Karen McGrane

I am almost entirely dependent on captioning to understand recorded media. I can only watch TV and movies with captions. I don’t go to movies in theaters. I can’t listen to the radio. I can’t listen to podcasts.

As you might imagine, I am positively thrilled to learn that there’s an organization out there threatening legal action against organizations that don’t provide captions or transcriptions.

I just have a brief note about strategy that I hope this group will take under advisement.

You seem to be focused on threatening small volunteer organizations providing free content to a niche audience, like ASIS&T and Boxes and Arrows. If your goal is to prevent hardworking volunteers like Jeff Parks from creating audio recordings at conferences, mission accomplished! Why, if we can’t have it, no one can!

Since you’ve got money to spend on lawsuits, please let me suggest some alternatives that would have a more meaningful impact on the world:

• File suit against Netflix for not providing captions on the vast majority of their streaming movies—and for not providing any way to find streaming movies that are captioned. Netflix is particularly hostile to hearing-impaired customers, refusing to provide customer service via any channel other than the phone.
• File suit against Apple for not providing captioning for television shows downloaded from the iTunes store. While you’re at it, sue the pants off of them for the abysmal selection of captioned movies they offer. It’s criminal.
• Hire a team of lawyers to go after all the television networks that provide captioning in their broadcasts, but not on shows streamed via their websites or Hulu. (You’re going to need a big team of lawyers, because it’s most of the networks.)
• Hire the most vicious lawyer you can find to go after any movie studio that “accidentally” or on purpose removes the captions from the rental release of a DVD.

The Twenty-First Century Communications and Video Accessibility Act, signed by President Obama on October 8, 2010, is a landmark piece of legislation, updating the 20-year-old Americans With Disabilities Act for the internet age. This bill requires captioning of television programs on the internet, as well as many other requirements that will enable the 36 million deaf and hard-of-hearing Americans to fully enjoy media delivered via the internet.

I’m glad to hear you’ve got money to spend helping to enforce this legislation. How about you leave the IA Institute alone, and focus on getting us some captions on streaming video from Netflix?

Filed under: Bionic Hearing

Do you know someone who needs to buy a hearing aid, but hasn’t yet? I do.

I talk to people all the time about the decision to acknowledge their hearing loss and invest in hearing aids. I know how hard it is for people to come to terms with that decision. While I can’t make the emotional decision any easier, I can offer some advice on how to shop for a hearing aid.

1. Shop for an audiologist

The most important decision you make isn’t which hearing aid brand or model to buy. It’s who will be your audiologist—the person who will dispense and fit your hearing aid.

Your audiologist is like a combination of your family doctor and a salesman at Best Buy. They’re going to evaluate your hearing, but they’re also trying to sell you a piece of technology.

The good ones have all the best qualities of both: able to explain complex concepts, don’t talk down to you, patient with your questions and struggles, give you the information you need but still let you make up your own mind. The bad ones have all the worst qualities of both: patronizing, brusque, use too much technical jargon, become impatient when you don’t do what they want you to. I mean no insult to the many good audiologists out there when I say: I’ve seen some bad ones.

Meet with more than one audiologist before you decide to work with one. Find someone who you’re comfortable talking to, and who seems like he or she will take the time to make sure you get the right fit.

2. There’s no best brand, only the brand that’s best for you

People ask me all the time: What brand should I get? The answer is: I don’t know.

There are many different hearing aid manufacturers: Widex, Siemens, Oticon, Phonak, and Starkey, just to name a few. In the same way that some drivers love Ford and hate Chevy, are passionate about their BMW, or only buy Hondas, audiologists and hearing aid wearers get attached to a particular brand.

Different manufacturers are known for different things. Widex has good noise suppression technology, and they offer a program that may help tinnitus sufferers. Phonak and Oticon offer Bluetooth. Starkey emphasizes its CIC (completely in the canal) model. Each manufacturer has different R&D priorities, so what they’re good at may change over time.

When talking to audiologists, ask them which hearing aid brands they dispense, which ones they prefer, and why. Hearing aid fittings are done using software provided by the manufacturer, and often your audiologist will be better at using one application than another, so it’s good to buy from an audiologist who is experienced with your particular model.

3. Buy for how you’re going to use it, not how bad your hearing is

You might be thinking “I don’t need an expensive hearing aid right now, because my hearing isn’t that bad.” Or you might think “Only the best for my mother! I want her to hear as well as she can.”

Like computers, hearing aids come in different price points. Make your decision about how much to spend based on where and how you’ll use the hearing aid. Buy a high-end hearing aid if you plan to use it in noisy environments, but don’t buy more power than you need.

Someone who mainly stays home and watches TV or has conversations in quiet environments doesn’t need a top of the line hearing aid — any more than someone who uses a computer mainly to surf the web and answer email needs a quad core Mac Pro.

On the other hand, if you’re relatively active, you will place more demands on your hearing aids. Crowded restaurants, conference centers, baseball games and airplanes all require your aids to work harder to filter out background noise and focus on what people are saying to you.

4. Don’t get seduced by features

I have fallen into this trap too. Bluetooth! Tiny! Colors! What you want is the absolute best hearing aid for you in terms of sound quality, noise suppression, and fit. Everything else is just decoration.

Personally, I do not believe it is worth it to get hearing aids with Bluetooth right now. I’m about as tech savvy as they come, and I wasn’t happy with my experience. This area is worth keeping an eye on, but don’t choose a hearing aid just because it has Bluetooth.

As a long-time hearing aid wearer, I also don’t think it’s wise to focus on size over other hearing aid features. I know first-time hearing aid wearers are sensitive about people knowing they have hearing loss, and I am completely sympathetic. But tiny hearing aids can have big problems with wax and moisture. You may also find that changing tiny batteries several times a week is a chore.

5. Try different earmolds for fit

It’s likely that you will consider a behind-the-ear hearing aid. While opinions vary on this, I personally prefer BTEs—I think they’re more comfortable and spend less time in the repair shop than in-the-ear models.

With a BTE, the hearing aid sits behind or at the top of your ear, and a plastic piece sits inside your ear. There are many different configurations for this earmold. You can get a little rubber dome (shaped like a gumdrop). You can get a custom made mold, fitted to the shape of your ear canal. Custom earmolds come in different shapes and can be made from different kinds of hard or soft plastic.

Which earmold is right for you depends on your degree of hearing loss—but it also depends on which feels most comfortable. Ask your audiologist to tell you about the options, and you may need to try different molds in addition to different hearing aids to find the right fit.

Buying hearing aids is not a great experience. The industry could do a much better job of focusing on what consumers need. Take advantage of the trial period offered (here in New York it’s 90 days) and plan to spend 6 months (or more) trying different models.

You will be better off in the end.

Filed under: Bionic Hearing

I finally got around to purchasing a new pair of hearing aids: the Widex Mind 440.

When I was trying to make up my mind I did a search to see if anyone had written a review of this hearing aid. Imagine my surprise when I discovered that I did.

What I originally tried was the m4-m-CB model, which is a micro BTE with a thin tube. I really covet that thin tube, but my hearing loss is just too much for it. My disappointment was compounded by a poorly fitted earmold taken by a less-than-competent audiologist. I sent these back, but your mileage may vary. This model might be a great option for someone with a milder hearing loss, and who is willing to tolerate the smaller batteries in favor of a less-visible aid.

I still wanted a Widex BTE, so I wound up getting the m4-9 model. These are a larger BTE and so they have the larger size 13 batteries I wanted. They also have the larger tubes, which are ugly, but such is life. I got half-shell earmolds rather than the full (skeleton) shell, which makes them a bit smaller and more comfortable. The smaller shells are really quite nice, though again, someone else’s hearing profile may require a different solution.

So here’s my review of these new aids: they’re fine. Really. Just fine.

Do I like them? Yes, I do. They work just as well as my old ones, and I adjusted to them easily. Do I love them? Eh. Not really. I don’t notice anything groundbreaking about them.

Here’s the deal. When I was doing this research, everyone I talked to emphasized how much better hearing aids had become in the five years since my last purchase. All the audiologists and manufacturers made a point of telling me that the technology had gotten exponentially better in the past five years. I was prepared to have my mind blown.

You know what’s gotten better in the last five years? My iPod. Five years ago I had an iPod with a scrollwheel and a black & white, text-only interface for choosing music. Today, I have an iPhone 4 with a touchscreen that has the sharpest color interface I’ve ever seen, and it can play videos, games, and other apps in addition to playing music. Heck, it will even make phone calls if I stand in just the right place and hold it in just the right way!

Has Widex improved its product over the past five years to the same degree that Apple has? Not even close. Frankly, I can’t even tell the difference between my old hearing aids and my new ones. But the new ones? They’re just fine.

Filed under: Bionic Hearing

I exchanged my pair of Oticon Epoq XW for a pair of Widex Mind 440s. The Widex Mind wasn’t even on my radar to begin with, because I was completely focused on Bluetooth.

Once I realized that Bluetooth integration wasn’t good enough yet for what I wanted to do, and I realized that the Widex family was a good fit for me because it offered superior noise reduction and a sound quality that I liked, I decided to stick with that brand and get their best model.

Problems, Problems

My initial fitting went badly. Widex sent the wrong hearing aids, and then gave my audiologist very specific instructions that caused him to break the earhook. I went home disappointed, but they promised to send the correct pair with a rush order.

CAMISHA Domes

I was told that I would do better if I was fitted with custom-made “CAMISHA” domes instead of regular domes. I spent $150 to have custom domes made that would sit deep inside my ear and connect to a thin, unobtrusive wire. The goal of the custom fitting was to reduce feedback.

These were a disaster. Blame it on my weirdly-shaped head, but the custom domes would not stay in my ears. The left earmold in particular popped out to such a degree that the hearing aid was useless. It was obvious from the second I put them on that they were not going to work, but I was a good sport and tried them out over the weekend.

Open Fit Domes

I then swapped out the custom domes for generic open fit domes. (Does anyone want to buy a pair of barely-used custom-made ear molds? I’ll give you a good deal.) I was pretty unhappy with these as well. I teach a class and when I wore these in class the first time, I couldn’t hear the students talking on the other side of the room.

I was told that the open-fit domes might not work as well for me, given my audiogram, and I’d get feedback. This was true! I had the sensation that the hearing aids were always just about to start feeding back, like an annoying whistle just below my range of hearing. Imagine what a teakettle sounds like when the water is just starting to boil. I was told that these fancy new hearing aids do a better job of recognizing and removing feedback, but that was not my experience here.

Back to the Drawing Board

During my trial with the Widex Mind 440s, I did not feel they were an improvement over my current Widex Senso Divas, which are 5 years old.

I did some research and learned that Widex makes an even newer hearing aid, the Passion 440. I’ve returned the Widex Mind 440s in exchange for the Passion 440s. I haven’t tried the Passion 440s yet, but I’ll tell you right now what my sense of the benefits and drawbacks are:

Benefits

• Receiver in the canal: I was pretty annoyed that the Mind 440 didn’t offer RIC, but it looks like that’s what the Passion 440 does. In exchange for Bluetooth, it will at least permit me to wear earbuds on top of them, which should make it possible to listen to music or answer the phone. A low-tech solution, which means it will probably work.

Drawbacks

• Size: Good god, these things are tiny. You might be asking “why is small size a drawback?” To me, this is just baby-boomer vanity. I’ve worn hearing aids for 25 years, I don’t care if anyone sees them, and I don’t need a hearing aid that’s the size of a dime. The smaller aids will have more moisture problems than the large ones, and they’re easier to drop. I’d be happier with a larger aid that I could hold onto more easily.
• Size 10 Batteries: This goes hand-in-hand with the smaller size of the aid. I’m going to have to change these things twice a week, and the small size means it’s going to be a pain in the ass. I have tiny little fingers and even I don’t relish the challenge of popping these things in and out. I’m looking at my Senso Diva with its luxurious Size 13 battery and thinking I’ll miss it.
• Remote Control: And yet another drawback because of the size! These aids are too tiny to include a button to switch between programs, so I have to buy a remote control to switch between programs. This is one more thing I have to schlep around in my purse, possibly lose, spill stuff on, etc.

I’m getting super cranky about this process. I think I’ve spent about 40 hours just going to the audiologist, I’ve plunked down over $7500, and right now I have nothing to show for it. I’m genuinely not happy with the options available to me. I hope the Passion 440s provide a great listening experience, and persuade me that the money and time are all worth it.

Filed under: Bionic Hearing

I am kicking off the process of buying new hearing aids, starting tomorrow! My audiologist asked me to make a wish list of what I want. Here’s my advanced, futuristic version of what I want from them.

1. Bluetooth

Bluetooth hearing aids would take me from feeling like someone with a disability to feeling like I’m a superhero. I’m reminded of Geordi La Forge from Star Trek: The Next Generation. He was blind, but he could see with his visor. He couldn’t see the way everyone else sees, but he could see better. Ever since I was in high school and I’d listen to my Walkman with headphones on, I’ve wanted to be able to pipe music in directly through my hearing aids. I’ve spent more money than most people will ever spend on expensive audio equipment, and I expect them to play music directly into my head. Frankly, if you’d asked me about this even 10 years ago, I would have been happy just to listen to music directly through the aids. Now, I also want my my phone calls piped into my aids, and while I’m at it, I plan to connect via Bluetooth to all of my computers, so I can hear movies, TV shows, and videos too. This will change my life.

2. Open Fit

The last time I bought hearing aids, I didn’t even consider buying open-fit models. But in the last few years this new style has taken off, and today more than 50% of new hearing aid sales are of this type. Open fit has a couple of advantages. To me, the best part is that it’s a BTE style with a new kind of tubing that doesn’t need to be replaced every 3-4 months. Open fit also sounds less “plugged-up” or occluded, which is probably more important to someone who hasn’t been wearing hearing aids for 27 years. I am hoping that open fit will be more physically comfortable, otherwise I’ll just stick with BTEs.

3. Data Logging

I don’t know much about this new feature, but it sounds great. Apparently newer models will record information about your different listening environments, which gives your audiologist more data to use in customizing your aids. I have always wanted to have my audiologist trail me around, reconfiguring my hearing aid settings for conferences, airplanes, and noisy bars. This might be even better!

4. Rechargeable Batteries

Battery life is a problem for every small, portable electronic device. My 2.5 year old MacBook Pro now gets about 24 minutes of battery life before it squawks and needs a recharge. But hearing aid batteries hold a special place in my heart for their environmentally-unfriendly neediness. Every purse I own holds a packet of hearing aid batteries, lest I get caught out on the town and wind up suddenly deafened. Every year or so I drop off a ziploc baggie filled with tiny batteries at my local recycler, the sight of which makes me relieved that I don’t have toddlers who might swallow them. I know hearing aids are more demanding than the average Bluetooth headset, but, as a society, aren’t we better than this?

5. Invisibility

I really don’t care that anyone knows that I wear hearing aids (otherwise I wouldn’t be writing about them.) I just don’t want them looking clunky and ugly next to my jewelry. The kids these days seem to be all into having hearing aids in bright colors with contrasting molds. Call me old-fashioned, but my main goal is for them to be as unobtrustive as possible. There’s nothing I like better than someone I’ve known for years telling me “No way! I didn’t know you wore hearing aids!”

Filed under: Bionic Hearing

Wearing hearing aids is just like wearing glasses, except for the part where they cost as much as a used car and you wear them inside your head.

As such, buying hearing aids is complicated and nerve-wracking. I’ve had lots of practice: I’ll be buying my 8th pair of hearing aids sometime this summer. These are the basic features I’m looking for in hearing aids:

1. No Tubing

My primary source of frustration with behind the ear (BTE) hearing aids is the need to have them re-tubed. In older model BTEs, the plastic tubing that runs from the hearing aid to the earmold (the part that sits inside your ear) gets brittle and dried out. When it’s too old, it can crack, separate from the mold, or get stiff and uncomfortable. Usually, BTEs need to be retubed 3 or 4 times per year, which means too many trips to the audiologist for me.

2. Moisture Controlled

The biggest cause of hearing aid repairs is moisture. Humidity can easily build up in the tiny workings of the hearing aid. For my most recent hearing aid purchase, I opted for in the ear (ITE) aids because they wouldn’t need to be re-tubed. However, ITE aids are much more sensitive to moisture because their electronics sit inside the ear, where they’re more exposed to wax, sweat, and other moisture. While having ITE aids did reduce the time I had to spend getting the aids re-tubed, it greatly increased the time my hearing aids spent being serviced by the manufacturer for moisture problems. Moisture will always be a problem, but BTE models are better, and newer hearing aids control moisture buildup.

3. Large Batteries

If I giving advice to anyone on what to consider in purchasing a hearing aid, the first thing I would tell them to consider is battery size. Size is important not just because it determines how often you have to change the batteries, but also because of how physically challenging it is to swap the batteries out. Tiny hearing aids use tiny, tiny batteries, which have to be changed frequently and can easily be dropped. I like to imagine myself as the sort of person who would only change my hearing aid batteries at a table over a soft cloth. In real life my hearing aid will die just as I’m late for a meeting, and I’ll find myself replacing the battery while standing on a street-corner waiting for the light to change. So the battery has to be large enough to be easy to manipulate (and hopefully last longer so I have fewer intersection exchanges.)

4. Wax Guards

Wax guards in my ITE aids changed my life. A previous pair of ITEs was in the shop constantly due to wax buildup in the tubes. Newer hearing aids have little plastic wax baskets that sit in the tubing, and can be flicked out and replaced when they get full of gunk. Genius.

5. Digital

Oh, yeah. The biggest revolution in hearing aids in the past few years is also the last on my list. My current set of hearing aids is my first digital set. The difference was life-altering. New digital hearing aids do a much better job of focusing the sound and filtering out background noise than older analog models. Analog just amplifies everything it hears, while digital focuses on speech and reduces static. I remember getting my first pair of digital hearing aids and going out to a noisy, crowded restaurant for the first time. Imagine what it feels like to go from having to struggle to hear anything in a noisy room to being the person who could hear better than anyone else at the table.

That’s the promise of bionic hearing.

Filed under: Bionic Hearing