My visit at the Costco Hearing Aid Centre 2023-11-15

Hearing Aids
#1

My visit at the Costco Hearing Aid Centre 2023-11-15

My appointment at the local (Lethbridge, Alberta) Costco Hearing Aid Centre today was successful, informative, and rather impressive inn terms of what I learned about Costco’s hearing aid practitioners, practice, and beliefs.

I arrived 15 minutes early to fill out the pre-test questionnaire, and then my audi took me in a few minutes early. The entire appointment took about 100 minutes.

Preparatory Discussion:

I was interviewed in detail about my perceived hearing issues, and in my specific case about the history of the issues, as i had brought in with me copies of 4 audiograms generated between 2005 and 2020, that tracked my hearing for those 15 years. I had all those audiograms not because I have ever worn a hearing aid before, but because my tubes have had an ongoing issue with becoming congested, sometimes one at a time, and other times both simultaneously. The problem was never significant enough to warrant hearing aids until rather recently, but I wanted over the years to track the issue in case that changed, and in about 2017, my doctor at the time, seeing how I seemed very attentive when he was speaking to me, referred me to an ENT.

By that time, technology had advanced, and the ENT was able to send one of the newest micro cameras up my nose (very uncomfortable!) and was able to visually confirm that my tubes were indeed rather prone to congestion, and she prescribed a daily nasal flush (Pulmicort) that she said would improve things notably. It did.

But this past few months, the Pulmicort became insufficient. I started to have difficulty conversing with my wife, hearing people “at the other end of a conference table”, and watching TV, as I seemed now to need so much volume that it is becoming uncomfortable for my wife and adult son. It seemed like time to get hearing aids, even though HAs would be rather inconvenient for my woodworking (high noise and dust damaging to HAs), TIG welding (damaging electronic interference), target shooting (damaging noise), and motorcycling (HAs incompatible with full coverage helmet and eyeglasses combined!). Obviously, I will need to do a lot of “removing” and “re-installing”, when I do any of these activities, and both the woodworking and target shooting require electronic hearing protection muffs instead. But, really, it IS now time because I am having a little too much difficult hearing and conversing, and am missing too much of what is happening around me. And yes, I AM 73 years of age as of next month.

My audi reviewed all the audiograms, and made an observation that I had not ever been told before. He said that the curves for ALL the test results showed a common “dip” in both ears at higher frequencies, and then a bit of recovery at the highest frequencies. he said that is a common characteristic caused by occupational exposure to excessive noise. He said that in The Province of Alberta where I NOW live, the presence of that dip is sufficient to qualify for a workers compensation award - but only IF the injury was incurred in employment within Alberta. It was not, as all the audigrams were taken in other jurisdicitons, and I have never held a job in Alberta. So, no award, but I was impressed that the audi made the observation.

The audi examined each of my ears. I had had them cleaned of any ear wax 2 weeks before at a chain hearing clinic, which I had not returned to because their quoted price for a pair of Oticon Real One HAs was $8250 after the $2000 almost permanent “sale discount”. That cleaning has porduced only one very tiny piece of skin with some wax on it in my right ear only. My Costco audi said he saw no issues in my ear canals that would present any problems.

The audi did say that ,my hearing loss was well within “the norm” for a person my age, and that it could be very satisfactorily managed by hearing aids.

Testing:

Immittance testing showed that while my left ear was within the normal graphical rectangle on the standard graph, my right ear was, at least today, notably to the left at about -250 daPa. My audi says that is becsause the right ear is today congested enough that it cannot vent properly.

The audigram shows a shape that has been for the most part consistent since 2005, but has progressively with age gotten “worse”. The right ear in this test, just as in the older test, does better than the left ear, but not is not dramatically different in shape for most of the frequency range., except at one point: At 1500 hz, it spikes upward before joining the left ear in its decline. The “bone” curve follows the right ear curve, including the midrange peak, although its peak was at about 1000 hz versus 1500 hz.

The maximum drops were of course at high frequencies, where they hit -75 db on the left ear, and -65 db for the right ear, before rising 5db each at the 8000 hz frequency. Hence the audi’s remark on a workers comp claim .

There was a slight difference in the amount of amplification that I found “comfortable” for the the 2 ears, which the audi said is no problem - he can program for that,

Other test remarks included:

  • Good speech thresholds
  • Excellent word recognition left (84) , slightly worse right (70)
  • QuickSIN score @70 db bilat was 6 db SNR loss

There was a LOT more data on the dense letter-size printout, but I have no audiology training whatsoever, so cannot comment on the vast majority of it.

Recommended Solution:

The audi said that any of the 3 brands Costco Canada handles (Jabra, Philips, and Rexton) could work for me, but I said that I had read at least a couple of times about issues with the current Rexton model that compares to the Jabra Enhance Pro 20 and the top Philips model. And, I have heard repeatedly that the Jabra app is far superior to the Philips app, for users who want to proactively try different settings for different situations. This does not imply that the Philips HA is not as good as the Jabra, but rather simply that any control freak would want the Jabra app (and I am a degreed engineer, and you know what engineers are like - always trying to optimize!).

So I told my audi that I want to try the Jabra Enhance Pro 20, AND I want to do it with the M&RIE option (no extra cost for that option, by the way). And the Pro 20 can be bought for either rechargeable battery use or replacement battery use, and I want the rechargeable as I seldom travel. (One of our forum members asked me to ask specifically if the Pro 20 is available in a model for replacement battery use, and so I asked and yes it is)

My audi had measured my ear canals, and recommended:

  • Jabra Enhance Pro 20 minin RIE rechargeable pair

  • #2 left and #3 right domes, fairly open, to avoid the “sealed chamber” feeling. I specifically asked if this would possibly induce feedback, and he said if it does, he can change dome easily to get me where I want, and if the M&RIE option did not work well for me, no problem to change out of it. He did warn me that more people dislike the M&RIE option than those that like it, but I am always a sucker for trying something that MIGHT be better for me, when there is no irreversible downside. I figure Jabra and Resound Omnia offer this option for a REASON, and I want to at least try it.

  • I did also tell my audi that I am NOT seeking to make my hearing like it used to sound. I want BETTER hearing than I used to havem because I figure the tiny computers and their programming might indeed be able to outperform my human brain at age 73, and I want to give them a shot at doing that. I don’t care if it alters the way I hear my own voice (I have never particularly liked my own voice - not macho enough!), and i would value improved sound quality and improved directionality. And I meant it. I have always though “The Borg” on Star Trek had the right idea. If you are going to buy a pair of hearing aids with the word “Enhanced” right in the name, I am eager to experience that enhancement.

Costco Audi Qualifications, Pricing, & Attitudes:

I was surprised at how well The Province of Alberta regulates hearing testing and the recommending and sale of hearing aides.

Anyone involved in advising on and recommending hearing aids is required to complete a two and a half year FULLTIME course at a specific college located in Edmonton, Alberta. This is apparently the ONLY college in Alberta credentialed and authorized to educate and train audis. They are also required to do a residency.

In addition, they have to be individually licensed by The Province.

One of the Hearing Aid center counter people proudly pointed out to me the degree college and license of my audi, as well as the degree and license for the other audi who took the time after my 100 minute appointment to answer all my credentials and Costco business practices questions.

That second audi also proudly told me that Costco specifically tries to avoid the “predatory” practices of some hearing clinics. He told me my experience at the chain hearing clinic is not unusual, with a quoted price for a pair of top quality HAs routinely being over $5000 after the semi-permanent $2000 “sale” discount and after the maximum $900 Provincial contribution.

This contrasts with Costco, where my Jabra Enhance Pro 20 (the newest model now already available to buy ) will cost me $2100 minus the government subsidy of 75% of the cost of ONE HA subject to a $900 cap. So, my Jabra pair would cost me $2100 minus 75% of $1050 = $1312.50 (Canadian dollars versus US dollars. About $984 US. I did have to pay the $1312.50 upfront today upon ordering the Jabras. The second audi told me my Jabras would be received, and then programmed, so that I can pick them up at an appointment he set for me for 13 days from today.

I asked about after sale service and costs. He also said that the clinics in our area charge for virtually any service or supplies, but Costco provides those ALL at no extra charge.

I get a 3 year warranty free. I get free replacement of each hearing aid in the pair, each one one time only, for 2 years. I get only a 28 day trial period (so that Costco can get the $787.50 government contribution from the government after 28 days of use by me). However, I can return the pair of HAs for a FULL REFUND any time up to 6 months. And, I am told the refund is “cheerfully done”.

This second audi I spoke with is also very proud to be part of the solution against the predatory clinic pricing, and is proud of the consistent processes Costco uses

EVERY employee I have spoken with at Costco’s Hearing Centre has been enthused, friendly, supportive, and happy.

I feel like I am off to a great start in my hearing improvement project. I am looking forward to see how well the appointment 13 days from today goes. If it goes as well as today went, I think I should be a pretty happy HA user.

Jim G

13 Likes
#2

Good luck with the Jabra. Please report back on findings.

1 Like
#3

Interesting that your word recognition was better in the left ear since it seems to have the worse audiogram. Perhaps related to your right ear being congested? In my non-expert view, your word recognition scores suggest that hearing aids can definitely benefit you, but I’d quibble with calling them excellent. You’re still going to be missing some things.

#4

It could also simply be that the audi did my right ear first, and then the left. I may simply have gotten better “with practice”.

1 Like
#5

I forgot to mention 2 significant things:

When I asked about Telecoils, he told me that very few places here in Lethbridge, Alberta Canada actually have a loop, so he does not see a lot of client interest in T-coils.

When I asked about the TV Streamer accessory, he advised that I should wait and see if I really need it before ordering one, as they are more costly here in Canada than in The U.S. (He said about $330 Canadian). He said i might be surprised about the quality of sound I get without the streamer.

I thought about that last evening after I returned home, and resumed my temporary usage experiment of the amplifying target shooting hearing protectors I mentioned so favourably in another thread (the “Crazy pricing” thread). I have been astonished at how relatively well they have worked when watching TV with my wife. The sound is not only notably improved over listening without them, but they also enable my wife to make comments or ask questions about the TV show. It would possibly be singificantly more difficult for me to hear HER when using a TV streamer.

These two audi pieces of advice reinforced in me the thought that unlike some other HA sellers, Costco does not try to “upsell you” with accessories. This thought is also reinforced by the fact that Costco HA Center employees are NOT on commission.

Jim G

4 Likes
#6

Sounds like you had a good experience. I hope the fitting goes well. My advice to engineers is always: remember the wetworks. The brain adjusts. Try not to fiddle with the tech too much for the first few weeks. Engineers always seem to be more focussed on the technology than the biology.

There’s no audiology program in Edmonton.

4 Likes
#7

Thanks so much Jim. I’ll be following you, and my appt is the 25th. Harris

#8

Telecoil batteries last several hours longer each day than normal rechargeable batteries. I chose telecoil for that reason, not because I wanted to use that feature. Too bad your hearing aid tech didn’t mention that. I’m not sure if I paid more for telecoil.

#9

Fantastic post, thankbyou for the details!

The one quibble I would have is with Costco tar’n’feathering of clinics as predatory. Costco and clinics is an apples and oranges comparison.

#10

This is the opposite of my experience. Once again, I believe it comes down to the actual person you are talking to vs. necessarily the ‘store’.

#11

Then what is that 2-1/2 year fulltime program of courses that the students must take at the college as a pre-requisite for the licensing? What could it be called?

Jim G

#12

Uh, I beg to differ. Check out: https://www.acslpa.ca/

It is located at 4445 Calgary Trail NW, Edmonton, Alberta, Canada.

Jim G

#13

I think that’s a college in the sense of a professional organization instead of a school. Professionals register with the organization but they don’t get their professional education there. (At least that’s my take from a brief look at the website.)

#14

Yes that is a regulatory body rather than a school.
From their website: “The Alberta College of Speech-Language Pathologists and Audiologists (ACSLPA) exists to serve the public interest through the regulation of professional speech-language pathologists and audiologists in Alberta.”

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#15

There’s a hearing instrument specialist program? Maybe that’s what they meant. I don’t know what their curriculum is. In Ontario HIS diploma is typically 1.5-3 years depending on the school and whether the individual student has to do preparatory courses.

#16

I looked briefly at some of the individual webpages on the site, and it is indeed the professional “college” that Province of Alberta makes responsible for ensuring that ALL individuals who want to practice in audiology and/or be involved in the provision of hearing aids specifically MUST have their credentials evaluated by the College and ONLY the college can license them. Selling or recommending hearing aids withOUT the license is unlawful. But, yes the prospective licensees must get their education first, presumably at a college or university thta offers it.

The key thing is that this college, under Alberta law acts just like the colleges / associations / Bar Associations that license professional engineers, lawyers, etc. in Alberta, other provinces, and The U.S. states. You can’t be involved with hearing aid selection or selling in The Province of Alberta without registration and licensing there first.

There are also provisions to evaluate the education, experience, and credentials of incoming applicants from other jurisdictions, including mentioning specifically applicants from other Canadian Provinces and from The U.S.

From what that 2nd audi at Costco told me, the education requires 2-1/2 years fulltime plus a residency period.

Jim G

#17

The college regulates audiologists and speech language pathologists. The biggest difference between an HIS and an audiologist, aside from educational background and scope of practice, is that HISs are unregulated.

But yes, everything you say about the college is correct. For audiologists.

#18

“There’s no audiology program in Edmonton.”

It looks like MacEwan offers a 60 credit hour hearing aid practitioner diploma program.

https://www.macewan.ca/academics/programs/hearing-aid-practitioner/academics/diploma/

#19

Yes, and it also says:
“If you study full time, you can complete the program in two years; part-time students may take up to seven years to complete the program.”

But you then have to also :
“complete a field placement course with a required minimum of 180 hours of supervised work in a hearing aid dispensing clinic.”

So 2 years + the field placement + the time to get the accreditation & license from the professional college discussed above.

So, yes, 2-1/2 years sounds about right, which is what the 2nd audi at Costco told me.

So, the Costco men I saw during my appointment were “hearing aid practitioners” I guess not audiologists. But with 2+ years of course and on-the-job education and training.

Jim G

#20

Interesting. In Ontario we supervise our HISs for 1000 hours. 180 sounds breezy.