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Need help with target and fitting for gains

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Edited

Hello!

So I got phonak target a few weeks ago and I’ve just been fiddling with it, learning all that jazz

The more I learn it the more I’m discovering how badly my aids are programmed,I’ve got a target gain of 8db yet my actual gain is like 30? (How do I even fix that?)

Anyway not the main priority I have discovered a discrepancy in the Insitu testing/ direct and I’m a bit stuck on what to do

So all my gains below 1k are amplified correctly but anything below it drop off massively,to the point 3k is showing nothing

I’ve tried turning off all noise cancelling and feedback suppression I could but nothing changed, perception improved when phonaks in ear estimate hit 40 but nothing noteworthy enough to see (if we assume it’s not a tech issue)

I’m hitting feedback thresholds and I can’t seem to make them go higher either

I feel incredibly confused and stuck, I’m currently in a large tulip which barely just fits,small vented domes just made everything muddy.

I don’t know where to go next,I can’t get a real ear measurement as nowhere is doing it,I don’t qualify for molds as my loss is “mild”

So my only real options is changing the receivers which I don’t really fancy or power domes.. (not appropriate)

My lows have a 20db loss While the highs sit between 35-45

Audiogram direct12

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It’s hard to make any sense of what your saying, lots of variables to consider, like what formula, experience level is used etc.

I’d start from the beginning, a new fitting. Enter your audogram manually and pick experience level, try NAL formula and let target sort the rest, don’t make any changes to begin with, is a work in progress.

Sorry I’m just an idiot

I thought the direct was testing my hearing while aided

Yay back to the drawing board of nowhere because nowhere does rem..

@IGoMoo said:

I thought the audiogram direct was testing my hearing while aided

Well yes in a way it is, but just as an experiment I wanted to see what your thoughts would be on doing a complete new fitting in target to see what your results will be, I believe it’ll be quite different.

@IGoMoo said:

Yay back to the drawing board of nowhere because nowhere does rem..

Yes you’ll be going back to the drawing board, but definitely not to nowhere, you’ll be going “somewhere better” and don’t worry about it’s not required to get a successful fit, remember it’s just another tool in the tool box and isn’t going to restore your hearing or anything magical..

Edited

Aided Being it just compensating for the fit right?

I don’t think they’re super wrong but it’s the little things adding up like the targets

I know in reality I’m hitting limits with my current setup,feedback fresholds compression ect and a max gain of 50.

But it’s what avenue to persue regarding that

Edited

I honestly would not know how to tell unfortunately I’m still very new to this,I’m trying to read as much as possible sorry

All I know is that in my first ever fitting I hit 110% of gain and didn’t even blink which in hindsight was a massive red flag

Yeah something is not right, could you post your audogram as this will help everyone offer advice, some screenshots as well.

I’d start a new fitting from scratch, have you tried the In-situ audiometry in target to see how much difference there is from your actual ? No point in just going in blind, need to get these basics right first before proceeding further.

Sure

Lol that first ever fitting they stuck me in open domes,two years of hell and constantly going back to figure it out myself

I did the Insitu, tried different domes and everytime it kept underpowering me to the point I felt my actual was maybe more accurate

Audiogram20

Blurry gains

Hmmmm that’s just the left side, and if that’s correct why do you think you’d actually benefit from , as in 35db from 3000Hz up is not like it’ll be difficult to hear a conversation right, or is there something else going on? is the right ear normal or completely dead? I’m confused.

In reply to @tenkan

My right is pretty much normal hence why I didn’t share it,I’ll share it here though now

No offense but this is the exact issue I’m having and I do not understand it, something is not lining up

“Oh your loss is so mild” “Well you don’t qualify for aids" -Nhs “Well if you were 80 I wouldn’t be giving them"

“Well since your mild you don’t hit the criteria for support”

“We’ll never ever give you molds,your best fitting would be open”

It is around and around the same thing that is why I’ve ended up looking into it myself

Without my aids I rely on lip-reading, especially considering where I am everyone is soft spoken

Sorry for late reply, only just seen your post.
Have confidence in your ability to judge.
First use the dome/ tip you are comfortable with.
Use direct and exaggerated your threshold where Target has been wierd.
If you selected long term user at 110% then go to 100% for continuity testing.
Be sure to do loudness level.
You didn’t mention real ear / feedback test results were they impinging on your gain curve?
Experiment with gradual increases in audiogram direct
Experiment with different fitting formula. Note A/D seems to work best with Phonak formula.
Have you become familiar with the media samples to compare your settings?

Edited

Sorry I’ve only just seen your reply

I’ve read up some more and experimented since then

I’m going through be honest I still have no clue how to adjust user length time I’m just still at 110% gain,I’m coming up 3 years now

I know I need about 7db in the highs spread out and 5 in the mids but trying to calculate app to programming is hard

I don’t have a rem because my audiologists for some reason don’t?

I did link the feedback test pictures but that was before Imgur died in the UK so apologies

That’s actually my biggest issue at the minute is the feedback measurements,i can’t get the threshold to go higher even with a more so I’m stuck with 21 gain for a 45 db loss

(It just keeps increasing the lows)

I can do overtuning which helps but the compression becomes a nightmare..

Oh and and trying to set it all automatically it’s underpowering too much I can’t hear anything

Media samples and any of the speach isn’t really working,eg for a distance I needed to push my aids up to the absolute max to understand it

I’ve currently got a large tulip and an open dome but I’m just hitting the roof with both of them (uneven loss)

The irony of all this is I’ve started looking into the paediatric fittings as taking a guess in the dark most of the settings are based for the average 50+ year old (no offense)

Hi,
I assume you have Paradise or newer because you mentioned overtuning.
Target is not easy to manipulate some things as it does hidden stuff.
You don’t need acclimatisation as you want more gain so forget that.
If you have domes then you have receivers so block the microphones with blutak and do the feedback test.
Use direct and increase each point by 10db when you are sure you hear the tone.
Gain rule is 33% for S/N and 50% for conductive so 21 for 45 is about right.
Try various plots for AD and also try using your audiogram as a base for AD.
Pediatric might be a good prescription eventually as it gives more gain but for now you need to establish a foundation, use adaptive digital at 100%(long term user).
If you still can’t hear the media samples then something is wrong, that will be the next step. Your loss is very low compared to most on here so no need worry.
I’m asking @tenkan to check my working as I’m no expert.
Please do as suggested above and report back.

Hello!

so I’ve been back and forth with audiologists, trying to figure out what on earth is going on,turns out I have hidden hearing loss hence the media player not working correctly (who knew)

But we are still struggling with the feedback manager,I’m having to use the app to bypass it and just tolerate the screaching

Nobody has a clue what to do as molds just give power to the lows :((

And they’re lumity

Hi there, well your Audiologist is not up with the play, but maybe you’ve misunderstood what their trying to do, the most common reason for feedback is incorrectly fitting domes or moulds, so sounds are easily able to bypass the dome or mould, now looking at your audogram your most likely using open domes, so this is quite easy to fix with a good quality audiology clinic, feedback manager in target needs to be “recalculated” your ears need to be checked for build up of wax as this is another common issue, your Audeo Lumity are good and should be easily fit to your loss, moulds do more then just “lift” the low frequencies, but you don’t need them anyways.

My hearing loss wasn’t showing up on standard testing done in the high street ie Specsavers

Suspected cochlear involvement and possibly the auditory nerve,time and tests will tell
(So what I’m hearing isn’t lining up with my )

By the way I did actually manage to fix the feedback manager by sticking my fingers in my ears ironically which proves my point its the fitting not just me

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