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First pair of hearing aids but see no improvement

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@DaveL said:

Second, put your index fingers in each ear. If there’s no change you have domes that were selected right. If the volume changes (becomes louder) you need to see your audiologist to get the dome type changed.

You’re implying that he should get regardless, which is not necessarily the case for everyone. With his type of hearing loss, open domes may work better for him because it would let in the natural lows for him to hear since he doesn’t need to rely on the aids to amplify the lows for him. Plus it would help minimize occlusion for him. Usually you’d only want to put up with occlusion because you have to due to severe hearing loss and feedback. If he uses open domes, the audi will specify that in the software and the software will take that into account to adjust his prescription to compensate for any leak due to the open vent.

The main disadvantage of using open vents (for folks who have suitable hearing loss to wear them) is that streaming may sound more tinny because the amplification from streaming can leak out somewhat through the vent, especially on the amplification of the lows. That’s why Phonak came up with the Active Vent receivers to allow the vent to be closed at the appropriate time.

Is there any chance these aids are simply not working? Batteries not charged type thing? It’s hard to believe someone who hasn’t worn aids before isn’t noticing the difference in things like water running and paper crinkling.

@tribalrose said:

It’s hard to believe someone who hasn’t worn aids before isn’t noticing the difference in things like water running and paper crinkling.

Last year, in my worst ever fitting, I trialed Resound One 9. They were only adjusted for my and nothing else. They were worthless for listening to speech. The high sounds were not noticeable either. I find it easy to believe if the aids were not properly fitted.

In reply to @tribalrose

I think they’re working cause I hear feedback when touch the aids. But yeah it’s possible I’ll ask her next time when I meet with her. Oh audi said we can do remote care appointment to make things clearer so hopefully it will work out. Is it normal that I can still hear water running, paper crinkling and bird chirping without the aids? Cause I can still hear them . I hear water running in the pipe too

Edited

In reply to @Rain.Drop

@Rain.Drop said:

Is it normal that I can still hear water running, paper crinkling and bird chirping without the aids? Cause I can still hear them . I hear water running in the pipe too

Your hearing loss in the mids and highs is only moderate, not severe. And your low frequency hearing is actually quite excellent. The water running and paper crinkling sounds do have components that span from the low end to the high end, so it’s natural that you can hear them, probably just not as sharp and clear as how normal folks hear.

Even the bird chirping, with your moderate loss, you can still probably hear it without the aids, but at a softer volume, albeit still noticeable. Once the aids are adjusted properly for your loss, you may be a little surprised at how much louder the bird chirping sounds to you with the aids on.

Your level hearing loss is not about not being able to hear things. It’s more about losing the clarity on things which can make it hard for you to be able to discern, especially speech.

In reply to @prodigyplace

Yes, remote care runs against every aspect of best practice from first principles.

You don’t even get to check whether one aid has a faulty receiver/blocked mic etc.

Even the long term averaging systems built to deal with microphone sensitivity/phase changes struggle with blocked/unblocked mics.

Remote care does have a role in extremis, with a sufficiently educated client and a newish fitting. Anything much older and you’re basically rolling the dice as you can’t be sufficiently confident in the result of your changes.

In reply to @Rain.Drop

Factory fitting on Oticon under VAC+ prescription is usually significantly under target. Tell her you want her to do or you’ll spend your moneybwith someone who has the goddamn decency to do their job properly. You’ll likely find full precription too loud butbshe can reduce the adaptation level to level 1 or 2 via thebGll Genie fitting software. These lazy pricks can’t continue tonruin the industry reputation. Get abrefund and find someone else.

In reply to @Um_bongo

I agree with you, @Um_bongo. I think remote care was probably never intended to be a replacement for in-person care. The intention is most likely that you initially get in-person care first, so you can get your done and all the initial basic checks and tests done. Then once everything is up and running adequately, the remote care can replace subsequent in-person visits just for minor fine-tunings.

But unfortunately, the original intention of remote care get diluted and the remote sales model starts making use of the remote care capability to bolster the remote sales lower cost advantage further. Now instead of just doing one initial pre-programming for the client in the pre-sales phase and then be done with it, and the client has to be on their own after that, the remote-sales businesses can now “hook” more clients in with the promise of further post sales adjustment via remote care, albeit not really disclosing to the client clearly up front the drawbacks that come with the 100% remote=care-only model.

Agreed: it’s probable that the manufacturers will use it as a tool to de-skill the distribution chain.

Unfortunately this business actually requires some face to face time to do the job properly, but that doesn’t square with their model.

In reply to @Louie

The OP did say that was in the plan. Leaving it until after an initial adjustment period is not my style, but isn’t necessarily incorrect. Perhaps the remote session was just offered as a stop-gap prior to the REM appointment because of scheduling reasons.

Why they would not want to run initially is beyond me. If the first fit is way off base, why subject the patient to such a nonproductive experience and give them such a bad taste to start with? Lazy is the only thing I can come up with.

I don’t know. Some clinicians like adjustment periods? Some don’t like to provide free services? Sometimes time constraints if a patient wants something same day? I can think of some reasons.

Adjustment to what? OP cant tell the difference. It’s a total time waster. What’s the reasoning behind giving them time to adjust to a setting that will likely change significantly. There’s a difference between a lazy first-fit, and running and then dropping adaptation to 80% for adjustment/adaptation. At least with the later they get time to adjust to the tone of hearing aids and the volume comes with time. With a first-fit it’s highly likely that both the tone and gain are nowhere near what is prescribed.

I dunno, I’m just trying to be generous to another provider. :laughing:

Like, what if they do an audio and discussion and then find out the patient was hoping to walk out with something, and they want to accommodate that but don’t have enough time for but then book them to come back ASAP which is four weeks out on their schedule.

My apologies Neville, I know the tone of my response was barbed, but it’s not directed at you. I’ve heard too many horror stories far too often to be giving any clinician the benefit of the doubt. It’s disheartening and clients need to be educated and empowered enough to stop funding lazy Auds. IMO, if you dont have time to fit correctly, don’t fit at all. There’s too much at stake. Most people are sceptical enough of hearing rehab as it is and won’t give you the luxury of a month of increasing disappointment to do your job the way you’re supposed to - nor should they. There’s already a damaging stigma in our industry - we have to earn a client’s trust fast.

In reply to @Neville

Interesting to hear all the comments. I don’t think I have ever had it in the last dozen years and 3 pair of hearing aids. The first time I had it was when the at Vanderbilt programmed my new Phonak Link that goes with my new . So, maybe it’s not common for AuDs to all have that?

The who fitted me with the Oticon OPN 1s in 2016 never did for me either. I asked on the third visit why she didn’t do REM and she said that she wanted to see how well it’d work out for me first. If it hadn’t worked out well enough, only then she would do REM on me, but since it worked out well, she didn’t think REM was necessary. At the time I wasn’t as informed as I am now, so I took her words for it. But in retrospect now, I know it was a cop-out/lazy answer. I was never happy with her knowledge of the OPN so I decided to go the route anyway after 3 visits with her. I only used her for warranty claims/service after that.

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