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Upgrading to new technology

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Hi, I have profound loss in my left ear and severe loss in my right due to ear infections as a child. In 2007, I got my first hearing aid: an Oticon Delta 6000. I tested them in both ears and decided that I didn’t get enough boost in the left, so I purchased one for the right ear only. I’ve used it without issues for the past 8 years (!). It isn’t great in noisy environments, but it definitely helps me understand soft-spoken people, women, and children one on one. And when I wear it I hear birds and a wide range of sounds I just don’t pick up without assistance.

I’m going to an audiologist today to discuss the latest technology in aids. There are features now that just weren’t available 8 years ago, and, of course, many brand choices beyond Oticon, which I’ve obviously had good luck with. I’ve talked to two audiologist in my area, one prefers Phonak, the other Starkey. Any suggestions on how to decide which brand is the best to trial with? Which features are work the extra cost (the Delta is the equivalent of a Ria, at the lower end of the current Oticon product line)? My insurance company says all aids are basically the same under the cover.

TIA!

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8 people in this conversation15 min readJump to latest

Well, I have a similar loss and find two aids much better. I wear KS6 aids. Hearing is fuller for me with the two aids. Also, the newer technology is designed for features that work best with two aids. If you stick to one aid though, you can get a lower model at a cost savings. My KS6 aids are near the top in quality and are sold at a much lower price than clinic pricing.

Thanks Ken and Brad for your comments and for the link to the thread on the pros of wearing two vs one aid. The audiologist recommended I try two aids as well. She is fitting me with with a pair of Alta Pro . I’m looking forward to reevaluating wearing two aids instead of one – and sampling the newer features from Oticon to see if they help with hearing in more challenging environments. I’m not sure if it’s worth waiting for my insurance company to add the recently released Alta2 Pros, but I decided to go ahead with the order anyway. This time around, with insurance (Amplifon via Cigna), two top-end aids plus the streamer will cost about the same as I paid (with no discounts or insurance) for one lower-end Oticon aid in 2007.

Any upgrade from 8 year old technology should have a big WOW factor. I am quite new to wearing hearing aids, but I am continuously amazed at how well they work.

I’m just going to add my two cents here. My loss isn’t at all similar to yours, but I’m the one who started the other thread (mentioned above) about getting a second hearing aid. I’ve only worn one hearing aid for the last year-and-a-half for exactly the opposite reason you’re describing: my left ear was considered too good to be aided according to my audiologist. But I do have hearing loss in my left (good) ear, and while my loss in that ear is considered mild, the second aid has definitely added extra depth and surround sound to my life. Honestly, I wish I’d done it sooner.

I have a friend who has a more severe loss than you in both ears. One ear is severe and the other is profound. She was told that an aid in her ear with the profound loss would be “useless” so she’s only ever worn one. She decided to trial a second 2-3 years ago and was astounded at the difference it made in her ability to localize sound, as well as her overall ease of hearing. I realize that one person’s experience won’t necessarily be indicative of another’s experience, but trying a second aid probably can’t hurt. If it helps, then great! If it doesn’t help, at least you can say you tried it. As I said, my hearing loss is very different from yours, but I’m so, SO glad I got a second HA!! I love it!!! My hearing is so much more balanced now.

Keep us posted about what you decide.

I’d actually consider your hearing aid severe in the left and moderate in the right. You probably didn’t notice enough benefit with the Delta aid in the left since it fit mild to moderate losses better. I’d guess you’re going to notice a big difference with the Alta aids over your current one. My patients who have upgraded from Delta to Alta have been very happy.

There is another thread here that mentions that the Alta and Alta2 are the same price and you should be able to upgrade at no cost.

Thanks. I did read that thread and contacted my insurance company last week. They don’t cover the Alta2, only the Alta. There is a lag between the time a new product line is introduced and added to the approved list of products that are eligible for benefit reimbursements. They could not tell me when the latest generation of Oticons would be added – it could be next week, next quarter, or next year. I asked my audiologist whether I should wait, and she thought that I would hear a dramatic difference with the Alta Pros (over my aging Delta), and that I should go ahead and try these out and consider upgrading to the Alta2Pros in two years.

According to the Oticon product comparison matrix, the big differences between AltaPro and Alta2Pro features are: soft-speech booster, tinnitus sound support, indium sense feedback shield, and special purpose programs.

Meanwhile, my AltaPros arrived on Friday and I will start wearing them tomorrow! I’m eager to see (hear) how two Alta Pros compare to my single Delta. Based on all your comments in this and other threads, I’m expecting a major wow factor.

Neither ear is profound, per Audiogal. You do need a powerful set of aids though. Either the Oticons with some meaty receivers or something like the Unitron Moxi north Dura.

In reply to @carol_hawkins_aud

Thanks, Audiogal. According to my last few hearing evals, I have mild loss sloping to severe/profound in my left ear, sloping to moderate/severe in the right. When I got my first aid, I trialed with two Deltas for a few weeks and found I could take the Left one out and not detect any difference. If they only corrected mild to moderate loss, that would explain a lot. I haven’t been wearing my Delta regularly for years. I only put it on when I’m in meetings or lectures–or want to hear birds and keyboard clicks.

I started trialing the Altra Pros and Streamer Pro 1.3 yesterday. So far I have mixed reviews. With the default program, I can’t hear birds, dog toe nail clicks, or keyboard clicks, which are my sound cues for hearing with . I can hear them with the music and exact programs if I turn up the volume, but then I start to get a headache from the noise level. When I listen to music, i feel like I’m missing a range of sounds in the upper register and percussion that I hear with the Delta in. I atried taking a phone call through the streamer, and the sound quality was awful, most of the sound was in my right ear, but it kept fading in and out with static and crackling in the left ear. I did sit through one meeting in a conference room with 7 people, and the conversation sound quality was very good and the second aid did seem to enrich the experience. I still turned my head so my “good” ear faced the speaker, but I know that was out of habit, not necessity. I’m taking notes (and reading the Alta Pro related threads) for when I go in to meet with my audiologist next week for adjustments. But honestly, if I had to make a decision today, I would return them and stick with my Delta.

Kgd, IMO you can approach your loss in 2 ways.

  1. significantly extend the range of sounds you can hear especially in your left ear

  2. better process sounds that enter your ears

option 1) can be done best with widex audibility extender technology. IMO it’s the absolute best frequency compression technology on the market. Starkey has a somewhat similar approach but imo widex does it better. Siemens and Phonak takes a different approach to frequency compression.

option 2) can be done via the adaptive beamforming technology that’s the rage on the board via the siemen binax (or their economy rexton emerald or rexton trax 42 line) and phonak venture line.

imo widex vs siemens binax or rexton emerald or rexton trax 42 would have been the perfect comparison for you. note the rexton aids do not have tintinitus support.

widex audibility extender technology imo is something you really need to try some time in your lifetime. if you current audi does not fit widex then ask your audi if you can come back after you’ve checked them out and get credit for whatever penalty is involved for not purchasing an aid.

Thanks, doubledown (and everyone on this thread) for your suggestions. I have my homework cut out for me. I am going back to my Audiologist on Monday for adjustments and she’s going to call Oticon while I’m there to discuss some of the issues I’ve had with the streamer and ways to optimize the settings for my loss. She chose to not use LifeLearning, and instead set me up with a default “balanced” program that she felt would be a good place to start. I requested that she load the other programs that I’d read about on this forum and the Oticon literature (of those available, she gave me: music, exact, and gentle). Currently, I’m spending most of my time in music as I find the default program too “muted”. In any event, I want to give these one more shot after she adjusts the settings before I turn them in and trial one of the other aids mentioned.

I’ve fit all of the above brands extensively, and I would suggest you have your audi do some verification measures. Both in sound field aided, and unaided, as well as using real ear and . I would strongly suggest staying with the Oticon Alta Pro (or Alta2 Pro) over the other brands as speech remains significantly clearer and less distorted. Widex is a good alternative, but Siemens and Starkey and Phonak are all significantly inferior. beamforming is an obsolete technology that Siemens and Phonak have attached themselves to because it sounds fancy, but it is actually just cheaper to do than actual binaural processing, which Alta Pros do. Starkey and Phonak actually distort audio in order to bring it into the range that their devices can process. It may help some people some times, but the problem is that it essentially gets you addicted to THEIR devices because you are training your brain to accept something that is not even remotely close to natural sound. Most likely, the problems you are having are because Oticon devices can be a little tricky to program sometimes. You really have to know their ins and outs. Have your audi delete the bone conduction test results from the fitting , make sure you have minifit85 recievers, the devices should be programmed to use double bass domes, and set to level 3 adaptation. Do NOT run the feedback manager. If you get feedback, use different size domes until the feedback is reduced. Then if you are still struggling, hook up to a real ear test box and verify your settings using targets. That should do the trick. Things may sound different than you are used to with your Deltas, but research shows that new hearing devices normally take between 2-4 months to get fully acclimated to. You can also have your audi use the Oticon optimization system to get the devices just a little more personalized for your hearing.

Edited

I’m curious as to why you are recommending any sort of dome for him rather than an ear mold? I’m not asking this to be confrontational :wink: I’m merely curious. I was under the impression that for most people with moderately severe hearing loss or worse, domes weren’t all that useful. Is that not the case?

Kerry

There are only two reasons to use an ear mold. The first is retention. If the dome will not stay in the ear effectively, and a retention tale/sport lock does not solve the problem, then get an ear mold to solve that problem. The second reason would be feedback. If you have tried a variety of domes and you still get feedback, then get an ear mold. But if you don’t have either of those problems, then use the domes. They are generally more comfortable, easier, and cheaper to replace. With the severity of kgd’s loss, it is entirely likely that an ear mold will be necessary for one of the two reason I just gave. And if kgd already HAS an ear mold, it is just fine to use that instead of the dome if it is comfortable and stays in the ear. The variety of different domes on the market exist for the sole purpose of mimicking the acoustics of various vent sizes in ear molds. So for example, an Oticon double bass dome is designed to mimick an ear mold with a medium (1.2-1.4mm) vent. a single bass dome is designed to mimick an ear mold with a small (.7-1.0mm) vent.

In reply to @JustinHIS

Thanks, Justin. This is extremely helpful! I spent more than 2 hours with my audiologist (most of which time we were on a speaker phone with Oticon Technical Support) last week fine-tuning the programs and trying get the streamer pro to work properly. We made a lot of progress, but haven’t yet addressed feedback issues or some of the questions I have about interpreting/processing speech, which may be more related to training myself how to hear and listen with two aids versus one or none. (In conversation, I still have a 2-3 sentence delay before I understand what some people are saying, which is a bit frustrating for both me and those I’m chatting with. Listening to music is a MUCH more satisfying, rich experience with two .) Although several of the Oticon users on this forum seem to have had good experience with the streamer pro, I think I’m going to return it. We got the music player to work well with Bluetooth through the streamer, but the telephone call quality through my iPhone is still quite bad, IMO. For me, the sound is tinny and grating – and more irritating than helpful. I do like the convenience of the iPhone connectline app, but if that’s all I use the streamer for, it’s not worth it!

Today, my audiologist is going to downsize my speaker wires from 3s to 2s, and we were going to try and address the feedback issues, which is quite bad, especially in the left ear. (I can’t brush my hair away from my face or hug anyone without the HAs squealing loudly.) The first week of the trial, my audiologist fit me with ; last week, she switched me to open domes, which seemed better. I’ve printed out your comments/suggestions to take in with me when I meet with her. It will be really interesting to see how much difference the double bass domes make, if she has them in stock. She told me she doesn’t do a lot of customized programming with the Oticon software and when she does, most of her clients have such different needs/requests that she doesn’t often remember what she did to optimize the settings.

Going to open domes when you have speech recognition issues and feedback on the closed ones doesn’t sound like she has much idea at all…

And that last sentence is very worrying for a professional.

I agree with the last two comments. It is particularly concerning to me for her to switch to open domes to control feedback. Open domes should be more comfortable, but to simplify hearing aid programming down its more most basic extent, it is a matter of balancing comfort with clarity. If you imagine comfort at one end of a sliding scale and clarity at the other end, you realize that the more comfortable you make them, the less improvement in clarity, and the more clear you make them, the less comfortable they will be. The greatest challenge for those of us fitting the devices is to coax people further along that sliding scale toward clarity. But at a pace that the patient can tolerate. Sometimes, in more challenging cases, it is necessary to have regular monthly followup appointments for 3-6 months to slowly ease that process along. We always hope it will be quicker than that, and in MOST cases, it is.

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