I am surprised WH, your A.uD throwing you in at the deep end, I tried NAL NL2 many years ago (DIY) I couldn’t hack it, it was too harsh, I love it now though… Cheers Kev 
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WhiteHat:
OK that was VERY helpful! I just printed out the link and will study it further before returning to my audi. AH to be a DIYer. I’d wipe my aids’ profile off and start tinkering with these presets.
kevels55:
I have to agree with your description that “crisper, clearer and slightly louder” is exactly the “lemon twist” I’d like to get on my new 312s. I’ve also read that boosting mid-levels can help with speech clarity, but with my uniformly FLAT/LOW audiogram I just don’t know.
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THIS:
I’m sorry, but your audi seems utterly clueless here. I bet Oticon has either a dedicated program or a way of setting up “Speech in LOUD Noise” which should use a forward focus and even overall lowering of volume on sides and behind.
The fact that this audi is also “unenthusiastic” about Phonak - another MAJOR player for speech comprehension in noise - seems to indicate he’s more of a HA dispenser and NOT a dedicated, “best practices” AuD.
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I should do some research on these, too. WOW. So much to assimilate. Thanks!
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The Intent has an extra 2 db of SNR Neural Noise Suppression over the More. It depends on how aggressive your audi set the NNS value for your More to solve your issue for you in the first place. The most obvious thing to do to suppress more surrounding sound in favor of speech in noisy places is to increase the NNS value. If its default max value didn’t satisfied you, your audi could have increased it higher (up to the highest available value for the More 1 (which is 10 dB). If that still didn’t solve your issue on the More 1, then on the Intent 1, he could have upped it to the max available of 12 dB to see if it helps.
But if he didn’t do any of that, then you most likely won’t see much improvement between the More 1 vs the Intent 1. Take the example below (using my personal hearing loss). The first screenshot is for the More 1, and for difficult environment, the default NNS Genie 2 sets for me is 8 db. If I weren’t happy with it, I could have upped it to 10 dB to see if it’d help. If it didn’t help, when I switched to the Intent 1, as seen in the screenshot below, Genie 2 already automatically puts me in for 10 db (compared to the default 8 db for me in the More 1). But knowing from my experience with the More 1 that even 10 db still didn’t help, I could have taken advantage of this extra 2 db from the Intent 1 and go up to the max available of 12 db to see if that solves my problem or not.
But let’s say your audi left your NNS setting in your More 1 at a lower default value. I don’t know what it’d be for your case, but for me, my default is 8 db, so I suspect with your less severe hearing loss, it might have been set even lower for you, like maybe at 6 db. So let’s just assume that it’s set to 6 db for you, and your audi never tried to increase it to 8 db, then if not resolved, to the max of 10 db, THEN how would you know whether the 8 db or the subsequent 10 db might have solved the issue for you, just with the More 1, not even considering the Intent 1.
Now, when you switched over to the Intent 1, if your audi had transferred over your settings from the More 1 and as a result, left the NNS for Difficult set at 6 db like in the More, following the example above, while it could have been set as high as 12 db, then no wonder you didn’t notice any difference.
Of course I don’t really know what exactly your audi did for you. It might have been different than the scenario I described above. But the scenario I described above is an example of what could have gone wrong and caused you not to see any improvement on either the More 1 or the Intent 1.
That would be something I would want to ask my audi to make sure that everything had really been done for me already, if I hadn’t already known for sure.
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Did the audi up the NNS in difficult environment to the max available value of 10 db in the More 1?
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Did the audi up the NNS in difficult environment to the max available value of 12 db for me in the Intent 1?
If the answer is no to both questions above, then I think your audi hasn’t done everything possible to try to solve your issue for you.
If the answer is yes to both questions above, then I think your audi probably had done everything he could for you, and it’s time to move on and try out the Phonak Lumity or Resound Nexia next.
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Thank you, @Volusiano for such a great explanation. I guess I’d better learn to self-program. I wish I could just go in and have the professionals just take care of it, but I think I would benefit from learning this stuff.
What would I need to buy to self-program (or at least be able to see the details of my HA settings)? Just a Noahlink wireless? Anything else? I think I have an old version of Genie already on my computer. I would probably just have to update it.
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I don’t think you need to self program per se. What’s more important is to understand what parameters are available for adjustment in the software program so that you know how to ask the right questions to your HCP in order to ensure that they’ve done everything properly for you.
To self program, you’d need to buy the NoahLink Wireless interface to work with the programming software. But a better first step is to just download and install the free programming software and just run in simulation mode to learn all about the parameters in it, using their online help. Then at this point you can ask better questions to your HCP and still not have to self program. Then if you feel comfortable about understanding all the parameters, enough to really want to take the next step and self program, you can proceed and buy the NoahLink Wireless as the next step toward actually doing self programming for yourself.
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I’m a relative novice when it comes to hearing aids (wearing them for about 8 years…) … I had the OPN1, then decided to trial the REAL last Fall … first time the audiologist just copied over the settings … the REALs were AWFUL - literally everyone sounded like Charlie Brown (wah wah wah …) … I went back and she did REM and after that, the REALs were fine… but then Oticon came out with INTENT and luckily, I was able to switch to the INTENT even though I was out of the trial period at a minimal cost … audiologist did REM with the INTENT and they are AWESOME… I didn’t really hear much difference with the REAL, but with the INTENT, I am hearing things I haven’t heard in years (clocks ticking, microwave beeps, birds, etc … …
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There should have been no reason why you couldn’t have heard the little things that you described (like the beeps, the ticking, the birds…etc) with the Real if it had been fitted properly for you. For sure if the aids didn’t meet target, then REM adjustments bringing them up to target will help make you hear better. But even with REM done on your Reals and you still couldn’t hear the little things, I wonder if your audi tried to enable the Speech Rescue frequency lowering technology for you or not, because it looks like your hearing loss might be able to benefit from it.
If all settings were the same and REM was done for both the Real and the Intent, but you couldn’t hear the little things before with the Real but now you can with the Intent, it’s possible that the actively self-calibrated receivers on the Intent gave you the edge against the passive receivers that were used on the Real. But the main difference over the Real should be on the Intent’s performance in noisy environments, it shouldn’t be on the ability to hear little things in simpler environments, because those are pretty basic things that most premium hearing aids should have been able to allow you to hear, unless not fitted properly.
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Thanks. Interesting about the Speech rescue sadly I don’t know all the right terminology to use with audiologist - I don’t really go to many noisy environments so can’t comment on INTENTs for that but I really like them.
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The idea of Speech Rescue is to take the sounds in the high frequency range where many people’s hearing loss is very heavy, and move those sounds into a lower (mid to mid-high) frequency range where they still have relatively better audibility. This will allow people to be able to hear those high sounds more audibly since they’re now presented in their more audible hearing range.
For example, in your case, your hearing loss in between the 1.6 to 2.4 KHz range is better than your hearing loss in the higher ends than that. So if the hearing aids can take the sounds in the 4 to 7 KHz range where your hearing loss is severe to profound and move it to the 1.6 to 2.4 KHz range, then it should help you hear those high frequency sounds better.
Below is the chart where the gray area is the high frequency band for the source sounds and the red area is the destination band for the source sounds to be lowered to. The Oticon approach is to chop the gray band into 3 sections and transpose the 3 sections into the red destination band, and compose them (stack them) on top of one another. There are 10 ways to do this, and the most appropriate way for your hearing loss would be the configuration 1, where you still have relatively better audibility in that destination range of 1.6 to 2.4 KHz area.
Your audi should know how to turn on Speech Rescue and get it set up for you. The second screenshot below is where it can be found in Genie 2. The 2.4 leftmost configuration is probably the most appropriate for your hearing loss. You might find the “s” and the “sh” sounding a little lispy at first, but if you stick with it and adjust the Strength value to gradually get acclimated to it, it might become more natural to you after a while.
It’s also worth noting that you can just add it to a secondary program and not your main program to try it out. This will allow you to do A/B comparison between the main program without it, and the secondary program with it, to see if you like it or not. It would also be helpful to get you gradually acclimated to it without having to commit to it 100% up front.
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Just a note…the “great beamforming” resound uses in Nexia is the same as what Phonak has been providing and refining since 2012…Nexia’s focus really is only on Bluetooth LE \ Auracast support, there is no real gains in speech performance over their last platform.
Wait a month, Phonak is launching something new then…
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Also, a 25% reduction in size and a reported 150% improvement in speech understanding in noise. The hear in noise program has changed. That said I have put back the Omnias manual cone adjustments and differing Directionality ‘to play with’.
What is the difference between NAL-NL2 and NAL-NL2 Tonal?
NAL-NL2 Tonal is for optimizing comprehension of tonal languages like Mandarin.
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Can this be used for Reverse Slope Hearing Loss, moving sounds in the lower frequency to the higher frequency where hearing is better?
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No, reverse slope hearing loss would not benefit at all from frequency lowering. In fact, it would generally be detrimental to the hearing experience to apply frequency lowering on a reverse slope hearing loss.