Terrible Hearing in Noise

costco
hearing-aids

#29

Up in the brain, everything is pretty much working by upregulating connections that are receiving input and downregulating connections that are not. (As the great Canadian Donald O. Hebb taught us, neurons that fire together wire together :smile:.) If you jump way up into the auditory cortex, the brain is still maintaining frequency mapping from down in the cochlea. If a particular frequency area is not getting input, then the other greedy areas around it will start to encroach. How much input that particular frequency area is getting, and thus how well it can maintain its mapping, is going to depend on the level of loss at that frequency out on the periphery. If you trust my memory, there is some evidence using reversible lesions in cats that if you allow those areas to atrophy and then reverse the lesion causing the reduced input, original mapping will sort of come back, but not precisely back to what it was. It’s a bit more disorganized, for whatever that means for function. Now in those experiments there was no actual damage to the auditory periphery, so reversal of the lesion restored normal peripheral function. Restoration of activation of those areas with amplification is probably going to be imperfect.

Now that I look back, though, are you talking about listening to audio over loud headphones akin to, say, part-time hearing aid use? AKA, How much part-time use does of amplification does one need to stave off any atrophy? (Or, rather than say atrophy, something like ‘neural reorganization’ seems a bit less loaded as the brain is just doing what it does best.) As far as I know that research area is still wide open. If you look at visual research–monocular deprivation in cats–you only need a much smaller percentage of normal binocular exposure to stave off the effects of monocular deprivation. Off the top of my head, I think it was something like one hour binocular experience per eight hours of monocular experience. Nature+Nurture: We are what we experience, but the brain is set up to ‘expect’ a certain ‘normal’ type of input and will weight it more heavily. One might suppose that something similar would happen in the auditory system, though what the absolute numbers are are anyone’s guess. My gut feeling is that the auditory system is a bit more plastic than the visual system, and therefore might need a higher percentage of normal input to maintain things.

Does this approach the sort of answer you were looking for?


#30

“Hearing loss is more like macular degeneration than simply an adjustment to your focal length.”

Um_bongo’s simple but excellent analogy should be used dispel the common belief getting hearing aids will restore hearing just like getting glasses restores eyesight.

And thank you Neville and Um-bongo for your excellent and authoritative posts.


#31

Great Post. Thanks very much indeed!


#34

My hearing loss is not (yet) severe. But how you’ve explained what is needed is what I already feel, just 4 months into this hearing aid “journey.” What I’m feeling now is that, in noise–my car and in restaurants primarily–I have far less speech understanding than before. And though the programs in my ReSound App change the soundscape some, they just don’t work to improve my speech understanding. What I wish is, that instead of research to have my hearing aids call 911 if they think I fell, or translate Spanish to English, or turn on my coffeepot, that I could understand speech better. If hearing aids could be programed to recognize the voices of my family and friends and to find and amplify those voices in noise, THAT seems like a technological advance I’d embrace. Maybe I still couldn’t order the special of the day because I still won’t understand the server, but I’d at least be able to hear and participate in the table conversations better.

I don’t yet understand most of the technical discussions on the forum. But I think I know that no manufacturer has this yet. I just hope they’re working on it.


#35

Noreen, what has your pro tried so far? Usually if I have problems I ask for the noise reduction program (speech in noise or noise/party program) to aggressively lower background noise. Sometimes it seems the pros do not want to stray too much from the initial fit but if I want to hear in noise then they have to crank up the noise reduction and that makes voices much more prominent. It would need to be the separate program, not part of the everything program.


#36

Thank you for your concern. I’ve had a lot of problems with domes backing out of my ears (I have custom silicone moulds since the end of November) and those problems have probably overshadowed my issues with noise in terms of interacting with my audiologist. She did tell me that she increased the noise reduction because, in quiet, I was hearing a constant sound like a faucet running water (which she thought, as I understand it, was me hearing the sounds the HAs make), She’s a solo practitioner, on maternity leave for 6 weeks. 6 more weeks to go. Then I am going to stop whining about my dome/mould issues and ask her to address my speech in noise issues. I like the idea of asking her to create a special program that will aggressively lower background noise. I also don’t think I ever had speech-in-noise testing. I’d like her to do that too, if she can, because I think it’s the hearing aids and not (exactly) my ears that are making understanding so difficult. I don’t know exactly why, but I feel like that might make a difference in how she treats the problems.


#37

I’d see if she has your global profile as “First-Time User.” You might not like it but I have switched my global profile to “Experienced (Non-Linear),” updating both gain and target curves. The option is in the Patient Profile and it would be very easy for your Audi to switch you back and forth. I think that I hear better overall after the switch. More amplification in mid tones for my loss at moderate volumes in All-Around program.

You might ask the Audi to fit you in a difficult listening situation using the Remote Assist feature. If your audi is unfamiliar with this, ReSound has a number of online courses at Audiology Online through which she could bring herself up to speed. Or if she’s too busy with her new baby, maybe she could temporarily refer you to a colleague?


#38

I plan to make time to watch those video links you posted on the Quattros in another thread. This audiologist works with 2 brands, once being ReSound. But I am her first Quattro patient. (We did use the remote assist feature for one tweak–the process worked well.) I didn’t know about the global profile difference. Interesting.


#39

I’m pretty ignorant about fitting but I also noticed the option in the fitting software when a specific environment containing speech is detected to favor the better ear. Have no idea what all the ramifications of doing so might be but (not remembering all previous posts) whether the difference between your ears could be part of the problem but your degree of hearing loss seems relatively mild to moderate with not a terribly extreme difference between ears. Maybe your audi could advise you whether favoring the better ear in speech situations might help or whether that’s going to create more problems than it might solve.

I find in listening to audio podcasts that I get the best speech recognition using the Outdoor program with the speech clarity quick setting. I find it helpful to dial the volume back a bit to avoid any tinny sound or danger of feedback (for me, the Outdoor program has the most amplification and brings me closest to the amplification zones where I am in danger of feedback, but also matches my prescribed fit, according to ReSound software, most closely).

In certain noisy restaurant situations, I like to use the Restaurant program instead, where I can dial in both directionality and noise reduction to my liking, and in very bad noise situations, I have a Multi Mic remote microphone. But in some very bare wall, bare floor, bare ceiling, bare table restaurants it seems like sound gets reflected off the ceiling or nearby walls right into the Multi Mic so just going back to a program works better for me sometimes in terrible reverberating noise situations. Apologies if you’ve already read this in other posts of mine. Just wanted to repeat my experience in case it can help you.


#40

I only have Resound Live 9, Resound linx 3d 7 and Oticon Opn 1 Hearing Aids to compare.

Resound Live 9 - I always struggled in noisy environments as everything was too loud, but I could manage to follow the dialogue to a large extent. But I know what you mean by noisy environments being a challenge for HA wearers.

Resound Linx 3d 7 - they were absolutely awful. It felt like I could hear everything except what I was trying to hear! I could not hear properly in noisy environments with these hearing aids. All I could hear was the background noise and I struggled to hear what people were saying. They were awful. My old Resound was far better.

Oticon Opn 1 - was like a dream come true. I love wearing these in noisy environments. For the first time in years of wearing hearing aids, I don’t feel overwhelmed with background noise and I find it so easy to hear what people near me are saying or whichever direction I am looking in. I fully agree with many people here - Oticon really shines for me in noisy environments and for me is vastly superior to Resound.

Resound also seems to pick up things like wind noise and other background that I don’t want. Never had wind noise issues with my Oticons.


#41

Wind noise suppression is excellent for my Quattro 9 61’s. It’s a little hard to tell for sure since I have open domes and good low frequency hearing so I think what little wind noise I do hear is just bypassing my HA’s and coming straight down my ear canal.

Reading Noreen’s post above, it seems that soft background noise is a problem for her and I have a different suggestion than standard noise reduction.


#42

Since your audi is highly trained, she probably knows very well about “expansion” but it’s a feature separate from “plain old noise reduction.” Some folks, especially those with very good low-frequency hearing may be able to hear in quiet environments the noise from their hearing aids or noise from devices like refrigerators amplified by their HA’s. Expansion, kinda opposite to its name, decreases the gain applied to very soft noise sounds so they become less perceptible or fade away entirely and are not boosted up into the range of audibility. So presumably, instead of just increasing global noise reduction, your audi probably should have applied the expansion setting (mine is set to NONE - I have no perception of background noise from my HA’s and I’m not bothered by the refrigerator running).


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#43

Every Resound hearing aid that I have had was a pain with wind noise. I had in the ear moulds. My left ear is really bad on low frequencies, but even the right ear I had a lot of wind noise. Oticons no issues in either ear.


#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…


#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.


#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).


#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.).


#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.


#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.


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#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.