Wanting custom earmolds which is being discouraged

I have Costco KS 8’s. I have significant high frequency hearing loss. In order to get the gain that I need, I have bad feedback in one ear. Not cool, as I’m young enough to still be in the working force. I went to Costco the other day telling the tech that I wanted custom ear domes which she discouraged. Instead, she fitted my right ear with this big black closed sleeve which I just hate mostly because everything is too amplified (but speech recognition isn’t necessarily better), but I can hear my pulse & they’re uncomfortable. What are the downsides to custom domes. She did look in my ear & tell me I had too much wax to make custom domes, which is funny b/c I’ve been to the ENT guy twice & asked about ear wax & he told me I had very little & it wasn’t even worth his trouble to clean them out. She said getting ear impression with wax in ears is painful. Can custom domes be vented? Would that just cause the same feedback problem? Don’t really like the occlusion feel.

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I have always gotten custom ear molds, and later in my life, unvented ones, to control feedback better. I tried the newer style domes, but they were much worse than my custom molds. To me it sounds like she just doesn’t want to do it, there is no drawback to them at all imho.

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My DAud/ENT also discouraged me when I asked about molds. He says I am doing much better with the new double power domes. I did have molds with my previous HAs and found them more comfortable then the domes available then so I thought I should try them again but he said now molds would not be better for me. The new domes do seem to be fitting better, are comfortable, and are closer to the ear drum. I am hearing better, I was just thinking that any little improvement may be worth trying but he convinced me to stick with these domes.

Sharing your audiogram would help us help you.

If your hearing loss does not justify wearing ear molds there may be good reason to discourage molds. If there are issues with domes not fitting right after trying many different domes, molds might be best.

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After I insisted on custom tips (to reluctant dispenser) the hearing was much improved for both feedback and clarity, going from 90% to 100% in speech comprehension testing. I was told they could slide out easily but had no issues at all. A custom fit will always give a superior result. Imagine listening to music through generic ear domes, versus custom ear tips. I didn’t realise the difference until I tried ric with domes after custom ITEs. The sound was significantly less clear and I was very happy to get back to custom.

That’s not a like for like comparison. Hearing aids use a mix of direct (via venting) and amplified input (through the aid) in a significant number of cases. Hearing reproduction for music needs to have a better seal to reproduce lower frequencies to maintain the timbre.

I’d argue that (barring other issues) if your low frequency hearing is/is better than -40dB, the use of standard domes may offer some acoustic advantages over solid canal moulds. Certainly in terms of replaceabilty and cleaning there are distinct advantages.

Losses with more than -40dB in the lower frequencies IMHO will suit moulds better. My current favourite is semi-soft acrylic with a 2.4mm vent and vari-vent inserts. The face sits just inside your Tragus.

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Just speaking from experience-I stream music directly into my aids. When using custom ITEs the sound is amazing and I can hear a vast amount of lyrics. When using the same aids in a ric with double domes although it still sounded good it definitely wasn’t as good as with custom aids. Most hearing aid users will be looking for best acoustic performance.

Yes, but you’ve not understood what I’ve written above. ‘Best Acoustic Performance’ for most hearing aid wearers is a combination of DIRECT (unamplified) sound + Sounds through the hearing aid. This yields the best clarity and minimises occlusion.

Best Acoustic Performance for streamed sounds, (music/phone etc.) is a different argument. People will accept extra occlusion here to improve the timbre of the incoming sound.

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Sounds to me like your HIS at Costco doesn’t want to do it either because she has never done one before or perhaps had a bad experience doing them once. If there is another Costco near you that might be an option to getting molds. If that isn’t an option your ENT or an audiologist can do it for you. Good luck.

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As a general comment, the fitters at Costco vary in terms of experience and aptitude. Which rubs against Costco’s desire to offer a standard experience with a limited range of devices. But, you pays yer money…

Trying to read between the lines, everything I’ve read makes me think the Costco fitter got it right except perhaps could have communicated better. She likely doesn’t want to do molds because she highly suspects you won’t like them. With the closed sleeve she’s demonstrated that you don’t like a more occlusive fit, which is what you’d need to reduce feedback and it suggests that you wouldn’t tolerate the increased gain that you think you want/need. I may have it all wrong and you’re an experienced hearing aid user and just know what you want and if so, I’ll apologize in advance, but it strikes me that you’re new to all of this and trying to tell the provider what to do, which doesn’t tend to end well.

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Me being someone that prefers custom ITE hearing aids, I have found domes to be very uncomfortable to me. Now I have to say the last time I wore domes was over about 6 years ago and I am sure they have improved since then.

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I recently replaced the power domes, with which my KS9s initially fitted, with custom molds (silicone SlimTips). The improvement when listening to music, especially streamed music, has been amazing. Feedback issues etc. also vanished.

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Patti, I am wondering if the hearing aid dispenser at your Costco did not have sufficient training. Keep in mind that they are not audiologists. I quit going to Costco because they were unable to get any settings done properly. If the mold is not properly taken, it may be more than unpleasant, which I never experienced. I have severe hearing loss. My ear canals are curved meaning that the typical domes never kept the speakers in proper position, they tended to slide out etc. For that reason I always got ear molds taken, even at Costco - there was no alternative solution. If you have another Costco in your area, you may want to see if you find more experienced people there.

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Find a different hearing center or audiologists that will make them for you. You liked what you had before, so get it for your self. Also take a usb sticks back and get your audio file. Your next audiologists probably can get or has the software to tweet the hearing aids after the fitting are made if needed.

Only with the earmolds you can get the best acoustic performance. However, the cost, the size of the ear canal and cosmetic issues are the reasons why people don’t get them. The domes is the quick, temporally solution like a fast food.

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Ask to have critical gain done on the ear giving feedback, see how you do. Not sure which mfg Costco 8 is I don’t follow that too close. Be sure feedback manager is at optimum. All else fails return them
If you can

Was able to get Costco KS hearing aid attached to soft silicone mold (SO MUCH BETTER THAN HARD SILICONE…soft/easy on ear!!) attached (btw, had ear mold made by an Audiologic company that kept & transferred to these hearing aids…made world of difference (LOVE SINCE VERY PROFOUND HEARING LOSS TO HIGH FREQUENCIES; love them…ONLY THING THAT WORKS!)!
But a comment you made, made me think of myself. The loudness/amplification not helping your understanding.
That’s exactly where I started feeling like hearing aids not helping (Who wants to hear loud garble?).
Loud garble was better than nothing until cousin drove me to place (northwestern Hospital in Chicago where I was tested to see if qualified as candidate for cochlear implant.
Long story short, in one ear I have the soft silicone mold attached to Costco KS hearing aid.
The other ear had cochlear implant surgery 02/17/2020; tomorrow it gets activated!
So far (even before worse ear gets activated), kind of excited. Reason is even without it activated feel I can hear better with the one hearing aid.
Know I will hear sounds never heard before tomorrow, but feel advanced Bionics cochlear implant is somehow helping hearing aid side to hear/understand more clearly!
Something thought I’d share; will be interesting what happens after activation of cochlear implant tomorrow!

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Congratulations.
Keep us posted on your new CI.

Good luck to you! Hope everything works out. Please keep us posted.