Hearing Aids

It certainly does need to be corrected. Your audiologist should know what to do, but whether an NHS audiologist has the time to do it well is another thing. That is why I buy hearing aids privately. And also why I adjust them myself. You have to have the special hardware and software to do that and also you have to learn to understand what you are hearing. This isn’t the place to describe all of that as it’s a bit controversial to DIY your hearing aid adjustments. But if you use google and look for DIY hearing aid adjustment, you will find the more suitable place that does exist in a forum much like this one.

This experience sounds a bit like when my audiologist used a different algorithm to the Phonak one (in an effort to improve speech recognition) but music was horrible and traffic and clocks ticking were just too much.

So check that the audiologist is using the Phonak algorithm ( or prescription, not sure the exact name).

.sjb

I think it’s “Prescriptive Fitting Algorithm” or sometimes Formula instead of Algorithm -depends on the hearing aid manufacturer, as to how they describe it. The “prescription” is what the prescriptive fitting algorithm makes of your audiogram.

I recently went for Widex HAs. I have to say they are better than expected. Certainly revealing details I had long forgotten.
In reality, they only amplify the higher frequencies I could not hear anyway.
Music mode is effective, even with headphones!
They were pricey, but I do have a great audiologist who really understands my needs.
Definitely a good investment

Today I had my (almost) 12 month hearing test and things have got slightly worse although nothing to worry about, I was assured. The reset Phonaks definitely seem to be doing more than before, which wasn’t much. I now realise that the nice people I’ve so far dealt with are not actually audiologists so I have been given the audiologists’ names and I number to call to bypass the online booking system. I’ll book an appointment over the next few days.

I do find it all quite difficult to come to terms with and I’m not listening to as much music these days, if I’m honest. There is a temptation to focus on what is missing rather than what remains.

Keith

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

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!

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.

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.

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.

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.

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.

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.

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.

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.

Maybe Mrs Pete has been replaced by an Alien shapeshifter?