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2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
I have the Oticon Ope S1 miniRITE hearing aids and if there's a better one out there I don't know what it would be. I love these HA's, bluetooth to the iPhone and so easy to hear the other person. bluetooth to the Oticon tv adapter that let's me crank up the volume to what ever level I want without it affecting the in room tv volume, solving a lot of problems with me not being able to understand low level conversations on the tv. if there is a downside (don't know why that would be..lol) it is that while I have my HA's cranked up to hear the tv, I can't hear the wife most of the time. ahhhh, too bad! LOL. if you can your insurance to provide you with the Oticon Ope S1 miniRITE's you won't be disappointed. get the t.v. adapter too.
Thanks....

So way back...my first set of hearing aids were supplied by a wonderful audiologist. Lydia Kreup

She tried Oticon with me as her first choice...I couldn't feel the controls? on the top of the hearing aids due to nerve damage.

She supplied Phonaks.

My second Phonaks were supplied about 3 years ago by the audiologist I fired. Peel Audiology. Peel Audiology has just been bought out by the firm set up by the company that bought out Phonak. Sonova.

The new audiologist has specified a Phonak high end hearing aid. I don't get a say....

DaveL
Toronto
 

Clix Pix

macrumors Core
I don't know a lot about the Canadian healthcare system but my first thought is for you to see about going to an audiology department which is affiliated with an ENT (Ear-Nose-Throat) specialty practice or which is affiliated with a university which has a medical school and offers Audiology as one of its health-related specialty doctoral degrees (Aud.D). In one of those audiology clinics you would have people working with you to offer choices in the brands of hearing aids that would serve your needs, rather than focusing on one particular brand or being associated with one particular brand.

Also......it is a possibility that at this point in your hearing journey that it might be recommended to you that you consider cochlear implants, which could provide a much more satisfactory experience than hearing aids. Much depends upon your actual type and level(s) of hearing loss. This would be something to discuss with your ENT and audiologist, of course, and based upon the results of the various hearing tests that you have already had and may have again when changing audiologists.
 

2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
I don't know a lot about the Canadian healthcare system but my first thought is for you to see about going to an audiology department which is affiliated with an ENT (Ear-Nose-Throat) specialty practice or which is affiliated with a university which has a medical school and offers Audiology as one of its health-related specialty doctoral degrees (Aud.D). In one of those audiology clinics you would have people working with you to offer choices in the brands of hearing aids that would serve your needs, rather than focusing on one particular brand or being associated with one particular brand.

Also......it is a possibility that at this point in your hearing journey that it might be recommended to you that you consider cochlear implants, which could provide a much more satisfactory experience than hearing aids. Much depends upon your actual type and level(s) of hearing loss. This would be something to discuss with your ENT and audiologist, of course, and based upon the results of the various hearing tests that you have already had and may have again when changing audiologists.
Thanks...
Would it help if I scanned my most recent test? I don't know the severity of my hearing loss. I have so much to learn.
DaveL
 

Clix Pix

macrumors Core
You mean scanning your test to show it here? Well, I don't think many of us are audiologists or knowledgeable enough to be able to interpret it, and aside from that it is really best to consult with trained personnel in any medical/health situation.
 

2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
Without knowing your hearing loss or your word recognition ability, I'm assuming you have a decent amount of high frequency hearing loss. Phonak hearing aids have some of the worst feedback cancellation in the industry, doesn't matter if they're lower end or high end, they all use the same feedback management algorithm in all their hearing instruments. Which means if they keep open domes on your hearing aids and turn up the highs (if the software allows), you end up with whistling (feedback). Closing things off means they have more useable gain with less chance of feedback, at the expense of taking away your normal/near normal low frequency hearing. They ran a measurement with the hearing aids in your ears the first time they put them in that measures just how much sound is leaking out of your ear canal, Phonak's software will limit high frequency gain very aggressively if too much is escaping. This in turn cause you to not be able to hear all the consonants that get you a lot of money on Wheel of Fortune, hence the lack of clarity. Patient will always prefer the feel of open domes vs. closed.
Here's my last hearing test at Peel Adiology who sold the hearing aids and set them up numerous times.
 

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2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
You mean scanning your test to show it here? Well, I don't think many of us are audiologists or knowledgeable enough to be able to interpret it, and aside from that it is really best to consult with trained personnel in any medical/health situation.
I understand.

I am working with a new Audiologist. He is helpful
He has applied to workman's comp on my behalf.
1. early replacement (5 years is the rule. it's bee about 3)
2. upgrade to a better Phonak hearing aid.

He has been very critical of the hearing aids chosen by Peel Audiology, AND the way they are set up.

Dave

both ears were tested--bad photo of the hearing test.
 

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Clix Pix

macrumors Core
Yeah, I was wondering if both ears had been tested......

That makes sense to receive workman's compensation for this since it was an injury sustained on the job as opposed to age-related hearing loss or acoustic neuroma.

It is good you have a new audiologist now and maybe that clinic and audiologist will provide the kind of hearing aids you need for your situation. Fingers crossed and good luck to you!
 
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BoxerGT2.5

macrumors 68020
Jun 4, 2008
2,104
14,136
Here's my last hearing test at Peel Adiology who sold the hearing aids and set them up numerous times.

O's are your right ear, X's are your left ear. You have a mild sensorineural hearing loss 250-1000Hz, sloping to a moderate to moderately severe sensorineural hearing loss 2000-8000Hz. Your right ear dips into the profound range at 8000Hz, not the end of the world because there's really no speech at 8000Hz. 250-8000Hz are considered speech frequencies, humans can hearing up to 20,000Hz. Your hearing loss is related to the inner ear or Cochlea. Your word recognition ability is excellent in both ears, 100% in the right and 96% in the left (missed one word). Tympanograms (Impedance audiometry) is normal and it would be unless you had a hole in your ear drum or fluid in the middle ear space.

People with your degree of hearing loss complain about the volume of the TV (or more accurately the people around you complain), they often say they can "hear" but it's not always very "clear". Soft spoken individuals are problematic, and hearing when there is a lot of competing background noise is difficult.

For your hearing loss no manufacturer recommends open domes, semi-open (Tulip) or closed. If closed domes bothered your ears then I would suggest you ask for a set of custom RIC molds to be made. You have too much hearing loss in the low frequencies to use open, if you do use open then you won't get any amplification at 250-500Hz. What'll end up happening is you'll complain you can't "hear" and if they could jack up the mids and the highs you'd perceive the sound as too tinny or sharp (if Phonaks software allowed and you didn't get feedback). Phonak has some of the worst feedback cancellation in the industry, so I'm not sure your problems are going to be solved by just going to their new Paradise hearing aid which really isn't that different from the Marvel you probably had previously. Because of that, their software will get aggressive in limiting the high frequency gain to prevent feedback. In turn if you're not getting the necessary gain 1000-4000Hz, you will struggle to hear clearly. If you are able to make suggestions about what you'd like, I'd look into the Oticon More (absolutely phenomenal) or Resound One.
 
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2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
Thanks so much.

Word recognition in the real world is terrible.
I constantly ask for help when I don't understand. And technical conversations are horrible at work. If I'm not immediately in front of the talk there's no hope that I'll hear them.

You're right...I do say I can't hear...and told that to my previous audiologist many times during many visits. She had fitted closed domes. I was a customer there for more than 5 years and they sold me my current hearing aids.

Phonak Audeo B70-312 for left and right ears.
 

2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
@BoxerGT2.5 a question...what affect do domes have on hearing aid setup and performance?

Peel audiology set up my hearing aids with closed domes after my appointment in April '21. I returned a number of times saying I couldn't hear! My hearing aids didn't work!
I had real problems understanding my wife when she talked to me face to face.
And I had horrible problems being unable to hear behind me when walking on our street. We have no sidewalks and walk our dog on the street. I can't hear cars behind me at all. I've been narrowly missed a number of times.

In desperation I've removed the closed domes. I've used open domes since then.

I'm floundering. I'm overwhelmed and trying to resolve my hearing problems. I'm cautiously optimistic that the new audiologist's appeal to workman's comp will result in my hearing aids being replaced.

Dave

I truly appreciate the help here.
 

Clix Pix

macrumors Core
As I mentioned earlier it may well be that a typically-dispensed hearing aid may not be what you need at all. In reading Boxer GT2.5's excellent post, I picked up on the reference to the cochlea(s) perhaps being a factor in all of this.... An important clue, maybe? If you've still got patent (working well) cochleas that will take you in one direction in terms of resolving your hearing issues, or if you've got non-patent cochlea(s) that will take you in another direction. Probably this is something which needs further exploration and addressing. It is very possible that off-the-shelf standard hearing aids which are dispensed to much of the population is not at all the solution which you need, and this is important for everyone involved in your hearing journey to understand and, most importantly, find workable solutions for you.
 

BoxerGT2.5

macrumors 68020
Jun 4, 2008
2,104
14,136
As I mentioned earlier it may well be that a typically-dispensed hearing aid may not be what you need at all. In reading Boxer GT2.5's excellent post, I picked up on the reference to the cochlea(s) perhaps being a factor in all of this.... An important clue, maybe? If you've still got patent (working well) cochleas that will take you in one direction in terms of resolving your hearing issues, or if you've got non-patent cochlea(s) that will take you in another direction. Probably this is something which needs further exploration and addressing. It is very possible that off-the-shelf standard hearing aids which are dispensed to much of the population is not at all the solution which you need, and this is important for everyone involved in your hearing journey to understand and, most importantly, find workable solutions for you.

The cochlea is the inner ear, where the organ of hearing is housed. It is the deterioration of the hair cells within the cochlea that lead to 95% of all hearing loss. Their deterioration can be due to age, noise exposure, certain medications, etc.
 

BoxerGT2.5

macrumors 68020
Jun 4, 2008
2,104
14,136
@BoxerGT2.5 a question...what affect do domes have on hearing aid setup and performance?

Peel audiology set up my hearing aids with closed domes after my appointment in April '21. I returned a number of times saying I couldn't hear! My hearing aids didn't work!
I had real problems understanding my wife when she talked to me face to face.
And I had horrible problems being unable to hear behind me when walking on our street. We have no sidewalks and walk our dog on the street. I can't hear cars behind me at all. I've been narrowly missed a number of times.

In desperation I've removed the closed domes. I've used open domes since then.

I'm floundering. I'm overwhelmed and trying to resolve my hearing problems. I'm cautiously optimistic that the new audiologist's appeal to workman's comp will result in my hearing aids being replaced.

Dave

I truly appreciate the help here.

All manufacturers software will recommend how to set up the instruments based on the audiogram the clinician put into the software. You can override it, meaning you can select an open dome when the software calls for a closed dome for your given hearing loss. The software will then cut all the low frequencies when that happens.

Phonak hearing aids are notorious for their aggressive directional microphone array. There is a way to make it less aggressive in the software, that's what I would have done with your complaints. By default Phonak sets the direct mics to what they call "Real ear sound", tell them to switch it to Omni for the calm situation. They might need to back it off for speech and noise as well.
 
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Clix Pix

macrumors Core
The cochlea is the inner ear, where the organ of hearing is housed. It is the deterioration of the hair cells within the cochlea that lead to 95% of all hearing loss. Their deterioration can be due to age, noise exposure, certain medications, etc.

Yes. The reason I mentioned "patent cochleas" was that for one type of hearing device -- the Bone Anchored Hearing Aid (BAHA), which is often used in situations of conductive hearing loss, it is critical that the cochleas be functioning, as they are inherent in the successful use of the external sound processor that is connected to a screw implanted in the mastoid process. This is what I use -- bilateral BAHAs.
 

BoxerGT2.5

macrumors 68020
Jun 4, 2008
2,104
14,136
Yes. The reason I mentioned "patent cochleas" was that for one type of hearing device -- the Bone Anchored Hearing Aid (BAHA), which is often used in situations of conductive hearing loss, it is critical that the cochleas be functioning, as they are inherent in the successful use of the external sound processor that is connected to a screw implanted in the mastoid process. This is what I use -- bilateral BAHAs.

BAHA's are fit primarily on those with conductive hearing impairments, which means the reason for the hearing loss is related to something in the outer or middle ear. Standard hearing aids are used on conductive hearing losses, more so than BAHA's are. Unless the patient has atresia and/or microtia, in which BAHA's are always used. Or single sided deafness, in which one ear has no hearing whatsoever, while the other ear has nothing more than a mild hearing loss (can be sensorineural). The BAHA is an ossilator, so you can't go much above 65dB without the patient feeling it more than hearing it. So there are stricter candidacy requirements for a BAHA then a traditional hearing aid.
 

Clix Pix

macrumors Core
Yup!!! Been wearing bone conduction hearing aids since I was a little girl, then went to modified BTEs (with the cord, oscillator and headband, the difference being that now the oscillator was behind the ear on one side and the hearing aid itself was behind the other ear, as opposed to a body-worn aid). When as an adult I learned about the BAHA my first thought was, "hey, I could wear TWO of these!" The device was all-in-one: both oscillator and hearing aid in a single, small unit rather than two separate entities of oscillator and hearing aid. No cords needed, no headband needed. Instinctively I knew that I was losing out on a lot by being able to wear just one aid, that the sound field was significantly limited. Humans are born with two ears for a reason. The first time I wore my BAHAs I immediately noticed the difference between hearing with just one side as opposed to hearing on both sides -- a much wider sound field. Doesn't always help with identifying sound location, though, but sometimes it does.

In 2001 I went to Johns Hopkins in Baltimore, MD, and had the appropriate audiogram and CT scans to determine if I were the prime candidate that I seemed to be (bilateral atresia/microtia, successful use of bone conduction devices) and indeed that was the case. I had the implantation surgery in April of that year and in July 2001 was fitted with my first pair of BAHAs. It was truly life-changing. I've been wearing BAHAs ever since and the freedom from headbands and cords and the constant pressure on my skull has been wonderful. I snap a sound processor on to each abutment and away I go.....and it's quick and easy to simply unsnap them to remove them for the night or showering, whatever.

The sound quality is significantly better because the implanted screw is connected to another screw which in turn is connected to the external sound processor via the abutment, and the user is getting much purer, clearer sound right from the bone as opposed to having to go through layers of tissue first.

The original BAHA was developed in Sweden by the Entific Company, which is now Cochlear Americas and worldwide. In addition, there are a few other companies which make variations on the bone-anchored theme, I believe Oticon being one, and research continues on as newer technology allows for development of newer and more effective devices such as the Osia, developed by Cochlear Americas, which has recently been approved by the FDA in the US.

Yes, in general candidates for a BAHA are those with atresia and microtia and those with what used to be called "glue ear," where the patient cannot tolerate anything in the ears such as ear molds due to frequent infections and issues in the ear canal. Those with single-sided deafness due to acoustic neuroma or other causes also benefit from the BAHA as well.

To clarify something: a bone-anchored sound processor, even though there is implantation involved, is very different from a cochlear implant, which also includes part of the device being implanted, and which is used for a different type of hearing loss, usually very severe.

The Bone-anchored hearing aid type of hearing device is definitely not for everyone, but for those of us for whom it is, the technology is remarkable and I am thankful every day for it.
 
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2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
Thanks Clix Pix!
Way back for me...bought my first hearing aid. I was unemployed at the time, and my hearing wasn't as bad as now.
I bought an in the ear hearing aid by Widex. About 2 years later they fixed feedback issues and squealing when I was eating by remaking the hearing aids using an aggressive wax template. Those hearing aids hurt! I wore them for short periods, then took them out and put them in a case kept in my pocket.
I met a fellow who had a cochlear implant or so he told me. He had a big ear like shape on the side of his head, behind his ear. He had lost his hearing. He told me that using one hearing aid affected his balance. Point is, I had fallen skiing and broke my right tib/fib. I was on crutches and trying to work. They let me go, saying "no work" and I was unemployed again.
I had been a ski instructor for 35 years. This was wayback in 2003.
 
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Mac47

macrumors regular
May 25, 2016
232
408
Really hoping the next Apple Watch can stream audio directly to MFi hearing aids without an iPhone.
 
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2mnycars

macrumors member
Jun 19, 2016
40
8
Hazeltown, Canada
All manufacturers software will recommend how to set up the instruments based on the audiogram the clinician put into the software. You can override it, meaning you can select an open dome when the software calls for a closed dome for your given hearing loss. The software will then cut all the low frequencies when that happens.

Phonak hearing aids are notorious for their aggressive directional microphone array. There is a way to make it less aggressive in the software, that's what I would have done with your complaints. By default Phonak sets the direct mics to what they call "Real ear sound", tell them to switch it to Omni for the calm situation. They might need to back it off for speech and noise as well.
I wonder if that's why I'm having trouble.

The closed Dome didn't work for me; I couldn't hear behind me.
I have open domes in the aids now.

Considering that the hearing aids were set up by the old audiologist with no high frequency gain or boost, if I have cut low frequency boost I have nothing left!

Dave
 

BoxerGT2.5

macrumors 68020
Jun 4, 2008
2,104
14,136
I wonder if that's why I'm having trouble.

The closed Dome didn't work for me; I couldn't hear behind me.
I have open domes in the aids now.

Considering that the hearing aids were set up by the old audiologist with no high frequency gain or boost, if I have cut low frequency boost I have nothing left!

Dave

Are they recalculating the fitting of the hearing aids every time they switch from closed to open and vice versa or are they just changing domes and handing you back your hearing aids?

I had a patient who wanted the "most aggressive noise reduction" in a hearing aid at the time. I fit him with Phonak and he immediately complained the hearing aid was reducing sound around him that he felt he needed to hear. Pulled him out of Phonak (who I'm not a fan of) and put him in Oticon, happy as a clam.
 
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