@Zebras
I guess those checkboxes are only there to confirm the Additional programmes, are there, and linked??
Peter
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Just lower. Phonak users compression rather than transposition etc. so maybe think of taking all the frequencies above a certain point and squishing then together. It depends on the settings. You can adjust the degree of frequency lowering, but also the static (lowered at all times) and adaptive (lowered ms by ms depending on frequency content) compression and that also effects the degree of lowering. And them there are also some limits built in to try to keep it from being outrageously distorted.
Ideally the method of setting frequency lowering is to verify with real ear that you have selected the least aggressive settings possibly that also maintain /s/ audibility.
I was reading through a paper the other day on how long it took over pediatric/adolescent patients to adapt to frequency lowering. I canāt remember the exact average time, maybe about 8-12 weeks, but what I find interesting is that while some reported adjusting gradually, others reported a sudden change from it sounding strange to sounding natural. This is a bit of a tangent I suppose, but the brain is neat.
We should differentiate the difference between turning automatic subprograms into manual programs and removing automatic subprograms from the automatic program while still having it adjust. You can only do the latter with the speech in loud noise auto subprogram thatās at the 90 levelāphonak added that option because some patients were finding it to aggressive and noticeable in a way that bothered them.
If you want to āremoveā some of that automatic subprograms but maintain SOME automatic switching, you can also in a lot of cases just match the gain and feature settings of the program you donāt like to the program you do. Iām always a bit baffled by people saying that they hate the auto program and canāt handle itāfor people who are sensitive to the switching there are a lot of different ways to make it more gentle. Iād think it might be better to pursue that prior to just abandoning the automatic functions altogether.
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Iāve been experimenting with Speech in noise, to try and stop some of the noise reduction, as it actually reduces the clarity of the person in front of me.
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I agree with this and so I have NoiseBlock turned off a long with all the other features.
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If you cannot remove the other sub-programs, Iām then puzzled as to why some of the other sub-programs appear unchecked in the screenshots.
My guess would be that it is switching in situations the user didnāt intend for it to, even if it switches properly in other situations and the sub-program parameters such as gain, etc, are to the userās liking for intended situations.
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Yes, as @Raudrive mentioned, you likely qualify for CI on both ears. However, if you donāt have high expectations and you can manage with hearing in quieter environments, thereās no obligation to do anything. Many CI recipients simply wish theyād got it earlier.
I donāt trust such statistics, they can be misleading to someone who doesnāt fully understand how they work. If CI were ineffective in older people, no health system would recommend it to them.
I have no success with CI for several years, because of relying on better HA ear. Thanks to @Raudrive advices I train my CI ear e.g. by streaming only to it, bypassing the HA ear. It simply have worked.
However, sentences such as āten percent hearing improvementā are a little dangerous for people who need CI and may be discouraged from having a positively life-changing surgical procedure.
So, I agree - there is no guarantee, but we must be careful in making such explicit (and not necessarily true) formulations.
CC: @Member361
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This is exactly the issue, it canāt get it right a lot of the time, remember itās a ādumbā HA it canāt think for itself no matter how hard they try to tell you otherwise, one day in the not to distant future itāll work as intendedā¦
I really donāt care whether it is misleading or not. It is what is true for me. There lots of posts on this forum as to the positives and negatives for the CI implant for the prospective CI patient.
Yeah, I can see how that could be sort of a confusing way of them representing what is happening. But when you check one of those boxes the software creates a linked manual program for that particular subprogram, it doesnāt actually remove any of the subprograms from the auto program.
Yeah, fair, I see what you are saying. My normal instinct would be to put the settings they like into an unlinked manual program and then adjust the automatic program to stop it from doing whatever they find objectional. Certainly you cannot stop it from picking whatever it picks, but you can reduce directionality, reduce noise reduction, or reduce gain changes, which are typically the things folks are sensitive to.
Thereās always a trade-off between noise reduction and speech reduction and increased distortion, so the degree of noise reduction that an individual with severe/profound loss can tolerate can be pretty individual.
I missed where this number came from. I see patients go from 0% speech clarity to 80% speech clarity with a CI. That seems like higher than a 10% improvement.
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Yes Neville you may have seen speech clarity go from O% to 80% but that does mean anything to me. I stated in an earlier post with the OP that I saw it in the CI literature from an audiologist. You did not say if the patient was over 70. And as I have stated earlier Iām not going to have irreversible surgery with no guarantee. Some people donāt seem to understand what irreversible surgery means. It means loss of any hearing in the ear without an aid. You have to have an appliance on the side of your scalp along with an ha. Now if you can give me a name of a CI surgeon who will guarantee me and increase of 80% increase in my word clarity I will give it some thought.
Absolutely, thatās a fair decision, and no surgeon can guarantee outcomes.
But yes, patients over 70. Iāve probably had about 8 adult patients get implanted in the past 4 years (pediatrics are their own category) a couple of whom were over 70 (4 off the top of my head, but Iād have to double check), all with good outcomes. Even the worst case had more than a 10% hearing improvement, and that patient had been unaided in the implanted ear for 14 years. But Iāve certainly also had a lot of patients who just werenāt interested in pursuing it, and thatās fine too. I will also say that while I have seen some amazing outcomes with hearing preservation from colleagues down in the States, up where I am I have not seen any success with hearing preservation.
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Okay, thank you for clearing that up about the sub-programs.
And while Iāve never been a fan of noise cancelling/speech enhancing sensing in general, I will do my best to give AutoSense a try. I may do the L30s just to keep things simple and more palatable at first. Like you imply, plenty of help from the right audiologist and attention to detail will also be important in getting it to sound and perform right, if possible. At the very least, I do like how one can switch it for a manual program with the default if it just canāt be done for my taste and needs.