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Frustration with my Audiologist

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I have been losing my hearing for 30 years and probably before that.

When I was 20, I flew small planes without hearing protection; before that, I raced 2-stroke bikes!

You can see from my that I have some issues.

I wore prescription hearing aids for years but they did not seem to do much. Then, 5 years ago I switched to Eargo (6 and 8) ’s. Eargo is now going out of business, so I find myself at a local audiologist.

First I tried a pair of Signia , then a set of ReSound Nexia. Yesterday I received a pair of Phonak Sphere’s. I had to return the Phonak’s because they did not seem to work at all. Really no amplification. Today I went in, and the Audiologist did a and reset the Phonaks. I left with them and the Nexia’s to try again with bigger speakers in the tips.

My impressions of these:

The Phonaks seem completely underpowered, and going to a slightly noisy shop, I could not understand what the person behind the counter was saying - 70db in that shop - I took a reading on my phone. I had some trouble hearing my wife at home face to face. With the one Eargo in my left ear, I could hear her fine at home.

The Resounds sound so loud that I can hardly handle them. It is easier to hear people talk; however, it is almost painful. I tried to tell the audiologist, but she had another customer, so I will have to wait till next week now.

From reading this forum, I would have expected a good experience with the Phonaks, but I find them completely underwhelming.

My thoughts are that there is some programming issue, or maybe my expectations are too high for my loss. I feel like I should try another audiologist, but this person is so nice and tries so hard.

Any thoughts on my situation would be most welcome.

17 people in this conversation26 min readJump to latest

Are you using domes or custom molds? Although you have pretty good low frequency hearing which suggest domes with an , your higher frequency hearing is so bad that you’ll need custom molds to hear much. What are your word recognition scores? If under 60% I’d suggest a cochlear implant evaluation.

You say Spheres, but are they custom or ? If RIC you need custom 105dB receivers with that loss. If custom you need the UP version.

From what you have described, almost certainly the issue is the suitability of the aid to meet your loss, and the fitting.

Hi MDB. Regular domes. I tried the power domes but I could not handle the blocked feeling I had. My word scores are 68% left and 72% right. Custom moulds are a possibility for sure although I’m not sure how well I would tolerate them.

I’m in Canada and the audio said that I would not qualify for a .

Gulcas. These are a “loaner” says Phonak Trial on them. Not sure what model of Audeo Sphere they are. I’ll ask at my next visit.

Edited
@Kiwicom said:

Regular domes. I tried the power domes but I could not handle the blocked feeling I had.

That “blocked feeling” can be greatly reduced when receiver is placed deeper. Regular (closed?) domes are too open so that you can’t get proper amplification of high frequencies because of low feedback threshold.

Seems you had P receiver. That receiver with Spheres is too weak for you. No wonder you didn’t feel the benefits. Perhaps you could get some benefits with it, but only with power domes or cShell with small vent.

You need UPs (no possibility to get them with domes, only in cShells, which is canal earmold). Look at my , I have the best results with UP in cShell with no vent.

To reduce occlusion effect, cShells should be made from deep silicone impression, reaching at least 5mm past 2nd bend of ear canal.

Unfortunately, even with UP is probably too weak for your left ear. That ear should have hearing aid, like Naida (the newest is unfortunately 2022 technology - Naida Lumity 90) or Resound Enzo IA.

To reap the benefits of high-frequency amplification, you have to compromise. You need an occlusive earpiece to prevent acoustic feedback.

With that you shouldn’t get , with that audiogram and WRS it would be more harmful than beneficial.

Custom tips might help, yes.

UP receiver is probably overkill. Nothing is going to touch the high end on the left side and the degree of venting required to vent sufficiently for 1 kHz is probably going to restrict the highs on the right a bit too such that you wouldn’t get much more with the UP. And the P fit in the ear may be better, which might actually improve the feedback managment relative to the UP. Depends on your ear a bit. Phonak lab in Canada tends to do a nicer job with cShells than with slimtips.

It’s not an easy-peasy hearing loss. What’s your word recognition, how is your speech in noise. You probably aren’t a candidate, but if things were going really badly with hearing aids candidacy on the right isn’t totally impossible and it might be worth getting a referral.

Edit: Oh, you gave your right . Probably not a candidate.

Don’t let nice keep you from good. But I’d probably try with this clinician a bit longer if you like her.

I understand your hearing loss, similar to mine years ago.

Do you actually hear tones in the upper frequencies? Or do you hear off sounds like pops and cracks? Odds are you are not hearing sounds above 80-90 Hertz. If this is the case adding gain to powerful aids in those frequencies will do no good. You might ask your audiologist to increase the () sound recovery on those Phonaks. It just might be what you need.

Good luck with this.

In reply to @Kiwicom

@Kiwicom said:

I’m in Canada and the audio said that I would not qualify for a CI.

An cannot say you won’t qualify for . The only way you will get a true answer is to go for a full CI evaluation. As MDB said the cut off is now 60% globally. My guess is you would possibly qualify

With regard to the Phonak, has you sound recover been fully enabled. By this I don’t just mean the toggle enabled. By fully enabled I mean all the vowels and consonants that sit in your high frequency area, been physically moved one by one over into your low frequency area.

My hearing is a bit worse than yours. My AuD shunted all of them into my low frequency range. It made a big difference to comprehension for another 6-8 months. Then phonaks just didn’t work for me any more. I had to go down the CI route then. Good luck.

Yup. No, the asymmetry isn’t a problem for that.

@Kiwicom said:

Anyone have an opinion as to why the resound aids sound so much louder than the Phonaks?

They’re probably set louder. Not hard to do with the resounds, I find them a bit less flexible.

@Deaf_piper said:

By fully enabled I mean all the vowels and consonants that sit in your high frequency area, been physically moved one by one over into your low frequency area.

Wut? This doesn’t make sense. I do not think works…how you think it works…

In reply to @Kiwicom

Gain averaging. The Resound SW averages more over the full chart and you invariably end up with more lower pitched sound where you tend to judge the loudness around 250-500Hz.

Also have you tried the EasyGuard single Power domes, they’re quite effective with less occlusion.

Additionally; It’s up to you, but I reckon you’ve got a fully fledged dead-spot at 4KHZ on the Right, so I’d consider either turning the aid down/off here or doing a fair chunk of frequency compression to bring this area back to somewhere more audible to you.

In reply to @Neville

@Neville said:

the degree of venting required to vent sufficiently for 1 kHz

Why that venting? For better occlusion tolerance? For naturallness?

Forgive my layman’s question, but, assuming that the goal is the best possible audibility achievable by a hearing aid, shouldn’t we be able to raise the threshold of acoustic coupling as high as possible? (at least in the left side?)

Isn’t that vent could make hearing in noise harder?

Naturalness and sound localization. You do lose some things by plugging up when the ear is still functioning normally at some frequencies.

In reply to @Kiwicom

My word scores are 68% left and 72% right.

One thing that is important would be whether these word scores are with masking noise in the opposite ear or not, and at what level they were tested. Masking would likely be numbers in [ ] brackets near the level it was tested and the percentage correct. Masking might make the word results end up with a larger difference between the ears than no masking.

If they were able to test the response of the eargo’s in a test box or in your ears, that could help some with understanding what it is the eargo provide that gives you more apparent improvement than the alternatives. This might not be an option and it’s understandable if not.

I think depending on how much time they have to spend with you, my first thought would be checking some of those hearing thresholds with the opposite of whatever they were checked with previously. If they were checked with inserts, then I’d try some headphones. If headphones, then some deeply fitted inserts. Looking for any improvement in where you respond.

Edited
@Bimodal_user said:

Okay, I’m not very good at localizing sound at all,

You can with the right practice. I had zero localization for the first couple years bilateral. Then I got out in the yard with the insects, frogs and birds. I would try to find the animal I was hearing. After time localization happened.

Something else that was a great tool and lots of fun is the Merlin bird app. If you can get it in Poland you might enjoy it. Very educational for learning birds and great practice for your ears. It puts your ears and brain to work to hear the difference between birds.

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