The audiologist counsels the patient along these lines.  “You do have hearing loss, just as you thought. It is about the same in each ear, but the amount of the hearing loss changes depending on the pitch of the tone.  For low pitches, which are like the bass notes on a piano, your hearing is fairly good.  Your loss is for the high pitched, or treble, sounds.  The loss of hearing is coming from your inner ear.  It’s sometimes called “nerve loss” but that’s not technically true.  Your nerves work just fine, but there is damage to the part of the ear that creates the nerve impulses.  There is no medical treatment to correct that type of hearing loss, but hearing aids can help.

“I can understand why you did not like the hearing aids that you purchased 7 or so years ago.  (Note: the case is circa 2010;  the hearing aids were purchased in 2003 —  the audiologist can tell date of manufacture from the serial number on the aids). The style that you purchased blocks up your ear canals, and that makes the low, bass part of your own voice boom.  Try this: count out loud one to five with your ears plugged like this.”  (The audiologist shows the patient how to put pressure on the tragus of each ear to close off the ear canal.)  “Is that how your voice sounds when you wear your hearing aids?”

The patient affirmed, and continued to describe what she didn’t like about her hearing aids.  The audiologist indicated that the aids are older technology, and that newer hearing aids can avoid blocking the ear canals, and will likely perform better in noise.  The clinic’s 45 day acclimatization period was explained; if the patient found she could not adjust to the hearing aids in that time, the price of the instruments would be refunded; however, the clinic would retain $250 of the professional services fee. If just one aid is returned the clinic, which unbundles [charges a separate fee for the hearing aid and a separate fee for the device], would not financially penalize the patient for returning one aid. The service fee would be the lower monaural fitting fee.

The patient has a few questions.

• How would you diplomatically, but truthfully answer them?

       I thought my left ear was worse than my right ear, but you are saying that isn’t true?

       Did I get ripped off by purchasing those old aids?