New to hearing aids, question about tech levels

@SpudGunner said:

Best leave this kind of judgment to science, not to subjective guesswork

It’s not actually that well defined. Different clinicians use slightly different descriptions. As far as I know there is no rise-over-run criteria for the application of the word “steep”. The OP’s loss is normal sloping to severe, or also possibly mild sloping to severe for clinicians who ignore 250 when describing. I’m not sure I’d go out of my way to add “steep” to any of the above audiograms. There was a poster in another thread whose loss drops from 25 dB HL at 500 Hz to 110 dB HL at 1000 Hz and I’d call THAT steep.

In terms of ease of fit. . . that can be pretty variable based on the individual as well. There are “hard to fit” elements that have to do with the interaction between the ear anatomy and the slope for fitting the hearing aid (venting/occlusion) and “hard to fit” elements that have to do with the expected limits of function even when aided. You can make a vague assessment that any loss less than 65 dB HL, in the absense of particular ear conditions (e.g. meniere’s), is mostly a result of cochlear outter hair cell loss, whereas anything greater than 65 dB HL is more likely to involve inner hair cells and supporting cells.The expected outcome of the latter is that things like poor clarity, cochlear distortion, SNR loss, and generally a harder time hearing even with amplification are more likely. So you can adjust your “hard to fit” slider relative to how many thresholds are above 65 dB, but then there are always individuals that defy your expectations–struggle with what seems like a milder loss or get normal aided speech-in-noise scores with a 90 dB HL cookie-bite (I have that patient). Calling someone “hard to fit” can discourage them or validate them, depending on their experience.

Given the individual nature of hearing, I think the struggle is always to find a shared language that we can use to explain what is easy for us and what is hard for us so that we can help each other out. Even growing public awareness of these differences for “normal” hearing people is, I think, valuable. For example, I have “normal hearing” loved ones who cannot carry on a conversation in the car with the radio on. If I manage to remember that and pop the radio off when we start talking, they clearly feel considered and valued and we have a more positive interaction.

I know I can be a bit of an optimist, and also go off on tangents with coffee on Saturday mornings, but I think in my lifetime I’ve seen some positive shifting in our wider human culture towards compassion, which I think is a good direction. My father, product of an older generation, seldom complains about medical issues that cause him pain, I suppose because of a culture of being “tough” and not whining. And yet, if he does tell us it helps us to reach for compassion, help him a little extra that day, understand that if he leaves early it isn’t because he doesn’t want to spend time with us, etc. I think there is absolutely tremendous value in individual grit, but also tremendous value in communication and community collaboration. People don’t help if they don’t know how and when to help. So discussions of both what is hard for us AND what makes listening easy are valuable.

@Neville: I think you’ve missed my point. I don’t know whether you’re HoH, but it can be very scary to have to confront one’s first pair of HAs because we don’t know what to expect, whether all that money is worth it, etc… There’s always some doubt whether we can be helped.

So, if one wants to be compassionate, why further intimidate a new wearer with the idea that theirs is a difficult loss to fit, when one actually has no factual basis for making that statement.

I would have preferred that the fitting assessment be foregone in favour of a statement like “find yourself a good fitter - that’s most important”.

Take it easy on the caffeine, @Neville (lest this become a Saturday morning phenomenon!)

@SpudGunner said:

So, if one wants to be compassionate, why further intimidate a new wearer with the idea that theirs is a difficult loss to fit, when one actually has no factual nasis for making that statement.

I do get what you are saying. Setting appropriate user expectations can be a tricky line. On the one hand you don’t want expectations to be so high that they are disappointed in even a brilliantly fit hearing aid, on the other hand you don’t want to discourage any action at all.

@Neville: Exactly. I’m just leery of scaring new users. There sre many, as you are well aware, who need treatment, but who het deterred for one reason or another.

I think that Members like you and @Um_bongo can make statements like"your loss is hard to fit", however, both of you are savvy enough to include several things the newbie can do to mitigate.

I suppose it’s a personal thing, but I, as a layperson, would feel uncomfortable making such a pronouncement.

Thanks for the detailed explanation. Being new to this every piece of information is helpful more to understand my hearing loss

@anytrams56 said:

helpful more to understand my hearing loss

@anytrams56: The better-informed you become, the easier it will be for you to communicate with your audiologist. It is this relationship, and not any single device, that’s the key to getting effective treatment for your hearing loss.

Be encouraged by @Neville’s assessment, and a tireless advocate for your own best interests. Don’t let anyone fluff off your questions and concerns.

@Neville said:

I’m not sure I’d go out of my way to add “steep” to any of the above audiograms. There was a poster in another thread whose loss drops from 25 dB HL at 500 Hz to 110 dB HL at 1000 Hz and I’d call THAT steep.

Yes, I agree that my loss and Jim’s loss is probably not steep enough to call steep yet because the slope is not a precipitous slope. But compared to the OP’s loss, mine and Jim are “steepER” for sure.

Going from 25 dB at 500 Hz to 110 dB at 1 KHz is steep for sure. I did remember seeing that loss in a poster on this forum a short while ago and telling myself “Wow, what a steep loss” but then I can’t remember who it was. Even something that looks like the one below can’t compare to that one, but it is probably the beginning of “steep” here.

Hi Volusiano, does my hearing loss look steep?

The Audi told me that More 1 helps a bit but not all in this type of hearing loss as the left and right loss level is different. The loss in the high frequency affects word recognition (that’s what I have). The Audi suggests CI (i do not want that).

Still happy with the HA because I can hear the voice watching TV (lower volume) with the good ear and the HA assist hearing in certain types of restaurants ( 60-80%) but not in a group of friends at a round table inside a room of 5 tables (down to 10-20%) (Noisy environment).

Your kind adviceand comments. Thank you.

@danka: You didn’t ask my opinion, however, I believe that your hearing loss is outside of More’s fitting range, is it not?

Hi @danka , yes, your hearing loss is rather quite steep in my opinion compared to most. In fact, I think it was your hearing loss that I saw and told myself how steep it was.

Your kind of hearing loss can really use the frequency lowering technology to help bring the sounds you cannot hear in the higher frequencies down to the lower frequency area where you still have some hearing left. Unfortunately, the Oticon frequency lowering technology (Speech Rescue) can only go as low as 1.6 to 2.4 KHz destination range, where your hearing loss is already profound, so it wouldn’t help. See the screenshot below for reference on the Speech Rescue ranges.

If you don’t want to go the CI route and want to get the most out of the HA route, you may want to explore the Phonak frequency lowering technology called Sound Recover 2. I think its destination range can go as low as around 750 Hz, which is the range where your left hearing still has some hearing ability left. This way, you may be able to “recover” some of those mid to high frequency sounds that you haven’t been able to hear before anymore. Note that I said “may be able to” and not “can”, because the Sound Recover 2 is frequency compression, so it works for some people but not necessarily for everybody, depending on how their brain hearing can adapt to and make use of the lowered sound information. But it really doesn’t hurt to try and it’s really the only option left for you to try if you don’t want to go the CI route but want to be able to “restore” and hear some of those mid and high frequency sounds, albeit at a lowered frequency range.

@danka

I’m not an expert tho knowing if it would make a difference tho in how you hear.

I have a 100db with mic with a power dome. Pls explain ob the mid frequencies. Thanks

@danka said:

100db with mic with a power dome.

100 DB receiver is even less powerful.

See my last post with the blue line. The 105 DB receiver won’t amplify past the blue line.

@danka

You’re missing out the frequencies in the red box at the bottom.

An expert might explain in more detail about amplifying those frequencies might actually not be the best anyway because of how bad they are.

@Neville might know?