Debating hearing aids, OTC hearing aids, or just muddle through

But you don’t have reverse so that’s probably the biggest reason they didn’t explain it to you,

@fitzie63 said:

Am hoping that either the Jabra 30 or Phillips 9050 with A I might help.

Not for you right ear, you need UP,or you should just use frequency lowering, this could help.

I agree with tenkan. You at least need a UP receiver with a custom mold. AI etc likely won’t make a huge difference. Consulting with an audiologist would probably be ideal, to at least discuss your options in depth. Then you could make a decision. It’s just hard to tell online if traditional amplification is your answer, especially if your WRS scores are very poor on audiometry. (Sometimes flat losses like your left ear are indicative of inner hair-cell damage and subsequently low WRS scores which may be difficult to correct with traditional hearing aids. In addition, just the pure severity of your right loss is probably associated with inner/outer loss which is also hard to correct with traditional aids.).

There is an answer for you, but we won’t arrive at it online. You need a good audiologist. I would consult with an independent one, not at Costco, even if you don’t get hearing aids from that audiologist.

Agreed with that: due to the Asymmetry and relative power needs.

Also there’s likely to be some issue with how mixed that loss is.

Might be nice if we established whether that test was done with headphones or inserts too.

@Um_bongo said:

most of the hearing aids on the market won’t fit this loss well without throwing out the fitting prescription and working from scratch. Also, fit verification like REM is necessary, but you’ve got to go somewhere where they have enough experience to ignore the REM result and include (like 60-70%) of your preference for loudness/background noise management.

Could you explain this in a bit more detail?

What is it about an in ear that is preferable to a RIC in this case?

Finding that balance is particular to each person so it may not be possible to generate a good final fit from any hypothetical fitting rationale?

@Um_bongo mentioned Oticon Zeal which is an in ear not a BTE.

Um Bongo was talking about the original post on this thread. Later we were talking about some worse audiogram in which the Zeal would not be strong enough. Could you post your audiogram?

As far as the fitting. Yes, there is only a roadmap for reverse slope. A single prescription like NAL-NL2 will not work without adjusting individually.

@DrJimmyJoeJimbob said:

Briefly, in reverse slope loss, amplifying just to REM NAL-NL2 prescriptive target often leads to the low frequency drowning-out the high frequency speech sounds. This is called upward spreading of masking. (Simplistically, vowels over-ride many important consonants.) Often the low frequencies need to be under-amplified a bit and the upper frequencies need to be over-amplified. But this is widely variable among individuals. It’s always a compromise.

Thank you for explaining this! During my initial fitting, my Costco fitter suggested adjusting the equalizer from the app to increase high and medium frequencies while decreasing lower frequencies if I needed better speech clarity. I wasn’t sure why this would help since my hearing loss is more severe in the lower frequencies, but it makes sense now.

I didn’t mention in my earlier post, but I did return for additional adjustment appointments twice. I’m not sure exactly what changes they made, but I expressed my concerns, and they addressed them.

Do you know about ‘Widex sound’ ?

This was an established basis of reproduction with fast attack times and slower release times. This gave full digital with some aspects of analogue reproduction. This worked for many users over a decade or more.

Several manufacturers have gone different ways subsequent to this, but it comes down to how you you manage slow and fast parts of speech combined with low frequency loudness management.

All of this sits over the lens of your current preferred AI and prescription algorithm of your choice.

Yes I’ve actually tried the zero delay “pure sound” from Widex, it certainly made a difference for music but for me not so much in every day settings, yeah why only Widex has developed and kept this is beyond me, maybe Signia will follow (borrow) this now that Widex has become the owner, if we could take just one single thing from each of the big 5 brands that actually work and combine that into one HA, if only…

I don’t know much about your WRS percentage in left and right separately and in binaural condition.

If it is below 60% (as a rule of thumb, nothing engraved in stone), it’s recommended to proceed with CI evaluation, which gives more useful information about your hearing.

When WRS is low, probably no AI will help because the inner cochlear cells are dead and there is very small amount of cell which can transform mechanical energy from sound to electrical for your brain.

@nsjmgm said:

Just looking at your audiogram, my first thought is do you need an aid at all.

It’s pretty obvious you are not familiar with audiograms to make this statement or just stirring the pot.

I have to agree Rick, quite a bit of low frequencie loss in that audogram which HAs would help.

I agree, and audiograms sometimes don’t provide the complete picture.

Please explain: WRS. Thank you