Just picked up Phonak Audeo Spheric I90

With the greatest of respect here: you have a pretty severe ‘Flat’ loss and fully occluded moulds. This means your unaided Articulation Index would be 0%; ie you basically hear negligible speech without amplification. Also I suspect that you would have limited tensor tympani and stapaedic reflexes. Plus you won’t experience occlusion.

This puts you in a position where amplification (particularly when the speech is ‘pulled out’ by AI) results in huge gains in understanding across the board. Which is superb, I’m really made up to see the technology has reached a level that a pretty debilitating loss of this extent can be ‘fixed’.
Even your own voice is going to sound great through the Spheres.
However if I was to put a near field mic under the nose of the person and give you a set of normal (closed) headphones with a volume control, I’d bet that we could produce a similar result with a little compression.

Sloping losses and open fits present greater difficulty as the mix of speech and noise varies by situation, presentation of one’s own voice vs other speakers in background noise represents massive intensity changes. Across a sloping audiogram we can see a 1000x change in sound pressure intensity. So the difficulty is multiplied as you start having to trade off clarity while stopping occlusion. That’s before you consider the other aspects of cochlear degradation.

Put simply; it’s pretty ‘easy’ to play a tune on a piano with two 32 Oz hammers, it’s a little harder to do it with one 5lb hammer and your little finger and achieve the same sort of sound quality.

That said: the Spheres are definitely a leap forward in providing a solution for severe losses by improving speech in real noise environments.

@Um_bongo said:

With the greatest of respect here: you have a pretty severe ‘Flat’ loss and fully occluded moulds.

IIRC, @JordanK has power domes.

@Um_bongo said:

This means your unaided Articulation Index would be 0%

My unaided Articulation Index is (IIRC) 17% (according to Target software), but I don’t feel that I hear that badly without any CI/HA…

So still occluded: with power domes.

Your loss in the right ear is a conventionally sloping loss with a big cookie-bite.

So. An entirely different proposition for fitting, occlusion and expectation. That’s before we consider the effect of listening through different modes on each side in addition to the loss of stereo due to different processing latencies.

At the very least I’d expect you to have a normal-ish response to low loud sounds.

What an incredible exchange.

DaveL

I currently have vented domes i.e. domes with little holes around them. As you can see, I’m not very tecchie! Before I had these, they were changed to closed domes which didn’t help. Yes, I also have the Sphere I90.

My opinion, for what it’s worth, would be to have impressions made and order custom inserts. It’s not a huge expense (mine were $200 for both), but it’s worth the risk if you’re not experiencing the phenomenal results that most Spheric I90 patients have reported.

My issue is understanding speech in noise

My dispensing Audi used open domes 3-1:2 years ago. People here suggested

….stick an index finger in each ear.

I heard better because signal was going towards my ear drum

….I moved to closed domes. Tried power domes and hated them.

Lots happened after that.

I’m now using moulded inserts and love them. I hear better

That’s a good suggestion and $200 sounds very reasonable. I’m in the UK so not sure what that would be. Incidentally, I noticed about an hour ago when I was talking to someone, that the sound dropped from my aids, sounding as if they needed re-charging. Another thing to add to the list for my audiologist.

@Judi_L said:

I was talking to someone, that the sound dropped from my aids, sounding as if they needed re-charging.

Try to determine if it’s mainly low-frequency sounds. This may be due to sound leakage outside of the ear canals, due to too much open-ish domes.

Thank you, sometimes I think that I will never get used to Phonak Sphere aids. I’ll see if this is due to low-frequency sounds as you suggest.

Hi there, that’s a very challenging audiogram, you most definitely need to go Power receiver with custom molds, as your doing DIY with the power domes you’ll be able to program for at least some usable gain, soundrecover is gonna be helpful for you as well, as your very experienced with HAs you’ll be able to punch ahead with the gain required, yeah don’t be shy! How’s the feedback thresholds on your set up I wonder.

Thanks for the response. I don’t remember the feedback threshold (at 84 my memory isn’t great) but I’ll check next time I’m in Target. Appreciate your thoughts on the Power receiver also. I’m hoping a switch is possible but with mail order, one never knows until asked.

I’m sure you’re already aware, but winding up (down) the frequency compression is going to give you a significant boost with that loss.

@Bimodal_user said:

As DIYer, I assume that because of less REOG/R with pressure vent cShell, my adjustment should be in less low frequency gain and more mid- and high frequency gain compared to power domes?

You should be able to use Audiogram direct (or whatever Phonak call it) to better judge the low-frequency performance of the aid. As long as you’ve correctly established which tips/venting is/are used. And run the feedback manager too. The modification to will likely show worse thresholds in the LF for you if you have big canals or more venting. Accept the new levels with the canal compensation (even if it doesn’t look like your ‘normal’ audiogram) then let Target do its thing with NAL and you’ll optimise the fitting.

It’s not REM, but at least there’s a degree of modification based on the IG of your fitting.