Am I OK wearing open fit power dome hearing aids?

[craftycrocheter]

I have always suffered with occlusion ie., hearing like I am bunged up. Between 2006 and 2015, have had 6 impressions of my ears (silicone and acrylic, non allergy ear mould so they called it), including 3 that has been vented starting from a pin hole to skeleton like, but unfortunately it did not make much difference despite wearing them consistently for weeks and weeks on end. Not only did I feel like I was under water, but my ears was always getting sweaty and itchy, came out in blisters as well and in the end, shamefully I stopped wearing them… I was still at school as well so I was stubborn and did not want everyone knowing I was deaf, even though they knew I was because of my speech problem.

I went back in 2015 because I wanted to be able to hear, they refitted another vented mould, they said they do not do the dome type, only mould… also my hearing aids was out of date (I had them since 2004), said there was no need to update them as they was still working. I was fed up of going back to the audiologist and kept getting them refitted… It got to a point where I went in and He said “what is the matter now?”, as if I was a burdon, so I just gave up again.

I moved to Wales from England 2 years ago and referred to another audiology department. I explained the issue I had previously, so they fitted me with a open fit power dome hearing aid… (here it comes), they are causing my ears to get quite moist and so I have to remove them every 2 hours to dry my ears out and itch them).

He did say to me they will not be as powerful as wearing moulded hearing aids with a thicker tube but because I am constantly uncomfortable, these are the next best thing. I have attached my audiogram to get your input… genuinely, am I suited for the open fit or is moulded the better option? If it is then dammit because I I had nothing but endless problems with them! I just want to have hearing aids that are COMFORTABLE.

[MDB]

You have a pretty significant loss. My questions: 1) What are your word recognition scores like? 2)May sound like a stupid question, but why do you want to wear hearing aids? Environmental sounds? Conversations? Do aids with open fit provide you with the help you want?
My suspicion is that you’d qualify for cochlear implants, but if your current aids with open fit are providing the help you want, stick with them.

[craftycrocheter]

No idea as audiologist in UK does not do word recognition scores. Mainly because I cannot hear high pitch/frequency noises and at my work I have to be able to hear them in emergencies… Truthfully, they do not help me to hear speech any better nor anything else. I still have to lipread and face someone. It amplifies their voices but that is about it. As for CI, my audiologist said it was not ideal as my low frequencies are in the good range. I cannot read my audiogram in depth like most of you guys can so I honestly do not have a clue if my audiologist is correct or not.

[MDB]

I’m not an audiologist, but my understanding is that good low frequencies do not make you ineligible for a cochlear implant. If you have the ability to get an opinion from a second audiologist, I’d highly recommend it.

[Raudrive]

Need to know your speech understanding. It will help you understand more about your hearing loss.

If you can hear actual sounds or tones at all frequencies hearing aids should be all you need if speech understanding is pretty good.

On the other hand if those high frequencies are pops and crackles those are dead zones and hearing aids won’t help those areas.

Good luck

[prodigyplace]

@craftycrocheter

I still have to lipread and face someone. It amplifies their voices but that is about it.

It appears you have low word recognition. It is not enough to hear a word. Your brain needs to understand what you heard to communicate properly.

[kevels55]

It is not something that is done here in the UK @MDB, WRS… In 30 odd years, I have never had a Word Recognition Score via the NHS, or indeed the private A.uD’s, some may do it now? But, it’s still fairly rare… The NHS, may do a WRS in their CI evaluation? I am inclined to think @craftycrocheter, given the short synopsis of your hearing history, you might be allergic to silicone moulds, I say this because for years I had horrendous problems with silicon BTE moulds, no occlusion to speak of, but constant wet ears, itch, raging ear infections… Eventually, the NHS gave me hypoallergenic moulds, these had a nano coating, and basically solved the issue. I now buy most of my aids privately from Boots Hearing Care… As far as the most comfortable moulds, these are on my Phonak Marvel 90 RIC’s, they are acrylic with 105db receivers, I don’t even feel them there, they are ultra comfortable, bought privately, they are actually made via 3 D printer… Cheers Kev

Edit. Qualifying for CI in the UK is fairly stringent, I have personally been assessed twice, on the second attempt, I was knocked back, because I was an excellent lip reader! It costs around £25K for a single implant, and that is the main problem for the NHS, lack of funding… Funny enough, on my last visit to NHS Audiology, they offered to send me to Kilmarnock CI center for a full assessment… I declined the offer, I have various underlying health conditions, and I am now retired, and the thought of going through the recovery, and relearning sounds, just didn’t float my boat… I have 3 good sets of aids, various Roger devices, I sign, and I am am a good lip reader, all in all, I communicate fairly effectively, given my limitations. I would say though, given the OP Audiogram, it would be extremely difficult for them to qualify for CI, it is difficult to pass the first muster, and the local NHS Audiology Department, must access you first, and if they don’t recommend you, then you have no chance whatsoever… Cheers Kev.

[MDB]

I can’t imagine how they evaluate for cochlear implants without a word recognition score. @Um_bongo
can you comment on use of WRS in UK? Seems really odd that it would be North American centric.

[kevels55]

Well @MDB, as stated, I did the local Audiology department CI assessment twice, I didn’t qualify! Mainly because I was an excellent lip reader (so I was informed) They might have, been doing a WRS, but at no time did they inform me, they where doing this, and I was never given any WRS results… There was 3 Audiologists there, electrodes placed on my head, one A.uD sat 3 feet away from me, facing me, I was made to wear my hearing aids, throughout the whole process… It was a farce, I had the feeling, even if I heard nothing, they would have still not sent me for the full assessment, they knew I met the criteria, but I believe they set me up to fail… Cheers Kev.

[mr.smithster]

If you just want a different mold material to try, depending on your aids, there are some available that are made from titanium, but only for Phonak aids i believe. Supposedly they dont itch or have any allergic affects.

[prodigyplace]

@kevels55

They might have, been doing a WRS, but at no time did they inform me, they where doing this,

The test involves wearing headphones while listening to 2 syllable words and repeating what you think you heard. I think you would know if it was done.

[kevels55]

Yeah @prodigyplace, I believe, and this is my opinion only, they where going through the motions… 3 feet away in good light, in a sound proof room, in a perfect listening environment, allowing me to lip read, no earphones where used in the process, electrodes hooked up to some machine, I assume these where to check my brainwaves, so I couldn’t fake a response?Then sentences followed by my repeating whatever was being said… IMO, this was a stitch up, and the only outcome was going to be no referral for a full assessment at Kilmarnock CI centre, I believe their only fear was if they referred me, it would come out of their budget, and I believe they where only following orders from their boss, whom was a complete imbecile of a man, TBH the biggest professional ignoramus it has ever been my misfortune to meet, whom was the ENT head surgeon, and therefore head of both ENT & Audiology… This guy talked to you as if you weren’t there, never once held eye contact, and faced away from you whilst speaking to me… It wasn’t just me, I spoke to other professionals whom worked with him, and let’s just say, their opinions of him, where much the same as mine… I suppose he might have been a good surgeon, but as a person, his attitude, and mannerisms left a lot to be desired… In truth, at the time I was upset, but not now, I try not to dwell in the past, and usually things have a tendency even out, and with the advent of newer, and more advanced hearing aid technology, I hear better now than I did 15 years ago, especially with Roger ALD’s, so no regrets… Cheers Kev

[prodigyplace]

Some of my older tests used words read by the tester. At Costco and at my latest tests they used a recorded voice, likely for standardization. I have also read that a recorded voice is now usually used.

[Deaf_piper]

That’s interesting you weren’t accepted for a CI, as your audiogram would qualify you here. Here in Australia in our evaluation process all the WRS, SRT, and white noise testing is pre recorded and comes through speakers. All this so you don’t /can’t lip read.
@craftycrocheter you would certainly benefit from a cochlear implant, it could be worth your while checking with your AuD.

[Neville]

Open domes are unlikely to provide the support you need, and it sounds like they aren’t comfortable for you anyway. Go back, explain the issue. You are right that you need a provider who will work on physical comfort first and you can worry about amplification second. I think the suggestion of trying a titanium mold was a good one, or even an acrylic mold if you haven’t yet. But if that doesn’t resolve things, you might consider referral to an ENT or dermatologist to try to further assess your ear canals. At home options that sometimes work: regular vinegar/water flush, switching to an anti-dandruff shampoo, Miracell drops.

[kevels55]

Thank you Sheryl… I believe, I qualified at the time, but they kept on moving the goalposts Sadly, the duty of care, was firmly in the hands of the bean counters… Austerity has a lot to answer for, and if I was 5 or 10 years younger, as I was back then, I would have bitten their hand off for a CI, I was desperately unhappy with my aids, and my ability to understand conversations… Nowadays, I am fine, you learn to adapt, and in time, you eventually except your hearing limitations… I feel most fortunate in many instances, and I am glad I had the insight to think ahead, to arm myself with various communication tactics, sign language & lip reading classes, ALD’s, DIY’ing my own aids, literally hundreds if not thousands of hours learning, most of which I forgot but some of it registered on my pea like brain … I can say with confidence, I communicate fairly effectively, given my level of loss! Perhaps, dyslexia is probably still my main obstacle in any learning outcomes, it’s a real PITA! For the most part, I am fairly content with my lot… Cheers Kev

[prodigyplace]

@kevels55

you learn to adapt

I am happy you adapted instead of getting discouraged.

[kevels55]

Thank you @prodigyplace… As the saying goes, “Necessity is the mother of invention”, and sometimes you have to to reinvent yourself, in order to adapt to things you have no control over… And move on. Cheers Kev

[Um_bongo]

@MDB

@Um_bongo
can you comment on use of WRS in UK? Seems really odd that it would be North American centric.

WRS is available here. It’s used by some audiologists, especially where there’s a notable difference between expected aided results and the client experience.

WRS’s lack of repeatability makes it a relatively weak test in anything but A:B comparison in one session. Reproducible sound field dynamics, vocal/recording variation, even the orientation and angle of the client’s head have a bearing.

At the end of the day the audiogram is the basis for the fitting prescription: WRS doesn’t change the baseline for this. Though I have (fairly infrequently) attempted to modify the moderate to high frequency output (g50/g65) to increase the apparent sharpness of lower intensity sounds to deal with poorer auditory resolution issues.

I guess it all depends on where you position yourself on the Dillon ‘everything max loudness’ or the other camp ‘normal loudness growth’ debate.

[MDB]

What kind of criteria is there for a recommending a cochlear implant then? It’s my understanding that here WRS play a big factor.