By Tara Bannow • The Bulletin

Under Oregon law, you can return a hearing aid if you ...

• Do so within 30 days of purchase.

• Provide written notice in person or by certified mail.

• Return it in good condition, “less normal wear and tear.”

Under this scenario, customers will get a refund of their purchase price, minus up to 10 percent of the price or $250 per hearing aid, whichever is less. (This is done to allow the practitioner to receive money for the cost of fitting the hearing aid.) This is negotiable, so be sure to learn your provider’s specific return policy before signing a purchase agreement. Any purchase agreement you sign is legally binding, but an oral agreement is not.

Source: Oregon Health Authority

For six years, 79-year-old Joan Verbarg struggled with a hearing aid that just wasn’t working out. So, like many who battle hearing loss, she decided to roll the dice on a different one.

She’s since tried a handful of models, including those made by prominent manufacturers Starkey and Phonak. More recently, she tried a tiny one made by Lyric that’s pushed into the ear canal, just 4 millimeters from the eardrum.

“It’s really nice but it’s very expensive,” she said. “It’s like $3,000 to $3,600 a year. I cannot do that.”

Verbarg was among dozens of local seniors struggling with finding the right hearing aids who attended a seminar on the subject in Bend last week. There, hearing aid salespeople showed off their newest models, including technology they promised would diminish the stigma around hearing loss. In the end, the event was a case study in just how complex the devices are, how slick their producers’ marketing messages are and how important it is to have objective experts weigh in.

Pacific Northwest Audiology, a local clinic that performs hearing screenings and fits patients for hearing aids, hosted the event, and most of its attendees were clinic patients. Josh Korotky, the clinic’s co-owner, explained in an introduction that some varieties of hearing aids can be controlled and located using an iPhone or iPad. Standing in front of a PowerPoint slide titled “Hearing aids just got cool!” he said, “There will be people using this technology just because it gives advantages without hearing loss.”

Verbarg, however, wasn’t convinced. She’s not interested in getting an iPhone or iPad.

“I don’t want to be involved with a lot of that technology,” she said. “That’s not for me.”

So with more than 30 million Americans battling hearing loss, just how does one wade through the marketing messages and choose which hearing aid would truly be the best fit?

For starters, the most cutting-edge technology isn’t always the best choice, warns Chris Halpin, an associate professor of otology and laryngology at Harvard Medical School. Although manufacturers will try to push their newest, high-tech gadgets — and they did in Bend last week — those are not always the best options.

“When you think about it, you can either make a more expensive product to make or a less expensive product to make that seems better, for some reason,” he said, “and as with anything in the medical world, you have a bunch of desperate people.”

Most people gravitate toward the smallest hearing aids possible, such as in-the-ear devices, said Halpin, who is also an audiologist at the Massachusetts Eye and Ear Infirmary in Boston. Those hearing aids often try to adjust the volume for the person wearing them, but they don’t always produce enough sound for people with more advanced hearing loss, he said. To produce more sound, hearing aids simply need to be larger so they can produce more power. The same sound will be clearer if it passes through a hearing aid with lots of power compared with one with less power, Halpin said.

“When you think about it acoustically, if you’re going to have a dance party at your house, you don’t go downtown and rent a speaker the size of a cigarette pack,” he said.

Dr. Ha-Sheng Li-Korotky, chief audiologist and CEO of Pacific Northwest Audiology, agreed that in-the-ear models are not for patients with severe hearing loss.

“All devices have limitations,” she said. “Remember: The best hearing aids cannot replace your normal hearing. So this hearing aid is only for certain populations with certain hearing loss.”

Buying a hearing aid should be a lot like buying a TV, Halpin said. Choose one that can get very loud and then turn the volume down to where you want it to be. Unfortunately, those don’t tend to be the most sought-after varieties, he said.

“Those are all bigger, simpler, harder to sell and have lower profit margins,” Halpin said.

(And, also like TVs, be prepared for a newer model to come on the market every year, he said.)

Hearing aids are not cheap. Although a survey released in April by Hearing Review found their prices have plateaued or decreased slightly over the past eight years, the same survey found that patients are spending more on average because they’re opting for the higher-end models. The average price paid across all styles of hearing aids at the end of 2013 was $2,363, according to the survey.

In her office, Li-Korotky said hearing aids run between $2,000 and $7,000. Higher-end hearing aids will automatically program themselves to control the volume, factoring in things like heavy wind, car noises or certain types of music. Less expensive hearing aids will likely require patients to come back to the office to have an audiologist reprogram them, which means putting on a different channel and checking for feedback and physical fit. Higher-end hearing aids might have 20 channels, or different sections of the audio spectrum, while a lower-end version would only have three or four, Li-Korotky said.

“Basically, hearing aids help you to adapt to your daily dynamic environment,” she said. “They try to reduce and eliminate the sound you don’t want to hear — car noise, wind — and help you to hear speech and music. That’s the technology.”

Online retailers and stores like Costco also sell hearing aids for significantly cheaper than at a hearing clinic, but there are several reasons to see an audiologist, even if it’s more expensive. Li-Korotky said hearing aids must be personalized to individuals, which is difficult to do when they’re bought in stores. They often need to be adjusted several times, which a hearing aid specialist will do. Li-Korotky, who was a surgeon before becoming an audiologist, understands the pathology of hearing loss and can refer patients to other specialists when there is something more behind their hearing loss. In some cases, she referred patients for MRI imaging that revealed brain masses.

Elizabeth Eden Samuel, the Oregon representative for the hearing aid manufacturer Starkey, spoke at the seminar last week about the company’s newest line of hearing aid technology that allows users to adjust their volume levels using their iPhones or iPads. They can even save volume settings at up to 16 specific locations — a restaurant they frequent, for example — and their phones will automatically switch to those settings when the user enters those locations, she said. That capability is not available in the company’s smaller hearing aids, however, including those that fit completely inside the ear canal.

In Halpin’s experience, most hearing aid users are like Verbarg: They’re simply not interested in that technology.

That said, “if a little old man from World War II walks in here with an iPhone, I’ll go with it,” he said.

Likewise, Cory Richards, an audiologist with Central Oregon Audiology, wrote in an email that only a small percentage of his patients prefer to use technology that allows them to control their hearing aids using their cellphones and other devices, despite the fact that those devices could significantly improve their communication abilities. Most cite the inconvenience of managing multiple pieces of technology, he said.

Eden Samuel also talked about her company’s new microphone that the hearing aid user can place near or on the person he or she wants to hear. If the user is on a “hot date,” for example, the user can place the hearing aid across the table in front of the other person and switch the microphone into a mode that focuses its attention in one direction. Doing so, she said, will cut out the noise around the user and focus solely on the person in front of the user.

Halpin, of Harvard, said the microphone approach tends to be very effective in allowing users to increase their ability to hear the person or thing they want to hear while reducing background noise. There is, however, a social awkwardness that prevents many from using it. To be the most effective, the hearing aid users would need to actually clip the microphone onto the clothing of the person they’re trying to hear, he said.

“You have to go up to your minister and clip it on them,” he said, “All the little old ladies I tell that to, they all faint. ‘I could never do that.’ Yet, I’ve never met a minister in my life who wouldn’t wear 15 of them.”

Despite the social barriers, Halpin said, he thinks the microphone model holds the most promise with respect to hearing aid technology.

As the seminar neared its end and attendees prepared for their free buffet lunch, Verbarg concluded she’ll probably stick with the Phonak model she just started wearing. It’s easy to use and she can finally hear clearly, she said.

“The Phonak was the answer to my problems,” Verbarg said.

— Reporter: 541-383-0304,

tbannow@bendbulletin.com

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