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!


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.


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


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.


This is a very interesting thread for me as I have almost identical problems with hyperacusis as the OP does. Moderately loud sounds (e.g., a person speaking to someone else who is 20 feet away) at certain frequencies as described by the OP are intolerable.
My audiogram shows what I think is UCL of 85dB and I think this was done at 1 kHz. The audi did not note the test frequency so I entered the UCL into my Genie 2 audiogram at that frequency. Initially the audi did not enter a value for UCL on the Genie 2 audiogram so when I got the equipment for self programming I entered the value and represcribed. I noticed that this increased the compression at higher levels (traffic noise) as plotted on the SPLogram plot. This additional compression did improve things for me in noisy environments. However the issue with certain frequencies or bands (mid-high) persists. I think I will ask my audi for UCL testing at the standard frequencies as shown on @cop704 's audiogram (the graphic in the post above). Perhaps Genie is smart enough to prescribe additional compression at the problem frequencies. Do you think that might help?


Got fitted for my Oticon OPN1 HA Tuesday. WOW. I had no idea how much I have been missing. The AUDI programmed the HA turned them on and immediately I heard this loud ticking. I said where is the clock? The Audi said behind you on the wall.

And for me, the tinnitus masked is a god-send. The AUDI set it as a shaped form to follow the path of the Audiogram, as oppose to selecting the White Noise, Pink Noise, etc. It is really very helpful and is a more soothing sound than the “ringing.”

By the end of the day I had convinced myself that the HA were good, but I didn’t know if they were that much of a help. Then I took them out in preparation for bed, and realized, ah, yes, I really have a much more debilitating hearing loss than I knew. The HA are definitely going to improve my quality of life.

I got the the Tele-coil version of the Otcion OPN 1’s because I return phone calls on SKYPE all day long for my business, so I normally use headphones. NOIZFREE makes a pair of ear loops with a microphone especially for PC’s that have a Hearing male 3.5 mm plug and a male 3.5 plug for the microphone. It works great.

Are their any other programs you folks would recommend? I have the Tinnitus program set in Program1 General, I have Speech in Noise in P2, I have the T-Coil in P3, and I have 1 program channel still open. General and Speech in noise still seem to make the noise louder than the speech. I mean I can hear my hard-drive whirring, I can hear the air conditioning, I can hear the dishwasher running, but I still have a hard time hearing voices clearly.

It would be nice to have a list of the possible programs available.

Also, I think the Audiologist did something really weird when programming. He gave me a printout, of the program settings and it says, BUTTONS (on the hearing aid) VOLUME FUNCTION “OFF.” So the only way I can change the volume setting is through the OPN App on my phone, which is fine, but not very convenient


I too was in Law Enforcement for several years. And while I did not shoot 500 rounds a month I would shoot enough so I could qualify. And like you I did not wear hearing protection.
I ended up with a hearing loss and Tinnitus.
I found that just adding the HA’s increased the volume of the surrounding sounds so it has effectively masked my Tinnitus.
BTW, I really suggest that anyone needing hearing aids first contact their health insurance carrier.
Mine has a contract with a group called Hearing Care Solutions which offers top of the line hearing aids at significantly reduced cost.
I have used them on my last two purchases as well as additional things like a bluetooth transmitter for our TV and a lapel mike that we use when traveling


I have Lecture in P4. It is especially useful when the speakers use a microphone in meetings and presentations in large rooms where the sounds bounce around the walls and ceilings. It is easy to adjust and tweak the volume on my iPhone during a lecture - not the OPN app. I also have a Comfort Program in P3. You may benefit from that program. I use it in the car, especially in loud traffic - Home Depot - loud restaurants - TV noise, when I am not watching it, and often when I am alone. Spoken speech is suppose to act like it does in P1 when someone talks to me. I would describe the program as a softer, non edgy P1. It is different than reducing the volume.

You need to have the buttons functional on the Hearing aids. I love the iPhone convenience to make adjustments, but I don’t always have my phone with me, but I Always wear my HA’s. I especially want to be able to mute quickly, such as when a leaf blower is suddenly turned on. Having worn HA’s a very long time, I instinctively reach to my hearing aids to adjust. Read about your choices to determine how you want them to function so you can tell your Audi.

It is great your Audi gave you the printout. I ask for mine. I keep them in order, take them to appts, make notes. It is easy to refer to them to compare changes, even if I don’t understand it all. Those printouts are always the starting point in the appt. It is a hard copy of the history of my changes and sometimes proves to me, I’ve already tried something, don’t try it again!



I too used Hearing Care Solutions. Although I found them under Hearingrevolutions.com.

They are super great to deal with, as was their local provider Ryan. My experience with them was the same as yours. Michael took care of me and he could not have been nicer or offered better customer service. He probably got tired of answering my questions.

Thanks for all the comments and help and suggestion gang.