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Frustration with my Audiologist

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@Bimodal_user said:

Very creative solution with M receiver and cutting amplification over 2 kHz. Like that out-of-the-box solutions.

This is pretty much what does through technology. If you are not putting gain in the profound areas there is no need for power aids or power receivers. My last couple years before this is exactly what I did for hearing aids. It worked very well for me.

The way I learned I had dead spots in the upper frequencies was with UP hearing aids while running direct on target software. These dead spots would pop and crackle at higher gains that non UP aids would not reach. That’s when I got very aggressive with frequency lowering and bought Phonak Audio and ran P receivers. This proved to do great for my hearing loss. I could have probably ran M receivers but had P’s on hand.

In reply to @Bimodal_user

If you look at the O/P’s , you can basically see the where it is notched to 120dB - that’s a classic dead-spot shape. Lower frequency dead-spots aren’t as obvious: there’s more of an overlapping function further down the basilar membrane, though the guys at the ISVR in Southampton U.K. reverse generated (using a Cochlear model and ) the potential Audiogram shapes that might result.

Even a flat 40dB to 2KHz and then a roll off to 70dB can result from a 250-500Hz deadspot.

In reply to @Raudrive

@Raudrive said:

This is pretty much what frequency lowering does through technology.

Except that (in nearly all cases) it either doesn’t do this, doesn’t do exactly this, can do this if you turn off other parameters AND it causes translational artefacts plus distortion in the frequencies you decide to dump the HF into.

Cutting all output in higher pitched sounds does have its flaws, but if it’s only one Ear, done judiciously, it can alleviate lots of potential issues with feedback, eliminate distortion and help with the audibility in the lower frequencies.

@Um_bongo said:

it causes translational artefacts plus distortion in the frequencies you decide to dump the HF into.

Thanks for the explanation, much appreciated.

Would these distortions go away with acclimation?

My dead spots were missed by 3 different audiologist/fitters. I suspect they were not doing something right to miss this very big problem.

@Raudrive said:

Would these distortions go away with acclimation?

If you don’t notice them, you don’t notice them.

Depending on your loss, settings, venting, manufacturer and the level of implementation you might not ever run into these issues.

No competent audiologist should set up a painfully loud fit (been there!). Every aid, even quite old models, include volume-limiting or ‘compression’ that can be set so that even very loud sounds won’t go over the top and hurt you, even if you set a manual control too high. I suggest a shout or two in the clinic to check. And I could suggest a further step - take a mouthorgan so you can check whether the higher tones clog and distort. Simple tone-testing is desperately inadequate. I’m not a clinician but a former sound recordist (uk) who has done time with ’s for 30 years. Good luck.

Quick update. The audiologist told me to think about my options this morning and took the loaner aids back…..I would have been clearly too much work for her….too many question!

So moving on with this. Seeing a new place on Thursday morning out of a hospital…. Hoping for better treatment.

Quick answer:

Open fitting possible (like the Eargo you liked)+ high after 1khz. like 1,8 for Left ear , more for Right ear
2nd step aided per ear.
Assess whether sound recover is needed => Adjust sound recover if required

Result might be disappointing on right ear. Left ear more chances to have a good result

In reply to @Kiwicom

You definatelly need custom molds. They are impressions of your external canals so you should feel them comfortable. You speech scores are not good at all, so I might think that you are used to POWER sensation in your ear and that is not what you need, you need clarity, give the audiologist a chance and ask for a longer consultation. So, you can explain better. are needed, but also your point of view.

Thanks for the advice. The last audiologist set up the Phonaks using an and said everying was “at target” still not that great from my POV.

Saw the new audiologist. She young but pretty awsome. I asked her why most audiologists were woman and she laughed saying the company she works for has 11 audiologists 2 are men!

She did a new hearing test. Pretty bad. Over posted it.

My word scores are 85 right and 35 left. She initially was talking bicross. But we are going to try the intent 1’s and see how they go. I am active and would hopefully like to hear where sounds from especially when driving or riding my scooter.

She says custom mounds but will try done first. I’m bought the Intents used for $800 and a portable charger for $200. She will charge $600 plus $300 for the custom molds.

I don’t she her till the 26th so will report back.

Edited
@Kiwicom said:

My word scores are 85 right and 35 left.

Left ear is eligible to at least cochlear implant evaluation. I am not sure if it is cost effective to buy expensive haring aid for that ear instead of getting . That evaluation can provide much information about your hearing and doesn’t oblige you to the surgery.

You can trial Bicros, but to be REALLY honest:

  1. it wouldn’t provide much benefit and will drain rechargeable battery much quicker.

  2. you deprive yourself of stimulation and training of this ear. That will be deteriorating and making potential rehabilitation with future CI much harder (but not impossible, I’m telling you this as someone who has had a left ear without stimulation for 20 years, before getting CI).

Intents are good, but recently there was new generation of Oticon hearing aid - Oticon Reveal. We will see if it is substantially better than Intent.

In reply to @Kiwicom

@Kiwicom said:

My word scores are 85 right and 35 left.

That’s quite a level of weirdness, given your loss is the other way around: and the possibility of a dead spot. It’s a shame that we don’t get to see (masked) bone conduction and tymp results for both ears too, as it looks like there’s something else happening.

In reply to @Um_bongo

@Um_bongo said:

It’s a shame that we don’t get to see (masked) bone conduction and tymp results for both ears too, as it looks like there’s something else happening.

@Kiwicom, @Um_bongo is right, there is possibility to another reasons of hearing loss, perhaps reversible by otologist surgery (other than the cochlear implantation). That would be checked in cochlear implant evaluationif you really need for your poorer ear.

In reply to @Kiwicom

Those numbers make a lot more sense to me although I’m still surprised at how good the left ear is doing with that loss. I’m no expert but to get enough gain to make higher frequencies audible in the left ear I think you’ll either need a more closed fitting (Power dome or custom molds with fairly small vent) or significant .

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