Question for those with good audiologists

I’m a bunny-slope tinnitus music patient. Not an easy customer. but what has kept me from DIY it is the ease my audi is happy to try anything… domes, settings, anything.

@Eilis
I’ve learnt to gather info when I can. A copy of your Audiogram would have helped you from the start.

What’s a bunny slope?

You definitely need a good audiologist. It doesn’t sound yours is using real ear measurements to fit the aids to your personal hearing loss and without that they will not be able to work for you to their full potential.

She tested my hearing, told me which HA options fit me best, and
then adjusted the aids I chose to match targets defined by my individual
hearing loss pattern. And they work great. What more could I ask for?

@PeterH said:

My hearing loss is similar to yours, so could be relevant. I have high frequency Tinnitus as well.

I have UK NHS funded Marvel M70’s and the Audiologist basically did ‘first fit’ and sent me on my way. I strugged with speech, and returned twice, getting quizzical looks, and very minor adjustments. Word recognition. I just knew I wasn’t getting the best out of these excellent hearing aids. I had custom moulds too!

I decided to go private this year, and bought P90s. They arrived with domes, and were only a very slight improvement. My Audiologist used to be a Phonak partner. He stated that the biggest problem with Phonak is “their aggressive feedback management”. He did everything he could to disable it. Firstly, he got me custom slimtips. These took a couple of weeks to arrive, so I lived with the domes and initial setup until they arrived.

From what I remember, on fitting the slimtips, he did the Audiodirect test in Target. He said my hearing was slightly better, but put that down to the RICs being closer to my eardrum. He did NOT do the feedback or the real ear test, as he said it would reduce the “headroom” he could work with. He spent a long time increasing MPO’s and the soft sounds, especially in the upper frequencies. I think he reduced some lower frequencies, but not sure. He then spent a long time on compression of the upper frequencies. This was beyond my knowledge (and still is), so I didn’t really know what, or why, he was doing it. He was frustrated with the Target software, as it constantly wouldn’t let him make certain adjustments, but he got round it somehow. About 2 hours spent. He was using the Phonak fitting formula.

The results are astounding. My speech recognition is much much better. I have not meddled with his work in the P90s since, and won’t.

I’ve since self programmed the M70s, and they aren’t up to his standards, but they’re getting there. I’m trying to get away with vented domes on these. My process at the moment is to take them to the pub, and open the app, select music (my default), and make adjustments in the graphic, to improve speech recognition (there’s usually 3 or more conversations going on around me). I save the amended programme, come home, and try and replicate those changes in Target on the original program. This deletes the custom program. As of now, I think some of the mids are too high as there’s a certain “honk” to the overall sound. Work in progress, and certainly great as spares. Using the TV Connector, I forget which hearing aids I have in!

Hope this helps
Peter

@PeterH and cvkemp

Your thoughts and posts really help me.

My good news: my new dispensing practitioner has set up my HA’s so I can hear better. Phonak Audeo Paradise P90R’s. I had a 2 year period with my dispensing audiologist telling him I couldn’t hear.
My question (unanswered) is, "should I do more?

He used the audilogist’s audiogram. He set up my hearing aids using the Target quick fit or whatever it’s called. He told me that the program before I saw him specified the wrong domes. They were set as open; not closed. (looking at the report, he has them set as POWER domes, not closed domes. I don’t know what effect that would have. He also said the audi had not linked the left and right hearing aids together so they work together.

It’s about a month since he did his work.

• should I ask for a new hearing test?
• should I ask for REM?

SWMBO has commented recently that I still can’t hear sometimes.

I really appreciate your expertice.

Finally I gather that there are different setup programs.
The myPhonak APP is helpful. I spent a lot of time adjusting and creating custom programs when the audi said it would help. the CLARITY button really helps me. It boosts midrange and high frequencies. One notch, and two. The DYNAMIC function on myPhonak can be adjusted. To the right makes high frequencies such as my Wifes voice clearer. So I have adjusted it to the right in the past. My understanding is that it is COMPRESSION.

DaveL
Toronto

@DaveL
A lot of questions here, and I definitely don’t know all the answers. It’s 1:30AM here, but I’ll reply in more detail in a few hours.

One thing… I believe hearing fluctuates throughout the day, so your wife will be correct. Some days you hear better.

Anyway, give me a few hours on the recent things I’ve learned on this journey

Peter

@DaveL
Hi again Dave

I guess you mean that your Audiologist entered Power Domes in the software, but fitted you with Vented Domes? Doing this, I understand, would give him ‘more headroom’ in adding gain to the higher frequences, but also more chance of the feedback management kicking in and taking that gain back off again.

I’ve been trying to get my Marvels to work with vented domes, but I just can’t get the high frequences boosted enough, so I’ve fitted my moulds again. This allows more gain. I keep Whistleblock as low as possible, as that takes away high frequency gain.

I’m slowly getting closer to my well programmed Paradise P90 13Ts, but it’s difficult, as you just don’t know the effects of any changes, until you visit the environments that give you problems. With the Marvels, I find myself using “clarity” a lot, so I still need more high frequency. I leave “Dynamic” in the central position.

Sound Recover2 was in my first fit, which was not helpful to me at all. Thankfully, @Zebras helped me, and I’ve disabled it. I’ve never had REM done (apart from the one in the Target software), so can’t really comment on that.

If you tell your Audiologist that you boost the mids and highs, he may be able to replicate it.

As @glucas states, Phonak 1st fit is just not good.

Peter

@PeterH

Thanks for your response. It really helps. Yes he entered Power Domes in the software.

My Phonak Audeo Paradise P90’Rs have closed domes (two tiny holes in each dome)

My hearing aid history. 3 sets of Phonaks over the last 10 years. A single widex for 10 years prior to that.

My current hearing aids…The dispensing audiologist always did REM I had 4 or 5 hearing tests over 2 years. Then he invited me in. He hooked up myHA’s to his computer and erased everything he had done. He did that without telling me.
He told me that my hearing had improved and my hearing aids would be quieter. (That’s a miracle! my hearing loss is due to exposure to loud noise. I have a workman’s comp claim.)
He used Target and did a quick fit.
Then he suggested I should find someone that could help me more than he could. In essence he fired me.

He asked me to tell him what I found out. I haven’t done that. We parted on friendly terms. I don’t feel friendly now.

My new practioner has worked miracles. I can hear so much better. I have times when I don’t hear; typically at the end of the day.

He used the quick fit from current Target. He boosted mid and highs, and increased the volume setting to 110%.
He said he found that before he started the hearing aid setup was wrong. The two hearing aids would not communicate.

I have great respect for good audiologists and practitioners. For two years I couldn’t hear; I gave lots of polite feedback to the dispensing audiologist.

I’ve read all these posts and I do agree that a good audiiologist makes a big difference. Many people mention that they need to communicate to the audiologist that they have trouble hearing low frequencies or high, noisy environment or telephone or that sounds are too brassy or too baritone.
Doesn’t anyone think that it is the audiologists job to take the time to ask these questions? As a hearing aid user for over 25 years I have known audiologists who never bothered to ask about my lifestyle, my tech ability or what specifically I was having trouble with. I have also had a few audiologists constantly trying to upsell equipment, rushing my appointments and even trying to make me feel it is my fault if I can’t hear well.
Just like doctors, auto mechanics and others, there is good, bad and mediocre. There is burned out, there are those that are still learning and some that just are lazy. i now have a BRILLIANT audiologist who has been willing to tweak my hearing aids, ask the relevant questions and spend the necessary time to reduce feedback, help me get the right balance between hearing speech and everything else. It makes a big difference in my quality of life. If any one has ever gone to a homeopath you might be familiar with all the questions they ask, when did the problem start, do you feel better in this or that situation. Why does the hearing aid user have to be the expert? It took me many years and many different ha’s to understand what I needed so I can articulate it now but what about the brand new hearing aid user? They need help and the audiologist should provide that help.

Why would insurance companies push for replacing aids with new ones?

Average replacement (at least in my area) is at 5 years. A 10 year hearing aid life is long. If you have traditional battery BTEs, then it is a bit more likely. If you have rechargeable RICs I wouldn’t expect another 7 years.

@montieth said:

towards the end of the three year warranty I had them sent in to the manufacturer for “clean and repair” which I was told should make them last another 7 years.

Disposable battery aids I assume. Rechargeable batteries might not last that long, and they depend on a charger that might not be replaceable if it breaks or is lost.

Many “insurance” companies aren’t really insurance, but a supposedly discounted buying program. (One is limited to certain hearing aids that one gets to buy at a supposed discount. It’s a strange kind of marketing.