Frustration with my Audiologist

Thanks for all the great feedback. At the moment I’m trying to figure out which hearing aid. What would be your recco. I think it’s either the Sphere or the Intent 1.

It’s your preference at the end of the day. All I would suggest is avoid Resound as their frequency lowering technology has been ineffective in my experience and you really need a good one.

Your the only one who knows for sure which is best for you, no one else could possibly tell you which sounds better to you, and you don’t have a complex hearing loss, nothing any HAs/Audiologist couldn’t help you with, yeah don’t let them “rush” you, nothing worse then that, it takes time to fit HAs.

@tenkan, complex doesn’t mean impossible, it means that there is probably going to be a lot more work required to reach an optimal outcome than for example someone with standard presbycusis. Any audiologist would call the OP’s loss complex because it’s asymmetric and profound in one ear with cochlear dead regions being almost certain and asymmetric speech recognition. This the kind of loss that would require the involvement of an audiologist over an audiometrist in my country.

I would refer to you the recent Oticon Intent thread with the OP from Bulgaria before saying “any Audiologist.”

Thanks for being such a great support guys. I love this forum!!

@Kiwicom said:

restaurant

Restaurant isn’t Spheric Speech in Noise program…! Do you have manual program Spheric Speech in Noise? That should be set up by audiologist.

Restaurant is traditional way to dealing with noise - ordinary (non-AI) noise reduction and directionality. Something similar to Speech in Noise or Speech in Loud Noise, but I don’t know much about technical differences between them vs. Restaurant.

How much “amount of” noise do you hear when you turn off haering aids?

Not much different. Or no noise reduction. I don’t think they are programed properly. Seeing the Audiologist tomorrow. Will let you know.

@Kiwicom said:

I have good low end so don’t like the feeling bigger domes.

Good low end is only one part of the whole picture. It is not engraved in stone: “I have good low end, I should have open earpieces”, that’s not.

All depends on your lifestyle and requirements. If you need real improvements in noisy conditions you need to compromise, because unprocessed noise overwhelms processed sound provided by HA near eardrums. Another issue is if your left ears has usable reception of the high frequency (as in my case). If yes - you need proper amplification of them to hear better, especially in noisy situations.

To provide high frequency amplification, there must be no acoustic feedback, so again - there must be more occluded fitting.

Every antinoise feature (directional mics, denoising algorithms) works better if processed sound doesn’t compete with unprocessed noise.

There is also sometimes problem with comb filtering effect, which can be prevented by less open earpiece.

There are interesting blog posts about openness/closeness of the acoustic couplings (translated by web browser):

Comme neige au soleil

34, 35, 37°C au mois de juin… tout va bien ! Les derniers glaciers fondent dans les Pyrénées, et se décrochent dans les Alpes. J’arrête là ce climato-alarmisme pour me consacrer à un su…

and

HOWEVER,

if you don’t take part in conversations in noisy places very often, and your priority is to hear in silence and better sound localization - then you can really stay with more open ones earpieces.

So, it’s all about lifestyle - something like person with peaceful, quiet life probably doesn’t need to have top-of-the-line HAs.

You may consider having a trial at another audiologist.

Very informative. Thanks very much for this very useful information.

Do you have P receiver power? It’s written on its side, like e. g. “2P”.

This is what it might look like. Although you would more likely see size 3 and p power instead of zero S.

Phonak receiver10

WH

Thanks. Here you go.

L=1P

R=3P

@Kiwicom said:

L=1P

R=3P

There you go, Power Recs, probable downward spread of masking, occlusion issue and dead-spots.

Finessing these kind of fits requires access to the correct tools, enough knowledge to know what to do, but more importantly enough knowledge to know what not to do. FWIW, you can’t ‘make’ the aids (without an activent) work properly at both 20 and 120dB*. Slopes of more 16dB per octave encounter adjacent channel reproduction issues (it’s one balanced armature/beam) doing all the bouncing around: this means that a single drive cannot handle that amount of differential in the drive power.

So, what do you ?

You either botch it with a bit of `frequency fiddling’ or cut your losses and do what I do: fit Medium receivers, abandon the region headed to the dead-spot, by turning off/down the aid above 2KHz on the RHS. You’ll save your self a whole lot of pain.

Now, here’s a bit of AI to explain the dB scale for you:

How Decibels Work

• Decibels (dB) use a logarithmic scale, not a linear one.

• For power measurements, an increase of 10 dB means the power is multiplied by 10 (\(10^{(10/10)} = 10\)).

• An increase of 120 dB minus 20 dB = 100 dB total difference. [1, 2, 3, 4, 5]

The Calculation

• A 100 dB difference breaks down into ten steps of 10 dB (10 × 10 = 100 dB).

• In power ratio terms, this is calculated as \(10^{(100/10)} = 10^{10}\), which equals 10,000,000,000. [1]

Real-World Reference

• 20 dB: A quiet whisper or rustling leaves.

• 120 dB: A loud rock concert or a jet takeoff close by (the threshold of human pain). [1, 2, 3, 4]

If you’d like, I can explain the difference between sound pressure level (dB SPL) and electric power (dBm), or help you calculate a different decibel differential.

@Um_bongo said:

You either botch it with a bit of `frequency fiddling’ or cut your losses and do what I do: fit Medium receivers, abandon the region headed to the dead-spot, by turning off/down the aid above 2KHz on the RHS. You’ll save your self a whole lot of pain.

Is there a particular test during hearing testing to check whether there are “dead spots” in the range of these frequencies or they are roughly OK, just needing very much amplification?

Or it is: “we just try with more amplification and we’ll see if there will be any distortion or worse speech understanding”?

I ask, because theoretically in my better ear (a bit similar to left ear of the @Kiwicom) I also “should” have dead spots, but I found much benefits from more amplification in that range.

Very creative solution with M receiver and cutting amplification over 2 kHz. Like that out-of-the-box solutions. A bit similar to the hybrid cochlear implant idea (CI electrical stimulation for the high frequency, HA amplification for the low in the one ear).