Phonak Audeo P90-R Programming

Hi, I have recently purchased a pair of Phonak Audeo P90-R. I have had 4 sessions trying to get setup right but my audiologists is struggling to give me same performance as my old Siemens aids. Looking to try self config. I believe I need Windows PC, Latest Phonak Target software and a Noahlink wireless connector.

Anything else?

I would love to hear from other folk on programming same.

Thanks in advance.

Make sure you get the REM done to check that the HA are matching/reaching your Hearing Loss Target… In what way that the P90 not matching the Siemens HA.

Thank you for getting back to me. I am so glad I found this forum as I have to say I have been getting very frustrated after reading such good things about these new HA but having such a bad experience.

So my audiologist has not done an REM. What is that? He just did the test from within HA.

So the main differences:

  1. When the new HA were turned on there was lots of white noise that was there all the time. He has cured that for the most part in the Autosense prog but others still have it. Even in Auto I can still hear it at the edges so it means its not as comfortable when just sitting in the quiet.
  2. any sharp sound is VERY sharp so any clatter from the kitchen feels painful. Even seems an echo.
  3. I can’t hear my wife (some might say a feature!) - or for that matter any voice in the house very well. it sounds like its coming from a tinny little speaker.
  4. The other programs still have white noise and so any time I use my phone on Facebook or whatever my HA switch to the link to my phone and Woooooshhhh!

So I have tried wearing the new HA for the past 48hrs to see if I adjust. But its just causing me stress. I have now gone back to my old HA and I can feel my stress levels from noise drop dramatically.

Now I am not saying my old HA are perfect - I was hoping through reading reviews that the new HAs would give me a better hearing experience with voices plus all the extra tech of connecting to phone, TV etc.

Rgds Nick

REM = Real Ear Measurement where a machine which measures sound has a fine tube inserted close to your ear drum and your HA placed back into your ears. Sounds are made speech, etc thru your HA where it is measured at the ear drum and compared to hearing loss target. Adjustments will then be made to HA to compensate where it hasn’t reached the required target level. If your HA are giving you grief then they must not be set correctly.

You are right with the equipment you need: PC, Target Software, Noahlink wireless adapter.
But I would say, before you try to adjust the HA by yourself, your audiologist should improve the settings.
I am owning the Phonac Audeo P90-312 and for the audiologists (I had 2) it was nearly no problem to adjust the HA to my needs.
I am now improving the settings by myself and it is not so difficult, but I am far away to be a specialist.
I am wondering about your white noise problem. My HA have also after switching on a little white noise, but this vanishes in a very short time (1-2 seconds).
There are special settings in Target to improve voice understanding, but I didn’t need to use them.

I’d look for better fitter who knows what they’re doing.

Yes, REM based fitting is gold standard which yields good results fast. What else is, check here under resources: https://drcliffaud.com/

However, workaround could be - do WRS test (word recognition score), fit the aids, repeat the test on speakers with 65db output and aids, tweak the aids until they give you at least the same result as WRS showed you could get.

If they’re not doing even that, just leave, return the aids, get the money back.

It’s not our job to learn fitting aids AND pay high prices.
If you want DIY, go buy them on ebay and save few hundred if not thousand.
If you pay fitter, they HAVE to deliver value for that money.

Get angry if needed for getting the money back :wink:

Thank you so much for the response. I will push for REM.

Rem in hands of person who doesn’t understand it is useless.

I wouldn’t push for them doing the proper job, I’d push for money back and finding a fitter who knows what they’re doing. It’s not our job to teach them their job. We have the money, we choose.

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So this was the response from my Audiologist.

Yes REM measures the sound pressure level in the ear when wearing a hearing aid. What we have done is AudiogramDirect. In-situ audiometry, such as Phonak AudiogramDirect, allows clinicians to measure hearing thresholds directly through a client’s hearing aids. It also takes into account of the unique patients clear canal during the measurement.

I think the challenge I have is that Singapore being a small island means I have a limited choice of practitioners. And this guy is “well” recommended. I have been with him through 4 generations of aids. But we are just not getting these ones right.

The whole idea of REM is to get rid of the response of the cllient and replace it with a microphone tube.

Not only does it effectively take into account the characteristics of the ear canal and the actual output generated by the receivers, but it also allows for more detailed information, than can be generated by the do-you-hear-this-beep approach. Apparently, the brain gets wonky very fast and the largest part of the ±5dB uncertainty in the audiogram is the client.

So you’ve effectively been ignored. Probably because the audiologist doesn’t have REM equipment.

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Sounds like it’s time for DIY, you’ll do much better yourself, it’s pretty easy to do and plenty of people from right here on hearingtracker to help, very easy to get the software and hardware needed (as you’ve already asked, you know what to get,it’s pretty cheap on eBay, plus you’ll save a lot of frustration) Don’t worry to much about REM for now, it’s not unfortunately the holy grail for a lot of people.

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REM based live speech mapping used for fitting has nothing similar. Because this method sends speech through the speaker in front of you, and measuring tube checks what came near your eardrum (4mm away) afer your HAs processed the sound.

First step of that process is indeed white noise sound made for pure calibration of instruments and your canal.

In situ audiogram is just that, audiogram. Beeps.
Yes, it does implicitly take into the account your ear canal, but how well you hear beeps unfortunately isn’t the same as how well HA process speech and if thing that comes to your drum is even comprehensible for the machine, let alone your brain.

Yes, your fitter has no clue what’s the purpose of it. And is seller.

You can be without equipment and still know what you’re talking about or what the equipment is really used for.

Also, WRS measuring doesn’t ask for REM equipment, just a speaker and sw with prerecorded words. And if fitted aids on 65db sound from speaker cannot deliver wrs that was measured with headphones (to see what db you need to get the best score, so, amount of amplification), then they’re not fitted properly.

Word lists are especially made to cover all types of vocals and hearing issues, so from listening 20 words, and repeating them back, it’s easy to both asses the progress and see where aids need tweaking eg which sounds you don’t hear but you should since you heard them during initial wrs with headphones and those words on blastingly loud.

Rem based live speech mapping makes process easier and faster for them. Gives good baseline and comprehension for you in just a few minutes of doing it.
So basically, it’s beneficial for fitter since it saves time enormously. One fitting session of 10-15 minutes and you immediately have the best speech comprehension in quiet.

However, it isn’t necessary. Unfortunately, people who don’t do that, also don’t do anything else. So ‘do you do REM’ is simple question to filter out good fiter.

However wrs with headphones to see how much help you actually can get from ampflication and then tweaking aids until you can get at least the same wrs using them on normal loud sounds (65db), is a bare minimum!!

In situ audiogram has nothing to do with how well you understand speech with aids.

Aids are just amplifiers. So if your initial wrs test showed that you need 100db input and you understand 80% of words, then well fitted aids should give you 80% of the same words on all sounds.

So, if I speak to you on 65db, aids should boost that to give 100db your ear need.

But if you heard wood correctly but not house during initial wrs, and with aids you don’t hear any, aids aren’t fitted properly, no matter the fitting process (rem is that, fitting process). However, no aid in the world will give you back house if your cochlea is that damaged and just cannot hear those sounds.

In other words, if your initial wrs is 90 or more, that means that aids can help you to understand almost everything.

If wrs is 50, aids won’t bring you up to 90, however, without them, you cannot hear even that 50, so they’re still useful to deliver that 50.

You only care about end results after all.

How can they know if you hear well if they don’t test and verify what they’re done?
‘how do you hear me now’ aren’t words from word list that addresses tricky sounds

Tell them you won’t need their services obviously, so, ask for unbundled price, just aid, without endless hours of pathetic work based on ‘how do you hear me now’. You can do better yourself, if nothing then from the sheer fact that you can directly test and tweak in your environment eg home, and not perfectly quiet office.
And from the fact that phonak programming software has a wizard which helps with fitting.

Like ‘problem with own voice’, then you click, and it adjust gains. Or ‘problem with female voices’. Or ‘problem with s, sh sound’ or many others.

You don’t need to be an expert to read that and click around.
It’s literally made in ‘for dummies’ approach.

Good fitter doesn’t use that since they now how sound behaves and they directly adjust gains when you tell them and describe your issue.
But sw is so good that you can pick an issue and it will do gain adjustment per frequency for you.

And I think we all are ‘smart’ enough to not click ‘problem with own voice’ if we have problems with sh sound.

And you can record your list, and put it on repeat and check which words you hear completely and which don’t.

It’s not even about perfect recording or calibration, it’s about being able to repeat the process in the same conditions and being able to compare before and after tweak.

And yes, sw has ‘undo’ and even direct comparison between two points in time/sessions.

It’s just that ‘how do you hear me now’ aren’t useful words for testing. Especially since you probably look at person.

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So I have been silent for a while while I have been getting the bits and pieces together and doing more research. I now have the Noahlink wireless connected to my MacBook Pro running Windows on Parallels Desktop. All now working.

My Audiologist did come to my house with a Phonak Audiologist bringing their equipment and did some changes. The major difference being changing the fitting Formula to NAL-NL 2 and the improvement was very significant. That being said I still want to try some minor tweaks.

Although I have done a bunch or reading and going through the manual and videos I just want to check with folks on some simple basics. I have connected my Aids to the Target 7.1 software and saved the session to my notebook without making any changes. If I screw up when playing around - what is the easiest way to “reload” the saved settings as they are now. Simply put if I make changes how best to undo to what I have right now?

Hi @nick.evered
Reload an old setting is easy to do:
Before you start your session, select in Target the original customer/session you want to reload.
Select “connect”. After the connection is established, Target compares selected session’s data and the hearing aid data. If they are different, Target will ask you whether to use the sessions data or the hearing aids settings.
Select this time the sessions data.
Then leave the session.
You will be asked, where the data shall be saved: hearing aids and / or to the session. Select only the hearing aids, so your (prevously) saved session will be untouched.

To play around, choose another session to start your own setting. Best is to define even a new customer name for your own sessions. To keep your originals save. For example name it “nick selffitting”.
This time you can save in both, the hearing aids and the session data.

And with on the fly testing: Each step can be undone with ctrl-z.

Yeah and one more thing:

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