Newbie, need advice after trialing Phonak Audéo M90 and Oticon Opn S

Hi community. I’m new to hearing aids, but my hearing loss is a little bit older. I have a sever hear loss in high frequencies, but I used to lived with it. I’ve already tried HA some years ago, but because of the horrible experience wearing them and having no remarkable win, I finished throwing them in the drawer.

After many years I decided to give it another try. I visit my audiologist and became a pair of Phonak Audeo M90. The same awfull feeling as for years ago, everything loud, the voices are sharp, synthetic, my own voice robotic. The audi said I need time to become used to it. After 2 weeks of torture wearing them a new adjustment. A little bit better, but the overall sound was still awful. The speech recognition was also considerably better. The next adjustement brought just a small improvement, in loud environment the ambient noise tend to overhelm the speech making it more inaccurate.

The next step was the Oticon opn s. Way comfortabler sound, but with open domes feedback problems. With closed domes considerably better, but occlusion effect. The high pitched signals which I didn’t even heard with the Phonak are way too loud. How is such a difference between 2 HA possible? With the Phonaks I didn’t even heard the parking sensor in my car, with the Oticons is this sound annoying loud. The speech recognition compared to Phonak rather worse.

I will try the Resound, Widex and Signia HA. But I’m a little bit dispointed. I had great expectation from HA, I thought this time will be better. I know that I don’t become new ears, the hearing aids are just aids. But with some voices, my speech recognition became worse. I can’t understand my friend clearly, before I used to have with him a conversation without hearing aids easily. It’s perhaps the fine tuning of the HA or it is acclimatisation or both that make me hard times.

Can you give me an advice. Perhaps has/had somebody the same problems and could help me. Can the speech recognition been improved, will it be later better?

Hi
I have a deja vue when i read your experience.
For me it have take about 1 year that i have got used to it.
However it is also very dependent from the skills your AUD have exactly the symptoms in hearing you describe can be norrmally corrected with the settings.
You need to make notice in all your hearing situations the good ones and the bad ones .
That you can present to the Audi who can than make a better picture of where the settings need to be adjusted.
Trying to many HA brands can make the choise even harder in the beginning because it is hard to compare them in this phase. However choose the one which you stomach tells you.
My self i ended up with Phonak but this is really personal preference.
Dont give up!

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I had about ten adjustments in the first three months. Slowly I got my Audi to tune them to the point that I felt j could hear everything and at the right volume.

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Welcome to the forum.
You have been given great advice by forum members.
The longer you wait to wear hearing aids the harder it will be to get used to them and longer time to get speech recognition back.
I waited too long to wear aids. It is taking a long time to get speech recognition back.
You are trying some top of the line hearing aids. All are good aids. The difference is the fitter doing the fitting. As mentioned, take good notes about the aids, good and bad. Include the environment you are in at the time.
Good luck.

Thanks guys for your answers. I know it takes time to get used to the aids. It’ just frustrated when you feel it’ s worse with the HA. Fitting is also important; how do I know they are right fitted and we got the best outh of them? You actually can’t. As a beginner.
I’ll keep wearing them hoping it will be better.

You have a very significant loss that certainly will affect speech recognition, and as a result you should benefit a lot from hearing aids. This loss presents at least a couple of issues. You need a high amount of gain at the high frequencies including the 3 kHz range which is susceptible to feedback. While you may get away with a double dome, power dome, or Signia closed sleeve, to get the best results you should have custom molds. The other hearing aid feature that you could benefit from is frequency compression. When you try them out, you should ask to have them turn on frequency compression. Here is what a gain curve with frequency compression looks like for your loss. This screen also shows the recommended vent sizes for custom molds. What the frequency compression does is take the high frequencies and squash them down to lower frequencies so you can hear better. The computer program with your loss shows taking the 5 kHz to 10 kHz range and squashing it down into the 5 kHz to 8 kHz range. That is just a computer default suggestion, and in actual fact frequencies may have to be squashed down to a much lower range. Perhaps others with frequency compression experience can comment.

My suggestion would be go back to the Phonak M90. Make sure you have a hearing aid fitter who is patient and willing to work with you. I suggest the Phonak largely because you said it helped with speech recognition, and because I think they do very well for people with profound high frequency loss.

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I second what Sierra suggested about trying out custom molds and frequency lowering. I think those are the 2 things that can help you a lot.

Since you’ve already moved on from the Phonak to the OPN S, I would suggest trying custom molds and frequency lowering on the OPN S. Both of these should also help with feedback a lot. I would select the lowest (left most) frequency destination configuration on the OPN S, which is the 2.4 configuration in Speech Rescue, which is the Oticon frequency lower. Also turn off the High Frequency Bands option in Speech Rescue to minimize the feedback issue, at least for the high frequency feedback. The OPN S has a new feedback prevention technology called OpenSound Optimizer that’s supposed to help detect and squash the onset of feedback. So maybe this feature is helpful to you.

Of course if you’re still not happy with these adjustments on the OPN S, you should move on to try other brands like Resound, Widex, Signia, or even go back to the Phonak again like MDB suggested. But since you’re on the OPN S right now, it’s worth trying to make the most adjustment out of it first.

i don’t know much about it overall…I trialed both of those same aids though.
My experience was that there was absolutely no feedback with OPN… and at first I did sense some of the similar issues you described with the M-90 marvels…but not nearly all that bad.
With some adjustments and a period of conditioning at lower settings I adapted quickly to the marvels and I really like them now.
Seems like it could be a tuning/setting/adjustment thing to me…

Thanks guys for your feedback.

Sierra:, Volusiano: I’m not sure if I understand those settings. As mentioned, I’m new to HA. Two things although (sorry if noob questions):

  1. Custom molds - my audi told me not to take power receiver yet, because of the amplification of low frequencies, where I dont’t need amplification. I understood the same is applicable for the power/double domes. What are the benefits to use custom molds (open or closed ones)?

  2. I’m not sure if I completely understand what frequency compression means, what I know is that I have the option “sound recover” enabled on my Phonaks.

I forgot to mention. I have the possibilit to try both hearing aids at the same time. I already became the Oticons, but I still have the Phonaks. Because of the frequent feedback by Oticon (with open domes), I seldom wear them. Maybe custom molds would solve the problem.

  1. I think you would do OK with a P receiver which does not require a custom mold, but it can use one. The advantage of a custom mold is that it fits your ear better, and does not leak around the mold (if it is well made). And, it allows the vent size to be adjusted to what you need. See the graphs I posted above. It that what the computer thinks is the right vent size. I really don’t think an open dome is suitable for your loss, due to feedback. See this graph below. The red and blue shaded areas (not the vertical bars on the right) are areas of potential feedback. If the hearing aid gain goes up into those areas you are most likely to suffer feedback. If you use open domes, the fitter would most likely have to reduce gain to avoid those areas. The colored graph lines are the desired gain lines, while the black line kind of illustrates the maximum gain possible without feedback. And, of course when gain is turned down you do not get the most benefit out of your aids. You may be able to get away with using double domes or power domes which seal better and have smaller vents. But the best would be to have custom molds made. Off the shelf double or power domes are the easiest to try. If you switch the fitter needs to do the REM adjustment over again though.

  1. Sound Recover is the Phonak term for frequency compression, so it sounds like you already have it.

Basically there are two approaches to allow you to hear sounds at the higher frequencies. You can also blend the two somewhat.

  1. Use custom domes with as little venting as you can tolerate. (Too little venting can result in occlusion resulting in your own voice and chewing sounds being very loud.) This allows more gain to be supplied to the higher frequencies without causing feedback.
  2. Use frequency lowering. Instead of trying to get more gain to the higher frequencies, the higher frequencies are shifted down to frequencies you can hear with less gain.
  3. Phonak’s frequency lowering system is called Sound Recover 2 and it is a form of frequency compression. It allows high frequency sounds to be shifted as low as 800 hz, which in your case might be helpful.
  4. Oticon’s is called Speech Rescue. I’m guessing Volusiano will tell you more about it.
  5. Frequency lowering is not just an on or off setting. It can be adjusted and if you’re going to use it, I think it will be important for your audiologist to work closely with you for you to get maximum benefit.
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It’s going to take a lot longer than two weeks!

I too waited many years before getting hearing aids. At first they sounded loud and high pitch and loud sounds were distorted. But week by week it got better. After several months they were crystal clear and everything sounded normal.

Wear them all day, every day, no matter what.

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Don and MDB have given you great information.

Nice explanation guys. Thanks again. So the main benefit of custom molds is the elimination of feedback because of the amplification of high frequencies. With the Phonaks I don’t have any feedback at all. And that with open fit. And I’m actually by 100% overall amplification. That can be raised to 110%. But we still have to improve my speech recognition, so I think we have to raise the amplification in high frequencies and after that chose the right domes.
One more question: will the speech intelligibility be better over time? Or you have the “maximum” right from the beginning?

It will get better with time and further adjustments.

I have Sound Recover adjusted very aggressively, starting at 800hz. I have some dead spots in the highs, so I want everything lower, and it does sound good, but something else to get used to.

I wish we had better news. It is not easy, or quick. But it can be very rewarding. I am very thankful for my hearing aids and would never give them up. They are truly life changing.

Hearing loss isolates you from people. There are situations and conversations that you just give up on.

Hearing aids give you that back. I like to be in the middle of things and for many years I just gradually withdrew more and more. I’m back!

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To add a little experience to this conversation my hearing loss was very similar to yours about 15 years ago. I used aids for a few years with good results back then but quit wearing them because of work and sweat. The aids don’t like moisture. A year or so ago my hearing got to where not much understanding was going on. I put aids back on and have learned my speech recognition has really plummeted! Now I am going through the process as Don mentioned to get that speech recognition back. The Phonak Sound Recover 2 is doing wonders for me and speech recognition is slowly coming back.
Good luck and wear your aids to keep your speech recognition numbers up.

Partly. Custom molds typically fit better so they reduce or eliminate any leakage of sound around the molds. They also allow a custom sized vent that is made just small enough to stop feedback. All RIC aids suffer from the same feedback issue. Sound leakage from the receiver that goes around the molds or through the vent can get back to the microphones in the hearing aid. That sets up a feedback loop. Due to the gain required at 3 kHz you have very high feedback potential. That makes me very suspicious that you could be really getting “100%” gain with open fittings. Feedback suppression can help, but it is always better to avoid it rather than just suppress it. Some fitting processes include a “critical gain” measurement step that determines where feedback is going to occur. That information can be stored by the computer and then when it applies the prescribed gain, they are limited to avoid the feedback. So it may look like you are getting 100% gain, but really you are not. And, there are different prescriptions which use more or less gain. A lower gain prescription will be easier to achieve. At the end of the day with the same hearing aids, a closed dome is going to allow for more gain than an open dome. And a custom dome is going to allow for even more. Also note that closed domes are most often not really closed and actually have a small vent or two in them.

I don’t really buy what the fitter said about closed domes not being suitable for you because you have good low frequency hearing. Closed domes do increase the amplified sound at low frequencies, but at the same time they reduce the natural sound levels (act like an ear plug). Receiver gain adjustment should keep the desired low frequency sound levels in the proper range.

And, yes getting the right domes to allow the optimum gains for your loss should improve speech recognition.

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Very helpful and well explain feedbacks. Thanks again. Although I tend to avoid closed domes because occlusion, I will tried them. There’s nothing you can’t used to it.