Vera Nelson was quite the golfer, Nelson says, and the two golfed together until he was diagnosed with retinopathy, a result of type 2 diabetes, which leads to vision loss. Eventually, his eyesight was too blurry to focus on golf.

Then, nearly eight years ago, he also began to lose his hearing. The loss was gradual; in fact, he wasn't the first to notice.

"Sometimes the wife would have to repeat herself two to three times," Nelson says. "It got worse and worse."

But Vera Nelson encouraged her husband to get a hearing aid. Finally, when Gus Nelson saw an advertisement for Sears Hearing Aid Center three years ago, he decided it was time.

Nelson had a hard time adjusting to the hearing aids, but he calls getting his hearing back "a blessing." Today, he carries on conversations without difficulty or hesitation.

Nelson's experience is shared by millions of Americans. More than 2.8 million people in this country suffer from some level of hearing loss, according to the website HearingLoss.org.

Hearing loss affects individuals in countless ways, from muting the sound of the rain to muffling the roar of an oncoming train.

Some resist getting a hearing aid even after being fully aware of their problem. Financial constraints and a sense of pride often keep people from purchasing hearing aids.

"I went for a long time without hearing, but I got used to it," Bud Hartman says. "When people laughed, I laughed."

He says he got to the point that he wanted to hear so badly, he decided to give it a try.

"Hearing aids make you look old, but when you can't hear," he says, "it makes you feel old, and that's a lot worse."

In the past, buying a bulky, conspicuous earpiece was a hard sell and not always effective, says Dennis McDonnell, a hearing aid specialist.

Recent technology, however, has vastly improved the quality and aesthetics of hearing aids. They are smaller and more effective.

The tools to ease the difficulties of hearing were once nothing more than crude hearing "trumpets," hollowed from the horns of cows, rams and other animals. By World War II, hearing aid technology began to develop, McDonnell says. McDonnell works at a Bay Area Miracle Ear store.

Older versions of hearing aids include some that were attached to eyeglasses or a box worn over the chest. These analog hearing aids amplified all sound, including speech and noise. Sometimes, people with the older hearing aids would have to physically turn to hear someone speaking behind them.

Nowadays, hearing aids are smaller, fitting inside or over the ear, and their effectiveness has evolved. Many are also digital, giving the user a wide range of adjustable options.

"They're very sophisticated," says Rufus Wesley, of Self Help for the Hard of Hearing (SHHH) San Jose chapter. "The technology changes as rapidly as it does in computers. We have a very hard time keeping up."

SHHH is a self-help group of more than 120 members who meet monthly. The organization has existed in San Jose since 1984. The members invite audiologists and other professionals to give lectures and presentations at their meetings. Many of the members use hearing aids, Wesley says.

In recent years, he says the advancements in hearing aids have made the devices useful in a variety of situations.

Digital hearing aids are equipped with several microphones, including an omni-directional microphone that can capture sounds from all directions. However, in a noisy environment, such as a restaurant, the user may have difficulty hearing a dining companion over the surrounding noise.

But a directional microphone makes it possible to focus on one person and some hearing aids automatically switch to this mode in such situations.

The new hearing aids are smart, says Inessa Rubinshteyn, a licensed hearing aid dispenser at the miracle Miracle Ear store in Sears on Wolfe Road. She says the new digital aids have noise reduction and speech enhancement capabilities, especially picking up on consonants. Consonants, Rubinshteyn says, are what the hard-of-hearing have most difficulty with. "For example," she says, "they will hear teach instead of peach." But the new hearings help the user hear the difference.

Another improvement is that the hearing aids no longer have the feedback whistle when the user turns the device up high.

"Now I can tune into anyone I want to," Gus Nelson says.

Like Nelson, many of the members in SHHH are seniors. Yet contrary to popular belief, old age is not the number one cause of hearing loss. About 95 percent of people with hearing loss experience sensorineural hearing loss, which is the result of nerve damage in the inner ear. Some of the damage can be attributed to old age, but often it's the result of extended exposure to loud noise, according McDonnell.

Rubinshteyn says the majority of her clients are 70 to 90 years old, but the generation of people with hearing problems is getting younger. She attributes it to exposure to loud noise.

"Sometime after a loud rock concert, a young person's ears will ring for a couple of days, and they will have temporary hearing loss, but then the hearing comes back," she says. "What they don't realize is that one day it might not come back."

Hearing aid technology started to develop after World War II as soldiers returned from the war with hearing damage, McDonnell says.

Bud Hartman is one of those who attributes his hearing loss in large part to the war.

"He was a paratrooper in the Battle of the Bulge with cannons going off all around him," Joan Hartman says.

After that, when Bud Hartman moved to the Bay Area, where he worked at a bakery for 43 years.

Hartman says it's not too surprising he's lost his hearing, after "firing those big old guns and being in that bakery with everybody banging around those racks for 40 years."

A hearing aid can actually restore not only a person's hearing, but his or her social life as well.

Marsha Snell, 83, who started losing her hearing about 10 years ago, was hesitant to admit her problem, even though it impeded everyday activities.

"I'm such a friendly and outgoing person, I didn't accept it for a while, and pride held me back," she says. "My family started telling me I was hard of hearing, and I said, 'Well, I just hear what I want to.' "

If she hadn't gotten a hearing aid, Snell says, she wouldn't have been able to keep up with her passions, such as dancing.

"My husband and I danced for 43 years until he passed on," she says. "We started out with the jitterbug."

"I got involved with the senior groups, and it's fun being with people my age," she adds. "I have seven couples I dance with, and we all have hearing aids, and we probably couldn't hear the music without it."

Snell also needed to revive her hearing to keep up with the help she gives her elderly neighbors. She lives in the adult low-income housing complex and regularly drives her neighbors on errands and to the doctor. She says that before she got a hearing aid for her right ear, she could not hear her turning signal or the people seated next to her in the car.

But hearing aids are expensive.

Though she has hearing loss in both ears, Snell says she's only been able to afford one hearing aid so far. She wanted a hearing aid that she could place inside her ear, to make it more discreet, which cost her about $2,000. She says she plans on buying the second one in June but purchased one for her right ear first so she could hear the passengers in her car.

"I think more people would get hearing aids if they weren't so darn expensive," she says.

Hearing aids can be costly at any age.

McDonnell says typically, insurance companies and programs such as Medicare will not pay for medical equipment such as hearing aids, but only for the preliminary testing for such devices, which Miracle Ear provides for free.

Philip Lee, a physician and professor emeritus of social medicine in the School of Medicine at UC-San Francisco, confirms Medicare does not cover hearing aids.

"The people who set the benefits felt this was more of a discretionary cost," Lee said.

Health insurance plans typically do not cover hearing aid costs either, says Bobby Pena, a spokesperson for the California Association of Health Plans.

"They're not available in the majority of individual plans," says Pena. Nor are they a standard option for employer plans.

Wesley says because most people don't have coverage, SHHH--which recently changed its name nationally to Hearing Loss Association of America--has been working on legislation on the state and federal levels that would require insurance companies to provide $1,000 for a hearing aid to those individuals with hearing loss under 18 or older than 55.

Sometimes the hearing loss is too severe, Rubinshteyn says. Other times a health issue can cause the brain to be unable to recognize the sounds. She says the ear does not hear by itself. The brain must interpret sounds.

"People with this problem sometimes ask for hearing aids anyway," she says, and sometimes there are miracles. She says one man had a stroke that left him unable to recognize sounds or able to speak. After four years of wearing a hearing aid and getting speech therapy, he was able to understand and speak. "It was the brain catching up," she says.

For more information about the San Jose Chapter of the Hearing Loss Association of America, contact Bruce McClelland at 408.241.3056.

Sears Hearing Aid Center is located at 101 Wolfe Road. 408.366.0402.

Stephanie Condon contributed to this story.

El Camino Hospital