I have ski slope hearing loss, have had hearing aids for 15 years, & Phonak Sphere I-90s for a year & a half. I wonder if I expect too much?
I struggle with grandchildren & soft-spoken adults in a quiet situation, even in Sphere mode. I know they are talking, but there isn’t clarity. A noisy restaurant in sphere mode is impossible, but I manage okay in a less noisy restaurant with sphere mode.
Car conversations are impossible in sphere mode or speech in loud noise. Roger helps in the car, if there is just one other person. After numerous adjustments & , my audiologist says that there is nothing more that she can do. I can hear crows and doves, but no songbirds & crickets. I have Cshells with vents & M receivers. Am I expecting too much?
A noisy restaurant in sphere mode is impossible, but I manage okay in a less noisy restaurant with sphere mode.
The relevant articles backing rather P receiver (I consider UP for myself, but it’s only my financial risk, I don’t encourage to overshoot if finances limiting your ability to experiment):
Additional thoughts:
These articles emphasize the important role of a sufficiently high MPO, especially when hearing in noise. Note that theemphasize the important role of a sufficiently high MPO, especially when hearing in noise. Note that the first article presents a situation with an SNR of +15 dB speech in noise, so quite favorable, but with too weak receiver intelligibity can be poor.
After numerous adjustments & REM, my audiologist says that there is nothing more that she can do. I can hear crows and doves, but no songbirds & crickets.
You had , but have she reached the target gain in the highest frequencies 2-8 kHz? REM isn’t a magic wand if can’t reach the necessary gains. It can be difficult especially in 6-8 kHz range, or even from 4 kHz if diameter of vent is large.
What’s your in quiet percentage in each ear separately and ? (Word Recognition Score)
If you had problems with loud places - what’s your (Maximum Pressure Outputs), perhaps you have them too conservative, too low? Ideally, they should be based on Loudness Discomfort Level () during audiometry and measured in REM by playing 90 dB stimulus (or 85 dB) to reach saturation of the receivers.
These are great questions and comments & I need to read more about them to understand fully! Thank you! My word recognition scores are: right ear 36% at 90 db and left ear 62% at 85 db. I just measured my vents & I believe they are:left ear 5mm at the widest part of the triangle & right ear 3 mm.
My audiologist says that a P receiver won’t help, but I would really like to try it because I feel that I need to do something because I am frustrating to my loved ones and colleagues. I am open to trying anything at this point.
All I could find in the notes is that was not exceeding estimated .
My word recognition scores are: right ear 36% at 90 db and left ear 62% at 85 db.
These are quite poor below or on the edge of 60% threshold to be eligible for cochlear implant evaluation (which doesn’t oblige you to do surgery, but provides you much information about your hearing).
I wonder how many times you have performed test (I think about repeatability).
Especially right ear is poor and speech understanding test should be repeated with hearing aid turned on.
Keep in mind that in most cases don’t help you to overcome that percentage, only can do.
I just measured my vents & I believe they are:left ear 5mm at the widest part of the triangle & right ear 3 mm.
These are huge. With that diameter it is much less probable to achieve proper high frequency gain before feedback. Audiologist set them that keeping in mind that you have good low frequency hearing, to avoid occlusion effect.
To avoid occlusion effect with smaller vent, the impression should be done deep, at least 5 mm after second bend of ear canal. It’s because earmold could achieve the bony part of ear canal, which helps decrease occlusion effect.
The quick way to check effectiveness of P receiver and preper high frequency gain could be power domes. I don’t know, which size of them would be the best. You can push them deep, just to the bony part of ear canal for checking roughly occlusion effect.
You probably have problem with upward spread of masking. That means good low frequency reception “mask” (hinder) the higher frequencies, which makes speech hard to understand. The noise is also mainly in lower frequencies.
There are a couple of points of concern. If you have a sever hearing loss, and your practitioner is recommending a silicone dome, the rules of sound physics will not accommodate that style of coupler. If your thresholds are below the 60dB thresholds, then the feedback management is going to cap the output and you will not receive the benefit of that portion of the speech spectrum. In that case, a custom earmold would serve you the best. If your practitioner performed a REM, you would notice that the fitting screen would reflect that the output has been capped at the most vulnerable region, hence loss of audibility. Hopes this will help you a bit.
Yes! I have made some progress! I have P receivers & they make a huge difference. Thank you for that suggestion! I started with power domes & I love the depth they provide, but have found them irritating to my ears. My audiologist ordered deeper molds, but Phonak made them shallow instead. They have no vents & that gave me some new & improved sounds, although chewing & talking have been terrible. Now I am at the settings of the custom mold without vents (more gain), but with power domes. I have to make sure the domes are just right to prevent feedback, but it seems good so far since I also have the additional gain. After the holidays, I will pursue a deeper custom mold. Your thoughts?
Sounds like you’re making progress. If it’s not adequate I’d suggest checking out Phonak’s (Sound Recover 2) It takes some adjusting of settings to get it right. It’s not just a turn it on kind of thing.
Thanks for the detailed information about your hearing, very helpful.
Your upper frequencies are severe/profound hearing loss. P or UP receivers are needed if you don’t use Sound Recover technology. I agree with MDB about giving this technology a try. It’s difficult for some to adjust to but those that stick it out typically have very good results concerning but not always. If you do frequency lowering you will fine that POr UP receivers just might not be needed.
You are getting some great information. Thankfully your fitter is listening to you. Your hearing is getting to a point that proper hearing aids and adjustments are needed. A fitter that understands is important.
If your WRS scores don’t improve with properly fit aids I also recommend getting a evaluation. The evaluation can be very helpful about understanding your hearing loss and possibilities to help it
They have no vents & that gave me some new & improved sounds, although chewing & talking have been terrible.
Bold move, I regret not ordering cShell with no vent, because I didn’t know that it seems Phonak can’t make 0.6 mm pressure vent. I received unwanted 0.9 mm.
After the holidays, I will pursue a deeper custom mold. Your thoughts?
Great, fingers crossed and I am glad that you had so much improvement just because of improved “basics”, which is better optimized receiver and earmold.
My thoughs? You can read my advices here, they’re pretty universal, not only for titanium, you can print it or show to your :
EDIT: This is continuation of my topic about my experiences with titanium cShells:
END OF EDIT
DISCLAIMER: Titanium cShells are not a cure for anything. Please have mercy on your HCPs and don’t insist on titanium if you don’t have experience with acrylic earmolds/cShells (you used domes only) and you don’t have an allergy or a narrow ear canal, because in case of discomfort the waiting period for remake will be too long. Make sure you’re comfortable with acrylic/silicone ones previously.
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If your WRS scores don’t improve with properly fit aids I also recommend getting a CI evaluation. The evaluation can be very helpful about understanding your hearing loss and possibilities to help it
Agree, especially in case if your poorer ear ~30% is repeatable. Probably no will break this ceiling for that ear, but of course first try to adjust your hearing aids to their maximum potential.
Poland
Texas Hill Country