Getting Started with Hearing Aids

From your first fitting appointment to full adjustment: learn what to expect, practical strategies for success, and how to overcome common challenges when starting with hearing aids.

Your First Fitting Appointment: What Actually Happens

Your fitting appointment is far more than just picking up devices and leaving. It's a crucial educational session where your audiologist ensures your hearing aids are properly programmed, physically comfortable, and that you understand how to use them effectively. Plan for this appointment to take approximately one hour—proper fitting requires time and cannot be rushed.

Physical fit and comfort check

Your audiologist begins by ensuring the hearing aids fit correctly in your ears. For behind-the-ear models, this involves adjusting the tubing length and checking that the earmold or dome sits properly in your ear canal. For custom in-the-ear models, they'll verify that the shell fits comfortably without causing pressure points. This physical fit is critical—not only for comfort, but also for optimal sound quality and preventing feedback (that annoying whistling sound).

During this stage, speak up immediately if you feel any discomfort, pressure, or unusual sensations. What seems like a minor irritation during a short appointment can become a significant problem when wearing the devices all day. Your audiologist can make adjustments right away, whether that means trying different dome sizes, reshaping custom molds, or adding retention features to keep the devices securely in place.

Programming and real ear measurements

Once the physical fit is verified, your audiologist programs your hearing aids using specialized software connected to a computer. This programming is based on your specific hearing test results (audiogram) and is designed to amplify the frequencies where you have hearing loss while keeping comfortable sounds at appropriate levels.

Many audiologists use a technique called **Real Ear Measurement** during this process. This involves placing a thin probe tube next to your hearing aid in your ear canal to measure actual sound levels reaching your eardrum. Research consistently shows that hearing aids fitted with real ear measurements provide significantly better outcomes than those fitted without this verification. This objective measurement ensures that your devices are delivering the right amount of amplification across all frequencies, not just relying on standard formulas.

Device operation and care training

After programming, your audiologist teaches you the essential skills for daily hearing aid use. This hands-on training covers:

• Insertion and removal: Practice putting the hearing aids in and taking them out correctly until you can do it confidently. Proper insertion affects both comfort and sound quality.
• Battery management: Learn how to change disposable batteries (with correct polarity) or how to charge rechargeable devices. Understand approximately how long batteries last based on your usage patterns.
• Controls and adjustments: Understand any volume controls, program buttons, or smartphone app connections. Know what each control does and when to use it.
• Cleaning and maintenance: Learn the daily cleaning routine using the provided tools. Proper cleaning prevents problems and extends device lifespan.
• Moisture protection: Understand when to remove hearing aids (showering, swimming, sleeping) and how to store them properly in a dry, safe location.

Don't hesitate to ask your audiologist to demonstrate these procedures multiple times. Take notes or ask if they have written instructions you can reference at home. Many clinics also have video tutorials available online.

Setting expectations and scheduling follow-up

Before you leave, your audiologist should discuss what to expect during the adjustment period. They'll explain that sounds may seem different or even unnatural at first, that you might notice background noises you haven't heard in years, and that your own voice may sound strange. These are normal experiences, not problems with your devices.

Schedule your first follow-up appointment before leaving—typically two to four weeks after the fitting. This follow-up is crucial for fine-tuning based on your real-world experiences. Many people need several adjustments before their hearing aids are optimized perfectly.

Your First Days: Managing Initial Experiences

The first few days with new hearing aids are often the most challenging as you adapt to new sensations and sounds. Understanding what's normal helps you distinguish between expected adjustment experiences and actual problems requiring audiologist attention.

Sounds will seem different

When you first activate your hearing aids, everyday sounds may seem surprisingly loud or sharp. The refrigerator hums more noticeably. Your footsteps sound crisp and clear. Paper rustling seems amplified. Your own voice might sound hollow, as if you're speaking in a barrel—an experience called the "occlusion effect." These perceptions are completely normal.

Your hearing loss developed gradually over months or years, and your brain slowly adapted to missing certain sounds. Now those sounds are suddenly back, and your brain hasn't yet learned which ones to prioritize and which to filter into the background. With consistent hearing aid use, your brain will relearn this selective attention, typically within two to four weeks. The key is wearing your devices consistently during this learning period.

Physical sensations take getting used to

Your ears need time to adjust to having devices in them. You may experience a feeling of fullness, slight pressure, or awareness of the devices for the first few days to weeks. Some people report mild itching or tickling sensations. These typically subside as your ears adapt.

However, distinguish between normal adjustment sensations and actual problems. Mild awareness of the devices is normal; pain, significant discomfort, or persistent irritation is not. If you experience redness, soreness, or any discomfort that prevents you from wearing the devices for several hours, contact your audiologist promptly. The fit may need adjustment, or you may need different dome sizes or materials.

Recommended wearing schedule

Rather than jumping immediately to all-day wear, many audiologists recommend a gradual schedule:

• Days 1-3: Wear for 2-4 hours daily in quiet home environments
• Days 4-7: Increase to 4-6 hours, including some mild background noise situations
• Week 2: Aim for 8-10 hours daily, trying them in various settings
• Week 3+: Work toward all waking hours except when showering, swimming, or sleeping

That said, some people find it easier to wear their hearing aids all day from the start, letting their brain adapt through constant exposure. Your audiologist can advise on the best approach based on your specific hearing loss and lifestyle. If you need breaks due to sensory overload or fatigue, that's perfectly acceptable—just don't give up entirely.

The Adjustment Timeline: What to Expect Week by Week

Understanding the typical adjustment timeline helps set realistic expectations. While everyone's experience is unique, most people follow a similar pattern of gradual improvement and adaptation.

Week one: Everything feels strange

The first week is typically the hardest. Your brain is being bombarded with sounds it hasn't processed clearly in a long time. Common experiences include:

• Environmental sounds seem excessively loud (your refrigerator, computer fan, traffic noise)
• Your own voice sounds unnatural or hollow
• You're hyper-aware of the physical presence of the devices
• Background sounds may compete with speech, making it harder to focus on conversations
• You may feel mentally tired from all the auditory processing

These experiences are signs that your hearing aids are working properly and that your brain is beginning the relearning process. Resist the urge to remove them and give up. Push through this challenging initial period—it truly does get better.

Weeks two through four: Finding your rhythm

During weeks two through four, you'll likely notice significant improvements. Background sounds that seemed overwhelming start fading into the background as your brain relearns to filter them appropriately. Your own voice begins sounding more natural. The physical sensation of wearing the devices becomes less noticeable—many people report forgetting they're wearing them.

This is an excellent time for your first follow-up appointment. You've had enough real-world experience to identify specific situations where you need adjustments. Your audiologist can fine-tune the programming based on your feedback, potentially increasing amplification now that your brain has adapted to the initial settings.

Months two through four: Achieving full benefit

Most people reach comfortable, confident hearing aid use somewhere between one to four months after their initial fitting. Research indicates that the typical adjustment period ranges from six weeks to six months, with full brain adaptation occurring along that continuum. During this phase:

• Speech understanding improves noticeably, even in moderately noisy situations
• You develop intuitive habits for device care and battery management
• You learn which program settings work best in different environments
• Communication becomes less effortful and more enjoyable
• You may notice reduced listening fatigue at the end of the day

Continue attending follow-up appointments during this period. Fine-tuning adjustments made during months two through four often make the difference between adequate hearing aid performance and truly excellent outcomes.

Common Challenges and How to Solve Them

Even with proper fitting and realistic expectations, you may encounter challenges during the adjustment period. Many of these issues have straightforward solutions you can implement yourself before contacting your audiologist.

Feedback or whistling sounds

Feedback—that high-pitched squealing or whistling—occurs when amplified sound escapes from your ear canal and gets picked up by the microphone, creating a loop. While modern hearing aids have sophisticated feedback cancellation systems, feedback can still occur occasionally.

Common causes and solutions:

• Improper insertion: Remove and reinsert the hearing aids, ensuring they're seated correctly in your ear canal. The devices should create a good seal.
• Earwax buildup: Check for visible earwax blocking the sound outlet or receiver. Clean gently with provided tools. If wax is in your ear canal, schedule an appointment for professional wax removal.
• Loose fit: Your ear canals can change over time, or you may have lost weight, changing your ear shape. You might need different dome sizes or new custom molds.
• Objects too close: Feedback can occur when you wear hats, scarves, or hold phones close to hearing aids. Adjust positioning or ask your audiologist about telephone settings.

If feedback persists after troubleshooting, contact your audiologist. The venting in custom molds may need adjustment, or the devices may require reprogramming.

Sounds are too loud or overwhelming

If amplification seems excessive, causing discomfort or sensory overload, take these steps:

• Use volume controls: If your hearing aids have manual volume controls, lower them slightly. This temporary reduction can help during the adaptation period.
• Take short breaks: Remove your hearing aids for 15-30 minutes when feeling overwhelmed, then put them back in. Gradual exposure helps adaptation.
• Avoid challenging environments initially: If a particular situation (like crowded restaurants) is overwhelming, build up to it gradually rather than forcing yourself too soon.
• Request programming adjustments: At your follow-up appointment, describe which specific sounds are too loud. Your audiologist can adjust amplification for those frequencies.

Difficulty understanding speech in noise

Many new hearing aid users expect immediate perfect speech understanding in all situations. However, understanding speech in noisy environments is one of the most challenging aspects of hearing loss, even with hearing aids. That said, performance should gradually improve as your brain adapts.

Strategies that help:

• Use directional microphone settings: Many hearing aids have programs designed for noisy situations that focus on sounds in front of you while reducing sounds from other directions.
• Position yourself strategically: In restaurants or groups, sit with your back to major noise sources when possible and face the person you're trying to hear.
• Employ visual cues: Watch speakers' faces and lips, which provides additional context that helps your brain fill in gaps.
• Request acoustic modifications: Ask to move to quieter areas or have background music lowered when possible.

Discomfort or irritation

Mild awareness of hearing aids is normal during initial adjustment, but ongoing pain or irritation requires attention:

• For custom devices: Contact your audiologist if you experience consistent soreness, pressure points, or raw spots. Custom shells can be buffed, reshaped, or remade.
• For dome-style devices: Try different dome sizes or styles. Some people do better with open domes, others with closed; some need larger, others smaller.
• For itching: Mild itching often resolves as your ears adapt. Keep hearing aids and ears clean. If itching persists, you may have sensitivity to the materials—hypoallergenic options exist.
• For pressure or fullness: This "plugged" feeling often relates to occlusion. More open venting can help, or your audiologist can adjust low-frequency amplification.

Never continue wearing hearing aids that cause genuine pain or produce open sores. Contact your audiologist immediately to address the problem.

Battery life concerns

If batteries seem to drain unusually quickly:

• Check usage patterns: Bluetooth streaming, maximum volume settings, and environmental noise management features all consume more power.
• Store properly: Keep batteries in a cool, dry place in their original packaging until use.
• Wait after sticker removal: For disposable zinc-air batteries, remove the sticker and wait 3-5 minutes before inserting to allow full activation.
• Clean battery contacts: Corrosion on battery compartment contacts can drain power. Your audiologist can clean contacts during appointments.

Strategies for Successful Adjustment

Beyond simply wearing your hearing aids, certain strategies can accelerate adaptation and improve your overall success.

Practice active listening exercises

Your brain needs practice processing and interpreting the sounds your hearing aids provide. Specific exercises can speed this learning:

• Read aloud daily: Spend 10-15 minutes reading aloud to yourself. This helps your brain adjust to how your own voice sounds through hearing aids.
• Use paired reading and listening: Follow along with an audiobook while reading the text. This creates connections between written words and their sounds.
• Practice sound identification: Consciously identify environmental sounds throughout your day. "That's the dishwasher running." "Those are birds outside." This active attention helps your brain categorize and prioritize different sounds.
• Have focused conversations: Engage in one-on-one conversations with family members in quiet settings. Gradually progress to small group conversations and noisier environments.

Keep a hearing journal

Document your experiences during the adjustment period. Note:

• Which situations feel comfortable versus challenging
• Specific sounds that seem too loud, too soft, or unclear
• Any discomfort, irritation, or physical issues
• Questions that arise about device operation or care
• Positive improvements you notice

Review your journal weekly to track progress. Bring it to follow-up appointments—these detailed observations help your audiologist make precise adjustments.

Set progressive goals

Rather than expecting immediate perfection, establish specific, achievable goals that build on each other:

• Week 1 goal: Wear hearing aids 4 hours daily at home; learn cleaning routine
• Week 2 goal: Increase to 8 hours daily; try one trip to the grocery store
• Week 3 goal: Wear all waking hours; attempt one small social gathering
• Month 2 goal: Confidently use in most daily situations; master all device features

Celebrate small victories. Successfully wearing your hearing aids for a full day, understanding a conversation in a moderately noisy restaurant, or confidently managing battery changes all represent meaningful progress.

Involve family members

Family members can support your adjustment process:

• Practice conversations: Have family members read simple word pairs ("cat" vs. "mat") first while you watch their lips, then while you can't see their faces. This helps train your auditory discrimination.
• Provide feedback: Family can help you gauge if you're speaking too loudly or softly as you adjust to hearing your own voice differently.
• Accompany to appointments: Bringing a family member to follow-up appointments means two people hear the audiologist's instructions and advice.
• Exercise patience: Remind family that adaptation takes time and that you may still need them to speak clearly, face you, and minimize background noise even with hearing aids.

Knowing When to Contact Your Audiologist

While many initial challenges resolve with time and simple troubleshooting, certain situations require professional attention. Contact your audiologist if you experience:

• Persistent physical discomfort: Pain, pressure points, or irritation that doesn't resolve within a few days
• Continued feedback issues: Whistling or squealing that occurs regularly despite proper insertion and cleaning
• No improvement in speech understanding: After two to three weeks of consistent use, if you're not noticing any improvement in your ability to understand conversation
• Sudden changes in sound quality: If hearing aids that were working well suddenly sound muffled, distorted, or much quieter
• Visible damage: Cracks in the shell, broken components, or moisture visible inside the device
• Battery problems: Extremely short battery life (less than a day for disposable batteries) or charging issues with rechargeable models
• Overwhelming difficulty: If after two weeks you're seriously considering giving up due to frustration or challenges

Don't wait for your scheduled follow-up if you're experiencing significant problems. Most audiology practices accommodate urgent adjustment appointments because they understand that early intervention prevents people from abandoning their devices. The first few weeks are critical—getting problems resolved quickly sets you up for long-term success.

When you contact your audiologist, have specific information ready: What exactly are you experiencing? In what situations does it occur? What have you already tried? This detail helps them diagnose issues more efficiently and determine whether you need to come in or if the problem can be resolved over the phone.