Hearing Aids

Ear Trumpets and Superpowers

“You’re lucky,” said Mr. Pelcek, my elementary school guidance counselor. “At least they’re not bigger. When I was a boy, hearing aids were huge boxes people wore around their necks, with cords running up to their ears.”

Was I also to be overcome with joy that I wasn’t lugging around an ear trumpet, like the elderly characters in Saturday morning cartoons? No one everwants to wear hearing aids, especially not a ten-year-old.

Wearing hearing aids and admitting you even have hearing loss are two different things. Determined to act just like the other kids, I kicked off a decades-long campaign to deny, ignore, and cover up any evidence that I couldn’t hear. Instructed to sit in the front of the class so I could hear better, I scorned the front-row dwellers, those unfortunates branded as nerdy, and defiantly sat in the back. I kept my hair long and avoided wearing attention-getting earrings. And I honed my skills in pretending I could follow. Even when I couldn’t.

I initially believed in minimizing people’s awareness of the challenges I faced—gave myself a simpler front-end interface. It took years, but I finally accepted the inherent complexity of hearing loss. I learned that people were even willing to work harder to communicate with me if only I’d let them know what they needed to do and why. My goal should not be to hide my use of hearing technology. It should be to find ways to make it appropriately visible.

As designers, we obsess over making technology easy to use and intuitive. But now I appreciate interfaces that are appropriately complex—technology that makes its challenges visible in the right way, at the right time. What elevates our profession from merely smoothing out the rough edges to making a meaningful—even transformative—difference in people’s lives is our ability to wisely decide how and when to communicate complexity.

The Invisibility Cloak

Our profession has a mantra: no one wants to use technology. People merely want to achieve their own goals, complete their own tasks. We’re judged successful if we remove any unpleasant friction; create a pleasurable, seamless interface to the mysteries that lurk within; and make technology invisible.

Ask an audiologist, and he’ll tell you: People want invisible hearing technology, too. People seek out the tiniest, most unobtrusive hearing aids. It’s a form of magical thinking: If no one can see it, then I don’t really have hearing loss. In recent years, as I’ve become more open about my hearing impairment, I frequently hear this response: “Really? I had no idea.” I’m ambivalent about this reaction. I’m proud of myself for passing, for successfully playing the part. Yet I now know that maintaining my facade came at a price. The cost I paid was pretending to understand even when I didn’t.

Conversation has a thread. During an evening out, you lose it and pick it up again in the encompassing din of roaring and clanging and buzzing. It’s all just noise until a robust pair of consonants springs forth: a th or ch or gr. Suddenly you have your arms around that thread, grab hold and follow that digraph down into the structure of the language beneath. Now you can grasp it—one sharp sound opens the door to an hour of conversation. But it’s exhausting. No matter how hard you try, you will eventually tire; your mind wanders for a second, and you’ve lost track. You struggle to maintain but eventually let go and just let the raw sounds and syllables wash over you. Language devolves into guttural noise, meaningless utterances, like that of the adults mumbling in Peanuts television specials.

How often can you ask someone to repeat herself? I’ll tell you. Three times. The first time, you offer a casual, quizzical look and say, “Excuse me?” The second time, you look a bit more serious, and ask, “Say that again?” The third time (and this is when things get real) you sit up straighter, stare the person in the eye and invest in a full sentence like, “I’m sorry, could you repeat that?”

If you’re lucky, she repeats herself more clearly. Restates the point using different words. Turns and faces you directly, so you get the full impact of watching her face move, feeling the air currents hit your ear drums. Praying all the while that someone else picks up the conversation, ideally a braying man with a loud, low voice.

Failing that, you’re in trouble. The wheels of conversation grind to a halt, caught in awkwardness and bewilderment.

Better to fake it. Smile and nod. Learn to mirror facial expressions, become a spot-on mimic of someone who can hear. Laugh a half beat too late at jokes you don’t understand. Be considered a great listener because you hang on to a person’s every word, lean across the table, focus intently on her face—as if she is the most important person in the room, or the world.

But in a conversation, the point of listening is to communicate. And I wasn’t succeeding.

I hid the fact that I had hearing loss because I feared that the interface to mewas frustrating. Who would want to engage with me if extra effort were required? But instead of helping people become aware of what I needed, I hid my challenges and glossed over the difficult patches. I put a simpler front-end on the experience of talking to me, one that made a difficult task seem easier. But by doing that, I only made it harder.

Challenge = Improvement

Working at the Stanford Research Institute in the 1960s, Douglas Engelbart led the team that designed and developed NLS (oN-Line System), a revolutionary computing platform. The project goal was “augmenting human intellect.” NLS is known for being the first to implement many conventions now familiar to us, including the mouse, hypertext links, and multiple window displays. These innovations made their way through Xerox PARC and into the Apple Macintosh graphical user interface, and in many ways are the features we think of when we call a modern computer “easy to use.” But NLS itself was not easy to use, nor was it easy to learn. Why? Engelbart’s philosophy was that to truly enhance human intellect and collaborative work, the interface needed to be powerful. Operating this powerful system would require trained users committed to learning a new interaction model, in support of a greater goal.

In the fifty years since NLS was in development, our values have shifted in the opposite direction. Ease of use is paramount, ease of learning reduced tointuitiveness. Consumer apps are expected to divulge their mysteries within seconds, lest they be abandoned in favor of something more obvious. A toddler’s ability to operate an iPad (so easy a child can use it!) is held up as the ultimate example of discoverability, the interaction paradigm for our new generation.

Designs that make technology completely seamless to the user often deserve admiration. But can we balance our desire for intuitiveness with a wider recognition that some tasks are complex, some interactions must be learned, and sometimes the goal isn’t invisible technology but appropriatevisibility? I yearn for more respect for Engelbart’s ethos, in which computers are thought of as tools that harness our collective intellectual capacity to solve the important problems facing humanity—powerful tools that merit the investment of time required for mastery.

Communicating with me can be more difficult than talking to people with normal hearing. By treating that as my failure, a problem that needed to be hidden, I missed out on opportunities to connect with people. When we seek obviousness above all else, we’re doing the same thing. When interfaces that must be learned are considered failures, we miss out on opportunities to create more powerful, meaningful engagement.

Powerfully Unsexy

In a 2010 SXSW keynote, Evan Williams of Twitter stumbled in response to a question from Umair Haque. After an uncomfortably long pause, he grabbed me with the most meaningful statement of the whole interview: “We want Twitter to reach the weakest signals. We want it to be inclusive, and by using SMS we can reach anyone.”

We may set our aim on dazzling the very consumers who already have too many options. But sometimes it’s the boring old unsexy technology that can reach people in new ways, make something out of nothing, make a thunderously transformative difference in people’s lives.

Back when I worked for a big-name agency, back when I worked on giant teams with resources and time and money at our disposal, I lusted after high-profile projects. I wanted the marquee names for my portfolio. I fought to win the media and fashion and consumer product brands, the clients I could name drop, the projects that would impress my peers.

Then I started my own firm, and my definition of a great client changed. No more boardroom presentations at giant corporate headquarters or large-scale redesigns. I wanted more intimate relationships, with clients who didn’t need a huge account-services cushion to help manage their internal strife. Instead, I made sure I had clients who hired me solely for my expertise and respected me for it. They were companies with problems I knew I could solve. I’d be working with nice people. And they would pay their bills on time. Household name was meaningless to me now. I wanted to be able to make decisions that would benefit people.

I learned to love the unsexy projects. I grew fond of places where I wasn’t trying out something perched on the precipice of the bleeding edge but rather was executing small, incremental, meaningful changes. Even if it was routine, it could still be exciting. And almost always more important.

My friend Stephen runs UX for a large financial services institution. I guarantee you they’re doing challenging and innovative work. Yet he told me once, “What we do might not seem very sexy. But we make a huge difference in people’s lives.” Enterprise applications often spill their guts—seemingly at random. Each is a giant database explosion of fields and inputs—screen after screen of layouts and workflows that make no sense. The challenge these designers face is not to sweep all that away but to find out how to communicate it at the right level for the user, improving the quality of a worker’s day-to-day life. These applications might not always be immediately intuitive, but they can be powerful and useful.

I love the idea that even if all we do on a project is create simple, nuanced changes, the results can make a significant difference in someone’s life. I know digital technology can achieve this because I’ve felt it myself.

Zeroes and Ones

I’d say to anyone whose job opportunities were opened wide by the web, whose friendships have been enriched by Facebook, whose finances have taken on a whole new twist with online banking and bill payment, or whose ability to solve the nightly dinner-table debate is now flavored by Wikipedia: Nothing in yourdigital life has changed even a fraction as much as mine has. Google’s power to answer questions or deliver information in an instant has nothing on the power of digital hearing aids to change the way hearing-impaired people communicate.

My friend Joe once told me a story about a mutual acquaintance who needed a wheelchair to get around. “She wants to get one of those new iBot wheelchairs,”—the gyroscopic, stair-climbing, all-terrain wheelchair which innovated many of the technologies inventor Dean Kamen eventually used in the Segway. “But it’s really expensive.” The iBot supposedly handled better than other wheelchairs and would even raise her up so she could sit at eye level with the person she was talking to. Was that worth $25,000? I replied, without hesitation, “To feel like I was on equal ground with everyone else, I would payany amount of money.”

And then it hit me. Obviously I wouldn’t. I’d been scraping by for years with cheap, antiquated, analog hearing aids. I told myself they were good enough andhad a few more years in them and would do for now.

I scheduled an appointment with my audiologist the very next day. I told her, “I want the best hearing aids money can buy.” Since I’d last purchased a pair of hearing aids, the digital revolution had swept this space as well.

A couple weeks later, I picked up my new digital hearing aids, had them custom-programmed, and went out into the night. I asked my friend Randy to meet me for dinner, and we met up at the bar at a crowded restaurant in a fashionable Manhattan neighborhood, a place I’d always wanted to go but never had. We sat close together on barstools and started talking. At least I did. “It’s so LOUD,” he said. “You have to SPEAK UP. I CAN’T HEAR YOU.”

Hey, that’s my line!

Years of struggling to participate in social occasions were replaced—through digital technology—with a clear, focused, intimate conversation, one that I didn’t have to strain to hear. Analog hearing aids amplify everything equally, so conversation and background noise move in lockstep, and the voice of the person I’m talking to gets drowned out by the roar of the crowd. Digital sound processing algorithms strip out the background noise, focus the microphone on the voice of the person next to me. The droning hum of other people’s conversations: Gone. The roar of the airplane engine, the buzz of the crowd at the baseball game: Gone. The endless asking people to repeat themselves: Gone. I could hear. I could hear well. I could hear superhumanly.

I felt like Helen Keller suddenly grokking the sign for water. Randy and I made the rounds of a few more bars that night, so I could drink it all in andhear it. Finally allowing myself to believe it all true, I headed home on the 6 train sporting a wide, irrepressible grin. As I walked through the door of my apartment, I burst into tears. Tears of joy, to be sure, but of gobsmacked amazement too.

My hardware purchase was a life-changing event. Parties, noisy restaurants, conferences, meetings, movies: All open to my participation in a way I’d never before experienced.

No one was jealous when I purchased these prosaic devices. I gained no geek cred from showing them off in a high-powered meeting. Imagine the designers who created this product: No one fetishizes it, their friends aren’t wowed, it’ll never be a Trending Topic. And yet its impact on my life brought me to tears.

Digital Superheroes

If I had a magic wand to wave that would enable me to hear like a normal person, I wouldn’t do it. I wouldn’t need it. Hey‚ if you had a volume knob for your life, one that didn’t shut the sound off altogether but just turned it down‚ you might not want to give it up either. Because I’ve mastered making what’s hard for me appropriately visible, I’m able to mitigate the downsides of my dependence on technology. Where I used to see only pain points, I now see the upside of a quiet hush where I can focus, my own private space where I can think clearly. What I used to think of as a disability, I now sometimes think of as a superpower.

Do you have the ability to grant your users superpowers? If you do, it might not be because your designs are simple, intuitive, or make technology invisible. A powerful interface might take time to understand; people might need to stretch a bit to learn it. Rather than striving to erase the parts of the technology that are difficult or challenging, you might seek ways to make them appropriately visible. Sometimes it’s only through communicating complexity that you can empower people.

These designs likely won’t get you written up in TechCrunch or on the leaderboard at the iTunes Store. But you just might profoundly improve the lives of a few people. Remove the daily frustrations that grind away at them, offer them meaning or whispers of love or a fresh chance, take pain and make the absence of pain seem like pleasure, or crack open the world and bring them right to the center of this great conversation of life that by all rights belongs to us all.

Superpowers, indeed.

Hearing Aids

To those with money to burn on captioning lawsuits

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?

Hearing Aids

How to buy a hearing aid

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.

Content Strategy, Hearing Aids

The user experience doesn’t stop at the nav

If you’re reading this blog, it’s likely because you A) know me and want to hear what I have to say about content strategy and user experience design or B) found it by searching for some variant of “hearing aid reviews” on Google. Never let it be said that I don’t understand my audience. But until now, I haven’t been able to speak to the interests of both audiences at once. UNTIL NOW.

I’m doing some research to prepare for an upcoming talk at Busan Design Week in Korea, and found myself at the HTC website. Imagine my surprise when I see this:

Hearing aid compatibility! In the nav! This company is so committed to making hearing aid compatible products that they want to market this capability on the homepage of their website.

Now, if you’ve ever bought a hearing aid before (and, if I know my audience, I can safely say that half of you hope you will never need to, and the other half are trying to do so right now and it’s the bane of your existence) you know that hearing aids don’t work very well with phones. I have a well-rehearsed routine if I ever have to take a call on my mobile that involves removing my hearing aid and hooking it over my thumb. Also, please never call me. That’s why God invented text messaging.

But the promise of having a phone that would work with a hearing aid is a good sales pitch. I’m intrigued. Until I get to this page (click to embiggen):

Um. What?

Here’s my question: Will your phone work with my hearing aid? In no way does this page actually answer my question.

Because I make websites, I know exactly how this happened.

There was a meeting in which everyone agreed that it was important, and valuable, and responsible, that HTC showcase its hearing aid compatibility. Negotiations ensued, and it was decided that Hearing Aid Compatibility would have its very own place in the nav.

Someone set out to make a wireframe for this page. This person was told that there would be some text on the page, and a table of ratings information. This person mocked up a generic page to represent this information (put text here, put table here) and then went about feeling very user-centered and accessible because of the attention given to the disabled.

Someone else (perhaps the engineer or business owner responsible for hearing aid issues) was asked to provide the content. This person knows an awful lot about technical standards for compatibility, but perhaps not much about writing for a reader. The content got populated in the CMS, and everyone felt good about it.

Except me.

No one ever came back to ask if the content that got published actually met the user’s needs. Someone defined a requirement that — in essence — said “have a navigation category for hearing aids.” It didn’t say “ensure that our hearing impaired customers can determine which product will best meet their needs.”

The user experience doesn’t stop at the nav. If the content doesn’t answer the user’s question, you’ve failed.

Hearing Aids

Widex Mind 440 m4-9 Hearing Aid Review

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.

Widex Mind 440 m4-m-CBWhat 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.

Widex Mind 440 m4-9I 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.

Hearing Aids

Widex Mind 440 Hearing Aid Review

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.


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:


  • 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.


  • 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.

Future Media, Hearing Aids

Oticon Epoq XW Hearing Aid Review

The first hearing aid in my trial was the Oticon Epoq XW. I did a comparison test with it and the Phonak Audeo Yes in the audiologist’s soundproof booth. The Oticon was the clear winner in that test. I liked the sound quality better immediately, and the brief hearing test he gave me scored the Oticon significantly higher in word recognition than the Phonak. I picked both of these hearing aids to test because they offered Bluetooth integration, and I was excited to take the Oticon Epoq home and try it out with my Bluetooth enabled devices.

Bluetooth and the Epoq

I spent about $7500 on the Epoq and its Bluetooth enabling companion, the Streamer. A comparable pair of hearing aids without the Bluetooth would cost around $6000.

In other words, I spent $1500 to get my hearing aids to act like a Bluetooth headset.

If I spent $1500 on a regular Bluetooth headset, I would expect it to work FLAW-LESS-LY.

The Oticon Bluetooth did not work flawlessly. Not even close.

Pairing with multiple devices

I wanted to pair my hearing aids with my iPhone, my MacBook Pro, and my Mac Mini. I ran into immediate problems when trying to connect to multiple devices. Although the documentation says that you can connect up to eight devices, after unpairing and repairing I was only ever able to connect to two at a time. This wasn’t a dealbreaker, but I was frustrated by the troubleshooting I had to do, and disappointed when I realized that I was better off only connecting two at a time.

Wireless Streaming from Computer

I watch TV and movies from a Mac Mini hooked up to my TV. Usually I watch with captions, but when that’s not possible, I sometimes put on headphones so I can listen more closely. Wirelessly streaming audio from the computer to my hearing aids was a compelling prospect, but a disappointing reality. The sound quality was very soft and unacceptably tinny — so much that a Bluetooth connection was in no way better than just normal listening.

Wired Streaming from Computer

I also tried listening to music from my laptop with a wired connection. The wire ran between my laptop and the Streamer (worn around my neck), and then the sound was sent wirelessly between the Streamer and the Epoqs. The sound quality was so weak and tinny that I can’t imagine ever choosing it over listening to music with headphones. My old hearing aids are Widex Divas, and they have a good music program. I was really excited about the potential for wireless music streaming to my hearing aids. The reality was a poor quality, wired connection. Headphones plus hearing aids were still a better solution.

Mobile Phone

I was able to successfully make and receive calls on my iPhone using the Streamer. If this is the only Bluetooth integration you wanted, it would probably suffice. The sound quality was good and there was something magical about being able to push a button and have calls come in via my hearing aids. The downside is that you have to wear the Streamer around your neck in order to make and receive calls. Also, some of the people I talked to on the phone complained that I sounded like I was on a bad speakerphone.

Snatching Defeat from the Jaws of Victory

I really, really, really wanted to love these hearing aids. I was so psyched to get them. But a couple of things pushed me over the edge:

Background Noise

Never have I appreciated my Widex hearing aids so much as the first time I took my Oticons into a noisy restaurant. I am accustomed to being able to hear relatively easily in restaurants, at conferences, and in other noisy situations. I assumed that all hearing aid manufacturers had similar noise reduction programs to the Widex. I was wrong.

Now, I admit that I am accustomed to the Widex and so a shift in manufacturer may have been more disorienting for me. Someone who was not as familiar with Widex may not have experienced the same dissatisfaction that I did. But I was shocked! There was a dull roar of noise in the background of the restaurant that I was used to having filtered out. This extended to other environments — I particularly remember visiting my mother and asking if her birds had always been so loud. I found myself thinking that smarter hearing aids would have made better choices about what sounds to filter out.

Streamer Fail

The last straw for me was the failure of my Streamer, only two weeks into my trial. I went on a ten-day trip and the Streamer stopped working on Day 2. It refused to charge, but it would blink a flashing orange light to let me know that it was still doing something. I couldn’t find any documentation or guidance online about how to fix the problem. The instructions in the user’s manual about how to reset the Streamer didn’t work.


So back they went. Let me offer some proactive defenses here about why this was a reasonable solution:

  • I had three fittings. I went in for fittings on three separate occasions, and spent a fair amount of time with my audiologist on the noise reduction program in particular. I don’t believe he could have done anything else to resolve that problem.
  • I tried to get help on the internet. Someone might be able to tell me here how I could have fixed my Streamer problem. And if everything else had been great, I might have been willing to sort that one out. But I was not willing to pay a significant premium for spotty Bluetooth on hearing aids that weren’t meeting my basic needs.
  • I’m an expert user. I am probably in the top 95th percentile in terms of technology savvy hearing aid wearers. I am willing to experiment to get things right, and I’m comfortable searching the internet for help. But the balance between cost and effort on one hand, and benefits on the other, was just not good enough with these hearing aids.
  • My next choice was the Widex Mind 440.