I have been using Oticon More 1 since 2 years now and I’m facing two challenges with them. The first challenge is hearing people when I’m in the car sitting with people. There were many cases where I was sitting at the backside and I could barely understand the people’s speech sitting at the front. I need to see their faces to hear and understand them clearly which is impossible from the back seat. Similarly, when I’m in the front seat, I have to turn around to see and clearly understand those speaking from the back.
The other challenge I’m facing is during gatherings at with guests. When my guests are talking, I often feel lost because I struggle to understand their speech, even in the absence of background noise. I need to look at each person’s face to properly hear and understand them. If I miss seeing anyone, I feel completely lost.
Please advise if anyone is facing the same issue and found a solution? Your help would be greatly appreciated. I have attached my report and other details for your understanding. Skaik_Rami_30.12.2023.pdf (121.7 KB)
Your issues are very common, by the way your hearing loss is very similar to my hearing loss. With concentrated effort and communication between your audiologist and you your aids should be able to be better adjusted. Some of it depends on the receivers you have and the domes or custom ear molds. I have custom ear molds and the 105 db receivers. At first the sound was way too loud for my comfort but over time i was able to get use to the sound and with it my speech understanding improved greatly.
I took a peek into your report. Here is my very own opinion.
You use mould and a closed vent. This may or may not work for everybody because of occlusion and makes low-frequency sounds overwhelm the upper-frequency sounds. AKA masking. Make it unclear or disturbed.
Did you find sitting in the car a bloomy sound that punched into your ears? You have a usable, high-frequency area which should not be too hard to understand in the noise.
I have pretty much a dead zone from 2+khz onward. I may hear or not hear it, I can’t tell it, but I keep gains there anyway. I don’t use a closed vent. I use a single-vent bass dome and it works perfectly for me. Sound is natural for me, no occlusion.
My suggestion is that you’ve been trying for two years. You should try something if it does not work. Ask your audiologist about changing the acoustic option.
I know a dome is not suitable for everyone but making a new mould is an expense and takes a long time. So you can ask them to try a dome with a vent (a single-vent Bass Dome). and see if you like it. If it works, you can order a new mould with a vent later.
I’m guessing that you probably must have subconsciously trained yourself for years now to read lips (and maybe also facial expression) to help augment your speech understanding, so much so to the point that you must be able to see their faces when they speak in order to understand them, hearing their speech is not enough. I’m guessing this because you said that not just in the car, but even in gatherings with no background noise, the recurring thing I hear is that you MUST be able to look at the speaker in order to understand them.
The Oticon More, assuming that yours is not set with Full Directional value but is set with Neural Automatic value for the Directionality Setting, should have been able to pick up speech not just in front of you, but all around you, especially with its open paradigm on top of everything else. So it’s not the case of a frontal beam forming setup that is limiting your speech understanding here.
You do have a very tough hearing loss to compensate. The More as a regular miniRITE is probably barely powerful enough to work effectively for you. Perhaps switching to some kind of ultra power version can help give you more boost all around for better hearing compensation. Maybe with a more powerful model, it can help you wean off the lip/face reading to allow you to understand more via hearing without seeing the speaker.
I had never honestly realized that i depended on read lips so much until people started wrar mask. I made it a point to tell people if i couldn’t read their lips then more than likely i couldn’t understand what they were saying.
What type of hearing aid you are currently wearing? I can see it is OPN S? Have you tried Oticon More 1 and it didn’t work for you? By the way, since I already have access to Genie 2 at home, is there any tweak I can do to improve my hearing aid? Going to the audiologist is a bit difficult as he is far away from my home.
By the way, since I already have access to Genie 2 at home, is there any tweak I can do to improve my hearing aid?
Well isn’t this why you have genie installed on your PC, I think it’s time to read the user guides, this is always helpful for setting up the first time.
You don’t have open, as in you have no vent, so closed, actually I haven’t seen this way of connecting the receiver to the mold before, must be a Oticon thing, is it a “click” type I wonder.
I don’t think you should be attempting any projects with such limited knowledge of what your doing, I don’t mean to be harsh, but it’s easy to make things much worse if your not careful, cheers
Your receiver is Power Receiver Molds either 100 or 105. But I think yours is maybe 100?
Yours is no vent. This will have very powerful amplification because low-frequency energy can’t escape the ears. If your low-frequency hearing is still decent (50–200 Hz), you will experience “occlusion.” Some people don’t like the occlusion because it makes them uncomfortable and muffles the sounds.
I just suspect you have a “closed” setup which may be an issue for you.
Here is my idea. If you can go visit an audiologist anytime soon. Ask them to try the one I circled top-right which is compatible with the dome. You can try various domes with it. Try a single-vent bass dome or other type as you need. If it works, you can then order new molds for venting.
Molds is expense and take a long time to make. When you find the correct one you can order it later.
So you think as per my audiogram, the Oticon More 1 is not much suitable for me? Which kind of ultra power version is suitable? Is it OPN?
As per my audiogram, do you think there will be anything I can do in Genie 2 to improve my hearing and not read the lips/look at the speaker?
The Oticon miniRITE models started with the OPN, then the OPN S, then the More, then the Real. So the OPN is not the power version like you think. It’s just the original miniRITE version, in the same class as the More, which is 2 generations later.
What you may want to try is the Xceed (see screenshot below). It’s for folks with severe-to-profound hearing loss like yourself. Your right hearing loss is in the severe range and your left hearing loss dips into the profound range between 500 Hz to 1.5 KHz, which is a crucial area for speech understanding.
As to what you can try to do in Genie 2 with your existing More 1s to help improve with speech understanding without having to read lips, I’m not really sure what else can be done because I assume that your More is probably already trying to amplify sounds for you at its max already, and you do have custom molds, and probably with a closed setup (no vent). I happen to think that a close setup with no vent is the right fitting for your kind of loss, so I don’t know why some folks have suggested venting for you. It’ll just allow some of the amplified sound to escape and get weaker, which is the opposite of what you need, stronger amplification.
I assume that you had done by your ? One thing you can try to do is look at the Fine Tuning section and copy the P1 default program to an empty/available program (assuming you have some left), then see if there’s anymore amplification room for your left ear between 500-2,000 Hz range, and if yes, add more gain to that range. Don’t do it directly on your P1 program though, just make a copy and play around with the copied program instead.
Another thing you can try is to specify in MoreSound Intelligence (see the second screenshot below) that the 4 right most listening situations are classified as Difficult for you (as seen how in the screenshot all 4 situations on the right are in the darker gray area and only Very Simple is in the lighter gray area). There’s no guarantee this will help much, but at least you’re telling the aids to give you maximum help in almost every listening situation. Also set the Sound Enhancer to Detail, and the Virtual Outer Ear to Focused. I would also max out on the Neural Noise Suppression values for both Easy and Difficult Environments as seen in the screenshot below. And also make sure that the Directionality Setting is set to Neural Automatic and NOT Full Directional. This way, in the car environment, max noise reduction is at work and speech should be picked up in any direction.
Actually i have the More1 as my backup aids now and my msim set of aids are the Real1 aids. I am a veteran and i do volunteer work at the audiology clinic, giving a lecture to new hearing aid patients on what to expect, how to connect to Bluetooth, how to clean the aids, and a lot of one on one advice. I have been wear aids for 20 years and wish i had someone to do that for me when i first got my aids
I have copied P1 to P3 and added more gains as per your advice and now it is like below:
Is the above okay or it needs more gains?
Only you can decide this. I would advise adding maybe 3 between 500 Hz to 2 KHz for Soft and Moderate on your left aid, and maybe 1 or 2 dB in this same frequency range for your right aid to start out, then evaluate and adjust accordingly. Needless to say, you’d have to be in P3 to evaluate how your changes fare.
Regarding the REM, I do not remember if it was previously done or not but here is the snip of REM section in Genie 2 for your reference:
There’s really no telling by looking at the Genie 2 screen if REM was done for you or not because there’s a good chance that your ran REM using a third party tool outside of Genie. If you remember your HCP inserting a tiny mic into your each of your ear canals then put your on and ran some test, then that means REM was probably done. If not, then REM wasn’t done. If REM wasn’t done, there’s a possibility that you’re underfitted, which would have explained why you struggle with speech. Why don’t you call and ask your HCP?
Also, here is the “Sound Controls” section in Genie 2 if it needs any adjustment according my audiogram:
I would adjust your Sound Controls Brightness to Fuller, and Soft Sound Perception to Detail. This will help boost your mids for the Brightness, and helps make Soft Sounds more clear for you.
Hot Springs Village, Arkansas
