Disappointed after annual review of Phonak Audeo Paradise P90R's

@Neville

Thanks. I see my audiologist tonight. 5:00 p.m. That’s after the last email I sent to him where I complained politely but firmly. I left my audi’s office more than frustrated last time. And you know what hit the fan when I got home.
Instantly I got the comment I wasn’t hearing as well. And that happens every time my audiologist changes the programs.

I’ve had 3 audiologists since I was approved by WSIB. The last one told me that she would need approval for custom tips and anything that she would add. Her new hearing aids were the worst experience I’ve had. She sold her business to a company owned by Sonova.

I haven’t tried custom tips.

The tv connector is a wonderful suggestion. I have one; I have real resistance when I use it at home. I can’t hear my wife at all. I use it when I’m watching tv alone. That’s hardly optimal.

Question: how come the sound quality is so good using the tv connector and listening? It’s far better than using my hearing aids and cranking the volume when I’m in the house alone. Why isn’t the sound quality of my hearing aids just as good when they are being used as hearing aids?

I’m hoping for a miracle tonight. Otherwise I need a new audiologist who understands that I’m a workman’s comp client who has hearing aids. Or I need to find a way to set them up myself. I need a pc to do that because my iMac is so old.

Thanks so much for responding.

DaveL
Mississauga

There was a window of time when custom tips needed approval. When WSIB most recently renegotiated with the manufacturers they made a deal that custom tips in less than UP receivers would be chargeable. WSIB’s tender requirement is that the manufacturers provide everything in the cost of the hearing aids that will make the hearing aids useable for the patient (so for example, if the hearing aids have no buttons the patient gets a free remote, but if it does you have to make an argument, have the patient sign the form, and get approval). The manufacturers argued that domes were fine for eveyone without severe/profound hearing loss and because WSIB doesn’t actually have working clinical audiologists on staff to advise them they believed it. I sent a lot of angry letters, as did everyone, and eventually it was resolved so now custom tips can be ordered as required again. Other accessories do always need approval and sometimes they do make you jump through ridiculous hoops before you can get something, particularly if it is an expensive request. Drives me nuts with FM systems because WSIB patients don’t have access to ADP, and so if WSIB denies it then they have to pay double what everyone else pays to get one privately.

Sound degrades very quickly over distance–anything that puts the sound directly into your hearing aids will be more clear. The TV connector might need a bit of management. Ask your clinician to make sure that the default hearing aid mic attenuation in the TV streaming program is turned off. Then, once you are streaming the volume control becomes a balance control, so you can turn the volume down to turn your wife up, and then if the TV is too quiet you can turn up the volume on the TV box itself. Or you can use the app to adjust the environmental balance. You may need to find an optimal place, for example adjust the volume down until your wife sounds better, turn the TV box up, and then just be aware that every time you connect you’ll need to go down X steps to get back to that ideal spot. That all said, your wife needs to know that with hearing loss background noise becomes more of a problem, so even without the TV connector, just having the TV on and creating a second stream of sound will make it harder for you–pause the program if you want to talk. And if she’s expecting you to hear her at a distance, her expectations need to be managed.

Thanks Neville.

I’ve printed off the user’s manual for the Paradise P90R’s, the APP, my remote control and the personal mike I have. I forgot to print off the one for the adapter.

I’ve tried to explain to my wife about background noise volume (it’s critical; we’re directly under the western final flightpath for Pearson Airport. Planes are about 1000 feet above our head on final.) I’ve shown her my audiogram and even the speech banana.

She is good about communicating when I can’t hear! And I definitely couldn’t hear when I returned from my annual review.
Change: I had the audiologist setup autosense as the dominant program. It wasn’t before. The "custom program that was startup program before is now number 2. It’s setup louder, and with changes from the “Mask” program that the owner of this site published from Phonak. It fills in the highs in speech and makes a big difference for me. It’s louder than my autosense start up program. That’s a big part of my issue.
I want to be able to use the automatic program and any mechanism Phonak has added into my hearing aids that will improve word recognition in quiet and noisy environments.
I still work on construction sites. My old hearing aids didn’t pick up noise in the environment behind me–i couldn’t hear noisy diesel loaders running at speed overtaking me. That’s a real safety problem for me. My Phonak Audeo Paradise P90R’s do! And I’m so grateful I have them.

So I’m seeing my audiologist tonight. I’m glad he has fit me into his week. Friday at 5:00. I just want my hearing aids to perform as well as they can.

I truly appreciate your response.
DaveL
Mississauga, Near Pearson Airport

Friday at five, that’s good of him.

Is the gain in the second, louder program something that you would just prefer all the time? Do you just hear better in it? Or do you find it too artificial and only use it in an emergency? If the former, why not just have him match the autosense program gain to that one?

One of the things that I can’t wrap my head around, but maybe it’s a new clinician thing (am I am old clinician now? When did that happen?), is why they would ever remove audibility if a patient is not having loudness (or related) complaints and the hearing aids are not set to a potentially unsafe level. The hearing test is a bit variable, so sure it might look like your hearing is a bit better one year, but that’s not a reason to turn a well-accepted hearing aid down, particularly when the patient reports regularly turning things up.

@PeterH If you needed custom moulds for the Marvels, I’d have thought you would need them for the P90s too,

The Marvels and the P90s use the same connector for the wires, so you could maybe try using your custom moulds in the P90s until the new ones arrive. (You have to fiddle with a little retainer pin, at your own risk. Search on YouTube.) The tuning will be off, though maybe not by much; your audiologist can fix that anyway, or you can DIY it.

My Marvels aren’t RIC sadly

Summary

Audiologist quit

Phonak Audio P90R programs we set up are gone
Suspect he used Quick Fit.
No REM

Start up is autosense.

Volume is so low they don’t work. He says he set volume at 110%. That was generous

Using the APP I’ve only increased volume. It’s +3 both ears. Simple. No feedback.

CHOICES? I’m thinking of going to my family doc for a referral to an ENT

DaveL

I no longer have an audiologist to fulfill my workman’s comp claim. Mike said he would provide a referral.

Today I used autosense with volume increased 4 notches using the app. While it worked for me (and Mikes setup hasn’t) I believe it’s the Phonak instant setup. Isn’t that first step for new customers? Doesn’t it require additional setup work?

ENT would only work for me if they can finish the setup process

During my last hearing test my word recognition score was 72. That’s awful

DaveL

My computer hates me. It’s a 13 year old iMac. I should replace it. However, I can’t afford to

I have very limited computer skills

DaveL

ENTs in Canada know nearly zero things about traditional hearing aids. Their job is diagnostic/condition/medication/surgery stuff. There’s more of an overlap with implanted devices, but they still aren’t the ones doing the programming.

@DaveL said:

I believe it’s the Phonak instant setup. Isn’t that first step for new customers? Doesn’t it require additional setup work?

The manufacturer does their best to create a good first fit for an average ear from the audiometric data that the clinician inputs. The next steps are real-ear measures to tweak to prescriptive targets (because nearly no one has an average ear and a perfectly pedicted acoustic coupling) and then adjustment to patient preferrence where needed. First fit can be decent if your ear is leaning towards average and your domes fit well.

@DaveL said:

During my last hearing test my word recognition score was 72. That’s awful

Unaided and at what presentation level? I wouldn’t say that’s awful.

Thanks for your comment. He actually emphasized he had set volume at 110%. He knows I’ve had 3 sets of Phonaks. His is the 3rd.
I had told him I had problems with word recognition after each hearing test. That’s at home in the real world and in the office and even outside. I asked him if there was something simple or basic we should change or add.
He scrubbed the programs he had worked on all this time and has them using Phonaks autosense. I don’t know how to interpret this.

So I have Phonak Audeo Paradise P90Rs

I just want them setup so they work. I’m overwhelmed this has taken so long.

DaveL

@Zebras

Thanks.
I had a follow up to the annual review. He scheduled it for 5:00 p.m. Summary–he thinks I should see someone else. He quit. He took my hearing aids and reprogrammed them, erasing the programs we had established over the more than a year I used the hearing aids.
The good news is that after I use the APP they work better than his programming/setup did. I’m using autosense as the start up program now. I hit the volume control on myPhonak APP and increase the volume 3 to 4 times.
My wife gave me heck. She said I have to take responsibility too.

DaveL
Toronto

@DaveL said:

increase the volume 3 to 4 times.

Each click is 2db. 4 times is 8dB.

That’s quite a lot.

@DaveL said:

(JordanK has helped with the name of another audiologist at my request, just in case. But I dread going into Toronto from Mississauga.)

Can you avoid driving there by taking train and/or bus?