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How to get the most out of hearing aids?

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Edited

As I wrote in another topic, my wife is evaluating a pair of Signia Insio AX5.
The are working, and my wife is happy that her hearing has improved.

But how do you know whether you are getting the best the HA can do?
In addition to settings that are determined by the hearing test, there are heaps of variables (settings) that are not.
I asked the audiologist who determined those settings. She said they are factory default settings from tests and surveys of many users.
Those settings might be ideal for Mr and Mrs Average, but not necessarily for other users.

So what to do if the user wants to know what is the best the HAs can do for him/her?
The user does not even know what all the variables are, what possible settings of them exist. There is nothing in the User Guide on this.

For example - are there any tests the audiologist could run to work out best settings for noisy environment?
The average person won’t be able to describe what went on in a restaurant a week prior to his/hers session with the audiologist. He will only remember that the experience was better or worse than without HAs.

Occlusion is another example. My wife says it is not bad. But when I talk to her while she is eating, she says she can’t hear me because of the loud noises she hears from her own chewing.

I asked if the system should automatically adjust between soft and loud speakers. Our daughter speaks softly, I, having some mild deficiency, speak loudly.
The audiologists suggested that I learn how to speak softly.
I didn’t say anything, but is this the best the latest technology can do, i.e. nothing, or was it a case of the audiologist being reluctant to do something about it.

I would appreciate any comments on this.

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From what you have described, it sounds like your wife’s may need some further adjustments.

Today I watched Dr Cliff on YouTube explain how to get the best out of your HA with Real Ear Measurement. This is something audiologists can/should use when fitting HA. It might be worth a view?

Edited

There isn’t a perfect solution @jfranek43, even if your wife had the best Audioligist in the world, there isn’t perfection available for your wife’s hearing loss, not at present, but perhaps in a hundred years time there possibly might be? You mentioned variables, with hearing loss, they are very diverse…. The biggest one, is we all hear differently, so there is not a one size fits all, no two are the same, a bit like a fingerprint…. If you do get 2 very similar, there will be other variations, like Tinnitus, distortion, recruitment or say Meniers, the point is, they may look almost identical, but they will sound very different…. Now, I have self programmed my aids for many years, and by any stretch of my imagination, I am no expert, but I know enough to get bye, by self tweaking, I can get them fairly good, but never perfect in every situation, so in the end we compromise, hearing aids are in essence, assistive listening devices, assistive being the operative word, unfortunately they will never restore your wife’s hearing to it’s former glory, to me, something like music will always sound off key or out of tune, so I avoid music as much as possible, as it just frustrates me! You mentioned perhaps the “Holy Grail” of hearing loss, the ability to hear in loud background noise, again this will not happen, but it may vastly improve in the not too distant future as technology advances? So, I basically try to avoid social gatherings, or loud restaurants, or try and pick a quieter restaurant, with good lighting, that doesn’t play background music…… I admire your tenacity, and it is commendable that you want to improve your wife’s hearing experience, but what we want, and what is available, is 2 different things entirely…… Good Luck, cheers Kev :wink:

I don’t know how often an audiologist spends time with your wife.

My opinion is that this is not the maximum that a hearing aid can give.

As an example I would cite my childhood experience when I went to speech exercises with an audiopediatrician. He often read something from the book and I had to say it and so I taught the brain to recognize words.

He occasionally programmed hearing aids, and I remember he gave a lot more attention than the dealer who sold me hearing aids.
He often asked me during the programming of hearing aids, is it loud, what is the voice like, are the sounds too loud, do I mind the noise, etc. He was an enthusiastic at work eager to study all the possibilities.

My opinion is that audiologists, at least in my country, do not have audiologists, but dealers who sell hearing aids and adjust them when selling. They are not trying hard enough to achieve my maximum and it seems to me that we are wasting his time because he just wants to sell as many hearing aids as possible.

Of course I agree here with someone who says that hearing aids cannot replace natural hearing and they will never be perfect.

But that’s why some of us set out on a path, to program our hearing aids ourselves, because that’s how we achieve the maximum. Because we know what we hear, we study the possibilities, and we experiment without bothering anyone.
At first I had poorly programmed hearing aids and the hearing aids also had a strange sound when listening to music. I didn’t immediately understand what it was about. I started studying options and realized where I was wrong.

I am still in the phase of learning and studying the possibilities in programming.

Since your wife is still new to hearing aids, I recommend that she write down on paper the events in which she heard poorly, write down how she felt at the time. So try to adjust your hearing aids with an audiologist. The problem with this is that when you come to his quiet office, and program your hearing aid, then you don’t know if anything has been achieved because you are no longer in the same conditions where you are. For example in noise.

Wear them and take notes. All hearing aids usually need adjustments. The is just a starting point. Make sure your wife wears the aids in all types of situations and makes note of what she does and doesn’t like about the aids. Don’t be surprised if she needs to go in for more than one adjustment. Also keep in mind that aids help but don’t fix. There are going to be situations where she will feels the aids are coming up short. The key to this is patience. The brain needs time to adjust to the new aids

There are also various programs that your wife could try out like speech in noise not sure what it is called for the signia hearing aids but they might help with certain situations and it also sounds like your wife could benefit from some adjustments

In reply to @kevels55

I did not make myself clear, I suppose.
I did not mean variables with hearing loss. What I meant are the perhaps dozens of settings in the Connexx program that are at present set to factory defaults.
How to make sure that these defaults, set at some sort of empirical or theoretical “average” are the best settings for my wife?
In other words, I am talking about methodology of how to get the best out of a given device for a given hearing loss.
I am not trying to get Ferrari speed out of a family sedan. Just trying to find out how fast the family car can go.
The best settings do exist, we just don’t know what they are.

With you adjustments, at least you know that your are at the limit.
I don’t want to go into the DIY area. It could impair the 5 year warranty.

I suspect your wife’s hearing aid settings could be improved, but it’s not straight forward. Often changing a setting will improve one thing and worsen another so it’s more about finding a proper balance. Some examples. More gain can be given to soft sounds than loud sounds. It’s called compression. If done to extreme, all sounds end up being the same volume which most people find pretty strange. There are also noise reduction settings, but increasing their strength often worsens speech understanding. My suggestions. Report issues to hearing aid fitter and see what can be accoumplished. If not satisfied, consider seeing somebody else. Try to make this decision before return period for hearing aids expires.

To get the most out of hearing aids the audiologist has got to know how to pull ever last bit of the fitting capacity out of the aids for the person wearing the aids. And that means the patient has to explain as well as possible what is working and what isn’t.

@cvkemp -

I sort of expected that after the initial fitting the audiologist will then do some tests with various simulated situations, and try to optimise the experience.
But it does not look like this is going to happen.

My wife is not a nit picker like me. She would fork out thousands and accept what she is given. She does not understand anything about audio, how work. She hasn’t read any of the material on HA manufacturer websites.

The audiologist is almost inviting my wife to try the Phonak Virto Marvel while she can. I would support that - why not. But before trying Phonak, it would be nice the know the limits of what Signia can do.
Because of the Covid, and us being old and in high risk category, we don’t go out, so that makes it difficult.

I’m glad to hear that :slight_smile: Korcula is one of the islands in Croatia. Yes, Marko Polo was born on that island :slight_smile:

Edited

In reply to @jfranek43

These programs are not something that you would be able to find as your wife’s audiologist would be able to install them on her hearing aids for her and i think they maybe worth giving a try in things like noisy situations. Some examples of programs are speech in noise, music for when you are listening to music programs for tv and calm situtations I’m not sure what else there are but there are a variety

Edited

yes, we asked for some programs, and the audiologist put some in. The Signia can have 6.

The sad thing is that Signia manufacturer does not have the decency to list and briefly describe the available programs in the User Guide.
So it is left to us to ask the audiologist what programs are available, and try them.

There is a TV program there, but the audiologist did not know what it is supposed to be doing, and whether it is for streaming or for plain listening to speakers.
However, we use headphones for TV, and my wife simply puts them over the which are running the Universal program. It works OK like that for watching news.

Similar with Outdoor Sports program. The audiologist does not know much about it. She thinks it is to reduce wind noise. But wind noise is not unique to sports, is it?

I’ve tried several brands over the past few months, and I don’t think any of the manufacturers really provide a list of pre-created programs in their printed guide that comes with the HAs. My guess is they are really relying on people having lifestyle discussions with their audiologists so the audiologist can suggest and inform users of programs suited for them. Should there be a more easily accessible list? Probably.

If the audiologist doesn’t know about the programs, I would think he or she should get in touch with their rep to get more information.

@jfranek43 said:

But wind noise is not unique to sports, is it?

I would guess in outdoor sports, users “create” more wind via fast movement, so perhaps the aids try to reduce that whistling noise that might occur without actual wind. Just my theory.

Bought my first hearing aid about 20 years ago. I could only afford one.
Widex. In the ear.

One issue I had was it squealed when I ate. And I couldn’t hear. They finally rebuilt it. Squealing stopped…story goes on, but I hope this helps you.

Edited

Most hearing aids can have individual programs installed such as restaurant, which she would switch over to manually. I have found that the audiologists office is the worst place to test aids because most offices are set up to be acoustically friendly for hearing impaired. Assuming your wife is in agreement with what you’re trying to accomplish and assuming you were given a trial period for the aids then she should keep notes of what she likes and dislikes in different situations. No aids are ready to go in all different situations right out of the box. Adjustments need to be made. Also always remember that any adjustments that are made to the aids doesn’t guarantee that your wife will hear better. Hearing aids are made to help. Hearing aids do not correct a hearing loss they try to help. Your audiologist should be able to tweak programs to better fine tune them. No program is set in stone and can’t be adjusted. And the best way to tell if the program is optimal is how well your wife can hear in that particular situation. An office test just gives you a certain parameter. Real world is very different.

In reply to @jfranek43

I suspect the various programs are not listed in the user guide because they may added, modified or deleted and replaced from time to time, so any listing would likely not be up to date. I can tell you that the TV program applies specifically to the streamer device, the must be in this mode to receive the stream. That works very well, but you’d really want to make sure you’re keeping the Signias before investing in that.

That said, it seems appalling to me that your audiologist knows so little about programming the devices they’re selling. If they can’t explain to you how to get the most out of your purchase what’s their justification for the substantial markup in price they’re changing you?

Edited

@jhbusse

The Signia AX platform is quite new. Our audiologist sells more Phonaks.
My wife does not have any specific complaints. She says she is happy. But we have no idea if she is getting the best out of the .
Most people here have been wearing HAs for years and have used several models/brands. They can judge because they have some reference.

Also because of Covid, and us being in the risk category, we don’t go anywhere. We may go to a restaurant next week with our friends. But it won’t be too noisy.

The only real complaint we have so far is that the Bluetooth connection from the app to the HAs is not reliable. It works for a day or so and than stops connecting. It takes a bit of fiddling to reconnect it.
Signia has a reputation for poor reliability, so that makes me worried.

The only other brand we could try at this audiologist is Phonak. But my wife wants / model, so it is only the Virto Marvel. It is not the latest technology and is not rechargeable.
We don’t want to go to independent audiologists and pay several thousand dollars more. Specsavers’ prices are very good.
Phonak will eventually bring out a rechargeable ITE/ITC Paradise, but when? Does anybody know?

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