As someone who has an appointment next week to try the Jabra’s, I am curious about a couple of things.
What hearing loss is suitable for the M&RIE receivers as opposed to the standard ones? Is the problem the OP due to having inappropriate receivers?
With the standard receivers are there only three settings for the frequency lowering soundshaper program? The chart Tenkan posted has a dot as opposed to three settings next to the soundshaper.
Apologies if I’m repeating stuff you already know. For starters, what are your word recognition scores from Costco? If they’re low, that largely puts a cap on what hearing aids can do for you. Essentially it means that the brain has forgotten how to interpret those sounds, even if they’re made audible. It’s doubtful if 60% gain is enough to make the sounds audible. Although frequency lowering can make high frequency sounds audible, there’s no guarantee your brain will be able to make sense of them, and if they interfere with other sounds it could make speech understanding worse. If your word recognition scores are low enough, (50-60% or lower) I’d suggest considering a cochlear implant evaluation.
I think that 60% is too low, and that would be easy to determine with real ear measurements done on your hearing aids as they are fit currently. Limiting the Maximum Power Output would be the preferred approach to control loudness.
Ear plug mode could be achieved with earmolds with no venting. It would also reduce speech by the same amount, and include a significant amount of occlusion effect.
Music mode is definitely a thing. I do wonder how low you keep the volume. I’ve measured the output of people’s headphones before to compare and each time they have been very loud compared to the levels of their hearing aids.
Increasing the volume with current fitting you have would be expected to have little effect since there is not a lot of headroom available and the 40% reduction in sound.
As MDB said, frequency lowering can make the sounds audible but that does not necessarily translate to improved speech comprehension. And our perception of loudness is generally based on the whole sound, meaning that any increase at any frequency will have a perception of increased loudness.
Best of luck to you. I would suggest finding someone who follows best practices, make sure they measure your uncomfortable loudness levels and measure the MPO with REM, and allow them to take the wheel for a little bit. After that (I’d suggest a month or two), I think you can absolutely work towards refining and progressing toward your goals.
OP, maybe post your full audiogram, with bc and wr scores. I have profound loss in one ear, practically dead for speech comprehension and my Resound One’s (Jabra enhance pro equivalent) work wonders for me. Freq lowering/shifting is available, although i find it provides strange sound artifacts if set to aggressively. But what i dont quite understand is how you qualify for the mic in receivers if you are “dead in one ear”, as you describe?
I would also suggest a hearing test by someone else. Over the past years my WRS in my best ear was measured at 55% by Costco. Last month I had an appointment with a medical otologist they required their audiology department to perform a hearing test. My. WRS was 30% higher in my better ear and the otologist thinks properly adjusted hearing aids would work. Later this month I have a follow up appointment with that audiologist.
Since you have the SmartFit software look into a setting called Environmental optimizer ll (i think i am getting that right).
That helped me with finding a good balance for soft and loud sounds. You may also find some really good info at Audiologyonline.com, the classes are free and they have specific courses on the Resound aids (your equivalent) and the SmartFit software. Each course is in video form, less than an hour long and full of useful info.
Best wishes
A cochlear implant evaluation would include word recognition testing.
The M&RIE receivers are not for everyone, they say mild to moderate/severe.
There’s 4 from very mild to strong, the charts I put up are data/specks features, here’s what you get in sound shaper.
My error. The Very Mild was added in 2019 and I hadn’t looked at it in quite awhile. OP would likely need Strong (starting at 2500 Hz) to hear any enhanced highs and even that might not do it.
I was wondering if I needed something more than aids. That test hopefully proved aids should suffice.
I actually wear earplugs in restaurants, movie theaters, loud venues. I can actually understand nearby speech better with these…even though the volume is attenuated along with the external noise. Limits me to close up conversation, but otherwise the noise drives me nuts!
Ethan
Hi…thanks for all the great replies. I was blocked all day from replying due to newbie restriction of 8 posts on first day! Out of jail now.
Followups:
I have had three comprehensive hearing tests in the past two years, one at Sams, one a TruHearing, and the last at Costco. Basically all the same result, with slow degradation over the past 2 years.
I actually comprehend speech pretty well…on the phone and with headphones nearly 100%…ie don’t really need to have phone repeats. Any speech with my Bose earbuds or headphones is pretty close to 100%. Volume is pretty low…as gauged by my wife…who has good hearing. I never turn the volume up much as it hurts…even with crappy overall hearing.
The issue is open field comprehension…ie in a room, restaurant, etc. Hence the idea that a good noise suppression HA might work…thought so…but not really any improvement. The real difference is how the sound is getting to my ears. Headphones are nearly 100% ok with speech. A cell phone is 80% or better…if the caller is not mumbling and the connection is ok. TVs are a problem…depending upon the program…wife has trouble too with a lot of programs. I use CC all the time…as does my wife…go figure. None of the HAs really improved the TV sound comprehension much.
Since I can comprehend speech really well with good quality headphones, I think the issue is more how the sound is delivered to my decaying hearing. I can process the t, s, th etc just fine with headphone (or the Bose earbuds). I think the issue is the overall quality of the delivered sound…both the Bose products have huge speakers (so to speak) compared to the tiny ones in HAs…this obviously impacts the total sound envelope.
Hence my wishlist of a HA that uses a high quality headphone system as the delivery method…
In the meantime, I have been playing with an old set of Phonak Virto V30 (312), in the ear HAs. Thought I could program with the wireless Noahlink…but turns out I need the Icecube II or a wired system. I am looking into that…the reason is that the V30 has SoundRecover.(frequency shifting)…and I could try it out on cheap…instead of the $1600 or so for the costco HAs. Problem is that only the Left seems to work…arg. Any suggestions? They do not look fixable…
I have a follow up at Costco in two weeks. Will see what we come up with. I think I will return the Jabras and try the Philips. If that is a problem for Costco, I will just return the Jabras and start from scratch with my old HAs…ie the Phonak V30’s. That would give me a chance to see if the frequency shifting might help.
Again, thanks for all the great suggestions, replies, information, etc…incredibly helpful!
Ethan
I’m not seriously suggesting you should go out and buy them, but… it sounds like a use case for Apple Airpod Pros. Before I got my own I’d seen reviews from people who’d worn them to loud concerts and felt that they enhanced the experience. You can block out the outside world or dial it in. Even with my severe hearing loss, I’ve felt that in a few situations they work better than my hearing aids. That’s where the good noise reduction cancels out the inadequate amplification.
Maybe the real difference is that with hearing aids, the sound has to travel through the air to get to your hearing aids.
I’d be curious to have you wear your headphones and play the ISTS signal through them and record the response with PMM (probe measurement microphones, used during real ear measurements). Or put them on a 2cc coupler in a test box and do it that way. Either way. Then you could do a transition fitting to match the frequency response of the hearing aids toward the frequency response of the headphones. Wouldn’t sound exactly the same due to the difference in the drivers, like you said, but it might bring some of the magic of the headphones to the hearing aids.
That being said, I do think that if you can hear that well with headphones and the cell phone, the biggest improvement would be to allow someone to fit you to REM verified NAL-NL2 targets and have them measure the MPO and keep it under your UCL limits. I would also ask them to run UCL for you across all the same frequencies of a normal hearing test, 250-8k so that it lessens the risk of discomfort from your hyperacusis.
I can tell you are putting a lot of effort into hearing well, and I hope that you can get that improvement.
Hi D Wooluf
Thanks…I have read about them…and agree they look like a possibility. Just don’t have Apple products (anymore)…hoping that the broader market will like them and incentive a wider market.
Ethan
Hi D Wooluf
Agree…how the sound is getting to the aid,vs headphones by wire…quite sure that has an impact on the overall sound envelope.
Ethan
BlockquoteI’d be curious to have you wear your headphones and play the ISTS signal through them and record the response with PMM (probe measurement microphones, used during real ear measurements). Or put them on a 2cc coupler in a test box and do it that way. Either way. Then you could do a transition fitting to match the frequency response of the hearing aids toward the frequency response of the headphones. Wouldn’t sound exactly the same due to the difference in the drivers, like you said, but it might bring some of the magic of the headphones to the hearing aids.
That being said, I do think that if you can hear that well with headphones and the cell phone, the biggest improvement would be to allow someone to fit you to REM verified NAL-NL2 targets and have them measure the MPO and keep it under your UCL limits. I would also ask them to run UCL for you across all the same frequencies of a normal hearing test, 250-8k so that it lessens the risk of discomfort from your hyperacusis.
I can tell you are putting a lot of effort into hearing well, and I hope that you can get that improvement.
Great idea! The Costco exam/fitting was excellent…and followed best practice as far as I can tell. Lots of discussion, repeating tests, final real ear testing, and more tweaking. Left very happy at the time. The worst was the “degreed” Audiologist as truhearing…younger person, with very little technical knowledge as far as I could tell…short test with little discussion. Canceled any further dealings with them. The Costco fitter (not a degreed audiologist) was near retirement, and was the most thorough and knowledgeable of any that I have encountered. Will see him again in two weeks. I will discuss this idea with him.
My working theory is that since the HA use a micro driver directly into the canal, they must loose a lot of overall sound information. Basically the headphones make use of the full ear physiology (ie shape), have an relatively enormous driver, and, very importantly, the muff cancels out most of the world. The end result is that I get as high an original signal to noise ratio as is physically possible.
I have always had a mild tinnitus…and any relatively loud noise would set it off for hours…so between the discomfort of loud sounds in general, and the increase in tinnitus after exposure to loud sounds, I have learned to attenuate and or avoid any loud sounds. Even now with crap hearing.
The most significant benefit I get from (any) HA, is that since world sounds are indeed amplified, my wife can get my attention easier :)…I can’t necessarily hear what she said…but I know I am summoned! Good thing. 
Overall, I like a quiet world. Always have. Loss of hearing sensitivity is definitely a two edged sword for me.
Ethan
Thanks! The Costco fitter was concentrating on my hyperacusis. That took up the final third of the fitting appointment. First set the HA to prescription (not sure which standard)…way too loud and VERY uncomfortable…then he did the discomfort test…across all frequencies as noted…and then tweaked the gain to best as he could…did note that the available margin in my lousy left did not leave much room for improvement…but he did the word comprehension test single, both, etc and determined that even with a dialed down left I was getting some comprehension benefit. The overall issue is that this test does not sufficiently mimic real world hearing situations and does not translate into better real-world comprehension in my case. My overall reading of dozens of papers on this subject has validated this point…ie HA in general work far better in the lab than they do in real world. As an engineer, this is of no surprise to me…
Ethan
This is the only reason my 2 kids survived their teen years…
Dan
