Like someone else mentioned about tinnitus and adjusting tones.
The Costco person did ask about my tinnitus so that she could adjust the hearing test to accommodate.
Hopefully I’ll finally get to do the test next Friday after getting my ears cleaned.
About 5 years ago I stopped guessing if I heard the beep, and I only said yes or pressed the button if I knew I heard the beeping, why? I wanted properly fitted hearing aids, with my hearing loss I have to guess too much as it is, so why not be sure when I could be. And to be very honest it has made a drastic difference in how my aids are fitted and adjusted. At first I was uncomfortable with the louder sound coming from my aids but I adjusted to the sound and my capacity to understand speech improved.
My point we as hearing disabled have to guess enough in life stop guessing when getting a hearing test that is used to determine the aids you need and the adjustments and fitting of those aids!
I find that my tinnitus interferes with the way audiologist’s do the test.
My DIY at home tests come up with different values. But my headphones frequency response is vary far from flat.
Hearing tests are pretty much a starting point to establish hearing loss. Hearing loss tends to be much more involved than just the results on a piece of paper.
Pulsed tones are good. Warble tones can under estimate hearing loss in steep slopes because of off frequency listening.
Of course they do, unless someone is presenting for you you are using completely different criteria. I’d guess you’re better at home, yeah?
I came back to say: There is no real “true” threshold. Neural perception is a bit stochastic. Clinically, your thresholds are defined as what level you are able to detect =/>50% of the time on ascending runs using a staircase psychometric method. This definition of thresholds is what has been used to develop all prescriptive targets and in all related research, so as far as hearing aid fittings goes, these are the “correct” thresholds and anything else is not.
Tinnitus can be tuff.
You can bet there are others on this forum with worse symptoms. You are not alone in this tinnitus issue.
For me listening for tones during the audiogram is allowing the machine to go louder than I can actually hear a particular frequency. That way I now know what frequency tone to listen for. Then as the machine lowers the db of each frequency I can truly say what is the audiogram tone versus tinnitus.
Hang in there.
Thank you @Neville, interesting reading on the Meniere’s for me, I suffered with this for about 8 years or so, my hearing would fluctuate greatly, prior, during, and post vertigo attacks, sometimes my tinnitus would go off the scale, and severe distortion would kick in, at this point I would be incommunicado, sometimes up to a week at a time, I got cluster vertigo attacks, the room, ceiling, and walls would all be moving… Strange as it may seem, the tinnitus became a godsend for me, it was like an early warning system as the tinnitus increased, I was acutely aware a severe bout of vertigo was very imminent, it was time to lie down, before I fell down! There was no rhyme or reason, sometimes attacks lasted a few hours, sometimes a few days, and a bad one, I was all week long in bed… Fortunately I haven’t had a vertigo attack in about 18 years or so, the lasting legacies, where my severe/profound loss, severe tinnitus, and balance problems, I am relaxed about the tinnitus nowadays, when it becomes annoying, I can switch it off, by concentrating on it, my balance is always at its worse in the dark, I am at peace with my hearing loss… They say, there is no actual cure for Meniere’s Disease, I am just delighted to be almost symptom free… Thank you again @Neville, you filled in some of gaps in my knowledge 
Cheers Kev.
I haven’t heard of auditory migraine before!
I’m aware that my migraines affect my hearing though. And maybe my vision too.
DaveL
Toronto
With meniere’s, once the affected vestibular organ just loses function completely, the vertiginous episodes kind of burn themselves out and the vestibular organ in the other ear does a fair bit to compensate. Then you are just left with declining hearing in the bad ear. But sounds like you are doing a fair bit of visual balance compensation too, which is typical. I’m not a vestibular audiologist and maybe you know all the tricks, but it can be worthwile consulting with someone about fall prevention prior to getting older, particularly when there’s a known weakness.
It’s not very common, although vestibular migrane is reasonably common, particularly in women, and tends to be incorrectly diagnosed as meniere’s. It’s pretty common for migraine to impact noise sensitivity, but I’ve actually only seen dramatic hearing fluctuations in a couple of patients who were having migraines associated with a significant history of head and neck trauma (car accident). That said, when someone is in the middle of a bad migraine they aren’t usually coming in for a hearing test, so maybe it’s more common than we think.
In the past, l had difficulty deciding whether it was test tones or my Tinnitus. Audiologists usually do three clicks of the test tones. Before l visit an audiologist, l usually take a prescription pill to help calm my Tinnitus. Nowadays, l use my hearing aid and fitting software to do an hearing test to see if it comes close or matches the audiologist audiogram.
Thanks Neville.
From about’95 to 3 years ago, I had 3 migraines a week. Now I have them about every 2 months or so, but they’re much more severe. My migraines started when I was about 17…
DaveL
Just a gentle chide, Neville: Not all of us are up on the technical lingo. I’m guessing no more than 50% of the readers know what “stochastic” means (it means “random,” though in a technical sense). Of course my guessing is a stochastic process. 
I can only guess what a “staircase psychometric method” is. I can’t find it in the search function. Does the staircase go up or down? Or is that stochastic, I mean random?
I do appreciate your posts. They help me.
The full quote said ascending runs so I’d say the staircase goes up. I appreciate people who use language that stretches me and if I can’t figure it out, I can always ask.
Yeah @Neville, climbing ladders is no longer my forte, and I am an ex scaffolding foreman, my last episode up a ladder, wasn’t so long ago, the inevitable happened, and I fell, stupid I know, but I do stupid well 
I got badly winded, and sore for about a week, damaged my thumb on the way down, I was most fortunate… The worst aspect of MD is the randomness of the vertigo, those 7 or 8 years where a living nightmare, not particularly for me, but my family where severely impacted by MD, you couldn’t plan anything like holidays, I was unable to work, so money was always tight! Yep, I learned a lot about Meniere’s Disease, how it damages the vestibular, the burnout, and much more besides, my MD was almost textbook… thank you for your insight @Neville To move back on track, I was also never quite sure when doing a pure tone hearing test, whether it was the tone or my tinnitus, nowadays it doesn’t faze me one bit, the A.uD’s have the skills to interpret each test correctly, I try and concentrate as much as possible, and hopefully I am correct most of the time… Cheers Kev 
Kev I’m so glad you are ok now. Stay away from ladders.
I just completed my 3 year renewal of “working at heights training”. Lesson learned…don’t work at heights!
I swear my broken tib/fib was caused by bad balance. I had a single in the ear hearing aid then.
DaveL
In the early 90’s I started having migraines 2-3 a week. After various poking and prodding the neurologist put me on betachron for 6 mos. Went away entirely while I was on the med. Once a month or so in the summer now. (Light dependent.) The pain like a hammered head is mostly gone. The pain like I’d like to die hasn’t. I could crawl in a hole and seal it up when I get a migraine.
Maybe ask about a beta-blocker?
WH
Google is RIGHT HERE though. There’s a good Radiolab episode called stochasticity, for anyone who likes podcasts.
The staircase method in psychometrics is a particular way of determining some sort of sensory threshold. It goes down until you can no longer detect whatever (loudness, brightness, frequency, difference in weight, etc.) and then up until you can, and then down until you can’t, up until you can, and so on until a certain number of pre-determined reversals occur and the “threshold” is determined from that. I suppose the audiometric threshold is based on a staircase method, but not exactly like one as certain adjustments were made to try to minimize clinical time while maintaining accuracy. So when I say that only detection on the ascending runs counts, when you are hearing the tone get quieter and quieter and quieter and then suddenly you feel you are just pressing the button in a rhythm it doesn’t matter. Your descending runs don’t count; audiometric thresholds are judged from ascending runs only.
Thank you, Neville, for enlightening me further than Google does. That, in effect, is what I use when I self-test in Phonak Target. As a retired research engineer, of course I experiment (carefully). I’m also an amateur musician with, fortunately, just constant tinnitus.
My friend has these and was diagnosed as these.
Noise gets really sensitive for her as well even tho she’s profoundly deaf.