Is this as good as it gets?

After trying expensive Phonak, then America Hears, I am 60 days into Costco Rexton canal ($1699 each). These are far better than the others, yet… even after several adjustments, I still struggle every day.
Some sharp noises continue to be almost painful, but what bothers me most is the daily difficulty in communication. Teenage girls - forget it; something in their nasal quality that I can’t pick up. Any soft voice, ANY voice in a fairly noisy environment, and my husband’s voice.
The Costco man is wonderfully patient, but I sense he is reaching his limit on what he feels he can do.
Am I just expecting too much?

250: 50/45
500: 55/45
1K: 55/50
2K: 60/55
4K: 55/50
8K: 70/70

By this point you may just not be one that can be made happy by seeking and seeking. :slight_smile:

I am sure they will smile when you show up in a few years to buy more aids. :slight_smile:

What do you mean one who is seeking and seeking…?

I know exactly what Gail means by “searching and searching.” I’ve been searching for 20 years. I just don’t understand why hearing aids are of such little use to me. I’ve purchased top models from siemens and widex and my expectations are not very high. I go to all the fittings with hope but in the end I just can’t quantify how they are helping me. I still can’t understand speech. But why? I think I will always keep trying…hoping that I might hit the magic hearing aid.

0250 Hz L-65 R-60
0500 Hz L-45 R-30
0750 Hz L-20 R-25
1000 Hz L-50 R-25
1500 Hz L-25 R-15
2000 Hz L-50 R-10
3000 Hz L-25 R-30
4000 Hz L-35 R-20
6000 Hz L-35 R-40
8000 Hz L-40 R-40
Word Recognition 35% in noise

My first aid 20 years ago was an ITE aid and I bet I did not use 3 batteries before I ditched it.

The rule of thumb I read was if you have a 50% hearing loss the very best you can expect with aids is to wind up with a 25% hearing lost.

The helped me when I finally was forced to do something to hear over the phone. After talking with Beltone and a local ENT who fits Starkey aids it was clear they were not likely to stick with me on fine tuning to the level I would want. In fact I wanted control of the knobs and slides I saw on their screens. :slight_smile:

When I found America Hears for about 35% of the price of the other options I visited could provide full featured aids and give me full control of their settings and 60 days to try them risk free I went that route this time. Thankful it worked out. No they are not perfect but I do think my loss has been cut in half per the rule of thumb.

Could I fine a better set of aids? That is unknowable since I have stopped looking. I will use hearing aids from this point forward and if find I have to replace my aids for any reason I will then make a new decision based on the new info I have when that time comes.

Some people never find a spouse because they seek that which can not be found. Well some find a great spouse but keep looking for one that is better and often loose the great spouse in the process. :slight_smile:

Any day I am not happy with my America Hears settings I can change them again. :slight_smile:

Since no one with much hearing loss is ever going to have GREAT hearing it makes getting happy with good aided hearing easier. If one does not have much hearing loss he or she will just place the best of aids in a drawer and forget about them.

Where you get happy with a compromise is a personal choice.

Do you really want to hear teenage girls?:confused: All kidding aside how long have you been wearing your aids? And not just those aids but aids in general.

JKallears, Most hoh who visit or participate here are searching for just enough of a level of solution. That level for me is to be able to focus on the content of a conversation instead of falling behind focusing on individual words. In noisy situations I have to position myself, face people, put my back to the noise and go to a directional mode. I am somewhat fortunate that my wife’s hearing is perhaps comparable to my aided hearing. We agree on where it is uncomfortably loud.
Even normal hearing people are constantly compensating to communicate in noise. They do it on an unconscious and conscious level. Some are more adept at it and it has nothing to do with hearing thresholds.
There is no aid that can tell the difference between speech you want to hear and speech you do not want to hear.

I’ve used hearing aids for about 8 years - 7 of which were Miracle Ear. Those aids were, until the last couple years, very satisfactory. Then, according to the dispenser, they had “maxed out” and could not help my hearing loss any further. I moved, had to find a new source - and I’ve been searching ever since. I intend to keep these Costco aids, but I’m at a loss to explain/report to the dispenser exactly what is missing, so he can make corrections. I really don’t believe that aids cannot allow me to be a better participant in conversations than I now am. I’m a social worker, community volunteer… and communication is very important to me.
Am I to understand from the responders on this forum that I am expecting too much, am hard to please, I should just shut up and be happy with what I’ve got??

I did not intend completely to say that, There would be an amplification scheme that would be optimum for your loss for almost any given situation. IMHO you have to be almost lucky for a fitter to find it. You could maybe call your old fitter and get him to send you a printout of your previous settings that you were in general mostly satisfied with.
The way things work is when you buy a set of aids the dispenser programs them to your loss. This is always done using a fitting prescription that is provided within the software, NAL-1 (soon to be 2) and DSL are the most used of the non proprietary prescriptions. All the manufacturers have their own versions also. Even Nal and DSL tend to or are always modified per manufacturer.
These prescriptions take your pure tone loss and maybe your uncomfortable level and by averaging come up with a proposed level of amplification. As a guess in one out of 50 hoh is this guess close to optimum. Even doing the esteemed Real ear test only gets you closer to this average. If you ever had time you should download a couple different manu software, input you info. and look at the recommended amplification. In all the software you will initially be looking at the default choice of prescriptions. Dispensers will sometime pick out a prescription they have been most successful with, but in general with some you will only see the default. Anyway in the software find in the toolbar where you can choose a different prescription. Choose one and notice the change in the recommended amplification. The differences are typically well beyond a tweek or 2 here and there. If you want to get intense with it google and study the different prescription rationals. Dispensers will tell you and it is to some degree true that the prescriptions amplify with basically the same scheme. This is true but 4 to 8 dB within ranges makes all the difference to an individual. Just for fun Ask your fitter what prescription they are using. Download some software see for yourself.
That said aids only take you so far.

For me as good as it gets is good hifi and headphones. Not practical for conversations, but a kind of benchmark for expectations.

JKallears said in part…

First off… I’m not a Audi or BC-HIS, nor do I play one on T.V. That being said…

A HA does NOT improve and/or fix ones ability to hear and understand sounds within certain frequencies. It only increases the volume in the frequency range that you’re able to understand anyways.

As a example: if the natural unaided hearing in your ear has problems recognizing the f, s and th sounds (which are between 4,000 - 7,000 Hz), then NO amount of amplification is going to help you understand them. If you can’t hear or understand those letter sounds in that frequency range… then you CAN’T hear or understand them!

Another way of looking at it is this: If you can’t swim and you’re in 20 foot of water, using a pair of “swim fins” on your feet isn’t going to help you solve the obvious. The only thing that’s going to happen is you’ll be going under with a set on fins on.

Here’s a link to a web site page that explains it much better than I can. Part way down it talks about (and has diagrams on) Hearing Loss and Speech Intelligibility. I hope this answers some of your questions.

Shi-Ku Chishiki

I take issue again with the way you explain this. You never mention hair cell damage, which I think is your underlying intent of someone not being able to hear certain sounds. A response like this is very misleading and confusing, and I for one wish you would stop posting it like this.

Reading this post as written causes people to wonder why anyone would ever buy hearing aids, and I know that’s not your intent.

You have provided a lot of information. I do have a few questions to be able to address your concerns.

  • What is your speech discrimination score in quiet ? Sometimes this is referred to as word recognition score as well and is given in %. Usually 25 to 50 single syllable words are presented at a comfortable level and your would repeat them back. This test can really help determine your level of success with hearing aids and I would be happy to explain why.

  • Same as above, what is your speech discrimination score in noise also known as SIN test ?

  • What condition has caused your hearing loss ?

  • Is this your first time with hearing aids ? How long have you had this degree of hearing loss ?

I should add that sharp sounds should not be painful and this should be addressed right away. You are not expecting too much. You do have to be 100% sure that everything possible (and unfortunately within budget) that all options are being explored to help you.

Yes, you have made this assertion before and I have to say once again that you are wrong. Selective amplification can indeed improve word recognition (for some people).

It takes only a single counter-example to disprove any theorem. My own experience is that counter example. When I boost the higher frequencies, where my hearing has become defective, my word recognition improves markedly, approaching 100% in non-noisy environments. :cool:

[quote=Shi-Ku Chishiki]JKallears said in part…
First off… I’m not a Audi or BC-HIS, nor do I play one on T.V. That being said…

A HA does NOT improve and/or fix ones ability to hear and understand sounds within certain frequencies. It only increases the volume in the frequency range that you’re able to understand anyways.

As a example: if the natural unaided hearing in your ear has problems recognizing the f, s and th sounds (which are between 4,000 - 7,000 Hz), then NO amount of amplification is going to help you understand them. If you can’t hear or understand those letter sounds in that frequency range… then you CAN’T hear or understand them!
end quote

Here is an explanation of speech audiometry by asha
((((((Speech Audiometry
Speech audiometry includes determining speech reception threshold (SRT) and testing of word recognition . Speech reception threshold testing determines the faintest level at which a person can hear and correctly repeat easy-to-distinguish two-syllable (spondaic) words. Examples of spondaic words are “baseball”, “ice cream”, “hot dog”, “outside”, and “airplane.”. Spondaic words have equal stress on each syllable. The individual repeats words ( or points to pictures) as the audiologist’ s voice gets softer and softer. The faintest level, in decibels, at which 50% of the two-syllable words are correctly identified, is recorded as the Speech Reception Threshold (SRT). A separate SRT is determined for each ear.

Tests of word recognition attempt to evaluate how well a person can distinguish words at a comfortable loudness level. It relates to how clearly one can hear single-syllable (monosyllabic) words when speech is comfortably loud. Examples of words used in this test are “come”, “high”, “knees”, “chew.” In this test, the audiologist’ s voice (or a recording) stays at the same loudness level throughout. The individual being tested repeats words (or points to pictures). The percentage of words correctly repeated is recorded for each ear.

Thus, a score of 100% would indicate that every word was repeated correctly. A score of 0% would suggest no understanding.

Word recognition is typically measured in quiet. For specific purposes, word recognition may also be measured in the presence of recorded background noise that can also be delivered through the audiometer.)))))

I believe you are mixing up some info. Your word recognition scores are determined (with amplification) to a comfortable loudness level. If with this amplification in quiet you still cannot distinguish (then) you supposedly will not be able to distinguish at whatever level of amplification. I have read that the 2 basic symptoms of sensorineural loss that make it so that you cannot distinguish, that cannot be remedied by a hearing aid are, loss of frequency resolution, and loss of temporal/spectral resolution.
If you do not want to hear about FM and signal to noise ratios, skip to Basic audiology

JMHO, you aren’t getting as much from the HA as you should expect. Depends on which HA are best for you and much also depends on who is doing the programming. In my case who programs the HA made all the difference in the world. I can understand speech, even young girls, in large rooms w/ vaulted ceilings and also w/ one pair of HA in a very noisy environment. Again…it depended on who programmed the HA. Home theater is wonderful again. Also, no more subtitles for evening news on TV.

For me, it has been a year long journey…time consuming and taking alot of patience. At one point I had to go to the Phonak site, see what the audi could control and then back to audi to say “did you do this and did you do that.” She had not. I’ve now in just this one year been to 3 audiologists. One was completely useless even 'tho the rep for a company w/ many different locations and covering multiple states.

Then I still has unresolved issues and my audi had no answer except “that’s the way it is for everyone.” So I went to different audi. She sent HA back to Phonak on Monday. This office called today, and the HA already back. Phonak had to replace 3 components in ea HA. I get to pick them up tomorrow! Can’t wait to have my “ears” back and see if problems all resolved and in fact could be even better than ever w/ this pair of HA.

Compare your numbers from your audiogram to mine. Will either your hearing or mine ever be “perfect” even w/ top HA and best programming? No. Definitely not. As for me, most of my hearing difficulties have been resolved. The rest soon will be…one way or the other. Programming will be checked when I pick the HA up tomorrow.

It’s quite obvious Jay_Man_2 and JCHunter don’t like the fact that I post on this web site, as I quote Jay_Man_2 in part, ie: “I for one wish you would stop posting.” :frowning:

Bowing to their wishes, from now on when I post I’ll make sure that anything I say will NOT create a controversy… or mislead anyone as I have been accused of. :confused:

Of course the only problem is, there be very little that I can say then… but so be it. :mad:

After all, I don’t want to have the holy wrath of JM2 and JCH to be brought down upon me. :eek:

Thanks to all of those who have let me post in the past though. :slight_smile:

Shi-Ku Chishiki

You need to get a little ‘thicker skin’. You cut the quote from Jay_Man short, when you add the rest of his context “…it like this.” The meaning is completely changed.

While the article you linked to was a good one, I would have to agree with the others that you are not interpeting what it says accurately. Speech is not a simple sequence of pure tones. It is a sequence of a number of pure tones. A modern digital instrument can do far more then simply amplify pure tones at different gains, it can ‘lock onto’ & amplify a sequence that is meaningful (i.e. ch, th, and other hard to hear combinations for many).

Please don’t quote me out of context. And don’t be offended. But as you can see, I’m not the only one who thinks that you’re communicating on this particular issue in a very misleading way. I just don’t want others to read posts like that from you or anyone else, and perhaps make a bad decision that it’s not worth even investigating hearing aids further.

I have absolutely no objection to your posting on this web site. Please continue. :slight_smile:

My concern is limited solely to your assertions that sound amplification can’t improve word recognition because there is far too much evidence that it can and does (for many people).