Cookie Bite Hearing Loss: What is the best hearing aid?

@staciej Welcome to Mayo Clinic Connect. Your husband has "middle range" hearing loss. Due to this, when he has his hearing aids in all sounds except the "middle range" sounds are uncomfortably amplified. This makes wearing his hearing aids extremely painful and he only wears his hearing aids on "special occasions." Certainly this is difficult and you would like to be able to converse with your husband on a day-to-day basis.

You will notice that I have added your question to the Hearing Loss group, along with the ENT group. I did this so you could you connect with members like @julieo4 @ken82 @imallears @katherinebouton @smbritt, in the Hearing Loss group, along with members like, @nrd1 @ellienewfan in the ENT group.

May I ask what the vendor of the hearing aids has said about his hearing aids uncomfortable amplification of high and low sounds?

Many aids having frequency adjustments in their apps. I am very soon getting new Phonak Paradise P90 aids and they have an app with adjustments for low, medium and high frequency. It would seem to me that this is what he needs. There are many that have this three settings for frequencies. He could turn down the low and the high and turn up the medium frequency range setting. What do ya' think?

"Cookie bite" hearing loss is unusual. It requires a different fit than what is most typical. Hearing aids can only do 'the right thing' when they are fit for a person's hearing loss. That requires real ear measurement done by a skilled provider. Hearing aids are sold by a variety of providers; some with a lot more education and experience than others. AuD after a providers name indicates a doctorate level degree in audiology. HIS which stands for hearing instrument specialist, doesn't require a degree in most states. While we know some HIS are highly skilled due to quality apprenticeships and experience, that is not always how it is. MS-CCCA after a provider's name indicates a master's degree in clinical audiology. You can see what variety there is among providers.

I have no idea what kind of provider fit your husband's hearing aids, but it sounds as if they are not adjusted properly. Without proper adjustment, based on an audiogram which shows where hearing needs amplification and clarity AND where it doesn't, it would be easy to amplify sounds heard normally without amplification. Cookie bite audiograms require very different settings than sloping audiograms, the most common kind. Your husband should definitely use hearing aids, and also be concerned about preventing further damage in the dB levels where he hears well. Excess noise can cause more hearing loss. I encourage you to discuss this with the provider. If he gets no support, go elsewhere. This is why it's so important for new hearing aid users to use the 30 day trial period a provider is required to give them to figure out if they need something different. I hope this helps rather than confuses. There is help out there.

Hi Julie. He went to the University of Iowa Hearing Clinic, this has been over 10 years ago (I think, time flies!). I will do more research on other providers who may be able to assist with his cookie bite loss. At the time we purchased the hearing aids we trusted the University was the best place to go at the time. I'm guessing though, based on your comments, that the traditional or common settings were used nonetheless. We'll have to start saving up for another pair - he is just losing out on so much conversation during family time and as well as being unable to hear our 4 and 2-year-old grandkids speak to him. Thank you for your time in explaining the type of providers there are - the doctorate seems like the best way to go - just have to prove to us they know how to best accommodate for this type of hearing loss. Kind regards, Stacie Johnson

Thank you, Erica! Appreciate the responses. He purchased the hearing aids and has suffered since without getting the vendor or the provider involved. We'll be starting from square one again. I really worry about the volume levels he uses when watching television. Closed caption helps a lot there 🙂 I'll need to start doing more research - but glad for the direction the forum provided. Kind regards, Stacie Johnson

Hi Ray. I'll check out the Phonak Paradise P90 aids - the app sounds interesting had the ability to turn the lows and highs down, while turning the middle hearing range up sounds like what he needs.

I also have the mid-range loss and have never had satisfactory correction. My source of care is the UC San Francisco Audiology clinic and I am fortunate to be able to afford the most sophisticated hearing aids. Each time I get new ones, every 3-5 years, there is some improvement, but not enough to hear my husband or TV well. I'm so frustrated. But it's time for an update.

Does anyone have any better experience with this type of hearing loss?

This is not a common type of hearing loss. Did he see a doctorate degree level audiologist, or a hearing instrument specialist? Those with doctorate degrees have an AuD after their name. The cookie bite configuration is tricky and requires an excellent fit, correct settings, etc. Because it's an unusual loss, there are providers with little or no experience working with a cookie bite audiogram.

Many people are turning to less costly options in hearing aids sold at big box providers like Costco and Sam's Club. While they sell high quality hearing aids, most of their providers/fitters are hearing instrument specialists (HIS), not audiologists. Getting a proper fit depends on skill and experience of the person doing the fitting. I encourage you to get your husband to keep going back for adjustments until it's right for him. . Sometimes it takes several adjustments to get to the right place.

Are the people at your audiology clinic sharing information with you about assistive technology that goes with your expensive hearing aids? Telecoils do amazing things. BlueTooth does too, but they are different. Hearing aids should have both options, and the providers should demonstrate them for you so you know what they do, and how to use them. Far too often the providers don't talk about these 'extras'. I learned about these options from other people who use them. I'm fortunate to have met people through HLAA (The Hearing Loss Assn. of America) way back in the mid-80s. We all learned together as technology evolved and became available. I use my telecoils on the phone, on my computer, with audio devices, and in public venues that have installed hearing loops. The BT devices work well in many instances, but don't do much in those public venues.Living well with hearing loss is truly a lifelong learning adventure!

I was diagnosed with cookie bite hearing loss ten years ago. My audiograms have remained nearly identical throughout that time with no new hearing loss. I will get new Phonak 70’s in a couple weeks. I’ve always had the same hearing aids, Siemens. I’m looking forward to having Bluetooth and telecoil capabilities. I also hope the new hearing aids can help more with loud, high-pitched sounds—I seem to have become more sensitive to them over time. An AuD fit and checked my original hearing aids; however, I hope a new AuD and improved technology will help me hear better, especially at work where we all wear masks.
I will post after I have some time to get used to the Phonaks. I understand midrange hearing loss can be difficult to fit…I’m just hoping for some improvement.