The following article may be helpful to some roasters who have difficulty hearing second crack (or even first crack) due to hearing loss: Wall Street Journal Thursday, June 9, 2004; Page D1 Cheaper Hearing Aids Crop Up Online As Prescription Devices Get Costlier, Consumers Turn to Web; Skipping the Medical Exam By ANN ZIMMERMAN Staff Reporter of THE WALL STREET JOURNAL A growing array of low-cost hearing aids is cropping up on Web sites and in catalogs, offering alternatives to pricey custom devices for consumers with mild hearing loss. An estimated 30 million people in the U.S. suffer from diminished hearing. Nearly 80% of them avoid hearing aids for reasons that include embarrassment, disappointment with the amount of relief the devices can offer and the expense. Custom hearing aids dispensed by a specialist cost an average of $2,300 a pair, and the cost often isn't covered by insurance. But a raft of cheap, ready-to-wear devices is emerging, ranging from $120 disposable hearing aids provided by Songbird Hearing Inc., to devices from companies such as Hearing Help Express and Crystal Care International Inc. that average about $600 a pair. These products, which are sold directly to consumers rather than through an audiologist or specialist, lack some of the features of custom hearing aids. Still, many consumers say these devices offer at least satisfactory results at a reasonable price. As the cost of prescription devices has risen with the addition of digital technology, consumers have turned direct-sales hearing aids into the fastest-growing part of an otherwise stagnant industry. Mail-order sales jumped 91% between 1997 and 2000, the most recent data available, although they still represent only about 4% of all sales. Hearing Help Express, a 22-year-old mail-order company in DeKalb, Ill., says it has seen sales jump 10-fold in the past five years. Because of Food and Drug Administration regulations, hearing aids can't be bought at the corner drugstore like reading glasses. Federal rules require that patients visit a physician to rule out a medical problem before being fitted for hearing aids by an audiologist or licensed dispenser. Regulators do allow consumers to buy hearing aids without a medical exam if they sign a waiver presented by an audiologist or licensed dispenser. Catalogs and Web sites have found ways to meet the letter of the law and sell directly to consumers. Hearing Health Express, for instance, requires that customers sign a waiver, which can be downloaded from its Web site or mailed to them, before shipping an order. Songbird's packaging outlines the warning signs of a medically based hearing problem and includes a waiver, but customers aren't required to send it back. "We are required to provide an opportunity to sign a waiver, but we can't make someone do it," says Tom Gardner, company president. A spokesman for Crystal Care International says its Crystal Ear device is an "assisted-listening device," not a hearing aid, so no waiver is necessary. Complex Subject Audiologists and hearing-aid specialists say that aids available through direct sales may not fit consumers' specific hearing loss. "Hearing aids are complex devices and hearing loss is a complex subject so it requires substantial intervention," says Brad Stach, president of the American Academy of Audiology. The FDA has resisted overhauling its requirements for hearing aids, in part over concern about missing underlying medical problems. Nancy McKinney, a 50-year-old Illinois college professor, was diagnosed last year with a mild, age-related hearing loss. She purchased several different mail-order aids, but none felt comfortable. On a repeat visit to the audiologist, she discovered she had collapsed ear canals, which require a special fitting. According to a U.S. Army study conducted in 1980, about 70% to 80% of people lose their hearing in a consistent pattern that can be predicted by age. Device makers say that ready-to-wear aids are preset to amplification levels and frequency ranges that correspond to these aging patterns. Some encourage customers to mail in a copy of their hearing tests to help choose the right device for their hearing loss. Hearing Help Express sells three ready-to-wear analog hearing aids that come with five different ear tips, so consumers can pick a tip that best fits their ears. For consumers who want customized aids, Hearing Help Express sells devices that match a person's specific hearing loss and ear shape for $499 to $699. Among other features, customers get materials to make an impression of their own ears, which they then mail back to the company. The newest device available on the Internet is the disposable Songbird, which sells for about $120 a pair and lasts for 400 hours. If replaced every three months, that adds up to about $2,400 for five years of use, about the price and lifespan of conventional hearing aids. The company says the Songbird appeals mainly to people with mild hearing loss who use the devices only occasionally. It comes with only one ear tip, so it may not fit all users. The RadioShack Option Some devices that help amplify sound also are sold at sporting-goods store and electronics outlets. RadioShack, for example, sells several different sound-amplification devices that are worn around the neck and plug into headphones. Sporting-goods stores sell in-ear devices designed for hunters: They muffle gun shots, but amplify soft sounds such as leaves rustling. Because these types of devices aren't marketed as hearing aids, they aren't subject to FDA rules and are readily available. Arthur Fink, a 73-year-old retired businessman in Florida, has tried four different hearing aids prescribed by specialists, ranging from $1,100 to $4,200 and wasn't happy with any of them. Then he bought a pair of $300 ear devices for hunters, called Walker's Game Ears, created by Bob Walker, a licensed hearing-aid specialist and avid hunter in Media, Pa. Mr. Fink says he finally has bagged the right hearing device for himself. "I can hear clearly now," he says. "I am hearing sounds I haven't heard for a long time."