Desired metrics for a hearing solution for a severe, bordering on profound, binaural loss wearer:

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Desired metrics for a hearing solution for a severe, bordering on profound, binaural loss wearer:

As seen elsewhere on this forum, I’ve been thrashing my problem for some years now. The most recent, including audiograms, can be seen here: Round 3; DING! - #15 by Bimodal_user

My advancing acuity decline, abetted by my even worse word recognition, has made me wonder: Am I going to be able to return to my music, and reliably understand my wife’s speech?

Music: Along the way in my hearing difficulties, I had a severe infection in my left ear which seems to have defeated my ability to reliably accurately hear musical pitch, as well as, in kind, my own voice. While I no longer play low brass instruments, I previously could be very accurate in sound reproduction, within my vocal range; I’d guess I was within a single herz of voice and instrument note matching when I was singing in a choir/chorus/quartet/solo-mixed situation. I lay that to 50 or more years of singing and playing music stuff, and in particular, being a barbershopper, in which tone matching is critical (4 voices, very close harmony, a cappella, successfully done, generates several overtones making it sound like more than 4 are singing); my inability to do that again/still is distressing to say the least.

When I got my most recent set of hearing aids, piano sounds were routinely clang-and-bang, and, worse, the reproduced tones were flatted. Removing compression on the music program helped that a great deal, but as time progressed from that occurrence (a severe infection followed closely on the heels of my latest Beltone aids, the Imagine 17s), my ability to hear my own voice, and others around me continued to diminish. Orchestral or other non-percussive tonality was pure, piano was as above; removing all compression in the music program seemed to assist mightily - but I still have difficulty hearing other musical tones or my own voice.

So, issue number one: Is it tilting at windmills to expect that I’ll be able to hear the tones around me, as well as from a piano, and my own voice (and others) so that I can resume singing?

Speech: My ability to understand folks’ speech has been going downhill, not surprisingly, as my acuity has deteriorated. Also not surprisingly, though very annoyingly, the use of the Beltone microphone solution (MyPalPro) DOES allow me to understand my wife’s speech, despite I and others having described her as mumbling, at least somewhat. Putting the MPP on the table when in a group conversation let the conference mode help out. But a separate microphone’s far from ideal, particularly as, at least within the Beltone line, it isolates any other speech I might want to hear, as the sound priority is given over to the microphone. I’ve hacked at that by relatively minimizing the gain of the MPP, and ramping up the gain on the “surroundings” segment of the HearMax program. As well, the MPP has a volume control; ramping up the gain on IT helps push through - but it’s a nuisance at best, and crippling for surrounding sounds at worst, not to mention the distortion of the clothing if worn on the person.

Enter the current generation of hearing aids; noise suppression seems far advanced in general, with the apparent current leader being the Phonak Audeo Infinio I90.

So, issue number two: Is there any likelihood that making my next (in a week or two, max) hearing aids purchase be the Phonak going to solve those speech issues? No mike, clarity of speech in general, and in particular, in group or other relatively noisy situations?

Those are all my begs in one askit. Is it asking too much?

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Do you have a Costco near you … they have the top of the line aids from several different company’s with a 6 month full return . I have the Jabra 30’s which are the same as the Resound Vivia 9 … $1700 for a pair … which is very much like the Phonak i90 Sphere ( they do not have that one)
And they do REM !

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No, not near us, and we’re not members, either,

That said, if whichever I choose is over an hour away, that point becomes moot, as, considering the end cost of aids, the cost of membership in Costco is trivial and the time factor becomes equivalent if the end result is the same.

That said, barring evidence to the contrary, it appears that I’m going to want the Phonak noise-cancellation feature; nothing I’ve read suggests that anyone else yet has that technology.

But thanks for the thought.

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I wouldn’t sell some of the others (and maybe yourself) short (like the Resound/Jabra and Oticon Intents) without giving them a try. If you are an existing phonak user, maybe it makes sense (as it did for me — I’m wearing spheres right now) but the experience of the other two I mentioned are also well regarded. I don’t think any of the makers has the solution yet that is miles ahead of the others for everyone. Even if you are an existing phonak user, spherical mode is very different from how phonak usually sounds, to me, at least.

The data on the test-rig may not provide the result the same as your ears & your brain in your environments.

WH

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Notes on non-Sphere alternatives…

Until I get something like the very deep discussion of My Phonak Sphere Infinio I90 vs Lumity L90 Shootout - #189 by JordanK, getting these results in some other HA mentioned, doing something else is a non-starter.

As speech is the driver for making the change (from my deeply discounted ($5000USD OOPocket/no-insurance) Beltone Imagine 17s with the same sort of detail and support of the noisy-environment speech recognition from any other), I’m left with the alternative of my humorous analysis of "there will be a murder or a divorce soon if I can’t reliably hear my wife) my reality or the Phonak $phere technology, and ideally, the highest potential (I90) within that technology possible, enhanced by whatever the best mold solution is.

I’m anxious to hear (well, read) documented evidence of others, but so far I’ve come up blank.

“Does a pretty good job at” doesn’t warrant $pending mid-to-upper-4-figure number$ only to wind up back in the same parking lot, albeit that it might be that others manage to get there in the interim before I give up and do it again, assuming my marriage survives.

In short, if I don’t have a verifiable solution (e.g. I hear- without a microphone - my wife in all our normal environments), I have no reason to change horses. The current Beltone technology is 2 generations later than what I own, but the trial costs (seen in a different thread) of over $1500USD makes that a non-starter.

The law of 30-day trials has now moved into, “yeah,but” territory, with various allowed chargeable costs (fitting fee, restocking fee, mold-if-you-needed-that costs, etc.) making it either a nuisance or attention-getting cost to try out different HA solutions…

But, I’ve asked this question as seen at the beginning of this thread of my next stop, a Phonak supplier referred by ZipHearing (the actual provider of the gear; the outfit locally is apparently one of their dealers); we’ll see what they have to say by Monday afternoon.

FWIW, there is another Phonak dealer (independent, many lines) about half-the-time closer to me who WASN’T referred to me by Zip (if they are one of that outfit’s suppliers, so much the better), which I might use for ongoing support merely for the cost-in-time-spent support benefit…

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How about how many have tried sphere and declared that it wasn’t for them? You’ll see a fair number of them on these forums too. No one thing “works best” for everyone. Do your trial with sphere, I love mine. Make an effort to take them to the nasty places you have trouble hearing. I hope that their performance makes it an easy decision! But I won’t be shocked if you say you didn’t like them.

WH

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IIRC, @Skip has problem with conversation with his wife even in quiet situations (correct me, if I am wrong), so in his case perfect adjustments of basics will be more important than all bells and whistles like Spheric AI program.

Basics like:

  1. Deep earmold with probably pressure vent (0.6 mm diameter) and proper receiver - probably UP (Phonak) or 105 (in Oticon)

EDIT:
By “deep” I mean earmold/cShell made from silicone impresion/electronic scan which reach at least 5 mm past 2nd bend of ear canal.
END OF EDIT.

  1. Proper alignment of wire lenght - not too long so that directionality beam wouldn’t “see” too much upward
  2. REM-based fitting in scientifically proved fitting rationale (NAL-NL2 or DSL 5.0). Phonak APD Contrast fitting algorithm is reportedly adjusted for people with profound loss, but I don’t know if it’s in fact better than NAL or DSL. Maybe @Um_bongo or @Neville have more insight in that issue.

EDIT:
4. As @Neville said below, in Phonak Sphere 90 case - activation of Speech Enhancer. In my, and possibly your case - slider to maximum in audiologist Phonak Target software.
END OF EDIT.

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Is this with or without hearing aids?
I haven’t read all your lengthy posts, sorry.

If money is a concern Costco is the answer if you don’t want to dive into DIY. My wife and I drive an hour and a half one way to go to our closet Costco and it’s very much worth our time. Plan on making 3 maybe 4 trips to get the aids tuned up well for your hearing loss. Then plan to go once a year for aids service and update your aids to your hearing loss. But something while there, we do.

If hearing aids won’t help with your above statement of needs, have you considered a cochlear implant evaluation? It will answer most and some you haven’t thought of questions about your hearing. It’s an education for sure. All the things you want from your hearing CI can do with a little effort from you.

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I have written that in another post, but when WRS is 48% (with words read by the examiner, which is easier, not played from records), the sound is distorted and out of pitch, the good results from my advice described above are highly unlikely…

In those circumstances, the only way to reliably improve speech understanding in quiet situations is bimodal hearing with a CI on the poorer side, supported by a hearing aid in the other ear, and a word recognition score of 68%.

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I don’t know how many have tried this but I find that turning on Speric in a calm, dinner at home, situation improves my speech understanding a great deal.

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Yes, I think I’ve seen that skip is having a hard time finding REM, which makes a nicely deep-fitting mold more valuable still.

DSL contrast is nice for a subset of users with profound loss and/or poor clarity because it turns off fast adaptive compression which can improve speech clarity–but it’s probably a smaller subset which makes it a bit trial-and-error. I still typically wrangle it to DSL targets.

Speech enhancer is, I think, a bit of an undervalued features in phonak 70/90 hearing aids for quiet situations, particularly for users with significant hearing loss. Users with better hearing will sometimes experience an odd echo with it if it is turned up too high.

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Oh but in regards to the initial question, with a 60% word recognition in ideal, quiet, audible situations, lipreading is always going to be a critical component.

Music acuity has probably declined with hearing loss, but once the hearing aids are dialed in as best as possible with probably a manual program for singing and one for playing and whatever, ear training is also important. Musicians can think back to how much work this took in the first place, way back when, and extropolate that it will take a bit of work again to improve things.

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Based on valuable @Neville recommendation, I added some thing in my previous post for clarity.

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In the meantime. Hopefully you have an android or Iphone and have downloaded the free Live Transcribe app from Google. It doesn’t work for phone calls but it makes personal conversations acceptable. I have even used it in meetings and presentations and get about 70% of what is being said. It’s not a solution but it enables you to communicate in stores and restaurants with some precision. Note that you need to have a Wifi or 5G connection for the phone to make it work. Sometimes 4G or LE level will work but not always.

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(And, equivalent question from Bimodal:)

I have, indeed, and have asked each audiologist so far (3); each has said that “You’re not ready for CI yet.”

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Apologies for leaving it all as it gives context:

If I understand it properly, I need WiFi active when I’m using that program? It’s not something which is in my phone? Or does it communicate with the HAs over WiFi instead of Bluetooth - and in which case I’d presume that I’d have my phone on my person, and thus distance would (should anyway) not make a difference.

Or are you suggesting that for my current HA, the Beltone Imagine 17?

Either way, if it’s someone else’ than my phone, is there a latency delay (e.g. in a big-box store, grocery, restaurant, using their WiFi)?

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I think you are not getting the message correctly. This has nothing to do with the HA you use. It is for when your HA cannot provide understandable audio or cannot otherwise be used in conversations. This is an android or IOS app that is used to transcribe audio speech into text fairly accurately. You can use it without an HA. The app was designed by Google for totally deaf people to understand conversational speech by reading it as text on their smart phone. For a while using the US English language transcriber it worked without any internet connection. It seems to have changed to now work only with any wifi connection you may be able to use such as a home wifi, store, restaurant, medical office , museum or public building with a free wifi connection or your phone has a good data connection to a 4G or 5G cell provider wherever you are, even in a car. I have used it in a car with Samsung or Google Auto connection so I can understand what the driver is saying over car noise. I am merely suggesting that it can be used as a supplement to your hearing aid for comprehension in a conversation with other people. It even works with audio announcements in an airport. Other participants from up to 10-15 feet away from your phone can be transcribed into your phone’s display of what they are saying. I have not noticed much latency but the app needs to be refreshed every so often if it is a long conversation depending on the memory available in the smart phone. It’s free, you can download it from either Google or Apple app stores. as Live Transcribe made by Google. Be sure you don’t get an imitator. Try it in a conversation. It does not work with phone calls as it requires exclusive use of the phone’s microphone. There are no ads in the Google app.

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Note that for Google Live Transcribe it is not a translator. It will only transcribe in the language of the speakers selected by the owner of the phone. UK English is available, as are Spanish, French and several other languages. I am not sure what would happen if there were multiple languages in a conversation. The displayed conversation in Spanish will be displayed in Spanish if the transcription language selected is Spanish.

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With three audiologist saying you are not ready I have to agree with them. I am curious what each ear word recognition is though

Have you considered BTE aids? They are know for a more robust sound and clarity for those in the sever and profound hearing loss ranges.

We do have a few members with similar audiograms as you that flat love the Infinity Spheres. But we always wonder if these aids are being properly tuned for you. It really doesn’t matter how new and fancy the aids are if they are not properly programmed. That includes the correct acoustics for you. Sometimes the proper programming is not done by an audiologist. There are some great HIS fitters that are fantastic.

Anyway, I hope you figure this stuff out so you can hear your best a have a great conversation with your wife.

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I don’t want to belittle opinions, but from my experience, very often HCPs have their opinions based on old guidelines, especially those who aren’t daily familiar with CI.

48% for poorer ear and 68% for better and 60% binaurally, which is in margin error with that 68%.

The words were spoken by the examiner, so it is highly probable that WRS would be even poorer when the test is done from validated recorded samples, as it should be.

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