Round 3; DING!

Hi, all!

Well, it’s definitely a mixed bag. I need to make an appointment to visit the audiologist due to two particularly annoying features:

1.) My left ear is very uncomfortable, nearly always. As well, the mold frequently migrates back out after its initial insertion, though that seems to be a singular (per day) event; perhaps I’m not fully seating it? Given that I had to go through 3 impressions and productions to get (Beltone) molds which actually were both comfortable and stable, it’s possible we’ll have to do that with Phonak. And, in fact, until they were made (with the higher power receivers), I put the Phonak (medium; it’s all he had on hand) receivers in THOSE molds and did very well, I thought. I’d gone with the Titanium molds based on other reviews here; if I don’t get more comfortable after the remake (presumed) of the left one, I’ll apparently have to eat the $312 charge (not insured) and revert to silicone. In the meantime, my Beltone molds MIGHT work with straight-up high power receivers, in which case, as there is some splitting of the receiver-in/out, and they’re still under warranty, I’d be able to get a new pair of Beltone Silicone molds - which mount and seal properly. I believe that Phonak’s molds are all of the same ilk, which is to say markedly less canal coverage than Beltone’s.

Here’s an example of the Beltone Left mold from all sides - left and right are very similar, with full post-turn width/depth; there’s no “handle” other than the rear-facing nesting triangle keeping it fully centered, though that entirely suffices to get them out (as well as to properly align/seat in my ear):

And side-by-side views of both the Phonak molds, likewise with no handle; I have to pull the receiver power/data line to remove them:

As well, I had an infection in that (left) ear which I caught early on, using my spare Augmentin and power-flushing (small bulb syringe) followed by the usual mix in ear drops; that was resolved in a few days, though I did continue a full Augmentin course. Both Eustachian tubes are now clear. I presume that the last two infections were a product of retained water after water skiing, so I have taken to flushing that ear after each session, now.

In general, the speech portion is drastically improved over the Beltone experience, despite my having my setting reverted to the one I’d THOUGHT to be wonderful; that’s led to my abandoning the Beltones, as, regardless of any other issues with Phonak, they are far ahead of my best with Beltone. As an aside, I’m not trialing the most current Beltone, regardless of whether or not there might be an insurance funding for them, as there’s a $1500 surrender fee if I don’t keep them; I can’t take the risk. Besides, Phonak asserts that their technology is unique (Sphere, on which more anon); whether it actually is I dunno, but:

I’ve had the opportunity to confirm my suspicions about the Sphere feature. In general, e.g. a kids’ performance on “Grandparents Day” yesterday, in a gymnasium banquet-style setting (all 8-top rounds), I clearly heard all the conversation at my table - AND, had to nearly shout for the others to hear me if I was conversing directly. As noted in other reviewers’ comments, it’s so effective that one doesn’t realize that the noise is sufficient that what you think is the level - and to which you adjust your speech - is actually FAR higher.

And last night, I repeated the restaurant experience (same place, same booth), this time with live music. And, again, there were a couple of very short disappearances of the Sphere protection, as well as the need for me to nearly shout to be understood by my wife only 2’ away.

Huzzzah for Sphere!

On the other hand…

2.) The vendor - whether tired of me (folks can get that way, as I refuse to put out mid-4-figure money (the Co-Pay; full retail gets very close to the 5-figure numbers) without getting the results I need to justify that expense) or just wanting to take one segment at a time - did not do anything with the “music” setting.

As to whether that will resolve on my next visit, I dunno, as “music” actually means “listening” - not the full-on music experience, which would include hearing accurate tonality (proper frequency per note), other voices around me (in a choral setting), and particularly hearing my own voice (in order to match tonality).

All of those were wanting, in any setting I tried, in a choir rehearsal, and in other cases, in a church service (after I and the director agreed I had no business being in the choir with those realities), in the congregation. Hymns I actually knew (the denomination isn’t the one I grew up with, nor the other I spent 10 years in before moving back to GA) didn’t do any better with my attempts at my - even knowing the part - bass line, as I couldn’t reliably hear the notes either in or outbound (“own voice”).

If we can’t resolve that, I really have no idea at the moment what I’ll do about it. I’m not the least bit convinced that it’s impossible for me to get accurate tonality in and out.

For the pros here, is this an issue which REM/LSM would attack more effectively? As discussed previously, I’m not fond of the idea of abandoning this practitioner before my 60-day trial (United Health Care, before I have to cough up the CoPay, though I did have to buy the molds outright) expires, only to go to another which has REM/LSM, praying that using that would resolve that issue.

So, again for the pros: If you could not resolve my issue(s?), but REM/LSM (reasonably) WOULD resolve them, is it reasonable to say, “Sorry Charlie!”, give back the Audeo Sphere Infineo I70s and go down the street an hour to the folks who DO have it? Or, more honorably, tell my vendor what’s happening, and pay the other guys to troubleshoot with the presumed superior REM/LSM experience instead of a simple audiogram?

Mind you, I’m not to that point, as I have a lot of detail of different situations and my issues or plaudits of them to share with the vendor before I give up. But if we can’t (or, maybe that’s doing a Quixote?) resolve what I can’t imagine is impossible technically, I want to pursue tonal recognition to its resolution.

All that said, I’m almost 5 weeks into my ~8.5 week trial, and I need to get some settlement on my issues or back out. I’ve been busy enough that my time got away from me a bit, so the next couple of weeks will be very focused on achieving my music metric, as I’m close enough on the speech that I believe that can be resolved once I’ve actually paid for these (if that’s the recommendation, vs walking away and starting over with the REM/LSM provider). I think I put myself at risk by being distracted with ordinary life and making excuses for the not-yet-addressed music issue.

Sigh…

My apologies for my usual length…

@Skip said:

For the pros here, is this an issue which REM/LSM would attack more effectively? As discussed previously, I’m not fond of the idea of abandoning this practitioner before my 60-day trial (United Health Care, before I have to cough up the CoPay, though I did have to buy the molds outright) expires, only to go to another which has REM/LSM, praying that using that would resolve that issue.

I think it’s better to choose the practitioner who follows best practices, where REM is important part of them. Your current one doesn’t have it, so after paying for your cShells, it is completely understandable that you choose the one who has REM equipment.

For what I see in your pictures, you have P receiver. Shouldn’t UP would be better? I has not only better headroom, but also better frequency response up to 8 kHz (counterintuitively, only in Infinio line SDS 6.0 - Sound Delivery System).

Your audiogram here make your ears perfectly for UP receivers.

I don’t see clearly if they have rough surfaces, which helps much in staying in place in yours ears.

I am not sure if they should be longer, because cone shape as in your photos predispose them to slide out.

Another option is asking your current/new audiologist if they can order silicone earmolds with UP receivers, ideally, they should reach quite deep into the ear canal.

@Skip said:

(Clipped, as it’s directly above Bm’s comments in his next-up post)

@Bimodal_user said:

I think it’s better to choose the practitioner who follows best practices, where REM is important part of them. Your current one doesn’t have it, so after paying for your cShells, it is completely understandable that you choose the one who has REM equipment.

For what I see in your pictures, you have P receiver. Shouldn’t UP would be better? I has not only better headroom, but also better frequency response up to 8 kHz (counterintuitively, only in Infinio line SDS 6.0 - Sound Delivery System).

Your audiogram here make your ears perfectly for UP receivers.

I don’t see clearly if they have rough surfaces, which helps much in staying in place in yours ears.

I am not sure if they should be longer, because cone shape as in your photos predispose them to slide out.

Another option is asking your current/new audiologist if they can order silicone earmolds with UP receivers, ideally, they should reach quite deep into the ear canal.

(His comments left despite it’s being the previous comment, for clarity in my usual long-windedness )

How do you determine the sort of receiver? He had only a medium intensity one when I started, using my Beltone molds as previously noted so we redid the settings/adjustment-metrics when the titanium shells arrived. I’m unfamiliar with the labels for Phonak, so don’t know what either P or UP mean in terms of my case.

The audiogram you cite isn’t what his review found (which may impact his choice); here’s what HIS looks like (response 61 in this thread):
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Whether that’s accurate or not I can’t judge - but it’s markedly better than the relatively recent previous ones. My assessment on that is that it’s impossible to fake successful hearing of tones, so, for whatever reason, my hearing seems to have improved in those lower frequencies compared to the previous couple of years’ experience (???).

As to the titaniums, I believe that these are the textured version of cShells, based on the lack of ‘shiny’ on them. And, as I try to figure out how this and my previous very successful silicone ones (pictured) sat in my ear, it appears that the big dent in the Phonaks equates to the turn to the relatively-rectangular portion of the Beltones, making the shape of the part past that turn more, as you’ve noted, more like a cone than a sandwich - but, also, perhaps, of little moment as to efficacy of sound reaching my eardrums. Whether or not the shape has anything to do with my discomfort in my left ear and (only infrequently in my right) is unknown, but I DID have to go through 3 sets of impressions to get, finally, a set of Beltones which fit perfectly.

And, while I may be mistaken in my presumption, as the cShells weren’t covered under my insurance, I expect that I could, indeed, have silicone ones (presumably with removable/more easily swapped receivers) made in hopes of them fitting better, but at a cost.

ON THE OTHER HAND…

If the receivers are appropriate to the current audiogram, and are similarly somewhat larger as were the Beltones HP vs M receivers, it may be that I can get some UP receivers to test, in my Beltone molds, side-by-side with the titaniums. I do know that whatever was initially provided were smaller than the Beltone space allotted to their larger HPs, but wasn’t what he needed (higher power of some sort) to fulfill my prescription. Which goes back to not knowing what the current receivers look like if they were out of the shell; how do you determine what’s there from the dark square presented?

And, finally (at least for this round, DING! ), I’m still mulling whether I’m being shortchanged in my musical acuity (what we’ll be addressing as we wind up the period my insurer allots for evaluation/twiddles) by not having REM/LSM, and the expectation that I’d have to pay for anything which happened at the more-distant outfit. But that thought makes me wonder; would I expect to have to pay for future visits to my current provider, in any case, and if so, that would seem to make movement to the other moot (I’d have to pay in either case). (??)

As to my cShells, am I appropriate in expecting that Phonak will remake them as needed until it’s done right, or is this a Sorry-Charlie event in which I’ll have to pay for each subsequent impression/production cycle (recalling the 3x in Beltone)?

And, to reiterate:

@Skip said:

So, again for the pros: If you could not resolve my issue(s?), but REM/LSM (reasonably) WOULD resolve them, is it reasonable to say, “Sorry Charlie!”, give back the Audeo Sphere Infineo I70s and go down the street an hour to the folks who DO have it? Or, more honorably, tell my vendor what’s happening, and pay the other guys to troubleshoot with the presumed superior REM/LSM experience instead of a simple audiogram

My apologies for repetition, but I’m not sure when the 60 day clock started running; it may have been on the day I was tested, and sent out with the aids and not-high-power receivers and power domes, or it may have been on the day I paid for and took possession of the titanium cShells with the proper (presumed) higher-powered receivers, an almost 4-week difference (8-11/9-4).

If I’m to jump ship (start over, entirely, with the further-commute, but REM/LSM-equipped vendor), it would be (ethically, for my conscience) better do to so now rather than have him do more work and then be stiffed on the sale…

Sigh. Nothing’s simple…

Again, my apologies for logorrhea…

@Skip said:

I’m unfamiliar with the labels for Phonak, so don’t know what either P or UP mean in terms of my case.

P - Power receiver

UP - Ultra Power receiver (stronger and with wider frequency response, which is important especially in 6-8 kHz zone. I think that frequencies are important for you for hearing the ‘s’ sound and for understanding in the noisy environments.

You can have UP receiver for sure if your hearing loss is poorer tha 50 dB, which is the case even with the newer audiogram you linked.

UP receivers cannot be attached to the domes, they are only for cShells, I haven’t experience about getting them with silicone earmolds.

The frequency loss segment showed that I needed the UP…

@Skip said:

Right; I think I saw that on further digging - though no reference to LSM.

@Bimodal_user said:

Don’t rush too much energy for LSM - I am not conviced that it is more reliable than REM with recorded validated stimulus, like ISTS at 50, 65 and 80 dB (or 55, 65, 75 dB input).

Theoretically LSM would be better for specific things like adjusting to your wife voice, but you are not sure if it will work overall.

@Skip said:

If getting the very best from a Sphere-enabled Phonak can’t beat the mike-enhanced Beltone speech recognition, there’s no point in not recovering my $2500 copay and just living with the reality of “miked wife” until a few more generations of aids come out.

You always can ask if they could do REM-based fitting of your Beltones (at least as a spares) and what price is for it.

In fact, I’ve just done that; I reached out and got a reply from a front-desk guy. From their picture, and the 3-branches list, I presume they’re pretty big:

Home

North Georgia Audiology is offering comprehensive hearing evaluations, hearing aids, and tinnitus treatment. Schedule your appointment today.

IF they can work on Beltone, I’ll try that. Otherwise, the response I got WRT Phonak was “Not until you own - and can prove it - will we work on Phonak” - though I expect they’d do that if I were trialing with THEM…

As well, and as expected, they’re locked out of Beltone, so getting REM/LSM accuracy there is impossible.

Perhaps worse (I don’t have a response yet) it appears that the closest of their 3 locations doesn’t have the gear, as I got " There are two offices that may be able to help you Go To Hearing, Maple Hearing Clinic." - and I’ve asked for clarification as to whether those are the other two branches of the same folks, or something else. Either way, if their other offices, it adds a minimum of an hour’s round-trip time.

OY!

Stay tuned.

Further to staying tuned I did some deep digging, and found this:

GRRRRRR it shouldn’t be this difficult.

PS; Choir rehearsal last night was a very mixed bag, following my tuneup earlier in the day; much improved but not-yet-ready-for-prime-time (singing with them in church). But my seatmate in the Bass section thought I was right on; I wasn’t sure, and also had difficulty in sorting what I was hearing, both inbound and OwnVoice.

But maybe that’s the 4-year layoff, and I just have to relearn how to sing…

@Skip said:

Choir rehearsal last night was a very mixed bag, following my tuneup earlier in the day; much improved but not-yet-ready-for-prime-time (singing with them in church). But m

I don’t have much time to response, but try to train witb a web app:

Login1

Login amd password for checking and trials: 555 and 555.

This is for CI users, but it may be helpful for HA users with problems woth tone perception also.

Maybe you simple need to do the auditory rehabilitation.

@Bimodal_user said:

(clip)

Perhaps try in another browser. I used the Chrome in the above case. The green dots are the correct answers out of 18 per test.

Login: 555
Password: 555

That worked. Got all but two.

There are different difficulty level. The most difficult with one semitone difference, and easier with more separate tones (IIRC, minor third or perfect fourth).

An update as I prep to go to yet another adjustment: I didn’t take copious notes (pardon the expression) in church Sunday, but had this experience:

Yesterday in church, I had a possible hearing aid anomaly: I found the organ, in all cases, starting relatively low in volume, but then ramping up to the point where I had to make my aids go to their lowest volume setting to avoid discomfort - which resulted in my not being able to hear my own voice.

The music director, as well as my wife, also a chorister, who had a piece with the choir and then joined me in my pew, thinks the organ volume remained constant. But it was(became) SO loud that I was forced to put it (whichever of the settings - Automatic, TV, Music, Restaurant) down to the least volume, which made my own voice inaudible, so my harmony was mostly muscle memory rather than hearing my sound.

So, we’ll need to figure out how to make that “feature” go flat. My next rehearsal is tomorrow, again.

I’m hopeful that this syndrome isn’t a new one (that they don’t know the answer for) and that they’ll successfully address that issue - or my music side will be well and truly gone.

Meanwhile, my (previous HP receivers) Beltone mold seems to be working - not well, but a dramatically more comfortable receiver than with power domes - but I had to go back to the one which previously had a high-power receiver, as the one remaining earlier left mold (made to accept the regular power, smaller, receiver, like the one now in my left ear) kept wanting to come out.

So, another adjustment shortly, followed by rehearsal tomorrow, and we’ll cross our fingers that this dragon is slain. The speech side isn’t perfect, but it’s acceptable, and I’m focusing my attention on the hearing and singing of accurate frequencies. My Own-Voice portion, and accurate percussive sounds (the piano is still a bit clang-y as well as somewhat flat/off-frequency) remain at risk, as well.

More as I know it…

Minor update while I await my left mold’s modification (it’s been over 2 weeks; about time!)

Phonak Launches Infinio Ultra and Ultra Sphere: Improved Processing, Battery...1

Phonak unveils Infinio Ultra and Ultra Sphere, its next-gen AI hearing aids with clearer 360° speech, easier maintenance, and all-day battery life.

That has promise, including the potential (though I can’t see how, as it’s a different chip) for upgrade electronically. But, if our (vendor spec) time is accurate, I have about 2 weeks left in my trial; I’ve asked to have them order the new aids and back out of my 60-day trial on the V1.x Sphere Infinio I70 (the most insurance will cover; the 90s would be nicer but…)

Meanwhile, baby steps are encouraging:
My choir director and I spent some quality time doing tone matching.
It’s clear that my compression or whatever else there is in my music program isn’t finished, as I had GREAT difficulty matching the piano, but to both of our astonishment, I was dead-on to her voice, even at an octave apart.

We’re still working on my being able to hear my own voice; currently it sounds like it’s originating in my head, vs my actually hearing it, so some tweaks by the vendor are in order.

But generally speaking, the speech portion seems very close to dialed in. Sphere (the surrounding sound occluder), however, seems to be intermittent, now, vs an earlier astoundingly good isolation. The restaurant setting doesn’t block out (or, at least, in our last visit, albeit not much crowd noise but LOTS of music/TV noise) any more, and my time in both our cars hasn’t had the previously reliable ambient sound squelch.

So, regardless of whether I’ll be able to back out of my current trial and go to the newer technology, what I have now isn’t yet where we want it to be.

Stay tuned!