Rx for readers

By JUDY SIEGEL-ITZKOVICH
I am a 68-year-old man who has been wearing a hearing aid in one ear for about four years. When I go to the company for repairs and supplies, I am encouraged by the staff to upgrade to "super duper" new models, which are of course more expensive. One of them is called Metrix. I am not so happy with the performance of my current hearing aid and wonder whether the Metrix and other new ones will be better and worth the extra expense. F.Z., Tel Aviv Dvora Gordon, an audiologist at Hadassah University Medical Center in Jerusalem's Ein Kerem who runs the Association for Hearing Disabled, a non-profit organization under Hadassah's auspices that works with adults and children who need hearing aids, comments: When reading your question, the first thing that struck me was that you are currently using only one hearing aid. While there are often medical or audiological reasons for prescribing only one hearing aid, if your hearing loss in both ears is similar, you should consider adding a hearing aid to the other ear before upgrading your present one. Using two hearing aids helps the user to localize sound properly, aids in the prevention of feedback, but most importantly helps the user hear in noisy situations. There have been many published studies showing the benefit of wearing two hearing aids, and even the hearing aid companies themselves will say it is better to use two relatively inexpensive hearing aids rather than a top-of-the-line device in one ear. Consult your audiologist to see if you are a candidate for binaural hearing aid use. The major advantage of the new premium products is known as "adaptive directional microphone technology." This means the hearing aid has two microphones instead of one, so the hearing aid can select certain sounds to be made louder, while others will not be made as loud. This technology has been proven to help people hear better in noisy situations. The more advanced hearing aids claim to be able to "know" which sounds you want to hear, and send those along for maximum amplification. If you have trouble hearing when you are in a noisy environment, this technology can help. Keep in mind that this option is not available in the "completely in the canal" (CIC) model of any hearing aid. The expensive hearing aids also have advanced feedback (whistling) cancelation systems, noise reduction - to make listening more comfortable, and the ability to fit the user with multiple programs (one for the telephone, one for music, etc.) and other "bells and whistles" that may or may not be important to you. It is important for you and your audiologist to define your needs so you can decide if it really makes sense to upgrade to a premium product. One other thing to keep in mind is that the average life span of a hearing aid is about five years. If your hearing aid is already four years old, it could be that it will need replacing in any event within the next year or so. I am a 56-year-old woman. I have been prescribed prednisone for a few months for an autoimmune condition, and Caltrate+D 6000 (calcium) for osteoporosis, in addition to Fosamax (Fosalan). There are restrictions on eating dairy and not eating at all for some of these drugs. I'd like to know if I can take the prednisone and the Caltrate+D together, or if I have to wait between them. I asked pharmacists in a number of pharmacies and everyone tells me something different. R.B., Jerusalem Prof. Jeff Aronson, Clinical Reader in Clinical Pharmacology, University of Oxford, UK, comments: Some medicines affect the absorption from the gut of other medicines, by changing either the speed of absorption or the extent of absorption. The speed of absorption of drugs doesn't usually matter, unless you want a really quick effect (for example with a painkiller). Medicines that reduce the extent of absorption of other medicines do so in two ways - by binding them physically in the gut and thus stopping them from being absorbed or by affecting the gut's absorption process itself. Prednisone is a glucocorticoid (steroid) drug used to treat a wide range of inflammatory and autoimmune conditions. Glucocorticoids reduce the absorption of calcium by the gut by affecting the active transport mechanism from the gut into the blood. But taking the prednisone and the calcium at different times of the day will not help; if the prednisone is affecting the absorption of the calcium the only thing to do is to increase the dose of calcium. However, individual requirements vary enormously, so it is best to consult your doctor about whether you are getting enough calcium or not. Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.