Wearing HA's on an ear with 'normal' hearing

Hi guys. I posted a thread about my hearing loss a couple weeks back. As you can see in my signature, I have mild hearing loss in my right ear. My left tested ‘normal’ - that is, all frequencies below 20 dbHL. I intend to aid my right ear, but here’s the problem. My left doesn’t seem to hear normally either.

A couple weeks ago, my friend played a silly prank on me. He popped an air-filled plastic bag right next to my right ear, and ever since then, my right has had hearing loss. He did the same to my left ear a few weeks later. I should have told him off the first time, but at that time I didn’t even know that what he did had caused permanent hearing loss. I thought that the ‘dull’ feeling after he popped the plastic bag on my right ear would go away, but it never did. He now knows the consequences of his actions, but it’s too late now.

Ever since then, my hearing hasn’t been the same. Everything sounds so distant and far away, even on my ‘good’ ear. So my question is - is it feasible to wear a hearing aid on an ear that is deemed to hear ‘normally’? All it’s frequencies are hovering at around 10-15 dbHL. Although this falls within the range of ‘normal hearing’, I certainly feel the effect of that 15 db loss. Previously I would be able to pick up a conversation a few metres away, whereas now it’s just noise to me. Music has also lost much of it’s quality.

I know it seems crazy to aid an ear with ‘normal hearing’, but what is ‘normal’? Definitely not what I’m hearing now. The world feels so dull and the difference between now and a few months back is like night and day. Any advice would be greatly appreciated, as I’m at a loss on what to do.

I would venture to say that many/most professionals would say “no”…however…I have had a few of patients who, at one point in time, had hearing that was around -5 to 5dB and then had a decrease to 15-20dB. Now, as far as our standards go, that is still technically normal hearing since the range of normal includes anything 25dB and below and if you had thresholds of -5dB a 15-20dB drop in hearing would still result in threshols of 10-15dB and that is well within our standard for normal hearing. BUT, are thresholds of 10-15dB normal for that person??? No, that’s a significant drop in hearing sensitivity and anyone would notice that, especially if it was a sudden loss. I have put hearing aids on a couple of these people because they had complaints characteristic of someone with a moderate hearing loss and it was negatively impacting their lives. Some like it, some feel it’s too noisy…you have to trick the software in the hearing aid a little because if you put in their true hearing loss the hearing aids won’t give them any amplification at all, since they, by industry standards, don’t have any hearing loss.

It can be done, but you have to find someone who will do it. I think once professionals let go of the idea of what is “normal” hearing we will see this more often.

Thanks for the advice, DocAudio. It really does feel significant to me. How much gain would you recommend for my level of loss? 15 db from zero definitely doesn’t feel normal at all. Any other experts care to chime in? :stuck_out_tongue:

Honestly, it’s basically just finding out what sounds best. Maybe start with somewhere around 2-5dB gain and see how that goes and go up/down based on your experiences.

In these kinds of scenarios it’s very helpful to have some sort of Real Ear measurements since the gain amounts the fitter will be dealing with are so small…they would almost need to have them hooked up and use those measurements for fitting instead of what their programming software is telling them.

Good Luck!

I have an audiogram that is similar to yours Dipshitt.

I also have Auditory Processing Disorder that affects my ability to hear, especially in noise.

I wear bilateral Oticon Acto Pros. They’ve been programmed as if I have a 20db hearing loss up to 1000Hz, and then a 30db loss from there on up.

It gives me just enough directional amplification to make it easier for me to hear people.

The key is to find a good Audiologist who will listen to you & the issues you’re having hearing, and then ignore your test results and trick their HA programming software into making aids work for you.

Hey Rosebee,

Would you mind posting your audiogram results here? I would like to see how similar it is to mine. Also, how is the sound quality from your two aids?

250 Hz—30 db
500 hz—25 db
1000 hz–15/20 db (don’t remember which)
2000 hz–10 db
4000 hz–15 db

Both ears were about the same.

I have RIC type aids with open domes, so the aids just add a little more volume in certain frequencies to add to the sound my ears get on their own.

When wearing cheap on-the-ear types of headphones JUST over the aids, music sounds decent, but much of the lower frequencies are missing because of how my aids have been programmed. The sound quality is excellent - it doesn’t sound tinny or mechanical to my ears.

Have you been to see an ENT? Has your friend offered to pay for the aids?

I’ve been to an ENT and he suspects noise induced hearing loss. My friend hasn’t offered to pay for the aids, but I’ve had little contact with him since the incident.

Not sure about this situation. The old formula for hearing loss was 1/2 gain rule so if you have 15dB of loss 7dB of amplification is approximately appropriate. The way I would fit it is by simply balancing the ears out. REM should probably be taken with and without the aids to ensure that there is a benefit and some gain provided. I have a similar notch at 2000Hz in my left ear, not so sure it is noise induced though. I have worn a HA at times but do not generally (I have access whenever I want due to being a fitter) as I find the benefit is minimal for me and it is a bit of a bother. My left ear often feels plugged and I suspect some minor middle-ear complication (ossicles?) but have not been able to get confirmation from a medical professional. Most noise induced losses I see in practice show notches at 4000Hz or 6000Hz. Notches at 2000Hz are often associated with otosclerosis (Carhart’s notch). Look it up on google. I’m not saying you have otosclerosis but there may be a similar problem with the bones in the ear. Possibly somehow due to acoustic reflex. As I am no doctor perhaps someone with more knowledge of medical pathology can elaborate.

HI Dipp,

HOw did you get on? Did you get a hearing aid? Did it help?

I recently had surgery for a patulous eustachian tube which didn’t work but has given me 15 - 20 db of hearing loss in my left ear.

So it happened quickly and is noticable. My voice sounds muffled - I think becasue of the air - bone gap so I’m getting more of the bassier signals through my skull straight to the nerve and less signals through the ear canal and eardrum - so a conductive hearing loss.

Any info you have is greatly appreciated.

Bests,
G

“Normal” hearing thresholds as you have posted, are vastly different to what you are experiencing. You have what now appears to be a higher than ‘normal’ preferred listening level. This means you require all sounds to be made louder in order for you to have balanced hearing.

To aid an ear that requires this, is not the ‘norm’, but at times is required for a more ‘normal’ ability to hear.

As for the programming aspect, amplification using the conventional methods would create essentially useless levels of amplification as they would underfit you. As stated before, the use of your preferred listening level as your ‘target’, your SRT as your starting point and your UCL as your ceiling, this should enable you to hear with relative normalness. My suggestion with respect to venting is keep it to the minimum. If the hearing aid is doing all the work, let it do so.

This method is not at all common or easy to do, so don’t be surprised if you are having people experiencing difficulty understanding what you are asking for.

I hope this helps,

One thing to keep in mind here is that 0dBHL may be ‘normal’ as is any result above 20-25dB. However, this doesn’t mean we are all born at 0dB and then get worse from there.

It is not uncommon for kids and even young adults to be able to score better than 0dB, -5 or -10 maybe even -15dBHL. So for all we know you could have been running an average of better than 0dBHL before your ‘friend’ caused you a permanent hearing loss. So while on paper your loss may still be in the normal range, if you were better than normal, and now you are towards the bottom of normal, that’s a big movement for you.

Clearly if someone is at 0 and moves to 20, that’s a 20dB movement. But if you were at -10 and moved to 20, that’s a 30dB movement; a very significant and noticeable change.

A good hearing professional should take that into account when evaluating your situation. We see lots of bad hearing losses all the time, so it’s easy to dismiss something that looks so close to normal hearing.

It’s worth mentioning that inserting a pair of ear plugs typically reduces the volume of the world around you by 25 to 30 dB. This isn’t really the same thing as having your thresholds shift from 0dB to 25dB, but should help give you a sense of how much of a difference 25 dB can make!

A few years back I had LASIK performed on my eyes. It was great to get rid of my glasses, but since the procedure isn’t always as precise as a well fit pair of lenses I did noticed that I’d lost some of the crispness and detail when viewing objects from a long distance away. My vision now is perfectly acceptable and “better than 20/20,” but having known what was possible from before I now find it just a little lacking. You probably feel the same way about your hearing and as others have said if you can find someone competent to fit your loss you’re likely to realize an improvement through hearing aids.

Hi guys, thanks for the replies. UKG, I ended up not getting a hearing aid for either ear. I trialled multiple brands including Starkey, Unitron and Oticon. Either due to poor programming or just the nature of hearing aids, they didn’t make much of a difference. The ones that did either made voices sound robotic to me, or made a constant white noise that the programmers couldn’t get rid of. I don’t have a conductive loss myself, but it’s akin to having earplugs in your ears right? If so, then your voice would definitely sound strange, even more so than with a sensorineural loss. Perhaps a hearing aid would help you in that regard, but you’ll have to ask the professionals :P.

How are you coping with your sudden loss? Even a mild loss like ours can be difficult to cope with, and if you’re going through what I did, I really understand and feel for you. I’d be happy to talk to you more about this if you need to. There’s nothing like people in the same situation to help you through it. Just PM me or reply here :).

HearingAidHelper & ZCT - There isn’t a doubt in my mind that my hearing used to be better, but this has become the new normal for me. There are some times when i feel strange, like things aren’t loud enough, but those moments are rare. I don’t require a hearing aid to carry out conversation, which if I understand properly is the main job of hearing aids. So I’m just going to live with my loss for now. But if you guys have any clients like me who did benefit from HAs, please do let me know.

MinnesotaHIS - Yeah, that’s my main problem :P. I can’t seem to find any competent audis. I do have one I really like, but she only carries Unitron, and even with her best efforts, they didn’t make much of a difference.

In my experience of your type of ‘loss’, about the only effective way to deal with it is to program the aid as if it were dealing with a flat loss approximately to the level of the worst point of your hearing. Then bias it with slightly more gain where your hearing is actually that little bit worse.

And I don’t just mean plug the numbers into the fitting software and let it spit out a prescription as you won’t like the way that the manufacturer algorithm sets the gain.

In your case, with the worst point being 20dB, all the gain handles will need to be set around 7-10dB and then a little extra bias through the mid frequencies to deal with the difference. (Ideally with REM verification)

Without this approach, your aid will effectively be switched off almost all the time and the input floor you need isn’t there.

You’ll have a couple of issues to deal with: firstly loud noises need to be limited properly, so the gains for the higher input levels ought to be set to zero. Secondly the level of input referred noise on the mics is around 23dB, so the aids themselves might be audible to you. Playing around with the gain ‘floor’ should help you see if that’s an issue.

The Unitron lady might be able to help here as their system’s remote can be used to optimise the fitting if it’s not giving you what you need. She has to be a bit judicious with the amount of gain though, as habituation to louder input levels can be cumulative and undesirable.

Thanks for the advice, Um bongo. I may ask her to give that a try when I have the time. What’s the best Unitron model for my level of loss? I’ve heard really good things about the Moxi 20, but I don’t know if they have it yet. Last I checked it wasn’t in stock.

You could give any Moxi a go, but the features are best on the 20. Your choice really, it’s a difficult one, as some of the more high-end features aren’t going to help a lot with the very mild loss.

It’s a marginal call whichever way unless you can really get the benefit of any system.

A couple weeks ago,

Err - did I read this right?

Your hearing was damaged a couple of WEEKS ago?

If so, aren’t we being a bit premature?

Why not wait a few weeks more before deciding on hearing aids.

Perhaps the ‘problem’ will resolve itself in the meantime?

If you quoted the first message, that was from July 2011.