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Recruitment please need advice and help!

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Hello all, after my visit with the new audiologist it has been determined that I do have recruitment, so we didn’t have much time however he did turn down my Oticon Alta pro hearing aids down in compression he said that we need to create in the low frequencies the ability for me to hear some high frequencies , is that even possible? I have to go back to have further adjustments done. now I would think that they would have to be some kind of testing for this to really determine it versus just what I’m saying we have not done any special testing however the complaint I’ve been having for four years match exactly what recruitment pain is and I will say since I have turn my hearing aids down my life is a lot better and pain-free , no I can’t hear everything but one thing is for sure I feel like a new person it even shows in my face I don’t feel so tired and fatigued from the pain and the strain . Here’s where I need advice it was mentioned to me that the Oticon OPNs and other hearing aids work well with hearing loss and recruitment??
I don’t know if he’s just trying to sell me another hearing aid , my Oticon alta pros are in beautiful shape , will they work for my loss and recruitment problem, if they will I would love to try it because I paid $6000 for them also how do I know for sure how to know that the audiologist actually really does have the skills to deal with recruitment are there any set standards are questions I should ask so I can know if he has experience , And also really set my hearing aids to where they can help me and not fool me into thinking that they don’t , just to sell me another hearing aid this has happened to me sadly I just want to try to be the best I can to 1/ feel better 2/ enjoy using my hearing aids especially now that I understand why I have pain it’s really not in my head as my last doctor had said it really is literal pain I feel so relieved to at least know what my problem is , Please Annie and Paul and anyone else suffering like this please anything will help me I’m new to all of this I live in Florida and sadly we have a lot of retirees hear that I really feel for I’m only 48 I’ve been wearing hearing aids for some years now sadly many people are taking advantage of here😪

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Practitioners and people all over this forum throw the term “recruitment” around like it is going out of style. All it means that that things get louder for you faster than they do for normal hearing people. It is a standard feature of hearing loss. Everyone with some degree of hearing loss has some degree of recruitment. No special hearing aids are required for recruitment, they just need to be set correctly within the limits of normal loudness tolerance, which varies a bit from person to person.

If your tolerance for loud sounds is abnormal, (e.g. you find sounds uncomfortable at a much lower level than a typical listener) then you may be experiencing hyperacusis. Hyperacusis can often be treated with sound generators. Oticon, for some odd reason, made two categories of their hearing aids one with an internal sound generator (Alta Pro Tis) and one without (Alta Pros). If you have the latter set, then you don’t have access to an internal sound generator. You could overcome this by streaming a broadband noise from your smartphone over the streamer if you have it.

In any case, you don’t need a pair of Opn 1s just to get a sound generator if your alta pros are working well for you. There are other, cheaper hearing aids that would provide that feature.

No, he’s using the original theory. It is certainly the reason “greater than normal growth of loudness” was given the odd name of “recruitment”, but it’s not supported. At this time, we still don’t have an exact description of the mechanism, so all it is is a description.

Craig Formby gives a nice description of recruitment vs hyperacusis here (my emphasis, DR is dynamic range): A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: Case Evidence Showcasing Treatment Efficacy - PMC36

“For those readers who may be unfamiliar with the phenomenological distinction between hyperacusis and loudness recruitment, consider the corresponding idealized examples of loudness growth shown in Fig. 1. Classical loudness-based primary hyperacusis,4 in association with sensorineural hearing loss, is characterized by loudness growth over a narrow DR between the elevated hearing threshold of ∼65 and an abnormally reduced uncomfortable loudness judgment at 80 dB HL. The corresponding loudness-growth function in primary hyperacusis therefore is much steeper than normal and the corresponding DR much narrower than normal. In contrast, loudness growth for a hearing-impaired listener experiencing loudness recruitment is accelerated for sounds just above threshold, which at higher levels is similar to that reported by typical listeners without hearing loss. The DR for the sensorineural listener with recruitment therefore is reduced because of the elevated hearing threshold, but not because of the reduced uncomfortable loudness () judgment, which is synonymous with and corresponds closely to the .14 Thus, the judgments of loudness by a hearing-impaired listener who experiences primary hyperacusis reflect a steeper growth in loudness than that for either a normal or recruiting listener, and there is no overlapping of the hyperacusis growth function with the loudness-growth functions for either the normal or recruiting listener at high sound levels. Consequently, the DR for a person with primary hyperacusis is much smaller than that of a recruiting listener with similarly elevated hearing thresholds because the UCL judgment for the former is lower than that of the latter.”

In reply to @Neville

Neville,
Thank you so much for your straightforward answer, I really need to do is much as I can about research on this tonight so I can really identify how to enjoy using hearing aids. I did figure that my Oticon‘s would be fine as I mentioned I live here in Florida and Minnie hearing aid companies just want to sell you a new hearing aid yet when you spend thousands of dollars it gets kind of desperate and frustrating however this is where you’re at or me so I have to get over it and keep moving forward thank you so much again still not clear if their special testing for this do you have any input for that or is it just a describe your symptoms and try your best to get down the decibels to find a comfortable level. Thank you again Shanie

If I understand correctly, if one has some hearing loss, one has some recruitment. One has hyperacusis if one has a lower than normal . I assume the testing for hyperacusis is just testing for UCL? Both recruitment and hyperacusis restrict dynamic range: recruitment from the “bottom” and hyperacusis from the “top.”

Yup. Frequency specific loudness tolerance though, so generally where I am whereas is for speech. 80+ would be normal (with standardized two-run testing and proper instructions), although some listeners have LDLs upwards of 110 . In my experience, they tend to be more successful with hearing aids. They have better gain acceptance and therefore better access to sounds and higher intelligibility.

Neville,

Thank you so much for the information, I do see my new audiologist Monday morning, I know my problem lays in the high frequencies due to sensonuial loss , I have had horrible tinnits even before H/ Aids … I would upload my however I asked for it , and still have not received it … Of course I will be taking a new H/Test Monday :thinking: I dont feel sound is overwhelming without my H/sids in my ears , I am finding that after I put them in unless I turn them all the way down by volume pain begins in my lower skull jaw near were aids are insterted neck tightness and so on … yesterday driving someone continued to try to talk to me and dummy me decided to turn up aids to answer firgot to turn them back down and wella major headache, my fault… as I am understanding each decibel must be lowered in the high frequencies for my tolerance and the compression adjusred with the gain turned down , just checking I am really trying to do mypart and be optimistic…

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