Real ear measurements and hearing aid fitting

highlands

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I was fitted with two naida V sp hearing aids a month ago. The audiologist didn't do a real ear measurement and I wasn't happy with the fitting. Sounds were low and weak. It felt as if naidas were useless. About a week ago , I went to another audiologist and she did real ear measurements before fitting , and now I am satisfied with my aids. Real ear measurement made a lot of difference . My audiogram is attached.


What's your opinion on real ear measurement ? Many audiologist don't do it.
 

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Maybe your first audiologist's audiometer needed to be calibrated.
Maybe she didn't program your hearing aids correctly. Your audiogram only has marks for air conduction test, not bone conduction tests -- she should have given you both. So maybe that means that she doesn't know what she is doing or that she likes to take shortcuts ... at the expense of your getting a good audiogram and a good fitting.

FWIW, I had an audiologist that liked to include REM along with the battery of tests that make up a complete audiogram.
 
My first fitting was so weak , the second has been a success. I heard that many audilogist don't do real ear measurements. The second audi was very experienced.
 
Also, I don't understand why your audi sold you the Phonak Naidi. Phonaks are great hearing aids, but this particular one may not be the best for your hearing loss.

According to this phamphlet:
http://www.phonak.com/content/dam/p..._Naida_III_V_IX_Product_Information_V4.00.pdf

(See page 2 of the chart, lower left hand corner, look for frequency range lines.)

The Nadia V has an upper range of 6900Hz or 5000Hz depending upon whether you were sold the Nadia V SP or Nadia V UP.

You have a cookie bite loss meaning that you hear better in the upper frequencies and could benefit from hearing aids with an increased range. In other words, you would probably do well with a hearing aid that gives you amplification in the 7000 and 8000 Hz ranges, maybe even beyond (unfortunately most audis don't have the equipment to test beyond 8K Hz.) I would ask your audi about that.
 
Thanks for the info. I wear naida V sp aids. with soundrecover, I can now hear some more high frequencies . I experienced this with the sound of our apartment building doorbell. I now hear the doorbell with more melodies.

As for frequency range for 8000 hz , I don't know of any super power hearing aid with that range.
 
Oticon claims to be able to do so. And if one manufacturer can do so, chances are that others can also.

Some models may only be available with the receiver in the canal option (eg BTE HAs, but the receiver is in the ear mold to prevent feedback).

http://www.oticonusa.com/eprise/mai...Oticon/The_Hearing_Review/Hearing_Review2.pdf

If you don't want a RIC model, as a person with a severe loss, you could still do better than getting a HA that cuts off at 5000 Hz. (You didn't say which model Naidi that you got.)

I don't mean to burst your bubble, but from what I've seen and read, many people are not fitted well and frankly, that makes me angry. A lot of people could be doing better and they're not. I'd like to see that situation improve.
 
My previous Audi did not do REM. My current Audi does. And I'm glad she does. I was getting too much bass w/my old aids & my new aids. She was able to adjust that using REM.
 
Oticon claims to be able to do so. And if one manufacturer can do so, chances are that others can also.

Some models may only be available with the receiver in the canal option (eg BTE HAs, but the receiver is in the ear mold to prevent feedback).

http://www.oticonusa.com/eprise/mai...Oticon/The_Hearing_Review/Hearing_Review2.pdf

If you don't want a RIC model, as a person with a severe loss, you could still do better than getting a HA that cuts off at 5000 Hz. (You didn't say which model Naidi that you got.)

I don't mean to burst your bubble, but from what I've seen and read, many people are not fitted well and frankly, that makes me angry. A lot of people could be doing better and they're not. I'd like to see that situation improve.

I wear naida V super power models. ( sp stands for super power ) . Upper frequency limit is 6900 hz. Oticon doesn't have a super power model with that limit. Yet, the reason why I chose phonak is soundrecover feature which shifts high frequencies to audible areas. Oticon still lacks this. Sumo Dm was great at the time but now its technology is old .
 
It seems you like your hearing aids and I'm glad.

I'm just going to play devil's advocate though for anyone who happens to read this -- maybe it will help when its time to replace a HA.

I wear naida V super power models. ( sp stands for super power ) . Upper frequency limit is 6900 hz. Oticon doesn't have a super power model with that limit. Yet, the reason why I chose phonak is soundrecover feature which shifts high frequencies to audible areas.

But you have a cookie bite loss. So if you did decide to go for frequency shifting, wouldn't you be better off to shift your middle frequencies to either low or high frequencies?

But also, I've been told that the benefits of frequency shifting is very controversial. Now that more and more people are referred to CIs, I think some audis are especially less inclined to use it.

Oticon still lacks this. Sumo Dm was great at the time but now its technology is old .

Oticon is saying they can offer HAs with a frequency range of up to 10K range even for people with a severe hearing loss. (Link is in post #6) However, I don't know if they only offer that in their RIC models. RIC models, as I understand it, are BTEs but with the speaker in the ear.

To be honest, I don't know if I'll ever go for an RIC even if the technology is better than BTEs in some ways because I would imagine that the maintenance expense is high.
(Ear canal is damp and hostile environment for technology, the speaker probably breaks down quickly and needs to be repaired or cleaned often. And even if it didn't, I think the replacement cost for an ear mold that contains a speaker is more than for a regular ear mold.

I have a difficult enough time affording and maintaining regular BTEs!
 
Yes, I do like soundrecover. I have been understanding speech a little better than before since my upgrade to naidas and the second fitting which was ten days ago. Speech sounds clearer. Absolutely , I like the new aids. Oticon still doesn't have any smilar technology and oticon products are way expensive .

Soundrecover doesn't shift middle or low frequencies. I do get benefit but some other may not like it. It is a personal choice . Try and see yourself .

I do know you do try to help by different ideas. Thanks. I do hope hearing aids have much wider frequency range in the near future at least 10000 hz. I may think of that when I replace my hearing aids in the future.

RIC hearing aids would be hard to maintain and expensive. I never want to use them.

Frequency shifting is still new and hopefully will be improved with new algorithms.
 
I've been debating with myself about how to post in this forum.

IRL (in real life), I find I spend a lot of time being polite and talking about trivial things that no one cares about so no one gets upset.

I do post at one other forum, a skeptical forum, and that is my major intellectual outlet. I ended up there accidentally because I was trying to figure something out and I found it helpful to post there. I ended up staying because I enjoyed having a place where I could discuss any issue without having to worry about being polite.

I find it hard to get good information about hearing loss, hearing aids and other hearing related technology. So ... at the risk of being a real PITA -- I'm just going to go ahead and post some stuff even though it may make me seem disagreeable -- particularly in this thread.

Frequency shifting is old technology. An Israeli hearing aid company had a reputation for doing this at least as far back in the 1990s. I recall audiologists talking about this technology at HLAA meetings I was going to in the 1990s. I think it may have been the early 1990s, but I don't recall for sure. I also don't know when other companies started implementing this technology. But I do know that this is not new technology.

Not all audis are enthusiastic about the technology -- some claim they think it makes sounds more muddy if so many more sounds are being shifted over to a narrow bandwidth.

I admit I never tried it -- its not easy to try a lot of different technology because audis expect you to pay for your hearing aids in advance before you even try them. Perhaps I should have been more aggressive in trying more aids even so, but I had other issues going on at the last several times that I was purchasing HAs that affected my ability to try a variety of aids. And also, I had decided to trust my audi when she said that if I wanted to get the frequency shifting feature I would have to give up other features that I cared about more.

Its not as easy to try different HAs now as it use to be say in the late '80s. I remember my audi setting up several diff analog HAs at a fitting and I would tell her which one I liked best. I don't know anyone who was able to do that after digital aids became more common. Now it seems to be .. pay in advance and only get to try one pair at a time. Imagine trying to buy a car that way and then having to stretch out the process of buying, trying it out, waiting for a refund so you can try another model, buying it, trying it out, etc over weeks maybe even months. Its pretty crazy, IMHO.

Hearing aid prices defintitely vary widely by hearing aid dealer. There's a lot of variability in the prices that various hearing aid dealers can get with hearing aid manufacturers -- it all depends on how good they are at bargaining.

On one hand that's probably good -- if you ask around you may be able to find a brand that you are interested in trying at a price you can better afford. On one hand that may not be good -- a HA dealer my not realize how much his or her opinion on what brand to fit a patient is influenced by the business deals he or she has with the manufacturers. In an ideal world, an audi would only be allowed to get paid for their time, regardless of what model hearing aid they fit you with. I don't normally have a problem with capitalism -- but HA dealers are basically treated like car salesmen by the HA manufacturers despite the fact that they are selling medical devices. This this can't help but effect what models many hearing aid patients are exposed to. I don't think that medical devices should be sold the same way non-medical consumer products are.

OK, those are my comments for today. :)
 
Every hearing aid has to be specifically tuned to an individual’s cochlea; this is called coupling. The inner ear cannot be fixed; we have to modify sound before it arrives at the inner ear. Without precise tuning which matches the hearing aids to your ears, hearing aids fail to provide maximum speech understanding. Experience gives you a huge advantage when choosing hearing aids. Combine that with our classroom approach and your field trip into the world of hearing, and you will see how it all comes together to provide High Definition Hearing. Learn before you pay and you will make a winning choice.
 
Bill Robison

First time in ---ever. Recently discovered alldeaf.com. I AM A:hmm: 72 year old male in Ohio. Have worn high powered analog HAs since about age 10. Profound loss in both ears. Have had mostly Zenith Regents, if I can get them. I bought one of the last Bosch body aids made, about 6 years ago. When it needed repairs I did it myself (I am a retired Electrical engineer).I buy up "vintage HAs" on Ebay and repair them if need be. Batteries ( 2 AAs) last about a week. The regent took 2 N cells but I made a battery pack for it that accommodated 2 AAs Now I am starting to looK at digital aids,etc. Can anyone talk to me about improving my hearing?:wave:
 
Every hearing aid has to be specifically tuned to an individual’s cochlea; this is called coupling. The inner ear cannot be fixed; we have to modify sound before it arrives at the inner ear. Without precise tuning which matches the hearing aids to your ears, hearing aids fail to provide maximum speech understanding. Experience gives you a huge advantage when choosing hearing aids. Combine that with our classroom approach and your field trip into the world of hearing, and you will see how it all comes together to provide High Definition Hearing. Learn before you pay and you will make a winning choice.

I have not heard the word coupling used that way.

Coupling, when discussing hearing aids, means how sound is transmitted to the hearing aid.

Hearing aids can be set to receive sound in numerous ways. These are the ones I'm aware of:

* Microphone

* Direct Audio Input (e.g., wires plugged directly into the hearing aid boots.)

* Telecoil (In analog HAs the telecoil can be switched on. In digital HAs the telecoil is switched on by changing HA programs either manually or automatically depending upon how the HA was programmed by the audiologist and how it was designed by the manufacturer.)
* Both the microphone and telecoil at the same time. (FWIW, one of my HA programs is set for that combination. People like to talk to me while I'm on the phone. Since these are usually the same people that pay me, I put up with that. Also, I like to be able to use this setting while I'm using a room loop also.)

* FM
* Both the FM and microphone at the same time

* Bluetooth

I don't have firsthand experience with bluetooth. My current understanding is that the way this works is that:

** the cellphone (or another electronic device equipped with bluetooth) is connected to a proprietary device that receives the sound carried on the bluetooth RF (radio frequency) and transmits it on to the hearing aid.

** This can be transmitted to the hearing aid by either:
*** telecoil
*** direct audio input
*** bluetooth

This depends upon the manufacturer -- their design and methods all vary a little.

I assume that a hearing aid wearer can have both bluetooth and their HA mic on at the same time.
 
I have Phonak Milo SP Plus. Not my first choice, but its what I was able to get. I'm not recommending them -- just answering your question. :)
 
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