Domes backing out

Hearing Aids
#41

If you look at Jcummins hearing test results, would you not say that he does indeed have a severe/profound hearing loss?

When some time back, and I discussed RIC Type HAs with my local audi, she said without a doubt, that with the degree of loss I have, no universal domes of any type would correctly work, that without question custom molds would be definitely needed, no matter brand-model of HA.

His hearing test results are not too different from my own if you look. (yeas, I note at 250-1000hz his hearing is not as bad as mine, and that closed domes or custom domes might kill a little of his natural hearing at these frequencies)

You say ā€œit forces you to hear the world almost exclusively through the hearing aids, which is a really bad thingā€. In truth, and not to be at all rude to jcummins, or you either, but he ainā€™t hearing a darn thing without HAs, virtually at any frequency, just like myself. That heā€™s losing normal hearing at basically all frequencies, and without HAā€™s, or HAs with open fitted domes, I donā€™t really see what advantage he w=might possibly gain, other than a universal dome is user changeable, whereas a custom mold isnā€™t.

Iā€™m no expert, only what Iā€™ve been told, and other audis have also agreed with what Iā€™ve mentioned above, that with this degree of hearing loss, there really is no other options but a custom mold.

Does that necessarily mean the first pair of custom molds he receives will be the answer, and these feedback issues will then be cured? The probability can go either way IMO. To get lucky and get a precise comfortable fit with both, or maybe not. That another set of imnpressions may have to be again taken.

That feedback will-can occur in any instance of mold type, and as Iā€™m finding myself, and just returned a custom ITC for feedback issues myself, thereā€™s no guarantee of correct fit first time out, no matter what 3D state of the art imaging etc what a company claims. It only lessens the probability of perhaps an incorrect fit.

This is also no doubt exasperated by the amount of high output gain required. The higher the gain needed due to the greater severity of hearing loss, the greater chance of feedback issues occurring. That for those who have mild, or moderate losses, yes, many can easily attain a better performance and get away with universal molds of the various types. In our personal instances, I think not.

If his HAs were knocked down in overall gain by 8-10 db, I bet he wouldnā€™t hear a peep of feedback. But then of course the HAs are not then performing and helping with his hearing loss, sounding like heā€™s got pillows over both ears, with not enough ample gain for his personal loss.

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#42

Yes, the audiogram is labeled profound loss.

Another thing Iā€™ve noticed, Iā€™ve increased the volume of the aids a few times over the past two weeks. Not sure if Iā€™m getting use to the initial loudness, or whether the domes are backed out that tiny bit, making me increase the volume. It also seems as the day wears on, they get looser and looser. Right now end of day, getting light ever so often squeals in my right earā€¦even though it seems the domes are in far enoughā€¦I think that deformity of the dome I spoke of is an issue. Not getting those light squeals in my left ear.

I am going to Costco Fridayā€¦and intend to at least discuss custom moldsā€¦pretty certain I will get them.

#43

when you open your mouth it causes your ear lobes to move. this is why you need a wire of a certain length that has enough slack to prevent the domes from moving.

#44

Darn it, was just typing a reply, hit one darn stupid key on this laptop, and the entire post vanished! Canā€™t tell you how many times this frustrating thing happens to me on these forums.

In a nutshell, perhaps jcummins, when he first installs his HAs, his canals are dry. But then as time passes, moisture builds, and perhaps oils and waxes within the canal, to cause things to get a bit ā€œslipperyā€?

I know when I shortly auditioned the Phonak Audeo V90 with custom molds, they were a clear hard see through plastic, you could see the receiver within, and believe too there was a vent.

Vent holes can be plugged if needed, and even some of the plugs that can be had also have a variety of smaller hole sizes.

Sort of defeats the purpose of having a vent though. Even still, and although a vent might help lessen that occluded feeling, and let some moisture escape the canal, under certain conditions of high heat and humidity, it appears no vent size may stave the substantial unrush of excessive moisture within the ear canal.

I gather with a new user, a personā€™s ear seems to recognize a mold or a HA as a ā€œForeign Objectā€, and then a person might then generate much more in the way of oils and waxes. I donā€™t think any user ever really gets over that, because anything in the ear hinders nature to naturally let the ear canal dry on a continual basis. Itā€™s like putting a lid on a pot, the moisture has nowhere to escape to.

Once a custom mold is selected, then thereā€™s no easy way to again try universal molds, unless one were to buy another pair of Recievers. (They sometimes arenā€™t that prohibitly expensive) The Receivers in a custom mold are in most cases I believe permanently incased in the mold. About the only thing user replaceable might be a wax guard at the very tip of the mold, and then vent cleaning, and gentle mold cleaning, thatā€™s about it.

#45

Jcummins, didnā€™t you once comment that you thought you had one canal which seemed to vary in size, shape, and or seemed to close at times of the day? Which one, and again which ear is causing you problems?

Sort of promising in a way, that it appears to only be one ear causing problems. That there may be a possibility of different ear canal sizes, meaning one size, or one type of universal mold may not be doing it for you?

That one type of mold, or even one size of mold may not be cutting it, and that one type-size may be needed for one ear, and another type-size needed for the other?

Example, closed dome in one ear, and a double dome in the other?

Again, Iā€™m far from being an expert, and perhaps some others here can shed some light on this, but I am of the thinking that when a certain size mold appears to not be staying in place, that a common belief may be that ā€œyou need a larger mold to seal things upā€?

This may not be always true I think. That if the mold is possibly too large, it then may not insert far enough into the ear canal, and that I believe can be a cause of problems such as feedback occurring. And also a seeming loss of volume output, that the receiver may be a bit too far from the eardrum.

The other, could be possible receiver wire length? I understand there are usually a number of different lengths to be had.
I could guess that in the instance of a too short receiver wire, the HA itself then would be a cause of not letting the mold with receiver stay within the ear. Or that even too long can cause issues as well.

Sort of like the ā€œthree bearsā€, that with a few different sizes of wires, two may be wrong, but one might be ā€œjust rightā€?

Sorry for somewhat rambling, but just trying to inject some ideas, and some possibilities as to the causes of these issues, and that you hopefully conclude with a much better fit, and hearing experience.

I know what itā€™s like, Iā€™ve gone through a literal hell over many years with fits issues. Even experiencing such at current day with a new pair of HAs, and even my old Perseos, the left HA which has been back to the repair facility 4 darn times for re-casing is hurting me a fairly good deal to wear over the past few days.
It is either mis-shaped in a certain area, or now too large in size, penetrating too far into the canal? Might have the audi look at these as well next week.

#46

I am using Phonak SlimTips with my V90ā€™s and they look like youā€™ve described. The receivers can be removed with the proper tools I believe. When I replaced my domes with the SlimTips I did not get a new receiver. They just reseated the SlimTips instead of the domes on it. If you donā€™t have the tool then you obviously canā€™t remove the receiver. My audi even offered me the tool but I didnā€™t see the need for it. Anything I need done with my haā€™s Iā€™ll have them do anyway.

#47

Yes I did. It was my left ear that seemed the canal would close upā€¦pre HAs. Since wearing HAs, it doesnā€™t seem that way at all. I thought it would be the problem ear, but instead itā€™s my right one.

The HIS mentioned she was using the largest double dome they have 10mm, and the way she said it, in thinking back, bet she was wondering if they would work. I ā€˜thinkā€™ my ear canals are simply large. The domes slip in really deep, to me, when I put them in first time in the mornings. Perhaps you thought of dampness etc in the ear as the day wears on, has merit. But whatever reason, it seems the pattern is the same every dayā€¦and getting worse, as if my canals are getting bigger, or the domes getting softer.

#48

Thats exactly what mine do even with the locks. I fell big occlusion until I push them back in every 20 minutes. I also get the squeal until I adjust them. Iā€™m thinking about taking a hair dryer and bending the lock somehow to make it more snug

#49

Jcummins.
Donā€™t quote me on this, but if you should ultimately decide to get custom fitted Molds, there ā€œmightā€ be an additional charge. Sometimes as I understand, this charge can be around $200 for both Molds.

They of course have to take impressions, and I would discuss with the fitter-etc the problems you might experience, what may be the best methods to then hold you jaw, slightly agape, wide agape, etc.

Thus, if youā€™re thinking that youā€™re liking these HAs you are now auditioning, and believe they may eventually be keepers that you like and can live with, then I would say go ahead. But if thereā€™s other issues you might not be happy with that you feel these HAs hold little to no potential for yourself, then you might have to make a hard call, one way or another?

Iā€™m sure in your state, thereā€™s a prescribed amount of a trial period, usually by state law.

#50

Impressions made for molds. $39+ each. Going any other route was band aids in my opinion.

HIS said she is using the largest double dome they have, and I think she said the longest wire. I got some big ears. She said my canals are large.

Soā€¦7-10 days, but because of schedules it will be probably 2 weeks before I can get back up there.

#51

If thatā€™s the total cost for custom molds, then it surely is worth a try. In fact Iā€™d say no matter the cost, it very might likely be the best option for you. The difference between satisfaction, and annoyance.

I would assume in just about any case, that one would try to use similar type domes-molds in both ears, and not mixing. (Example custom mold in one ear, and a universal in the other)

As some have told me when trialing HAs, write down notes of any-all issues in detail, dislikes, likes, changes you think might help if implemented, etc. This way when you go in, there wonā€™t then be something you had forgotten to mention

#52

I had a two page word document printed out when I went in last time, of notes/issues that I wrote down as they occurred. The HIS said I like this. Most people donā€™t give you the feed back.

She put on new domes, same as what was on there. Think these are worse than the others. Like squeals at odd times. The HIS said thatā€™s leakage around the dome. I think the molds are going to solve these issues. Nowā€¦if I could make the bluetooth work rightā€¦which is in a different thread.

#53

Not really, the wire seems pretty tight against my ear. Iā€™ll discuss that with him tomorrow.

if not then you need a longer wire. the domes should never ever move once youā€™ve placed them in. they should go in about 1 cm into your canal. any squealing or loss of volume is probably due to the domes moving and not pointing directly into your ears.

They go plenty far into the canal. My audi said I should not be able to see the receiver, which is true for the most part. I usually use a small mirror with the bathroom mirror to check, and itā€™s pretty far in there. But they do slide out at times, especially when eating, so Iā€™ll discuss the wire length with him. I donā€™t usually get squealing, once or twice when pushing them back in is all. Loss of volume is an issue.

closed domes should be more occluding than open domes and double domes should be the most occluding domes. but none of these domes are as occluding as a custom mold. you can get custom molds with larger vents which many in this discussion should consider. however, I donā€™t believe the people who designed these custom molds ever intended them to be used by people with your kind of loss. they probably never dreamed that people would opt for custom molds to hear music and because of discomfort issues.

Iā€™m going to keep trying different domes I think. Iā€™m also considering another brand of aid. Whatā€™s your thoughts on that? Do different brands have better success with retention?

as for things slipping out, how in the world have rite aids been existence for 10 years and now all of a sudden nearly all users on this board needs a custom mold? clearly thereā€™s something else going on here.

Look out folks! Heā€™s on to us! :wink:

Just teasing doubledown, thanks for the advice!:slight_smile:

#54

looks like you need a longer wire and possibly bigger domes.

#55

There is no rule that says the wires and domes need to be different sizes. They just need to fit. While ears can be a range of sizes there is a small range of sizes available in domes and wires so fit is not always perfect.

I have tried different domes from two different manufacturers with their brand HAs and can assure you that there is a difference. I found Resound domes to be more springy and made of slightly thicker material. This was not just a second HA effect because my first HA trial was with Phonak and they were comfortable from day one. The Linx were my Third HA trial and the domes were not as comfortable. I had those for 7 weeks. The Linx2 were a bit better (redesigned) but still not as good as the Phonak. Others may find that a different brand is more comfortable for them. The domes should not be the only reason for changing brand if the HAs are otherwise excellent. I am sure that working with the HA fitter/Audiologist to find a solution is best.

#56

Had a long talk with my audi today. (Which was actually yesterday, since Iā€™m writing this after midnight. I really need to stop staying up so late.) Impressions were made for me as well. Once the impressions came out of my ears he pointed to a funny little bump, which of course would be a recess in my ear canal, that he said was the cause of my problems.

Heā€™s going with something he called ā€œFoilā€ RIC Molds. I asked him what the term ā€œFoilā€ meant, and he said it just referred to the thickness, or rather, thinness of them. He said they are extremely thin, wonā€™t move at all, and will actually hold the receiver a little closer to the eardrum. He thinks I will really like them a lot, but assured me that if I didnā€™t, we would find another solution. No extra charge for any of this, one of the reasons I love this guy.

Iā€™ll have to update my original thread with some of this info.

He said heā€™s ordering them with a loop kind of thing that fits in the back of my ear to hold it steady, but if that turns out to be undesirable, he can remove it easy enough, he has all of the tools to make modifications. I should get the new molds next Wednesday the 21st, and I will definitely provide updates. Looking forward to hearing how this works out for jcummins as well.

#57

Quick comment from a newbie: Wearing Oticon Alta2 Pro mini rites (AGX version) for 2 months. Tried small, medium & large Oticon open domes. The medium domes worked well in R ear, but all sizes backed out of L ear. Tried canal locks - no help. Tried custom molds - backed out even more than the domes did. Also disliked the occlusion of the custom molds, despite drilling the vent to max size. Then tried Phonak & Starkey open domes. The medium Starkey stays in fine in the L ear, does not back out at all.

So, if your hearing loss is appropriate for open domes (mainly high frequency loss) but the domes are backing out, consider trying a different brand of open dome. Make sure that it fits the receiver, so that it does not fall off in the canal.

250 500 1k   2k    4k   8k

R 30 25 30 40 55 75
L 20 15 15 30 50 75

#58

Dayovilla -
Why not (after spending $3K-$5K) spend another $50-$100 and have them custom fitted?
I still canā€™t figure out why the same ā€œitemā€ is called a ā€œdomeā€ it not custom fitted and a ā€œmoldā€ if made for your own ear.
They all come with ā€œopen fitā€ if called for.

#59

Dayovilla already explained that custom earmolds were slipping out. Some people have very straight ear canals which wonā€™t retain molds. They may also have a shallow concha bowl, so a canal lock doesnā€™t work either. A full skeleton lock may be needed. Instant-fit domes are also called ā€œeartipsā€ or ā€œearbudsā€ by some manufacturers. And not all earmolds have the space for a large vent to prevent occlusion.

#60

Thereā€™s two ways of looking at this. Your way is ā€œwell, youā€™ve already spent several thousand dollars, whatā€™s $50-100 more? No big deal.ā€
But my way of looking at it is ā€œIā€™ve already spent several thousand dollars, and now you want $50-100 more? Are you crazy?ā€

All a matter of perspective. Luckily my audi is not charging me extra for the custom molds.

I still canā€™t figure out why the same ā€œitemā€ is called a ā€œdomeā€ it not custom fitted and a ā€œmoldā€ if made for your own ear.

Probably so we know the difference between the two. And because the dome looks like a dome, and the mold is molded to the ear. But Iā€™m just guessing. :stuck_out_tongue:

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