@habasescu.nicu
How did you make out?
Did you buy hearing aids?
How are they working for you?
DaveL
My own experience…
It’s the setup that matters the most.
It takes time. But I’m impatient, and that doesn’t help.
The hard part is finding an audiologist that is skilled and experienced.
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OK since the OP is More vs Paradise I’ll repeat my post from another thread here. FWIW
Here is my initial impression of the Phonak P90-R/T subsequent to my trial with the Oticon More 1. I got them yesterday (12/16) at 10AM so we’re only talking about a 10 hour wear time. They were set a 100% of the target as were the Oticon.
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Music is clearly superior with the Phonak. Not quite as nice as the Evoke but still pretty good.
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I was at a meeting in a home with a lively discussion that followed—men in one room and women in another with a large opening between the two immediately to my right. There were four men, and I was seated facing the three others. One was directly across from me with one on either side of that person facing inwardly, so I was looking at the sides of those two faces. They were approximately 6 or 7 feet away. There was plenty of noise from the girls, lots of elevated volume with loud talking and laughing hitting me from the right side. Not restaurant or party loud but enough that I struggled even when the person directly across and facing me was talking. I played with app and adjusted every setting available and did improve things somewhat, but I was never close to comfortable and missed most of the conversation from that position. I had to change seats. I was in that same situation a couple of times with the Oticon and had a much, MUCH easier time with things missing only a few words here and there. Usually because of a poorly accented fricative or trail off at the end of a sentence. Nothing that kept me from understanding things. With the Phonak most of the noise coming from the other room was just that—noise. But with the Oticon, if I paid attention ,I could actually pick up some of the conversation. Quite impressive.
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In regular situations the difference between the open paradigm and the traditional is also apparent. The Phonak are most definitely quieter. There is less going on around me. In spite of it speech is not quite as crisp and distinct as with the Oticon.
Again this was only 10 hours on initial settings with no adjustments so things could improve but they have quite a ways to go to equal the More 1. I have an appointment this coming Wednesday and I’ll see what magic the audiologist can work. But if he can’t get the Paradise close to the More 1, I see no reason to keep it and add a $2K Roger On to cover complex situations that comprise less than 10% of life.
One quick update. The Phonak app is sophisticated enough that I can, in the quiet of my home, make it sound, at least make speech sound, just like the Oticon. Kudos to @Neville because I believe that is all he was saying. But that all changes out in the noisy world (which I believe Neville also granted) and save for some improvement from brightening up the sound of the Paradise everything I wrote above remains true.
100% of what target? Were they verified against NL2 at different levels, or set to 100% manufacturer fit in the software?
Software recommendations. Output REM confirmed.
A question arises about whether this is the source of the recommendation is from the software of the company that makes the HA or if it is a standard like NAL-NL2. Companies often give “softer” or weaker prescriptions for initial fitting than the NAL-NL2 prescription. If you try two brands, and the HCP used the companies’ targeting philosophies in setting them up, this leaves you apples and oranges comparisons.
That is part of Neville’s question. REM only shows if your fitting is against what was intended. It could be to the brand’s prescription, the NAL-NL2, or adjustments that have been made as you go along for your situations. REM shows how well it matches the fitting, but it doesn’t assure you the “standard” fitting was prescribed.
I may be all wet here, but that’s how I read the situation.
WH
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So, ADP vs VAC+? Or NL2 vs NL2?
It is the company software but it’s all irrelevant to me as it’s just a starting point. I know what I want to hear and I’ll have them adjusted to get to my preferences as close as is possible before I’m done. I know what REM does.
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With the Oticon it was the Oticon software. I assumed the Phonak was theirs.
Hm, I don’t know then. Phonak’s “NL2” compression is higher than Oticon’s “NL2” and could account for the people in the next room being louder, but off the top of my head I don’t know if that’s true of ADP/VAC. They were likely both verified against NL2 targets, but compression may not have been adjusted.
I don’t think I’d say the people in the next room were louder. Same people each time. It’s that speech with the Phonak was considerably less distinct. It just blended in with the noise from the other room while the Oticon pulled it out. It was a big difference. Again I did brighten up the sound on the Oticon with the first adjustment which made quite a difference and I’ll have that done to the Phonak this coming Wednesday. It’s early yet.
Your source for this, as I’m not so sure it’s “weaker” or “softer” as such,or do mean they usually use the adaption management settings as well in the initial fitting.
REM is a no go for the manufacturers rationale/formula tho.
Not sure what you mean. This video pretty clearly shows being able to do REM against any number of fitting rationales.
WH
I don’t profess to know much about how REM is done in terms of using a mfg’s proprietary fitting rationale as a target for REM adjustment. But I notice that for like the Oticon Genie 2 software, it has a feature called REM autofit built-in and if you use compatible REM hardware that works with it (I think the Verifit from Audioscan is a compatible one), you can use it together with Genie 2 and the Genie 2’s REM Autofit feature is supposed to use the Oticon VAC+ as the target to match the REM adjustment to.
Of course if the HCP can also use an external non-Genie 2 compatible REM hardware if he/she wants, then in that case, the HCP will probably not have access to and be able to use the proprietary Oticon VAC+ as the targeted prescription and must use a non-proprietary standard fitting rationale like NAL-NL2 instead.
I’m guessing per the video that the TargetMatch software works like the Oticon Genie 2 REM Autofit and that’s why the Phonak proprietary fitting rationale can be selected like the other rationales simply because TargetMatch is compatible with the Phonak Target programming software.
But if REM isn’t done with TargetMatch and Target, but is done with an external non-Phonak-compatible setup, then maybe the Phonak rationale won’t be available in the selection.
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Yeah that’s interesting, because this hasn’t been able to be done, so it’s a recent development?
Same with Phonak target software?
Yes exactly, this is how it was in times past. Strange nothing’s been mentioned about it?
So to the Pro’s on the forum, who are willing to confirm exactly what can be achieved with the manufacturers proprietary algorithm/rationale when doing a REM fitting.
Correct me if I’m wrong but I thought REM simply measured and verified the output gain designated by whatever software was used.
Manufacturer settings, being proprietary or NL2 or whatever, are often providing less gain/audibility than would be expected or optimal.
Yes, it just measures what the hearing aid is doing and compares it against prescriptive targets at different frequencies and levels. Then, if it’s not hitting targets (as it is frequently not), you can make adjustments to correct this. If, for whatever reason, you are ignoring prescriptive targets, it also tells you whether a particular sound is audible at all relative to the hearing loss. Tenkan is right that we cannot compare against manfucaturer targets because they are proprietary, but if you’re assuming they are hitting whatever target they are supposed to be hitting, “inaudible” still isn’t necessarily great.
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I’ve never left an aid where it was set though it did take a long time to sort things out with my first set the Oticon Alta2 Pro. I had no idea what I was in for when I walked out of the clinic the first time. It was a total inundation of things I hadn’t heard in a long time. I also had only a marginal idea what they could and couldn’t do. But after 6 years I’ve got a good idea of what I want to hear. That’s why I said that the first fit on new aids is just a starting point. When I got the Evoke 440s three years ago I did my best to drive my audiologist crazy. But she had the patience of Job. Unfortunately she’s now 160 miles away and I have to break in a new one.
Anyway whatever standard is used to fit them, the chance of them staying there is zero. One thing has been consistent though. For Speech in noisy complex environments they’ve all been found wanting. If I can get the Phonak to come close to the More 1 in the situations I encounter on a regular daily basis, I’ll get the Paradise just for the Roger as you suggested.
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Yeah, I can’t predict whether you’ll end up liking the paradise or the mores better. I expect that the Roger would do better in noise for you than the paradise or the mores alone, but it may be that on their own the more will do better than the paradise. I haven’t had enough chance at setting up head-to-head comparisons with patients to have a strong opinion on that.
You can connect a Roger On to a More through the Edumic. It’s expensive and unwieldy and won’t have quite the same functionality, but it’s possible.
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Time will tell. I have an appointment a 2:00 PM for my first adjustment.