Not necessarily, I am not sure if the OP has too severe/profound a hearing loss for BAHA, not only in air thresholds, but also in bone. However, OP condition is definitely for at least CI evaluation, to determine impartially the WRS, among other important things.
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As the number of my audiograms expands, with ever-increasing variances, it would not only be an exercise, it likely would be an exercise in futility.
My avatar stuff doesn’t allow links - just numbers from a single audiogram.
As this is a moveable feast so to speak, I’ll leave the audiogram part blank until I’ve moved into whatever solution there is (new purchase or revert-to-first time-with-wife adjusted Beltones).
FWIW, in organizing the now-blizzard-level pile of audiograms, including from the very beginning as I floundered with ear infections several years ago, I note that the most current 'gram (see citation for round 3) approaches those of several years ago.
Just how that’s possible I have no clue. But it’s hard to fake “ya, I hear that” so I presume the Phonak provider I’m currently testing got it right, despite being in a bare office with only a quilt hanging on one wall for damping extraneous sound (compared to sound booths or the single example I’ve seen of waffle-walled office) during the assessment.
OY!
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AUGH, I think you nailed the downside of all these hearing tests (tone and word scores). If the setting isn’t acoustically optimal, then I can “deaf”-initely see how results would vary. That can impact the set-up of one’s aids from the get-go. I had a gal do the word test while wearing a face mask (2022) AND wearing a headband mic that bobbed up and down about 2-3” from her mouth. The tone tests are probably a bit more accurate, but no matter. I take the results with a grain of salt, and when the aids come in and get programmed I simply KNOW that I’m not walking out the door with them set as-is.
I guess I have my own nuanced preferences for high, mid and low freqs. I hope your persistence and patience pays off! Keep us posted here … cuz you’ve got a WAF (wife acceptance factor) to consider.
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If you have larger than average ear canals or oddly shaped ear canals a standard sized insert tip can fit poorly and then a leak will result in a low frequency roll off. That’s usually the first thing I think of when I see that rounded configuration which exists but not that commonly. Low frequency bone conduction has a lot of variability as well (bone conduction does generally), so sometimes the air conduction is rolled off at the bottom but then the bone conduction is also lower than average (especially if someone has a bit of a meaty neck or placement is poor or just with skull variation) and then the clinician thinks “ah, the bone threshold agrees so the air threshold must be accurate”. I’d probably trust the newer audiogram just looking at the configuration. You need a sound booth to get people down into the normal range, but the level of quite background noise in a quite room but outside of the booth won’t matter much for a severe loss and well placed insert tips. Maybe that guy is better at insert placement BECAUSE he’s not in a booth. Maybe he also used the (much more expensive) big daddy insert tips.
If you’ve got a tip leak that is causing a big low frequency roll off, word recognition will also be impacted as the person is missing audibility. I might hypothesize that it might even be worse than someone with a real rounded hearing loss configuration because they’re just not used to listening to things that way, but that’s just me hand waiving.
Good practice is to double check the lows with a circumaural headset if there is any reason to suspect a leak. Though circumaural headsets have their own drawbacks which is why they aren’t just used all the time. But a smart clinician will know how to troubleshoot both types.
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Thanks, Neville, as always, for your erudition.
The latest test, as I await my titanium molds, was to take two of my prior - left from the current Beltone, and the right, from before I went to the high power ones; those pretty much matched my Phonak receiver - ear molds and trial the music program at church this morning.
I normally sit relatively close (never a challenge to find a seat in that neighborhood), but this time it was the second (first with a back in front of my knees) row. Perhaps being that close had an impact, but:
Very significantly:
For the first time in well over a year, I understood every word from some/any/one speaking (all amplified), and the previous lousy-sounding organ approached my expectation of what it should have sounded like. Unfortunately for me, my OV (own voice) wasn’t as good as I needed to be confident of my bass line harmonizing. I imagine there’s a tweak within the music program which can address that; I certainly hope so, as I’d love to be singing again!!
As to my ears, indeed, the canals are relatively large:
That’s the current BT right; a past one (not entirely as well fitting, but with the regular power receiver which matches my current Phonak for size) is in my ear and has no feedback.
The larger current-Beltone-left receiver hole makes for a tiny bit of feedback in my left ear; none of my prior left ear molds survived the stuffing of the high-powered, larger-than-the-hole receiver, so the new one, with a presumed leakage, is in my left, but I’ve plugged the vent, allowing the relatively loose fit to perform that duty.
The difference from the power domes is notable. However, it’s still early days; this is the first church or music exposure since my initial fitting 5 days ago, so the comparison is against the Beltone results, and my unfamiliarity with the MyPhonak app at my first handbells and choir rehearsal. I’ll take another swing at it Wednesday now that I’m a bit more acquainted with how to make it work for me.
As to the tips used in my initial testing, they’re the typical plastic nipple with a foam barrel around it (varying sized barrels - they looked like this);
https://www.amazon.com/SOUNDLINK-Insert-Foam-Eartips-Earphones/dp/B0D4M67YR4
I presumed them to be plain jane and unsurprising in any way to me, other than the fact of the markedly better reading on this audiogram.
There have been a couple of circumaural headset evaluations; I’d expect that the nipples would be more-sound-delivered, but perhaps not using the shape of the ear - but, with molds, perhaps that’s irrelevant, anyway? (Presumed sound aggregation coming from the mikes behind my ears and delivered via receiver, however encased…)
Thanks again for your participation!
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Typically for any serious singing and performing of music one needs a secondary manual program. It’s not what the automatic program is built for. The phonaks have an automatic music subprogram, but it is for music listening not music performance. If you like to sing, let your clinician know and have them build a program for that–remember that with hearing loss is will never be perfect because the basic damage to the cochlea results in a lack of pitch acuity that hearing aids cannot compensate for, you’re trying for good enough and then re-training your ear. If you are brave enough to sing in the office that helps, similarly I encourage all musicians to bring their instruments in or to connect remotely in a place where they can play during adjustments.
If you are a performer in a rock band or an orchestra and consistent noise exposure and moderating hearing damage is also a concern, that’s a difference situation altogether.
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Heh.
Noted. The most serious would be singing in the church choir.
That said, I used to be pretty good at finding and hitting a note, and played for decades (low brass; principal instrument trombone but all others down to double b-flat tuba) in bands and orchestras long before the advent of clear plastic shields; I expect there’s a connection there!
But my music now would be the occasional opportunity for appreciation, and the above small chorus (choir).
As to a secondary program, fortunately Phonak gives me up to a dozen programs (of which 4 are boilerplate/taken/modifiable and saved as another program), and I expect I might be able to find an audiologist sufficiently knowledgeable to set me up with one of those custom programs.
As far as I can tell, for whatever reason, Sphere isn’t enabled, or if it is, it’s not very automatic and I don’t know how to turn it on. My attempt 4 days ago, in a restaurant, to do something that the ‘restaurant’ installed program wouldn’t, largely failed. I had to massively tweak noise parameters, let alone have Sphere cut it all out and allow me to hear my wife 18" away, let alone successfully understand her all the time.
The “shootout” thread, moribund for about a year, had the user absolutely thrilled with his Sphere blocking anything other than speech in noisy circumstances, so I’m a bit bummed that I’ve seen nothing approaching that performance here.
Baby steps, however; we’re a long way from throwing in the towel.
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The sphere program is a sub program of the automatic program. Either you haven’t been in a place loud enough to activate it, or you’re always switching to your manual restaurant program in which case it won’t activate. You can capture it for manual use by going into a loud enough place that it comes on and then adjusting that into a custom program in the moment. Or you can have your clinician pop it into a manual program. You need to take a bit of care with it if you’re using it as a manual program because it drains the battery quickly.
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Aha. I think I had a mini-demonstration while refueling yesterday; ambient noise disappeared frequently (and mostly, but returned briefly several times in the several minutes’ exposure) while I was in the Automatic program.
As to battery life, and making a manual program, I’m guessing that to be the “adjust” button on the right, and from there, “save as new” button on the left once I’ve made any changes?
I think I saw some other similar thing about added programs which identified which of the 4 base programs it was modeled from (?)…
I’d dearly love to just use “Automatic” but the limited use I’ve had so far shows my speech acquisition to be marginal in a noisy situation (e.g. Home Depot service desk, lightly populated restaurant).
Complicate all that with my provider not having REM (but the potential, not yet explored due to a 3-day weekend, to visit one suggested in another thread (Find a Provider | HearingUp), also a Phonak provider). The fact of another having already started a provisioning of the Phonak Sphere I70s under my current health insurance makes that a bit politically incorrect, but if that’s the only way I’ll get optimal settings, I would happily pay the other guy for the tweaking if it answered all my begs in one askit.
Sigh…
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If you need a loud place to activate Sphere mode, is there a bowling alley anywhere reasonably nearby? Those are usually rife with a variety of loud noises!
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No, but I expect you’re correct!
On the other hand, virtually any sit-down restaurant is inherently noisy…
I await the resumption of business tomorrow to see if Sphere is enabled and automatic; I see nothing on “My Phonak” suggesting I can manually engage it, nor does anything I read in the paperwork (Quick Guide, Phonak Audéo Sphere booklets) suggest that, at least that I’ve discovered.
Quite the journey…
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Yes. You got it. When you see spherical in loud noise on that adjust screen, save that baby!
WH
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This is like catching Pokemon…! 
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Huh.
I’ve never seen that in all the mucking about I’ve done so far…
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I think you need to hit the adjust button while in the noisy situation to see. If you can’t get it, your clinician can add it manually when you see them.
The noise threshold for when the sphere program clicks on can be lowered if it turns out you like it, which might improve your ability to use the automatic program all the time.
I’ve heard of a few people who actually like to be in the sphere program all the time, but in that case I think you’re looking at about eight hours before the battery is dead. The automatic program manages it a bit more careful, although there is an option for the default 3-hour sphere cap to be turned off too.
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Find a car shop with a big air compressor? Some place with a big air handling system that is loud? I had it happen in a warehouse today with forklifts zooming past. Traffic on the road. At the local food pantry, the walk-in coolers do it nearly every time. Either of my motorcycles can do it, but the v-twin is far more likely. With activevent receivers, it is very obvious to me when it changes to an occluded program. I hope you can get it sorted soon!
WH
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For a wearer with severe-to-profound hearing loss, here are the key metrics to consider when choosing a hearing solution:
-
Gain and Output
The device needs sufficient gain to amplify sounds to a level you can hear. Also, ensure the Maximum Power Output (MPO) is appropriate; it should be loud enough without causing discomfort or further damage. -
Speech Intelligibility
This is more critical than just “hearing.” Look for advanced noise reduction and directional microphone technologies. These features help you distinguish speech from background noise, especially in challenging environments. -
Comfort and Battery Life
Custom-made earmolds are essential for a comfortable fit and to prevent feedback. Also, consider the battery. Choose a model with long-lasting battery life or a rechargeable option for convenience. -
Connectivity
If you need it, choose a hearing aid that supports Bluetooth connectivity. This feature allows for direct streaming from your phone or TV, which can greatly improve your daily life.
So, the best hearing solution is one you and your audiologist select together. Always request a trial period to ensure it meets your specific needs.
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A busy tire shop where they’re firing the pneumatic socket wrenches to remove and apply lug nuts allll day long. There’s usually shouting and loud phones ringing at places like that, too. Or, find a bowling alley during a tournament. 
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Agree, a bowling alley is a good place for testing . That’s one of the top 3 places I’ve used for testing my aids (My Phonak and Widex passed , Rexton and Signia failed the tournament test ).
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My wife and I did a small test by starting my car, opening the hood, and conversing over the (admittedly small) engine noise, then stepping away far enough that the sound was virtually undetectable, and again returning.
I didn’t sense any switch-off of background noise, but I did sense a difference in our voices’ timbres, and found that I could still understand her even with my head pretty close to the engine.
However, an attempt at church choir, in rehearsal last night, wasn’t encouraging; I’m hopeful of getting some tweaks when I’m in later today to get my new titanium molds, which arrived yesterday afternoon. I did very poorly in pitch recognition and in pitch reproduction, I thought. I told the director that no harmony is better than bad harmony; if I was still unhappy after our pre-church warmup, I’d sit this one out.
So, including getting my new titanium molds, I’ll see if my provider will be able to do anything to improve my musical clarity.
Baby steps…
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