3 Weeks with my Oticon Intent 1. Need advice

@Jonathan_B said:

1. The Real 1s have the older chip from last year but are thinner. What am I giving up here and is having a better fitting HA a worthy trade off moving down from Intent 1s.

You’re giving up a lot. First and foremost, the DNN 2.0 is on the Intent compared to the DNN 1.0 on the Real. I think you can get better speech in noise performance on the Intent when you combine the use of the DNN 2.0 with the 4D sensor, which is the other next major thing you will give up if you go to the Real. And finally, the Intent has BT LE Audio and after a future firmware update, will also be Auracast compatible. These will be the 3 big things you will miss.

By the way, Oticon has managed to eke out another 2 dB of noise attenuation out of the Intent compared to the Real, going from 10 dB to now 12 dB max. That may not seem like a lot, but for every 1 dB improvement in noise attenuation, there’s usually a 10% dB improvement in speech clarity. So you’re looking at giving up 20% more speech clarity by going backward to the Real.

Some audiologist like Dr. Cliff who has a presence on YouTube has said that he usually doesn’t recommend upgrading from 1 model to the next because they’re usually just incremental. He usually recommends upgrading after at least 2 or more models away. But for the Intent, he said that he’s making an exception for the Intent and is willing to recommend upgrading to the Intent from the Real. That just goes to show how significant an upgrade going from the Real to the Intent is.

Like I suggested to you in the other thread, it’d be worth it to find another eyeglass frame that can accommodate the Intent rather than just going backward to the Real just to fit your current eyeglass frame. And again, post your audiogram in your profile so people can see and be able to make more helpful suggestions to your questions.

@Jonathan_B said:

3. I like to listen to music. Like on a real stereo system. I have a rather high end one. I know it is sort of pointless with hearing loss, but are there HAs that work well with live music and stereos as opposed to earbuds. The Music Mode is decent on my Intent 1s, but still not the same. I know that music is like the 1-3% use case here, so shouldn’t be the priority, but I’m still curious. I hear Widex is good for this, but they seem to not be as good as Oticon in other ways. Actually my Airpod Pro 2s with a custom audiogram are very good as headphones. Thoughts?

Again, it’s difficult to comment here without knowing what kind of hearing loss you have because you don’t post up your audiogram. But I’m going to assume that you have a typical ski slop precipitous loss and your low frequency hearing is OK and your loss is mostly in the highs and maybe some of the mids.

Assuming this kind of loss, all hearing aids regardless of what brand will not be able to deliver good punchy bass for you like your AirPods Pro 2 can when streaming, just because the hearing aids’ receivers are much smaller. But it should prevent the low frequency sounds to naturally reach your ears through the vent in the case of listening to music through the air, again, assuming that you don’t have hearing loss in the low frequencies. So overall, it should not be a bad experience across the board.

When streaming audio, however, this is where hearing aids can be lacking because they can’t perform well compared to AirPods in the low frequency region due to their tiny receiver size. But you can actually just use both together. Put on your hearing aids first, then put on your AirPods over on top of the hearing aids next. then you can get the best of both worlds, the punchy bass from your AirPods, and the amplification of the mids and highs from the hearing aids to compensate for your hearing loss.

Welcome, Jonathon. I also have cholesteatoma and wear glasses, but no ENT specialist has ever informed me of the significance of the growth and in what ways it can affect your hearing/ear health. So hearing loss is one of them, isn’t it.

All the hearing aids I’ve had over the years has put a lot of pressure on my my ear to the point of pain and redness because of the tubing, even with the light weight metal framed ones, so I understand where you are coming from. I am also searching for a solution to this problem… I wish I had an answer. I use Phonak, so am not familiar with Oticon Intent 1s, e

I should clarify that I had quite invasive cholesteatoma in my 20s and had 4 surgeries to remove them. The hearing damage is not so much from the cholestheotoma but from the surgeries themselves. They need to drill into your skull to remove them. The drill often does permanent high frequency damage (in my case), also if they are invasive, they can destroy inner ear bones (also my case on the right side) so I have a prosthetic bone in my right ear which I expect impact conductivity.

@Jonathan_B said:

I’m coming to the conclusion that listening to live music or via a conventional stereo is probably going to mediocre on most models of hearing aids.

I have to disagree there with regard to listening to music on a stereo. The HAs, if correctly set up, will put back all the frequency information you are missing without them. If I listen to music on my studio monitors without HAs it is awful, but with my HAs in it sounds like it used to when I was 20 years old…

However, you have to make sure the HAs are not interfering with your listening experience by using any of their automatic noise reduction capabilities. That’s what the music programs are for (but even they can need tweaking).

@Jonathan_B said:

Hi There. I added my audiogram to my profile. Not sure I did that correctly though.

I have AirPod Pro 2s with my audiogram installed and they are quite good. It’s just that I have an expensive stereo system and I’d like to keep using it and not wasting it. I’m playing with earpieces now on the intents. I had the open ones and am now trying the 2 hole ones. I have not tried putting headphones over the hearing aids, but since Apple now has audiograms installed into their settings, I’m not sure why this would matter. Let’s say I had Airpod Pro Max headphones, why wouldn’t I just use those with my audiogram?

If you don’t see the word “Audiogram” underneath your avatar on the upper left corner of your posts, then you didn’t do it correctly yet. Same with yor Airpod Pro Max headphones, if they have audiogram accommodation, then it might be good enough for folks with moderate hearing losses but probably not good enough for folks with severe to profound hearing losses, simply because these AirPods devices can’t deliver the same level of amplification that hearing aids are designed to do.

So if you’re perfectly happy with your AirPods Pro 2 earbuds or AirPod Pro Max headphones in that their audiogram accommodation seems to compensate for your hearing losses just fine, then of course you don’t need to use hearing aids together with them. But for folks like me with severe to profound hearing losses, I like to use hearing aids in conjunction with headphones or earbuds so I can get the best from both device types.

I’m aware that the AirPods Pro 2 does have audiogram accommodation. But it only can do so much, and while folks with only moderate hearing loss find their audiogram accommodation on the AirPods quite good, folks with heavier losses like me find it only barely adequate and far from “quite good”.

I am on day 6 with my INTENT1 aids, I have went from my Real1 aids to INTENT1 aids. So far I can’t say anything negative about the INTENT1 aids. I am even enjoying music for the first time in a very long time. I have the Samsung S23 phone and pairing was simple, connectivity is rock solid. I have the default general program, t-coil program, TV adapter, and connect clip. I haven’t yet been in an extremely noisy environment but I have been to a restaurant and vehicle dealership that are noisy with no issues understand speech. I haven’t needed my TV adapter to hear the TV at my wife’s comfort level of listening to the TV, this is a first. I didn’t need the T-coils to hear the sermon or music at church Sunday, another first. I had a men’s meeting Monday morning with 10 of us talking, joking and fellowshiping, I had no issues with conversations even at the far end of the table from me, another first. I can ride my motorcycle wearing my helmet with no feedback and no need to remove or mute my aids, this was also normal with my Real1 aids and the More1 aids before. Driving the Jeep with the windows down isn’t an issue I don’t have any wind noise issues, this also is true with my Real1 aids but somewhat uncomfortable with my More1 aids. My dream and goal has been to only need and use the default general program, with my INTENT1 aids this is proving to be very possible. And the sound is so natural that I don’t feel the need to mute my aids while setting in my recliner and reading while my wife watches TV or having someone over to visit. Sometimes I do lower the volume to -1 or -2. I made a note in my journal yesterday morning and this morning stating that I feel like I have been given my natural hearing back.

@cvkemp said:

My dream and goal has been to only need and use the default general program, with my INTENT1 aids

Does the new INTENT have something like Phonak AutoSense where it goes into Speech in Noise?

Or do you mean you want to get on well with just the default program but it isn’t default Speech in Noise?

Oticon aids has their on version of it. And it has been evolving over the 14 years i have been wearing Oticon aids.

re: cholesteotoma. Yeah I had a lot of surgeries for this As a result I have mostly conductive loss. My auditory nerves are fine; perfect in my right ear. For those with conductive loss, a BAHA (bone anchored hearing aid) is one option. I have the Cochlear Osia and it outperforms my BTE aids by a good amount. Kaiser finally covered the cost, and so it became affordable to me. BUT: mine is not very good for music. That’s the only drawback. Worth it for all else that it gives me. I love it.

@cvkemp said:

My dream and goal has been to only need and use the default general program, with my INTENT1 aids

@Zebras said:

Does the new INTENT have something like Phonak AutoSense where it goes into Speech in Noise?

Or do you mean you want to get on well with just the default program but it isn’t default Speech in Noise?

Many of the non-Oticon hearing aid brands have different groups of FIXED settings in different program types, specifically when it comes to noise suppression in favor of speech. That’s why there’s a general program with not too aggressive noise suppression and beam forming directionality settings, and then there’s a Speech in Noise program with much more aggressive noise suppression and beam forming directionality settings. So to adapt to different environments, the user either must manually switch between the programs that have different fixed settings, or use something like an AutoSense feature in the Phonak to sense the change in the environments and make the program switch automatically for them.

But with Oticon aids, in just the same single program, the noise suppression and the directionality settings are not fixed, but they’re varied automatically by the Oticon aids depending on what environment the Oticon aids find themselves in. So again, other brands’ aids detect an environment change (let’s say from simple to complex) by something like an AutoSense, then automatically switch programs from default to SIN to pick up the new noise suppression and directionality settings. But Oticon aids detect an environment change and continuously changes the noise suppression and directionality settings on the fly in the same program back and forth to adjust to environment changes, instead of switching programs back and forth (like the other brands’ aids) to change between 1 set of fixed settings and another set of fixed settings.

So while the other brands’ aids switch back and forth between 2 discrete sets of fixed settings residing in 2 different programs, the Oticon aids continuously adjust the relevant settings back and forth in much smaller incremental values as the environment changes from very simple to simple to moderate to complex to very complex and anything in between at any time, all in the same single default program.

Although you can add the built-in Speech In Noise program that Oticon provides into a separate program, then manually switch to it whenever you feel the need, you can also just set up the default program to be aggressive with noise attenuation and speech contrast improvement just like how Speech in Noise is setup, and the default program will perform almost the same as the SIN program when you encounter a complex environment. But when you’re back out into a simpler environment, Oticon will dial back the noise suppression level and the directionality inside that same default program to match up with the new simpler environment.

By the same token, if you step into a complex environment and manually change to and use the built-in Oticon SIN program, if you step out of the complex environment into a simpler environment, technically you don’t really have to manually switch back to the default program. The Oticon aids know to appropriately dial back the noise suppression and directionality as necessary to adapt to the simpler environment that you’re in now, even though you’re still in their SIN program and haven’t manually changed back to the default program yet.

I think even Phonak, starting from their Lumity version, is also beginning to do this similar thing that Oticon has been doing since the OPN → adjust the noise suppression value on the fly in its general program instead of forcing a program change from general to SIN.

Thank you for the advice. A couple of people have had issues with the widex (hair rubbing on the device causing noise, and another said that the voice in a noisy situation wasn’t a patch on the intent)…but I need to trial these for myself.

I remember back with my Alta Pro aids I could hear a click or tone when moving between quiet and noisy environments.