(Editor:  My Dad is still talking here in this section about the tele-coil.  Hearing loops and Bluetooth connectivity both use this feature.  The hearing loop can be a very important part of life for a severely deaf person.  In theory they are available in most public places, but it seems a bit hit and miss whether they are maintained well and work.  If you go to the cinema and the hearing loop doesn’t work, make sure you take it up with the management.)  The size and location of the switch varies with the make and may present more or less difficulty (Editor: today they are often automatically activated, or controlled by changing to a different program in the digital hearing aid), but at least it will not be necessary to operate it when it is being worn.  Later the aid will need to be operated in the “TEL” mode in conjunction with “hearing loops” and the switch for this may be combined with the On-Off switch of may be a separate switch depending upon the make of the aid,.

The Volume control is crucially important from the start (Editor – at the time of writing, Dad would have been wearing a BTE, compression based hearing aid.  Implementations of compression are now more sophisticated, and the volume control is of less critical importance.  The Blamey & Saunders Hearing aids have moved on from  compression. Our hearing aids use 32 channels of sound, each of which optimises to an audible and comfortable level automatically.    In theory, a volume control is not necessary at all – however, many people like to have one, so there is a volume control.   Dad’s practice instructions then apply pretty well. )    Once again, the location and operation of the volume control varies according to the make and type of hearing aid, but it really is necessary to master this quickly.  Some makes of aid are a lot easier to adjust than others, and one or two have been designed by individuals who clearly have no intention of ever wearing them.  Your audiologist will have demonstrated the use of this control and it is recommended that it be practised “out of the ear” until the action is very familiar.  In general it relies upon the aid being gripped by (typically) the thumb and second finger whilst the forefinger rotates the knob or wheel or lever, but there are variations on this theme.  Once the action of the volume control is familiar it should be practised with the aid in the ear, preferably at home and in a quiet room.  It is sometimes a good idea to have the aid switched off whilst practising because we are concerned with manual dexterity at this stage, and the aid is very liable to give vent to strange and uncomfortable noises and whistles in the process.

There is no particular once-for-all “setting” for the volume control (Editor: In the Blamey & Saunders Hearing aids, comfortable listening is individually set for the midpoint of the volume range, so that the user has scope to go louder or softer as they wish).  There is however a minimum level below which the user cannot hear effectively (Editor: today it has become trendy to talk about “audibility” which is obviously about whether you can hear or not), and an upper level beyond which the aid simply “squeaks” (the headroom before you get to “Squeaks” has been greatly increased in recent years, for most hearing aids, because of new technology in feedback cancellers, but at the end of the day most aids will still squeak, under certain conditions, especially if the hearing loss is very severe.  For very severe losses, good earmould fitting is still very important).  Between these limits there is a level which is appropriate for the activity of the moment (Editor: this is what we at Blamey & Saunders Hearing  tend to call the sweet spot”  We use fuzzy logic to keep the sound in the “sweet spot“ all the time, automatically).

The beginner, now familiar with the adjustment of the volume control and with the aid switched on, should set it so that ordinary everyday sounds can be heard at a comfortable low level.  Make small noises, for instance by tapping a pencil on the table, scrape a shoe on the floor.  Little noises which may not have been heard for some time or not noticed will become apparent.  But do not get involved with the radio or television yet.  And do not wear the aid out of doors for the time being.