Hearing Aids

Lounge
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It may be a sweeping generalisation here and I may be misinterpreting some things.

It appears that NHS audiology departments prescribe a one size fits solution using HAs not on the Phonak website.

My and I assume other private audiologists chose a whole of market approach to HA’s and supply the one most suited to your lifestyle in fact in my case it took longer to discuss what I did work and hobby wise and wanted to, than it did to fit the aids!

I seem to remember Phonak ones were described as a bit like Apple OS - it just works and there were some adjustments made to the automatic mode with Music, restaurant user selectable for fine tuning in situ.
whereas Widax were a bit like Linux infinitely adjustable in some cases by the users and were the preferred HA”s for professional musicians.

My private consultation included a standard hearing test and an interpretation test where I have to repeat a few words / sentence from noisy background some sentences were consonant rich and some vowel rich was from these two examinations my prescription was made up (Phonak)

The downside is ones has to pay

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I’m assuming “NHS” means National Health Service – not, non-hearing specialists, or something like that. :slightly_smiling_face: I’m in the US, where our politicians think it’s better to make us pay the highest health services rates in the world, for worse outcomes.
But, back to hearing aids and my particular problems, I do have a follow up visit with my audiologist, who I like a great deal, and will try to see if he can give me access to adjustments. The HAs I’m using are loaners from the audiologist to see if they work for me, and only then will I actually buy them. I’m wonder if there are huge differences in sound quality b/t brands, and Oticon, which I have, are very highly rated for sound quality.
Thanks for your feedback!

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Yes that is the UK National Health Service.

There are lots of top brands and they can all sound good if they are adjusted right for your hearing loss. Oticon is good, but so is Phonak, GN Resound, Widex and a bunch of others. Some suit some types of hearing loss better than others, which is why no-one can say that the best hearing aid is brand xyz, because what’s best for me may not be what’s best for you.

Anyway that’s why we need audiologists to work it out for us.

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Two questions:

  1. Anyone have experience of the Audibel AI 2400 by Starkey? If so what do you think of them?
  2. Regarding the hearing test by good private audiologists, do they measure at only about 8 frequencies (e.g. 250, 500, 1k, 2k, 4k and 8kHz) or do they do more, filling in the gaps?

For a birthday present my sons booked me an appointment with a local private audiologist (nearest of the two there are here), offering to pay part of cost if I found something better than the Phonak Nathos Nova I’d got from the NHS six weeks earlier. Audiologist did the same tests as had the NHS one, and asked we what I was wanting out of it. I said a prime interest was music, and that I have a very good hifi system, go to concerts and play music myself. I also told him about my NHS aids (about which he was quite dismissive, and actually ill-informed - he said they just boost everything, not just the required frequencies). He talked about two or three models, saying most people go and are very happy with the second to top (£5,700, top being about £2k more), so I said OK, try that. They are the Audibel AI 2400.

A week into trying them, and bearing in mind I’d had the NHS ones for six weeks and so not completely new to wearing aids, they are certainly not leaping out and saying “buy me” like I would expect spending even half as much on a piece of hifi kit. As set up they are unpleasantly shrill, over-emphasising sounds like water droplets, rustling paper, clattering crockery and cutlery, rusting waterproof clothing, to the point where if I am somewhere where that is constant I have to turn the volume down very low. Listening to music that same shrillness catches some bits of some music. Doing a hearing test on myself using a phone app and comparing the two aids, they appear to be giving a similar compensation with nothing peaking at any of the measured frequencies. At the moment I can’t hear any benefit of these aids over the NHS ones - quite the reverse! have a checkup appointment in a week’s time and obviously will explore with the audiologist then, but in the meantime anyone’s thoughts/experiences around either this particular aid or this type of problem would be very useful.

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I don’t know that particular model of hearing aid, but I have long experience of using hearing aids and all of my Naim kit has been bought since I started using hearing aids.

The problem you describe of some frequencies making shrill sounds is also one I recognise. It does get discussed in hearing aid circles a bit, the effect being that the aids have been set up by the automatic fitting software to match your audiogram, but sound shrill at some (upper mid or treble) frequencies. I believe this is basically caused by non-linearity in your cochlear. Normally high frequency hearing loss is caused by damage to hair cells in your cochlears. This could be by viral disease, exposure to loud sounds or other disease process.

The standard hearing test measures your threshold of hearing, so the quietest tone you can reliably hear at a number of frequencies. It’s hard to conceive of another way of doing it, but some people (including me) believe that ideally you would use a test that looks for equal loudness above threshold. That is obviously very subjective and would take a long time to get right. It’s also hard for a professional to know whether you are right if you say tone a is the same loudness as tone b. One could imagine a large number of tests of the “is a quieter or louder than b” variety. But no-one does that.

Anyway the point is that it is quite likely that some tones are amplified too much because your threshold is low. That can cause shrillness, particularly noticeable in music.

The currently used way to get things right is to fit using the automatic software and then adjust from there to get the best word recognition score. This reflects that the whole hearing aid industry is focused on getting best speech comprehension, especially in noisy environments that are particularly challenging.

For people who are interested and willing to go deeper into the whole thing, it is possible to get the fitting software and the special wireless interface that allows you to adjust your hearing aids in the same way the audiologist does. This practice is somewhat frowned upon because it would be easy for someone who just blundered into it to actually cause further harm to their hearing. But nevertheless you can do it if you want to and you can do all the same online courses that your audiologist will likely have done.

Anyway, the point of all this is that you can ask your audiologist to reduce those strident frequencies a bit. I would say take 2dB off to start with snd reassess it from there. If you are able to adjust them yourself, then you can actually sit in front of your hifi with your hearing aids connected to the fitting software and adjust in real time on the music you want to sound right. Then you save the session and get on with your life!

On your question about the number of measurement frequencies, the audiologist can increase the number, but there is very little point in doing so. You might even make things sound worse. In my chosen make, the standard frequencies used are 250, 500, 750, 1K, 1.5K, 2K, 3K, 4K, 6K and 8K.

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Thanks, David - interesting and potentially useful. The audiologist did do a speech recognition test, which was fine. One thing I have thought of doing Before next seeing the audiologist is playing a sweep tone to see if I can identify any particular problematic frequencies.

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Yes that’s a good idea. Don’t forget that the answer may be different if you do it quietly from if you do it loud. So do both!

If you do want to get into adjusting them yourself at some stage, then there is a whole lot more I can tell you including how to get the fitting software and so on. But probably not in this forum. (There is another forum though….)

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I have a Widex pair that are great for everyday use. Via the App, I can switch to “music” mode and via a sort of graphic equaliser tune to suit a hi fi environment. Settings can be saved.

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Earlier in the year I decided to to demo a few brands of HA as I would hifi.

I had done an A vs B on Phonak vs Widex initially (choosing Phonak) so went for newer Phonak vs Resound vs Starkey.

In the end, I just stayed with my current Phonaks as none of the three gave the sort of improvement that you would expect from the outlay.

Certainly, I found the Starkey gave quite a different presentation with music to the resound or phonak, and I could imagine that some people would very much prefer it. I got the impression that it was a bit like the difference between minimum phase and linear phase filter implementations.

My recommendation would be to try a similarly priced phonak model so you will be comparing like with like and you would really get an idea of how much your current NHS set are giving you and I’d be very surprised if there was night and day difference.

.sjb

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What does your graphic equaliser actually adjust? My app on the Phonak Nova NHS ones has sliders for bass middle and treble, but subjectively I think it us relative to the assistance range not what we think of with hi-fi, with “bass” more like 500Hz, middle 1-2KHz an treble 4 KHz, and my trial Audibels have low, mid, high and ultra , but I think range isnof a log fifferent.

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There are 14 bands to adjust across the frequency range. I leave the bass and mid as is but take the HF down by about 10% if im listening loud.
If for background I leave the settings alone.
Apart from the frequency adjustment, there are several modes and directionality to play with
Music mode takes out all compression and gives 360 degree soundstage

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Mrs Pete has hearing aids that were responsibly expensive and I often hear them chattering away, that kind of noise would drive me crazy. Is it normal for them the make so much “background” noise.

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38

I assume she doesn’t hear it as amything spurious, and that what you’re hearing is leakage of the higher frequencies being amplified and played in her earpieces to compensate for her hearing loss - leakage just like when you are close to someone wearing earbuds playing music, except her aids are probably only playing high frequencies, possibly with increasing loudness as frequency increases. If set up right the user shouldn’t notice anything, other than restored (or partially) upper frequencies.

My wife says she can’t hear anything from mine - but mine might not be amplifying as much,p.

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It often like there’s aliens with us all the time and it doesn’t sound like anything we’re playing or saying. It’s totally random.

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Maybe Mrs Pete has been replaced by an Alien shapeshifter?

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That could explain a lot. :rofl::rofl::rofl:

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The question now, is how long ago did it happen?

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Who knows, they (aliens) must be pretty damn bored if they’ve chosen us as an entry point to humanity.

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Humanity? No, just to Oz :joy:

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45

I posted this elsewhere a couple of days ago, and am adding it here, with a few edits, in case it’s useful.

As some will know, I lost the hearing in my left ear in Spring 2020 during Covid. This was my good ear, and the right was pretty ropey. In late 2020 I bought Starkey hearing aids privately, as the basic aids I got from the NHS via their contract with Scrivens were pretty useless. The Starkeys are Cros aids, where the left sends sounds to the right.

Since 2020 I’ve found female vocals on folk and classical virtually unlistenable on the stereo, which was pretty upsetting as it’s one of my favourite firms of music. This is largely what led me to explore changing speakers earlier this year.

I recently bought the Unthank : Smith album and it made no impression as I really couldn’t hear the words, which are the heart of the album.

Anyway, a few months ago I read a post on here that the NHS could do Cros aids, which was news to me. I went back to Scrivens, who told me that they don’t have the contract for Cros aids. The contract in this area is with QA hospital. Setting aside the pottiness of NHS contracting, after a doctors letter and an appointment at QA, last week I got my new NHS Cros aids. Unlike the private supplier, the testing was done in a sealed room, and the fitting and programming was a million times better, with microphone probes put in my ears as well as the aids so everything could be set perfectly.

What a revelation. The improvement in sound quality and sheer engagement is astonishing. I listened to Unthank : Smith last night and could hear every word. I can listen at 31 on the Nova rather than 39, which Mrs HH is delighted about. My free NHS aids have given me a whole new stereo for free, and I’ll no longer have to spend £3,000 on new private aids in a couple of years time. Simply amazing.

The above is what I posted on System Pics, so it was deliberately hifi related. The new aids have given improvements all round and I can hear so much more. The way extraneous background noises are excluded is way better. I can hear speech better, the radio better, and they work in echoey rooms much better.

I’m an inquisitive person, and inspired by the improvement I rang Oticon and asked where the NHS aids sit in their range, and whether spending £3,000 on private Oticons would get me even better hearing than the NHS aids provide. Given that I was speaking to Oticon I expected an unequivocal yes. They told be that my aids were just as good sonically as their top aids, and that what you are getting is more bells and whistles. Basically I was told to save my money, which I thought was hugely refreshing.

As I understand it, the aids that you pay £3,000 for cost about £300, and the rest is paying for aftercare, running costs of the provider, and profit.

I’m not suggesting that the Oticons are better than the Starkeys, rather that it’s all in the fitting. My private appointment was done in a consulting room, the aids were tailored to my audiogram, and that was that.

The NHS test was done in a soundless room, which must make a difference, but it was the fitting that differentiates the two. They put probes in my ears and played tones through a speaker. This gave a trace of the sound that was being heard in my ears. They then put in the aids, which were connected to the computer, and set them so that the two traces matched. They then balanced the two aids using the same method.

Maybe some providers have this tech, but mine didn’t, and the results show very clearly. The downside of the NHS aids is that they take batteries, whereas the private Starkeys are rechargeable, which is much better environmentally. That said, the internal batteries of the Starkeys failed after two years.

As I wrote above, Scrivens have the NHS contract locally for standard aids. I ended up at QA - that’s Portsmouth’s Queen Alexandra hospital - because I have Cros aids. But whoever does it, don’t think that paying £3,000 for a swish private fitting will necessarily get you more than the NHS.

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