Adjust hearing aid to audiogram

Hearing Loss
#1

What is the goal for adjusting hearing aids to an audiogram? It appears that they should be adjusted to at least 25dB for normal hearing. Does that mean that they should be adjusted to that level for the entire frequency range? My audiogram shows 35dB right and 75dB left @ 250Hz. 70db right and left at 6000Hz and 85dB right and 95dB left at 8000Hz. Is it necessary or even desirable to boost the entire range? So if they were adjusted to 25dB from say 500Hz to 6000Hz would that provide a reasonable adjustment?

The audiologist where I purchased my hearing aids sold the practice to Miracle Ear so I am kind of left without reasonable service. I have ordered a Noahlink Bluetooth link and I have the software to adjust the aids so the plan is to save the original settings and then play around with various settings to try to improve the results. Miracle Ear will make adjustment for $65/visit with very questionable results or another ENT I have gone to wants $225/aid to reprogram my existing aids.

Actually that brings up the question of whether OTC aids which could cover the 500 to 6000Hz loss would provide reasonable service.

#2

I am not an expert but I have used two different brands of OTC hearing aids basically to determine if I could tolerate HA’s before dropping the big bucks on prescription aids. The problem I have found with OTC aids is that they have very few frequency bands for adjustment. I currently wear the Sennheiser OTC aids, and they offer a service for $250 where you can have them adjusted by an audiologist. During this session, I saw on the software, and the audi explained to me, that there are only 3 frequency bands across the range of the HA’s. My hearing falls off sharply right in the middle of the middle range, so the audi had the choice of over amplifying the lower frequencies in the middle band to properly amplify the upper frequencies in that band, or under amplifying the upper frequencies in that band so as to not blow me away with the amplified low frequencies. I had him adjust for the low frequencies, because I could not tolerate the constant loud, booming background noise when they were adjusted for the higher frequencies.

From what I have read, prescription hearing aids may have as many as 20 - 22 separate programmable bands, allowing for much closer programming to my actual hearing loss. So, I am planning on switching to prescription hearing aids in the hope of much better hearing than the OTC’s provide.

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#3

When you have the Noahlink Wireless and the software, the software should use your audiogram to generate target amplification levels based on one of the widely used prescriptions such as NAL-NL2. This will give you targets across all frequency ranges. You can then slowly make further adjustments as needed. There are a lot of people on this forum which can help you. What hearing aids and software do you have?

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#4

I have Resound omnia hearing aids and the resound software. I am sure that once I get the Noahlink things will become clearer. I am hoping that my present settings will transfer from the hearing aids and I can start tweaking from there. I plan to save the current settings so that I can go back to the original settings if I screw it up too bad. I am just trying to get a head start.

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#5

Gordon,

I’m a newb to this, and haven’t even got my hearing aids yet. But I did get the software (Resound) and the Noahlink to program the hearing aids. Here is some of what I found in the software while I was running a simulation.

First, you create a profile, and enter your audiogram. Simply click the graph or enter the numbers at the frequency, whichever is easier for you.

As you proceed to the fitting, the software provides you with options based on your hearing. I defaults (for my audiogram) to medium power receivers, but you can see the receivers output performance with your audiogram overlaid on it.

This illustrated to me that with my moderate hearing loss, if I were to choose a high powered receiver, then more of my audiogram frequency points would be outside the range of the high output receiver.

By simulating, you can see what various combinations of equipment can and will do. What amazes me is how many folks talk about giving up on a set of hearing aids after about one or two tuning sessions when there are about a jillion adjustements that can be made.

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#6

Yes, you can start out with Target’s recommended settings. However, I found that tinkering with, especially, the higher frequencies improved my hearing of speech considerably. So I would not blindly trust algorithms that merely try to restore normal hearing- experiment.

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#7

My main problem seems to be that the “tech” from Miracle Ear keeps trying to increase the treble range because my hearing loss is profound in the high range but that just makes everything sound like I am in a bell tower and every dish or silverware clinking is overwhelming. I can adjust somewhat using my iPhone so increasing midrange helps but the adjustment on the phone is limited. The hope is that I can make adjustments and try it for a day and then tweak that. The main problem is that I purchased the Resound aids and a month later the office was sold to Miracle Ear and they are mainly interested in selling me their new aids thus the DIY approach.

#8

Gordon,

I’m fortunate that in the middle of a trial my (ex) audiologist walked out to attend another client without making sure I was set up first. That made me question the whole thing. I don’t have insurance, so I started digging. I may be off base badly, but this is what I found. Costco. They sell premium models from top manufacturers, and everything is free except the hearing aids. I paid the $65 price of admission to just get the option to choose these brands.

Jabra is Resound, and from what I can tell the Enhance Pro 20 is the Nexia 9. The Resound software is free, and I believe you have the Noahlink. You’re in a similar position to me it looks like. I’ve found lots of features not mentioned by the audiologists, one being Impulse Noise. You mentioned clinking, that may be one of the adjustements. I’m taking a wild guess here, but you get the gist. Install the software, open it up, practice making a profile and adding your audiogram and hearing aids, and see what the program recommends. Use the Simulate button. Heck, maybe you’ll do better than your audiologist.

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#10

We adjust to prescriptive targets for a particular hearing loss. The software will try, but then you adjust on ear with REM to make sure it is actually hitting prescriptive targets. I’m not sure what is meant by “adjusted to at least 25 dB”, but it’s not a 1-to-1 replacement and also remember that there are different types of decibel scales, so 25 dB HL on the audiogram is not the same as 25 dB SPL in the world.

#11

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The image shows 25 dB as being normal hearing range so I assumed that the goal was to get the boosted hearing within that range.

I am just trying to figure this out but my audiologist sold the business so I am left on my own and I am trying to make the necessary adjustments. I am probably a little ahead of myself because I do not have the Noahlink unit so I am just playing around with the software. Hopefully things will become clearer once I am able to actually see the present settings in my hearing aids.

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#12

I want to follow your conversation here, and learn from your experience.

We all have different needs, and fixes for being hard of hearing. We even all come from different countries.

I had your experience too. My wonderful audi had worked miracles qualifying me for workman’s compensation, who provided my first Phonaks. Then every time I had an issue she solved it, and I heard better. She sold her business. Turned out it was to Listen Up Canada. They were a piece of work, and I left. Great respect for my first audi. Incredibly skilled. She had the right to sell her business and deserved excellent payment for it.

My lesson–it’s the person who sets them up that’s important. But the audi is the customer who the manufacturer sells to.

I’m following…good luck.

DaveL

#13

OK I just received my Noahlink and plugged it in. I connected to my existing hearing aids and it showed all of the existing settings. I saved all of that to somebody named Gordon Original and then started a new session under my name. Again it downloaded all of the setting including the audiogram from the hearing aids. I then did some playing around with gain settings and increased the gain in the 2000Hz range because increasing the mid range on my iPhone seemed to make the most difference. I am assuming that 2000 is considered midrange. I will try that for a day or so and I think that I will want to lower the treble just a bit but that is for later. The nice part is that I can make incremental adjustments and try that for a day and then do some more tomorrow.

I am not sure of how to set the default over all volume. Anyone know how to set that on the Resound aids?

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#14

for volume change
first select all complete lines/rows of all G values on the hearing aid side (left/right) you want to increase/decrease the volume.
then increase or decrease the values to your liking. up is louder

keep in mind that you dont select and highlight the MPOs and you need to unlink the L/R side , if you want to change one side only

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#15

I’ve tended to conventrate on G50 and G65, above 1.5k

#16

Is there a way to select more than one value? For instance how would you select 2000, 3000 and 4000Hz to adjust them together? At this point I have just adjusted 2000 and it has improved my hearing and understanding. So far I am pleased with the results.

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#17

Click and drag to select more than one or hold Cntrl

#18

IMO hearing ald hardware is amazing, programming is still stuck in the past. Traditional clients had severe loss and the only goal of prescription formula (audiogram to programming process) was improving speech recognition, leaving deal with the overload, maybe your brain will adjust. Then 50% stop using them and people with less severe loss that the hardware could help with are scared off and the industry is mystified. My initial experience was similar to yours. I was at least able to use a “perceptual equal loudness curve” with headphones over hearing aids and an equalizer to propose dB/frequency adjustments to the specialist and got much happier in a couple iterations. My second pair I explained this experience up front to a new specialist, set the goal to “normal hearing” for my age (20 dB is normal loss as I recall), he used a different formula (often used with children I think), and set programming to a percentage of prescription, much closer first pass (also changed from Signia CIC to Phonak RITE). If you are prepared to adjust them you should do fine making the tradeoffs.

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#19

It is a shame that hearing professionals who are educated in hearing loss seem to miss improving my speech recognition. I have been wearing hearing aids for at least 10 years and I have never had a pair which I thought did a good job of solving my speech recognition. I got the last pair a year ago and I have come closer with just blind experimenting than the Miracle Ear receptionist/now programmer did in several visits. The first year was free and then it was $65/visit so I was looking at alternatives. Note: the hearing aids are not Miracle Ear but Resound as sold by the previous owner who sold the business a month after I got the aids. There should be some science to this better than me randomly trying stuff. Folks, including folks selling hearing aids seem to have a problem realizing that it involves more than increasing the volume. I have been told many times by folks who realize that I have a hearing problem “Well I will talk louder”. That includes my wife.

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#20

Just went through this.
Tried Resound Nexia.
Just like when I tried Starkey Genesis.
The new aids are louder than my present aids. Ok.
The problem is I’m distorted in my left ear.
The new aids make the distortion nice and LOUD.
The Nexia had tulip domes that occluded.
When you occlude my left ear it gets very hollow and loud. The sound is just weird. The right is not bad.
I told her this going in.
I do not care what the audiogram says. I do not hear the same with my left, even though the audiogram says they are close.
The exact same thing happened with the Starkeys.
I know people on the forum say each manufacturer aids sound different.
Not to me because of the distortion.
I wear Audible/Starkey aids that I know are not tuned correctly.
If I bring the volume up I can’t stand the distortion.
She talked moulds, but said there would not be much difference.
We agreed that there wasn’t much she could do for me.

#21

Have you had Real Ear Measurement done using Speech Intelligibility sounds by your audiologist?