Phonak Infinio Sphere 90's...One year in and still not right

@Caseycody said:

Last week I sent them back again and I was told when they send them to Phonak they are telling them to replace with new ones instead of just trying to fix them. We’ll see.

I posted a possible solution to the i90 problems you’re talking about. A lot of i90 volume and voice issues are caused by two things: far too many adjustments and Autosense conflicts. The constant adjustments are being made to try to fix the Autosense issues, which usually doesn’t work. This is especially true for people who wear P and UP receivers. Every adjustment corrects for a perceived problem, but those changes can impact other HA sound processing elements.

If switching back to the Sphere default settings, allowing Target to reprogram the HAs to your audiogram and then using only the two custom programs I defined without Autosens in the rotation doesn’t improve the HA function for you, then the i90’s are likely to never work for your hearing loss. And getting 10 pairs of new i90s won’t fix it.

This basic setup should provide stable volume, 80 to 90% of possible clarity, and acceptable but certainly not perfect voice sounds.

If the switch to the Target default fitting and two custom programs makes the aids work better for you, then a couple of fitting tweaks are ok, but 20 will break the fitting again.

I suggested bringing recordings of speech that causes problems with you to the audi visit to let you test each single adjustment after you’re back to basics while you’re in the fitting. This will eliminate a lot of frustration with the going back and forth for both you and the fitter. If a change doesn’t work, reverse it right then, and tell the fitter how it changed the sound.

Having HA issues is frustrating. Hearing is important.

I may be missing some of the background here, but one thing I’d be careful not to overlook is word recognition / speech discrimination, not just audibility.

In my own case, I have Phonak aids that now work extremely well, but I got there largely through very careful self-programming with Phonak Target, repeated AudiogramDirect testing, real-world listening notes, and very small methodical changes. For me, that has been much better than standard clinic fittings or remote adjustments. My ENT has also been supportive of the accuracy of properly done in-situ testing, so I’m not just freelancing from outer space.

That said, I would not push DIY programming on someone who does not want to do it. It requires patience, caution, and the willingness not to chase every bad listening moment with another slider move. A good audiologist is still the right path for many people.

But after significant sensorineural loss, especially if there has been sudden hearing loss in one ear, there are limits to what amplification can do. Speech can be loud enough and still not decode clearly. That is a different problem from simply needing more gain, another dome, or another fitting formula.

So if someone has had 20 fittings and speech is still poor despite adequate volume, I’d want to know: what are the unaided and aided word recognition scores by ear, at appropriate presentation levels? Has an ENT/neurotology evaluation ruled out sudden SNHL or other retrocochlear issues where appropriate?

My own experience is that excellent fitting can make a huge difference — sometimes far more than I expected — but it still cannot fully overcome poor speech discrimination. Hearing aids can do wonders for “I can’t hear it.” They can only do so much for “I hear it, but my ear/brain is not decoding it clearly.”

@Elderly

I was with my dispensing Audi for a year and a half. He had me write an email before each hearing test.

@hearingMac said:

but I got there largely through very careful self-programming with Phonak Targe

As you said, DIY is only right for a small group of HA users.

The majority of hearing aid users don’t know how to properly clean their hearing aids or how often they should clean them. Learning Target is out of the question.

Fitters can’t hear what we’re hearing, so they try to turn less than accurate descriptions of hearing issues into program changes.

Every hearing aid user should have word recognition scores done with no hearing aids and with the hearing aids in. And they should have bone conduction tests also.

Hi Frank, it seems to me that the overall adjustment is too loud for you. Assuming the AuD has done a REM, this can happen if you didnt have a test or update over the 4 years using the old hearing aids. Here are my thoughts:

1. You can adjust the volume of the Sphere through the myPhonak app and through the rocker switch on the hearing aids. You complained about the sound being too loud. Did you ever try to adjust the loudness in the situation yourself? Any result?
2. If the answer to the above no 1 is a no then you better do a speech test (SRT). There is a chance that your auditory cortex, where the understanding of speech happens, has degraded. As you know, hearing loss is a combination of a decline in the thresholds of hearing in the ear (peripheral auditory system) and the cognitive decline in the auditory cortex. You may need some auditory processing training.

I hope the above helps. Please see this brief: https://www.hearingnow.co.uk/learning/my-audiogram-is-normal-but-i-struggle-with-speech-intelligibility-in-noisy-places-why11

Hi Frank. How very disappointing for you ! I’ve had the spheres a similar length of time and after a trial was about to return them when I found out about DIY on this group. I know you’ve said you don’t want to go down that route but just to say the single biggest effect was just by turning off sound recover. It struck me that with you loss you may be used to using sounds recover to reduce the frequency of the high pitches you’ve lost into the lower ones you still have. In my case I’ve lost a lot of the lower ones too and sound recover was neither use nor ornament. You could ask your audiologist to try turning it off and see if it helps.

Something definitely needs to change with the set up though - you should have a significantly better experience with them than you’re describing. The ‘too loud ‘ and fluctuating volume are both things that were driving me mad too.

Mine are now perfectly set up for me. They don’t know I’m wearing them and can hear speech in all kinds of situations that I couldn’t previously with paradise 90s. One example is hearing my husband speaking to me behind me while kayaking !

Don’t give up ! They are amazing aids when properly set up for you.

I also use custom c shell moulds which have a 3mm vent. I use Roger streamer with the TV and stream from my laptop and phone.

Hope this helps. Sandra

Hi Sandra, thanks for the encouragement. I actually have a new specialist that took over for the business I purchased the aids from. She listened to me and I showed her some of the suggestions from this forum and she took it a step further and actually called Phonak while I was there and they went over some changes to make to help with what I have been experiencing, One problem was the prior specialist(#2) made some changes but did not change the setting from domes to custom molds. That alone made a huge difference. It has helped some and I will be going back nest week to do some tweaks and adjustments based on the new settings she used. The volume problem has not reoccurred and voice recognition has improved about 50% The sound is still very hollow and tinny but she says to see what happens over the week while my ears and brain adjust to the new settings.

I am in UK. had mine for 2 weeks and returned them. Added complication was that they messed up my Apple phone. Found Phonak inadequate in every way and much worse than the NHS ones. Latest technology is not always the best for some people. Try a different make or different audiologist!!

Have a new hearing aid specialist that actually listens and is working to make the aids work like they should. She called Phonak for help while I was in for adjustment and it feels like they have helped. Still have some tweaking to do with her but it is night and day difference already. I don’t think it was the aids, but incompetent programming by the specialist for the last year.

Thanks for your post.

I’ve had problems with my Paradise P90R’s since I got them

It’s good news reading your post

DaveL

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I think it was the specialist more worried about getting the aids to 100% power rather than listening to what the problems were. My new specialist has done wonders in the first adjustment and I think with a few tweaks they will be where I need them to be.

So sad reading about people not able to hear because their audiologist either doesn’t know what they are doing or is purposefully cutting corners and skipping important things like REM testing.

My advice is to dump your audiologist and start again with someone else. If you could hear really well with your old hearing aids but not with the new ones…it’s not the new hearing aids. It’s the person programming them.

Just my 2 cents….

Jordan

Fortunately for me he decided to leave the company he worked for and went elsewhere. I now have a new specialist that is competent, listens and understands what someone tells her. One sitting and things took a big turn for the better.

Awesome news! Just as I suspected. The other thing to check is that you can get bad results if you are using the wrong receiver or dome/mold, open fitting vs closed. I was having issues with speech using the M receivers and double domes on my Sphere’s. My audiologist couldn’t figure it out but decided to try P (Power) receivers to see if that made a difference. HUGE! Everything sounded better. Turns out I was pushing near the max on the M receivers and the software was over compressing everything. Swapping out the M’s for P’s fixed it. It wasn’t the audiologist’s fault because the software was recommending M’s for my loss. A good audiologist will experiment and try different things to fine tune your fitting.

Jordan