Hearing loss -- I can't understand conversations

Allow me to share my experience since I started wearing hearing aids in 2007 because I was increasingly facing difficulties with word recognitions, such as understanding my team members during project review meetings. In noisy restaurants it was even more noticeable. I was fitted with a pair of Oticon Epoq which cost me at that time a whooping $6,600. Initially, I faced the same issue as you: I could not hear clearly and I had to make more efforts to understand others, so when the meetings were over, I would take the hearing aids out. I never wore them at home. That was a mistake. Complaining to my audiologist, she repeated again to wear them all the time during waking hours in order to allow the brain to gradually adapt to recognizing again the sounds as it remembered it. Having "gotten the message", wearing them all day became a habit and my word recognition in any environment was no issue. Whenever I felt an adjustment was needed, I would get a hearing test, the HAs would be adjusted, again requiring my brain to adapt to it, sometimes it would take a few hours, sometimes 1-3 days maximum. As my hearing gradually deteriorated, I was fitted in 2017 with a pair of Oticon miniRITE S1. It took my brain about 2 weeks to adapt to them and I wouldn’t even notice I was wearing them.

The key point I want to make is that apparently many licensed audiologists (they have a doctor's degree in audiology), as well as the Licensed Hearing Aid Fitters (like at COSTCO) apparently don’t explain it well enough, or emphasize, or make it clear to HA users that there is a need for the brain to adjust to the sounds provided by the hearing aids. Whether the patient is new to hearing aids, or a longtime user seeking an adjustment, or needing HA replacement, the brain simply needs time to adjust to it. It requires patience and sometime determination. There is no way around it.
On the online Hearing Aids Forum I found other HA users making similar comments.

@deberh

Excellent explanation in understanding how hearing aids work. I have been wearing aids for over 40 years and have only come across one audiologist who adequately explained what I would be experiencing, what to expect and the limitations of hearing aids in general.
I am not sure what @jane87 means by clarity but I suspect it has to do with speech perception or understanding . I have a profound bilateral hearing loss and wear powerful Phonaks. I don’t have all the bells and whistles programmed because, no matter how high end the aid is, I will always have trouble understanding what people are saying especially in loud environments. I am better at one on one conversations and rely on a phone app (Live Transcribe) for back and forth in groups.
It’s unfortunate that most audiologists or hearing aid techs don’t give adequate explanations to their patients. This should be in their training.
The only additional information I could offer is to be very clear and specific to the Audi what exactly are the problems you are experiencing . Keep a journal and jot down the situations where you are having the most problems. It’s a big help in adjusting and reprogramming.

I hear ya
Fl Mary

@ deberh and imallears Thank you for sharing your information, which explains the reality of hearing loss and the typical issues with speech understanding in noise. Hearing aids do not make that issue go away when the degree of sensorineural hearing loss is severe or more profound.

@ jane87 The damage to the hearing mechanism, most likely, lies in the cochlea, which when healthy is full of tiny hair cells that each distinguish different sounds. Those cells are damaged when hearing loss occurs; not all of them, but most often the ones that send consonant sounds to the brain for interpretation. Those are the higher pitches, which is why women and children are harder to hear than the lower voices of men in most cases. Of course there are exceptions to this if an audiogram shows just the opposite, but that is unusual.

Write down a few 4 syllable words and eliminate the consonants in them. Keep the vowels and spaces. _o_o_ _ y _ _ e is an example. I will give you only the consonants at the end of this post so you can see the difference. Vowels give speech power; consonants give speech meaning.

Your comments and concerns about the hearing aid industry and the field of audiology are echoed by many. They should take time to share more information, to educate about hearing assistive technology that goes beyond hearing aids, and to tell their patients about support group like HLAA. Very few do. You can help by sharing information with them once you know about it. Yes, it should be a part of their training, especially if they want to be referred to as 'doctors'.

On top of that, the hearing aid industry itself pushes stigma that prevents people from talking about hearing loss and getting help by telling people their products are 'miracles' and 'cures' and are invisible. Why should people be discouraged from talking about hearing loss and/or for wearing and using technology that shows?

I was diagnosed with progressive sensorineural hearing loss 50+ years ago. It progressed to profound over time and impacted my quality of life significantly. I was lucky to discover an organization called 'Self Help for Hard of Hearing People, that is now known as the Hearing Loss Assn. of America (HLAA), when I had pretty much given up everything I had always enjoyed doing. Through this organization I learned about help that had not been explained to me. I learned to advocate for myself and to not be ashamed to talk about it. I also watched people improve their lives by getting cochlear implants and eventually went that route myself. That too was positively live changing. Involvement in HLAA truly gave me my life back.

If/when hearing aids are no longer helping you, it may be time to be evaluated for a cochlear implant. If that's the case, go to a cochlear implant center for an appropriate evaluation. Too often, people who fit and sell hearing aids will not suggest this to you, or they will tell you that you don't qualify. Like hearing aid adjustment, CIs also require time for adjustment. The brain needs to adapt to hearing differently.

Now here's that word with only the consonants m_t_rc_cl_ Do you know what it is? Try a few more and show the results to your family members and friends. It will help them understand what you are missing. It will also help them understand why it may take you a few extra seconds to understand something. You need to think about it.

There is help out there. Be open to finding it.

Thank you for your reply. It seems, we both have something in common, also with many others!
I may add to my post that seeking for any options, I just underwent additional extensive hearing tests because of my extreme discomfort with noise. Any noise, like washing dishes in the kitchen sink, a vacuum cleaner nearby, are almost unbearably loud. Setting the HAs to mute helps somewhat, but HAs, I guess, were not meant to be ear plugs.
Furthermore, I was explained that while a typical/normal range of hearing is at 75-80 dB, mine is at 35-40 dB, As I understood it, my “loudness discomfort level” requires “squeezing” the hearing aid adjustments into that 35-40 dB range. Newest HA models will not help improve my very low word recognition, nor help with the loudness discomfort.
Conclusion: I just qualified for Cochlear Implant, initially on one side.
I am trying to understand and learn the details about CI, primarily because I was already told that eventually I may have to chose from one of the 3 FDA approved CI manufacturers. The surgeon and his audiologist will assist with making a choice because there is no trialing, like with HAs.
I decided to accept the challenges, the unknown length of the adjustment phase, as well as any risk related to the procedure. I hope that at my advanced age of 85 I might be able to regain hearing to a better level and be able to enjoy again many things, like participating more in social events or going to classical music concerts, for the remainder of my life.

Extreme sensitivity to noise is a symptom of hyperacusis. It is not common, but when it happens it's usually accompanied by hearing loss and tinnitus. There is some interesting information at the link below.
https://my.clevelandclinic.org/health/diseases/24320-hyperacusis