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Trialling new aids

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I’m just one week into a 90 day trial of Phonak R-170 aids after 12 years with NHS provided Oticon BTE aids with custom moulds and all I can say so far is that they are ‘different’.
Physically, one issue I have is that the power domes don’t feel very secure in my ear and one has come out more than once. The Phonak device itself is a little smaller and lighter than the Oticon Engage and I am concerned that one could drop out and get lost. Maybe even smaller domes is the simple answer. They seem extremely delicate when inserting and I don’t know how much wiggling the connection wire will stand up to. Unlike the custom moulds and tubes are pretty much indestructible. I’ve not yet completely mastered insertion and removal.

Sound wise, they seem slightly better than the Oticon aids but I do wonder if all they are doing is simply amplifying higher frequencies where my hearing loss is greatest and approaching profound (see my ). This means that ‘sharp’ sounds can be uncomfortable but so far, one-to-one conversation appears to be no better.

I’m lucky to also have some later Danalogic NHS funded (free)BTE aids which I don’t use owing to the ‘sharp’ sounds so I’m not sure if the Phonaks are any better.

Both the Danalogic and Phonaks have more app features than the old Oticons but I don’t consider this too important.

The hearing test for the Phonak aids was pretty basic but the audiologist seemed very knowledgeable and capable so I guess there was a reason for this.

I’m yet to be convinced that the Phonak £3000 price tag is worth it but it is very early days yet and I intend to persevere.

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In reply to @ronshere

It’s not just me then. I have very narrow ear canals which must be the problem. I’m finding the domes difficult to insert and I am trying not to be to brutal with the wire/tube as it seems so delicate.

I didn’t have an issue with the custom ear moulds, they are bulky compared to the domes and very easy to push in firmly. Having said that, I did break one mould but it was around 10yrs old and I guess getting a little brittle (that’s my excuse anyhow).

Thanks for the tip, I’ll ask the audio at the next progress appointment.

The wires are a lot more robust then they seem. In the unlikely case that you do break one, the audiologist can fix it (or even retrieve the speaker and dome from your ear if they have to).

If you aren’t getting the domes in all the way you are probably missing out on some bass which will make the sound sharper. If you’re used to custom earmolds, you may be better off getting custom tips for these, too.

You could be right, Neville, missing out on lower frequencies due to poorly fitting domes would explain why speech clarity isn’t any better than my old aids.

I have Power Domes (medium size I think) and they are much bigger than my wife’s standard small domes. A change to small size could be the answer.

I’m getting quite a bit of feedback noise which indicates poor fitting.

A change to small will also vent the low frequencies if the small domes aren’t appropriately filling your ears, and additionally may increase feedback resulting in an associated limit on the highs. The clinician probably picked medium because it was a good fit for the ear in regards to both of these things, but absolutely if insertion is too challenging it’s not going to work out. But a custom tip is often a better solution than moving down a dome size.

Honestly, power domes often fail. There’s a very specifically shaped ear canal that they work well in, but for many people who have a degree of hearing loss that needs more than an open or vented dome, a custom tip is better. The power dome has to fit quite precisely to work well. If you have a narrow canal then it needs to squish into that shape, a small power dome that is a circle in an oval won’t work well.

But sometimes insertion is just tricky and you can figure it out with a bit of practice. If you have the shoulder mobility to get your other arm up around your head to pull up and back on your ear that can straighten out the ear canal and allow for deeper insertion. Sometimes if fingers are too big, you can kind of catch your pinky nail on the speaker and do a little twirly action up towards the back of your head. Or sometimes you can grab the bend in the wire and tug down a bit and then wiggle up and back and it will twitch around the bend and get in well. But if there are tactile issues, custom tip is often a better option for that as well.

Just had my second update appointment with the audio during the Phonak trial.

Issues raised:

1.Medium size power domes (which are quite bulky) keep popping out, esp. my right ear. I am quite worried that I could lose an aid which would be quite embarrassing.

The audio examined my ears again and fitted a small vented dome for my right ear (it looks more like a tiny tip) and small power dome in my left. So I had different domes in each ear.

2.Getting feedback and a sort of sympathetic whistling to certain sounds and still having problems with speech in a group situation. She made some adjustments on her pc to reduce feedback and (I think) raised the prescription volume setting.

Almost as soon as I left, the right hand dome came out. I deduced that it is actually too small and not gripping the sides of the canal.

When I got home I replaced the rh very small tip with a small power dome same as the left. So far it has stayed in.

While I’m was doing the swap of domes, I temporarily put my old Oticons in with custom moulds and they felt quite comfortable and secure.

The power dome type has a sort of ‘ double flap’ which helps to keep it in but they are all vented.

I am yet to be convinced that the Phonak aids are any better for me than the old Oticons Engage aids with custom moulds.

I have about 60 days left of the trial and I shall persevere.

Domes are totally unsuitable, you already know custom moulds are what you should be using, get them made up to sort all your other issues out, you need to inform your Audiologist what you want done! trying to sort a feedback issue out by “making some adjustments” in the software is not the way to fix it, you should be having some doubt’s about this clinic being able to fit these successfully for you ..

Thanks, you are confirming what I had already began to conclude. The provider is Boots Hearing in the UK and they haven’t offered custom moulds as an option even though they saw my existing Oticon aids moulds at the beginning. . Clearly, there would be an additional cost with custom moulds and I guess it could be substantial even if they could offer them. As I am already faced with around £3,000 for the Phonak aids with domes, it seems a no-brainer. Luckily it is only 90 day trial.

The real clincher is the fact that the NHS-provided custom mould aids were free and I have a choice of using the older Oticon Engage aids(provided by the NHS Audiology department) which I still have or the newer NHS-funded Danalogic Ambio ones provided by M&S Hearing (actually Scrivens) with - for the time being - a free back up service.

What I wanted to find out is if paying would get me better aids, as the NHS is obviously budget constricted in what they can offer patients.

In reply to @tenkan

Having said that, the domes do feel more natural when they stay in, in fact, I sometimes forget they are in and have to check. The domes and the device are more discreet but I’m not bothered about that. Also I have got used to disposable batteries and have many, supplied free by the NHS. The Phonak sound is very similar to the Danalogics, as you would expect as the Danalogics are newer than the Oticon aids. Both have similar app features and adjustments although I rarely use them. I tried listening to the either the TV or the radio (I forget which it was ) with the Phonaks and the sound was incredibly tinny and not acceptable.

Yeah so this is the thing, domes can be okay, but going moulds gives that perfect fit with better gains and of course better feedback control, domes verses moulds will give you quite different results, as for paying more $ will get you “better ” isn’t always the case, now if you factor in Costco which is the place I’d recommend you go, way cheaper then 3k and only the premium models are sold.

Edited

Until I read this forum, I’d not heard of Costco and had originally assumed that were a USA only store but I’ve now discovered they are in the UK too. The nearest Costco Hearing centre to me is 12 miles in Birmingham which isn’t too bad. Wish I’d spotted this earlier.
Most of the big UK optician chains now do hearing but are much more expensive than Costco. However, some are on the NHS providers list if you are lucky enough to already be an NHS hearing patient as I am. Otherwise there’s as long waiting list once you have been referred.

Still talking pros and cons of non-custom domes v custom moulds (I’m talking of the outer ear visible moulds),

I would have thought that theoretically, having the RIC ‘receiver’ i.e. the speaker, inside your ear canal should be better than the custom ear moulds where the speaker is inside the BTE device and the sound has to travel through a plastic tube to the mould. Seems it’s not as simple as that without custom domes?

The tubing rolls off the highs, so it can be depending on the loss and the amount of overhead available. But you can still put a custom tip onto a receiver in the ear.

In reply to @acjm99

Here are my current aids (right ear). New Phonak with small powerdome on the left, NHS Oticon Engage with custom ear mould on the right. You can see how much bulkier the Oticon device is but these particular ones are about eight years old. The NHS Danalogic Ambio aids (not shown) are identical in size to the Oticon device.

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