About two and a half years ago I wrote a series of columns in this space on my experiences with age-related hearing loss. The series generated a lot of reaction from B.C. Catholic readers, many writing in to share their own journeys, their successes and difficulties, in dealing with hearing loss and attempted remediation through various forms of hearing aids.

A common theme was that  many were had been in denial about declining hearing for years, even decades, and saw hearing aids as a stigma. When some did eventually decide to address their hearing loss, they were dismayed at the high — dare I say exorbitant — pricing of typical hearing aids.

We noted in the series that, not unlike the eyeglasses industry, a handful of companies control most of the hearing aid market, operating through small storefronts which, for the most part, are owned by these companies.

When hearing aid costs are fully covered as an employee benefit, the typical $6,000 or more cost may not be balked at. For others, such an amount may be a tremendous obstacle, even if the cost can be written off as a medical expense, depending on income.

Enter the big-box retailer. I don’t even have to spell out the name; you know it right away. When I began my series I didn’t consider this option. In fact, I didn’t know it was an option until one of the interview subjects in my series — a doctor — mentioned buying hearing aids there.

It was during my first visit to the big-box store that some of the control exercised by dominant industry players became apparent. The brand of hearing aid worn by my doctor interview subject was suddenly no longer available. That brand, Phonak, had been pulled. We can speculate on reasons, but the reality is that with big-box outlets selling pairs of aids at $2,000, manufacturer-controlled stores were feeling the pinch on sales of their triple-cost pairs.

My local big-box store had two audiologists on staff. I received a comprehensive hearing test, resulting in an audiogram, at no cost. At the small storefront where I first enquired about dealing with hearing loss, I paid $100 for such a test, although I don’t believe this is necessarily common across such outlets.

I was initially fitted with a behind-the-ear set from the Jabra brand. I tested them carefully for a month before electing to try another brand, Rexton. I eventually settled on these as my permanent solution. The final process involved selecting appropriately fitted cones and the small, shaped connector from the aid to the ear cone.

Here I am now, two years later. I regularly replace the microfilter and cone on each earpiece. The aids are used 16 or more hours a day, every day. They are placed in a charger overnight and still show about 15 per cent charge remaining at day’s end.

I’m particularly happy to have aids with rechargeable batteries. These have only become commonplace in recent years. I can’t imagine dealing with tiny replacement batteries every few days.

As for warranty, my aids come with three years of blanket coverage and two years of loss coverage. Had I lost an aid it would have been replaced without question. I did actually “lose” an aid when helping prune trees for a friend. It was only some hours later, around nightfall, back home, that I realized one was missing. I raced back and used the pairing with my phone to confirm the aid was indeed in the area and to get a general location, from which I closed in on a spot where I recalled a branch brushing against my head.

In general I’ve been happy with my aids and with the service I’ve received. In the near future I will ask for a new audiogram to address additional falloff in hearing, which may be real or apparent. I’m hoping this will lead to the aids being reprogrammed with new baseline settings suitable for my current hearing status.

What has changed in the field over the past two years? So-called over-the-counter (OTC) hearing aids — both behind-the-ear and in-ear — are seeing some adoption in Canada, mainly through online orders from the United States, as they aren’t generally approved here. Apple has released software allowing recent AirPod models to function as hearing aids of sorts, but their limited battery life makes them less than ideal. Who wants to recharge hearing aids in the middle of the day?

Expect artificial intelligence software to continue making inroads into the processing of audio signals. Although the software accompanying my aids carries some AI references, in practice it is quite limited.

Will we see the price of hearing aids decline? I simply cannot grasp why aids should cost $6,000 or more, especially when the lifespan of these devices is typically measured in five to seven years.

What we may see is a blurring of the distinction between prescription and OTC aids, which cost a few hundred dollars. At one time these were mostly amplifiers rather than aids, which take loss across the spectrum into account. They can work well for mild to moderate hearing loss, but they are one-size-fits-all devices. Prescription aids generally have long trial periods — in my case two months — and offer superior noise management and other adjustments over OTC units.

Thinking about getting hearing aids? The Johns Hopkins University article Choosing Over-the-Counter Hearing Aids: Tips from an Expert offers a quick overview of both OTC and prescription aids and may help you decide which is appropriate for you.