Cookie bite struggling with quiet voices

I have to put my 2 cents worth on this. Cookie bite hearing loss is a challenge to fit with hearing aids. I have been wearing aids 20 years, and only in the last 5 or 6 years have I had aids and the proper fitting. It takes being patient and having a patient understanding audiologist that is willing to spend countless time insuring that fit. And actually helps if that audiologist has a cookie bite too, then the audiologist understands the complexity of the fitting. I have worn nothing but the top tier aids from Oticon for the last 15 years and that has made a definite improvement in my hearing. This Friday my audiologist is switching me to Phonak Spheres, something he has been hinting at since the Spheres became available on the VA contract. Yes I am a veteran with service related hearing loss, and my aids are provided to me. I couldn’t have afforded my aids and the countless appointments and adjustments any other way. Your hearing loss is even more complex than mine. Be patient. With my Oticon aids, I have the TV adapter, connect clip and EDUMIC, they all help me survive in a hearing world where even my wife doesn’t understand why hearing aids doesn’t fix my hearing like glasses fixes vision.

@cvkemp said:

in a hearing world where even my wife doesn’t understand why hearing aids doesn’t fix my hearing like glasses fixes vision.

Oh, yes. People with good hearing do not understand how complicated the process is. I’ve just started wearing hearing aids, and I’m already getting comments from people close to me like, ‘Why are you wearing them if you still can’t hear well?’ or ‘Did you buy them or are you still trying them on?’ When I say I bought them, then: ‘Maybe you should have tried some others?’
By the way, I tried 5 other brands.

Over my 20 years wearing aids, I have found that the correct audiologist is more important than the brand of aids or how advanced the hearing aids are.

The nightmare for me is women’s voices, so high pitched they sound like cartoon characters. I know this isn’t what you were talking about, but I don’t know where to enter my problem.

Serious question:

Did you get a proper masked bone conduction result on both sides? And was it entered with your loss.

Aside from the REM which you should have been checked with, your basic prescription is massively dependent on the degree of the mixed loss. 5-15 dB it doesn’t really matter, 15-45dB the prescription is significantly altered.

We use an audiology system that automatically enters the BC values from your test, directly into the fitting algorithm. If you haven’t been tested like that or it’s not been entered into the fitting software, there’s going to be a significant shortfall.

Also: get yourself some custom receiver shells, vented if necessary and looking at your loss: power receivers. You’ll get a more solid sound and provided they are fitted deep enough you’ll lose the occlusion.

No, the OP on this thread, not you.

Also it doesn’t change the approach: fit with the right receiver, and then REM to a decent target.

I don’t mind you bringing up the problem here, but you should definitely open a new thread so more people can answer you.
You should also enter your audiogram.

When I first noticed tinnitus, 13 years ago, I thought I could hear well. Then it turned out I had hearing loss, but it wasn’t as dramatic. At that time, no one mentioned hearing aids or surgery to me.
It wasn’t until a couple of years ago that I started to notice that I couldn’t hear well. I consulted an ENT doctor who performs stapedectomies. She said it was too late now. In fact, she said, ‘we wouldn’t get satisfactory results’.
Besides, I’ve read some studies and a lot of patient experiences, and it seems to me that ‘successful stapedectomies’ are rare. Quite often, there is no improvement in hearing. Even with ‘successful’ stapedoctomies, tinnitus often increases, or even occurs if it was not there before. And believe me, my tinnitus is so loud now, I don’t know how I could stand it if it got louder. And I don’t even want to mention the other side effects that can happen.

So when I heard that a stapedectomy was not an option, it was somehow a relief. If it were, I couldn’t decide to go for it.

Hm. The stapedectomies I’ve seen have been largely very successful. Perhaps we just happen to have a good surgeon nearby.

With that degree of conductive loss in the right ear I’d be tempted to put an SP BTE on that ear. But if you want a RIC then at the very least you need a custom tip with a power receiver (or ultra power if you’ve got big ear canals). Vented custom tip is a good idea for the left as well. Open dome on the left cannot support that low frequency loss.

@Neville said:

I’m going to assume that the right bone conduction has actually been appropriately masked

Looks suspiciously like the shape of the contralateral loss to me too.

For the OP did you have a large proportion of the test listening to white noise in your better ear while they tested your worst side?

Yes.

I reviewed some other audiograms that were taken over the past 6 months at different locations. All show very similar results.

Ok, you’re going to need to get a hearing aid fitting that’s basically doing two different things.

The left can be quite ‘light touch’ affair: medium power receiver, dome/custom tip with appropriate venting for comfort and lack of occlusion.

The RHS is going to need to be a C-Shell (or equivalent) with a pressure vent only just to get it to sit without putting sealing the canal completely. Most programming SW is going to handle the mixed loss ok, but you’d want to be REM’d for level, and potentially for CROS masking through your head: ie where your ‘good’ cochlear picks up the reproduction from the other side - not always a negative, unless it contaminates the clarity of the better ear.

Thanks again for the tips, @Neville and @Um_bongo . I have my next fitting session in about 2 weeks, so we’ll see what’s available and possible from all of that.

@Neville said:

a custom tip with a power receiver (or ultra power if you’ve got big ear canals)

Unfortunately, my right ear canal is very narrow.