Has anyone had a positive experience “reactivating” an “unaidable” ear?
After wearing my Phonak Paradise P90 CROS aids for a couple of years. I have recently trialed the Phonak Sphere for my right/good ear only. The results were remarkable, but like my CROS aids, there was something missing. I experienced the head shadow effect as expected, but also the aid was not great in some situations, that is, not better than my current single Paradise or CROS configuration.
Now I am beginning to ask 2 questions.
Is my left/bad ear really a total loss? My Audi has never suggested an aid with different receiver or domes etc and I have only ever trialed standard RIC aids with open or closed tips/domes
Can you go back to wearing a full hearing aid in an ear with my hearing loss?
If I could work that out I might be confident buying a new set of aids as I suspect much of the tech depends heavily on binaural hearing and 2 aids??
You have aidable hearing to somewhere above 2000 Kh in your right ear. I would definitely try a pair of spheres. With Sound Recover 2 you should hear quite a bit in both ears. Maybe I am missing something here because I don’t understand why yout audiologist is not recommending that.
Maybe their word recognition in the left ear is 0%.
You’d need a UP custom tip in that ear at least, assuming your ear canal could accomodate one. Or a super power BTE. You could ask about your options for a budget level BTE–it’s not going to work in tandem with the other ear, but it would give you some idea of whether you’re getting any benefit on that side. Cochlear implant candidacy is expanding for people with one bad ear that had gone unaided for a long time as more people like that have unexpectedly good outcomes.
I think my previous experience with aids was that the amplification required was so great it made my tinnitus so much worse in that bad ear…but no one has suggested anything other than standard fit for that ear ever. The more I read, the more I wonder if I haven’t found the right Audi. The practice (several audiologists) have said they don’t prescribe many CROS, so maybe they don’t encounter SSD very often??
I think my word recognition is ok on that side if it’s loud enough. Not very scientific, but if I play a podcast on my phone and hold the speaker to my bad ear, I can understand the speech and hear the background music, it’s just full blast
It depends on the, for example, Word Recognition Score (WRS) in quiet and possibly additionally QuickSIN (for speech in noise) test. So, what’s your WRS in quiet percentage?
If you have poor WRS on poorer ear (below 60% is a rule l of thumb, but there is many another factors), even best hearing aid with high probability couldn’t provide you better word recognition, even in quiet situations.
It is recommended to go through cochlear evaluation, which can give you and you Audi much useful information about your hearing. Bear in mind that evaluation doesn’t oblige you to the cochlear implantation.
However, in case you want to get better WRS and speech understanding - CI is only option to break through that WRS percentage celing.
Stimulation of the bad ear by a properly fitted hearing aid (even if it’s cheap) improves the outcome of auditory rehabilitation after possibly getting a cochlear implant.
Try to relieve that shadow effect a bit, making manual Spheric Speech in Noise program with Speech Focus slider maximally to the left.
Which acoustic coupling do you have? Domes? cShell/earmolds? If domes, especially open, it’s possible that you wouldn’t achieve much improvement (former Paradise user here).
I think I need to go and see a new Audi to try some new ideas. Possibly try a more powerful aid in my bad ear.
While I could also try to get a CI evaluation, I’m not keen to go that route, especially if there is still hope for my bad ear. Even with tinnitus and no aid, I still hear something there and want to preserve it.
Food for thought!
Closer dome is quite open-ish. Even power domes have some slit leaks. The best outcomes are often from deep placed earmolds/cShells.
See here
EDIT:
Your bad ear has a complete roll-off of frequencies over 2.5 kHz, but lower frequencies are pretty decent for the Sphere (or cheaper HA) UP receiver if you don’t have a very narrow ear canal to fit it.
I did trial a P90R in my bad ear back at the beginning of my HA journey. I couldn’t tolerate the volume so Audi recommended CROS. In hindsight, I may have quit too soon, or maybe the aid needed different volume settings /programming /receivers/ molds /domes etc to improve the experience. I had no idea then - I know more now!
I think when I was fitted for my CROS, my Audi was unfamiliar with the technology and assumed the advanced features of the P90 (like Sound Recover 2) would be available. In reality the CROS has fairly basic functionality. Sometimes I think it makes speech in noise worse. I have also recently found it is a massive battery drain, so I have stopped using it a lot of the time.
Something to remember is that bad ear has not been aided properly in a long time. It will take time for you to acclimate to a hearing aid. Start out at lower volumes then slowly increase volume as you can tolerate. In the end you just might hear very well from that ear.
If cochlear implants are available to you I can say they have been great for me. I am bilateral CI and do great with them.
In this case you may be better off with a BTE. We fit earmolds nicely into even baby ears, whereas a UP custom tip can get pretty awkward with a small ear canal. The earmold cost will be non-refundable, but it’s not that steep for a gamble. Again, I really wouldn’t worry too much about the hearing aid being premium or compatible with your other ear–the function on that side is just SO much lower. If anything it’s just going to be playing an assistive role and you likely wouldn’t really notice many of the binaural features. The Sphere uses a unilateral noise strategy anyway. Even an old Naida/Sky M30 SP would be a nice option with a similar sound profile to the sphere. I think it’s discontinued now, but if you’re asking your clinician for a budget option to try, they could just have something old/refurbished/donated.
This is a rational reaction to the idea of a CI, but consider that if a you don’t experience benefit from having a hearing aid on that ear. . . you’ve been living without it for years anyway. But try the hearing aid for sure (but in the meantime you could still do the candidacy assessment–the process is typically slow and will give you a lot of information. You may not even be a candidate in Australia).
I think you don’t know this for sure. If this is indeed the case, then the BTE is an option. The Naida Infinio should be released soon, but I’m not sure if that lineup would be better than Lumity in terms of your left ear hearing loss. I also wonder about that cheaper Naida lineup, as @Neville said.
Definitely. If you have long-lasting hearing loss, first time with 100% hearing prescription target could be too loud. Often, your Audi should set the target to, for example, 80-90%, and counsel you to adjust the volume if you want. Over time, you should get used to gradually louder sounds.
Wow! Thank you again everyone for taking the time to share your knowledge. This has all been very informative and I now have some new ideas to work with. I’m on it!
Yes she would qualify for the evaluation here Neville. It’s under 60db to be eligible for evaluation. As she hasn’t worn HA’s for years, Steph would most likely be told to go away and try aids for 6 months, here that can be a a very expensive option.
