Frustrated by new Phonaks

This is my first post on the forum. I’m having a negative experience trying to get used to a new digital hearing aid.

By way of some background, I have nerve damage from spinal meningitis at age 2, and wore an analog hearing aid (Beltone and Qualitone) in my left ear from age 5-20. I’m now 30 and have gone without a hearing aid for ten years, but am having trouble understanding speech and would like to find a new solution that doesn’t just turn up hiss like my old hearning aid.

I’ve had my left ear only fitted (I’ll maybe get a right one next year). I tried a Phonak Exelia IX CIC first, and the sound of the digital was nearly impossible to get used to along with the occlusion sensation. Sounds were tinny, unnatural, and my own voice echoed. The audiologist was able to get the sound tuned a bit, but the automatic noise reduction and compression made me feel like the left side of my head was closed off, especially in especially quiet or loud environments (like the battery was dying). My speech recognition was significantly worse, and chewing caused popping sounds.

I returned that one and traded for a new Phonak Audeo Smart IX with a standard receiver and open fit dome. Overall, it is ten times better than the Exelia, but there are still frustrating issues. The directional mic doesn’t always kick in correctly in loud environments. My speech recognition is much better, but music sounds odd when the Audeo is in either auto or a custom music setting. Tones are slightly off (sound recover is activated), and when I put the dome in my right ear, I can detect a slight delay in sound delivery and some out of tune reverb. Also, to my right ear, the sound reproduction is highly artifical, and electronic sounding - like a cheap tape recorder.

I could live with the other stuff, but most annoyingly, the Audeo actually cuts out or crackles when I am speaking loudly, another person is talking to me, or I hear a loud noise. The audiologist tried to turn down the sound compression today, but that made the cutting out worse. The problem is distracting.

So far my digital “top-of-the-line” hearing aid experience has been overwhelmingly negative. I find myself missing my old analog that turned up all sounds and acted predictably.

What are my options? More tuning? Another digital HA in a different brand? Back to analog with a mold? I’m really frustrated and expected the best to be better.

It sounds like a tuning issue. First of all have the Aud turn sound recover off, secondly thye need to reduce global compression to about 40% and thirdly they need to raise MPO as much as they can. They could also reduce the amount of noise redution in the comfort in noise program and set the microphone strategy to fixed directional in comfort in noise. Were these verified by real ear measurements such as insertion gain measurements or speech mapping?

your hearing loss is below 60, it is very very likely that your cochlea DOES NOT
have dead regions, so having sound recover is plain crazy. If you are coming from the analogue world, ask your audi to put set the instrument into linear mode.

I strongly suggest speechmapping and also something that has 8-10bandwith.

If I understand you on these changes, you are saying he has better hearing than the audi is setting the aids up for. Does that sound right?

Maybe just over processing the sound until the perception is distortion?
Instead of starting with everything on, right off the bat??/

As far as SoundRecover , yes. Increasing MPO reduces distortion of loud sounds. For someone with experience with aids without adaptive features such as noise reduction, they can really annoy and make their ears feel like they shut of, so reducing those can help. Global compression related to linearity of processing and 40% global compression is 60% linear, more like he was used to, while still giving some benefits of WDRC.

That makes since, thank you.

Hopefully this will help the OP too.

I see the audiologist tomorrow to try to get some retuning. Any additional suggestions?

I think you are onto something regarding the global compression. Loud or sharp noises seem to be what causes the HA to cut out or drop suddenly in volume. Do you think 40% is a good number, or should I try it off altogether since I previously wore an analog HA?

The audiologist did some things to make my own voice sound less loud and “echoey”, but I think some of it might have been at the expense of a more full sound. I’ll check on that, too. What is speech mapping? My hearing test included speech discrimination - 96% right at 65 dB and 92% left at 75Db.

Would sound recover off help much? I notice with it on, I hear keystrokes on my keyboard better along with the rustling of my own clothing. I tried it off with the Exelia, but the sound output seemed to be slightly deader without it.

Finally, am I bumping up against the output capability of the Audeo with a standard receiver, or is the MPO adjustment ceiling higher than what my audeogram would require?

What difference in sound would the linear mode make? Is the music program the audiologist added that does not include noise block a linear mode?

The sound recover does make the sound of keystrokes louder, but it seems a bit artificial.

From experience I find 40% is a good compromise for an analogue user switching to digital, giving a more acceptable sound, but still getting some compression benefit.You can go lower and gradually increase, but I have not ye tmet any analgue user wanted less than 40%, even some very pedantic Profound hearing loss sufferers. Make sure the aud turns SoundRelax to a minimum or even off and see if this helps with the loud sound issues.

Speech mapping is a test where the audiologist places a microphone probe in each ear. The output of the hearing aid is then mapped onto a graph of your hearing loss converted into dB SPL (or HL but SPL makes more sense). You and the aud can then see how real speech maps onto your hearing results and also measure whether the hearing aid is delivering suitbale output, at various frequecnies in real time, while on your ears.

Sound Recover on would introduce much more artificiality into the signal and compared to your compliants, it should be off, but the fullness can be compensated for by boosting the high frequency gain slightly.

I would suspect a standard receiver would be suitable for your loss, but the audi should be able to swap to Power on the spot for you to try during the fitting. I wouldn’t turn MPO up all the way with a power receiver though as this can cause damage. Again if the aud is using real ear measurements or speech mapping the risk is significantly reduced as output is actually measures and compared to safe targets. Targets aren’t everything though and the aud should also be listening carefully to your comments while adjusting.

The thing I love about Phonak is that they are adjustable to the extreem, compared to most other brands, but the fitter needs to know what they are doing. So make one change at a time, evaluate and then make another until it sounds right. Using environmental simulation through surround sound speakers as I do with every fitting is very useful for this.

Lastly don’t be too pushy with the Aud as each has their own style and that needs to be respected. I wish you good luck.

I too am disappointed by these aides. I have three problems, of which two are still ongoing to try to be resolved. One is clarity of sound. Considering these are to be the bee’s knees aides, I feel the reproductive sound is slightly muffled, it like I want to turn the base down and trebble up slightly. The main problem though is the inconsistant level of reproductive sound. I can be listening to the radio in the car, or watching tv, and suddenly I’ll get a boost of sound for several seconds. This will then then die down to below the level it was before, then creep up to the level it was before the boost. Sometime I have to use the music setting, or just turn up the aides volume. This is my second set of aides as the first set was so bad that when the kettle was comming to the boil, it sounded like a jet aircraft going over my head! The audiologist has tried altering compression etc, but I still do not have an even level of sound. The last problem is using a landline phone. You think you have the opimimal angle for pairing the aide and phone speaker, then suddenly the callers voice goes to a low level, or disappears. I then have to fiddle around trying to regain the caller, sometime without success, as I think the aides turn the volume down automatically. The phone setting on the mypilot does not help much either, as it amplifies everything. With the Icom, using bluetooth for mobile phone calls is definitly a bonus, if you can live with square medallion around your neck all the time!

These are all hearing aid tuning issues. Try to take notes of how the aids sound and the environment you are in. The more detailed information you can hand over the better the tuning will be. This information will help your audiologist tune them for your needs.

You have to work together to get the aids properly tuned.

Good luck

Absolutely correct Raudrive. In the above case hte hearing aid’s sensitivity to sound level changes are to high for the client and the adaptive features too aggressive. They can be easily altered under soundflow preferences and also program options.

The phone issue should be easily resolved by using two magnets on the headset to keep the aids in easy-t mode with movement in the phone receiver.

Maybe the fitter is inexperienced with Phonak as it can be fiddly if you don’t know what you are doing.

I had nearly identical issues with my Starkey Destinies.

My dispenser was perfectly familiar with my complaints and adjusted them occordingly.

I’ve got an update on my Phonak Audeo performance. My audiologist dropped the gain-80 so that the it did not intersect the MPO. Additionally, sound relax was increased from light to moderate and global compression stayed the same at 60.

I don’t notice any hard cutting out or crackling in response my voice, other’s voices, or sudden sounds, so that’s great.

However, everything now sounds a little flatter and a little less natural than it did, sort of a bit more muffled and like the sound pulls away just slightly a moment after I hear it. The best I can describe it is that the volume doesn’t quite hit the expected level and drops away somewhat while a sound is in progress. It reminds me a little bit of trying to hear after being whacked in the ear with a soccer ball. I find myself straining a bit to hear what was fine before. More significantly, speech recognition isn’t quite as good as before and I need to ask people to repeat things more often.

But we’re making progress, I think.

I want to try turning sound relax back down or off, dropping the global compression to 40 or so to get a bigger range for louder sounds again, and keep the gain-80 at the new settings where it doesn’t touch the MPO and see what happens.

It might be interesting to try the opposite as well, and bring the compression back up and sound relax back down to what it was before the adjustment after the first week (above 60 and light, I think) because the cutting out and crackling seemed like it worsened after that adjustment.

If it came down to it, I think I’d be ok trading some distortion for the better speech recognition.

Sounds like a worthwhile experiment as it seems the audi has overdone things a bit. Does the Audi use environmental sound simulation? I find this really useful for simulating sounds and fixing most issues before they present in the real world.

it is interesting that you like to get a “bigger range for louder sounds”. the only
way to see that this is properly done is getting your aids finetune using rem (speech mapping- to be specific). With my verifit, within 5 minutes you can check that soft, med. and loud sounds are withinn your dinamic range. try to ask for it…
it saves time and it does indeed work