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Oticon More 1 speech-in-noise programming suggestions?

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Edited

I’ve had my More 1’s for a few months now. I’m still not satisfied with the fitting, though. I have an audi appointment next week which will include a full hearing test and . I don’t expect any huge changes but we’ll see.
I have been going to some loud bar/restaurants again, and of course, I’ve been paying attention to how my perform. Subjectively, it seems like when I increase the volume a couple of notches to try to hear someone sitting across from me over the loud speech noise, the background speech noise is amplified too. With my previous Oticon Opn 1’s my go-to action would be to to bump up the volume a couple of notches in that situation. Doing that with the Opn seemed to help more in those loud situations than doing it with the Mores.
Noise on either side seems to be almost as loud as the speech directly in front of me that I’ve been trying to hear. This is the case even when using the speech-in-noise directionality program my audi set up.
I have been thinking of asking my audi to set up a really extreme program that would minimize sounds on my sides and maximize speech in front of me. I’m figuring that if that program proves to be too extreme we could back it off a little. I feel we are not even close to the setting I would need in order to have background speech minimized and targeted speech maximized. So I feel that it would be best to start out from an extreme fitting and back off, rather than take incremental steps toward that extreme fitting. I hope this makes sense.
So I’ll put it out there: Do any of you have any suggestions as to what I could suggest to my audi that he do to get the programming where I’d like it to be? @cvkemp and @Volusiano, you guys have been really helpful to me, so I’d especially appreciate any suggestions you’d be willing to offer. Thank you, everybody.

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Edited

If you’ve been able to get better speech clarity with your OPN 1 by bumping the volume up a notch or two, but not with the More 1, then I’m guessing that the settings in your More 1 is not optimal like the settings in your OPN 1. The More 1 is supposed to be better at this than the OPN 1, even if not by a lot, it shouldn’t be worse.

Below is the screenshot for the built-in Speech in Noise program AS IS, before any changes are made to it. As you can see, it is set to the default max of only 8 Neural Noise Suppression for Difficult Environment. For the More 1, you can enjoy up to 10 dB of Neural Noise Suppression, so I don’t know why Oticon chooses 8 dB for the max value. It should have been set to 10 dB, ESPECIALLY for the built-in Speech in Noise program. If your setting is at 8 dB there, try to change it to 10 dB. It won’t always use 10 dB. If there’s less noise, it should be smart enough to use less. But if there’s more noise, it’ll use up to 10 dB suppression. And while you’re at it, also set the max Neural Noise Suppression for the Easy Environment to 4 dB max value as well. There’s no reason to set it to only 2 dB there. That’s like crippling it to the equivalent of the More 2 by doing so.

You can also change the default of the Sound Enhancer to Comfort or at least Balanced to suppress the surrounding sounds a little more. The default value of Detail may let you hear more of the surrounding sounds than you’d like.

Finally, instead of Neural Automatic for Directionality Settings, you can try to change it to Full Directional to block out the surrounding sounds more and focus more on the front. The default for the built-in Speech in Noise program is Neural Automatic, unless your audi has already changed it to Full Directional. But that would be a permanent change on the program. You can do the equivalent of this by enabling the MoreSound Booster feature in the ON app, which is the equivalent of setting the Directionality Settings to Full Directional. But at least here, if you turn off the MoreSound Booster in the ON app, you’ll be back to the Neural Automatic if that’s what you still have kept for this program.

Another change that you can do is to go to the Fine Tuning section → Sound Control to change the Soft Sound Perception to Detail. The Brightness Perception can be changed to Brighter, but since you have a cookie bite kind of loss, I’m not sure if Brighter sounds would help, though.

One other thing to notice is that you have a cookie bite hearing loss. which is especially tough to fit. If your audi did for your hearing targeted toward one of the standard fitting rationale like , that might have neutralized whatever special sauce the proprietary Oticon VAC+ rational may have to treat cookie bite losses. because REM adjustment on VAC+ but targeted toward NAL-NL2 would in effect change the VAC+ program into an NAL-NL2 program. So one thing you can ask your audi to do is to add a VAC+ program but don’t run REM adjustment on it to preserve the integrity of its original fitting rationale. There’s no guarantee that this will help, but at least if there’s a special sauce in VAC+ to deal with cookie bite losses, you can see if it’s helpful for you or not. You can toggle between the default program you currently have that has REM done on it and this non-REM VAC+ program to compare the difference, too.

Beside doing a full hearing test and again at your audi’s visit, I would also recommend asking your audi to do an in-situ audiometry test while you’re wearing the More 1, then compare this to the new audiogram result that your audi enters into Genie 2. This way you can see if the results are close or are off. If they’re off and the in-situ result seems worse, I’d ask the audi to re-prescribe the gain on your More 1 for the in-situ result instead of the standard audiogram result. This should provide a better prescription because it will have taken into account the perfomrance of the actual hearing aids as they’re being worn in your ears.

Good luck with your audi visit.

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I haven’t gotten my More aids yet, hopefully will have them this time next week. But I agree that the signal to noise hasn’t been set to the optimum setting. Now I have to say that after wearing hearing aids for over 16 years I still haven’t found that optimal setting and with my hearing loss I never will. Your hearing loss is similar to mine so I would say we will always be reaching for that next best setting.
My suggestion is this keep a journal with what is working and what isn’t working for you. I always send an email to my Audiologist a head of my appointment with a summary of what is and isn’t working. I also ask some questions about what I would like. I don’t try to tell him what to do but I make suggestions. I also try to be as positive as I can even while pointing out my dislikes. I learned a long time ago not to get on the wrong side of my Audiologist or doctors, while explaining my total dislikes.

I have had my More 1 one week now. I’ll quess that it takes many appointments with Audi untill all settings are good, because there are so many of them. Unfortunately it’s like 65€ per appointment, and two week waiting. So, I wonder why these settings are not in phone App, so user could test them.

What I do and it has really helped; I keep a journal of what is working and what isn’t. A week before my appointment I email a summary to my Audiologist so he has time to think about it, and he normally has either made notes are made changes to the settings he has saved on his computer for my aids. It makes the appointment go faster and better. It also gives him a chance if needed to contact Oticon for help and other suggestions. I know so many say just do the test and make sure the aids are set to prescription and be done with it. That hasn’t worked for me to be able to understand speech. Yes the REM is important but it is only a starting point for my needs.
By the way I get my More1 aids this coming Friday afternoon.

Edited

In reply to @akk

I guess mfgs have to strike a balance between having simple and easy to understand knobs on the phone app for users to tweak, and giving them too much control of complicated stuff that may be beyond their level of understanding and make it prone for them to screw things up, then blame the HA mfg for making bad hearing aids.

I think their approach of not locking out their programming software from unauthorized so folks can do their own programming is a balanced approach. If you don’t want to go through the hassles and expenses of working through an audi, then you can take up the DIY approach, and most importantly for the HA mfg, it indemnifies them from the responsibility of supporting the DIY folks because those DIY folks will have to assume all the risks of screwing things up.

I’m sure protection from liability is a big consideration in giving too much control to the users directly.

And I am someone that wants to be able to just put my aids back in my ears in the morning and not have to think about them the rest of the day. Yes I know it is a dream but it would make life so much simpler. I have better things to do than trying to remember what program I need for this or that environment. Or what program I am in at this time. With my OPNS1 aids I am close to that happening, but not quite there yet.

Have you considered a like the ConnectClip? It’s the best way to get a robust signal-to-noise ratio. I can hear speech really well when my mic is near whoever I want to listen to.

Thank you so much @Volusiano and @cvkemp and everyone for your kind help. @sufhl, the remote mic would probably be a big help, but at this point in my life I am still trying to project to the world (and to myself) that the only difference between me and those who inhabit the normal-hearing world is the two (hopefully invisible) hearing aids behind my ears.
It will be a VERY big psychological adjustment for me to get to the point where I can meet someone and say “Hey would you mind if I put this mic on the table in front of you so I could hear you better?”. @sufhl, If you have already made this psychological adjustment I salute you. I’m not there yet.

The ability to hone into speech in noisy envoronments is something even able hearing people lose with age. I have many friends who have very good hearing but when it comes to speech in noise, they also struggle.

I have long come to recognise hearing aid sales speel as nonsense when it comes to claims in solving this problem.

In reply to @ziploc

Well said @ziploc! It took me years to reach that point and I still hesitate. Once you get there, you are likely to feel so loved by the enthusiastic support of others once you tell them about the mic and you will enjoy conversation with more ease. It’s a journey!

In reply to @Volusiano

I love this insight into the fitting options, thanks @Volusiano. I just got More 1s and love them, but they took away the on-aid mute feature :sob: I get much better when I mute the hearing aid mics while streaming. Has anyone tried the ON app streaming vs. environment volume sliders? They don’t seem to be separate. When I slide down the environment slider it turns down the streaming volume. What am I missing here? Is there a way to easily mute the hearing aid mics while streaming? I can do it with the ConnectClip but for the TV it is not going well.

With the More aids being rechargeable you have to mute the aids using the ON app, or connect clip, or if like me the Apple Watch ON app, or they have a remote control for the aids.

Edited

In reply to @sufhl

@sufhl said:

Once you get there, you are likely to feel so loved by the enthusiastic support of others once you tell them about the mic and you will enjoy conversation with more ease. It’s a journey!

FWIW, I also find this to be true. In fact I have good friends with whom I occasionally have lunch in noisy restaurants. If I’m slow offering them my ConnectClip, they’ll say: “Aren’t you forgetting my mic?”

It’s a nothing adjustment and only as big as you make it. Asking constantly for people to repeat bothers my vanity much more than using my ConnectClip to preclude the need.

But … that’s me.

[Addendum: It’s well to subtly remind the wearer of your ConnectClip that the devices:

1. Cost several hundred dollars
2. Have a delicate microphone array under the metal grille cloth
3. Are not impervious to plum or soy sauce (plum sauce is a killer!)
4. Don’t capture voices effectively when dangling loosely from a collar or lapel.

This may sound like a tall order, but my friends have been curious enough about the ConnectClip that it was easy to cover all this during their “orientation”.

I don’t usually offer a ConnectClip or EduMic to someone with whom I’m not quite familiar. My More1s are capable enough on their own. That said, you can’t beat the clip-on mic in a really loud environment.]

More than likely don’t know and if like my Audiologist at the doesn’t have the time to explain near enough. That is why I volunteer at the clinic to help out with some technical issues. I don’t understand all of the aids or how to set up Android but normally can stumble through the settings and figure it out.

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