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I really don’t want hearing aids!

Updated: Aug 5, 2021

“Hmm. It’s getting harder to hear conversation, especially high pitched or soft voices. Those noisy restaurants make it hard to hear – so much background noise and I end up wishing I could just go home. I don’t go to concerts any more – the music seems less complex. I don’t go to the theater any more – it is tiring to try to figure out what they’re saying when I miss a lot of the words. And, everybody at home grouses when I turn the TV volume up. But I really don’t want hearing aids! They look funny. They would make me look old. They are big and uncomfortable. I don’t want to fuss with those little batteries and besides, they are crazy expensive and I bet insurance doesn’t cover them. And what if I lost one!”

Sound familiar? Well, there is some truth to it (they are expensive); others of these ideas about hearing aids no longer apply (they are much smaller, some have charging components instead of batteries, and some are bejeweled like fashion accessories!). But here’s the thing: whether they make you look older, without them your brain will become effectively older. To understand why, you need first to understand how we detect sound.

Sound generates pressure waves that vibrate your eardrum. That vibration moves 3 tiny bones in the middle ear, the last of which has a “footplate” attached to a small membrane, essentially a window to the inner ear. As that membrane moves, it generates waves in the fluid that fills the cochlea in the inner ear. These waves move a cochlear membrane that has sensory ‘hair cells’ atop it. Microscopic hairs at the top of hair cells bump up against another membrane and bend. That bending sparks an electrical impulse which travels to the brain. Hair cells are arranged along the cochlear membrane such that those in a particular location respond only to a specific sound frequency. Since most sounds are made up of many frequencies, many hair cells respond. The brain puts inputs from all the responding hair cells together and we perceive what we have learned is a particular sound – a bird song or our child’s voice.