If you’ve decided to pursue a set of hearing aids, good for you. The literature on the importance of hearing aids for preserving multiple aspects of physical and mental health keeps growing, and it’s increasingly clear to those in the larger medical community that hearing aids are not a luxury but a necessity for maintaining our overall health.

A hearing aid fitting is a crucial part of the process of getting hearing aids, and the last step in getting your hearing aids into your hands… or, more appropriately, into your ears!

What to Expect

Your hearing test will begin with a conversation about your lifestyle, your medical history and your family’s medical history, a physical examination of your ears, and of course the hearing test itself, where you’ll be played a series of tones and human speech and asked to respond to what you hear. Afterward, your audiologist will show you your audiogram, which is a graphic depiction of your hearing loss profile. From there, you’ll be able to discuss options for hearing aids.

What is Fitment?

Fitment is the process of making your hearing aids yours. It involves determining how much amplification is required so that you can hear quiet sounds, and also how much compression (dynamic range reduction) is required so that loud sounds don’t hurt your ears. It may also involve some adjustment to the equalizer (the process that makes some frequencies more amplified than others, and very important for addressing an individual’s specific hearing loss).

Real Ear Measurement

Real ear measurement uses a tiny microphone to actually measure the sound coming from your hearing aids as they sit inside your ear canal. While most people’s ear canals are shaped such that sounds at 3,000 and 6,000 Hz are slightly accentuated, minute differences in our ear canals mean that we cannot present a “one size fits all” audio process from the hearing aid speaker directly to the eardrum. Using the microphone and measuring the sound as it actually presents in your ear canal means we can get a much more accurate fitment.

Hearing aids don’t work like eyeglasses. A new set of glasses makes the world look sharper, and if it’s still blurry you can immediately recognize that something’s wrong. We can’t simply ask whether you’re hearing everything in your environment because if you’re not, you don’t know! Real ear measurement is the best way to confirm that your hearing aids are amplifying sound to the appropriate level for your specific hearing loss.

Be Prepared to Return to the Office

While some hearing aids allow fitment adjustments via teleconference or smartphone apps, others will require that adjustments be made at the audiologist’s office. It’s important to remember that fitment is an ongoing process. What seems comfortable in the audiologist’s office the first time you put in your hearing aids might be different once you get out into the world, so don’t be shy about calling with questions or complaints.

Hearing Aids Require an Adjustment Period

While some concerns should be addressed with fitment, it’s also important to remember that hearing aids may take a while to get used to. Unlike eyeglasses, where blurry things simply become sharper, hearing aids may present to us a portion of the world we’ve forgotten about. Some people report being annoyed by the sound of their clothes rustling when they’re wearing their hearing aids. They’ve forgotten, but up until they had hearing loss they spent their whole lives hearing their clothes rustling! After a little time, the brain gets used to tuning out these sorts of sounds, and the more you wear your new hearing aids the sooner you’ll become adjusted and forget all about the annoying little sounds. And on the plus side, you’ll hear the birds chirping and all the other pleasant background sounds you’ve been missing.

Keep Testing Your Hearing!

Once you’ve got your hearing aids, remember that hearing loss profiles can change. Hearing loss tends to progress for a while and then plateau at a certain level. This will likely happen as slowly as it has been happening until you got your hearing aids, so you may not notice for a while. Get a hearing test regularly to make sure your hearing aids are still working for you. While your hearing aids will probably have an expected lifespan of 5–7 years, your hearing loss profile is likely to change before that, so get your hearing tested regularly and see if you’re due for a refitment.