Hearing aid battery life will vary with the size of the battery.

• Size 10 batteries last for approximately 3-8 days
• Size 312 batteries last for approximately 5-14 days
• Size 13 batteries last for approximately 1-4  weeks
• Size 675 batteries last for approximately 2-4 weeks

Sizes Available:

Size 10	Yellow Tab
Size 312	Brown Tab
Size 13	Orange Tab
Size 675	Blue Tab

Battery life will also be influenced by:

• The type of hearing aid you wear
• The amount of amplification you require
• The amount of time you wear your hearing instruments

Please note battery sizes are not interchangeable across different types of hearing aids. To monitor the length of time your batteries are lasting, place the removed tab on your calendar every time you use a new battery. Zinc Air Batteries This is the most common type of hearing aid battery. Zinc air batteries make use of oxygen in the air to fuel the reaction in the battery that provides power to the hearing aid. This reaction begins once the tab is removed allowing air into the battery. It is recommended that you do not remove the tab until you are ready to use the battery. Replacing the tab when the battery is not in use will not extend the battery life. Battery Storage Batteries should be stored at room temperature in a dry place. Avoid storing batteries in the refrigerator or in hot places as this will shorten the life of the batteries. It is recommended that the batteries are stored in its packaging until use. This will prevent the batteries from coming into contact with metal objects such as keys or coins that may cause the batteries to short out or become damaged. Batteries should be kept out of reach from children or pets at all times as they are toxic if ingested. Rayovak, Duracell, Power One,  and Siemens batteries are available at Elgin Audiology Consultants.

Ear Infections (Otitis Media) Most ear infections are caused by either bacteria or viruses that invade the middle ear. The infection may cause fluid to build up in the middle ear space which may persist even when the infection has ended. Fluid can also build up in the middle ear if the tube that connects the middle ear space and the back of the throat (the Eustachian tube) is blocked. Prevention Common colds can lead to ear infections. The best way to prevent an ear infection is to avoid risks associated with contracting the common cold.

• Limit your child’s exposure to large crowds and others who have colds
• Encourage your child to wash their hands frequently
• Reduce or eliminate your child’s exposure to second hand smoke
• Be aware that children with cleft palate, respiratory illnesses, and chronic allergies that cause congestion are at a higher risk for developing ear infections

Treatments

• Bacterial infections can be treated with antibiotics prescribed by a physician
• It is important that your child receives the entire antibiotic dosage prescribed, even if your child feels better prior to the completion of the medication
• Viral infections cannot be treated with antibiotics
• The physician may also prescribe medication to relieve any pain or discomfort your child may experience

Ear Infections and Hearing Loss

• Hearing is temporarily affected in most children with ear infections and usually improves in the weeks following the infection
• The fluid in the middle ear space may persist for several months and can cause temporary hearing difficulties
• Children who experience chronic middle ear infections and / or persistent fluid in the middle ear may require medical intervention such as long-term antibiotic treatment or ventilation tubes (to drain the fluid from the middle ear).
• Untreated chronic ear infections could lead to temporary or permanent hearing loss in some cases and may interfere with your child’s language development

This information should not be used as a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

Noise Induced Hearing Loss (NIHL) Noise exposure is a common but preventable cause of permanent hearing loss caused by repeated exposure to loud sounds. The level of the noise you are exposed to (the intensity) and the length of exposure (the duration) both significantly affect the amount of damage experienced. This means the louder the sound and the longer one is exposed to the sound, the more damage will likely be done to the hearing system. Everyone from infants to older adults are susceptible to noise induced hearing loss. Common Sources of Dangerous Noise

• Power tools and chainsaws
• Motorcycles, ATVs, etc.
• Loud music
• Rifle or gunfire
• Loud machinery in the workplace

Characteristics of Noise Induced Hearing Loss

• Hearing loss caused by noise exposure varies from person to person and depends on the person’s susceptibility.

In the early stages of noise exposure:

• A reduction in hearing sensitivity or ability may be experienced. This is referred to as a temporary threshold shift.
• Tinnitus (a ringing, roaring or buzzing in the ear) may also be experienced for a brief period.
• These symptoms subside after the ear has had time to rest and the system returns to normal functioning.

With increased noise exposure:

• A permanent reduction in hearing most likely will occur. This is referred to as a permanent threshold shift.
• The tinnitus experienced most likely becomes permanent.

For exposure sounds that are of short duration but at a very high intensity or level (called impulse sounds), severe and permanent hearing loss often occurs if the ears are not protected. This is due to the physical damage caused by the impulse noise to the organ of hearing (the cochlea). Effects of Noise Induced Hearing Loss on Communication

• Noise exposure typically damages the area in the cochlea that responds to the high frequencies (or pitches) that are used in speech.
• High frequency sounds are related to consonants such as (f, s, th, p, t, k, ch, sh). It would be difficult to follow conversations if you don’t have access to these sounds. Your brain would have to “fill in the blanks” for what your ears are missing.

Noise is too loud

• It exceeds the allowable noise exposure standards set out by the government for workplace settings ( this varies from province to province)
• As a general rule, noise may damage your hearing if you are at arm’s length and have to shout to make yourself heard.
• If your ears hurt or you experience tinnitus during or after the noise exposure

Prevention Wear hearing protectors (earplugs or ear muffs) that can be purchased from our clinics:

• Working in excessively noisy environments
• Using power tools
• Using firearms
• Using noisy yard equipment (lawnmower, snow blower, etc.)
• Riding a motorcycle or snowmobile

Early Warning Signs of Hearing Loss

• Do people mumble?
• Do you frequently have to ask others to repeat what they have said?
• Do you misunderstand names and numbers?
• Do you like the television or radio volume louder than is comfortable for other family members?
• Do you have difficulty hearing in groups of people or in noisier environments?

Yes. The Ontario government provides funding through the Assistive Devices Program. Assistive Devices Program (ADP) The objective of the Assistive Devices Program (ADP) is to provide consumer centered support and funding to Ontario residents who have long-term physical disabilities and to provide access to personalized assistive devices appropriate for the individual’s basic needs. ADP funding can be used towards the purchase of:

• Behind-the-ear hearing aids, in-the-ear hearing aids, canal and completely-in-the-canal hearing aids, eyeglass hearing aids and body hearing aids.
• FM systems and some accessories.

Applicants Must:

• Have a long-term hearing loss who requires the use of a hearing aid for six months or more
• Be eligible for Ontario Health Insurance and have a valid Health Card
• ADP does not pay for equipment available under the Workplace Safety and Insurance Board or to Group ‘A’ veterans for their pensioned conditions.

ADP Covers:

• ADP will pay the registered vendor 75 per cent up to a maximum of $500 of the cost of the hearing aid, earmold, accessories listed with ADP, and the dispensing fee.
• If two hearing aids a prescribed, the vendor will bill ADP for 75 per cent up to a maximum of $1,000 of the cost of two hearing aids, two earmolds, accessories listed with ADP, and two dispensing fees.
• For FM systems, ADP will pay the registered vendor 75 per cent up to a maximum of $1,350 of the cost of the ADP listed device and dispensing fee.

Some Conditions:

• You must obtain your hearing instrument from an authorizer/ dispenser who is registered with ADP.
• If your hearing aid is no longer working, and cannot be repaired at a reasonable cost, ADP will help replace it once every three years.
• If your FM system is no longer working and cannot be repaired at a reasonable cost, ADP will help replace it once every three years.
• ADP does not pay for replacement during those years if the original equipment is lost, stolen or damaged due to misuse. You may want to insure your hearing aid.
• ADP offers a 30 day trial period. If you are not satisfied with your hearing instrument(s), return it to the vendor before the end of this trial period.The vendor may charge you a handling fee.

Items Not Covered by ADP:

• hearing aids/FM systems that are used for only one purpose such as school, work, sports, recreation or social activities
• batteries
• optional service plans
• repairs
• used hearing aids/FM systems

For More Information: Assistive Devices Program www.health.gov.on.ca/english/public/program/adp/adp_mn.html 1-800-268-6021 (Toll-free in Ontario only) 416-327-8804 (Toronto) TTY 1-800-387-5559

You may be eligible to receive funding from one of the organizations or companies listed below. Department of Veteran’s Affairs (DVA) Canada

• Access to DVA benefits depends on your eligibility and your health needs. Benefits may include items such as standard hearing aids, telephone amplifiers and hearing accessories.
• www.vac-acc.gc.ca

Workplace Safety and Insurance Board (WSIB)

• The WSIB provides hearing devices to workers if entitlement has been established for traumatic hearing loss or occupational noise induced hearing loss. A hearing device evaluation, authorized by the WSIB, is required prior to authorizing the purchase of a hearing device.
• www.wsib.on.ca

Services Canada: Services for Aboriginal Peoples

• The Non-Insured Health Benefits Program (NIHB) is a national, needs-based health benefit program. The program covers some of the costs of medically required benefits, items and services for eligible First Nations and Inuit.
• http://www.servicecanada.gc.ca

Private Insurance Companies Some Audiological services and devices may be covered by private insurance held by the client.

• Greenshield Canada: www.greenshield.ca
• The Canadian Auto Workers Union: www.caw.ca
• Manulife Financial: www.manulife.ca
• Johnson Inc:  www.johnson.ca

The following is a brief explanation of some of the technologies and features that may be included in your hearing aid.

• Volume Control: The volume setting of the hearing aid is often automatically controlled. Larger hearing aid styles can permit a manual volume control that the user can adjust via a remote control or a dial on the hearing instrument.
• Programs: Your audiologist can set your hearing aid with a variety of programs for different listening environments. The hearing aid you select will determine the number of programs available to you and whether the programs change automatically to suit the environment or if they must be manually changed by the hearing instrument user. Common programs include speech in quiet listening conditions, speech in noise, comfort in noise, telephone, and music programs.
• Remote Control: A remote control allows the user to change the hearing aid program to suit their listening environment without having to manually manipulate controls on the hearing instrument. Since the hearing aid is either in or behind the ear, the remote control buttons are often easier to operate because the buttons are larger and the user can see the buttons they are pressing.
• Direct Audio Input: This is a feature available for some behind-the-ear hearing aids. It allows an external audio source to be directly connected to the hearing aid and bypass the hearing aid microphone for a clearer signal. This technology can be used for watching the television, listening to music or using an FM system. The direct audio input uses a “boot” which slips over the end of the aid and electrically connects the audio source to the aid. The boot may connect to the sound source through a wire or may be wirelessly connected through an FM signal.
• Telecoil: This small coil within the hearing aid can detect a signal, such as a voice on the telephone, and process it directly through the hearing aid for a clearer signal. Not all hearing aids contain a telecoil, although most behind-the-ear hearing aids and in-the-ear hearing aids will have this technology. The telecoil can be used directly with the telephone or in conjunction with an FM or infrared system with the use of an induction loop. This setting may be manually selected by the user or automatically activated depending on the hearing instrument.
• FM Capability: A Frequency Modulated or FM system can make speech clearer and background noise less bothersome. The system requires that a transmitter with a microphone be placed by the sound source which transmits the signal via an FM radio signal to the receiver. The receiver may be in the form of direct audio input “boot” that can be attached to a behind-the-ear hearing instrument, it may be incorporated into the hearing instrument, or the receiver may send the signal via the telecoil feature of the hearing aid.
• BlueTooth Technology: Hearing aids with Bluetooth capability use a short range radio technology to allow a wireless connection between the hearing instrument and other audio sources such as an MP3 player, cell phone, and television.
• Feedback Cancellation: Acoustic feedback is the whistling noise produced by the hearing aid when some of the amplified sound leaks from the ear canal and is picked up by the hearing aid microphone and re-amplified. This whistling may occur when the hearing instrument user chews, talks, wears a hat or needs a high level of amplification. Feedback cancellation algorithms in the hearing aid prevent whistling from occurring in these situations. This technology has made open fit style hearing aids a possibility for some patients.
• Omnidirectional Microphone: Hearing instruments typically have an omnidirectional microphone that amplifies sound from all directions equally. This setting is useful when the listener wants to hear all sounds around them equally, but background noise may interfere.
• Directional Microphones: Directional microphones attempt to increase the desired signal level (such as speech) in comparison to the background noise level. This is accomplished by amplifying the sound coming from in front of the person wearing the hearing aid and suppressing the sound coming from behind. This assumes that the noise is most often coming from behind the person and they are facing the person with whom they wish to speak. Directional microphones work best in larger in-the-ear and behind-the-ear hearing aid styles. Hearing aids with directional microphones will often have an omnidirectional microphone program that can be selected.
• Digital Noise Reduction: This is essentially digital filtering that is used to eliminate steady noises, such as noise made by machinery, from the audio signal when the hearing aid processes and amplifies sound.

Selecting the most appropriate hearing aid depends on many factors. Your audiologist will work with you to find the best product to meet your needs. Factors often considered when selecting a hearing aid include:

• The degree and shape of your hearing loss: this will help determine the power, size, and style of hearing aid that is most appropriate for your hearing loss.
• Your listening needs and lifestyle: this will help determine the programs and features that should be included in your hearing aid for you to optimally function in your environment.
• The size and shape of your ear and ear canal: this can also determine to appropriate size and style of hearing aid best suited for you.
• The dexterity of your hands: some styles of hearing aids are easier to manipulate than others.
• The cost: there is a wide price range for hearing instruments that is influenced by the style, size, technology, and features incorporated into the aid.

What are the available hearing aid styles?

• Completely-In-The-Canal (CIC)These are the smallest hearing aids available and are inserted deep into the ear canal. Although they are cosmetically appealing, their small size and small batteries are not ideal for everyone. The small size of the CIC may also limit the program options possible. They are suited for mild to moderate hearing losses.
• In-The-Canal (ITC)The ITC aid is slightly larger than the CIC, and is inserted to the ear canal. They provide enough room to accommodate additional options that may not fit into the CIC, such as volume control and allow for a larger battery. The ITC is suited for a mild to moderate hearing loss.
• In-The-Ear (ITE)The ITE is available in half-shell and full-shell options. These aids sit inside the outer ear and ear canal. Their larger size can accommodate many functions and features as well as a larger battery size. These hearing aids are well suited for mild to severe hearing losses.
• Behind-The-Ear (BTE)The BTE amplifying unit sits behind the ear and is connected by tubing to a customized earmold placed in the ear canal. The BTE offers the most power and programming capabilities. They are suitable for mild to profound losses.
• Open Behind The Ear (BTE)The Open BTE is a small BTE hearing aid that is connected by a slim tube to a dome placed into the ear canal. This type of fitting is very comfortable and discreet. It allows you to hear low frequency sounds naturally and is suitable for mild to moderate high-frequency hearing losses.

Audiologists are trained for a minimum of 7 years and graduate with a Masters or Doctoral level degree at an accredited university. Audiologists specialize in accurately assessing hearing and provide complete hearing health care to all ages. Only audiologists and physicians can prescribe hearing aids in Ontario. Audiologists are licensed by a regulatory college, the College of Audiologists and Speech-Language pathologists of Ontario (CASLPO), just like dentists and optometrists. This college requires audiologists to upgrade their training every year and abide by professional standards.

Auditory Processing Disorder (APD) [also known as Central Auditory Processing Disorder or CAPD] is a disorder in the way auditory information is processed in the brain. It is not a sensory (inner ear) hearing impairment; individuals with APD usually have normal peripheral hearing ability. APD is an umbrella term that describes a variety of problems with the brain that can interfere with processing auditory information. Is my child a candidate for a Central Auditory Processing (CAP/APD) assessment? Your child may be a candidate for this test if some or all of the following apply:

• 1. Difficulties understanding the teacher.
  2. Appears to not be listening.
  3. Difficulty sustaining attention.
  4. Difficulty following instructions.
  5. Poor reading or spelling skills.
  6. Poor memory (difficulty following multi-step directions).
  7. Difficulties understanding in noise.
  8. Poor organizational skills.

What is involved in a CAP/APD assessment? Two appointments are involved:

• The initial appointment involves a complete hearing and audiological assessment. The results and concerns about the child’s listening abilities will be discussed. A questionnaire that can be completed by the child’s teacher will also be provided.
• The second appointment is approximately one hour in length. Several different tests are completed based on the concerns regarding your child’s auditory processing.

What types of tests are involved? Several different types of tests are available. These will be selected based on your child’s needs. The tests will determine your child’s ability to:

• Process speech that is distorted or unclear, such as when the teacher is walking around the classroom or writing on the blackboard while talking.
• Process speech in the presence of competing noise such as classroom noise.
• Process competing speech signals both at a word and sentence level; this could also be considered selective attention.
• Process rapid speech.
• Process speech quickly and accurately.
• Organize and sequence auditory information with other information.

Some of these tests may help to identify difficulties with short term memory and auditory attention ability. What type of information will I receive following the assessment?

• The audiologist will discuss the results with you.
• After all test results have been completely scored and interpreted, a detailed written report will be forwarded to you.
• The audiologist will provide recommendations that are appropriate and based on your child’s individual case.

Is there any treatment / intervention available if my child has a Central Auditory Processing Disorder? Recommendations will be made based on test results. These may include:

• 1. Modifications to the classroom environment (child placement in the room).
  2. Noise reduction measures to reduce competing noise sources.
  3. Modifications to the way the teacher delivers instruction.
  4. Personal or Sound Field FM systems. This equipment provides an improved signal to noise ratio in the classroom to ensure the teacher’s voice is delivered at an optimal level and above other noise in the classroom.
  5. Auditory training programs. These are specially designed programs for children with auditory processing problems and are available on CD and can be used at home or in the clinic to strengthen skills.
  6. Further assessments by other professionals may be recommended.

Meniere’s disease is a disorder of the inner ear and is thought to be caused by an abnormality of the fluids in the inner ear. The cochlea (the organ of hearing) and the semicircular canals (the organ related to balance) share the same fluids. A person with Meniere’s disease will most likely have both hearing and balance problems for this reason.Symptoms

• Rotational Vertigo (a spinning sensation) which may last from 20 minutes to 2 hours and may be accompanied with nausea and vomiting
• Tinnitus (a ringing, roaring or buzzing in the ear)
• Aural pressure (a feeling of fullness in the ear)
• Fluctuating hearing loss

Hearing Loss

• Usually occurs in only one ear
• The low frequencies (pitches) are usually affected first, and may fluctuate
• Over time the hearing may decline across all of the frequencies resulting in a permanent flat hearing loss

Treatments

• Diet modification (low sodium) and medication (usually a diuretic or “water pill”)
• Avoiding the consumption of caffeine, alcohol and smoking is often recommended
• Reduce stress
• Increase physical activity
• Maintain proper sleep patterns
• Hearing aids may offset the effects of the related hearing loss
• If the vertigo attacks are not controlled by conventional medicine, surgery may be considered with your otolaryngologist (ENT).
• Your ENT will help you choose the treatment that is best for you

This information should not be used as a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

Tinnitus (pronounced either “tin-NIGHT-tus” or “TIN-it-tus”) is the perception of sound in one or both ears or in the head when no external sound is present. Symptoms

• The tinnitus may be perceived as a ringing sound, but many people may experience other sounds such as high-pitched hissing, sizzling, buzzing, chirping, or clicking.
• The sound may be constant or occur intermittently. Several noises may be heard simultaneously.
• Feelings of pressure and fullness or pain in or around the ears may accompany the tinnitus.

Prevalence

• More than 360, 000 Canadians experience bothersome tinnitus
• It can affect people of all ages, including children
• Not everyone experiences tinnitus to the same degree

Causes of Tinnitus The exact cause or causes of tinnitus are unknown. There are, however, several likely sources known to trigger or worsen tinnitus.

• Noise-induced hearing loss: Excessive noise exposure can damage and even destroy hair cells in the inner ear. Coincidentally, up to 90 percent of all tinnitus patients have some level of hearing loss.
• Wax build-up in the ear canal: Sometimes, people produce enough wax that their hearing can be compromised or their tinnitus can seem louder.
• Certain medications: Some medications are ototoxic-that is, the medications are toxic to the ear. Other medications will produce tinnitus as a side effect without damaging the inner ear.
• Ear or sinus infections: Many people, including children, experience tinnitus along with an ear or sinus infection.
• Jaw misalignment: Some people have misaligned jaw joints or jaw muscles which can lead to tinnitus among other problems. Many dentists specialize in this temporomandibular joint (TMJ) misalignment and can provide assistance with treatment.
• High or low blood pressure: This may cause “pulsatile tinnitus” where you may hear a rhythmic pulsing, often in time with your heartbeat.
• Certain disorders: Disorders such as hypo- or hyperthroidism, lyme disease, diabetes, fibromyalgia, and thoracic outlet syndrome can have tinnitus as a symptom.

Treatment An appointment should be made with your audiologist to investigate the possible cause of the tinnitus. In most cases, there is no specific treatment unless the underlying cause is identified and corrected, for example removal of excess wax or treatment of an ear infection. If the exact cause is unknown, other treatment options may include:

• Hearing aids: Some patients with hearing loss see a decrease in tinnitus related symptoms when they wear their hearing aids.
• Tinnitus maskers: These devices produce sounds that “mask,” or cover up, the tinnitus.
• Relaxation therapy and counselling: This can involve learning techniques to effectively manage the symptoms of tinnitus.

Additional Information: Tinnitus Association of Canada: http://www.kadis.com/ta/tinnitus.htm American Tinnitus Association: http://www.ata.org/ ASHA: http://www.asha.org/public/hearing/disorders/Tinnitus.htm

The advantages of binaural amplification (two hearing aids) as opposed to monaural amplification (one hearing aid) ” if you have hearing loss in both ears” are listed below.

• Speech Understanding: You will hear speech and conversation better with two hearing instruments compared to wearing one hearing instrument.
• Understanding in Noise: Two hearing aids will give you better speech understanding in difficult listening situations such as in noise.
• Better Sound localization: Your ability to know where sounds are coming from is better with two hearing instruments.
• Improved Sound Quality: The sound quality is more natural and balanced when two hearing instruments are worn.
• Tinnitus Masking: Wearing hearing instruments in both ears may improve tinnitus by masking the bothersome noise in both ears.
• Volume: The volume needs to be much louder when only amplifying one ear. A high volume reduces battery life and increases the chance of feedback (whistling or squealing noise made by the hearing aid).
• More Choices: The smaller styles of hearing aids are not able to supply as much power as the larger styles. If you choose to wear two hearing instruments you may be able to select a smaller hearing aid style.
• More Comfortable Hearing: Individuals with binaural amplification find listening less tiring and more enjoyable than those with only one hearing instrument. It is easier to participate in conversations because they don’t have to strain to hear with their “better ear”.