Nailed it. This is exactly my past and now different current experience. The shifting isn’t being done as it had been before. I get plenty of sound that is plenty loud, it just isn’t recognizable. Going to see if I can adjust them myself (worth $150 to try) and if not, move on. Life’s too short. Custom molds are an option, but I’m reluctant to add that expense with this audi and these HAs. Maybe if DIY gets them close I will.
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Good thing is you can adjust the hearing aids (like the sliders for the frequency shift) while you listen. I use the piano to fine tune harsh frequencies since I know the exact frequency of the notes. With sound recovery, I can bring clicks in the upper keys to real tones. I also hear the birds pretty good now.
Some say sound recovery is not good for musicians, but I am no longer a great musician.
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What do you mean by “work best”? Work best compared to what? And has your hearing declined since you determined that tulip domes work best? Unvented domes are not more shrill than vented domes. If that’s your experience, it was a programming problem not a dome problem.
But there’s a limit to how much bass you can push into the ear with domes, regardless of the programming. The hearing aids will always sound shrill and squaky so long as the bass you need is just leaking out.
One of the most helpful things any audi said to me was, “Remember, you don’t hear like most people.” He meant I use different speech cues due to such longstanding high frequency deafness. Phonak has an algo specifically for severe loss, I have found it helpful. The other useful thing (I’m a DIY programmer) is Sound Recover 2 as a frequency shifting method BUT I roll off (turn down) the highs so they don’t make it harder for me to understand speech. That means I shift the mids but not the highs. I use HAs with vented earmolds because having some venting blocks out some background low frequency sound that would make it harder for me to hear in any background noise whatsoever. Hope this is helpful to you and it’s great to hear (well THAT is a weird turn of phrase, huh?) that you have done so well with comprehension in the face of the audiogram you have.
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I became a DIY HA adjuster. I got the exact software my audiologist used along with the necessary hardware to connect the software and HAs to my laptop. To be clear, I have been trained in audio and video settings and have a good basic understanding of making decent adjustments. It took me a few days to dial my phonak p90r aids in the way I wanted them and it worked. I now have totally usable HAs.
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You would think that at least so called professionals would comprehend by now and and accommodate their patients with a clear mask.
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I do have residual low frequency hearing that doesn’t come through if my ear is occluded. Obviously I can’t use open fit. But “power” or unvented domes when fitted by my audi have not provided great results for me. The highs leak out even more than the lows, and I’m getting too much of the highs and not enough of the lows.
Seems like the original prescription just abandoned the 1KHz+. More recent fittings are trying to reintroduce it (perhaps with frequency compression), but he’s not used to it: hence the ‘squawky/shrill’ comments.
I’d be willing to bet that running the gain line flat across from the 750Hz value would sound fine for him. In that case, it would be around 20-25dB. I don’t think the HF targets are going to be met, but it sounds like they won’t be missed anyway.
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You might be helped with cochlear implants! But take a trip to see Dr Cliff in the Phoenix area if you can afford it. You only understand the A E I O U letters
Okay, but how much gain is he really getting AT ALL with a tulip dome in that left ear; not 1000 Hz gain, but 250 Hz gain? Always hard to know over the internet, but him feeling like he hears more with a vented dome than a power dome sounds like combination of poor fit and low frequency underamplification to me.
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Depends on the canal seal below 500Hz. He might ‘think’ the Tulip dome is venting, but it’s actually just folding better to his EAM shape.
He might have a tall 7x4mm oval canal, residual canal volume of half a CC and consequently a huge boost in actual SPL at the drum. That would point to why the other first fits are so errant, but the Widex is better due to the input from the Sensogram.
It’s also probably a case of habituation to his previous fitting and probably a bit of auditory deprivation too. Walking that back is going to be a long path.
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Aside: We tend to think of people with this kind of loss (at least in the U.K.) with large canal volume, seeing as they’ve usually been wearing full shell moulds from pretty early on.
However; there are a few people I’ve seen recently (notably ex-Rugby players) who have over developed cartilage in the EAM. Provided you can keep the area clear of wax, it’s possible to fit them with ‘pop-in’ receivers with 5mm Sonova domes and tackle pretty hefty losses.
Scheduled Microsuction is part of the management of the fitting, but that works within our business model. This has proven effective for severe losses: though not always as bad as the one above.
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Well I’ve now logged in via Compass GPS. So can confirm the low frequency under amplification. It was absurdly low. Just a big spike in the midrange, which I’ve never heard in my life. I bumped 250-1000 and will bump it more and bring the upper midrange down. Doing somewhat better now. I will screen shot the settings I had. The software has a warning 
saying likely insufficient gain.
As for fit I can’t put a medium Widex round dome in my ear. Too tight. Painful. The Widex tulips seal up quite tight. I liked the Resound tulips better with a more oval shape. So it may be as Um_bongo suggests. I can only say sone sounds are too loud.
I think that’s close to accurate. I think it went past 1000Hz but maybe not too much past. They did the frequency shifting too. I remember talking about it. I don’t think the new audi has done that. I can see in Compass she basically gave me nothing below 750, which I don’t understand. With prior audi we looked at the screen together. With the new one I never saw it, sitting 10 feet away due to Covid.
I’ve got warranty/ repair through 10/23. I’ll DIY until then, then go elsewhere.
But have you never had a custom product? An earmold?
Not with RIC HAs. I did when I had BTE, my very first pair.
Update for those following. Attached is what the settings were when I pulled them from the HAs with Compass GPS. I was able to find the “shifting” functionality, which they call Audibility Extender. It was not enabled. So far I have bumped 125Hz-1kHx up across the board. I enabled the Audibility Extender to shift from 1.8k. I initially tried 1.2k and that was muddy. I will try different things. So far I’m doing quite a bit better.
Thanks slance66. I am astonished your audi did not enable frequency shifting given your audiogram.
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That makes two of us. I was also surprised by how little I was getting in the lower frequencies. It makes sense now why I was having problems.
You sound like me. It’s bizarre to me that I can spend thousands of dollars on hearing aids which are tailored to my hearing, yet I can’t hear anyone on phone calls linked to the hearing aids via bluetooth. I had an iphone 6S which was plug in cord to headphones (Sennheiser) and phone calls were clearer - actually understandable if the connection was good and the speaker wasn’t rushing. I’ve now had to move to wireless headphones (Sony WH 1000xm4) as I was gifted an iphone 12 which has no plug. These are also much clearer than the hearing aids. I still use my corded headphones for desktop use.
I also have mainly high frequency hearing loss. I also have severe tinnitus. I’ve had audiologists who don’t seem to understand that the tinnitus muddies the testing - ‘press the button whenever you hear a beep’ Ha!. I hear layers of noise constantly. I currently have Resound Linx 3D also. They’re about 5 years old but the audio quality was much better than the last ones I trialled but didn’t buy. I’ll trial different ones again soon.
I’m not sure any audiologist can actually help us. I know I need to find a balance between exercise and keep busy during the day so my tiredness overrides the tinnitus at night, but not so much that I’m stressed out because that exacerbates the tinnitus to the level of wanting to put my head through a non-safety glass window. Even on a good day I’m often find sleep impossible. Reading is the only thing to take my mind off the noise. I’ve tried a ‘white noise’ app but I have to turn it up so loud to hear it that my partner complains he can hear it from my earbuds
I find the disinterest of tinnitus by professionals alarming. Two ENTs have not commented on it at all. Audiologists pass over it and get annoyed because its putting their testing ‘out’. A trainee audiologist looked at me like an alien when I mentioned how loud and disconcerting it is (eg phantom ambulance/police siren all day) and that no one seems to believe it’s real. Some of the sounds are so like an blocked hearing aid microphone whistle that I can’t tell. Can’t hear the hearing aid whistle. At all. I have never had anyone enquire as to what it sounds like. There don’t seem to be any apps or programs I can download to help people in my life understand what it’s like. The only one I’ve found online only lets you replicate one noise, not layers and not different sides.
I also think audiology testing should be done in a real-world situation such as the audiologist’s reception. I normally can’t hear anything the receptionist says to me when I leave the quiet room even immediately after an adjustment.
I just hope there are people working on tinnitus and its relationship with hearing/stress/sleep.
I’ve moved audiologists before and they have adjusted my previous hearing aids which were bought from someone else. That shouldn’t be a problem. If you still have your last hearing aids you might be able to get them adjusted to your current levels as well, and do a comparison.
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