Hearing tests--accuracy question

Not meaning to hijack this thread, While everyone speaks of hearing tests to establish the need for aids, are there tests available from the audiologist to establish how well your new aids are working to correct your hearing ?

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The thing I’ve wondered, since high frequencies are more damaging than low and we’re amplifying the heck out of them if we have serious high frequency loss, i.e., all the soft sounds are now moderately loud so we can hear them again, is whether that doesn’t just contribute to more high frequency loss down the line. Guess it would takes thousands of subjects to do a study but has anyone studied the relative progression of high frequency loss in folks wearing HA’s vs. those folks who never bother to get HA’s - or what’s the official opinion among hearing care providers at to whether or not serious high frequency amplification to recover “lost” sound eventually leads to some further hearing loss? Or is it like “Not to worry because at your age you don’t have another lifetime in which to incur a lot more loss…”

High frequencies aren’t more damaging than lows. High frequency hair cells are more vulnerable than low frequency hair cells. Which sound almost like it works out to the same thing but doesn’t really.

But this is an interesting avenue to go down. I’m not super familiar with the noise-induced hearing loss literature. I recall that if you work in damaging noise, the majority of damage takes place over the first ten years. That suggests that there is a ceiling to the damage. We encourage people with hearing loss to continue to wear hearing protection, but I think part of that is that we don’t actually have good data on how noise is differentially damaging to people with pre-existing hearing loss? Better safe than sorry? I’m not sure. However, I have pediatric patients with stable, severe-profound loss who have been stable over years and years despite considerable amplification, which would suggest that the output limits of modern hearing aids are effective.

Yes-ish. Real-ear verification is the easiest way to ensure that the output of the hearing aid at the eardrum is matching appropriate prescriptive targets. Prescriptive targets were developed as a way to try to optimize hearing aid benefit–the creation of a standard that can be tested and refined. On an individual level, some practitioners will also run additional aided testing (say, speech in noise testing with and without hearing aids), particularly if they do not have access to real-ear verification. However, these tests are very much contrived laboratory tests and do not always reflect the experience of the individual in the real world.

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It upsets me a bit to be labeled as faking, as I thought I went into sufficient detail to explain the consequences of previously having pressed the button for extremely faint sounds comparable to a gnat taking a short breath. Aren’t I supposed to be identifying only sounds that I hear? What is the definition of “hearing?” If I can’t comprehend a sound, how can that be called “hearing?” Doesn’t hearing imply comprehension? And if my previous results from acknowledging these cosmic half-breaths was that I still couldn’t hear what my wife said after the HAs were set to the test results, what is the point if I go home with hearing aids set so that I still couldn’t understand what she was saying? Why buy hearing aids if they don’t improve my hearing? I always had to keep those former aids kicked up 3 clicks above the normal default setting to hear her just because of that gnat’s half-breath. And by kicking up the volume 3 clicks above normal in order to understand her high frequency sounds that resulted in my lower frequency sounds being too loud, isn’t that what we have always been warned is the bad consequence of buying “sound amplifiers” instead of real hearing aids!?

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well I think that’s a great point…adds another very important variable…the damaged biological side of things!

That sounds like a brilliant idea!

my audiologist didn’t do the REM. I don’t think she has the equipment it turns out. Instead, after I asked specifically for some verification she did some aided in the booth testing.

Seemed like a pretty decent but subjective ‘test’ of improvement in my understanding of speech. Her opinion is that REM is primarily useful for pediatric patients who can’t really articulate what they’re hearing and issue they might be having with the aids. Her thinking is that the aided testing is more useful and to the point of fine tuning my experience. Seems plausible to me…although it also does seem to me that this REM I’ve recently learned about would be a very good and OBJECTIVE starting point…and I really do wish that I had the data points!

Nate, has your audiologist done or offered any sort of aided testing? If not it seems to me that it might be worth asking for as a prompt into a discussion about better fine tuning of your prescription.

Overall, it seems to me (a newby novice) that your audiologist probably isn’t doing a great job of follow-up on your complaints

100% right. The audio test are purely subjective and if so, how do you determine which hearing aid (out of the 50 or more offerings by each manufacturer!) that is fit for you? The manufacturers are spending tons of money to develop state of the art hearing aids. What is needed is technologically advanced audiometery and that’s where the research spends should be under the current scenario. So right now the manufacturers are putting the horse before the cart- almost! Because that’s where the money is!

Just like the olden day eye tests vs the technologically “automated” eye tests today - far less subjective, we need something similar for hearing tests as well. This will also have the effect (hopefully) of not leaving the hearing impaired confused by a barrage of offerings by the manufacturers.

Hope someone is hearing!

I have to undergo a hearing test at work on a yearly basis. My audiologist also tests me. I get very consistent results from both places.

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If you are able to consistently respond to those gnat breathes, then you are hearing them. If you are not able to consistently respond to them, then your inconsistent responses won’t factor in to your results anyway.

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I’m curious with you being a practitioner and HoH yourself whether you press the button when you think you heard it as opposed to when you know you heard it.
I sit there wondering is that it and then they turn it up a notch and I press the button because I know it now.

So if I consistently “hear” tiny noises coming from my spouse’s mouth but I don’t know what words she is saying, then I am “hearing” her?

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Speech recognition and hearing sound are two different things.
I really don’t believe an audiogram is based on speech recognition.

I try to acknowledge the very first sound I hear per frequency. At least that is my understanding of a good audiogram.

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Actually, my overall experience with the Costco Hearing Center over the past 5-6 years is far superior to my prior experience over 6 years with the private audiologist from whom I purchased my first pair of hearing aids 12 years ago. That’s why I am soon picking up my KS9s from them, and I am optimistic, and hopeful that I will be able to hear and understand my spouse without having to push my volume control up 3 clicks above the default setting.

I’m only just barely HoH, but I have a pile of tinnitus so I am the worst kind of trigger-happy in the booth and awful to test. I press when I think I hear the tone, and I ALWAYS think I hear the tone.

Yup. They are only testing detection in tone threshold testing.

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I just came back from my “pickup” appointment for my KS9s and I am so pleased! The first thing my Costco rep did, without any request or prompting from me was to run an updated (best practices) Real Ear Measurement test on me, followed by all the other set-up steps. She had already pre-set the KS9s based on my latest hearing test from a couple weeks ago described above, and now she made several re-adjustments based on the results of my new REM test, followed by pairing the new aids with my Moto X4 phone and running through the rest of setup including but not limited to fitting, instructions, receiving several test phone calls from my beloved who of course accompanied me to the appointment, ordering the TV streamer, etc. and so far I am hearing her beautiful soft high-frequency voice quite well as we walked through the store! I’ve got a followup appointment set for any needed adjustments.

I’m glad I was reminded by other members above about the one-pairing limit on Bluetooth which was the reason I decided to go ahead and order TV streamer without waiting further.

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Since KS9s are Phonak Marvels that are rebranded for Costco, you should also be updated to version 2.0 of the KS9 firmware that now allows for more than one pairing! I have Marvel M90-Rs and I am paired to my phone, my computer, and with my TV Connector device. There’s no problem switching between devices!

I’ve had mine for just over 9 months and your audiogram is similar to mine. Just wait til you experience streaming music and no-hands phone use! I absolutely love what these things can do! Hope you do too!

Just learned from a forum member the KS9 aids do not get the 2.0 Marvel update.
Was hoping…

Since my tinnitus is a single tone (and almost always the same tone), I don’t ask for a non-single tone. I need that range boosted so I can hear it over my tinnitus.

They may not. Sonova dances a line between selling in costco, and keeping their independent customers happy even though they don’t give them access to the same pricing structure. Roger is not sold in Costco and to my knowledge there are no plans for it to be sold there. Costco also tries to keep away from any patients who might be “complicated”, since they are interested in churning people through.