She did tell me that she would be “easing me in”, as some first time users are overwhelmed at the full correction. We shall see, I’m in learning mode right now obviously, and not sure what to expect going forward. I’ve learned a lot already just reading this forum. Thx for comments!
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You have a really good chance at improving your word understanding by wearing properly fit hearing aids. Since you haven’t heard many of your upper frequencies very well for a long time your brain has forgot how to use those sounds. Your new aids should bring those sounds back to you and then your brain will begin to relearn them. This will hopefully improve your word recognition.
Good luck
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The fitter may simply be “new to Costco”, but with experience elsewhere. You can always ask her.
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This is interesting. Please post how it goes for you. Which receiver are you using?
I have the Jabra Enhance Pro with M&RIE in my only ear that works. I find it very natural sounding with improved speech recognition and restoration of the higher frequencies. I use the NAL-NL2 prescription. Compared to NAL-NL2, Audiogram+ has reduced gain on the higher frequencies. It sounds very dull compared to NAL-NL2 and NAL-NL1 as well.
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Here’s some fitting curves for my hearing loss experimenting with the recommended amplification for soft, medium, and loud sounds with ReSound’s Audiogram+ vs. NAL-NL2 vs. DSL5 Adult. You can see that Audiogram+ actually amplifies loud mid to high frequency sounds more than NAL-NL2 (top curves with diamonds in top two figures). The big difference (and the reason that I use NAL-NL2) is that soft mid and high frequency sounds are amplified more than for Audiogram+(bottom curves with diamonds in top two figures). So soft sounds in these frequencies ranges are delivered closer in volume to medium level sound as received by the external mics (compression of sound differences into remaining range of louder sounds that can be heard). But look at the lower graphs for DSL5 - it REALLY amps up higher frequency amplification. I could hear sounds as well or better with DSL5 than I could with the other fitting algorithms but the amount of amplification was just a bit too much for me! @Don loved DSL5 and I trust that he still does!
I’m going to respectfully disagree here. The gain values for the 50dB input curve are actually lower for Audiogram+ than NAL-NL2. The input gain curves are much more evenly spaced for Audiogram+ than the are for NAL-NL2. NAL-NL2 starts with higher highs than Audigram+. That is consistent with my experience that in a fairly quiet environment Audiogram+ sounds muted compared to NAL-NL2.
I’m not sure what you’re “disagreeing with.” Your statement above is exactly what I said. NAL-NL2 amplifies “soft” input sounds coming in at the level of 50 dB from the external environment more than Audiogram+, which is based on the original NAL fitting algorithm. If one reads the overall output level for the “50” row in the tables below the top two graphs in the link I provided in my last post just above, the numbers show that plainly and you don’t have to interpret the graphs(see table at end of post here, too). Same for going to the loud input sound levels in the row of the table labeled with “80.” The situation is reversed. Audiogram+ at 80 dB input has a higher level output than NAL-NL2 with loud input sound.
To make things clearer, here is a table with data taken from the figures in the link that I provided showing the overall output levels for 80 and 50 dB received input level for Audiogram+ vs. NAL-NL2. Then the next to last row in each table for Audiogram+ vs. NAL-NL2 shows the difference in output level for 80 dB input vs. 50 dB input. And finally (not calculated from data given in tables, the COMPRESSION RATIO for each algorithm). I didn’t make any of this up. The data comes directly from the ReSound Smart Fit fitting program calculated for my hearing loss and a binaural fit and an experienced, non-linear user fitting profile applied.
One can see in the row that I’ve labeled “Difference” that there is more output difference between 80 and 50 in the Audiogram+ fitting algorithm than for NAL-NL2 and that is because the output levels are more compressed (closer together) in NAL-NL2 than Audiogram+. And this shows in the compression ratios given for the two fits. The LOUD highs aren’t as high for NAL-NL2 and the SOFT highers are higher for NAL-NL2, which leads to more compression (less difference between SOFT, (MEDIUM), and LOUD sounds - what I said in my post above, which you say you are disagreeing with.
You have a different hearing loss, you might not be using the EXPERIENCED, NONLINEAR user profile and perhaps you are only fitted for a monaural device rather than binaurally as I am (you need about 4 dB less amplification when both ears are working together). But I don’t think that should affect the overall outcome and differences between the two fitting algorithms we’re comparing here, which I hope I’ve demonstrated with actual numbers to be exactly as I said in my previous post.
If one clicks on the image, one gets a much bigger view of the spreadsheet table. The table shows for an input dB of either 80 or 50 at each frequency given what the overall output dB by the HA into the ear canal would be (with a binaural fit and the user profile given) for my hearing loss. Also, the data is generated for the ReSound All-Around program for ReSound Quattros, the rechargeable RE961 version, fitted with MP receivers.
I only started doing this about a month ago. I got lost in the technical data, particularly your statement about Audiogram+ providing more amplification in the loud mid to high frequency sounds. That is true by the charts. Experientially though, the sound I hear using Audiogram+ at average TV levels is like a stereo with the treble turned all the way down.
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TV’s have equalizers, too. And I should imagine there is a “sound quality” output setting in the TV, too, or if you have the TV audio output hooked up to an amplifier, in the amplifier sound settings. We have a really old Yamaha amplifier and its output can be adjusted to sound like a small room, a large room, a theater auditorium, etc. So if you’re not getting the sound you want directly from room speakers, I’d also check your TV or amplifier sound settings. If you have other folks around or visiting relatives, etc., they could have messed with sound settings that are relevant to TV. If you are using a streaming device like the ReSound TV Streamer 2, I’d check the Sound Enhancer settings for that program/device in the Smart 3D app and make sure that somehow the sound levels aren’t out of whack relative to the relative amplification levels you’d prefer to hear. In my experience, the quality of sound can vary a lot from movie to movie or DVD to DVD depending on the sound engineering that went into making the film or DVD or Blu-ray disc. We were recently watching an old time movie from the '30’s or '40’s (in the 20th century!) and I really had to crank up both the volume and the treble for my old ears to enjoy the sound quality of the movie - so maybe the same sort of need to customize HA output to your ears depends on the item you’re listening to and with some HA brands there’s a lot of “Autosense” but with ReSound, the user may have to configure sound more themselves but then you can save a unique configuration as a Favorite to reuse as necessary.
I had my Jabra M&RIE connected to SmartFit via NoahLink Wireless and went through various settings while I was wearing the aid. As you are likely aware, Smart Fit allows you to hear your changes live. That way I was able to see how my usual experiences (TV, Conversation) would sound on different HA settings. I tried Audiogram+, NAL-NL1, NAL-NL2, and DSL5. I like the NAL-NL2 best. All my stereo components and TV go through my receiver via HDMI. All the settings on the stereo were the same for the tests.
I wonder if any differences in fitting algorithms perceived for the M&RIE receiver or M&RIE program settings relative to the supposed canonical differences between NAL-NL2 and Audiogram+(NAL-NL1) could be due to accidental or intentional changes in implementation by ReSound for the M&RIE receiver and M&RIE program?, i.e., they didn’t get something right or intentionally changed something for M&RIE? Or perhaps it could be like the Moon Illusion (the moon appears larger close to the horizon, particularly relative to nearby objects at the horizon in our view than it does to us high in the sky, even though it’s actual size is the same). Since gain in NAL-NL2 is adjusted based on loss of neighboring frequencies as well as for the frequency band being adjust, perhaps there is some perceptual effect from that sort of adjustment as opposed to what’s done for NAL-NL1, etc.
Nevertheless, Harvey Dillon is the expert. He was the head of the Australian National Labs when NAL-NL1 and NAL-NL2 were devised. In the 2nd Edition of his text on hearing aids(2012), he has a whole chapter on prescribing hearing aid amplification (chapter 10) in which he makes gross comparative remarks. Here’s what he says in general summary on page 317, top right, relative to the algorithms I’ve mentioned:
NAL-NL1 prescribes an average gain, across frequency, that is a few dB more than adult subjects prefer. (NAL-NL2 prescribes a lower overall gain than NAL-NL1). (perhaps he’s writing about medium or loud sounds or average sound level for broad bandwidth sounds ??)
…
DSL[i/o] prescribes a higher average gain than NAL-NL1. Not surprisingly then, it prescribes more gain than is preferred by adult subjects. DSLm[i/o] prescribes a lower overall gain than DSL[i/o] (I didn’t bother checking how that relates to DSL5, ~the most recent evolved verson of DSL).
It’s great to experiment with how input from your own environment sounds in your HA’s with different fitting algorithms. There’s also a very interesting set of sound files in the Common folder (…\Common\MediaSoundFiles of the Smart Fit program files). Try listening to the series of files related to the file name _ENmd+5lunch.wma. That one the speech is only 5 dB above the noise. And the one _ENmd+0lunch.wma, the speech is only 0 dB above the noise. Um_bongo has pointed out that such recordings are not real 3D sound to your HA’s but if you play it into room speakers, it might be an interesting test of how well your HA’s are working for you with different fitting algorithms. That’s what I used to decide which speech algorithm I liked best.
That went over my head like a flock of geese headed south for the winter. I’ll come back to this after I’ve read some more. Any thoughts on this: https://www.amazon.com/gp/product/1635502101/ref=ox_sc_act_title_1?smid=ATVPDKIKX0DER&psc=1
Harvey Dillon’s book is a little old and not going to cover the latest digital aids.
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I have that book. It’s strong on how hearing aids work (technical on the HCP level, not the engineering level), current HA features, and hearing tests and fitting procedures. But it doesn’t cover manufacturers’ fitting software. The writing style is intended to be entertaining, which some people might find distracting.
I found it to be weak on audiology and acoustics and physiology. For that I recommend Audiology Science to Practice, Second Edition by Steven Kramer. AbeBooks has used copies for less than $10.
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Here’s what I said about Harvey Dillon’s book a while ago. The basics of hearing loss and hearing aid correction haven’t changed. DSP signal processing advances are just in the way the HA’s function to deliver sound recovery. I doubt any book is going to explain the “magic” of how any particular HA works as the OEMs are keeping that stuff to themselves as proprietary trade secrets, etc.
Then there is this nationally used text on audiology itself:
IMPORTANT NOTE ON KINDLE EDITION: Actually it turns out that the Kindle edition format isn’t so great for the pictures and the video available with the ebook. So in the end, I returned my Kindle edition purchase to Amazon and bought the etext directly from Pearson, which necessitates installing the Pearson app on a smartphone or using a web browser on a computer to read the book. But it does have some very nice illustrations and videos and sound media files, IIRC.
Martin, like Dillon, is a grand old man of the hearing/hearing aid world so as for Dillon’s work, his text may be petering out on updating, etc. The last edition was in 2018 - but then maybe such books don’t need to be updated that often?
A great free reference on hearing aid fitting, mostly about compression of sound loudness to restore hearing and how it works, is Starkey’s free downloadable PDF, The Compression Handbook:
@MDB very helpfully recommended the Dillon and the Martin and Clark books to me once upon a time.
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I’ve read the Starkey pdf. It was a good start.
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THIS is exACTly what I needed to read. I’m a classical musician and sound is important to me. I am also trying the MORE1. But… is you’re saying the sound of the Jabari is on par, then the extra 3k isn’t worth the spend. Ty. Very very much!
Curious to know what the fitting range is for the M&RIE? Would the M&RIE always be the better choice if your hearing is in the acceptable range? I was at Costco today and no mention was made to me about one or the other, i.e. RIE vs. M&RIE.
The Jabra is the same as the ReSound One. The data sheets posted here will show you the fitting range:
https://pro.resound.com/en-us/products/support-materials/one-support
There’s another thread here somewhere on the ReSound One M&RIE fitting considerations that includes additional detail: