Hearing Impaired: What hearing aids do you wear?

[2mnycars]

BoxerGT2.5 That all happened November 21 last year. After a week or so of saying to her, "Excuse me? What did you say?" or not even knowing my wife was talking to me, I went back and wasn't grateful with my audiologist at all. This was the second time they had put closed domes on my hearing aids.
I went back to semi closed domes...2 holes. I hope that describes them. They hadn't changed the setting at all.

My hearing aids are Novak Audeo B70-313 that they had sold to me.

That's exactly how I feel. Reduced sound around me. I can't hear behind. Walking my dog on the road I live on (no sidewalks) I feel is perilous. People speed. It's terrifying and unsafe.

So yes, handing my hearing aids back with no setting changes.

In fact before the audiologist I liked retired, she hadn't changed settings on my hearing aids (closed to semi open domes). I asked her why, and she said she had another patient. Settings stayed that way until my next annual checkup.

Every time I called in or visited for batteries and parts I said my hearing aids didn't work. Last time a new worker said, "That's OK." I said "it's not. I bought them here. And you had an opportunity to do something about it." That's when I talked to the spcialist in the school board and got a referral to the new audiologist. The old one? I haven't been back. It's been about 2? months....

Thanks for your help!

 

[2mnycars]

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.

I talked to my new audiologist yesterday. Asked some questions too. He got back to me today. Said workman's comp is taking longer to answer questions as offices are opening up but with a backlog.

I had asked about loaners. I get a pair at the end of this month. Phonak Paradise.
So we are moving along....I'm happier now.

I truly appreciate your posts and the posts of others here.

(My experience with hearing aids and sleep apnea treatment are similar. With sleep apnea I found a wonderful forum, and my treatment has improved a lot. I'm happy to be able to post here. I truly am grateful.)

Dave
Toronto

 

[2mnycars]

Question:

The domes they set my hearing aids up with--two full seals.Are they the reason I couldn't hear cars behind me, and my wife to the side? I'm not using them now. However my Phonaks are still set up ad if I was.

 

[BoxerGT2.5]

Question:

The domes they set my hearing aids up with--two full seals.Are they the reason I couldn't hear cars behind me, and my wife to the side? I'm not using them now. However my Phonaks are still set up ad if I was.

Phonak's software wants to cut all low frequencies in your right ear, doesn't matter open or closed. Which means if you just put a closed dome on the right side you're going to struggle to hear someone next to you on the right. Phonak's targets have never made much sense to me in regards to prescribed gain for a given hearing loss. If the previous audiologists recalculated your prescription for an open dome, your mids and highs are getting severely tuned down to prevent feedback, as I said early. Couple that with no low frequency gain and that right HA isn't doing much for you. I'll attach the difference in prescription from an open vs. closed on Phonak and then what another manufacturer wants to prescribe and you'll begin to understand what I'm talking about.

This is your hearing test used when I did this and Phonak Paradise P90's. The first pic is the prescribed gain for an open dome and your hearing loss. The dotted line over the top of the solid red and blue lines is Phonaks feedback manager preventing the gain from reaching the fainter lines which is the target for your hearing loss. Notice there is zero gain below 500Hz and in you left ear (blue) 2000-8000Hz is getting limited to reduce feedback. As I've said before, Phonaks feedback cancellation is some of the worst and most aggressive at using gain reduction (something you don't want if you're trying to get someone to hear better.

This is with closed domes, which Phonak's software recommends for your hearing loss. Notice how the software isn't crunching down the highs (esp in the left ear) as much. That's because the risk of feedback is greatest with open domes as opposed to closed domes. Nonetheless, Phonak's software doesn't want to give you any gain in the right ear below 1000Hz. Something I don't understand why Phonak does that when you select a closed dome and the patient has a hearing loss at 250 and 500Hz.

This is an Oticon More 1 set up for your hearing loss, notice the difference? This is with closed domes.

 

[2mnycars]

Thank you so much for taking the time and showing me this!

edit: I see substantial gain at 250, 500 to 1,000 Hz in the Oticon More 1.

I don't understand Phonak closing out low frequency gain in the right ear! Latest word with the audiologist's office is that Friday August 28th I have an appointment to get some loaner Phonak Paradise hearing aids.

(Fond memories of being able to listen to music with my own ears. Started with a healthkit power amplifier I built--a chore because I'm colourblind. The amplifier worked, and passed the smoke test when I turned it on. No smoke leaked out! First speakers were Advent and I could hear the distortion. Later bought some used JBL speakers and enjoyed them. My turntable's cartridge was carefully chosen. I listened to many systems A-B testing them until I found one and used it for years.)

So my first test is on the 28th and I truly appreciate your help.

 

[2mnycars]

I Was mistaken about Domes.

They had installed Power Smokey Dome M's at Peel Audiology back in April. They have two seals.
I also have Closed Smokey Dome L's in a box. What confused me is that they have 2 holes in them.

I'm not using either of those.

I'm using Open Domes. Medium ones.

It was the Power SmokeyDomes I found reallyprevented me from hearing. I couldn't hear to the side; Couldn't hear behind. I was told by my wife that I heard much worse than before I went in (this was about a week later).

edit: Workman's Comp has a list of 3 manufacturers for audiologists to choose from. Oticon is not on the list. Phonak is.
Dave

 

[BoxerGT2.5]

Thank you so much for taking the time and showing me this!

edit: I see substantial gain at 250, 500 to 1,000 Hz in the Oticon More 1.

I don't understand Phonak closing out low frequency gain in the right ear! Latest word with the audiologist's office is that Friday August 28th I have an appointment to get some loaner Phonak Paradise hearing aids.

(Fond memories of being able to listen to music with my own ears. Started with a healthkit power amplifier I built--a chore because I'm colourblind. The amplifier worked, and passed the smoke test when I turned it on. No smoke leaked out! First speakers were Advent and I could hear the distortion. Later bought some used JBL speakers and enjoyed them. My turntable's cartridge was carefully chosen. I listened to many systems A-B testing them until I found one and used it for years.)

So my first test is on the 28th and I truly appreciate your help.

It's no problem at all.

Every manufacturer uses a fitting rationale to set targets for a hearing loss. 10-15yrs ago everyone set theirs according to NAL-NL1. Now every manufacturer has their own rationale due to proprietary circuitry and how they want their hearing aids to behave. There are times I scratch my head on how/why a company like Phonak sets their targets for a given hearing loss.

A power dome for your right ear is unwarranted, the left ear it can be used. The domes with the two holes in them are closed vented domes (the two holes are vents). They're not "open" as open domes have 5-6 larger holes around the circumference of the dome.

Chances are you couldn't hear to the side/back because of Phonaks Autosense OS that enables the directional mics. Couple that with a plug in your ear and no amplification in the right ear below 1000Hz and good luck hearing and not feeling like you have your fingers in your ears. By you using open domes you are allowing the lows to come through your open ear canal, it's just that you're at a higher risk of feedback (unless your settings are as such in the first screen shot, in which your highs in the left are getting compressed down).

Ask whomever you're seeing on the 28th if they can perform a real ear measurement in order to analyze the actual gain you're receiving at the ear drum across the frequency spectrum. This will give him/her a better understanding about what's going on in your ear. If that doesn't work, tell them to pick a different manufacturer to fit you with (Not Unitron, they're owned by Phonak/Sonnova and you'll end up with the same hearing aid/problems).

 

[2mnycars]

Thanks.
I talked to Mike the audiologist who is helping me apply for hearing aids earlier than normally allowed, and higher technology than what i have.
As i said he is getting me Phonak Paradise hearing aids on trial in two weeks. (Phonak is a mile and a half from my home. I should offer to pick them up.
Workman's Comp will not authorize Oticon as a supplier. They must have had a request for proposals to reduce cost.

Sonnova bought Peel Audiology...through another company they own.

When I go in to choose glasses and pick them up, I expect to see better. When I go in to see Peel A. I expect to hear better coming out. Twice i had 5 visits to resolve hearing problems after an issue. Their test for word recognition was in the booth with me straining to hear. Real world I have real trouble with word recognition. And real trouble realizing I'm being talked to. 74 and counting. Maybe that's part of the problem.

 

[2mnycars]

I'm very happy. Workman's Comp has approved new hearing aids for me. Phonak Paradise rechargeable...I'll learn more.

I'm getting them earlier than normal....about 2-1/2 years early...they approve new ones every 5 years.
I'm getting the ones my new audiologist suggested. Phonak Paradise. rechargeable. Blue tooth.

He's offered loaners for Friday...I hope I still get those.

Now I get to pick colour.

Oh...Oticons are not available. 3 manufacturers passed the selection process. Phonak and Siemens I remember from what I was told. So it's Phonak Paradise for me.

Everyone that has commented has helped me. Thank you.

Dave
Toronto

 

[BoxerGT2.5]

I'm very happy. Workman's Comp has approved new hearing aids for me. Phonak Paradise rechargeable...I'll learn more.

I'm getting them earlier than normal....about 2-1/2 years early...they approve new ones every 5 years.
I'm getting the ones my new audiologist suggested. Phonak Paradise. rechargeable. Blue tooth.

He's offered loaners for Friday...I hope I still get those.

Now I get to pick colour.

Oh...Oticons are not available. 3 manufacturers passed the selection process. Phonak and Siemens I remember from what I was told. So it's Phonak Paradise for me.

Everyone that has commented has helped me. Thank you.

Dave
Toronto

Ask Mike to order them with the new ActiveVent receivers, it might be something that can work perfectly for you.

Hearing Aids | Phonak

Compare Phonak hearing aid features to find the best model for your needs.

www.phonakpro.com

 

[2mnycars]

I'll find out more tomorrow...thanks for the suggestion.

 

[2mnycars]

Got them. I'm so impressed. They work so much better than my old ones. The audiologist is so easy to work with. I left with the hearing aids, new case--self charging Hints for better use (some change of habits) During a follow up appointment he is going to take my old hearing aids and re-program them so I shall have spares.

Rechargeable==no batteries to change (fiddly for old hands and eyes)
Wax shields are different.
Domes are different.

Came with an app. I've already adjusted volume; too much when I used my iPhone I had feedback. So I put it back to the normal setting. The app appears to have many settings....

I'm grinning from ear to ear. (my concerns about which brand to buy were resolved. workman's comp allows Phonak, Siemens and another brand. not the Oticon brand.

I didn't get the new ActiveVent. I'm grateful for what I have. Oh--got a tv streamer too.

Dave

Heartfelt thank you to everyone who responded, and your patience with me.

 

[Hallstar]

I’m in the UK and have NHS issued Phonak Naida V-70 SP - BTE.

I have been wearing HA’s in both ears since my early 20’s (I’m now 43)

I had Siemens models early on, but mostly I have had Phonak.

 

[2mnycars]

Ask Mike to order them with the new ActiveVent receivers, it might be something that can work perfectly for you.

Hearing Aids | Phonak

Compare Phonak hearing aid features to find the best model for your needs.

www.phonakpro.com

Thanks for your suggestion.
Mike got permission for Paradise HA's quickly. They don't include the ActiveVent receivers. I can request them later.

He has been incredible. He has worked miracles for me. I've used the new Paradise aids with rechargeable batteries for about 1-1/2 months now. They are great.

He gave me about 6 different dome types. I've tried them. I'm using the largest open domes. I have no issue with feedback.

At one point I was told I was talking much to loudly. I was using the smallest little domes supplied to me. I went back to the large open domes, and I've stayed with them. Haven't been told I'm talking too loudly. The only change was the size of the domes (went from small to large open) and it seems to work.

I've experimented with the programs a little bit. This whole week I left the Paradise on auto. I've had a week's vacation and it's been glorious. First time off in a long, long time.

I'm very grateful to have these new hearing aids. They are so much better. I wear them for about 17 hours every day. Battery strength is wonderful. I've only forgotten to charge them once. And it took about 1-1/2 hour to charge fully from being absolutely flat.

Dave

 

[BoxerGT2.5]

Thanks for your suggestion.
Mike got permission for Paradise HA's quickly. They don't include the ActiveVent receivers. I can request them later.

He has been incredible. He has worked miracles for me. I've used the new Paradise aids with rechargeable batteries for about 1-1/2 months now. They are great.

He gave me about 6 different dome types. I've tried them. I'm using the largest open domes. I have no issue with feedback.

At one point I was told I was talking much to loudly. I was using the smallest little domes supplied to me. I went back to the large open domes, and I've stayed with them. Haven't been told I'm talking too loudly. The only change was the size of the domes (went from small to large open) and it seems to work.

I've experimented with the programs a little bit. This whole week I left the Paradise on auto. I've had a week's vacation and it's been glorious. First time off in a long, long time.

I'm very grateful to have these new hearing aids. They are so much better. I wear them for about 17 hours every day. Battery strength is wonderful. I've only forgotten to charge them once. And it took about 1-1/2 hour to charge fully from being absolutely flat.

Dave

The fact that you are doing so much better with the Paradise as opposed to your previous set of Phonak aids (likely Marvels, unless they didn't fit you into the current line at the time) leads me to believe whomever fit you did a horrific job. But I'm glad you're finally doing well. There honestly isn't that much difference between the Marvel and the Paradise. Which is why I tell patients all the time, "You can shop price of the device, but you better like and have faith in who's fitting you because they're going to make or break your success with those devices."

 

[2mnycars]

thanks for your comments. I've never had the Marvel HA

Mine were B70-312's.

They were set up very poorly. Your comment about "you better like and have faith in who's fitting you because the'r going to make or break your success with those devices" is absolutely true.

 

[FocusAndEarnIt]

So glad to see this thread so active. I’m the OP.
I have Audeo Paradise P90-13T’s and am a self programmer with some help from the audiologist. LOVE these hearing aids!!!

 

[2mnycars]

Thanks FocusAndEarnIt
Your post helped me a lot. I was using other Phonak hearing aids with real difficulty when I found your post. They were Phonak B70's. They were set up wrong.
I had found a new audiologist who had been recommended to me by a hearing specialist at work.
Long story short--I got the Paradise hearing aids with rechargeable batteries. You helped me make that decision. I'm sorry I posted so many times--but I have so much to learn.

My new audiologist said that I should work as you have self-programming the hearing aids. I've been using the auto program, and cranking the volume up a little.

I really really want to learn more about self programming. May I post here? or start a new thread?

DaveL
Toronto

 

[FocusAndEarnIt]

Thanks FocusAndEarnIt
Your post helped me a lot. I was using other Phonak hearing aids with real difficulty when I found your post. They were Phonak B70's. They were set up wrong.
I had found a new audiologist who had been recommended to me by a hearing specialist at work.
Long story short--I got the Paradise hearing aids with rechargeable batteries. You helped me make that decision. I'm sorry I posted so many times--but I have so much to learn.

My new audiologist said that I should work as you have self-programming the hearing aids. I've been using the auto program, and cranking the volume up a little.

I really really want to learn more about self programming. May I post here? or start a new thread?

DaveL
Toronto

Feel free to post here! However you need to know that self programminghearing aids with the software that audiologists use can not be recommended unless you really have a deep sense of how hearing aids work. You could harm yourself. I am a lifelong wearer and in healthcare and also have a unique working relationship with my audiologist. She knows I have the equipment at home to self program. It’s made a true difference for me as I have been able to make subtle changes in a stepwise fashion. But really she has done 90% of the works and i tweak the remaining 10%. I cannot recommend it as there are serious risks involved if you don’t know what you are doing. But I also can say that self programming has unlocked me to hearing the best I ever have. Speaking as a doctor with a deep respect for audiologists, I will say that audiology is like medicine. It’s certainly a science, but there’s an element of art to it. An audiologist doesn’t hear what you hear, and if you make the changes in real time and experience the difference for yourself, it can really help.

I think you should use the myPhonak app to do exactly this and NOT self program. That gives you a ton of control and can help you figure out what you need, if changes are in fact needed. Make programs and once you find the perfect one (or several), then show what you did to the audiologist and they will be able to make a similar default program, if that makes sense.

the biggest thing is probably making sure your hearing aids are fit with real ear measures. Bring this up to your audiologist if you aren’t sure. For more info on REM, check out this video:

Dr Cliff is awesome and very knowledgeable. He’s not blowing smoke on the importance of REM. I lived the first 25 years of hearing aids without REM and the difference it made was astounding and at times incredibly frustrating I went so long without REM — I could have been hearing so much better.

MR is great, but if you really want to take a deep dive in hearing with a community online, check out HearingTracker.com and the forums over there.

edit: also, not sure if any of this has already come up yet - I haven’t had the time to read the whole thread.

 

[2mnycars]

Understand now. My audiologist suggested that I use the software app and save programs that work.

I haven't done so--but I hope to develop some skill there.
I find myself increasing gain on the automatic program. That's all.

I've worn hearing aid(s) for about 20 years. One at first. Now I've had 3 sets of PHonaks. first experience was absolute gold. When I had to change audiologists when the first wonderful one retired, things went downhill. Severely.

Things are improving. My wife hasn't asked whether i'm wearing my hearing aids in the last week....and that's after my follow up visit with my wonderful new audiologist. I've had my new Paradise Phonaks for almost 2 months now.

Thanks for helping. Means a lot.
Dave

 

[2mnycars]

I appreciate the time you've taken.
Yes the audiologists have used REM. However, they have not followed the line suggested as well as the video shows.

I am posting at hearing tracker.com My experience confirms that the ability of an audiologist to set up the hearing aid is the most important factor in treating my hearing loss.

Thanks again.

 

[BoxerGT2.5]

Feel free to post here! However you need to know that self programminghearing aids with the software that audiologists use can not be recommended unless you really have a deep sense of how hearing aids work. You could harm yourself. I am a lifelong wearer and in healthcare and also have a unique working relationship with my audiologist. She knows I have the equipment at home to self program. It’s made a true difference for me as I have been able to make subtle changes in a stepwise fashion. But really she has done 90% of the works and i tweak the remaining 10%. I cannot recommend it as there are serious risks involved if you don’t know what you are doing. But I also can say that self programming has unlocked me to hearing the best I ever have. Speaking as a doctor with a deep respect for audiologists, I will say that audiology is like medicine. It’s certainly a science, but there’s an element of art to it. An audiologist doesn’t hear what you hear, and if you make the changes in real time and experience the difference for yourself, it can really help.

I think you should use the myPhonak app to do exactly this and NOT self program. That gives you a ton of control and can help you figure out what you need, if changes are in fact needed. Make programs and once you find the perfect one (or several), then show what you did to the audiologist and they will be able to make a similar default program, if that makes sense.

the biggest thing is probably making sure your hearing aids are fit with real ear measures. Bring this up to your audiologist if you aren’t sure. For more info on REM, check out this video:

Dr Cliff is awesome and very knowledgeable. He’s not blowing smoke on the importance of REM. I lived the first 25 years of hearing aids without REM and the difference it made was astounding and at times incredibly frustrating I went so long without REM — I could have been hearing so much better.

MR is great, but if you really want to take a deep dive in hearing with a community online, check out HearingTracker.com and the forums over there.

edit: also, not sure if any of this has already come up yet - I haven’t had the time to read the whole thread.

You want to know why 70% don't use REM's? Because they were useful when every hearing aid manufacturer was using the same fitting rationale (NAL-NL1, POGO II, ect). Now every manufacturer has their own proprietary fitting rational that general REM systems don't take into account. Secondly, it's usually bad practice (other than when fitting pediatric patients), to tell a patient their hearing aids are set where they should be because I did Real Ear and I know better than you, in the face of them telling you their hearing aids are too loud, tinny, sharp, etc. Yes measuring the output of the hearing aid at the eardrum is useful, but when the patient tells you his/her aids are too loud you can now throw that measurement in the trash.

In all honesty, it's turned into a gimmick. Because Dr. Cliff feels it differentiates him from the hearing aid dispenser down at Beltone who couldn't perform Real Ear if his/her life depended upon it. Patient's think it looks cool, like video otoscopy, but at the end of the day you have to listen to the patient. I'll do real ear when a patient can't provide me feedback. I'll do it on a surgically altered ear as well. To try and match target on a first fitting/new user is insane. First fittings are about easing people back into the hearing world. I liken it to when we wake up in the morning and walk out to a brightly lit room, we're all squinting because our eyes haven't seen light for 6-8hrs. People walk around with hearing loss for years before they decide to do something about it, matching real ear targets during a first fitting is like flipping the switch and telling the patient "Here's all this sound, try and get used to it." I recently saw a patient who will never attempt to be fit again because she went to someone like that. A person who had WAY too much faith in her white lab coat IMHO.

 

[FocusAndEarnIt]

You want to know why 70% don't use REM's? Because they were useful when every hearing aid manufacturer was using the same fitting rationale (NAL-NL1, POGO II, ect). Now every manufacturer has their own proprietary fitting rational that general REM systems don't take into account. Secondly, it's usually bad practice (other than when fitting pediatric patients), to tell a patient their hearing aids are set where they should be because I did Real Ear and I know better than you, in the face of them telling you their hearing aids are too loud, tinny, sharp, etc. Yes measuring the output of the hearing aid at the eardrum is useful, but when the patient tells you his/her aids are too loud you can now throw that measurement in the trash.

In all honesty, it's turned into a gimmick. Because Dr. Cliff feels it differentiates him from the hearing aid dispenser down at Beltone who couldn't perform Real Ear if his/her life depended upon it. Patient's think it looks cool, like video otoscopy, but at the end of the day you have to listen to the patient. I'll do real ear when a patient can't provide me feedback. I'll do it on a surgically altered ear as well. To try and match target on a first fitting/new user is insane. First fittings are about easing people back into the hearing world. I liken it to when we wake up in the morning and walk out to a brightly lit room, we're all squinting because our eyes haven't seen light for 6-8hrs. People walk around with hearing loss for years before they decide to do something about it, matching real ear targets during a first fitting is like flipping the switch and telling the patient "Here's all this sound, try and get used to it." I recently saw a patient who will never attempt to be fit again because she went to someone like that. A person who had WAY too much faith in her white lab coat IMHO.

Wholeheartedly agree. That's why audiology (and medicine) is an art: you take what you know and apply it to the patient in front of you, and it is directed based on what they tell you (within reason).

On a technical note, of course you wouldn't use REM with say Phonak's algorithm. Personally I use NAL-NL2 and thus can use REM to meet targets. It really did make a huge difference for me. Phonak's algorithm predicted that I would want way too much bass (i.e., sensation of volume) than was really indicated for my HL or desired by me. On NAL-NL2, I say "what?" about 20% of the time as compared to the HA maker's algorithm. But as with most things, other people's mileage may vary.

 

[2mnycars]

Thanks. Great posts.
My audiologist uses REM; so did the previous 2 audiologists I saw. I thought it was state of the art.

Trouble hearing the last couple of day using my Phonak Paradise HA's. my wife said I wasn't hearing her at all. Asked what's changed?
I had changed the wax filters on my paradise speakers. I messed up. Left one was way out of place. Right one was fine.
I've had problems putting them in.
Talked to my audiologist. Suggested--he agreed--that I would do without wax filters until I saw him. Time for some re-training on how to change the wax filters. They're so tiny. I never had issues with my previous Phonak's. They had larger wax filters.
Follow up--I'll see him on Monday. Couple of days.
Dave

 

[BoxerGT2.5]

Thanks. Great posts.
My audiologist uses REM; so did the previous 2 audiologists I saw. I thought it was state of the art.

Trouble hearing the last couple of day using my Phonak Paradise HA's. my wife said I wasn't hearing her at all. Asked what's changed?
I had changed the wax filters on my paradise speakers. I messed up. Left one was way out of place. Right one was fine.
I've had problems putting them in.
Talked to my audiologist. Suggested--he agreed--that I would do without wax filters until I saw him. Time for some re-training on how to change the wax filters. They're so tiny. I never had issues with my previous Phonak's. They had larger wax filters.
Follow up--I'll see him on Monday. Couple of days.
Dave

I'm assuming you're using the wax guards that come in the disk, they're a PITA and I really wish some manufacturers would just stop trying to be "proprietary" and just use what's easiest for the patients.