Considerable Difficulty Outside & Restaurants and Speaking with People

I suffer from moderate to sever hearing loss in high frequencies. My diagnoses is sensoneural hearing loss. I wear Oticon More hearing aids. They help me but I still have considerable difficulties outside, in restaurants, with groups of people and when there is background noise. I am now reluctant to speak to people in social settings.

I understand that senso-neural hearing loss is incurable. I am 63 years old. I can function with Oticons but having conversations takes concentration and can be tiring.

Would a different brand of hearing aids make a difference? Are there any treatments or anything that I can do to improve my hearing?

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What you are saying is so common to all of us with hearing loss and hearing aids. I have been wearing aids for over 20 years and Oticon aids for over 13 years. I have the More1 aids, with custom ear molds, I have no problem with being outside,but noisy restaurants are an issue,as is meets, and conversations in general. I have come to finally understand and accept the fact I have severe hearing loss, with very poor word recognition.
They call hearing aids , aids for a reason they arenā€™t like glasses they arenā€™t going to give you your hearing back to normal.

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If it has been awhile since you saw your audiologist, do pay them a visit and see if they canā€™t make some adjustments to improve your situation! One should visit the audi at least once a year for a checkup. Maybe different ear molds or other changes would help. You donā€™t necessarily need NEW aids. And donā€™t fear a sales pitch at the audi. Just resist and say you want the most advantageous adjustment. An external mic might also help you in group situations. Others here who use Oticon can advise you about this.

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Thanks for your response!! I havenā€™t seen my audiologist for 18 months so maybe it is time for a return visit. An external mic is a good idea.

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I get an annual full hearing exam, and a semiannual quick check to make sure my aids are functioning properly. I am at this time giving the thought of getting a CI some hard thought.
My word recognize score is dow to 40%.

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@alan1

Hi Alan, I have similar hearing loss, and are the same age, and had all the same problems with speech as you. Your hearing aids may not be the problem, The Audiologist is the key, as they can get the best out of them. I changed Audiologist and bought new HAs online. They arrive with domes, programmed to the same Audiogram as my existing ones. The performance at that point was about the same as my previous HA, struggling in crowds and echo. I then took them to the new Audiologist, and those problems have pretty much gone. This is what I remember him doing:

Firstly, he fitted custom moulded slimtips, to help control feedback. He said that by reducing sound escaping from the ear canal, the automatic feedback suppression will be less severe, and he tried to pretty much turn feedback suppression off. Feedback control effectively takes a big chunk out of the gain, where you need it, in the speech areas, hence the problems hearing speech.

Secondly, he concentrated on Compression in the upper frequencies. He tried to turn up the soft sounds, and compress the loud sounds. He demonstated this by taking me outside into the traffic. I faced the traffic as a loud truck passed us, and he spoke normally. I could hear every word!

My hearing aids are Phonak (Marvel & Paradise), but I would imagine that your Oticon HAs will work in a similar manner. I donā€™t use the Automatic programme any more (which switches settings by guessing your environment), as I find it gets it wrong too often, and takes away sounds I want to hear.

My Audiologist has changed my hearing life. I hardly ever have to ask people to repeat themselves, or withdraw from a conversation.

Good luck
Peter

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(1) this info on auditory training programs might be useful. I have not tried any myself. Auditory training helps your brain hear better
(2) I agree with others that the audiologist is key to success.
(3) if you decide to trial other HAs, many of us on this and other forums have had great success with Phonakā€™s Lumity. I wear the L90-R model and they are the best aids that Iā€™ve had and I experience noticeably less listening fatigue.
(4) good luck!

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I had similar issues and finally had to find a skilled practitioner to set up my Paradise P90Rā€™s. I can hear now! Setup is key. My audiologist didnā€™t know how.

Along the way I discovered that some simple things affected my hearing.

  • waxguards need to be changed. Mine are hard to doā€¦sometimes the waxguards werenā€™t in right.
  • domesā€“I stuck a finger in each ear (receiver in canal HAā€™s) and they were louder. Changing from open to closed domes made a huge difference. Then I had to experiment and make sure I had a good fitā€“right sizeā€“to prevent feedback.
    I had help here; my audiologist didnā€™t have a clue.
  • I had to advocate for myself. I sent emails to my audiologist telling him what was wrong; then scheduling an appointment.

DaveL
Toronto

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Yipes. I know that Oticon makes state-of-the-art aids that utilize a more ā€œopenā€ hearing paradigm, but when I tried a pair of their OPNs about 5 yrs ago I simply could not make sense of ANYONE talking: at restaurants, cashiers, in the docā€™s office, places where HVAC roared in the background, outside with WIND, it was just exhausting.

My audi was a very caring, patient guy, who had me try Phonak by comparison. I found that model (Audeo B, Marvel, now the Lumity Life) is the kind of hearing experience I need for my cinderblock ears. Yes I have high freq loss ā€¦ along with mid and low! So I was very happy to try these out and have stuck with the brand!

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Thatā€™s what I was thinking. The open fit of the Oticon may have been the wrong choice.

Since the aid is probably beyond the return period. I would try to see if the audiologist can tighten up the openness.

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You should be doing daily auditory training exercises. An app such as Hearos can help wonders.

Hearoes app

Hope this helps. Thanks for the suggestion I shall try it too.

DaveL

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I use the partner mic for my wife and try to sit with my back to a wall

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I think @user990 is probably right that the Oticon aids with their open paradigm is probably the wrong choice for you, because it seems like you donā€™t want to make the brain hearing work to sort out what you want to hear and focus on it, but you simply want the hearing aids to ā€œspoon fedā€ the speech to you instead of developing your brain hearing.

Oticon makes all sounds around you available, balance them up a bit to favor speech (how much in favor of speech depends on your personal settings in Genie 2), but you must be willing to work and develop your brain hearing to sort out all the sounds presented to you and learn to focus on what you want to hear (usually speech) and ignore the rest. Thatā€™s how normal hearing people listen anyway, because they can hear everything and they have no choice but to sort things out.

An analogy is to make all things on a photo sharp and clear for you so you can see whatever you want to see better, but you must do the work to scan through everything and pick and choose to focus on what you want to see. People who like the open paradigm tend to care about being able to hear more than just speech. They want to have a better sense of awareness of everything around them, and be able to hear all those things. They just donā€™t want those things to overpower speech. And Oticon delivers them all that.

The traditional paradigm is different. It aggressively blocks out everything behind and on your sides to let you focus on the sounds in front of you better. Itā€™s like putting blinders on a horse so it can only see up front. Now if you want to hear the person on your left, you must turn your head toward the left before you can hear that person. People who like this approach usually donā€™t care about hearing anything else but speech in a noisy environment. To them everything non-speech is noise and is not important to them. They would rather have more comfort and less listening effort at the expense of not having full awareness of the surrounding.

But sometimes itā€™s not a matter of choice. Like @1Bluejay shared with you, she tried in earnest with Oticon aids and simply couldnā€™t get them to work for her. But the Phonak aids work out better for her. So sometimes itā€™s a matter of limitation in your hearing loss and not just a matter of choice. Her hearing loss, however, is much much worse than yours. My hearing loss is also worse than yours, although not as bad as @1Bluejay . But Iā€™m doing OK with Oticon aids, simply because Iā€™m the type who prefers to be very aware of my surrounding, even in noisy surroundings.

Because of this, Iā€™m guessing that you seem like the later type of people, based on you post. it doesnā€™t seem like you want to have to sort out the sounds to focus on what you want to hear, you just want to hear speech and donā€™t care about anything else.

You asked if a different brand of HAs make a difference? I would say Phonak aids will probably work better than Oticon aids for you. Furthermore, Phonak seems to have come up with a new solution to solve this ā€œblinderā€ issue with their Speech Sensor technology, which will detect where speech comes from and automatically adjust the width of the beam forming accordingly (see screenshot below).

The advantage of this is that you donā€™t have to turn your head to hear the speech coming from behind you. But the disadvantage is that now you donā€™t have a narrow enough beam forming to help you if you have multiple speech cues coming from all directions (the middle scenario). For the scenario on the right below, the beam forming is adjusted to be a bit wider than the scenario on the left, so now you will have to turn your head a bit to the right to hear the person speaking on your right, and your beam forming field becomes a bit wider, thus youā€™ll have to put up with more noise compared to the scenario on the left.

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@Volusiano

Iā€™m from the Oticon camp, of wanting to have full situational awareness, to the extent that I have my Phonak P90s default to ā€œMusicā€ and have removed the blinkers to enable 360ā° input. Iā€™ve minimised things like windblock and noiseblock, and reduced whistleblock as much as I can, as they just remove high speech frequencies. I donā€™t always face speakers, as in meetings and restaurants, people are speaking all around. There are very few examples of where I find their Autosense an improvement. I can switch it in if needed though.

Great post by the way.

Peter

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Thanks for your input, @PeterH . Before I started wearing Oticon aids (and Iā€™ve been wearing aids for 30 years), I was used to the noise blocking approach, so I struggled a lot to get adjusted to the open paradigm, but eventually I did. Thereā€™s nothing wrong with either camp, some folks like to have full awareness, other folks prefer the comfort of more quietness because the full awareness can be exhausting or annoying to them. So itā€™s really just a matter of preference. But if youā€™re used to the comfort camp and you want to switch over to the awareness camp, it takes a lot of positive attitude in addition to time for the brain ā€œtrainingā€ to get your level of acceptance adjusted.

The level of their hearing loss can also dictate whether they can even have the option to be able to get the full awareness or not. If their hearing loss is high (severe or profound), especially across the board, the dynamic range of their hearing can be greatly reduced, so there is not enough range to differentiate the subtleties in the volume of the various sounds anymore. In this case, almost everything gets amplified to sound almost equally loud, so it makes it extremely difficult to differentiate and sort out and focus certain sounds and ignore other sounds. In this case, the only choice really is to block out the unnecessary sounds aggressively enough to help them focus on the more important sounds in front.

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Hi Volusiano:

Thank you writing an extremely detailed response.

The Oticons do allow me to hear more from the general environment. Birds chirping and sounds that I could never hear. It would be a shame to sacrifice that. But I cannot distinguish speech from the background noise. The moment, I am at an event, I cannot hear comprehend the voice of people even a few feet away. The same thing on the subway in New York City. I have had Oticons for three years so I am not sure if my brain could ever be trained. That being said I see an audiologist once a year at most and maybe that is not enough. Do you think the Oticons can be adjusted to perform much better?

Your observation that:
ā€œnot enough range to differentiate the subtleties in the volume of the various sounds anymore. In this case, almost everything gets amplified to sound almost equally loud, so it makes it extremely difficult to differentiate and sort out and focus certain sounds and ignore other soundsā€ is exactly the way I perceive the sound from my hearing aids. There is just too much data and I canā€™t interpret it and understand speech when there are other sounds in the environment.

If the Phonaks work noticeably better with speech I should probably give them a try. At this point, I am avoiding public events, groups of people, restaurants and social settings. Even if I can function it is unpleasant.

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I think your situation is unique in that you actually have a pretty mild hearing loss up to 2 KHz, and beyond that, itā€™s only a moderate and not severe or profound loss. So Iā€™m kind of stumped to see that you struggle so much in complex listening situations.

It makes me wonder if you have some kind of undiagnosed hearing conditions beyond your hearing loss, like maybe hyperacusis or recruitment. It kind of jives with what youā€™re describing here about how everything sounds too loud and they just overtake each other until everything sounds equally loud and takes away your ability to recognize the sound dynamics to differentiate and separate them. Iā€™m no ENT or audiologist to be able say anything intelligent beyond mentioning a couple of these words above. Have you complained about his to your HCP? Did they say anything?

Iā€™m not sure if Phonak would work better for you either, if you actually have some undiagnosed hearing condition beyond the hearing loss. But I donā€™t think it would hurt to try, as long as you can just try first before buy, or have a trial period with a no hassle return in writing.

To OP @alan1 - Aside from seeing an audiologist, have you seen a neurologist and/or speech therapist? Are your age and/or medical history such that you might have a history of a stroke or other neurological condition? Hearing aids help with hearing; might you have difficulty with language rather than hearing? Has this been the case your whole life or has this started only recently?

Hi Volusiano:

I havenā€™t had my hearing aids adjusted by a HCP for 18 months so it is time to go back.

I looked up ā€œrecruitmentā€, and that very much describes my experience. That in any situation with background noise, I have enormous difficulty making out peopleā€™s speech.

I have no history of stroke. My difficulty in group settings/background noise settings has gotten worse in recent years gradually. I am 62 years old and healthy for my age.

I am 100% fine in one to one settings with no background noise, fine on the telephone. Some difficulty with group dinners at a table. Restaurants with many people creating background noise make it very, very difficult when people are more than 3-3.5 feet away.

Yesterday, I was at a reception where 60-70 people attended at a buffet, and trying to speak with a friend 3 feet away. It was almost impossible.

Strange thing is that my speech recognition test at my audiologist are very good (had a test last April, but hearing aids not adjusted for 18 months). I think I scored about 92% in speech recognition. But it seems that the moment the environment is not ideal, that number plummets.

Oddly, other things that can cause difficulty, are interpreting speech on iPhone video calls when the phone is more than 12 inches away (even difficult at that distance).

What you are saying is very concerning. How can ā€œrecruitmentā€ be managed?