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Round 3; DING!

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Edited

Well, it’s a start…

I got the new Sphere I70s yesterday. Along with them, I got, finally (and that was via email; no reason I can see why that didn’t happen the first time I wrote, rather than while I was in the office) the current (well, a week and change ago) .

As commented earlier, to my surprise, they’re markedly better than my previous ones, even going back a couple of years (see upstream comments with earlier 'grams), in the speech range:

image
While these readings are much better, and in particular as regards speech recognition, I’m disappointed that there isn’t a “both” section for my word recognition outcome. And, my disappointment that the seen size wasn’t the same as my earlier, upstream, ones.
But, I digress…
Clicking the image will bring up a full-sized rendition,
And…
The aids came with ‘regular’ receivers; they need high power ones.

So, we did the best we could and I’m trialing them with power domes (two layers, no perforations) while we await the cShell Titanium arrival and the high-power receivers.

(They had other HP but those were for all the other, not Sphere models, of Phonak aids).

However, regarding earlier urgings seen elsewhere in my postings, is built into their software, so we did another hearing test using my new aids during my initial setup. Once done, I had a chance to see the Target (don’t recall the version he has) setup screen, and Real Ear Measurement was noted in several places. Despite my initial challenges, I’m cautiously optimistic, once the end result (high power receivers, sShell titanium molds) is achieved.

Perhaps I’ll have to make another trip for proper receivers, before the cShells arrive. But, regardless, my initial impression, formed on the hour drive at freeway speeds for short sections, was that the “automatic” setting did pretty well at dropping the sound level of the in-car noise compared to my Beltones.

But when I arrived at Home Depot to pick up an order waiting for me, I couldn’t understand the customer service guy. Out with the new app, select “restaurant” (an approximation: lotta people talking in a huge space), and up comes his voice, almost.

That it should take movement to that separate program was disappointing. Apparently the Sphere noise isolation isn’t automatic in this model?? And with the only-standard receiver perhaps not doing as the high power ones will, understanding his speech was definitely better, but far from stellar.

Further work to become familiar with my app is definitely needed, because…

Last night I went to a bell and voice choir rehearsal. Bells is no issue; I could do it without any , as it’s a matter of following the director and swinging my arms at the right time (to play my single assigned note at that spot). But the voice choir rehearsal, where I could not even find my sound let alone participate, was excruciating. I spent the entire time trying to engage the music program and have any sense of what was happening (musically; I was well aware of everything else, other than my needed sound - including speech - comprehension).

Initial results sounded very encouraging but I’ve got a long learning curve to figure out how to use these and to adjust them…

As I always told my clients, RTFM. So today will be spent deep-diving into the owner’s manual, and playing with my app, so that I can do any changes fluently, as I can currently in my apparently far more user-friendly Beltone app.

Stay tuned…

Well that’s a very different . I take back my suggestion.

@Skip said:

REM is built into their software, so we did another hearing test using my new aids during my initial setup.

:thinking: Sounds like in situ. He inserted a probe microphone into your ear?

In reply to @Skip

Thanks for the updated .
As mentioned you are not a candidate.
You just might be able to get some word understanding back with properly fit aids worn all waking hours.

By the way, you do not need HP receivers, way overkill and they may not fit well in your ears?? P receivers would be plenty if not M receivers.

Are you telling your fitter what to do? Just curious.
Thanks

Edited

In reply to @Skip

If you have P receiver with power domes, try this carefully:

Audiogram and Phonak Infinio Sphere's
I have power domes with P receiver and no occlusion at all despite my audiogram. If you feel occlusion effect (boomy own voice or very loud chewing sound during biting e.g. nuts) try to: Pull your auricle upward and backward and then Carefully push receiver with power domes as deep as you can (It doesn’t require much force) - milimeter after milimeter. If power domer will be placed at least partially in the ⅓ deepest part of ear canal, which is bony part - you will win!

It’s worth noting that the side of the receiver with writing like “1P” or “2P”, “0P”, etc., should be directed backwards when you insert it into your ear canal.

@Raudrive said:

You just might be able to get some word understanding back with properly fit aids worn all waking hours.

I think, as @MDB noted, it is good to know if test was performed from recordings or from the examiner’s mouth, which is less relevant.

@Raudrive said:

By the way, you do not need HP receivers, way overkill and they may not fit well in your ears?? P receivers would be plenty if not M receivers.

Not necessarily if someone has larger than average volume of ear canals. That is my case. I am theoretically eligible for an M receiver, but for my needs I have to have a P receiver, which is even maxed out over 2.5 kHz and is still a few too little, despite perfect feedback threshold. And I have no changes in my .

And UP receiver (SDS 6.0, for Infinios) has counterintuitively better frequency response than P for Infinios, which is not usual compared to the previous receivers generations.

This is the part where would provide information if someone needs a stronger receiver for their needs.

@Skip, ask your audiologist to make a manual Spheric Speech Clarity program.

Trying to hit all the shorty questions’ answers here before telling you what’s happening:

I’m not telling my fitter anything other than responding to questions; I have no knowledge of what he may or can do so am not qualified.
My speech recognition test was recorded, but as noted, only L/R, not a “both”. And, TFOTMatter is that I don’t actually clearly recall doing the recorded words - too many tests in a short time, overall. But the WRT results shown are very markedly better than any other I have had done in the last few (more than a couple, even) years, and were done in his office using foam tipped earphones, with only a large quilt hung to the side for ambient noise suppression (compared to the typical sound booth, and the immediately previous test, done in a waffle-foamed-walls office (nothing on the floor or ceiling), also with foam tips.
My ear canals are very large; they can easily accommodate full molds; I’ve been in high power receivers in my Beltones for some years, due to the level of -informed sound deficiency, very significantly as to words, to boot. I’m fine with that thought, and my (Phonak) provider/fitter was certain that for my situation, HP was needed (but the ones he had didn’t have the same plug profile as the standard aids, so he’s ordered the tiny-ended (vs relatively larger, 3-wire-inserts) receivers for the Sphere; in the meantime, I have the standard power.
I’m accustomed to stuffing the power domes (or whatever the no-vent round rubber things are called) all the way down. As it happens, due to the power level, I can tell for sure when they’re properly seated, as, if not, there’s occluded (hand near my ear) or, even, open-air, feedback. Fully seated is no feedback in either case.
All that said:

Lydia and I spent some quality time fiddling with the fine tuning of the restaurant setting late yesterday afternoon, and that part seems at least acceptable. So far, however, I’ve not experienced the reason for purchase of this pair, the “Sphere” mode, which (supposedly; I’ve not experienced that yet) automatically clamps out noise and emphasizes speech in noisy conditions (Home Depot service desk, restaurants, group gathering, e.g.).

I also manipulated the TV setting while watching a couple of segments of a series; the ads (no captions) were mostly understandable, which is an improvement from before’s best (with the Beltones). On the subject of Beltone, I’m STILL banging away on getting the profile achieved with Lydia and me on our first, 4-hour, appointment with the second Beltone office. Lydia thinks she didn’t record anything, but just made notes to herself about what she’d done within the SolusMax program. I will be VERY fussed-out if I can’t get that profile back because 1) my aids are virtually useless due to my ill-advised request for bringing the speech clarity tweak into the general profile (All-Around), and 2) without that previously VERY good speech-from-Lydia profile, I have no comparative metric with Phonak. My INTJ MBI, with a high J (greek to most but those who know will understand completely) demands rigor and certainty, not guesses, so this is most disturbing - at least if it can’t be resolved. As yet, I can’t say it can’t - but the fact that this wasn’t immediately resolved on request suggests I’m being gaslighted. GRRR.

But, back to the story, my time at the choir rehearsal, and yesterday’s manipulation, confirmed my presumption that I just wasn’t yet familiar with how to make them jump through the hoops. More research is needed!
☺

In reply to @Bimodal_user

@Bimodal_user said:

This is the part where REM would provide information if someone needs a stronger receiver for their needs.

This is a great statement for @Skip to pass on to his audiologist. Rational to justify which power receiver is needed for his hearing loss. would prove so much in this situation.

I have been reading the OP’s posts and keep going back to properly fit aids as an issue. Has he had improperly for aids for a long time? If he has he will need time to acclimate to properly fit aids. Things will sound off until acclimated. With his music background this all gets more critical and patience is needed.

He is getting great help from the forum.

Good to know! Maybe @Skip can contact his audiologist and ask for a program, then remotely download it to his ? Or ask for his audiologist to set Sphere to automatically activate at a more sensitive noise level?

Edited

As before, some housekeeping:

I wear my all waking hours.

I’m starting to get the hang of the smart phone software.

Remote care MIGHT allow me to do whatever it is regarding Sphere kicking in. My experimenting, during a dinner out, with tweaking the restaurant section seemed to help, but I saw nothing there, nor on TV later, which suggested that Sphere kicked in; I had to squelch or raise various parameters to approximate Sphere’s presumed performance (noise suppression and speech clarity simultaneously), and I see no place which allows me to initiate it on my own.

All the audiologists/HAsupplying outfit owners I attempted to achieve before starting with the Phonak have said that the REM is VERY expensive - and, none had it. But looking over the audiologist’s shoulders suggest that the “Target V.unknown” adjustment program had the equivalent. Indeed, in mucking about in my phone program and the “My Phonak” app’s instructions, I got told that my HAs picked up my voice and transmitted it to the phone (bluetooth), rather than that travel being over-the-air. From that I impute that I’m getting the rough equivalent - but given that nobody - ENT or just HA sellers I’ve contacted - has it, it’s sort of moot.

I’ve been in full molds for a couple of years at least; the most recent Beltone revision (March ‘25; first couple of pairs weren’t a good fit), with a new impression, has been very comfortable. I’m awaiting the arrival of my cShell Titaniums for these; until then it’s power domes - which given the standard strength 3M , doesn’t have feedback. Likely, the more powerful receivers will require the molds to avoid feedback.

My tweaking (modifying every possible parameter) is at least fairly productive, as, most of the time, I can understand my wife, the paramount requirement if I’m to keep these (otherwise, the MyPalPro works very well with the Beltones, albeit with little to no understanding of anyone else’ speech).

I’m accustomed to dealing with the angled output of the RIC; I have to make sure it’s that way every time I clean my molds (I remove the receiver to do the effectively-like-flossing of both vent and receiver cavity)…

So, the earlier replies dealt with, I’m currently fighting yet another infection in my left ear (the one which started its decline with a perforation of the ear drum nearly 65 years ago, and has had 4 other perforations due to infection since that time, but none in the last several years), and treating it with Augmentin, a strong antibiotic with a keep-it-active-longer chaser. That’s meant that I’m currently right-ear-only. Fortunately for my marital bliss, she’s away for the long weekend dogsitting, and I may be back to two aids by the time she returns, as I got a quick start with the meds.

As I got the miasma of stuff related to this journey corralled by type/brand/date, I note that the current is a marked improvement in the lower frequencies in particular, and overall as well. AND, for an additional headscratcher, my word recognition scores are up dramatically as well. Now, if I can only translate that into real life speech recognition ability…

Thanks to the many participants here; I have high hopes that this will prove efficacious to my issues AND that my first SolusMax (Beltone) profile done with my wife’s participation will ALSO be retrievable and resume as the effective speech portion would allow me a comparative metric for speech. Music is still TBD; I’ll do some mucking about at church tomorrow to see how I do in that regard.

L8R, y’all!

@Skip said:

All the ENT audiologists/HAsupplying outfit owners I attempted to achieve REM before starting with the Phonak have said that the REM is VERY expensive - and, none had it.

@Skip said:

But looking over the audiologist’s shoulders suggest that the “Target V.unknown” adjustment program had the equivalent.

In Target software there is in-situ test named AudiogramDirect. This isn’t equivalent; it’s more a very imperfect prosthesis, although better than nothing.

Remote Care would be good to set a manual Spheric Speech Clarity program by your .

Just curious:

Before I did my current purchase, as encouraged by others, in another thread, I and my long-suffering wife called every and provider within 100 miles of my home in hopes that we could find an -equipped fitter.

Not quite Jiminy Cricket, but the results were the same: zippety doodah, or some other synonym for feces; NSSherlock, so to speak.

And in the excruciating search and 2-3 month trials (all extended from the 30-day norm, and followed up weekly) in Vero Beach FL, where one might reasonably expect state of the art providers, given that there was one of every corner so to speak, my 4-provider/6-maker attempt to find something better than the Beltone Imagine 17s I’d gotten a year before in no case used REM. That I didn’t know it existed means that I don’t know why not, but prior to that time, I’d also used the locally best rated (Vero ENT Associates) ear/nose/throat doctors during two separate infection resolutions (not included, BTW, in the above thrashing around), generating November ‘22 and May ‘23 and an attempt to sell me new (Oticon or Starkey) HAs; REM wasn’t in their arsenal, so far as I’m aware.

Is there some trick (shortcutting all the unproductive effort) to discovery of providers with REM gear? And presuming that REM “merely” (I know, I know…) results in a better setting of what frequencies are enhanced in the various programs such as HearMax or MyPhonak, but also involves (at least according to your video) 3-6 return visits, before I pull the trigger on these Phonaks I’m currently trialing (due to their Sphere fillip), would you find it appropriate to climb onto airplanes and travel to wherever it is that such a provider exists, renting a car or calling a cab to go meet with same, and then returning, on whatever number of times needed to make this happen (and, of course, spend a minimum $2500 copay or some numbers of times more than that if whatever they’re selling isn’t covered in my insurance)?

I’m not (Grumble, grumble) finding any alternatives to just that…

But, maybe it’s worth it?

In reply to @Skip

@Skip said:

All the ENT audiologists/HAsupplying outfit owners I attempted to achieve REM before starting with the Phonak have said that the REM is VERY expensive - and, none had it. But looking over the audiologist’s shoulders suggest that the “Target V.unknown” adjustment program had the equivalent.

Reading this leads me to thinking you need to start looking for a new fitter that does .

As far as Target software doing REM you are incorrect. What Target does is insitu fitting, not REM. To have REM done it takes a separate piece of equipment that tells the fitter what the actual sound levels are at the eardrum. Then the fitter can adjust gains as needed to reach target prescription.

In reply to @Skip

@Skip said:

All the ENT audiologists/HAsupplying outfit owners I attempted to achieve REM before starting with the Phonak have said that the REM is VERY expensive

They charge enough that I’d expect state of the art equipment and performance of best practices. If they do “good enough” for some of their customers/patients, and they are happy with that, I guess caveat emptor?

I had a couple oral surgeries earlier in the year. In preparation for the surgery, the surgeon relied on a 3D model of my head, and explained the engineering behind what he needed for it to be successful, and how he determined that looking at the model. I was a bit blown away that he had the equipment in office to generate that. But I was paying the rate for the procedures. I’m thankful my dentist referred me to this guy. If I knew someone else was practicing without the best tools, maybe they do “good enough” but I couldn’t say I recommended them over someone using the better stuff. Maybe you can do ok with a couple flat X-rays. I dunno. I can’t see the surgical practice coughing up the money for that gear if it didn’t give them confidence in doing a better job.

That’s what gives, confidence that you know what is reaching the eardrums. Maybe not your final curves, but you know you aren’t under fitting or over fitting any place without being intentional.

Some in Europe have discussed international “holiday” trips to get in another country where they can get lower enough costing HAs it pays for the trip. Maybe a good fitting would be worth a trip for you? Especially if there were other benefits to taking the trip.

WH

@WhiteHat said:

Some in Europe have discussed international “holiday” trips to get HAs in another country where they can get lower enough costing HAs it pays for the trip.

My friend from Pakistan bought her Dad over to the UK as the UK is way cheaper to get then over in Pakistan.

Paying for the flight and the HAs, was cheaper by far, then getting them in Pakistan.

In reply to @Raudrive

@Skip said:

(None of) the ENT audiologists/HAsupplying outfit owners I (contacted while attempting) to achieve REM (clip) had it.
(clip

@Raudrive said:

Reading this leads me to thinking you need to start looking for a new fitter that does REM.

(clip)

Well, I did that before giving up, as noted, limiting my search to a 100 mile radius.
I was looking for some selector which would allow me to expand my search beyond that radius which wouldn’t involve both searching out and then calling each of them, only to learn that, “No, sorry, we don’t have .” “Howcome?” “Too expensive…”

None of the ones we found ( per one of the providers here, probably in a different thread, but failing at that we started calling providers, too, due to the paucity of ENTs in our radius) - HA providers and the original ENT targets - had it.

HOWEVER…

I searched, this time, for “REM/Real Ear Measurement near me” and got a single result (https://yourhearinglink.com/1). That one was cited in the search results: the website has a specific reference to REM.

Going to their website, however, had an identification that they used, instead, “Speech Mapping” which was cited as far better than REM, being newer, here: Real Ear Measurements vs Speech Mapping | MEDRX1 (that’s not their website, but me searching for Speech Mapping). It happens that they also sell Phonak, though it’s unfair, I think, to change horses in midstream - but perhaps I can buy their audiology services, presuming that they’d also have the Target software.

OY!!

But, as we await the reopening after the Labor Day weekend, I’d appreciate knowledgeable commentary on Speech Mapping, as this is the first I’ve heard of it…

Thanks, y’all!

@Skip said:

Going to their website, however, had an identification that they used, instead, “Speech Mapping” which was cited as far better than REM, being newer, here: Real Ear Measurements vs Speech Mapping | MEDRX (that’s not their website, but me searching for Speech Mapping).

and are the same thing I believe. Speech mapping is the act of adjusting gains to the prescription per the REM equipment.

That’s good news they do Phonak. You just may have found better hearing. I sure hope so.

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