. It evaluates theentire hearing pathway from the ear

canal to the auditory cortex in the

brain. The frequency testing should

be repeated with a second method of

sound presentation. This time an os-

cillator is placed on the skull behind

the ear, bypassing the middle ear and

stimulating the cochlea directly.Speech Testing

There is a big difference in

hearing speech and being able to

understand speech. A critical part of

any evaluation is a measure of the

accuracy in understanding a spoken

word list. This test is administered in

A beroptic camera inspects the general health of the external auditory canal

for cerumen (ear wax) and any conditions that require attention. Tympano-

metry and Bone Conduction determine Middle Ear function.

A hearing test will determine how the auditory system is working.Speech

discrimination tests are run to determine the potential benet and under-

standing you should expect.

Video Otoscope

a "quiet" situation with each ear eva-

luated separately and then again with

both ears working together. Because

we live every day in background

noise, and it causes such a disruption

of our ability to understand speech,

it is very important that a speech test

in the presence of background noise

be included in the evaluation. One

test in particular that is commonly

used is the QuickSin. It is invaluable

in guiding the hearing aid selectionprocess and the advisability of direc-

tional mics and sophisticated noise

processing.

Before, during and after the

testing expect the audiologist to ask

questions- lots of ques-

tions. Each person has a

unique hearing history,

medical conditions, expe-

rience with past amplica-

tion, expectations, social

and work environment

needs as well as budget. Any pro-

fessional who does not ask enough

questions to understand completelyyour unique situation and need is

treating you like a hearing loss and

will then recommend a hearing aid

for the hearing loss not for YOU.

Once they have a complete un-

derstanding they are then able to linkup your history, experiences, sym-

ptoms and needs and convert that

into selecting the most appropriate

instrument for you.

Watch out for high-pressure

tactics and sales gimmicks. A true

professional will allow you to make

this decision on your own time

frame. Feel free to continue to ask

questions about the process or the

hearing aids until you are comfortab-

le and ready to move forward with

the purchase. If you need to take

time to discuss it with family, you

should do that.One of the best things that can

happen during your appointment is

to experience what amplication is

like and what you might expect to

hear with hearing aids. Some au-

diologists will do this automatically

before explaining the test results;

others may schedule a follow up vi-

sit for the hearing aid demonstration

or even allow you to test drive the

hearing aid.

A complete explanation of your

hearing and test results is an impor-

4

5

tant part of the test and your evalu-ation. It is not complete until you

understand the results, recommenda-

tions, and all of your questions have

been answered.

Patient Thomas Mauss was in a

rush and got his hearing aid that

same day.

Rex Wise purchased a set of

Starkey and loves them!


6/8



In general terms, there are

two types of hearing loss,

conductive and sensorineural.

A combination of both is also

seen as a mixed hearing loss.

Conductive

hearing lossConductive hearing loss

is caused by any condition

or disease that blocks or

impedes the conveyance of

sound through the outer or

middle ear. The result is a

reduction in the sound intensity

(loudness) that reaches the

cochlea. Generally, the cause

of conductive hearing loss can

be treated with a complete

or partial improvement in

hearing. Sensorineural hearing

loss Sensorineural hearing

loss results from inner ear or

auditory nerve dysfunction.Often, the cause cannot be

determined. It is typically

irreversible and permanent. It,

too, reduces the intensity of

sound, but it might also result

in a lack of clarity even when

sounds, particularly speech, are

loud enough. The treatment for

sensorineural hearing loss is

amplification through hearing

aids.

Mixed hearinglossA mixed hearing loss is a

combination of a conductive

and a sensorineural hearing

loss. Hearing aids can be

beneficial for persons with a

mixed hearing loss, but caution

should be exercised.

Causes of

hearing lossThe main causes of hearing

loss are as follows: n Aging

(presbycusis) n Excessive noise

(i.e. construction, rock music,

gun shot, etc.) n Sudden onsetn Infections (otitis media)

n Injury to the head or ear

n Birth defects or genetics

(i.e. otosclerosis) n Ototoxic

reaction to drugs or cancer

treatment (i.e. antibiotics,

chemotherapy, radiation)

Tinnitus, or

Head NoisesTinnitus often simply

referred to as ringing-in-the-

ears or head noises is a sound

heard by one or both ears that

is described by different peo-

ple in various ways. To some

it is a high-pitched ringing,

whining, or hissing sound, like

listening to a conch shell. To

others it may be a low roaring

noise. Tinnitus can be very

mild, noticeable only in a quiet

room, or it can become so loud

and annoying the victim hearsnothing else. It can be persis-

tent, intermittent, or throb-

bing, depending on the cause.

Some 50 million adults suffer

from Tinnitus. For 12 million,

the problem is so severe they

are incapacitated. While Tin-

nitus does not cause hearing

disorders, it may accompany

decreased hearing and other ear

symptoms such as pressure, un-

steadiness, or dizziness. Often,

it occurs alone.Some of the main causes are:

wax buildup or obstruc-

tions in the outer ear canal per-

foration in the eardrum or fluid

accumulation behind

Otosclerosis - the stirrup

bone (stapes) becomes fixed

Otitis media (ear infec-

tions)

exposure to a sudden

loud noise or repeated

exposure to noise without

adequate protection

trauma to the head or

neck as in a concussion or

whiplash injury

some medications indu-ce head noises

high or low blood pres-

sure or anemia

Treatment of Tinnitus

Correcting treatable causes

of Tinnitus (i.e. ear wax

build-up, allergy, infection,

syphilis) often will improve the

condition.

However, when the cause is

unknown, or when head noises

arise from within the cochlea,

auditory nerve, or brain, treat-ment becomes more difficult.

Most medications and surgical

procedures have not been suc-

cessful in relieving Tinnitus.

Because of the direct asso-

ciation between the hearing

mechanism and the nervous

system, Tinnitus sufferers have

been advised to avoid nervous

tension, fatigue, and stimulants.

Sedatives, biofeed back, and

other relaxation techniques

may offer some people tem-

porary relief. The only other

approach that so far has

achieved any success has

been Tinnitus Maskers to

mask the ringing sound

with other sounds as a

means of distracting

the individuals

concentration on

Tinnitus. Other

worthwhile

As a musician in an orches-

tra, hearing the directions

from the conductor was a

problem. Now, its a lot better since

Ive had my hearing aids.

The biggest problem I disco-

vered was in a crowded restaurant

where everyone is talking. I used

to just sit and eat. The first time I

came home with my new hearing

aids, the sound didnt seem quite

right, so I went back to Dr. De-

Kriek.

He fine-tuned and adjusted them,

and now and its much better. When

I play my instrument by myself,

no problem. Even the quality is so

much better. Im able to control

the dynamics and play with more

sensitivity, power, and passion

in my music. Now its easier to

follow, hear, and be in sync with

the conductor, and to get through

the entire piece easily. Through

this experience my association

with Dr. DeKriek has been veryhelpful. Both my mother and father

had hearing problems when they

were in their eighties. It hit me a

few years ago. and I had problems

in situations struggling hearing

people, even when I was talking

one on one. Now the hearing aids

are fitting well and are tuned so

clearly.

Now I can function again normally

and hear with confidence. Im so

glad I came in!

PATIENT TESTIMONIAL

John Feeney

Types of Hearing Loss

treatments to explore are cogni-

tive therapy and Tinnitus Retrai-

ning Therapy (TRT). Conclusion

Because Tinnitus may be symp-

tomatic of a more serious dis-

order, it is important to try and

find the cause before treating

the head noises by any of these

means. If you or someone you

know suffers from Tinnitus, I

urge you to contact an ear doctor

(otologist or otolaryn-gologist)

or audiologist as soon as possi-

ble.

Patient Ray Munoz says I can

hear in noisy places again!

Packard Polin


7/8



day-by-day, it grows worse.

Before long, only half the words

are clear and many he can barley

make out at all.

Most people think hearingloss is simply words and sounds

becoming fainter, turn up the

sound or talk louder will enable

the person to hear better. Not so.

Distortion- how clear the words

are-is also major part of hearing

loss.

Even if the words are loud

enough, the inner ear interprets

them as distorted. This gradually

grows worse and worse with

time. It can become permanent,

ruining the ability to understandwords and even limiting how

much help can be obtained after

correction.

The longer hearing loss is

ignored, the more deterioration

there will be. A person thinks

they may be able to get away

with turning the TV louder or

ask to repeat and talk louder, but

they are usually disappointed

when they still cannot under-

stand.

If help is sought early

enough, studies show that the

right hearing devices, if worn

regularly, can actually slow

down the deterioration of the

Spontaneous inter-

change is important

to our everyday

lives. For some with fading

hearing abilities, it seems impor-

tant to continue to maintain anillusion of proper hearing in any

given situation. When social en-

vironments present themselves,

the hearing impaired individual

will often laugh whole-heartedly

at the unheard punch line, or

vigorously applaud for no other

reason than everyone else is do-

ing so.

Over 90% of those with hear-

ing loss are in denial. The invis-

ibility of hearing loss makes it

almost transparent to the suf-ferer. As the problem worsens,

it remains easy to deny that they

have a hearing problem. Some

are actually convincing them-

selves that its still too early for

help.

As the hearing loss progress-

es, the hearing impaired become

more psycho-socially inhibited,

keeping them from seeking

hearing assistance that is avail-

able to them.

The continual denial andrefusal for help or to accept their

problem causes them to live in

a distorted perspective and in a

constant defensive strategy to

hide their loss for fear of being

discovered. In many instances,

they have to bluff their way

through even the most trivial

and mundane social situations.

This is the social equivalent

to ght or ight which is

a subconscious avoidance

of any potential commu-

nicative situation such as

church, family gatherings,

noisy restaurants and clubs.

Perhaps the situation

calls for a visit with a hand-

ful of friends and family

in a living room where the

lights are low, the televi-

sion is blaring, and some are

sitting at a distance. That

situation can be tough with

normal hearing, but with hearing

loss its al-

most

impossible.

Instead of relaxing and enjoy-

ing the moment, a person is in

the throes of almost insurmount-

able communication obstacles.

More pressure, more tension,

anxiety, and energy is spent try-

ing to catch the conversation.

No wonder people get frustrated

and exhausted. No wonder

they fall asleep in church. If

you cant hear it why bother to

listen? Drawn inward from the

loss, people can become nega-

tively self-centered. Interactions

become forced, belabored, rep-

etitious, and worse - responses

become inappropriate and em-

barrassing.

With those kinds of humiliat-

ing mistakes the person feels

embarassed, and the fear of re-

peating such an incident reducesinteraction.

This can be a strain on the

spouse. There is a loss of close-

ness and intimacy for both of

them. What is happening? The

spouse is smothered by depen-

dency, and then blamed for not

speaking clearly, or not under-

standing, or expecting too much.

The spouse is supposed to be

the ears now. That certainly is a

lot of pressure to put on anyone,

and usually does not work out

too well.

Even tripsPerhaps they get

away to take a trip, just them

alone. He nds that he cannot

hear in the car because of the

road noise or the distance be-

tween them. Then theres her

quiet, high-pitched voice, not to

mention she may be sitting on

his bad side.

This results in wanting his

wife to repeat herself and speak

up over and over again, it even-

tually becomes a tug of war

battle of whos right and whos

wrong. They are

each drawn

inward and resign themselves

to going it alone into their quiet

world, feeling sorry for them-

selves, unloved, depressed, and

eventually forgotten.

If a man has a chance to help

his hearing and delays it, he

tends to do so for an average of

seven years. He will not be back

until he is nally convinced

that he is not just a cantanker-

ous, opinionated or socially

diminished individual but has a

legitimate hearing problem that

really needs help. Little by little,

The psychological and social strains of hearing loss

I was very hesitant to go

to a hearing doctor, my

kids finally convinced

me to go. They would get frus-

trated with me at family parties

because I could not hear very

well and I would have to have

my wife next to me to help. So

I started looking around and

through another friend, found

Dr. DeKriek. I was very im-

pressed with his office and ex-pertise.

He fitted me with an aid that

day and it has progressively

got better so now I can hold a

conversation with people. Dr.

DeKriek was great, he asked all

the right questions, did an ex-

tensive examination that led to

my new aid.

I would recommend Fidelity

Hearing Center and Dr. DeKriek

to anyone.

Luis Salazar

PATIENT TESTIMONIAL

Your hearing aids are blessing to our

marriage- Everett and Mary Jo Baker Duffy Baker loves his new hear-

ing aids.

Kay Kimura could not believe

how much she was missing.


8/8



Reclaim your hearing

Mention this paper and get

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Dr. David J. DeKriek, Au.D.

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