I have just got my Starkey Destiny 1200 ITC today. My dispenser set the kneepoint around 50db for high tone, about 48 for low tone. The compression is about 1:1.2 to 1:1.3 for the frequency range. I don’t know what she means but she said something like used 70db sound for my hearing aid and then the sound was louder. She set the output of the sound for high tone around 115db, for low tone around 100db.
For now, the sound is comfortable and quite clear, but definitely not loud enough. I compared this hearing aid with two of my old ones, Beltone CSP-II (5 yr old) cannot be compared with the volume and broadness of the sound, even a little bit less clear than my 7 yr old Oticon digifocus and about the same volume.
If you were my dispenser, what you would do to adjust the hearing aid?
My loss is 40db in the low tone and curve down to 70db in the high tone.
Thanks for your help in advance.
The first thing I would do is set the aids to NAL-R. That is one of the math formulas that take your test results and convert it to a prescription for your loss. That formula is very linear and avoids using compression a lot. It is ideal for a former analog users.
If that wasn’t enough, I would consider using BERGER that is a really powerful punchy formula that again is great for an analog user.
If she has taken the NL1* program, which is the factory default, then she is making a big (and honestly stupid) mistake for a previous analog user.
You can check which formula is being used by looking at her screen next time you have your aids adjusted, the formula name is displayed at the top right of the screen in the Inspire OS software.
The next thing she should have done is run an IN SITU test. In the Inspire OS it is the menu option on the top left, marked Audiogram. It lets her do a mini hearing test using the aids themselves. This will reprogram the aids to the exact output that you are hearing. It’s a great fitting tool.
Make sure she has calibrated the feedback suppression. It should involve you hearing some funny rushing noises for about 10 seconds.
I guess those would be my first thoughts.
Also FYI, in May the new OS comes out. This will allow the dispenser to install the new BluWave technology on your aids. It’s supposed to be a superior operating system (firmware) that sounds a lot better.
Thank you for your valuable information. I will definitely tell my dispenser to follow your instructions.
You mentioned about BERGER formula. What is the kneepoint, compression, output etc. for this formula? I am interested because I just want to compare Destiny with my old Beltone CSP-II. Am I comparing apple with orange?
BERGER is a big in your face power program. I doubt it is using much in the way of any compression. But honestly, it’s too loud for most people’s taste, most people do better with NAL-R.
But keep in mind that with each of the formulas I mentioned, once you’ve set them, you can at any time add compression or kneepoint values. The fitting formula is just a base from which to begin your adjustments.
If NAL-R works for most previous analog user, what is the kneepoint, compression, output etc. for this setting?
Also, in terms of sound quality for me, previous analog user, do you think 1600 will be better for me than 1200 or 1600 just have some fancy features that I might not use it?
NAL-R is a linear model, so there is no compression, unless it is added by the dispenser. Analog users tend to like a lack of compression in my experience.
As for the 1600, on the face of it it may seem like some gimmicks just for the sake of it. For example, if the battery is low, it actually beeps and then says the word ‘battery’ in your ear. The hearing professional can even program it to remind you when it is time for a check up. One morning you will put it in, and it will say ‘make appointment’ to you.
It can even be programmed to do this in an English accent, or a male or a female. In fact, it can even do different languages.
All sounds like crap right?
Well that’s what I thought too. But the one thing it has that really seems to make a difference is built in real ear measurement. Using a special probe it will analyze the shape and acoustic properties of your ear, and then calibrate itself to your ear. Most other aids you buy are calibrated to an industry standard called the 2cc coupler, which is an approximation of a human ear. But it’s not your ear.
I have had a few patients upgrade from the 1200 to the 1600, most notably my grandfather in law. He wore the 1200 for about six months, and then switched to the 1600. He is a 20 year veteran of hearing aids, and has worn all kinds. He’s quite well off so can afford to buy the latest stuff at whim.
He swears up and down that the 1600s are at least TWICE as good as the 1200. I’ve asked him repeatedly about it, and he claims there is no comparison. He loves the 1600s, and claims that he has not heard this well for 20 years. Bold statements, and from a man who is not known for hyperbole.
I can also think of another man who I upgraded. He too was pretty impressed. He described the difference as substantial.
Those are the two patients I can think of who had extensive experience with both aids in real life situations.
So based on what people have told me, I do favor the 1600. I was initially skeptical, but so far the results have spoken for themselves.
Of course the downside is that with more to program, there is more for the dispenser to mess up. So make sure your hearing professional is experienced and proficient in the use of Inspire OS.
Boy, That ain’t no lie!!
Yeah, and from what I hear the new version 3.0 contains way more stuff (including Bluwave). If a hearing professional wasn’t comfortable with 2.1, they are going to be sweating in May.
And that’s why mine are suffering from “dresser draw syndrome” right now.
This is a very interesting story.
When I first got my 1200, my HIS set me up with kneepoint for low freq. 44, 50 for high freq. The compression is about 1.2 to 1.5 etc. for the frequencies. I don’t know what formula she used but the sound was awful.
The second time I went there, I told her to set to Berger. She said she did it. The next day I tried in my office, I found I could hear the speech well for most people, although I hate to hear sometimes some compression for some speech.
Two days after, I went to see Starkey Canada and saw a very knowledable audiologist there. She said actually my HIS set up NL-I for me. She said if I were satified with this settings, don’t bother to adjust it again. I asked her whether I should try Berger formula, she said no.
What do you think? ZCT.
One more thing, she said 1600 would have not much help to me compared with 1200. What do you think?
I have fit a few of the Destiny/Virtue/Rhapsody/Radius models for former Analog/Linear/Power users.
One thing I find that works very well is reducing or completely turning off the Acoustic Signatures (start with Quiet) to reduce the “fading” that can make it seem unnatural for you.
I think if you are getting to like NAL-1, you should leave it alone. BERGER is only a formula I use occasionally for an extreme power hungry user.
As for the difference between the 1200 and 1600, I agree that on paper they look like the same aid, with some gimmicks added to the latter. But I have had a couple of patients I can think of who have worn both. My grandfather in law wore 1200s for about three months, and then switched to the 1600. He claims there is no comparison. He thinks the 1600s are twice as good. And he is a long term user, been wearing aids for 20 years.
I really wasn’t that excited when the 1600 came out. It just sounded like fluff. So I wasn’t even recommending it. But I’ve fitted a lot of these aids, with a great deal of success (not that the 1200 wasn’t very successful too). It seems the integrated real ear measurement makes a hell of a difference to the sound.
Having seen the results of this aid, and seeing how patients who had worn both have fared, I really do like the 1600 a lot.
I’m just off to do a fitting now. A set of 1600s, with the new Inspire OS 3.0 software. It’s got some new toys including integrated speech testing, which I am really excited about.
As an aside, the new software has this amazing hearing loss simulator so you can demonstrate to a patient’s support exactly how their hearing is, based on their audiogram (or some pre-set examples). That’s a nice bit of software.