New hearing aids not having much effect

Hearing Aids
#1

I’m a first-time hearing aid user, and have been wearing my new Philips 9040 with open domes 12 hours a day for the 7 weeks. I’ve been using them almost exclusively in their default “General” mode.

So far, I’m not too thrilled. The aids are comfortable, and the adjustment period seemed pretty easy - there’ve been no annoying audio side-effects that I’ve had to get used to. On the other hand, they don’t seem to be doing much. I’m now hearing the high frequency beeps and squeaks that I’d previously been missing, but they seem to be having a minimal effect on speech intelligibility.

Most of my interactions are in quiet home environments, which should be relatively easy for hearing aids to deal with. However, I’m still asking my (quite soft-spoken) wife to repeat herself just as often as I used to without the hearing aids, and I just had an appointment with a woman doctor in a quiet office whom I had a lot of difficulty understanding (she had a fairly heavy accent, but still…)

Also, FWIW I have a home hearing test CD that when used with a good pair of flat-response closed-back headphones normally generates an audiogram reasonably close to what I get from the audiologist (allowing for the higher noise floor in my apartment). When I run the test with my hearing aids on, my home audiogram shows the frequences below 1.5 Khz basically unchanged, as they should be since I’ve minimal hearing loss in this range, and shows the frequencies above 1.5 Khz corrected roughly 35-40% towards what would be a normal response. Rightly or wrongly, I was expecting a greater correction.

When I first got the aids, I was surprised how little changed my hearing was, and assumed that the Costco fitter had started me off with the volume set to less than my full RX (at the initial consultation, she had said she normally set the aids at a reduced volume and then raises them to the full RX at the follow-up visit). However, when I saw her again after wearing the aids for 2 weeks, she told me that when she fit the aids she had in fact set them to “90%” of the RX which is her normal target, and that most people found 100% to be too much.

I plan to go back for another visit, but I’m not sure what I should be asking for. I’ve attached results of the REM test the fitter did when she first fit the aids. I have no idea how to interpret the results; does it suggest anything that might be usefully adjusted?

Any advice appreciated!

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#2

You have a lot of minus gain and no more then 6dB in the gain that you do have.

Hearing Aids don’t amplify everyone to normal hearing. SN loss, you only get a 1/3 of the gain that is needed for your hearing loss.

I would definitely ask for 100% gain. You have the right to ask.

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#3

Over an 18 month period of time right before covid my audiologist and I pushed my hearing aids to the limit so I could hear and understand speech. That meant for me instead of the 85db receivers that my hearing loss indicated i should be using my audiologist fitted my aids with 105db receivers. This allows my aids to be adjusted much higher without feedback issues. It took 14 appointments, 2 changes in receivers and 3 changes in ear molds. And a progression in adjustments to allow me to adjust to the extra loudness of the sound. But in doing this my word recognition with aids is almost 100% now compared to less than 70% before that time. Yes it was definitely worth the time, effort and sometimes the painful sounds I endured. It was doing what wr did or giving into CI surgery, which i didn’t want to have if at all possible to get away from.
And yes my aids are so loud that my wife complains about hearing them if I am streaming anything to my aids. And my pets look at me strangely too when i am streaming audiobooks or music.

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#4

That’s interesting because, in my case, louder doesn’t mean clearer…

#5

It is a process of getting use to the sound, that is why it took my 18 months the get use to it. The gains were vey small and I would even lower the volume of the aids and I would slowly work the volume up until I maxed it out then my audiologist adjusted the aids up and the process started again.

#6

Just reading that result: the Costco REM (which I’m not 100% with) seems to suggest that when when using an ISTS stimulus, the output in lower pitches is ok, but seems to be underfitted above 2KHz - or where all your hearing loss is.

So they’ve slapped a sticking plaster over it, even the bit that needed stitches.

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#7

Yeah, ask her to actually match targets please.

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#8

It is common for audiologist to set new patients aids for comfort instead of to the patient’s audiogram requirements. I my case my aids were set 20% below my hearing loss needs. And yes at first that was still loud. The key is to increase the level as your brain adjusts to the sound.

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#9

Yes- audiologists tend to be very conservative, treating all patients as if they are at their first HA, only reluctantly and gradually increasing amplification. I suspect they “lose” many elder, first-time users. In my case, had to insist heavily to increase outputs, and in the end figured things out for my Phonaks myself with Target.

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#10

I have an awesome audiologist that listens to me, but it did take 18 months and 14 adjustments to reach that point wear I could understand speech the way I do now. I had to overcome a signal to noise sensitivity that I had. It isn’t an easy and comfortable process. But now some 4 years later and with the INTENT1 aids I am reaping the benefits. My word recognition with my aids is almost 100%. 6 years ago it was down to around 65%. I wasn’t benefiting from my aids when it came to speech understanding. And I couldn’t stand the sound of music. Now i am also enjoying music again for the first time since my early 20s. I will be 77 Thanksgiving this year.

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#11

@cvkemp increase volume like you are talking about , is this process your audiologist did, different that me just increasing the volume on my hearing aids? Is the Audi working increased sound and your hearing loss together to make them compatible? I have Ohonske Lumity 90s and still do not hear speech well. A server at a restaurant standing next to my table , asking questions and I still could not make out what he was saying. Lumity’s were Suppose’ to improve Speech, but for me - Not. My word recognition is low too, thus very interested in you experience.

#12

There is a lot of fine adjustments that go a long with it to insure that my aids don’t feedback. It also meant going from 85db receivers to 105db receivers. The main thing with that was overhead room to help prevent feetback. And along with that was other frequency adjustments. Yes there was a lot of volume adjustments but it is a lot more complicated that just that. It shouldn’t be tried without the professional experience of a doctor of audiology.

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#13

Thank you cvkemp. Appreciate th info. Will talk with my Audi. The issue is - she is 2 hrs away.

#14

I don’t think it takes a doctorate to self-fit your HAs. In my case I got a lot more out of my Phonaks with a PC, Target software and a Noahlink. The nice thing there is that you get to tweak your HAs with very quick turnarounds (testing your settings in situations that are relevant to you, then back to your PC).

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#15

Ask for a program in your aids for soft speakers like your wife. It does help.

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