I’m ready to try something new and actually be able to understand speech. I have tried so many different hearing aids, including the new Resound one, and I still feel like I miss so much of what is being said. This sounds promising and was offered as an option for my severe high tone loss. I welcome any advice:) Thank you so much!
Dr. Cliff review (video and audio transcript) from June, 2018. Another web page hit says he was one of the first to sell Earlens back in 2016(?), if I got the date right (maybe not).
Perhaps there are newer versions. There’s also this link:
Perhaps it’s indicative of something that Dr. Cliff doesn’t seem to have reviewed the Earlens since.
What is your word recognition score?
That score sets up expectations for HAs. HAs can’t repair our hearing, they can just make things louder, and features in them can give us cleaner sound with as low noise is possible.
It’s not expected that HAs are able to give you more than this score, but also, they should give you that ballpark, eg if your WRS is 100% and with aids you get at best 70% then they’re not fit properly.
If the test isn’t done, do it.
Since you don’t have that number in your profile and you say that top manufacturers aren’t working for you, it’s either your low WRS (and unfortunately, no help there is available, unless score is that bad that you qualify for cochlear implant), or HAs aren’t fitted correctly.
If you haven’t already, check here: https://drcliffaud.com/ then top menu > resources > best practices checklist
And seek someone who follows them.
Also, understanding speech depends on our brain. So we have to train it a lot so it can use this messed up sounds and comprehend it. But of course, more difficult environment makes it more difficult even for trained brain.
Since so many people don’t know about WRS and the point of it, and unfortunately fitters are oftentimes sellers and not provide all information, and those earlens looks insanely expensive, I’d rather warn you / prod you to double check things.
Also, I’d post a comment on that video asking for newer informations, maybe Cliff sees it and shares something. He’s definitely noticing comments.
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Thanks Jim! This is great info. I am seriously considering this option. I’ll keep you posted if I go for it. There is a 75 day trial and I can return for a full refund. I guess I’ll never know if it’s for me unless I try it out myself…how wonderful to be able to hear if it does what it says:)
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Thanks Blacky. I have had 3 hearing tests in the past 6 months from different providers, all without wearing hearing aids. The results were so mixed that I didn’t include them. The audiologist that I purchased my last two pairs of hearing aids from had a recorded woman’s voice that sounded so distorted that I’m surprised I scored 28% in my right ear and 40% in my left. The high end was performed by a new audiologist who gave the most thorough hearing test I’ve ever had and was wonderful. She used her own voice and I scored 72% in my right ear and 84% in my left. The third test was somewhere in between.
I did like the resound quattro and I might be happy with that model, but it’s just another hearing aid that doesn’t reach the frequencies I need to be able to understand speech. The wonderful office that let me demo both resound models is unfortunately very expensive, charging $7800 for quattros. Once I add the two TV connectors, the earlens is not that much more at 10k. Since the earlens is fully refundable if I don’t like it during my trial period, I may as well try it and see if I’ve been missing anything great that might be a better fit for me.
A couple of things to consider with any hearing aid brand. What fitting algorithm is your provider using and are they using an “Experienced User” profile? Having read this forum before I got my first HA’s, I told my audi that I didn’t want any gradual accomodation: I wanted the “full experience” right away. She still fit my with the New User Resound profile, which backs off high frequencies. Why? Most folks have age-related hearing loss and compression makes soft sounds middling loud so folks with high frequency deficits now can hear soft sounds amplified loud enough to hear. So marketing studies have found most users don’t like really loud new sounds in their ears that they haven’t heard for years and the companies back off “shrill” amplification so users can be happy - lots of treble sounds “tinny,” especially when you haven’t heard it very well for years. The Experienced User (nonlinear) profile dials in more amplification at high frequencies (if I recall correctly) and NAL-NL2 and DSL5-Adult even more for the amplification of soft sounds in the high frequency range. So if you can talk your provider into it, you might tell them you want to experiment with NAL-NL2 and/or DSL5-Adult and be sure that they are using an Experienced User profile with you. Those options are in the ReSound Smart Fit fitting software and my audi says that all the other techie things in the ReSound’s HA’s will still work just the same with these different fitting profiles as the different algorithms and user experience profiles are just messing around with applied gain at each frequency for soft, medium, and loud sounds.
The other thing is that $7800 is a bit outrageous to pay for HA’s that are no longer the latest model. You could go to Costco and get the Prezas for about $2200 and they are essentially supposed to be defeatured versions of the Quattro’s - no tinnitus management, no remote assist, the HA’s are locked by Costco so you can’t play around with DIY and maybe someone else can comment on how willing a Costco fitter is to allow a user to try different fitting profiles and fitting algorithms. One can always get one’s hearing aids as I did from an online provider like Tru-Hearing where you get limited service from the fitter and then after an initial few post-fitting follow-ups, you’d have to pay a la carte but the warranty issues I’ve had have all been covered by ReSound and my audi at no charge whatsoever to me. For your $7800, you’ll probably get a lot more free trialing than from Tru-Hearing but Costco has a 180-day return period so you could try the Prezas for quite a while and perhaps try different fitting algorithms - same for other fine Costco HA’s like the KS9’s.
P.S. You might try reading some posts of user “Don” ( who disappeared from the forum around March 11th of this year - hope it didn’t have anything to do with COVID). https://forum.hearingtracker.com/u/don/summary
Don was very big on DSL5 and also having an almost occlusive fit using Select-A-Vent. Particularly if one has good low-frequency hearing, as you seem to do, noise and possibly out-of-phase normal sound coming in through a really open fit can be a problem. I think a more occlusive fit is something to experiment with and see if it works for you - especially with custom molds. One good thing about the forum - one can get better educated about all the possibilities and one’s provider might not necessarily have the energy or the motivation to explain to you all the possibilities - but it’s always good to check out any bright ideas with them - and see if they have good answers/explanations.
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Using own voice isn’t a reliable test. Because output varies, that’s why calibrated recordings are used.
Just checking, you did around 20 words or more? Eg not just 2-5?
Also, guessing words instead of hearing all sounds also skew the results. At first glance, guessing is what we do anyway in normal conversation. However, in those lists are words that depending on your loss, you can guess A and A whilst they’re A and B words actually. That’s why it’s important to do whole lists once they figure out you’re at the best loudness.
And third thing, some people don’t do their job properly, and they will mark anything you say as ‘said’. Or if your guess is cat and it was hat, they say, yeah but 2 out of 3 are here, and they’ll mark it as good.
I had an experience where lady did just a few words, high frequency ones (I have low frequency loss), and concluded that I have 100% wrs. In highly respected clinic. She even did test with HAs, both ears, and speakers in front of me, I asked her but that makes no sense, I have one normal ear, she insisted that I listen with both, I of course scored 100% again, and then told to another doc and he concluded that test is invalid but I don’t need to repeat because of the first one where I have 100% and wouldn’t listen to me that that was also not done properly. But I was there for other reasons so I didn’t care much.
In reality I’m around 70-80%, when I do it with my fitter who does whole lists and doesn’t assume I’ve heard it if I don’t repeat all letters. Which corresponds with my experience in real life.
So ask yourself which number is the closest with your real life experience.
If first fitter really had bad recording (and it wasn’t your brain that heard it distorted bc of your cochlear damage, which mine does for example), then I’d probably be most inclined to believe the third test, if it was done with recorded words and big list.
So that’s probably around 60-70%?
That unfortunately means there are no HAs in the world that could bring you to 90-100%. They don’t do that at all.
They don’t remove distortion created by the cochlea, they only amplify sounds, per frequency (as opposed to headphones which amplify everything, and by that, create distortion bc how sound waves work).
Took me a while to accept that. I was at 70% few months ago.
Then I ‘trained’ my brain with sending streaming (I never did that with HA before, didn’t know it was possible 
), and focusing on understanding. Also, sounds I receive are highly distorted, my fitter and I managed to find some ok workaround, eg using open dome instead of closed or custom mold that everyone would suggest, opting for NAL-NL1 algorithm, reducing bass even more. Basically in my case, not trying to chase the area that I don’t have, but working on the middle area.
Now I definitely feel and we tested few weeks ago, that I can comprehend a bit better (got 80%), even though sound itself is similarly bad. But my brain learned more how to use it.
Higher tech won’t give you back WRS, because aids only send thing through the middle ear bones to the cochlea, and cochlear damage is still here. And that’s the part that messes up with our understanding.
I think I’ve read that anything higher than 60db means those cells are probably dead or almost dead.
So, for less than 60, amplification works, because they’re just tired and need more energy, but higher, they’re basically on life support and don’t expect much from them 
Eg signals they send to the nerve is distorted as a consequence of their life-support condition.
Also, I tested some cheapest unitron without any tech, got the same WRS in quiet, mine 70% at that moment. So, high prices definitely don’t mean anything for WRS itself.
Tech helps to clean up sound from all other noises and make job of our brain a bit easier. Same with external mics, they basically stream directly into your ear skipping the air, and reducing the distortion or sound pressure loss that would happen over distance.
I definitely use mics and they definitely help me.
So, earlens simulate the eardrum with light as opposed to sound wave from regular HAs.
WRS still depends on what will cochlea interpret.
She is still damaged.
It took me a few months to figure that out, and accept. Only chance I can have to ever again hear normally is by skipping the cochlea - with cochlear implant. But for that I still hear too good to qualify. Eg my WRS has to be 50% or lower to qualify.
Listening life with 70% wrs is shitty and hard. And there’s no tech that can resolve it.
I found streaming and mics useful because I get the closest to that 70-80%, because HAs in real life don’t reach it, no matter the tech. Only in booth.
Like my WRS in booth with white noise was I think 40%. And I didn’t even hear the white noise, bc of noise cancelling from HAs. But everything was quieter as a result of noise cancelling.
My quickSIN with HAs on one app was like 15db. Horrible
Streaming doesn’t suffer from external noise in same way, bc it skips the surrounding anyway.
I’d recommend you to sleep it over. Cry it over if needed. 
Then see what tech features could help you skip the noise from surrounding best. Noise is everything you don’t want to hear.
I’d probably look into available mics as well.
Streaming if that’s what you want (that includes phone calls!).
Also, check costco.
And, about your loss, that part I did ‘work with hearing you have left, don’t chase dead parts’, for your loss there’s thing called frequency lowering. That basically transfers the high frequency into lower area. Sounds aren’t natural (I argue there’s no natural sound anyway after a loss) but comprehension could be better.
I’d try that. Manufacturers call that variously, speech rescue, and whatnot.
And abandon all those fitters you went to. For your loss, frequency lowering should occur to all of them. And not pushing for the aids that won’t bring anything different since they also depend on the same, damaged, cochlea.
Definitely check best practices summarised by dr cliff if you haven’t already, to see what they did or didn’t do.
And also I highly recommend this blog
They really explain a lot there.
Once more. It is tough.
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Julie, I hope you find solutions you like. I struggle a lot with word recognition too… Have you tried remote mics and captioning apps like Live Transcribe or Otter? Hearing aids are too often viewed as solving our hearing problems like glasses solve vision problems and that’s simply not true. It’s a matter of physics. You need to capture sound close to the source before the noise gets in. Hearing aids work best within 6’ and improve signal-to-noise ratio 4-6dB. Even my brand new premium Paradise hearing aids with all the latest algorithms improve SNR by 4 dB. Many people with moderate-severe hearing loss need SNR of 15-20 dB. Remote mics improve SNR by 20-25 dB. Consonants get dropped in the damaged cochlear on the way to the brain I use captions to fill in the gaps.
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Hi Jim! Thank you for all of this great info. I am not very high tech when it comes to hearing aids so I have had to do a lot of googling to try to catch up. First, I made an apt at Costco hearing center, first available on 10/16. I really appreciate your advice on this…the cost difference is definitely worth a try. Do the Prezas work with the same app as the Quattros? When I wore the demo pair, I found myself playing around with the app a lot and enjoying it. If they are actually the same quality as the Quattros that is pretty amazing and wonderful advice. Thank you! I have to admit I feel a little guilty not purchasing from the lovely audiologist who let me demo.
Regarding some tips that I will give the audiologist, I will ask for an experienced user profile and NAL-NL2 and/or DSL5 adult program. Also I have never had a custom mold and it sounds like this could really help my speech clarity problem, but is it correct that I want a larger vent in diameter (3mm or larger) and shorter in length?
I’m learning a lot from you all and really appreciate your taking the time to chat with me:)
Thank you Blacky. All of the tests were 20 words or more. I definitely guessed a lot on all of them. I am used to guessing in life and sometimes I get it right and often times I don’t. Per the advice given on this forum, I just made an apt at Costco, so soon I will have a 4th test to compare. I wear my hearing all day every day. Without them I cannot understand anything unless I’m lip reading.
I was wondering how I train my brain to focus on understanding? I would love to do that!! Do you have any suggestions for fitting/programming with my high frequency loss? I have never tried custom molds and am considering giving this a try with larger, shorter vents? Sounds like earlens won’t do much for me except frustrate me, so I’m going to try Costco brands first. I will ask for frequency lowering as well. Is this something that is available with the Costco Preza and regular Resound Quattro?
I really appreciate all of your advice. thank you!
Thank you for the kind words and info. You are right. When I am just talking to one person who is facing me and I am concentrating on their lips I can hear pretty well. It’s in group situations or if someone is calling to me from across the room or in another room or has their back to me that I cannot hear them at all. I will def look into remote mics for group situations. Do you happen to know if my iPhone will work as remote mic for the resound quattro and costco preza?
Advice I was given here is - audiobooks. Especially if you read the book in parallel.
What worked nicely for me is streaming everything in my ear, then brain finally get something useful to work from it.
I also tried LACE training (made a topic about it), but I found it too hard. When they would start with target speech in speech babble, I’d flank it completely. Also, I did only lowest level of challenge. I tried one day level up and I was horrible
I did that training when I started trialing my marvels 2-3 months ago. Luckily, it’s lifetime access so I plan to use it more, to help my brain with more challenging situations.
Some time after I finally finish the trial, and sort things out with the insurance to see if they’ll give any money
For other things, I’d say, go and be evaluated. Then gather information and come here and we’ll brainstorm.
My order would be first hear out the fitter, make tons of notes, adjust fitting. If that isn’t enough (to get your unaided wrs with aids), then look into molds and play with vents. Then if that’s given the best possible, peek into frequency lowering just to see if you can get more out of it. If you’ll have energy by then
audiobooks sound like a wonderful way to train the brain. I’ll give that a shot! Thank you
Someone who owns the Prezas would have to comment on Prezas vs. Quattros. One thing that I do remember was that one of our forum members, focusandearnit, had a severe enough hearing loss that with ultrapower receivers, he found that Quattro’s didn’t go far enough into high frequencies for him. I only need medium power frequencies and the ReSound MP receivers go much farther into the high frequencies.
I think the active user profile applies across all programs that you can have access to in the ReSound Smart 3D app. But one thing Neville, an HCP who frequents this forum, suggested to Volusiano is that if you want to compare fitting algorithms side-by-side (and if you can talk your own fitter into doing it), is instead of having the usual four ReSound programs, All-Around, Restaurant, Outdoors, and Music, the fitter could temporarily remove one of the basic programs like Outdoors and substitute a second copy of the All-Around program. Then you could have the first copy of the All-Around program using the ReSound Audiogram+ fitting algorithm and the 2nd copy of the All-Around program employing, let’s say, the NAL-NL2 profile. Just by switching in the Smart 3D program from All-Around program #1 to All-Around program #2 and back, you could compare fitting program sounds side-by-side in the same listening environment - and if you wanted to temporarily sacrifice the Restaurant and Music programs as well, you could even have additional versions of the All-Around program fit with DSL5, etc., to decide if any of the different algorithms make more of a difference to your sound perceptions.
Volusiano has a post from a while back that shows with the OPN fitting program how the different amplification schemes of the different fitting algorithms affect the amplification he gets for his hearing loss: New OPN1 ITE aids In his comparison, he didn’t find NAL-NL2 worked as well as he expected whereas I like it better than other fitting algorithms I’ve had the opportunity to try.
With an agreeable fitter, you could probably try the fitting algorithm comparison scheme for almost any other brand of HA that you might want to trial, too.
Thanks Jim:) That is great advice and I will plan to do that! I have been searching the internet for discount sites and have found some very reasonable options, which I am seriously considering.
Also I am thinking of trying out the new Phonak Paradise 9? I had Phonak before my Widex (so that would have been purchased 6 years ago) and def did not love them, as they never really fit correctly (always sliding out of my left ear) and maybe they weren’t adjusted as well as they could have been either. I think I need custom molds and I won’t really be able to tell if I can hear better until I try them.
Honestly, I’m a little overwhelmed with the choices…the quattros were a bit tinny but I felt like I could understand speech better than my current or previous aids. Is tinny what is necessary for understanding? I tested the Phonak Marvels and I didn’t like them because I still felt like I couldn’t hear words…do I just need custom molds and then they would be wonderful? My most recent hearing aids, widex, have too much feedback and break often. I’ve had some advice here that the earlens won’t be substantially better than a better hearing aid because of my high frequency loss. The prices at Costco sound great but it’s so crowded and hard to get an apt. Anyway, sorry to go on and prob in the end all the hearing aids have pros and cons. I really need a fantastic audiologist to help me figure this all out.
Thanks for chatting with me and all the advice. I really appreciate it!!
Trying out as many different HA’s as you can and picking the one that works for you best sounds like a great idea. Good luck and it will be interesting to hear what you settle on and why.
P.S. Relative to tinny sounds, for any HA, including ReSound’s, there are options to boost the relative amount of bass in the fitting software and a more closed fit traps more bass in your ear as compared to an open fit, which allows relatively more bass that the receiver has produced to escape your ear - this perception particularly comes into play in streaming where you are not hearing sound from your environment but rather “sound” streamed directly to your HA’s electronically and then produced directly in your ear canal by your receivers. The more closed a fit, though, the more you may be bothered by the sound of your own voice - some HA brands have adjustments for that, e.g., Signia Nx.
Hey Jim, I’m interested to try NAL-NL2. How do you set different target rules on separate programs? I don’t see any options in fitting software for that, if you change target rule it applies to every program. Thanks.
@jim_lewis (also, check correction at the end)
Resound works on one base concerning gain curve and then modify it by features (like noise cancelling etc)
Phonak has ability to have more bases (gain curve) and modify by features. But they all still depend on the chosen formula, eg you cannot have one program fitted with NAL-NL1 and another with DSL 5. Dependency is seen in terms how adjacent frequency behaves when you change gain at one frequency handle. Formula determines behaviour of the curve. You cannot enter the values directly as you’d like, like put 10 at 250Hz and then 100 at 500Hz and then 20 at 1000Hz.
Different bases for phonak means that you can have eg calm where gain at 250Hz is 20, and music where gain is 40 (all other left same or changed automatically because of non ability to put discreet values).
You cannot do that with aids that work from single base, like resound is.
But even with phonak, when you do verification with REM-speech mapping aids are in special mode for that, you don’t program some program but aids, the base.
Maybe oticon really has ability to do completely independent several bases. Can’t recall that I’ve heard about it though.
Ok, correction, single base and multi base I picked up was for the automatic switching.
Still, base formula for phonak is the same. You can change gains but behaviour how curve moves will follow the formula.
For resound I concluded that I don’t have the ability to change gains per frequency, but granted, I didn’t stare at the programming software for days. I concluded that they don’t have automatic programming as phonak which I like, so I closed it.
Easiest way to compare two formulas woud be to fit two aids and swap them for comparison in different situations.
If you haven’t already, I highly recommend this guy, and also value hearing channel (and their blog) to gather information.
In my experience, paradise and marvel are the same from hearing abilities. But I have good high frequency hearing so I wouldn’t notice if they did something different.
One thing I’ve noticed is that we don’t use same words to describe same sounds. Eg tinny, distorted, sharp and so on.
If you aim for best speech comprehension, then chase that and ignore if people sound like Mickey mouse. After a while it’s all be your new normal anyway.
Earlens use light to cause your eardrum to vibrate. Hearing aids use sound.
But, for you to hear, your eardrum has to send vibrations through the middle ear bones, they excite cochlea and it sends signals to the brain.
If only cochlea is damaged (no matter which frequency), it really doesn’t matter how eardrum was excited in the first place.
One use case where earlens could shine, is if their optic device is tiny - for people who have huge loss but tiny ear canals who couldn’t use big receivers. Or in general have better domes/molds option for people with really small canals.
But I have no clue what’s the size of that part for earlens, so might be quite the opposite.
Or if someone has some really problematic ear canal, I can’t even imagine what would that be, where sound could be messed up but light wouldn’t during the travel on that short distance between output point and eardrum.
Or if independent of that tech, their mics and software are insanely better for eg speech in noise situations. But I highly doubt that. If they did something so revolutionary, it would be on the headlines already 
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ReSound must have changed the application of the fitting algorithm. Back in March, 2019, when Volusiano remarked that it was Neville who had suggested the idea to him of having different fitting algorithms applied to different copies of the same program within the smartphone app, I was able to do it for my ReSound fit (would have been v1.5 or less of Smart Fit, probably). I even had the music program set up to use Audiogram+ whereas All-Around, Restaurant, and Outdoors were NAL-NL2. I couldn’t upgrade the last few versions of Smart Fit and had to do a total new install for each. So I was surprised recently when I restored my fit from a backup that all programs including music were NAL-NL2 fit now (but I didn’t appreciate why). A “new” feature, relative to my memory of past versions, is when you look in patient profile, both the fitting algorithm used for the patient and the user experience profile assigned to the patient are now summarized on the patient profile page and both these parameters can be changed on the patient profile page without any announcement of recalculating anything - it just happens. So that’s new, too, by my recollection.
I’ll see if I have an older version of Smart Fit on another computer (1.5 or less) and double-check how that behaves. Maybe I was badly hallucinating at the time?! 
The forum does not like DIY discussions in main threads so any further comment I will contribute to the DIY area.
The Dr. Cliff video on Word Recognition was good. I’d quibble a bit about shortening the word list being a problem. If somebody gets the first 9 or 10 words right, odds are there is little to be gained by doing a full 50 word test. If however patient only gets 5 out of 10 right, getting a more accurate score is of more value.
Totally agree with your comments about speech comprehension and ignoring sound “quality.” I think there should be more patient education letting people know that things are going to sound different because they haven’t heard certain sounds for a long time and that softer sounds will sound much louder because otherwise they wouldn’t be audible. Basically a brief explanation of dynamic range and compression.
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