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Severe/Profound Loss At a Loss

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Thank you finovox.

The whole thing is a bit distressing, because I’ve now, to my count, trialed a total of 5 different digital hearing aids over the past several years, including two this year, and so far only one has sounded good despite numerous adjustments to each of these. Not an encouraging batting average so far.

@anon99509572 said:

probably with a need for 100-105ish db of power this time around

This is pretty much UP hearing aids. That alone limits your choices.

The Oticon Exceed is older technology but still a great aid. It might be easier to program as Neville mentioned and is one of our very respected pros here on the forum.

There are other super and ultra power aids available that would drive the bass more to your liking.

Thanks Raudrive. The 2017 Oticon sounds great, which is what makes it puzzling. Everything else has sounded like crap. When any attempts are made to drive up the bass on the others, it sounds too garbled - perhaps this is the compression issue some have mentioned? Again, though, it’s puzzling as to why it’s not an issue with my 90 db 2017 Oticons.

In reply to @anon99509572

@anon99509572 said:

Would switching to a more powerful BTE result in better sound due to a greater buffer between the maximum attainable volume and the actual gain programmed for me, and therefore less compression?

Possibly. I haven’t seen your , so it depends a bit on how much headroom you have now–if you have sufficient headroom, the gain won’t automatically decompress by adding more and will still have to be done manually. But if your gain is being being compressed because of a lack of headroom, then yes it will help. Adding in to the software on a fit will decompress if the Loudness Discomfort Levels are higher than average.

A couple of things to consider:
DSL became the dominant fitting targets for children in the 80s and it’s possible you were transitioned at that time, but maybe also possible that you grew up with NAL-R or NL1 targets after a bit of time with half-gain rule. If I had to guess, the hearing aids that you like are maybe set to NL1? Or DSL child. In any case, your clinician should pay attention to this, although if they are matching it barely matters because they will end up in the same place.

Individuals who grow up with a and a full silicone mold may struggle switching to a different style because in comparison the sound quality can be a bit thin. It is commonly, although not always, the case that a or simply cannot occlud the ear well enough to provide the lower frequency response that the individual is looking for. Look at the depth and snugness of the you were happy with and make sure that anything new at least matches it.

Have you considered candidacy assessment?

Hey there.
Im a clinician from Australia and I know exactly what you are talking about.
I have several clients like your self who have had congenital hearing loss - originally fit with analogue and linear fittings - anytime I fit them with a new digital device with noise reduction or any kind of noise management - I found they always disliked it. I did find that some signia device like the motion or even a widex device are more preferable. I Would generally never recommended a widex due to the sound quality . but for people with severe to profound congenital loss looking for that non digital sound i find widex Pritty good at achieving this for them, as well as signia to an extent with the older models with less features . I am a big Phonak Advocate and love their products - but sometimes we as clinicians need to find a product that is going to suit our clients’ needs and for my clients who have worn devices for years and prefer analogue it either takes lots and lots of counselling and adjustments to get them to adapt to the different sound quality - or we try and get them back into something more familiar and comfortable . Keep in mind also that most of the manufactures can change the prescription settings from their proprietary formula to generic NAL-NL1 / / … But sometimes it really is a matter of trying different manufactures and turning off all adaptive features like directional mics, noise reductions etc. Also doing REMS on your old aid to find out how they are set up and trying to match to newer aids would definitely help as a starting point.

Thank you Neville,

I will share all this with the audiologist when I visit them on Wednesday, as well as post my here afterwards.

A couple questions on what you wrote:

When you state that if headroom is increased, compression may still need to be undone manually, how is that done in Genie? The audiologist seemed to imply that compression is a result of my settings and couldn’t be fixed, but maybe that was due to lack of headroom. I also ask this for future reference in case I do end up going (which I suspect may ultimately end up happening due to my poor experiences so far with digital aides, save one).

Second question, are the fitting targets you mentioned all available in Genie or is another program needed to run those and transpose them onto Genie?

In reply to @Alex_D1

@Alex_D1 said:

Hey there.
Im a clinician from Australia and I know exactly what you are talking about.
I have several clients like your self who have had congenital hearing loss - originally fit with analogue and linear fittings - anytime I fit them with a new digital device with noise reduction or any kind of noise management - I found they always disliked it. I did find that some signia device like the motion BTE or even a widex device are more preferable. I Would generally never recommended a widex due to the sound quality . but for people with severe to profound congenital loss looking for that non digital sound i find widex Pritty good at achieving this for them, as well as signia to an extent with the older models with less features . I am a big Phonak Advocate and love their products - but sometimes we as clinicians need to find a product that is going to suit our clients’ needs and for my clients who have worn devices for years and prefer analogue it either takes lots and lots of counselling and adjustments to get them to adapt to the different sound quality - or we try and get them back into something more familiar and comfortable . Keep in mind also that most of the manufactures can change the prescription settings from their proprietary formula to generic NAL-NL1 / DSL / NAL-NL2 … But sometimes it really is a matter of trying different manufactures and turning off all adaptive features like directional mics, noise reductions etc. Also doing REMS on your old aid to find out how they are set up and trying to match to newer aids would definitely help as a starting point.

Thank you so much Alex for your valuable input. You are the second person here to suggest Widex. And, in actuality, if the majority don’t like the sound of Widex, then that probably means I will like it, because the majority of your customers have a different type of hearing loss and different experience. I’ve found this to be the case in the past.

Regarding the prescription formulas, you state that the manufacturers set these. So if I wanted to have it changed to one of generic formulas you mentioned, would the aids need to go back to to the manufacturers to have them reprogrammed, or can the audiologist do it?

The Audiologist will be able to change this , they will be able to change the formula in the software. The default is the manufactures formula but this can be changed.

You need to be able to think outside the box as a clinician, one size doesn’t fit all and everyone has a completely different experience of hearing loss :slight_smile: Good Luck with your journey I hope you’re able to find a devices that you are comfortable and content with.

Edited

Thank you for your guidance. And I agree fully.

I will try your and Neville’s programming suggestions with the Owns when I follow up with the audiologist on Wednesday, and if it still sounds like crap after these efforts then I’ll return them and try the Widex’s next.

If the Widex’s also sound bad, I may shift to with them or the next one. I require multiple appointments with each aides I try as a result of my issues here, and each appointment must fit in the audiologist’s schedule, which limits things quite severely in terms of pace, especially when I’m in a trial window time limit. With DIY, I can tinker long hours endlessly with formulas and programming AND get help here when needed, and therefore move lot more efficiently and effectively in getting to a solution (if one exists). Then I could just make a single appointment before the return window ends to bring my final programmed result to the audiologist for “a thumbs up”, or return them if I cannot get a satisfactory final result and then order the next one up and start again.

I need to keep trying here … while I still have aides that run that I can try and match, before it is all too late.

Edited

I have spent years and ££££ chasing small improvements in the latest and greatest hearing aids. Maybe some are better than others but two weeks ago I had my cochlear implant switch on…I can only say the experience has been utterly transformational.

I wish I had done it years ago and saved ££££ and had the benefit.

I am in UK and I only have one Cochlear, a Nucleus 8, the other is Resound Omnia and they work together brilliantly even at this early stage of my Cochlear journey. Provided you meet the criteria, NHS will give you one implant free unless you have other disabilities.

I decided to go the Cochlear route after realizing the inescapable truth that 100 x zero is still zero. If you have next to no hearing naturally no amount of clever amplification is going to change this. The Cochlear electrode generates the signals that the little hairs in the Cochlea are supposed to, but no longer do.

Edited

Thank you boreham. I’m glad you have found a solution that has worked for you.

I do not wish to go the route due to cosmetic reasons. It is not something I can hide in hair because I have none.

As long as hearing aids can amplify enough for me, I will continue to go with those. With the right set, I can hear everything at a normal volume others can - speech, music, you name it. It is just the quality of sound that is the issue here, but I know it can be remedied since it has been for my 2017 Oticons.

From what I’ve read with CIs, the sound is quite different and takes getting used to, particularly music. And the bass is the biggest MIA. These are all issues that seem to precisely mirror what I have with badly fitted aides. So I would hate to go under the knife for something only to end up with something that has the same issues.

Maybe if I get age related loss on top of my congenital loss, then I’ll have no choice. But until then, I’ll stick with aides, especially since they still work for me in terms of amplification.

Member361, you got a LOT of great advice and suggestions here! :grinning:

I can only add my own perspective from an equally profoundly DEAF person (check out my , which slithers low as a snake’s belly).

My first pair of aids (when I was in early 30s) were Starkey analogs way back in the early '80s. My hearing was about half as bad as now, but I don’t recall the sound quality of analog being SUPERB! I think even my next pair of aids were analog. Both of those aids used a custom mold which seemed to fit okay.

Flash forward to the 2010s and beyond, and I transitioned to using a soft, silicone power dome cuz now I done got old! My ear canals swell UP and go DOWN throughout the day, so custom molds never fit. On top of which I’m allergic to any kind of firm silicone, acrylic or hypo-allergenic material.

I’ve gone from AGX (anyone ever hear of them?) to Oticon and now to Phonak. I transitioned to Phonak in 2016 cuz my brain didn’t do well with the “open sound” paradigm of Oticon. I’ve worn Audeo B-Direct (GONG! streams to one ear only) to Marvels (3 gold stars!) to now the Lumity Life. I own 2 pairs of rechargeable Life aids (can’t make it thru ONE DAY with stoopid rechargeable aids that last 15 hrs) and as of March, Phonak’s 312-battery realease of the Lumity Life (10 GOLD STARS for sound quality, speech comprehension AND being super portable on the road with just a small pack of batteries).

Like you, sound quality is important to me. I’m a bit of an audiophile, and despite my cinderblock ears, act as my husband’s nuanced “sounding board” when he’s checking out hi-fi equipment. I have a dedicated Music program on these aids, and that’s what I use at concerts or even when I don’t want the smarty-pants AutoSense to adjust volumes for me. I find that Phonak delivers a RICH, full sound - and that’s given the enormous compression my aids need to do given my hearing loss! There’s full bass, high freq clarity and even midrange. So I’m super happy with these.

I do have a very patient and caring audiologist who works with me to make minor adjustments - that’s crucial! You may find a good hearing aid dispenser at a local Costco and save a bundle of money, but I’m guessing that San Diego, with its large retired population, may also have hearing/balance clinics?

I have to toss it out there: TRY THE Phonak Lumity Life aid! I’ve trialed the Oticon Intent, but a different audi couldn’t give me the time of day to set it up right. On top of which, those aids were extremely unreliable connecting to my Android Samsung Flip-4 phone. Most times, the connection was dropped or simply not there upon start-up. VERY ANNOYING. So if you’re lucky, try both Oticon and Phonak. But a good audiologist is KEY. GOOD LUCK TO YOU! Keep us posted. We’ll be looking for your audiogram, cuz that’s the starting point for folks here to give a more personalized opinion.

Thank you 1Bluejay. I looked at your suggestion and I do like the discreetness of size of their compared to others. So I’ll add it to my list of aides to trial. Thank you!

Hi, I also miss the analog sometimes. After putting up with several mediocre audiologists, I searched around just by trial and error in my area and found a really good one. She really has helped me hear better by tweaking my aids to my needs. Also in reading this forum I have learned so much so I am better able to explain what sounds I am missing and what conditions are most problematic.

Edited

Okay, my has been posted. Hopefully that will narrow down the advice given for my situation.

Also, I showed the audiologist suggestions presented by @Neville and @Alex_D1 in terms of matching the 2017 Oticons I like, as well as trying out generic fitting formulas, on the new Oticon Owns.

I have included screenshots of the 2017 Oticon gain charts along with their compression ratios, for reference. By the way, these are Nera2 Pros, as I found out today.

The audiologist was open trying the suggestions. She got an Oticon support person on the line who is the one who actually did the matching via screenshare.

Matching the and gains didn’t seem to do much, especially since the MPO was already apparently maxed out on the new Oticon Owns. Neither did changing the Owns to generic, linear, and “pediatric” fitting formulas. When the latter was tried, the compression ratio was 1:1 across the board, so very little compression. But none of these solved the issue, the sound was still too soft, “tinny”, and the bass missing.

Then the compressions were matched, and suddenly the volume was much higher, to a point that there was a tremendous amount of feedback (the feedback analyzer was afterwards run to eliminate it). It sounded much closer to my 2017 Oticons, with the exception of the bass, which, while better, was still largely absent.

Which was all very surprising, apparently. Both the Oticon technician and the audiologist were at a loss on how this occurred, because the compression ratios on the 2017 Oticons range 1.5-2.5, HIGHER than the Owns. They said that increasing the compression on the new Owns to match it should SOFTEN the sound, not raise it.

Why did increasing the compression ratio drastically increase the volume/power?

At any rate, I still wasn’t pleased with the lack of bass, so I returned them. I will wait for further help here before deciding what model/make to try next.

The 2017 Oticon Nera2 Pros:

IMG_1770
IMG_1769

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