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Please help me understand my initial fit of KS10

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Edited

Thanks for all the help I got here with downloading Phonak Target 7.1 software and fitting documents. I spent several hours understanding the Target software and listening to Audiology Online Courses for Target (Welcome and Fitting Guides). I then saved Costco’s fitting and performed my first Initial Fit using following steps.

  1. Input the measured from Costco.
  2. Connected my hearing aids using Noahlink and performed feedback and real ear test.
  3. Did audiogram direct.
  4. Performded Global Tuning using 90% gain level.
  5. Few additional steps like bluetooth at fixed bandwidth and TV connector manual. But no fine tuning.

I listened to TV using TV connector and so far it sounds good, but can not yet tell whether it is better than, same or worse than costco fit.

When I compare Feedback and real ear test that I did with costco, they are quite different. I am attaching my audiogram, which shows that it is a good comparison to the audiogram direct that I measured at home. I am also attaching My Global Tuning and Costco Global Tuning, and they are different.

Can someone please kindly explain how to read these charts? What are all the curves on the chart? I know x axis is frequency, and y axis is gain, but what are all the curves. My tuning is kind of increasing with higher frequency but Costco tuning is kind of flat.

Thank you for any help.

Costco_GlobalTuning.pdf (76.0 KB) MyGlobalTuning.pdf (80 KB) Audiogram.pdf (32.4 KB)

6 people in this conversation18 min readJump to latest
@BeachBoy said:

When I compare Feedback and real ear test that I did with costco, they are quite different

Good on you for taking the plunge on , ok so your not going to be able to get exactly the same as your Costco fitting, but you don’t want that anyway right, so the first thing I noticed is the feedback threshold is quite a bit off, that purple line on the graph is not quite where it should be, so I’m thinking you have an incorrect dome or mould, you need to try and get a bit closer to it, you should be using at least so as to get more gain without feedback, work on getting a better feedback measurement, before moving on. The fitting seems a bit loose.
What algorithm are you using? Adaptive Phonak or NAL-NL 1 or something else. Phonak seems to offer a few.

Your also using SoundRecover2, have you tried the settings without it, just to compare if you like it?
curves on the graph are the G80, G65, G50 gain levels,

@BeachBoy said:

My tuning is kind of increasing with higher frequency but Costco tuning is kind of flat.

Didn’t Costco use semi linear and your using prescribed compression, so that will give the difference. You could change it if you wanted to.

Thank you for your very helpful comments. I will try to work on them.

Meanwhile, to respond, I am using Adaptive Phonak Digital 2.0, with Sound Recover 2. Let me continue to work on improving. I will report back. Kind Regards.

@BeachBoy said:

Input the measured audiogram from Costco.

@BeachBoy said:

Did audiogram direct.

This is contradicting. You do one or the other.

@BeachBoy said:

Connected my hearing aids using Noahlink and performed feedback and real ear test.

Terminology is important. Did you use the Noahlink Wireless? If you did, please say so.

The global tuning page…
Your left ear is way off on tuning. Too much gain for the acoustics or just too much gain period.

I would start a new client and program per Target as designed.

You are doing good.

Just do as Target recommends. Learn Target first. Trying things that you don’t understand will confuse you. Stick with recommended programming for now.

Good luck

Edited

Raudrive:
You are correct, I did input the measured form Costco, but never used it. I input it just to compare with audiogram direct. Also I used Noahlink Wireless.

I did find my problem as pointed out by tenkan. Since then, I used feedback test to predict vent for audiogram direct (I was wrong in my last post, I used dome, but I should have used vented dome).

I am attaching my revised result here. I have left the Costco audiogram just for comparison, but I am using Updated Audiogram direct for the fit.

Should I use vented dome or feedback test to predict vent? Also, should I use any speech boost?

Another question I have is: whether I use vented dome or use feedback to predict vent, my measured audiogram direct is 10 to 15 db less for freq less than 1.5k, but similar above 2k when compared to costco measurements. Any ideas?

Thank you for your help with my tuning. I am learning a lot here.

Updated_AudiogramDirect.pdf (36.1 KB) Updated_FineTuning.pdf (105.3 KB) Updated_RealEarMeasurmt.pdf (43.8 KB)

I need to get back into Target to answer your questions.
Right now I am preoccupied with a brew tomorrow. A new recipe, Rotbier.
Anyway, I will get back to you. Try to stay in line with Target. Don’t sway away from recommended programming for now. You need to learn how Target works before altering the programming. Follow the flow of the software.

Hang in there.

I use thin tubes / domes and aid in my right side for night time.

Even tho I fit in the fitting range of open domes, the feedback test always reduce high frequencies by quite a lot.

I have no idea why but now I use and I can get the right gain in the high frequencies without the feedback test reducing it.

I used large open domes and they felt quite secure and the same with the closed domes, they are large.

@Zebras said:

I have no idea why but now I use closed domes and I can get the right gain in the high frequencies without the feedback test reducing it.

Yeah so this because you need a good tight seal, you don’t want a loose or open fitting, otherwise target will reduce the gain to stop the feedback, which is one of the problems the OP has at the moment.

In reply to @BeachBoy

PXL_20210629_135903748
About 35 gallons of Rotbier.
Brew went well.

Are you having feedback issues?
If you follow Targets guidelines and still have feedback your domes/ molds are not occlusive enough.
As mentioned using more occlusive acoustics will allow more gain without feedback. This will usually make sound much better too. This all depends on your hearing loss.

I have family and friends that get beer from me.
The beer actually disappears quickly.

Crikey…I have to look that up.
Got it!
I brew in a style brought about by the Aussies.

Edited

That brew looks excellent. I did try brewing decades ago. My first brew was excellent, like Heineken. But the second batch got bad, may be I did not sterilize the equipment thoroughly. Anyway, it tasted great, but I got sick after drinking it, had to stay in bed for 3 days. Never did I brew again.

By the way, I did take another dive into getting a fitting from scratch, following Rudrive suggestion of just following target. Without inputting any , I created new session, did feedback and real ear test, used feedback test result to predict vent, and generated audiogram direct, see attached.

Next I did global tuning with 90% gain level, with prescribed compression. I did not use sound recover 2 (now they call it high frequency protect in target 7.1.2). Target suggested speech boost of moderate level, 14. But that gave me a lot of static noise, and I reduced it to weak level of 6. Please check my global tuning and fine tuning attached.

I will appreciate any feedback. It does sound better than costco fit which had used different feedback and real ear test, semi-linear compression, and sound recover 2.

Please let me know if you have any suggestions about how should go next based on my audiogram (severe high frequency loss, and asymmetry in loss).
FineTuning.pdf (92.4 KB) GlobalTuning.pdf (84.9 KB) Audiogram.pdf (30.5 KB)

In reply to @tenkan

@tenkan said:

Yeah so this because you need a good tight seal, you don’t want a loose or open fitting, otherwise target will reduce the gain to stop the feedback, which is one of the problems the OP has at the moment.

But I am in the fitting range on my right side for an so why does it reduce the highs massively? They reduce it so much that I basically have no gain left in the highs.

@Zebras said:

But I am in the fitting range on my right side for an open fit so why does it reduce the highs massively?

Ok so this may well be that your doesn’t show your actual loss, do you use your audiologist test to enter into target, if so, you could try a couple of experiments to get to the bottom of it, one you could use audiogram direct instead and see if this changes from open to closed.

Are you using a std receiver, if so a medium power could probably be a better fit, spread the frequency range out a bit more.

You could also try changing the acoustics to closed but actually leave the open dome fitted, it’s possible you won’t have feedback issues constantly.

One more thing, what happens when you manually lift the frequencies to where you can hear, are you getting feedback constantly or only when triggered?

In reply to @BeachBoy

A quick look at your attachments leads me to believe you are wearing open domes or acoustics that are vented too much.

@BeachBoy said:

I did not use sound recover 2 (now they call it high frequency protect in target 7.1.2)

This is KS9 and KS10 only description.

The absolute first thing you have to do programming hearing aids is set them up properly.
That means the correct acoustics in particular with the correct . This will allow the software to give a good prescription for a particular hearing loss. When set up right there will not be any feedback. If gain is too low because of feedback manager the acoustics are too open/vented.

@BeachBoy said:

That brew looks excellent. I did try brewing decades ago.

Brewing isn’t for everyone. It’s kind of like hearing aid self programming. Art and science.

@Raudrive said:

A quick look at your attachments leads me to believe you are wearing open domes or acoustics that are vented too much.

I looked into acoustics, and it had vented domes. I think that was an error. I started a new fit, and connected the hearing aid. This time it said it was open dome. I redid the steps. Here are my updated 3 files.

Do they make sense to you? Sorry, I am so new to this that I do not quite understand how to look at all the global and fine tuning fit plots. I am searching internet for literature on audiology fundamentals. If you have some good links, please pass it on.

I will appreciate you feedback. I have appointment with Costco on Tuesday, so I will bring that up to my audiologist then. By the way, so far the fit seems OK.

Updated_FineTuning.pdf (79.5 KB) Updated_Globalfit.pdf (78.0 KB) Updated_Audiogram.pdf (33.9 KB)

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