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Making best use of allocated hearing aid - Siemens "Reflex M" (Artis 2 S VC)

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I live in the UK and as I am sure some of you know most of us get hearing aids allocated through the public health system. Whilst that has some huge financial advantages, it also means your aid is fitted based on a pretty generalised assessment of what you need i.e. mild, moderate, power, superpower or ultrapower, and then based on which manufacturer your area has a contract with. For my hearing loss and location in the country the hearing aid I get is a Siemens Reflex M, which is a National Health Service brand marking for the Artis 2 S VC (with a few very small differences like location of direct input contacts). The aid itself is non-negotiable, so now I need to make it fit my needs.

Next problem is that because I am a wheelchair user I wasn’t able to get fitted at the hospital they use for younger patients and more “complex” fittings, the hospital with access only normally fits people over 60 with the standard age-related mild loss. The audiologist, therefore, didn’t know a whole lot about the aid she was giving me, in fact she said it wouldn’t take a direct input shoe, which is interesting, because I’ve fitted one and it works fine…

So, given that I clearly don’t have an expert in my corner, I am wondering what options there are on this hearing aid to make sure I ask for everything it can do that would benefit me. They do not issue the so I haven’t got any great understanding where my hearing fits in, though I do know it’s an unusual pattern, with biggest losses in the middle range rather than the extremes, it’s mostly in the “moderate” zone on both sides, combined loss, i.e. some SN and some conductive.

Some specific questions are:

  • What programs can be put on the aid and what will each one offer?
  • Can they change it so I can press the program switch with an input shoe on the aid, to flick to M and T (or program 1 and 2) and back to shoe without unclipping them?
  • Can the aid offer DAI and M together?
  • I have double "full" domes, but I really cannot hear my own voice - is this the only option for my loss? Difficult without an audiogram I am sure, but in 24 years of tests they are yet to show one to me. Can they fix the aid up to help me hear myself speak better?
  • Does this aid do anything else I may not know about? I didn't know about hte e2e thing till I got home and one ear was louder than the other and I can't change it cos it alters both sides!
  • These aids all seem to come with a good zoom to help you hear what you are looking at in front of you - is there any program they can set to prioritise what is not in front of you? If I am driving the aids block out my husband's voice and amplify the engine for me! :rolleyes: I also find that I am more likely to miss the fact someone is talking to me at all. I can always zoom in once I know someone is speaking, but of all the things I need the best shot at without lipreading support or context it's people sneaking up and talking unexpectedly.
If anyone knows about these aids that would be really useful to me, as I'm not going to get the best out of them unless I am able to tell them what I want.
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@RoseRodent said:

I live in the UK and as I am sure some of you know most of us get hearing aids allocated through the public health system. Whilst that has some huge financial advantages, it also means your aid is fitted based on a pretty generalised assessment of what you need i.e. mild, moderate, power, superpower or ultrapower, and then based on which manufacturer your area has a contract with. For my hearing loss and location in the country the hearing aid I get is a Siemens Reflex M, which is a National Health Service brand marking for the Artis 2 S VC (with a few very small differences like location of direct input contacts). The aid itself is non-negotiable, so now I need to make it fit my needs.

Next problem is that because I am a wheelchair user I wasn’t able to get fitted at the hospital they use for younger patients and more “complex” fittings, the hospital with access only normally fits people over 60 with the standard age-related mild loss. The audiologist, therefore, didn’t know a whole lot about the aid she was giving me, in fact she said it wouldn’t take a direct input shoe, which is interesting, because I’ve fitted one and it works fine…

So, given that I clearly don’t have an expert in my corner, I am wondering what options there are on this hearing aid to make sure I ask for everything it can do that would benefit me. They do not issue the audiogram so I haven’t got any great understanding where my hearing fits in, though I do know it’s an unusual pattern, with biggest losses in the middle range rather than the extremes, it’s mostly in the “moderate” zone on both sides, combined loss, i.e. some SN and some conductive.

Some specific questions are:

  • What programs can be put on the aid and what will each one offer?
  • Can they change it so I can press the program switch with an input shoe on the aid, to flick to M and T (or program 1 and 2) and back to shoe without unclipping them?
  • Can the aid offer DAI and M together?
  • I have double "full" domes, but I really cannot hear my own voice - is this the only option for my loss? Difficult without an audiogram I am sure, but in 24 years of tests they are yet to show one to me. Can they fix the aid up to help me hear myself speak better?
  • Does this aid do anything else I may not know about? I didn't know about hte e2e thing till I got home and one ear was louder than the other and I can't change it cos it alters both sides!
  • These aids all seem to come with a good zoom to help you hear what you are looking at in front of you - is there any program they can set to prioritise what is not in front of you? If I am driving the aids block out my husband's voice and amplify the engine for me! :rolleyes: I also find that I am more likely to miss the fact someone is talking to me at all. I can always zoom in once I know someone is speaking, but of all the things I need the best shot at without lipreading support or context it's people sneaking up and talking unexpectedly.
If anyone knows about these aids that would be really useful to me, as I'm not going to get the best out of them unless I am able to tell them what I want.

So you get a pair of hearing aids fitted free and they don’t perform as you wish…

…and that’s all I’m going to say.

@Um_bongo said:

So you get a pair of hearing aids fitted free and they don’t perform as you wish…

…and that’s all I’m going to say.

First this is a very common misconception: “Free at the point of delivery” is not the same thing as “free” - all UK citizens have compulsory health insurance deductions from their salaries for their entire lives, whether they want it or not. It’s not free as in you don’t pay for it, it’s free as in paid for by taxes, the same as you guys probably have your trash taken for ‘free’ and your police force provided for ‘free’ and your highways maintained for ‘free’. If you need medication that is an additional charge on top of your insurance, so is all dental treatment, optical treatment, wheelchairs, etc. We cannot switch to a different insurance policy with better coverage that suits our needs, has a better deductible, has a better choice of treatments and hospitals, this is THE insurance package, take it or… ummm… take it, cos it’s compulsory. If you pay in twice as much (i.e. you earn more, it’s not an optional thing) you do not get any extra cover, unlike private insurance products. It’s a better solution for some people, but it’s not a universal panacea.

Furthermore, the virtual monopoly purchase of hearing aids by the National Health Service has driven the cost of non-NHS hearing aids significantly higher than the cost anywhere else in the developed world. Free isn’t as free as it sounds.

And the second thing is that’s not what the question says. I didn’t say I want the aids to do anything they do not already do or that I want to change it for a different one, I asked what they already do so that I can ask them to press the button that switches those programs on! I’ve gotta go to the appointment anyway, and they are going to ask me what programs I want, I may as well know what there is to choose from. That’s not quite the same thing, is it?

I suspect that your NHS fitter will not be happy if you give him/her a list of things to do.

The NHS has its way of doing things, and very limited time for each patient session.

To be blunt, (what they perceive as) ‘pushy patients’ aren’t high on their list of priorities … and they may not even know anything about the features you ask to be set up … but good luck anyway.

Furthermore, the virtual monopoly purchase of hearing aids by the National Health Service has driven the cost of non-NHS hearing aids significantly higher than the cost anywhere else in the developed world. Free isn’t as free as it sounds.

Huh? Our private sector has a wide range of prices … ranging from very low to extremely high. Germany, Switzerland, Australia can be a lot more expensive than the UK.

@EnglishDispenser said:

they may not even know anything about the features you ask to be set up

Precisely why I wanted to know what can be set up so I can ask for it! The thing is, I am more than happy to pay a private dispenser to set these things up if the NHS doesn’t want to do it, but the private dispensers will not touch an NHS hearing aid. So they can lend me a hearing aid that probably does everything I need, but will not activate the “on” switch that makes it do it - we are talking press a drop-down box here! Is it a ‘pushy patient’ if the dispenser says “I’m happy to set this any way you want it but I am afraid I don’t know anything about them - tell me what you want” but then is unable to issue a user manual so I have any clue what I want?

Not everything costs money, some things just cost a small nod of courtesy for another human, yet the perceived free nature treatment is taken as an open remit to treat everyone as if they are scum that waste staff time. When you have a job of work to do for which you are receiving your pay then it’s your duty to do that job in a way that matches the expectations put forward by your employer, the local trust. The trust asks that patients receive this care and the audiologist is paid to provide it. She’s not a volunteer giving her services!

What is the point of spending large amounts of public money to improve the NHS hearing aid issue service to move over to digitals if they then do not program the digital aids to activate their capabilities? It’s a criminal waste to allow people to order expensive models and set them up like cheap ones, isn’t it?

Retail prices might be higher elsewhere, but my German friends get to apply their health cover towards the costs in the same way you can apply an NHS optical or wheelchair voucher to a higher cost product. So the amount they pay out of pocket if qualifying for a state product is less.

I only brought up the whole NHS thing to prevent the virtually inevitable “get a different hearing aid” or “why did you buy it if you don’t like it” and “why didn’t you get a trial period” answers. So perhaps we can stick to the question:

What can a Siemens Artis 2 S VC do?

Thank you.

The trust asks that patients receive this care and the audiologist is paid to provide it. She’s not a volunteer giving her services!

Exactly! That’s why you should be demanding info from HER … not here!

Why not write a letter to her based on your list of points?

In this way, other patients who follow you will also benefit.

As I pointed out (apparently too bluntly) in another thread, the dispensers should earn the their money … and not rely on clients to train them!

Thanks, but I don’t think they will see it that other patients will benefit since I am the only relevant patient. I have made many a complaint about the very old and non wheelchair-accessible hospital that serves the paediatric and young adult audiology clinic. They moved me to a place I can physically get into (that only took 4 years of asking!) but they only dispense aids with no programs and no volume controls. So they know nothing about any other aid. Rock the boat and they will tell me what can I expect if I “demand” to go to the other hospital. You know, the one where I can get in through the front door!! Head-wall

If I had another few grand after having to buy my own wheelchair cos the NHS refused me (apparently being able to walk 2 steps will take you everywhere you need to go in life) I’d just buy my own aids… again. Honestly, you wouldn’t think the law would still allow them to provide hospital services in a place that doesn’t have disabled access, but actually medical care is among the very, very worst! Ah, another letter for the old files. I think I should put my MP and MSP on my Christmas card list.

I suppose the other issue is how do you know if someone is just bluffing to get rid of you and save themselves time? I’d happily ask the woman if the aids can have the program button operated with the shoes attached, but if she says no then I shan’t believe her cos she said they didn’t take shoes at all!

In reply to @RoseRodent

@RoseRodent said:

First this is a very common misconception: “Free at the point of delivery” is not the same thing as “free” - all UK citizens have compulsory health insurance deductions from their salaries for their entire lives, whether they want it or not. It’s not free as in you don’t pay for it, it’s free as in paid for by taxes, the same as you guys probably have your trash taken for ‘free’ and your police force provided for ‘free’ and your highways maintained for ‘free’. If you need medication that is an additional charge on top of your insurance, so is all dental treatment, optical treatment, wheelchairs, etc. We cannot switch to a different insurance policy with better coverage that suits our needs, has a better deductible, has a better choice of treatments and hospitals, this is THE insurance package, take it or… ummm… take it, cos it’s compulsory. If you pay in twice as much (i.e. you earn more, it’s not an optional thing) you do not get any extra cover, unlike private insurance products. It’s a better solution for some people, but it’s not a universal panacea.

Furthermore, the virtual monopoly purchase of hearing aids by the National Health Service has driven the cost of non-NHS hearing aids significantly higher than the cost anywhere else in the developed world. Free isn’t as free as it sounds.

And the second thing is that’s not what the question says. I didn’t say I want the aids to do anything they do not already do or that I want to change it for a different one, I asked what they already do so that I can ask them to press the button that switches those programs on! I’ve gotta go to the appointment anyway, and they are going to ask me what programs I want, I may as well know what there is to choose from. That’s not quite the same thing, is it?

Cool down Alanis, I work in the UK and used to be responsible for training and sales into NHS Audiological departments. I was merely pointing out the irony in using this forum to have a moan about a service which is ‘free at the point of delivery’. I can certainly tell you it isn’t free of charge form the amount of personal tax we (I and my other UK colleagues) get to hand over at the end of this month.

The Artis is a fairly basic aid that gives you reasonable performance and E2E function in most non-challenging environments. Directionality performance will vary in different reverberant conditions, while the noise management and speech sensors my struggle with the challenges of a car (especially if your husband’s voice is in the same bands as a noise source that is being supressed).

In addition the E2E function is probably working against you here - as the aid detection of the 75-80dB of wind noise from the wing mirror area cuts in - it will kill off the low frequency sounds and most of your husband’s voice below 1 KHz - on BOTH aids.

I’d suggest that you either invest in a conversor and use the T position on the aid or you get them to turn off the E2E function especially WRT wind noise management. Failing that stick a program in there that deliberately biases the aids to the listening side, so you can hear better in that environment - again with the noise management reduced and the directional effects limited.

Aids capable of supressing multiple noise sources and amplifying single or multiple speech sources are available, but they cost more than the £56 that the NHS wants to pay.

What you might not realise is the extent to which you lip-read and follow a conversation by context in addition to the performance of your hearing aids. For obvious reasons you can’t concentrate to the same extent when you are driving - in a MORE challenging acoustic environment - this is why you are struggling with your hearing aids.

I really hope you are getting the help you asked for- as tortured as the process seems to have been.

Sorry if this seems tangential to the topic but I hope folks in the USA are following this thread. It should constitute a fair warning about what we can expect here after a few years if congress pushes through the monstrosity of a health care bill currently under consideration. I’m sorry you UK folks are having to cope with all this. The answer to controlling health care costs AND quality is to get government out of the process as much as possible. The scariest words in the English language are “Hi, I’m from the government and I’m here to help you”.

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