Changed to moulds but problems remain

I have over the last year posted a number of posts regarding my Oticon OPN1 hearing aids that I bought last year. I had a number of issues with them which has taken time to work through.

You will need to look at my hearing chart as I have an extremely unusual hearing loss in that lower frequencies are really bad in left and higher frequencies are really bad in right ear.

We are now trying moulds instead of domes. I originally started with double bass vent domes, then moved to power domes, bigger receivers, REM testing etc.

I have only worn the moulds for a couple of days so far so too early to test. I think it has improved the loss of bass and listening on the phone seems better. Movies sound bassier in both ears and general bass in normal environments seem to be more present. In addition, I no longer get any feedback when chewing food which I used to get in the left ear using the domes. I also am not finding higher frequencies too loud in right ear as when on domes. So there have been improvements.

I also feel that listening to music in the car the volume differential while still present doesn’t seem to be as signicant as before and its not so much a volume differential as more a feeling of open range and clarity in one ear compared to other.

We have deliberately not tweaked any settings. We wanted to see what it was like at default. Normal listening environments and listening to music in the car, the volume differential at normal music volumes (i.e. background music) does not seem to be as noticeable as before. However, I am wondering if this is because of wearing moulds, the sound is now completely occluded whereas before my right ear was getting the lower frequencies open and this may have made it sound louder before? In other words, I probably still need to boost lower frequencies in both ears now?

When it comes to movies using the streamer and listening to music on headphones. I still encounter exactly the same problems. Feedback on right hearing aid using headphones and the volume differential between left and right ears is tremendous whether listening to headphones music or using streamer for movies. I very often have right on 0 and left on 3 and right still occassionaly sounds louder - but higher frequencies I think. I do feel that I am hearing more of the lower frequencies now in the left ear. The sound is more balanced in the lower frequencies, but a touch too trebly - but that may be more that my ears are simply not use to hearing the treble so it sounds unnatural to me.

However, I am wondering whether the problem is twofold. One in the past I had the volume differential because the right ear was open and was fairly good at low frequencies and the left ear just was not high enough in the low frequencies. Moving to moulds has fixed this because the sound is now occluded. But all it it has done I think is reduced the lower frequencies volume in right ear not brought left ear up to spec as it were. I think the volume now may be slightly lower than it should be overall. I noticed for example the beep beep sound when you punch in your code on the credit card machine sounds softer now with moulds than with the domes.

The second problem however may be that the right ear has substantial increase in high frequencies because of the high frequency loss in that ear which is making everything sound louder in the right hear because presumably the left ear high frequencies has not been boosted. I had always thought that the problem was that the left was not getting sufficient low frequencies because the left ear low frequencies is really bad.

But maybe I have had two different problems. One is not enough low frequencies in left ear and two perhaps too much high frequencies in right ear is creating a feeling that everything is louder in right ear but its not a volume thing, but the treble makes it sound louder? Someone suggested a while back that I should have speech rescue enabled in left ear because while my left ear was reasonably good for high frequencies, it could be improved by enabling speech rescue in LHS.

I find it very interesting that with the moulds, I don’t find normal environments nor listening to music in the car at reasonable volumes - I am not noticing a noticeable volume differential (like I used to with the domes), although I still feel like the right hearing aid is switched on and the left is not. I have however noticed that if I really pump up the volume of music in the car, then it sounds noticeably louder in the right ear, but it does appear to be higher frequency sounds. Which explains why I only notice this issue now with headphones and streamers as the sound is going directly into the ear at higher than usual volumes.

Interestingly my cellphone in sat nav mode does sound a lot louder in the right than left - presumably because the woman speaking is not a natural sound, but very artificial sounding so probably leaning more towards higher frequencies?

I also commented that I still struggle with d’s, j’s, m’s, n’s and other fricatives because I am hearing it more in the right ear than left ear. The right ear has speech understanding issues in that my brain can’t translate the sound 100% accurately so having higher frequencies too loud in right ear is actually distorting speech understanding. so the other person who suggested Speech Rescue for left may have been right all along.

Now that I have given a complete update on my hearing, aids etc, I come to the questions.

Is this problem more because of Oticon or the audio. I fail to understand why it is so difficult to get this volume differential sorted. I think the moulds have helped with the lower frequencies, but I am unsure whether I should be increasing the higher frequencies in the left ear or lowering the higher frequencies in the right ear or both?

My next question is, is there a better way to resolve this. I find it hard to believe that the only way to fix this issue is to keep going back to the audio, adjusting and endlessly tweaking the frequencies, volume and trying for a couple of weeks and then going back again. Is there not some tests that could be done to identify why the right ear sounds louder than the left ear.

What I am thinking of doing when I go in a fortnights time is taking a dvd and my streamer and getting him to keep adjusting settings while I am watching the video because I can immediately replicate the problem on the spot.

Secondly, maybe what I should suggest is that he set the right hearing aid to just pass through sound if possible with no settings for my ear (we may have to use the dome for that) and then gradually adjust settings on the right till we can identify what change causes right ear to sound so much louder than left ear whilst using headphones or streamer or really pumping up the music volume in a car?

In other words, how I can identify what frequencies are causing this volume imbalance and whether its the right ear that is too loud or the left ear that is too soft? Any advice would be appreciated, because this issue has been very frustrating in that there seems to be no resolution to this problem.

@Sierra said:

When the molds were put on your HA’s were they refitted, tested for feedback, and the REM adjustment done over again? What size of vents are in your molds?

To me you don’t have that big a difference the left and right. Max seems to be a 2 kHz. Have a look at my audiogram. I would expect that when properly set up you should not hear that much difference between your left and right.

They were re-fitted and tested for feedback. He said the REM could not be done because its a mould. I presume the REM does not work with moulds only domes or the type of mould that I have?

I am not sure what you mean by difference between ears, whether you are referring to frequencies or volume. Since getting the Oticons I have always found the right ear sounds significantly louder than left. Especially using streamer or headphones. Now with the moulds, not really so much in normal listening environments - which is an improvement over the domes. With the domes the right was louder than left even in normal environments and I found things like traffic pedestrian beeping very loud in right for example.

I suspect that the problem I now have is an imbalance of high frequencies between the two ears making it sound louder in right. But I could be wrong and I am just wondering what is the best way to identify the underlying source of the problem. Initially I thought it was the dome, but while a mould has helped, the underlying problem is still there. So I am trying to avoid guessing what the problem is here.

I am wondering if I need to look for a new audio. I find it a bit concerning that a number of different people seem to indicate that I should have been wearing moulds for my ears whereas he has frequently stated that it was not necessary for my hearing loss. I definitely think it has helped though. The fact that I no longer get any feedback whilst chewing is a definite improvement. So why does he recommend domes.

In addition, I have always had feedback in one ear or the other with these Oticon hearing aids when using headphones. I have never been able to use headphones with them. Even with the mould, the right ear still is unusable in headphone.

And more than one person here says that REM should work with moulds. Maybe mine don’t have a vent? They are clear plastic of some sort and I don’t see any holes that I could push a wire through. How do I tell if I have vents?

REM test was done on the domes. While it helped, it never actually addressed the volume differential problem either! So while I agree that REM would be helpful in general, I already know it won’t address the problem as we have done this with domes already and it made no difference to volume differential.

@Sierra I am sorry, but I don’t understand what the diagram means. I can see the differences but no idea what it all means unfortunately. Why do you suggest cutting back gain on the left ear. That is the ear that sounds like it’s not switched on compared to right.

What I will do is find out how to buy the Genie equipment to connect my hearing aids to the Genee software and upload the chart of what he has configured my hearing aid for and you can see whether I need a new audio or whether you think he has configured it correctly.

I just don’t know whether my ears are just extremely difficult (as I have never worn two aids before and they are opposite slopes which is very unusual compared to most people - always before I was wearing just left hearing aid) or whether the problem is the guy doing my ears. I get the impression he knows what he is talking about, but this problem of volume difference is never resolved. Surely I can’t be the only person who has this problem and thus it should be easy to fix.