Hearing aid reserve gain

What is better?

  1. A hearing aid that just barely covers your loss
  2. A hearing aid with plenty of “growing room”

gonna have to go with 2 on this!

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One that adequately covers one’s loss. Although “growing room” is nice, it can be overdone. Also, my take is to focus on the frequencies between 1000hz and 3000hz. Profound losses at the very high frequencies are unlikely to be aidable no matter how powerful of aids one has.

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If your hearing loss is stable, fit the loss.
If it is getting worse, allow a little room to grow.

As mentioned about frequencies, I agree but feel 4000-5000 hertz is important too. Beyond that little is gained in speech but nice to hear if you can.

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Unless the worse loss is like mine in the 1000- 3000 range.

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It depends on the needs of your hearing loss. If the loss is stable and not expected to progress, then fitting just within the fitting capabilities is reasonable to trial. If the loss is expected to increase in the next few years and the aids being considered wouldn’t cover this, a more powerful aid should be considered. I have worn aids that I am just within the fitting range for, over many years. This is fine for me as my loss is stable.

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I would go with # 2. Better to have aids with extra gains when needed depending on age related hearing loss.

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I agree that 4000 hz + is important, but unless one has nearly a flat loss and can get by with very occlusive molds, one is unlikely to get enough gain to hear 4000 hz without feedback issues. At least that’s my experience. For my own case, medium receiver supplies all the gain I can handle without feedback (I’m guessing the small one would work fine too, but no need to try) I think for most people with profound loss in the 4000 hz+ to hear those frequencies will require some sort of frequency lowering.
Downside of more powerful (bigger) receiver is it can be more difficult to insert and uncomfortable, if one has small or torturous ear canals.

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This may well be true.
All my years with Phonak I have not had feedback issues. It could have been my really bad high frequency hearing loss that I just couldn’t hear the feedback.

It really wasn’t until I started using aggressive Sound Recover setting that I could hear high frequency things. Doing this I did learn I didn’t need big powerful hearing aids. Using the gain for hearing frequencies was all that was needed.

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I have always had feedback issues, well after some research and experiments, I have come to understand that the feedback I am getting is due to my nature hearing of high frequencies better than the middle frequencies from 1500 to 4000. Most have high frequency hearing loss and hearing aids are designed for high frequency loss. And it is hard to get the needed gain at the lower frequencies and depress the gain at the higher frequencies.

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Thank you all for your replies. It is about what I suspected. I am approaching a new appt with VA and wanted to know what y’all thought about it. I think I got about all I can expect from this thread…Thanks again!!

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I have been getting my aids from the VA for a little over 16 years, I have always had great service, and nothing but the best top of the line hearing aids.

I have been getting mine from VA for over 40 years, with good service as well. I have finally gotten to the point that hearing aids are not working so well for me. I have an appt coming up. Will see if they can do anything at all to help me…

My hearing issues are not terrible compared to some, except for my word recognize, and my Audi told me if they couldn’t get my word recognize up some, that he would recommend CIs for me. I am using Oticon OPNS1 rechargeable aids and they are helping better than even my Audi was expecting.

My situation is similar. Word recognition is awful. I really have no idea which way the are going to recomment this time. It gets crazy, I have to go to ENT for cleaning before audiology. BUT, I can’t go to ENT at VA unless my PCP attempts to remove the cerumen first and fails, then they can request an ENT consult. That could take up to 6 months. So I am gonna go into my pocket for private ENT, then I have a “hotline” to my VA Audi office. She will get me in within a week. Then we shall see…

I haven’t had issues with ear wax and haven’t been required to see an ENT in over 15 years. I got my OPNS1 aids this last June and I have an appointment the last half of March, where I expected to send my right hearing aid in to get the t-coil repaired. My right aid has static whenever I use the t-coils. Other than that am having no issues with my aids. Now my word recognition with my ads is up to about 70% maybe a little better now after to hear therapy that I have been doing.

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@danhuddleston if you have gotten to the stage of aids not doing much, it’s very hard to say what’s better. Have you tried power aids? If you have and they are not helping, maybe it’s time to start thinking about a Cochlear implant.

I was at the same stage as you, WRS was in the 20’s. I had to move forward as well, throwing $7.5K at new aids wasn’t going to improve my hearing just waste my money.

With age your hearing does deteriorate so allowing yourself some “growing room” is a good idea.

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65 now. WRS has been going down steadily for last 5 years or so, currently 36 and 38%. Te money is not an issue. VA is my provider. Will see what they have to say. I am not against the idea of CI, however; in theory I have a lot of room for hearing aid to improve me…we shall see…

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My take is with those word recognition scores, expectations of hearing aids would be pretty meagre. If it were me, I’d ask for a cochlear implant eval.

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Number 2. You’re more likely to experience distortion with louder sounds and experience poor performance in noisy environments if you don’t have enough headroom, and if you need to increase the volume you’re more likely to run into distortion issues if you don’t have sufficient headroom. In saying this, if you have a severe hearing loss in the high frequencies you’re probably going to be using frequency lowering technologies for sounds above 3.5 kHz anyway, so if you don’t have a lot of headroom there make sure you have a frequency lowering technology in your hearing aid that actually works. Sonova Brands have the most flexible frequency lowering option (Phonak/Unitron), William Demant Brands not so flexible if you need to lower below 2.5 kHz (Bernafon/Oticon etc), Widex was good the last time I looked. Signia’s always on compression isn’t so ideal if you’re compressing a lot. Resound’s soundshaper doesn’t seem to do much in practice.

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