My audiologist has given up on me

After prompting from others, I booked an appointment with an audiologist at the audiology clinic of my local university back in May. At 82, I have what is apparentely typical quite steep ski slope hearing loss. (Sorry no audiogram; I was asked if I wanted a copy and said no, as I didn’t think I would ever need it.) On the physical side, it was decided that my ears were unsuited to behind the ear aids, so custom moulds were ordered and had to be sent back for venting because of occlusion. The aids are Unitron DX Insera W 312 Dir, supplied free under the government programme for age pensioners, except for an annual fee of A$50 which includes batteries. No complaints there.

I live alone and am only occasionally with others, but I wanted to hear better when face to face with one another person in a local café, and at a weekly meeting with 12-14 others over a shared meal - perhaps 5 hours a week in all. Apart from that there is no noise in my environment that I want amplified. I like silence. I don’t have television or a mobile phone, but I do depend on captions on any online videos.

I think the hearing aids do improve my hearing of speech a little, except when the café becomes noisy or people talk over each other at the meal. But I really dislike hearing my own chewing and eating so loudly, and I was told I would simply get used to that. No, it hasn’t happened.

Nothing much changed between my September and November appointments, but now no further appointment was offered. Last time wearing the aids proved to improve my word recognition score from 45% to only 50%. I have the feeling I have been written off because my requirement is so limited. I could try another provider but only by severing the link to the University clinic.So should I giveup on them too?

It would be better if you could get a copy of your audiogram and post it, as it’s really necessary for everyone to offer advice.
The Unitron DX models seem like a good hearing aid on paper, but really depends on the exact model you have (there are 4 different models 9, 7, 5, and 3)
Free from the government is probably the 3 or 5 version.
This could explain why your still having issues with a lot of background noise, just remember hearing aids don’t restore your hearing, they are only a aid.
Why can’t you request another visit to the clinic, did you explain that your still having a number of issues that most likely need further adjustments.
Nothing wrong with getting a second opinion from another clinic, if you do (I would) there’s nothing at all stopping you from going back to the Uni at a later date. My only concern would be why ITE over BTE type, at 82 I’d say those higher frequencies would be in profound loss.
Hearing you own voice and chewing food etc is something you’ll need to get used to, unless you are able to have a decent sized vent in the mould to stop the “occlusion effect” (domes with BTE also would good, but depending on how bad that loss is) again we need a audiogram to know for sure.

Thanks for the reply, Tenkan.
I think it’s the 3 version.
As for behind the ear, it was tried, but fell out as soon as I moved my head. (The arms of my spectacles have a slight outwards turn at the ends so that might have been why.) There was also something about my having narrow ear canals so that was why they decided on custom moulds. My closest friend was glad they were not BTE as he regarded that as “old tech”.
As I recall, on the government scheme one has to inform the first provider that one is moving to another. This is also part of why I am hesitant to ask for a copy of my audiogram at this late stage.

BTE Aids are definitely not old tech.

You get the same level of technology in CIC/ITE Aids, RIC Aids and BTE Aids.

Ok so there are ways to help with this, one is to use a canal lock on custom made molds, in most cases this would stop them “falling out” so to speak, as for the arms on your glasses, these no doubt can be replaced with slightly curved ones or “straight through” types that don’t curve behind the ear.

Of course you can have custom molds made with BTE, this is a really easy and common way of using them.

Yes but even so, there’s nothing to stop you from doing so, it’s not like your not allowed to,also the audiogram is yours as part of your medical history, so it’s no problem to ask for a copy as it’s just normal service,and it’s your right to change to any other clinic that supports the government HSP, as you’ve already been supplied and fitted they are now “yours” it could be possible you’ll need to pay a fee to have another clinic make adjustments, this should be at a very low price through the HSP system, quite possibly free! No doubt you have a concession card so you could actually go just about anywhere for the Hearing Services Program(HSP)

https://tinyurl.com/ybbdrtr4

Thanks for the link. Many HSP providers in my area, but I have no idea how to choose between them.
The impression I had from the Uni audiologist was “This is as good as it gets, given you are not willing to wear them full-time.” The aids were sent away for vents to be made, but the noise of my own chewing still blocks out the conversation I want to hear. However, that meeting over a meal is the main occasion when I want to hear better! And I can’t practise that in silence at home.
Look I’m grateful for your help, but I’m beginning to regret that I posted here. It was a challenge for me to get this far with hearing aids, but I have a lot more in my life where hearing is unimportant, so I’ll probably leave it at this.

No. don’t give up!
The main point is that your ears do take time to get accustomed to the hearing aids so I think (as somebody who is at home most of the time) you should give it a go for an absolute minimum of 2 weeks, & preferably longer, to wear them all the time. If you find it overwhelming at first then start with a few hours and build up to all day.
There are noises at home. Inside, amongst others, you have the TV/Radio, toilet flushing and refilling, cupboard doors & other kitchen noises. Outside you have traffic, wind in the trees, birds etc

First-time user here, and only a couple of months in, using the aids most (not all) of the time. My first impressions were that with the HAs my world became full of tinny, crinkly, tinkling, metallic, snap-crackle-popping noises. (Just the hissing/swishing/sliding noise from pulling my pants on seemed ridiculously loud.) I didn’t like it AT ALL. But there were other effects too. The purring of our cat was no longer just a low rumble, it now has depth and resonance and multiple tones I couldn’t perceive before. Many sounds are similarly multi-dimensional when they were overly-simplistic before.

I too didn’t like the sounds inside my head like eating. Sometimes the sounds that are now amplified overpower the speech I’d like to hear. But as I continue to wear them, I notice my head noises less. And I am regaining my ability to differentiate noises in my head from important outside noises.

HAs provide a new normal, and it takes time to adapt to it. I’m still on that journey, but I get the very distinct impression that it WILL become perfectly normal. I just didn’t realize how different my old “normal” had become. Now when I’m not wearing my HAs I feel like I have pillows over my ears.

I like silence too, but silence is more what you pay attention to, not so much what’s really happening all around. Even being out in the wilderness on a still day isn’t silent. Your brain creates the silence by not acknowledging some sounds. Your brain just needs some re-training.

If you really don’t want to wear your HAs constantly, I would suggest doing so anyway for a few months. This would get you really accustomed to the new normal. You could then decide whether you still prefer your old normal, and if so, your brain would be able to accommodate the new normal much more readily when you really need your HAs.

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This is really good advice, but - if you decide it’s not the advice that you want to hear, and don’t heed it - there’s not much more that anyone can add.

I’ve discovered that there’s no “Easy” and no “Perfect” in learning to live with hearing loss … there’s just “the best you can do after exhausting all possibilities.”

Them’s the breaks …

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Look, the idea of me sitting alone in my flat wearing those plugs in my ears for 12 hours a day for the 5 days a week when I go nowhere and interact with no-one is plain ridiculous.

@cg1: Maybe if you could hear all the things going on around you, that you’re missing right now, you’d want to go out more?

Sounds like you’re mind’s been made up from the get-go. Nobody can encourage somebody who’s already beat down to the mat, unfortunately. Cheers and good luck!

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What things around me? I can already hear the humming of my fridge and the flushing of my loo; I have no wish to hear those noises any louder. And why would I want to go out more? I am happy being solitary; some people are.

If your brain reprogrammed itself to make better use of the hearing aids, by you wearing them most of the time, you might stand a better chance hearing when you do go out. The sounds you mentioned will fade into the background again. But you might have a better shot at hearing your friends. Hearing aids aren’t like glasses, put them on and you instantly hear well again. That is why you are encouraged to wear them. If that isn’t worth it to you, that is your decision. Best wishes.

WH

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[@WhiteHat: You served in the Diplomatic Corps, didn’t you, WH? Eh?]

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I’ve been an (acquisition) systems engineer for most of my career. I have had to to deal with people above and below who can either be allies or enemies. Best to try to collect allies.

WH

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I wear mine 18 hours a day your brain will ignore those things I jumped from a hearing aid to a ci, i can tell you it is extremely louder than my hearing aid side and i got used to it…

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Thankyou for your measured (and diplomatic) reply, WhiteHat.

True problems. Ski slope with good low frequency hearing requires venting to avoid occlusion (crunchy chewing). Behind the ear receiver-in-the-canal hearing aids provide that venting, but they are too floppy and difficult for you to manage. In-the-ear hearing aids resolve the retention and dexterity issues, but limit the venting that can be provided given the size of your ear canals. There are no perfect options. It is possible that with a lot of practice you could learn to manage a receiver-in-the-ear style. It is maybe possible that they could open the vent on the in-the-ear hearing aid but it sounds like there may not be physical space. It is possible that a traditional behind-the-ear hearing aid with plastic tubing connected to a mold with wide venting and a skeleton lock could offer the balance you need between retention in the ear, stability on the ear, and venting, but the tubing itself requires its own cleaning and management that some find difficult. A patient clinician could work through these with you but it might take some time/$$$.

Different sort of problem. I hear you, I’m solitary too. That being said, the world sounds loud to you through hearing aids because you’ve slowly gotten used to it being silent over years and years. That silence will grow over time and when you truly do need the hearing aids, it will only be harder to treat if you’ve let it go. The auditory system will become lazy from disuse, clarity will drop, speech-in-noise skills will atrophy and even small amounts of background sound will make hearing impossible. The 1 hour you spend out chatting with people is not sufficient for your brain to re-adjust to the hearing aids, so they will never sound great and will not really stop this deprivation-induced decline.

You CAN adapt to hearing aids, but if they are currently un-wearable for you there are things that the clinician can do to improve that and help you adapt more slowly over time. But you do have to be motivated to wear them, to TRY to adapt.

If you are not prepared to do that, however, there are other communication devices and strategies that could be considered to support you in the short times that you need them. Most people don’t want to let spoken communication go. But, as I said, I am also very solitary. If your feeling is that being able to hear other people isn’t really worth the effort to you, I get it. I can sit at home for weeks with no other human contact at all and it doesn’t bother me–not like all these crazy extroverts floating around who need to see people every day.

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Thankyou, Neville. You seem to understand me better than most. What you say about venting makes me wonder why I was given unvented moulds in the first place. The question of whether the vents I now have could be enlarged was never raised. I suspect you are right that I would find anything with tubing difficult to manage. Even now, I find opening the battery compartment to switch the aids off when I take them out quite fiddly. I also find it hard to tell whether they are still functioning or have come loose or run out of battery.

What bothered me and led me to post here was that the audiologist was clearly not interested in pursuing any such alternative solutions for me. My hearing loss has been so gradual - I knew 40 years ago that I couldn’t hear very high frequencies - so perhaps just support in the short times I need them (approx. 5 hours total in a week) as you suggest, would see me through whatever years remain for me.

But I don’t know how to find an audiologist who would be motivated to do that. I don’t want to go through the whole rigmarole from scratch again, though I would be willing to ask for my audiogram to shortcut that.

Edit: have now requested my audiogram; when I receive it (as email attachment, perhaps?) it may take me a while to work out how to post it here.

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@cg1: That will permit some of the really knowledgeable people here on the Forum to comment intelligently on what some of your options may be.

It would also be helpful if you were forthcoming about other salient factors like manual dexterity that are a clear obstacle to hearing aid use if you have to fight just to get them into your ears.

You may not like everything you hear, but I guarantee you that most of it is going to be pretty high-quality input from other people who struggle to cope with their hearing loss, just like you and me.