Rexton Bicores -> Oticon Intent 1

Hearing Aids
#1

I started my much-anticipated journey of trialing the new Oticon Intent 1 hearing aids this week, and have a few impressions so far. If anyone is interested, I’ll continue to document impressions as they come up! I’ll start by admitting that I went into this trial with a huge bias from other user’s posts, where it seemed the general consensus is that these Intents are much better for speech in noise. That is the main reason I wanted to trial them, as I have a terrible time understanding conversation in noisy places. (as I suspect many of us do). So I probably went into this with higher hopes than I should have.

My fitting appointment was fairly brief, just under an hour. My audiologist did a Real Ear measurement and set them up as recommended by the software suggested settings. I have custom molds on both sides, with a power receiver and power earmold on one ear (my worse ear), and a medium receiver/mold on the other. I may not be saying that right. She did no other adjustments and did not enable frequency lowering, as she said that the REM shows that I’m hitting all the targets with the suggested settings. Frequency lowering IS enabled on my Rextons, and it made a big difference for me. She was also very reluctant to add any additional programs, as she said these hearing aids would adjust automatically and I would not need any more programs. But she said she would add some in the one-week follow-up appointment, if I really wanted them.

Honestly, I was a little disappointed by her reluctance to make any changes or add programs, as I’ve had a great relationship with her so far, and she’s always been super helpful. But I agreed to wear these for one week with the software suggested settings, then make tweaks and changes if I need them in my follow-up appointment.

Straight out of her office, my first impression was not that of awe-inspired wonderment. They do sound a little different from my Rextons, that is true, but not SO different that I really noticed after the first 10 minutes. The biggest difference was, that I heard a bit of a crackly/staticky noise whenever she said any word with “sh” in it. She said this was because I was hearing frequencies I have never heard before, and I should get used to it, but if I didn’t, she could make an adjustment.

So I went straight to the grocery store to see how I would fare. At one point, I could hear a lady talking on her phone in another aisle as if she were standing right beside me. Her voice was crystal clear and I marveled that I could hear every word. However, my victory was short-lived because I could barely hear a word that the soft-spoken older lady at the cash register said. I probably understood 30% of what she said, and sometimes could not even hear her voice at all, just see her lips moving. So that was a disappointment. I wondered if my hearing aids need to be turned up, but then felt that would make everything too loud.

A few hours later, I took my cat to the vet’s office and when she came into the tiny room to give me an update, her voice was so loud, sharp, harsh and shrill that I was almost in a panic. It was so bad that it was nearly staticky - like a shrill screech over a staticky radio - and I couldn’t make out what she was saying for the first 30 seconds or so. Another disappointment. I knew then that turning my hearing aids up would not solve the problem.

The next day, I decided to trial them in a noisy restaurant. I was particularly excited for this, as that is one of my biggest challenges and I’ve found that I no longer go out to eat because of it. Unfortunately, I could hear the soft-spoken waitress about as well as I could hear that cashier at the grocery store. One time, I literally didn’t even know that she had spoken to me, and had to be prompted by my fiancé to answer her. I also had trouble understanding my fiancé at times, who was right next to me. This is not typical, as his voice is fairly loud and well enunciated. Yet another disappointment.

As they are right now, as top-of-the-line technology, they are NOT an improvement over my $1,600 Costco Rextons. So, I’m not sure what to think. But I realize that’s not really fair to say, as I know it’s still only my very first week and there are still so many tweaks my audiologist could make! So I am making notes to ask her about in the follow-up appointment next week:

  1. What is the NNS (Neural Noise Suppression) set to? (max is 12)
  2. Can we add a Speech-in-Noise program with max NNS?
  3. What fitting algorithm do I have?
  4. What can be changed to enable me to hear soft women’s voices better?

If you know of anything else I could ask her, please let me know!

Thanks for listening, and I always appreciate any feedback (<-- see what I did there!) :smiley:

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#2

Thanks for sharing.

You have a difficult hearing loss to fit imo.

Static and crackling can be a sign of dead frequencies or it could be that you are hearing sounds you haven’t heard in a long time. You may need some time to acclimate.

Thanks again

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#3

Also your aids may need more adjustments for your loss, the crackling could be that your aids are engaging the feedback circuit due to the sh sounds being loud enough to trip the feedback circuit

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#4

Just don’t give up and keep continuing. I have teste Signia, Resound, Phonak, Starkey and Oticon and I can say that Starkey Genesis is one of the best on speech in noice, because they are also lower the noice much more than Oticon Intent, but Oticon Intent is also very good in this Situation.

The Situation that you are explaining I had with the Oticon Real but not with the Intent, of course there are some speechsound that will keep up better than others but this would also be for normal hearing person

Back to your questions

  1. NNS how you would like it, I started with 10 but am now with 12, maybe I will test the lower one to see any difference
  2. Yes you cann do up to 4 programms, I can say that normally the Standardprogramm will be good enough and you don’t really need other ones, but I use now all possible programms, 1. normal and the 4. is the telecoil, 2. I use with different NNS and 3. with more directional microphones
  3. I can’t help
  4. Oticon has 3 options (detailed, balanced and confortable) you would probably need the first one (normal its balanced) there are for sure some more options
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#5

Thank you for the report. I am very interested in hearing your impressions as you get more experience with them and as adjustments are made.
Ray

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#6

Thank you for your comments! Interesting that Starkey Genesis is one of the best for speech in noise, I haven’t even heard of this one!

I will note the detailed/balanced/comfortable options to my audiologist and see what I’m currently on, and what might be better. And I definitely plan to add more programs! I have 4 programs with my Rexton’s, and even though I don’t use them often, it’s still nice to have the ability when I’m struggling.

#7

I’ve heard quite often that I have a difficult loss to fit! A few audiologists have done a double take when looking at my audiogram :laughing:

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#8

@Misterref78 Oh yes, I meant to ask you… do you find that having your NNS turned up to 12 diminishes your speech comprehension at all?

I’ve read a few posts on here that mention that, so it’s a concern of mine. Thanks!

#9

Regarding frequency lowering, it may be OK if your audi doesn’t want to add it to the main P1 program, but there’s nothing wrong with making a copy of the P1 program into another of the other 3 available programs then add the Speech Rescue frequency lowering feature to that program so that you can do A/B comparison between the 2 programs in real time. That’s the best way to determine if whether you still want the feature like you had in the Rextons or not. Another thing to point out is that your hearing loss has a spike up between 1 to 2 KHz on both ears, then a very steep precipitous drop right after that down into the severe loss range. This means that you should be able to take advantage of the lowest Speech Rescue configuration where the destination range is in the 1.5 to 2.4 KHz range (see screenshot below). Now that you have respected her wish of trying it out “as is” for 1 week without satisfactory results, on your next visit, you should insist on having a second program that is a copy of the P1 program with Speech Rescue added on it. This might alleviate the crackling that you hear that might have been due to excessive amplification in the high frequency region where your hearing loss is in the severe to profound range.

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Regarding your issue with hearing soft spoken people, there is a feature in Genie 2 (only available for the VAC+ fitting rationale) called the Soft Sound Perception (see screenshot below) where your audi can go in and set it to Detail to help. She can also go into the Fine Tuning section and increase the Soft level at the bottom row up another dB or two or three to help you be able to hear softer sounds better (see second screenshot below fot that).

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As for your questions, I’ll answer them below:

  1. If the default NNS value is lower than the max and you are not happy with being able to hear speech in noisy places as clearly as you want to hear, then you definitely can ask your audi to set it up to a notch or two above the default to see if it helps. You can also ask your audi to set it to the max right away, but just be aware the it might be better to try it incrementally one notch at a time because as you go up in the NNS values, the quality of the speech might get lowered a little bit. But nevertheless, it’s still better to be able to understand the speech rather than have a higher quality sounding speech that you can’t understand anyway. So it’s a trade-off that you need to experiment and decide for yourself. And that is why Genie 2 might have suggested a default max value that is lower than the highest available max value.

  2. You can either up the highest available max NNS in the default value, or you can add a Speech in Noise program and only have the highest available max NNS in the SIN program. If you chose the earlier option, then it’s not necessary to have a SIN program, of course. But if you add SIN in as a separate program, you definitely should apply the highest available max NNS to it and leave the main program with the default (if lower) max NNS. You might even want to set it to Full Directional as well if you feel that the highest available max NNS still doesn’t suffice. Then you reserve using the SIN program only for the most difficult situations. For less difficult situations, you might be able to get by with just the main program most of the times.

The important thing to remember here is that if your audi left the NNS at default value (as set by Genie 2) and you’re not happy with the result for speech in noisy places, definitely make sure your audi increase the NNS value to the next notch or more, up to the highest available max value, until you’re satisfied with it. Either that or have her install the SIN program and put the highest possible max NNS value there that gives you satisfactory result.

  1. Unless your audi went out of the way to change the fitting rationale for you, most likely, all your programs are VAC+ based. You can dedicate a program or two to other standard fitting rationales to try them out to see if you might like them more than VAC+ or not, but remember that you will lose the ability to set Soft Sound Perception outside of VAC+.

  2. I already addressed that above after the frequency lowering discussion.

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#10

my intention was not to have a better speech comprehension but to have a less background noise and I like +12 more than +10

#11

I know this is not addressed at me, and rightly so because I don’t have first hand experience with the question like @Misterref78 does, but I’d like to clarify between speech comprehension (or understanding) and speech quality.

The reason Genie 2 does not always go to the highest available value of the max NNS for a particular tier of aids is because there’s a trade-off between speech quality versus speech comprehension. If certain max NNS value (lower than the highest available value) can do the trick to give you speech understanding/comprehension, then upping the max NNS value above this point doesn’t help further, but yet might degrade the speech sound quality.

But the priority is always speech understanding over speech sound quality. There’s no use to have better speech quality if you don’t understand what is being said in the first place. So as long as you find yourself not understanding the speech at the lower max NNS set, then you should not be afraid to up the max NNS up a notch to see if it helps. If it helps, then stop there. But if it doesn’t help, then up it to another notch, and keep doing so until you hit the highest available max NNS value for your tier level.

I myself am also interested in hearing @Misterref78 's answer about whether there’s a perceived degradation of speech quality when the max NNS is set at 12 dB or not.

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#12

If you’re the type of person who prefers to not hear any background noises at all, then perhaps Oticon aids are the wrong type of aids for you because they’re prescribed to the open paradigm, where the focus is to allow users to hear most background sounds (which you might consider noise) at a lower volume so that they can understand speech better.

Sure, you can also set the Directionality Settings on the Oticon aids to Full Directional to force it to use frontal beam forming to more aggressively block out surrounding noise. Or you can also use a one-time MoreSound Booster activation on the Oticon phone app that does the same thing until the next session in the phone app (because it gets reset to OFF) after the phone app is off.

But overall, Oticon might not do the frontal beamforming as aggressively as other brands’ aids do in the first place, simply because they support the open paradigm. So if that’s what you truly want, to block out noise rather than to get better speech understanding amongst the noise, then I think you might be better off with the Phonak Lumity or the Resound Nexia or other brands like Widex, etc.

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#13

I tried every possible aids except Widex. Yes Oticon is not the aids for eliminate the background noise, but I like the sound of Oticon, Nexia has nearly the same sound but there were situation in the restaurant were I could hear people speaking that weren’t in the same room, also I didn’t liked the jump in of some conversations of the neighbours.

Genesis ist for me the best aids in this situation, it’s really relaxing listening with them, but I don’t like the sound, especially when I am streaming and there is no more the automatic programm listening.

The Intent is nearly at the same level, the difficulty is that everything is overhelming you and it could be very exhausting when you are 3h in a loud restaurant, that’s why I wanted to have a maximum reducing of the background in noisy situation.

As I have children I need this open paradigm otherwise there are situation where I don’t hear them or my wife calling for lunch (happened with the Starkey Genesis)

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#14

@Volusiano Sorry so late to reply, this is my first time back to this thread after a busy weekend. I thank you SO much for your detailed reply! In truth, I was hoping that you would respond, as I’ve seen your helpful replies to other posters with the Oticon Intents! I also truly appreciate your screenshots, this is incredibly helpful, and now it has me wondering if I want to attempt DIY :laughing:

I am taking all of your notes to my audiologist next week, and am particularly interested in having her add an extra program for the SIN with the NNS feature at max 12db. Perhaps also a copy of P1 (after any tweaks we make to it) with added Speech Rescue frequency lowering and NNS feature at 12db, so that I can compare all.

I will also see what she’s got my P1 NNS value at currently (I suspect it’s not turned up very high as background noise has been a bit overwhelming), and also have her turn it up a few notches. I might not have her add the frequency lowering to P1, as I want to be able to compare.

If I understand correctly, I can also have her add an extra program with a different fitting algorithm? (ie, the NAL NL2) If so, is there an algorithm that you would suggest to try?

Again, THANK YOU for your wonderful advice! :smiley:

#15

Yes, the available standard fitting rationales on Oticon aids are NAL-NL1, NAL-NL2, DSL V5 Adult, and DSL V5 Pediatric. You can add them in the remaining 3 program (or even the main program if you wish) so that you can do A/B/C/D comparison to find out which one you like the best. They tend to be sharper than the Oticon VAC+ formula. I personally like the DSL V5 and I use it for noisy situations because the extra sharpness from it helps me with speech clarity in noise.

Of course the DSL V5 Pediatric wouldn’t apply to adults, but I would try at least the DSL V5 Adult and the NAL-NL2. Both of them were designed for speech in noise so they’re fairly sharp. I find the DSL one a little sharper than the NL2, so depending on your taste for the sharpness, you might prefer one over the other.

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#16

@Volusiano Thanks the the clarification on this, I will ask her to add one of these programs (if not both) for comparison! I’ll admit that I’m not a fan of super sharp sounds, as a cupboard door banging shut behind me will nearly cause me to jump out of my skin, but I AM a fan of speech comprehension, so I’m definitely willing to try them out.

#17

The Real and the Intent both have a feature called Sudden Sound Stabilizer. Make sure you ask you audi to enable it, and set it to an appropriately high value that you prefer. This should help a lot with sudden loud sounds causing you to jump out of your skin.

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#18

I think that folks with normal hearing, who don’t use HAs, are also exhausted after being three hours in a noisy restaurant. The problem isn’t with the aids, it’s with the environment. Or at least this last has to be entered into the equation. Everyone has difficulty understanding speech in a noisy environment. Yes, for us with hearing loss, that can be even more challenging.

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#19

Yes of course, but if I have the chance to hear “better” and “easier” than a normal hearing person, why don’t take it. :wink:

When my children are screaming my wife get stressed, but for me it’s still relaxing because the hearing aids makes this situation comfortable for me.

#20

Yeah but now we’re looking for HAs to provide a narcotic to our chaotic lives. I don’t want a curated hearing environment, with all the disagreeable sounds that normal folks hear filtered out.

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