Aren’t all hearing care providers doctors?

The majority of audiologists practicing are doctors of audiology, meaning they studied hearing and balance in the ear and in the brain for eight years. They have worked hard so that they can provide you with the best possible care. Some audiologists do practice with a masters degree. The transition from Masters to Doctorate happened about 12 years ago, so an audiologist with a masters degree is someone with a lot of experience.

To sell a hearing aid in North Carolina, a person is required to have a hearing aid dispenser license. This license requires passing a test and completing a one year internship. Most hearing care provided in retail outlets is provided by someone who has invested a year preparing to take care of you. At our audiology practice, your care is provided by doctors who invested a significant portion of their time and energy to be able to provide you with the best possible care.

Make sure you know who is providing your hearing care. We know from research that a good provider and a comprehensive plan of care results in better long term usage rates, speech understanding, and patient satisfaction.

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Trade In Event: May 31

All right folks here’s the deal: We are trying a new Trade In Event!

On the last day of May we are offering a trade-in on your old hearing aids toward the purchase of new hearing aids.

I know we have lots of folks out there who have been successful hearing aid users but their current devices are wearing out her no longer serving their goals.
A trade-in value of $250 per unit will be granted toward the purchase of a standard advance or premium device with a maximum of one trade-in device her one new device purchased. Professional fees are what they are and cannot be discounted as part of this program.

We are happy to accept trade-ins from other providers, even if the technology is “locked” or the devices are custom molded to your ears.
(This is a great opportunity for those of you who had hearing aids from Sam’s Club before they closed in Morrisville.)

If you would like to take advantage of this opportunity call us and set up a consult time so that we can make some decisions about what will move meet your needs best moving forward. Then we can go ahead and schedule your trade-in and Fitting for May 31!

Happy Better Hearing and Speech Month!

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Hearing Is Wellness

Must we hear well to be well?

Hearing loss is often written off as an invisible disability and a natural side effect of aging. Many treat it as something they would just rather not deal with.

 In recent years, study after study has shown us the connection between hearing and so many other important functions in our brains and bodies. Hearing loss is associated with accelerated cognitive decline, increased fall risk, and increased rates of depression. Having even a mild hearing loss has been associated with physical changes in the brain that impact our ability to function in many ways.

If your hearing is changing we can help you understand what is going on and help you take care of the ears that you have.

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Selective Hearing

Dad does fine talking to me when it is just the two of us, but when we get together with the whole family he just seems to tune out.

I think it’s just selective hearing. Is that common?”

This is a very common thing for us to hear this time of year as audiologists.  Most adults with hearing loss experience the type that introduces a great deal of distortion to sounds coming in. If your dad has even a little hearing loss, it makes it a lot more work for him to carry on a conversation with you. Extra noise from the family, the football game on TV, and holiday celebrations makes for even more work for him to organize the sound.  At a certain point, the effort of hearing and listening become so much that folks will often check out of the small talk.

Good hearing care take this into account and helps manage the effort of listening through amplification and auditory training to help an individual receive and process sound as effortlessly as possible.

It sounds like it might be a good idea for your dad to come see us before the holidays!

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Patient Testimonials

” I was so surprised! I had no idea how hard I had been working to hear. Now that I can hear I have more energy at the end of the day and I enjoy social times so much more!”

“It has been very helpful. I think I may have waited too long! You don’t realize how much you have to work and pay attention and watch to hear people. Now I hear so much more easily and naturally. I am so grateful for your help!”

Mr. M 10/6/2017

“Dr. Cristobal is very knowledgeable and efficient. I have received excellent care from her and would highly recommend her practice.”

“Dr Cristobal is awesome! I can’t be happier with my Resound Linx and the service that comes with it.”

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OTC Hearing Aids?

You may have seen that the Over-The-Counter Hearing Aid Bill was recently passed as a part of the FDA Reauthorization Act. This is exciting news for the hearing care industry, as around 80% of individuals who would benefit from amplification do not currently utilize any form of hearing care.

Much is still to be determined as the FDA has three years to create regulations and distinctions for this new category of devices.  Eliminating the current marketing and use of unregulated Personal Sound Amplification Devices as an alternative will greatly improve public safety.

I anticipate widely available amplifiers with treble/bass and overall volume control and a built in gain limiter so that the devices are not capable of creating further hearing loss in their users.  Most will be digital with feedback controls and the ability to adjust sound level and quality through a computer or phone or onboard controls.  These will be very similar to our hearing aid technology of the early 1990’s. These will be a great option for individuals with mild hearing loss that has not impacted auditory processing in a significant way.  Aiding hearing loss at an earlier stage will slow the process of auditory deprivation hopefully resulting in less loss of auditory processing as well as improving overall health goals such as cognition, social engagement, and physical activity levels.

My hope is that traditional hearing aids will be designated as Class 2 medical devices.  These will remain the appropriate treatment option for individuals with hearing thresholds greater than 40 dB, sharply sloping hearing losses, or auditory processing difficulty such as difficulty understanding speech in nose.

Our current hearing aid technology has 12-32 channels of frequency control and 3-4 loudness levels with additional algorithms for different types of noise reduction, special shaping, frequency compression, and tinnitus management.  In my practice, all devices are fit with a small microphone tube located 3-4 mm from the tympanic membrane to calibrate the sound very precisely.  The hearing loss levels and acoustics of the ear canal are taken into account, and sound levels are set to match an independent, Evidence-Based prescription for ideal speech understanding.  Sometimes additional settings are created for sound quality of music, or specific environments.  Accessories can be connected to aid with processing difficulties, for individuals with difficulty managing competing noise due to cognitive decline.  The recommendation and selection of these hearing systems is based on concrete test results.

Hearing care has been a field of rapid change for over 20 years now, and the changes will certainly continue!  I hope to be a resource to you and your family as we navigate expanded access and changing technologies.  Please call or message the office to find out more information about hearing care resources, changing regulations, and our practice.

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What to Expect (Part 5)

Most of our patients who wear hearing aids come see us 2-3 times a year for routine maintenance to keep their devices working as well as possible.  Our climate in North Carolina is brutal to tiny electronics and computer chips worn on the body all day!  Routine care helps the hearing aids work well all the time, and stay working longer.  This helps you get the maximum benefit from your investment!


Hearing aids are able to give you the most help if you wear them the whole time you are awake.

Eyes Open = Ears On


The average adult takes 4-6 weeks of wearing hearing aids for at least 1 hours a day to reach maximum benefit and best understanding in noise.  The brain has to relearn what to do with all those sounds in the world.

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What to Expect (Part 4)

We do dispense hearing aids through our office, as well as fit appropriate amplification devices purchased through insurances or reputable outside sources.  We are preferred providers for TruHearing and Amplifon.


Hearing Aids available range from made for iPhone and Bluetooth enhanced options, to 24/7 invisible solutions, to traditional devices optimized for limited dexterity and vision.  We use your hearing ability data in the hearing aid selection process, basing our recommendations on your lifestyle needs, degree of hearing loss, and your speech understanding scores.


A hearing aid fitting, refitting, or amplification assessment involves very precise measurements of the sound level at your eardrum through a process called Real Ear Measures.  This allows the Audiologist to make sure that the devices are working in the best possible way to meet your needs. The sound is lined up to match a prescription – to ensure the best possible speech understanding.

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What to Expect (Part 3)

A comprehensive hearing evaluation assesses how loud sound needs to be for you to be aware of it across a range of different types of sounds, or pitches, as well as how well you are able to understand speech when it is quiet and when it is loud.  If additional information might be helpful, we may also assess your loudness reactivity, speech understanding in background noise, and/or measure your tinnitus.


We like to review the results and implications of the hearing test at the same visit, and an evaluation with us means that you and, if you wish, your primary care provider will get a written report explaining the results. If management or treatment options are suggested, we can discuss them at that time as well.


Hearing aids are NOT the only treatment that we have to offer!  Some individuals with hearing difficulties may be better treated with auditory rehabilitation through computer-based retraining programs, or assistive listening devices.


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What to Expect (Part 2)

Did you know that we are in-network providers for Medicare, Blue Cross Blue Shield, and Cigna?  We are also preferred providers for TruHearing and Amplifon.  Carlisa, our Financial Coordinator, is here to help communicate with insurance companies and make sure that you know what to expect.


New patients typically begin with a consultation – just a sit down visit with Dr. Cristobal to discuss what experiences and goals you may have.  Bringing a family member or the person you talk to the most can be very helpful, as he or she may understand what you are missing even more than you do!


Once we have an understanding of your goals for the visit, we often proceed to an evaluation of the ears.  We will look in the ear canals for wax that may interfere, appearance of the eardrum, and any notable anatomy. We see many different ears on a daily basis, and your anatomy contributes to how you hear!

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