Terrible Hearing in Noise

costco
hearing-aids
#44

I got the Quattro’s in part because of great reviews by @Bryan9 and @teejayess of the ReSound Forte’s. The Quattro’s offered the possibility of direct Android connectivity (still waiting!) and I like the rechargeability aspect. I tried both ReSound and Opn smart phone apps for Android and like the ReSound app much better. Plus I read reviews by Dr. Cliff and others on this forum that said that said the ReSound accessories were excellent (and I didn’t want to spend a bunch of money on Phonak Roger stuff ……).

Perhaps those folks might have a comment on wind noise and dealing with noise in general. Bryan’s review compares his experiences with the Forte’s to the Opn’s and he liked the Forte’s, especially the much lower price through Costco. Might be as you remark in the Marvel vs. Opn thread, different folks, different hearing, different audi’s with differing levels of experience and knowledge of each brand. Presumably Bryan and Tim got expert help with their Forte’s at Costco, which is praised by most forum members for its level of service. It does seem, though, that most Opn users feel their model of HA is superior to almost all others in dealing with noise.

I might add @efigalaxie, whose quite a long-time, experienced, and advanced HA user has used both Opn 1’s and Quattro’s and prefers the Quattro’s (switched from Opn 1’s). All I take this to mean is some HA’s fit by some audi’s work better for some folks than other HA’s for whatever reasons. But when you find an HA that really works well for you, don’t worry what anyone else says about it…

0 Likes

#45

I’ve had my Fortes for about 4 months and it’s been mixed. You asked about wind noise. Today was very windy here and I was standing at the gas pump. I had to cover my right ear which is my good ear. That’s on the All Around program and the Wind Guard is off. Normally I’ll get a bit of wind noise but I’m not outside enough for it to bother me.

As for the hearing in noise problem, I’m still not satisfied. I’ve had lots of setting changes but things are inconsistent. I suspect that the HAs are trying to be too smart. In a restaurant, there are voices near and far. If the HAs are trying to pick up the far voices, that poses a problem. What I basically want for a Restaurant program is a 4 to 5 foot long cone in front of me. Maybe the cone flexes based on the voice source, but I don’t care about anything outside of that cone.

On All-Around, hearing in noise is iffy. Sometimes okay, sometimes awful. I suspect that the HAs are trying to be too smart at detecting noise and unless it’s a constant noise, they’re too slow to keep up.

At my next adjustment, I’m going to try setting the Noise Tracker to mild or medium and I’ll adjust manually if necessary. I already have the Environmental Optimizer off for all programs and the Noise Tracker off for Restaurant and Music. I’ll also bump Expansion to moderate or strong because I do hear those low level sounds.

0 Likes

#46

Curious. You’re from Canada. Your Fortes are not locked in Canada? In the main forum, it’s helpful to be oblique in DIY comments.

Presumably from what you say, you’re not using your default fitting. On my Quattro’s the default directionality is different for each of the four programs that my audi set up. All-Around is “Binaural Directionality III with Spatial Sense.” Restaurant is “Autoscope Adaptive Directionality.” And Outdoor and Music are “Omni.”

Noise reduction in All-Around in on a Per Environment Basis. In Restaurant and Outdoor, noise reduction is set to mild for me, and in Music, to none.

Wind Guard is set to Off in all programs but Outdoor where mine is Mild. Directional Mix is set to Very Low in All-Around and Restaurant while Off in Outdoor and Music because they are Omni directionality.

One of your ears is a lot worse than the other so I wonder if in your instance favoring the good ear would help. Presumably you have more occlusive molds or domes whereas for me, I’m pretty sure hearing noise outside of my HA’s through my open domes reduces the utlimate benefit I might get from Quattro’s. I read somewhere that the sound of speech heard thru HA’s vs. through open domes at the same time can conflict, reducing speech-in-noise recognition so that’s why I’m going to try tulip domes and power domes to see whether if I wear these in very difficult speech-in-noise situations it helps. For example, when I am exclusively streaming from a remote microphone, in spite of this, I’m still hearing some noise all around from the openings in my domes. For most situations, I greatly prefer open domes but it would be easy to carry around power domes, for instance, in a little ziplock bag to switch out in a situation where the noise thru open domes might get overpowering if switching to a more occlusive dome for a short time would help speech recognition.

Your situation is undoubtedly very different. Just wanted to mention that my Quattro’s as programmed by my audi using Smart Fit 1.3 and the Audiogram+ ReSound fitting logic (similar to NAL2) have very different directionality behavior and default noise reduction for the different programs offered the user. And that’s why I love the Smart 3D app for the limited ability it gives any user to override those default settings and, for most users, for the ability to use the Remote Assist app to get the audi to fine-tune settings “in situ” without another trip to his/her office.

Binaural Directionality III with Spatial Sense allows one set of microphones to favor the direction of detected speech while other microphones listen all-around (unless noise is overwhelming from a non-speech direction) and coordinates sound ear-to-ear to maintain spatial sound location as much as possible with BTE mics.

“Directional Mix allows for adjustment of the frequency that blends between omni-directional and directional processing. A low directional mix means that most of the signal is processed omni-directionally, while a high directional mix indicates mostly directional processing. The directional mix is calculated based upon the patient’s hearing loss and the hearing aid style.”

ReSound likes to emphasize that you get more bells and whistles the more you pay. Hopefully the Fortes have all the directionality and noise reduction bells-and-whistles options. But perhaps finding out what your directionality mix is in different environments and favoring directionality at times, which you can do through the Smart 3D app to some degree, would help at times. It does for me, even with open domes.

Not offering this advice to say the ReSound approach is better than any other HA. Just to document how the default settings for directionality, wind and noise reduction, and (not discussed) relative sound loudness will vary considerably depending on what basic ReSound program I’m using (and the All-Around program attempts to emulate the same automatic switching of sound processing that one also gets for other premium HA brands).

2 Likes

#47

Don’t know about the Fortes but for the Quattro’s, an option is the global profile setting of “Custom,” “First-Time User,” “Experienced (Non-Linear),” and “Experienced (Linear).” The First-Time User dials back gain in the All-Around program to avoid overwhelming the new user with new sounds, regardless of whether the gain is only slowly being dialed up over a (potentially variable) trial period setting. ReSound literature advises audi’s that switching to the Experienced global profile settings can enhance speech recognition if the user can tolerate the perceived “loudness.” So that might be something else to look into for the Fortes, if that adjustment has not already been made. Listening to a ReSound audi advise on Audiology Online, she seemed to recommend a user going for the Experienced (Nonlinear) profile if it works for them but seemed to imply that Experienced (Linear) might be a bit too much for most. Also mentioned that the latter global profile setting is really not linear, just less compression than the Nonlinear experienced option. I can see why if one is running back and forth to the audi to try all possible options, that’s why HA service can cost so much. There is so much to try! (but a lot can be ruled out by the nature of your loss - and past listening preferences, etc.).

0 Likes

#48

Thanks for the reply. Some interesting ideas plus a verification of some of my research.

As far as I know, the Fortes are locked in Canada as elsewhere, so I’ve been having adjustments made at Costco every 3-4 weeks. As far as I know, the Fortes are the same as the Linx 3D except for the remote assist and tinnitus features. I’ve been researching all the Resound settings to try and get at least a basic understanding.

I started with the default fitting and went from there. The audi used NAL-NL2 rather than Audiogram+. I have no idea whether one or the other is better. She is using REM to fine tune.

I have the RIC model. I originally had a mold in my left ear but it gave me headaches. I now have a power dome in the left and open in the right. I’ll ask whether using a power dome in the right might help. Interesting idea. I’m told that if the type of dome is changed, that other adjustments are needed.

So my Directionality settings are the same as yours. I’m rarely outside where I need to hear so I dropped the Outside program. Noise Reduction is still per environment in All Around but set to considerable in Restaurant. I’ve yet to have the opportunity to test that. However, since it’s not per environment, I do have a noise slider that I can use. All Around Directional Mix is very low for the right and high for the left. In Restaurant, it’s high for both ears. I’m not using Wind Guard at all, although I can see where it would be useful outdoors.

1 Like

#49

For my last two fittings, I’ve asked for and received the Clinician’s report from the Smart Fit software. As far as I know, they’re set to Experienced (Non-Linear). I also have the Smart Fit software at home. Not that I can use it to adjust, but I can look at options. In case anyone out there is a Mac user, I’m running it on Windows 10 inside a VMWare Fusion virtual machine.

Before last spring, both ears looked more or less like the right one. I lost a lot of hearing in the left probably due to an infection of some sort. Actually getting any meaningful hearing back in the left ear doesn’t seem possible although when the HAs are working, the sensation is hearing in both ears. That said, I have to hold the phone up to my right ear now.

1 Like

GN Hearing introduces ReSound LiNX Quattro
NoahLink Wireless - worth it?
#50

A terrific series of messages and info re hearing in noise. But as one who has deteriorated past this point to where I now use a Cochlear implant as well as an up to date Phonak hearing aid, I was surprised to not see a single mention of the use of FM technology like the Roger pen or the Roger table mic and Select The whole intent of these Roger devices is to improve the ability to hear speech in noise and it is of terrific help to any brand of hearing aid. It probably delayed my moving to a CI by four years or so and it works equally well with my Medel CI. There is a lot to be learned with this technology too in terms of tricks and techniques to solve problems - but the technology exists and works well for hearing in noise situations. Don’t forget it is out there.

1 Like

#51

I wonder how hearing aid brands with their proprietary sound processing plays into the neuro mapping and if changing from one maker to another is more problematic for users than sticking with one.

0 Likes

#52

Interesting question. I don’t know. If I had to speculate I would presume that there is some complex description of the magnitude of the difference between old and new hearing aids, but that it may or may not be the case that one manufacturer to another is more different than old to new tech by the same manufacturer and/or old to new fitting by same or different audiologists. I’d also expect length of adaptation time to be effected by user variables including how long they were in their last devices, their listening experience over their lifetime, and neurological health variables.

I do have users who come in who are only satisfied when I make their new tech sound as close to their old tech as possible–plug it in to the test box and match gain frequency by frequency decible to decible. Often matching gain will suffice, but sometimes other processing options need to be matched too, which may or may not necessitate a manufacturer match. However, these users are fairly rare and tend to be very long-term users with profound loss.

I don’t know that I would use the word ‘problematic’ though. The world changes and our brain adapts day by day, second by second. There might be a slightly easier transition sticking to a similar sound, but that’s not to say that one wouldn’t transition with a different sound. Any processing that will help to provide information to the brain similar to what built its framework during the critical developmental period (however one does that through a damaged system) will probably be better. Congenital loss that has been amplified from birth would probably run a bit differently.

1 Like

#53

Neville, thank you for your thoughtful response. Just a little background. I lost much of my hearing in one ear overnight in 2008. Sudden onset. No known explanation. Then, 3 years later - the same thing in the other ear. (See audiogram) I had Oticon Acto pro for 9 years. Good longevity, but I should have updated in half that time at most. Last year I got some Ria pro 2s for free. They are a basic model, but they did outperform the old ones, though they are a bit harsher. Then 3 weeks ago I got th M70 R. I say all this because I wonder if my brain mapped out some new auditory pathways or conversely did not make new connections based upon the 10 years with Acto pro 2 and is now unable to adjust to Phonak marvel or perhaps any new aid because it is too much input that it cannot process. That a mouthful and maybe nonsensical. I obviously don’t understand the science of audiology or auditory neurology. It’s just a thought as to why Phonak sound was terrible for me. I’ve ordered OPN S so in 2-3 weeks I’ll post initial impressions.

1 Like

#54

Ahh, that’s tough. Bilateral sudden loss is not that common. I often wish we had the ability to model the change in sound caused by different types of hearing loss. That is, as someone with somewhat typical hearing I would like to be able to hear what it is my patients hear. I’m not talking about filtering a sound through an audiogram, but actually understanding the physics of change in the ear and in the auditory nerve based on different types of cell damage. It’s beyond our capability right now; we can’t even identify the precise site of damage. We talk about damage to cochlear hair cells, but there are all sorts of other cells in the ear and auditory system that can change, too, presumably affecting perception in different ways. We may hypothesize, for example, that the cause of a sudden loss might have been a virus that causes swelling to the auditory nerve, with the resulting mechanical pressure on the nerve from the boney channel that it runs through damaging the nerve fibers. Altenatively, something that causes a sudden limit in blood flow to the ear might damage all sorts of supporting cells alongside hair cells. In my experience (albeit limited, as this is a small subgroup of people with hearing loss), the hearing of people who have experienced sudden loss is more distorted relative to someone with a similar audiogram that resulted from slower age or noise-related loss. I would not be surprised if you to need a higher signal to noise ratio to be able to understand target speech than is average with your loss, and at that point there may be no modern high end hearing aid that does enough to make much of a difference (so, not surprising that you may not notice much difference between more expensive and less expensive tech). rsinclair mentions the roger system just above your comment, and that might be something worth considering. Phonak does have the best FM system on the market right now, but it can be connected to other manufacturer’s devices if sometimes a bit clunkily.

It’s difficult to pin down comparisons between hearing aid brands because it is very rare that they are fitted identically. I was reading someone here yesterday comparing the opn and the opn s and they mentioned that the opn s sounded a bit sharper/crisper. But they also mentioned that their hearing had changed slightly, which suggests to me a high liklihood that the new opn s was fit to their newer audiometric results and is providing more high frequency gain than their old opn, which would explain the difference in sound perception without any need for the devices to be performing differently. If that makes sense. However, depending on the circumstances, tweaking one hearing aid to sound more like another may end up being more or less time consuming than simply moving over to the one that gives you a closer starting point.

I also think that device-focus has been taking over a little bit more than is useful. There’s a general perception that if you develop hearing loss you just plunk hearing aids on and away you go. This can actually work quite well for a very specific segment of the population with a standard sort of mild/moderate loss, but doesn’t work very well for MANY. Hearing loss, especially sudden, is a huge change that affects not only the individual, but all of their loved ones with whom they communicate. Communication strategies need to be re-learned by the whole community. I think that we would do better if this were addressed clearly from the outset and more emphasis was placed on bringing in friends and family for counselling/practice. People come in to my office alone and want to address their hearing loss alone, and it is very limiting. As difficult and emotional as it can be, I think people need to sit down with their loved ones and have serious conversations about what their hearing loss is like for them, and what sorts of behaviours make it better or worse. Sometimes many times before it sinks in, which can be very trying.

1 Like

#55

I haven’t really noticed that, changing from Resound to Rexton to Phonak. The big adjustment is hearing things I had not been hearing in a while. Things sounded loud and harsh and tinny but after a few months, everything sounds really, really good. I’m glad now I didn’t try to get rid of the uncomfortable sounds.

2 Likes

#56

I hear you, so to speak. If I keep the Marvels more than 45 days the trial period will have expired. Three weeks in they are still no better than Day 1 with 3 adjustments so far including the initial REM. They certainly outperform my previous basic Oticons in a quiet to mild noise setting. But my impression is that speech in loud noise is worse. The only thing I can do is turn the volume down to avoid chaos and that is with or without the speech in loud noise activated manually on the M70. So it’s on to the OPN when they come in in a week or two. If that doesn’t work I’ll try Signa. My insurance only offers Oticon, Phonak, Signa and Starkey at present.

I’m not well versed in hearing aid technology or brands. Trying to get up to speed.

0 Likes

#57

Again, Neville, your comment is much appreciated. You’re absolutely right on about dragging in the whole family to the audiologist. They had no idea or appreciation for the predicament of a person with sudden hearing loss. Even now they still don’t get it years later.
I haven’t kept up with the hearing aid technology. I had high hopes for the Marvels. I have 2 more weeks to trial them, but I’m not expecting much improvement. I’ve used them side by side with the other two sets of older and lower level aids. I actually prefer the older ones in noise. The Marvels create a sense of chaos that I can’t tolerate. The others don’t improve my hearing in noise. They just don’t make it worse. Just too much chaotic noise with or without the Speech in Loud noise enabled. All I can do is turn down the volume. I hoped adjustments would solve that but no cigar. I need good hearing in a noisy classroom where I started teaching in th last year. I’m realizing that if I can’t solve this issue I will have to bail on this job because I simply can’t hear what the students are saying much of the time. As you know, if you struggle to hear it is quite stressful and draining and it’s not fair to the students.

0 Likes

#58

Could it be the technology level on the M70’s vs. the M90’s? I know with the ReSound Quattro’s, it’s amazing how “dumbed down” the lower levels are as compared to the highest level - but then you pay a lot more for stuff you might or might not need.

1 Like

#59

My understanding is that the difference between M70 and 90 is Speech in Loud Noise program is manual vs part of Auto Sense. But they should work the same either way. I chose M70 to avoid the program automatically activating. I dramatically increases the volume of the speaker.

0 Likes

#60

I have the Kirkland Signature KS8 which I believe is essentially identical to the Signia Pure 7Nx, except it lacks the tinnitus masking. I believe speech in noise is very difficult for any hearing aid. All around it works pretty well in the Automatic program. In fact for most situations the Automatic program works just as well as the special situation programs. These are my first hearing aids so I have nothing else to compare it to. So it may be a case that the Automatic program is very good at switching automatically, or that the special programs are not great! Don’t know.

For speech in noise it does have a special Noise/Party program which I do find helpful. It does have some limits in really loud situations. Adjusting your seating position and as a last resort turning down the volume works. In the Automatic mode it has a manual microphone focus which goes down to a very narrow forward beam. That in some situations is also very helpful. You need a smart phone to use it though. In theory the Automatic program may be doing it as well. Hard to tell.

At least with an iPhone you can use the iPhone microphone as a remote mic. You put the phone in the middle of the table or where you would like to hear. I have only tried it a couple of times and it does seem to help. I need to try it with a larger group in a noisy environment.

For your classroom situation it has reverberation detection and reduction. You could set up a special program for that situation and fine tune it to your needs.

I think most premium level HA’s have similar tools in their toolbox. Where they may differ is in how much they do automatically, and how much requires manual adjustment or a special program. The degree of microphone directionality and the intelligence of it, may be one area where they differ. The 7Nx uses what is called a 3D classifier system to identify hearing situations so the features can be automatically adjusted to suit. It uses the standard acoustic information from the directional microphones, identification of the user’s voice, and smart phone detection of motion. Again, I have nothing to compare it to, so can’t say much other than it generally works well.

1 Like

#61

That’s a shame. I would encourage you to imagine whether this might actually be a teaching moment for the students. Depending on the layout of the class and how old the students are you may be able to explain to them your difficulty and train them to use a microphone when they have questions which could be sent to a classroom soundfield and/or directly to your hearing aids. I think it would probably be very valuable for them to be taught what sort of communication strategies might be beneficial for them to support someone with hearing loss. Certainly it would require exceptional self-advocacy and classroom management skills, and I do know how exhausting that can be. If the students are very young, the effort to train them may be too great. Maybe with young kids you could elect a student up at the front each day to be your ears, and to repeat questions from the class to you in closer proximity. There may be someone in the school, too, who can help out with strategies. Where I am, there are educational audiologists and itinerant teachers for the Deaf and hard of hearing who are already trying to implement strategies for students with hearing loss.

With university students who all bring laptops and phones to class these days, you can use instant message systems (commonly offered within electronic classroom systems these days) that would display their questions directly to you. This might actually increase student participation, as students are often shy about speaking up in class. University students may also be used to pass-around microphones if they spend any time attending seminars or public lectures where this is not uncommon practice for question period. In undergrad I had an older professor who would jog up the the student with the question–at the time I thought he was tremendously high energy and dedicated to making students feel included and listened to, but in retrospect I’m sure he had hearing loss.

But imagine a world where you train your students how you need them to communicate with you, and they then take those skills back to their family and their friends and their jobs and are suddenly more confident in how to effectively communicate with someone else with hearing loss. Maybe they will be more inclusive, too–approaching someone with hearing aids when previously they might have hung back for fear of communicating poorly and causing insult or general social awkwardness. Seems like a nice idea. But I have been accused of being a wide-eyed optimist in the past.

8 Likes

#62

If it isn’t tried, and given a fair test, no one will ever know if the method would work or not.

2 Likes

#63

If things seem loud you may not have been up to target in a long time and it will take a couple of months for the brain to adjust. If soft voices are too low they can be adjusted separately from medium and loud sounds. I always have soft sounds boosted.

0 Likes