Just ordered HA, this has been an experience; Audiologists, hearing loss, tinnitus, recruitment


The concert and gun thing never bothered me. Groups/singers IMO are seldom as good as their recorded music do to mixing done in the studio; my wife wants to go see Elton John and having heard him singing on TV in recent years, I told her I would only go if he lip synced his songs because his voice is GONE and I would insist we both use hearing protection(her hearing is worse than mine)! Guns and shooting just have never appealed to me at all. My ENT was probably trying to impress on me the importance of protecting what I had left by saying “never go, never shoot” or he was ahead of the curve in ear protection; OSHA in the US didn’t start getting serious until the late 70’s early 80’s in regards to hearing protection in the workplace. When I taught woodshop I insisted that the kids used ear muff suppressors when using any power tools and I used custom made ear plugs to protect mine. I guess it goes by the old adage “an ounce of prevention is worth a pound of cure!”


I know what you mean with live being so different from recorded. Some reproduce well. Some don’t. Some lend themselves really well to a live rendition that isn’t reproducible in studio. Others just sound dumb live.
I saw one of those Yes nostalgia tours and Jon Andersons’ voice was just lost in the sound. Yeah hang it up.


I live in Las Vegas, so occasionally I have business clients visiting town that I will take to one of the shows. Generally a Cirque du Soleil show. Generally LOVE, because who doesn’t love the Beatles. However, I have to always use ear plugs otherwise it is overwhelming, and my tinnitus is at fever pitch for 2 weeks after.

My Audiologist told me my HA came in yesterday but he doesn’t have the molds back yet.


LOVE is a really interesting mix. But it’s not live per se. Good to wear those ear plugs!


Some interesting testing choices.

Out of curiosity, why did you choose to go to the hearing instrument specialist when it looks like there are two audiologists basically down the street?


I did a google search on Oticon. I visited the first link that came up, read everything there, then I went to the second link. The second link was Hearing Revolution. I called Hearing Revolution and they referred me to the place where I got the test.


Here you go. I think I understand that the O and X’s are right and left ear. the < and > is bone conduction?

I am assuming that the M, is Loudness Discomfort Level? After he noticed me being in pain at some of the tones he said it appeared I had “recruitment” and gave me a test where the tone got louder and I was supposed to push the button when it got uncomfortable. So I am assuming that is what the “M” is?


I think “m” is most comfortable level (MCL). Typically used “u” (UCL) is used for the uncomfortable level.


I’ve always assumed MCL stands for Maximum Comfort Level. I assume it’s synonymous to UCL.


Maximum Comfort Level certainly fits with the talk of recruitment. If that’s the case, very little dynamic range to use. I checked the abbreviations on my audiogram and they agree with what I originally stated, but I can’t speak for what the audiologist meant.


Yeah, the MCL in my audiogram is around 110-120dB, so a 60dB MCL certainly seems like recruitment.


I think the difference might be Masked and unmasked. That what the legend seems to indicate.


The M is most comfortable level, which is an interesting thing to see measured. There is no evidence of masking on this audiogram, which would make me wonder whether bone conduction was done with inserts in, whether inserts were placed poorly in the first place, or whether there is actually a low frequency conductive element in which case there sould be an ENT referral.

L and backwards L are usually used for loudness discomfort levels.

(If these Ms indicated loudness discomfort levels, that would be some DRAMATIC hyperacusis. I’ve seen it before, but OP would be reporting significantly different struggles–like having a normal conversation without wearing earplugs.)


Normal conversation is fine. But anything that is in the frequency of my tinnitus is really painful. Power drills, music, my grand kids screaming. I was putting a tire on my utility trailer a couple of days ago and accidentally dropped the lug wrench on the concrete. That sound went through me like a shot. Anything that is 'clanky" sounding just kills me. There was some test on the internet that you were supposed to match the sound you heard to the ringing in your ears and I got a pretty good match right between 5000 and 5200. My tinnitus is really high pitched, and it drives me out of my mind.

He used some kind of head band when he did the bone conductance test, positioning it behind my ear, first on one side and then the other.

He also said it was going to be interesting to adjust the HA when he fits me, because some of the frequencies I have a loss in, are the frequencies that I find painful if they get too loud. Some tones I could not hear until they got louder than the ringing in my ears and and as soon as I was able to realize the tones were there they were above my comfort level, because my tinnitus is above my comfort level. But I don’t know if my tinnitus is really loud, or it’s just that I find it so darn irritating.

Neville, I have read some of your other posts. You must have been doing this a long time because you appear to be extremely knowledgeable. I appreciates your insights.



I haven’t, actually. Though I have a PhD in a relevant field, which helps.


I have a Ph.D. as well, in Criminal Psychology, which, of course, is of no help regarding my hearing issues.


Oh nice! I almost went that way when I was first going into grad school. I had a professor who had studied under Bob Hare who was great, and for a time I was a bit ambivalent about whether I wanted to lean that way or continue on with perception neuroscience.


Either way, this is a peculiar Audiogram. It is not standard practice to collect MCL (Most Comfortable Level) or LDL/UCL (Loudness Discomfort/Uncomfortable Levels) at every frequency, though it definitely isn’t wrong. Tonal MCL/UCL gives better information for hearing aid programming, while speech LDL/UCL is often better for real-world performance.

MCL, or the level that the sound would be considered the most clear, and most comfortable, is typically going to hover around 55-70 as your responses are, with LDLs in the highs for people with recruitment (loudness sensitivity) likely hovering in the high-70s to low 80s at worst. Low-frequency LDLs would still be in the upper 90s, 80s at worst. So, these are likely MCLs, as LDLs/UCLs would be marked with that particular letter.

It also means your LDLs/UCLs are probably not marked on the audiogram. I can’t call out exactly which audiometer maps out the lowercase m as MCL, but I’ve seen it before used in that fashion.

As a small possibility, the Audiologist could have erroneously marked m for LDL/UCL based off of their software, but if so, you were a bit too trigger-happy on how to respond on that particular test.

Unless you completed some sort of intake questionnaire that indicated your tinnitus was debilitating to your everyday life, most people do not need a tinnitus masker on day 1. Those that get it more than likely push for it, because it falls much later in typical Tinnitus Retraining Therapy Jastreboff models.

There are many MFi hearing aids if you have an iPhone, or consider a bluetooth intermediary device if you have any other brand, or even the Phonak Direct/Unitron Moxi All if you feel you absolutely need masking noise (as it can be streamed from phone apps using a bluetooth intermediary while taking phone calls without the intermediary), but otherwise just go with the recommendations given to you and see how you do.


It would be accomplished through the TV Connector connected via the phone and a 3.5 audio jack. I wasn’t clear on that, as it still requires an intermediary device, so I’ve edited the post to reflect that.