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Why are hearing aids so bad at doing the job they are made for?

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Edited

In reply to @tenkan

Adding to what you said.

Jabra Enhance Select (behind the ear, ) include three different products. https://www.jabraenhance.com/?utm_device=c

Jabra Enhance Plus is an in the ear (ear bud like) OTC product. Jabra Enhance Select Hearing Aids - Jabra Enhance

Jabra Enhance Pro10, Pro20… are Costco prescription products.

The Jabra Enhance Select 300 is a high quality product (do not have experience with the other OTC) but the implementation/setup with no in-situ or is very flawed at best.

As someone said before, “” have a lot of different processes before they can make a sound for you.
Comparing a device that aims to emit a pre-recorded sound versus a device that must take the live sound, edit it on the spot and adapt it to your hearing loss as quickly as possible, seems absurd to compare. But I understand your doubt a little and I intend to tell you from another point of view:

  1. Your type of hearing loss. How does this affect how I hear my “HAs”? Your type of loss seems very much of peripheral origin, which means that your central auditory processing system adapted to your hearing loss, which is why you haven’t practically heard some specific frequency sounds for a long time, especially high frequency sounds. from what I can see in your . So when you have to listen to a sound with all the noises that you had stopped listening to, your brain will hardly be able to adapt to hear with quality what you want to hear.

  2. Your type of loss again: But now talking about the tools of your auditory system affected by your type of loss. I see from your audiogram that it is most likely peripheral deafness, caused by age, and a little by exposure to noise in the left ear. So it is very likely that the cells in your inner ear are made to improve the perception of certain frequencies. That, first of all, is one of the main difficulties when it comes to the first adaptation.

  3. Adherence to treatment. In general, low satisfaction leads to us not using the products, and the adaptation time is variable from patient to patient. I am talking about some taking up to 6 months to achieve a good adaptation, using it at least 8 hours a day.

Going back to the “HAs” vs “Earbuds” part.

“HAs” have the following scheme
briefly until the sound reaches you.

  1. The sound is emitted

  2. Sound travels through air, reducing its intensity due to the distance it travels

  3. Get to the microphone or microphones of your hearing aid

  4. The sound is transformed into a digital signal, losing some information.

  5. The new digital signal is processed to be converted back into sound, some things happening such as:
    A. Division of sound into channels and bands. Each core of the processor transforms a group of frequencies to generate the final sound.
    B. The signal is processed through an algorithm (there are many, “Best fit fast SE”, “NAL - NL1”, “ 5” etc.) These calculate the gain per frequency.
    C. Unwanted noises are eliminated
    D. Very loud sounds are compressed, due to limitations of the hearing aid or software configuration.
    E. Sounds are put together and emitted through a speaker

  6. The sound reaches you and your auditory processing begins.

Vs “Earbuds”

  1. A device that has a prerecorded sound delivers a signal to your “Earbuds” to produce a sound
  2. Your “Earbuds”, being a device that should only generate unprocessed sound beyond the frequencies, can use all the energy in just that.
  3. The sound reaches you and auditory processing begins

I have some questions. How many channels and bands did your headphones have?
Did you use headphones in both ears at the same time?
how long did you use them?

I hope is well translated, i wrote it in spanish first it was too much

In reply to @Justme

@Justme said:

The Jabra Enhance Select 300 is a high quality product (do not have experience with the other OTC) but the implementation/setup with no in-situ or REM is very flawed at best

They aren’t having many complaints, well not as yet anyway, you can input your or a hearing test in a App as least, for the purpose of mild to moderate loss they currently are doing the trick, funny thing tho is I really thought would really take off, hasn’t put much of a dent in the big 5 yearly profits, only Phonak= Sonova complaining about a loss in revenue in USA market, because…you guessed it, no sales through Costco!

Well, streaming is not the job of the hearing Aid.
Anyways, in that case the path still goes under the processing i refer in point 5. It should be better sound than the one coming from the outside because you go kind of straight to 5. But the quality is very much lost under the usage of an processing algorythm for a hearing loss, the hearing aid will still try to make you hear the frequencies you don’t normally listen, if you add the biology i explain first, you will experience the same difficulties when hearing with a . Also, it depends on the processing for the streaming of the hearing aid, if you have less than 20 Channels, processing should still be bad.
Now if the hearing aid were to directly stream without any processing, and just equalize a bit for better hearing, (i don’t know if any hearing aid does this) then only depends on the quality of the speaker, and the sound should be similar to the earbud sound, but still, with less quality.

I appreciate your explanation. It’s helpful.

Two ways to run a business.
Quick Fit, and out the door/Next! (and supply the product with the biggest margin.)
Multiple setups and frequent call-backs; fitter spends the profits with each one.

There still is a mystery in all this. Streaming audio through cheap (like 3$ Chinese) earbuds sounds about as good as through my $3,000 . That input may come from, e.g., someone talking somewhere in a microphone (let’s say live radio). What I don’t understand is when that same voice talks live to my HAs that output is so horribly worse. This is not a fitting problem- what I suspect is that studio microphones are vastly superior to those in my HAs. Second, speakers usually sit a few meters away from my HAs.

Maybe i have been wearing aids so long that i have no idea of normal hearing is. But I personally find listen to someone face to face so much more enjoyable than listening to streaming audio. It maybe just that i prefer personal interaction. I very much understand that we are all so very different when it comes to our hearing. To me I find the sound from cheap earphones to be the same as not having any thing at all. My hearing without aids is so muffled that it sounds like having two tin cans strung together but not even that loud
That is actually the same to me as using even high end ear buds. I have tried expensive equalizer the help me hear with ear buds with zero improvements. And to be honest it took 18 months of monthly appointments to make fitting adjustments to 2 different sets of hearing aids to find that sweet spot for me to understand speech. Music to me is something i can no longer even attempt to enjoy. I am just extremely happy to understand about 75% of the conversations i am involved with.

In reply to @RobHooft

You are right on the money. My same experience. I do not believe it is a fitting problem. I have had 4 different experienced people fit my current jar a enhances pros.

In reply to @RobHooft

In a studio recording, there’s a studio mic with a low internal noise floor, damping screens on the walls, somebody mixing the sound to produce the best output and mastering/re-mastering of the final version. Even stuff on direct transmission without all the mixing has a huge advantage due to power supplies, bigger amplifiers and multi-driver outputs.

In the real World you have a a couple of single silicone mics measuring 2mm across with a high noise floor using a couple of volts, with a chip designed to, communicate, amplify, do and control noise on a constant basis with a couple of volts delivering sound in real-time via a driver diaphragm measuring 7x3mm again using the same couple of volts.

It’s really not difficult to understand why they’re two entirely separate propositions from an Engineering perspective.

All true. Plus, people usually sit centimeters from a studio microphone, but meters away from my …

Very interesting topic and everyone is right. I personally use ha all the day (Oticon Opn s1), but for tv and music I enjoy my blutooth streamer and earbuds (100 euros all).
The audio is simply perfect and I forget having an earing problem…
Yes you can stream tv from an dedicate ha streamer but it will cost you more , and results will be very far from previous ones…
For the cost of actual quality ha (4-6 k euros in Italy ) they could perform better and probably they will do in the future or when a guy as Elon Musk will put money in a big research program on guided Hearing aids.

Yes- Listening to TV with earbuds over Bluetooth works absolutely great, and you can easily set this up with a cheap transmitter and buds. The only downsides as compared to e.g. a Phonak streamer with compatible are: (1) A significant lag in sound. Now, for most AV equipment (say, a Firestick, or a box with enigma2 software) you can adjust this “lipsync” (there are useful videos with bouncing balls out there to help you get this right), but then avoiding an echo with audio that the people around you listen to is a challenge. (2) You are cut off from conversing with people around you- whereas HAs can simply mix two sound inputs. (3) The maximum volume from earbuds is generally far too low for me (tried many models). For listening to music (or when it rains) I use the OnePlus Buds Pro 2, which take your and boost their output (with great sound). I paid 116 Euro for these, though.

I agree for all but , for point 3, try1 Mii Bluetooth 5.0 Transmitter Receiver for TV, HiFi Bluetooth Audio Adapter with ESS DAC, aptX HD/Low Latency . Is the best (cheap) trasmitter I have tried .The device supports the aptx standard which allows 2 options, low latency (switch to LL) and high definition (switch to HD). For those who don’t know, low latency is the ideal mode for listening to TV with Bluetooth headphones in order to best synchronize the images with the sound, or rather the actors’ lips with the dialogues.

Hi
I agree with your title: hearing aids are bad at doing the job they are made for.
In your comparison with the Bose noise canceling ear buds did you use the Bose as hearing aids or as just earphones for whatever is played to them over wire or . My point is that with the hearing aid its microphones are in the loop and contributing a lot to the loss in speech comprehension. for TV and music I use the phonak TV connector and the voice quality and my speech comprehension are perfect, so my conclusion is that the ’s microphones are the culprits.

In reply to @DaveL

Dave,
Thank you for you comments. They are right on target. There are those of us who pride ourselves on doing the very best we can for our patients. But, like all groups there are the others that do just what is needed to get by and not more. So reading this is truly thankful.

Edited

@Dr_Palmer and @Neville

I’m so glad I read your answer.

I’m sitting here having a bad day.

On the way to work my hearing aids were so bad I spent the entire trip trying to find the right program to use. I was stressed from the noise and chore of hearing while driving…
I got to work. I talked to someone who really patiently listened. I said I was ready to smash my phonaks.

I didn’t. I spent some time in myPhonak.

Modified the program that I’d found.
Saved it; I’ve used it all day.
Today I had to drive to sites to work, and the program helped.

It’s 4:00 pm. I’ve had warnings that both my Phonak Audeo Paradise P90R’s batteries are dead. Normally I can barely get through 14 hours. Today: 7 to 4. That’s 9 hours. 6 of the hours was with the modified program I had saved.

Way-back: About 2-1/2 years ago, I went to my dispensing audi because I couldn’t hear from behind with my other Phonaks. Almost got hit 3 times on construction sites. He didn’t tell me what hearing aids he chose until he handed them to me. They came with rechargeable batteries. I know…I could have had replacement ones. I didn’t get to choose.

After lots of appointments and almost two years, he asked me to find someone who could help me better than he could and handed me my hearing aids back. Shook hands. When I got home I found he had erased my hearing aids. All my saved programs were gone. He had done a quick-fit, or whatever it’s called.

I’m delighted to have found someone with more skill to set them up. Here with workman’s compensation I’ll be able to get new hearing aids in 2-1/2 or so years. They’re selective in what service they’ll pay for…

I truly mean what I said in the note I left. You, Neville and others are my heroes for contributing so much to all of us. @Michael_Phonak please help the heroes that do so much for us here, if you can.

sorry for the rant. It’s been a tough day.

Follow up.

@Neville

@Dr_Palmer

My specialist sent my Phonaks in at end of warranty. Today I visited and he set up a brand new pair of Phonak Audeo Paradise P90R’s. He handed me a brand new charger.

They are so much better.

I’m smiling

Edited

In reply to @cjb4

Noise Canceling earphones aim to cancel (by reversing the sound waves) all sounds that aren’t streamed via the earphones. Hearing Aids aim to assist normal hearing (albeit with an emphasis on voice), and not to eliminate sounds selectively (earphones NC isn’t selective). That said, there’s no reason why couldn’t provide an Active Noise Cancelling mode, but that would only work for completely occluded fittings while in streaming mode and otherwise make no sense as it would do the opposite of what HAs are supposed to do.

@Regor250 said:

but that would only work for completely occluded fittings in streaming mode and otherwise make no sense as it would do the opposite of what HAs are supposed to do.

That would totally make sense in advertised as “earbuds first”. Case in point:

Signia Active Pro IX – Hearing aid earbuds | Signia Pro4

Signia Active Pro IX. Hearing aid earbuds with prescription-grade hearing technology. Visit Signia Pro.

and yet, their features are nothing like of modern earbuds, it’s just pure empty marketing.

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