Are Words Blurry? Or, "I Can Hear But I Can't Understand"

  • By proadAccountId-358356
  • 07 Oct, 2016

By: Sara Nagel, Au.D.

Many hearing aid users come into our office with the complaint of "I can hear but I can't understand."  Does this sound familiar to you?  There are a few reasons why a person using hearing aids may not understand speech as clearly as they would like.  

Firstly, the hearing aids may simply not be adjusted appropriately for the person's hearing loss.   Unless verification of the amplification levels has been done, there is no way to know if the hearing aid is delivering the precise levels of gain needed at every frequency.  Unfortunately, patients sometimes come in to The Center for Audiology with hearing aids that were fitted elsewhere that were simply not providing the necessary gain needed for their hearing loss.  I have also encountered patients with hearing aids that were set too loudly at certain frequencies, putting the hearing aid user at risk of further hearing damage.    Sometimes simple programming adjustments can make a significant difference in the user's ability to understand and distinguish speech sounds.  At The Center for Audiology, every hearing aid fitting is followed by probe microphone measurements performed in the ear canal with the hearing aid in the ear, to verify that the user is getting the most precise fitting possible. 

Secondly, sometimes, even with the best hearing aid technology, and the most precise fitting, the hearing aid user may still experience a "clarity gap", i.e., they do not hear speech with the clarity they would like.  Sometimes this is isolated to very challenging listening environments with loud background noise, but sometimes speech may sound distorted even in quiet environments with good acoustics.  This is one of the most frustrating and challenging situations that we encounter as audiologists.

Poor word recognition stemming from a breakdown of the nerve endings in the inner ear may be the culprit.   The sensory cells in the inner ear have a remarkable ability to make extremely fine distinctions among sounds, for example, "f" and "th".  When these sensory cells, or the nerve endings connected to these cells start deteriorating, it can cause some blurring of speech sounds, leading to distortion.  This is more common with more severe degrees of hearing loss.  Even with the best hearing aids, these patients may not ever achieve the quality of speech distinction they may have once enjoyed with normal hearing, and expectations of realistic hearing aid performance may have to be adjusted.  

Thirdly, there is evidence that our "auditory processing" skills decline as we age.  The higher levels of the brain play a large role in our ability to hear and understand speech in complex environments, such as those with background noise.  Once sounds pass through the ear and reach the auditory cortex (a process which may already be compromised with sensorineural hearing loss), the brain must then assign meaning to what it has received and, in complex environments, sort out the signal of interest from the other unwanted noise. This is an extremely complex operation that requires rapid processing of signals and the use of various interconnections among different regions of the brain. 

Is this cause for pessimism?  I think not.  Despite all the challenges we audiologists sometimes face in providing help to those with impaired auditory systems, there is still reason to be hopeful.  With the use of well-fit, appropriately adjusted hearing aid technology, assistive listening devices, the right counseling and setting of expectations, and other rehabilitative therapies (e.g., the LACE auditory training program), we can still significantly improve the quality of life for the majority of those with hearing loss. And that's why I love what I do.

Hear It Here! - The Center for Audiology Blog

By proadAccountId-358356 25 Jul, 2017

´╗┐As more hearing aids are developed with direct-to-iPhone or iPad Bluetooth connectivity, more hearing aid users are realizing the wonderful benefits of hearing aids that also serve as wireless headsets for music and audio-book streaming, as well as Bluetooth headsets for phone conversations.  Amy and Liz are two patients seen in our Houston office this week.  Both could finally carry on a phone conversation with no difficulty for the first time in years, via Bluetooth-enabled hearing aids.  It was amazing to see the joy on both their faces as a new world opened up to them. 

 In addition, the iPhone can serve as the remote control for the hearing aid, and users can adjust various features from overall volume to frequency response to background noise suppression, all through handy apps on the iPhone. 

This is all wonderful when everything works!  Occasionally, the iPhone will drop the hearing aid connection, or something gets "hung" or "stuck" in the iPhone that prevents a good connection.  Should that happen to you, follow the instructions below that walk you through re-pairing the hearing aids to your iPhone. 

How to Pair you Hearing Aids with your iPhone: 

1.       Re-boot your iPhone

2.       Take your hearing aids out of your ears and open the battery doors

3.      Go to Settings on you iPhone

4.      Go to General

5.      Go to Accessibility

6.      Go to Hearing Aids

7.      Close your battery doors (your phone will start searching for the devices)

8.      Your name and the hearing aids will pop up under devices

9.      If you wear 2 hearing aids you will see L + R

10.      If you only wear 1 you will see either L or R depending on which side you wear your aid

11.      Click on the box with your aids labeled

12.      You will then get a pop up box to PAIR your aids with your phone click PAIR

13.      If you wear 2 aids this box will pop up 2 times and you have to hit PAIR twice

14.       Your aids are now paired with your iPhone.  Enjoy!

Hearing aids available with direct-to-iPhone Bluetooth capability include Oticon Opn, Resound Linx, Starkey Halo, and Widex Beyond.  Coming soon-- Phonak Pulse which will have direct to iPhone and Android phone Bluetooth connectivity.  All these and more available at The Center for Audiology-Houston, and The Center for Audiology-Pearland.  Call today at 713-255-0035 to schedule a free demo and 2 week trial of made-for-iPhone hearing aids!

By proadAccountId-358356 30 Jun, 2017

Fireworks, firecrackers  and concerts  may be Fourth of July traditions and are beautiful to watch, but they also make the holiday one of the noisiest and most likely to cause hearing loss. With sound levels from exploding fireworks reaching as high as 155 decibels, here are steps recommended by ASHA that you can take to minimize damage to your hearing:

  • Keep a safe distance.  The closer you are to the source of the noise, the greater the risk for immediate, sudden and permanent hearing loss. Stay at least 500 feet from fireworks, firecrackers, speaker systems and other sources of loud noise.
  • Wear earplugs.  Ear plugs are an inexpensive and easy way to protect your hearing during loud events. Make sure your ear plugs fit snugly. For children below 8 years old, use ear muffs.
  • Know your limits.  A good rule of thumb is to avoid noises that are "too loud" and "too close" or that last "too long." If you notice ringing or buzzing in your ears, move farther away from the noise source.
  • Seek professional help.  If you feel that your hearing may have been affected, seek the help of a certified audiologist.
Wishing you all a Happy and Safe Independence Day 2017!
    By proadAccountId-358356 28 Jun, 2017

    It’s summer time in Houston! Humidity is up, and that means increased chance of moisture buildup in hearing aids.   You may also notice that your ears are sweatier due to hearing aid use. What are best summertime do’s and don’ts when it comes to hearing aids?

     DO : Store your hearing aids and hearing aid batteries in a cool, dry place.

    Don’t :  Leave your hearing aids in direct sunlight or in extreme heat, like inside your car.


    DO: Use a hearing aid dehumidifier to dry out hearing aids.

    Don’t : Get your hearing aids wet. Be careful to remove daily-wear hearing aids before showering or swimming.


    Do: Pack back-up supplies, like batteries, vent cleaners, wax filters. Clean your hearing aids regularly, including the air vent if applicable, which will allow your ear to “breathe” while wearing the hearing aids.

    Don’t : Ruin vacation by forgetting one of these important accessories. If you do, call us! We can mail you supplies if needed.

    Do: Keep them on for important announcements from airport officials

    Don’t : Take your hearing aid out while going through airport security or while in flight. The airport is not the best place to lose a hearing aid. Hearing aids do not have to be removed for security.

    The summer season doesn't have to be hard on your hearing technology! If you do your due diligence to protect your hearing aid from the sun and heat, and make sure to plan ahead and pack a hearing aid travel kit before leaving home, you can ensure a non-working hearing aid won’t get in the way of your summer fun.   If your hearing aid does break down due to moisture buildup, The Center for Audiology is here to help with fast, efficient, and friendly service in both our Houston, TX and Pearland, TX locations.  


    By proadAccountId-358356 05 Jun, 2017

    Life happens.  Every year, as summertime water activities ramp up, we experience an increase in calls from panicked patients who accidentally jumped into a pool or the ocean while wearing their hearing aids.  As much as electronics and water typically don't go well together, all is not lost if your hearing aids do get a soaking!  

    5 tips that can get your waterlogged hearing aid(s) working again: 

    1. Remove the aid from the water as quickly as possible – the less water exposure to the hearing aid, the better.
    2. Open the battery door, remove the battery, and throw away or recycle the battery.  A wet battery can become corroded and cause rusting inside the hearing aid. 
    3. Dry the hearing aid gently with a towel. Shake it gently to get as much water out as possible.
    4. Leave the aid to dry out with the battery door completely open, preferably in a hearing aid dehumidifier.  You may need to leave the hearing aid in the dehumidifier for a day or 2, depending on the amount of water exposure. 
    5. If the aid still does not work, call your audiologist and have the hearing aid sent to the manufacturer for repair.  Hearing aid warranties cover the cost of this repair.  If your hearing aid is out-of-warranty, a hearing aid repair charge will apply, which is significantly more cost effective than purchasing a new hearing aid.  

    What not to do:

    1. Never put your hearing aid into a microwave or conventional oven. You may overheat the hearing aid and cause some of the circuitry to melt. 
    2. Don’t just assume it’s broken. Give it time to dry and then get it sent away for repair if you need to.

    Note: Many hearing aid models now carry IP67 or IP68 ratings (IP is the Ingress Protection or International Protection rating system, which is a classification system showing the degrees of protection from solid objects and liquids.)  The first number 6 is the level of dust protection which is dust proof. The second number, 7 or 8, is the level of water or moisture protection. This means it is water resistant to a level that it could withstand up to 30 min in 3 feet of water before it must go into the company for repair due to water damage.  

    If you are in the market for new hearing aids and tend to perspire heavily or are frequently around water, ask your audiologist for a hearing aid that carries a high IP rating for maximum water resistance.  

    By proadAccountId-358356 10 May, 2017

    • Approximately 36 million Americans suffer from hearing loss.  
    • More than half of the people with hearing loss are younger than age 65.  
    • Untreated hearing loss can affect your ability to understand speech and can negatively impact your social and emotional well-being—hearing impairment can decrease your quality of life! 
    • Hearing loss is the third most common health problem in the United States. 

    •  You have difficulty hearing people talk in noisy environments such as a restaurant, shopping mall, in a car, or at the movie theater. 
    •  People seem to “mumble” all the time. 
    • Family, friends, or colleagues often have to repeat themselves when speaking with you. 
    • You have trouble hearing people when they are not facing you or are in another room. 
    •  You have ringing, buzzing, or hissing sounds in your ears. 
    Hearing loss is often more conspicuous than hearing aids!  May is Better Hearing Month.  If you or a loved one is experiencing any of the above signs of hearing loss, see an audiologist for evaluation and treatment.  Early diagnosis and treatment typically results in the most successful outcomes.

    Call The Center for Audiology at 713-255-0035, and take the first step to reconnect with friends and family, and enjoy life again!  We have offices in Houston, TX and Pearland, TX with dedicated audiologists on staff to help customize the most appropriate hearing solution for your hearing loss, lifestyle, and budget.  
    By proadAccountId-358356 20 Apr, 2017
    Teenage hearing loss in the U.S, is on the rise, with recent studies indicating 1 in 5 teenagers exhibiting at least a slight hearing loss.  This 30% increase in teenage hearing loss since the early 1990's is due in large part to the ever-present earbuds attached to smartphones and portable music players.

    Teens are more likely to  engage in risky hearing behaviors, including listening to loud music and using lawn and power tools with no hearing protection. The findings also revealed that teens are aware of the risks, yet still choose not to protect their hearing. 

    Slight hearing damage in teenage years puts teenagers at risk for accelerated hearing loss later in life.  Educating children from an early age about the risks of unsafe listening practices can save them from significant, permanent hearing loss later in life.  The good news is that with these few simple steps, teenagers (and everyone else) can modify their listening behavior and protect their hearing: 

    • Prevention:   Stop it before it starts!  Prevention is the best way to deal with noise-induced hearing loss.  Using headphones instead of earbuds keeps some of the direct sound out of teens’ ears.  Ear protection should be used consistently in loud environments like concerts, sporting events and when operating power equipment.
    • Stop future damage : If teens do experience symptoms like ringing or buzzing in their ears, they should immediately turn down the volume, wear ear protection, or see a hearing care professional.
    • Help a friend:  Teens should warn one another if they’re putting their hearing at risk. If you can hear your neighbor’s music over the headphones, it’s too loud.
    • Custom ear protection:   For teens who play in bands or shoot firearms, custom hearing protection is ideal.  Contact a hearing professional for guidance on the best custom hearing protection device for your particular needs.  

    By proadAccountId-358356 04 Apr, 2017
    Hidden Hearing Loss- what is it and how does it impact your life?

    More and more people are discovering that although they hear well in quiet or one-on-one situations, they have increased trouble hearing conversation  in background noise.  Routine hearing testing may show normal sensitivity to the different test frequencies!  Hidden hearing loss is the term used to describe this condition.   A likely cause is damage to the ear from repeated noise exposure over time.   This damage affects the connection of the nerve cells with hair cells of the of inner ear.   

    The effects of hidden hearing loss can be reduced by improving the signal-to-noise ratio in the environment whenever possible.  This can be accomplished by lowering background noise, or by boosting the speech you are trying to hear via an assistive listening device such as an FM system.  Various smartphone apps can turn your smartphone into a remote microphone which can then equalize target speech sounds to your preference and send them to your ears  via ear buds or headphones wired or paired via Bluetooth with your smartphone.  The best thing you can do is protect your ears from damage (or further damage) by consistently using hearing protection whenever you are exposed to loud noise.  
    By proadAccountId-358356 24 Feb, 2017
    If you are a  hearing aid user who depends on your hearing aids, a non-working hearing aid can spell trouble.  This is especially true if your hearing aid stops working or does not sound right just before an important family gathering, business meeting, or important doctor appointment where it is critical for you to hear!  Following are some easy, at-home solutions you can try to get your hearing aid working again: 

    A) Check your battery
    B) Make sure your hearing aid is turned on/battery door is completely closed
    C)Visually inspect your wax filter, ear mold sound opening, or ear mold tubing for blockage caused by wax.  Replace your wax filter or clean the sound opening of your earmold if blockage is found
    D) If none of the above help, contact us for help.  Your hearing aid may have an electronic failure and require service.  

    A) Visually inspect your wax filter. Even if partially clogged, your hearing aid can sound weaker than normal. 
    B) If your hearing aid has tubing, visually inspect the tubing for blockage, cracks, or beads of moisture.  Run vent or tubing cleaner through tubing to clear blockage, or use ear mold blower to blow moisture out of tubing. 
    C) Try a different hearing aid program.  You may have accidentally switched to a different program with lower amplification. 
    D)Consider whether your hearing may have changed.  We recommend annual re-evaluations to monitor your hearing and adjust your hearing aids accordingly.  Schedule a hearing test if it has been a while since your last evaluation.  Our audiologists can adjust your hearing aids precisely for your new hearing levels.  

    A) Make sure your hearing aids are inserted correctly.  Try removing and reinserting your hearing aids.  If you wear receiver-in-the ear hearing aids, the thin wire should be flush against the side of your face and ear canal entrance.  
    B) Turn down the volume.  If your hearing aid is set too high, it is more likely to feed back. 
    C) Visually inspect your ear mold tubing for any cracks.  Sound may be leaking out of your hearing aid and causing feedback. 
    D) You may have wax buildup in your ears.  Ear blockage will cause the amplified sound to bounce back, causing squealing or whistling.  Your audiologist or ENT physician can safely remove wax buildup from your ear. 

    A) Visually inspect the battery and/or the battery contacts in your hearing aid.  If your battery looks corroded, discard it, clean the battery compartment and battery contacts, and replace with a new battery. 
    B) Check your program setting.  You may have accidentally switched to the telecoil setting (if you have one) in your hearing aid.  If you are not in an environment with a hearing loop, you may pick up electro-magnetic signals from other appliances or fluorescent lighting which may sound like static in your hearing aid. 
    C) If you suspect your hearing aid may have gotten wet, store the hearing aid overnight in a dehumidifier to remove moisture buildup from the hearing aid. 

    If none of the above suggestions work, contact your audiologist or the friendly staff at The Center for Audiology.  We offer same-day appointments for repairs at either our Houston or Pearland locations, and can often fix your hearing aid immediately.  Should your hearing aid have to be sent to the manufacturer for repair, we offer loaner devices that can tide you over and save the day!  

    By proadAccountId-358356 17 Feb, 2017

    One of the first cultural shifts I experienced when I moved to Houston 18 years ago from NYC was the ubiquitous smile and nod when passing strangers in the street, often followed by a cheerful greeting, and sometimes even by an entire conversation. What a refreshing positive social connection the smile and nod can engender!

    However, when the smile and nod occurs repeatedly in conversation because someone had no idea what was just said, the result can be anything but positive, and can sometimes even get you into trouble.

    Seinfeld Discovers the Dangers of the Smile and Nod

    In this “Puffy Shirt” episode , Jerry unwittingly agrees to wear a flouncy ruffled pirate shirt on the Today Show when he nods and says “uh huh” to a question posed by Kramer’s low-talking girlfriend.

    It may seem less embarrassing to smile and nod than call attention to yourself by asking for repetition, admit you did not hear, or seek treatment for your hearing loss. However, The Smile and Nod often leads to embarrassing moments when it becomes obvious to all those around you that you did not hear what was said. Consider the following scenarios:

    “What time is the meeting scheduled?” *Smile and Nod*

    “So what do you do for work?” *Smile and Nod*

     “Where is your favorite vacation spot?” *Smile and Nod*

    “Did you hear what I just said?” *Smile and Nod*

    Avoid the Puffy Shirt

    Here are three suggestions for avoiding an embarrassing “puffy shirt” episode:

    1) If everyone you encounter seems to be a mumbler, or a “low talker”, consider the possibility that you may have hearing loss, and seek diagnosis and appropriate treatment. Hearing loss is usually more conspicuous than hearing aids. Properly fitted hearing devices enable you to engage in conversation with less effort, and will greatly improve the quality of your life.  If you know someone who performs the Smile and Nod often, gently suggest that he or she check their hearing. You might just be the one to start their journey to a better quality of life.

    2) Be assertive and upfront about your hearing loss. This can alert people that you are not ignoring them, or mad at them, or mentally challenged; but rather, you do not hear them. Educate people to face you when speaking, speak more slowly but not more loudly, and re-phrase rather than repeat when you do not catch what was said.

    3) If you do wear hearing aids, commit to regular maintenance and hearing re-checks. Even a slight change in your hearing can contribute to listening fatigue if your hearing aids are not tuned precisely for your current hearing levels. Re-calibration of your hearing aids on a regular basis helps ensure that you are part of the conversation again.

    Tired of the Smile and Nod? Call The Center for Audiology’s Houston, TX or Pearland, TX locations to start your journey to better hearing today!

    By proadAccountId-358356 12 Feb, 2017

    Do you have difficulty making out all the dialogue at the movies? What happens when the music swells in the background, and the movie characters drop their voices? Sometimes, even the best hearing aids cannot overcome poor signal-to-noise ratios, leaving you guessing at the punch line, or wondering what twist the plot just took.

    6,000 Regal Cinema screens across the United States (including Edwards Theater at Weslayan and Hwy 59) now boast availability of Sony closed captioning glasses for patrons. These lightweight glasses project captions which appear to float about 10 feet in front of the user.  The captions are synchronized with the dialogue on the screen. They also come with audio tracks that describe the action on the screen for blind people, or they can boost the audio levels of the movie for those who are hard of hearing. Simply ask for them at special services, and sit back and enjoy the show.   

    - Special thanks to our special patient M.A. for this special tip! 

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