Advice for learning to optimize my Sphere Ultras?

These are some great questions and maybe I can “tackle” a few from my experience (I have the same hearing aids) and my hearing loss is a little different than yours.

1. I am a business owner. When talking to a client in person (they all know I wear HA and respect my limits), I would often adjust MyPhonak App in real-time to adjust for all the noises in the particular environment. Tweaking each specific program did take some time to get it close. It’s never perfect.
2. This depends on the settings your audiologist has put in. In my particular case, I have AutoSense OFF. This way, I can manually change whatever program I have and not let my hearing aids do it. Some people like that, but I find it annoying. I like to have full control over my hearing aids. See your audiologist about this.
3. I can’t remember, but something like 4 programs per base setting and up to maybe 10 or more? Play around with it in real-life scenarios and adjust as you go.
4. Sometimes it takes getting used to. To me, it sounds like you need to get your HA tweaked a little bit more and take control of your hearing aids MANUALLY. That’s what works for me.
5. This is a great question. Any audiologist worth their weight in gold will be able to translate what you’re telling them into what you need to have done. They’re trained to do this, actually. I remember telling my audiologist things such as “I sound like I’m wearing old-school analog hearing aids I’ve never worn before,” “I sound like I’m in a barrel,” and your “errrrrrrs sound like oooorrrrssss” “Your S letters when speaking sound like Sean Connery!” etc. etc. The audiologist will know what you mean.
6. Explain to your audiologist.
7. This what mine do also. The right hearing aid is the primary for streaming, thus eats battery slightly quicker. If you feel it’s eating battery really bad, you might wanna have it looked at. I had this issue when, for some reason, my hearing aids were stuck on a program even though it sounded like the program it was on. I think this was a rare type of error. What I did is I screenshotted my settings on my phone, deleted them and re-entered. But, this is mostly normal for the primary.

Good luck.

@Bell said:

I’d love some help troubleshooting and getting advice on the following things!

Here are a couple of possibly useful comments on your questions/issues:

1. Does anyone have advice on making a “ teaching ” programing setting that prioritizes hearing quiet children’s voices…

Quiet children’s voices? Where did you get these children? Are you sure they are actual human children, and not some form of fairy changeling/alien invader?

I’m not certain what kind of program would work best for this situation, but you might want to play with a variant of the Spheric Speech program: Create a separate copy of it for manual use, and then try tuning the level of noise reduction; I suspect that what you’re looking for would be a bit less intense than the default Spheric Speech in Hell mode, with “Spheric speech clarity” reduced from its default of 7 (full strength) to something a few notches lower. You might also want to play with microphone directionality - although the default of 12 (moderately directional) may already be OK. You may also want to try changing the “Soft noise reduction” option to see if it helps with the pencil taps. (Best practice is to change one parameter at a time - but of course this is a major pain if you’re not set up as a DIY-er and have to go back to your audiologist for every program change.)

2. Is there any way for me to know if my aids are currently using sphere? Would using a custom “classroom” program keep sphere from automatically activating when needed?

Phonak is kind of a pain about letting you know what automatic program its AutoSense operating system has decided on; part of this may be because AutoSense can actually interpolate between two different programs (at least when the programs are not “Spherical”), so at any given moment you may be at something like 60% “Calm” and 40% “Comfort in noise”. The only thing you can really do here - and it’s definitely annoying! - is go into MyPhonak, tap on “Automatic” (I’m assuming that’s what you’re running, since you want to find out what the automatic logic is doing) and then tap on “Adjust” in the lower-right of your screen. The next screen that comes up will show you which automatic program you’re adjusting.

If you use a manual program - whatever basic program it’s derived from - then AutoSense is not in control, and you will be hearing the results of the program you’ve chosen. Obviously this approach is a good idea only when you’re in a reasonably static environment for some span of time and you neither need nor want your aids to be adjusting their approach.

@Bell said:

3. What other types of custom programs are worth making? How do I test them and make sure they are appropriate?

There’s no one-size-fits-all answer to this question - it depends on your hearing experience, lifestyle, and preferences. I’ll give you an example of my own custom programs, which are tailored to my own needs:

1. Standard Spheric Speech in Loud Noise - basically just a copy of the standard, default Spheric Speech in Hell program. (Having a user-triggered version of Spheric mode is a good general recommendation; and some people also like to reduce the volume level at which AutoSense automatically triggers Spheric mode.)

1a) Spheric “narrow” - a “local copy” of Spheric mode, with speech focus set near the narrow end of the range.

1b) Spheric “wide” - you guessed it: a local copy with speech focus set wide.

2. Music - a copy of the standard Music program, which itself is set to minimize almost all the fancy stuff that the hearing aids can do other than provide amplification.

3. Singing - based on Music, but with the equalizer set to “Clarity”, fairly wide directionality, and some extra amplifications to faint sounds. This is for my a cappella singing rehearsals - it’s designed to support me in hearing all the little details (mostly regarding what can go wrong!) rather than enjoying music as a listener.

4. Tinnitus Balance - based on “Calm”, but with Phonak’s Tinnitus Balance feature enabled. I trigger this mode when my tinnitus is bugging me and (for whatever reason) I don’t feel like using a masking program like “myNoise”.

5. Calm + Ambiance - based on “Calm”, but with almost no noise reduction, wide sound focus, and a notch or two of quiet-sound amplification. This is also a response to my tinnitus: I want to hear all the meaningless high-frequency stuff when I’m in a quiet room, because my tinnitus is basically my brain’s stupid response to missing its natural supply of high-frequency sound. (Quiet rooms are the enemy of the tinnitus sufferer - and both my private and professional lives involve a lot of time spent in quiet rooms.) This is a program I spend a lot of time in.

6. Driving solo - this is a new one I just set up and haven’t even used yet. It’s based on Music, and is intended for when I’m alone in my car with music playing over its (rather good) sound system. In its preliminary, untested-in-real-traffic version, it’s got noise reduction turned to zero, sound focus on almost full-wide, and everything else left alone. I created this program because AutoSense seems to have a very hard time deciding that what I’m playing in my car is music; I’m not sure if the problem is because of the noise of the car itself, because Phonak has really stodgy taste in music, or perhaps a bit of both. Previously I had noise reduction in programs like “Comfort in noise” turned way down so I could still hear the treble in the music my car was playing; but I decided to restore the original level of noise reduction in most of the automatic programs and use this program when I’m driving instead of “Automatic”.

Your list will be different, because your hearing is different, your lifestyle (especially your work) is different, and you’re probably less of a techno-nerd than I am. (For example, I have three different manual Spheric Speech options even though in fact I studiously avoid being in situations where I would need any of them; since I got my hearing aids back in September, I don’t think I’ve been in a single “Spherical” situation for more than a couple of minutes at a time.) Testing whatever programs you set up is just a matter of trying them out to see if they’re making you happy - there’s no objective standard other than your understanding what you want to understand at a level of effort you feel is acceptable.

@Bell said:

4. Going from hearing aids with only one programing setting has been a shift… it’s a weird adjustment. Is there a way to “stabilize” programing in some way? Hearing the programing shift has been a little odd to adjust to…

You can stabilize things by using manual programs; but it’s equally true that there’s a normal acclimatization process in switching from single-program hearing aids to something as “interventionist” as the Spheres. The business about the Spheres switching from voice to voice (presumably in Spheric Speech mode) is something other users have experienced as well; some of the people on this forum, particularly @JordanK , have written at length about their experiences in this regard. It may be that simply spending more time with the Spheres will get your auditory circuitry working better with them; beyond that, I can’t offer much - but maybe some others on the forum can.

@Bell said:

5. This one is weird- How do I explain what I am hearing to my audiologist? I am having trouble with finding language to express what I like and what my concerns are…

Wow - this is a hard one! I just gave up, bought a Noahlink and installed Target, and set myself up as a DIY-er - I usually understand my own needs and annoyances, so I save myself the effort of making an appointment and trying to translate my experiences to the local language.

Assuming you don’t want to go that route (and it’s certainly not for everyone!), I’d say that your best hope is that a combination of persistence on your part and some patience, wisdom, experience, and insight on your audiologist’s part will have to do the trick.

@Bell said:

6. What settings would make it so someone scrapping a bowl with their spoon does not sounds like nails on a chalk board?

1. Avoid environments with bowls and spoons.

2. Failing that, I suppose the first question is which program(s) you’re in when this is happening. Programs like “Comfort in noise” and “Speech in noise” (and of course “Spheric Speech in Horrible Cacophony”) should already have a degree of noise reduction; but “Calm” might conceivably be a problem, especially if its “Speech enhancer” is turned up very high and is somehow deciding that the bowls are trying to talk to you. Have you discussed this one with your audiologist?

@Bell said:

My right hearing aid seems to be going through battery slightly faster than my left

How much faster? A few percentage points at the end of the day is normal, as @cvkemp explained. But if it’s more than that, there may be an actual hardware problem here - there have been some issues with faulty receivers that resulted in excessive battery drain.

I hope some of this was at least slightly helpful!

It is the one that your aids had determined is the best for your current environment. There are 6 possible programs that the aids can use. Calm, speech in noise (not Spherical), speech in loud noise (Spherical), Music, speech in Car, ?. Sorry I don’t remember the last one.

@cvkemp said:

Sorry I don’t remember the last one.

Car crash in progress.

I can’t answer most of your questions, but if you have a restaurant mode, try it in the classroom. The critical feature is that the aids hear what is in front of you and tend to suppress everything not directly in front of you. To speak to a child, you would look directly at them. You can adjust the “Focus” from wide to narrow as needed. There is also a control that I have never used that controls how soft and loud noises are treated. So, where I am headed with this is for you to build your own classroom mode, possibly starting with restaurant mode as the base program. Restaurants have a lot of silverware on plates, noise…

Next, not on your list: I use the TV connector, which streams TV audio directly to my HAs. You may be able to stream TV directly over Bluetooth, depending on your TV’s features.

Yes, I used Target to set up a manual Spheric speech in loud noise program that is not linked to autosense. I used the settings suggested by ChatGPT. So when I use this manual program I don’t hear much if any benefit in speech in noise. Maybe I should have the audiologist send the aids to Phonak for evaluation.

The Target settings for my manual speech in the loud noise program are: the hearing aid microphone is UltraZoom, and Spheric speech clarity is set to Strong. All other settings are turned off.

@Rambo26 said:

with custom c-shells.

What is diameter of the vent? Did you have REM? Maybe your feedback threshold is low and doesn’t let you set proper high frequency amplification. I certainly has benefit from Spheric program.

Which receiver do you have? M? You should use P because the larger MPO provides better amplification of speech peaks, helping to differentiate them from noise.

Even sophisticated technology such as AI will not help if the basics are not managed properly.

@Rambo26 said:

My vent sizes are 2.4mm and 3.5mm.

That’s huge and probably the source of your problems. It’s because it didn’t let to amplify low frequencies, which leaks outside of ear canal. You have reverse slope hearing loss part in your lows, which requires more closed venting, probably maximum pressure vent (0.5-0.8mm).

That large vent makes your feedback threshold so low, so that you’re surely underamplified in the high frequencies.

If the basics described above are not adjusted/fitted correctly, no AI will help you.

Why HCP ordered that vent? Probably because she/he was afraid you’ll feel occlusion effect you would refuse to wear hearing aids.
I often see that conservative approach, which is annoying, because this is lack of appropriate counselling and preparation of patient to a bit trial and error.

My audiogram is a bit similar to yours. I have cShell with UP receiver with 0.9mm vent.

I recommend UP because it provides much more high frequency gains than P.

I am pretty happy with my cShell, the only one I am not glad is that doesn’t provide earplug effect like power domes.

Don’t look into fitting range of the UP. Its internal noise is very quiet, I don’t hear it.

You can experiment a bit with P receiver in the power domes. However, I recommend Unitron power domes, not Phonak’s, because the former are a bit thicker and stiffer, providing better feedback threshold and isolation from direct patch for noise.

You should push it carefully very deep, past 2nd bend of ear canal. It is a bit trial and error to determine if you need M or S size of power domes in that depths.

Your final cShell should be from a deep impression, with silicone reaching at least 5mm past 2nd bend of ear canal.

I am now working with the audiologist who sold me the hearing aids. She is out of state. Anyway, she is going to remake my molds with smaller vents. And for some reason, she is recommending medium power receivers rather than power receivers. I sent her an email asking which vent size she plans to use and why she prefers medium receivers to power receivers. I will post her answer when I get it!

How do you press them in so deeply? Pressing on the back of the receiver? Can you reach without pressing the wire? Are they then sometimes hard to get out?