problems with latest new hearing aids & what to do about them.

Posted by awilst @awilst, Dec 29, 2020

I am a senior who has been getting hearing aids from VA . I have been diagnosed as having a severe hearing loss. My latest hearing aids are phonak audio M90s, both ears.. I have been refitted several times (using real ear measurement technology) by VA & am still unable to get much clear speech benefit from these Phonaks. The audiologist says the problem is with compression & frequency transfer issues.
At the moment I am dead in the water. Been to VA several times with little benefit.
question … Is there much difference in hearing aid brands ? would a different manufacturer have better managing technology in handling attack/release & compression? The literature I read says Phonak is a top brand?
Anyone out there who can give me some advise.
thanks for reply

art

the phonak m90s, that I have , in adddition to audiologist programming the HAs, have a additional feature. a phonak smart phone download that allows you via bluetooth to tweek the hearing aids using your phone . a bunch of different controls.
and guess what, nothing I try does much good. and I have tried.
i THINK THE PROBLEM IS ATTCK/RELEASE SPEEDS, MY GUESS. but as I said before I previously had an older set of phonaks & I could understand my wife pretty well.
now she had to repeateverything.

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@tonyinmi

@raykraemer Thanks for your evaluation of the Phonak Paradise P90 aids. Given the problems you're having, I would not keep them. It sounds like there may be some design flaws and they may be able to be fixed with firmware updates. Do you know if those Phonaks can be programmed remotely without a visit to the audiologist? My Resounds (Linx 3D) are 3 years old but have remote programmability.
Tony in Michigan

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not sure if it is hardware or programming?

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@tonyinmi

@awilst I ALWAYS get a copy of my latest audiogram for my records. As far as any of the technical settings, that is something I've never requested. I really don't think you want to try to get the settings unless you plan to program your aids yourself. People do that but it requires the programming software plus a piece of hardware that connects your aids to the computer. Chances are that the settings file is most likely a binary file that you would not be able to read anyway without the programming software.
Tony in Michigan

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as I understand it, the technical settings determine the quality of the speech perception.
the computer takes the sound, converts it to digital. (does it replicate the total sound wave, does it slim it size & mabe distort output?) how fast/how slow? whats best for my condition?? and a bunch of other stuff I dont know.
all technical questions that can effect output.

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@colleenyoung

@awilst, good question. You should always be able to get copies of your tests as well as read outs from transfers that the Phonak aids are programed to perform. I'm tagging @julieo4 @nurseheadakes @imallears @tonyinmi @dsh33782 to get their input too on requesting this data.

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I believe you are entitled to your test results and also to any information about the products you are fitted with. As Tonyinmi pointed out, those settings may be worthless to you. On the other hand, if you are traveling and something goes wrong with your hearing aids, a provider in another area could possibly be of help. It's important to know that some providers 'lock' the hearing aids they sell, so they cannot be programmed or adjusted by a competitor. This is more typical of the 'big box' providers. Most audiology practices, especially those that sell a variety of brands, do not do that. Still, it's a question worth asking.

Keep in mind when buying hearing aids that the fitters vary greatly in skill, training and formal education. Hearing aids may be the best on the planet, but if they are not fit well, they won't do well. The fitter's skill if the key to success. And, if you don't get enough value from new hearing aids, return them and go elsewhere unless the provider is willing to give you more than 30 days time to work on them. I read things like bundled services that 'allow' 2 visits per year and it makes me sad. In many cases it may take many more visits to get it right. A provider should be willing to work with you as often as needed. It may not seem fair, but we are consumers of these products, so must be assertive enough to help ourselves.

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@tonyinmi

@barbb The programming software is very complex. Each manufacturer has their own software so most audiologists have to have some familiarity with several programs. It's hard to be an expert on everything that each manufacturer provides.
Tony in Michigan

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Thanks Tony for your description of the reality!

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I find huge differences between audiologists. I have been to 3 different VAs and have been seen by 7 different audiologists there. Of the 7 I have found one audiologist to be excellent. In VA it is very difficult to go cherry picking for an audiologist you like. All of them have been competent and compassionate people and tried to be helpful. But out comes are quite different. Biggest factor here is you need to be your own advocate – read up, inform yourself, and go back till it works. For example, I didn't get a real ear measurement until I asked for it.

I have also been to 4 different private practice audiology clinics and been seen by 6 different audiologists there and found them to be about the same as VA. I think there is at least as much difference in outcome from the audiologist as from the hearing aids themselves. Getting hearing aids properly fitted is one of the keys.

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@arrowshooter

I find huge differences between audiologists. I have been to 3 different VAs and have been seen by 7 different audiologists there. Of the 7 I have found one audiologist to be excellent. In VA it is very difficult to go cherry picking for an audiologist you like. All of them have been competent and compassionate people and tried to be helpful. But out comes are quite different. Biggest factor here is you need to be your own advocate – read up, inform yourself, and go back till it works. For example, I didn't get a real ear measurement until I asked for it.

I have also been to 4 different private practice audiology clinics and been seen by 6 different audiologists there and found them to be about the same as VA. I think there is at least as much difference in outcome from the audiologist as from the hearing aids themselves. Getting hearing aids properly fitted is one of the keys.

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@arrowshooter Exactly. This may sound harsh, but it is reality. I would not be surprised if 1 in 7 is the national average for audiologists that know how to properly fit. Just as doctors rely on pharmaceutical companies to be the experts on drug information, the audiologists rely on the hearing aid manufacturers for setting up hearing aids. Audiologists really need to understand audio engineering to help understand all of the factors involved in sound reconstruction. Because it is so complex, I would expect a proper fitting to take much longer than the time that we are given. The number of clinics that do not conform to "best practices" is shocking. Why is this not considered unethical and why can it continue? My research comes from audiologists that have become consumer oriented. People should Google Abram Bailey, AuD of http://www.hearingtracker.com and Dr Cliff Olson of http://www.doctorcliffaud.com. Dr. Cliff also has a YouTube channel. Patient Centered Care (www.idainstitute.com) is a new buzz word in hearing health care. Why is this not commonly practiced? Tele-audiology, the ability to remotely program hearing aids has been available for over two years yet most practices are not set up to do this. It does require that the hearing aids are able to take advantage of this but the biggest problem is that there are no insurance codes that are directly applicable for this. How long before this becomes common practice? Sheesh, I would go on but the reality is that its no wonder that hearing aids end up in dresser drawers. I've mentioned in a previous post that one of my audiologists told me "Audiologists are doing this to themselves".
Tony in Michigan

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@tonyinmi

@arrowshooter Exactly. This may sound harsh, but it is reality. I would not be surprised if 1 in 7 is the national average for audiologists that know how to properly fit. Just as doctors rely on pharmaceutical companies to be the experts on drug information, the audiologists rely on the hearing aid manufacturers for setting up hearing aids. Audiologists really need to understand audio engineering to help understand all of the factors involved in sound reconstruction. Because it is so complex, I would expect a proper fitting to take much longer than the time that we are given. The number of clinics that do not conform to "best practices" is shocking. Why is this not considered unethical and why can it continue? My research comes from audiologists that have become consumer oriented. People should Google Abram Bailey, AuD of http://www.hearingtracker.com and Dr Cliff Olson of http://www.doctorcliffaud.com. Dr. Cliff also has a YouTube channel. Patient Centered Care (www.idainstitute.com) is a new buzz word in hearing health care. Why is this not commonly practiced? Tele-audiology, the ability to remotely program hearing aids has been available for over two years yet most practices are not set up to do this. It does require that the hearing aids are able to take advantage of this but the biggest problem is that there are no insurance codes that are directly applicable for this. How long before this becomes common practice? Sheesh, I would go on but the reality is that its no wonder that hearing aids end up in dresser drawers. I've mentioned in a previous post that one of my audiologists told me "Audiologists are doing this to themselves".
Tony in Michigan

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@arrowshooter@tonyinmi etc. The information in this thread has been really interesting and helpful to me as someone who is looking for an audiologist and will be getting a hearing aid for the first time in the spring or summer. I'll read it and the links more closely. I hope I understood one of the comments that seemed particularly valuable that was totally new to me, i.e. don't rely on hearing aids alone to achieve your objectives but on the addition of accessories geared to match the hearing aids with particular situations we find ourselves in as well. I know word of mouth is probably the best way to find a good audiologist, and I've contacted the Hard of Hearing Organization in Pittsburgh Julie recommended to try to find some members out my way who might be willing to advise me. Since I'm starting scratch, I need to know what questions to ask an audiologist to tell if he/she is good. The big medical center in Pittsburgh dealing with my unusual lung problem has a hearing center with audiologists that fit and sell hearing aids. Would it be better to go there than to a local audiologist in a nearby town? I guess I'm leaning that way just because I'm new to this area and don't have many contacts to get recommendations from. I've read some reviews of big companies and chains that sell hearing aids and was amazed Costco rated number one from customer satisfaction. They didn't have Phonak listed as a brand they carry though. One blessing from the pandemic is having time to research things carefully. Thanks for all I'm learning from you! Nancy

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@nla4625

@arrowshooter@tonyinmi etc. The information in this thread has been really interesting and helpful to me as someone who is looking for an audiologist and will be getting a hearing aid for the first time in the spring or summer. I'll read it and the links more closely. I hope I understood one of the comments that seemed particularly valuable that was totally new to me, i.e. don't rely on hearing aids alone to achieve your objectives but on the addition of accessories geared to match the hearing aids with particular situations we find ourselves in as well. I know word of mouth is probably the best way to find a good audiologist, and I've contacted the Hard of Hearing Organization in Pittsburgh Julie recommended to try to find some members out my way who might be willing to advise me. Since I'm starting scratch, I need to know what questions to ask an audiologist to tell if he/she is good. The big medical center in Pittsburgh dealing with my unusual lung problem has a hearing center with audiologists that fit and sell hearing aids. Would it be better to go there than to a local audiologist in a nearby town? I guess I'm leaning that way just because I'm new to this area and don't have many contacts to get recommendations from. I've read some reviews of big companies and chains that sell hearing aids and was amazed Costco rated number one from customer satisfaction. They didn't have Phonak listed as a brand they carry though. One blessing from the pandemic is having time to research things carefully. Thanks for all I'm learning from you! Nancy

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Reply to nla5625: I'm a very satisfied Costco customer. One great plus is that you can go back as many times as needed without any additional fees. That, along with the fact that their aids are roughly half what they cost elsewhere and their solid 30-day trial and two-year guarantee are all good reasons to consider Costco. My Costco aid is a Bernefon, but I've learned that it's made by Oticon; I assume all Costco aids have a Costco-specific brand name that's different from whatever the mfg.'s name is. I've heard that they do carry a line of Phonaks, renamed, of course. I stumbled into the nearest Costco (over an hour away) and lucked out with a fitter who has taken the time and effort to learn about hearing and hearing diseases. She knows more than not only many audis but the surgeon at the CI center about my particular disease (Meniere's). I had some radical changes in hearing when I went bilateral over a year ago, and she was very patient explaining what she could and could not do. As a result of changes, I've had many appts. to make my $1,500 aid more effective.

I have heard that some Costco fitters are just that: mere fitters who know little. However, after having appts. with two audis at the really big hearing center two hours away that does CIs, I learned that neither of them knew as much as the lady from Costco. Further, one of them advised me to trash my "crummy" Costco aid and spend over $6,000 to buy a pair of Phonaks…and come back in six months for a second hearing test to see if I would then qualify for a CI. Imagine: spending $3,000 for an aid that might only be useful for six months! The second audi at the same center gave Costco high points and told me to stick with what I have.

The other thing I'd advise is to take lots of time to choose what to buy. Don't be too quick to buy something because it's a hot, new thing. I dumped my IPhone, switched to a Samsung Android just to be able to use Live Transcribe…and then found that it didn't really work well for my situation (meetings filled with tech terms). You'll never be able to learn enough, but you should learn as much as possible. Every place selling aids has reasons why they may want to sell a certain brand or aid; those reasons may not mean you should buy that aid.

I've avoided the nearest audi, only 40 minutes away, because she does lots of advertising, big ads that cost real money. She found my older friend (94 but extremely sharp) a great source of income, sold her aids that never really worked well. She always had tech reasons why things didn't work, was ready and willing to sell something to make things better. Then she flushed my friend's ears, resulting in severe vertigo that meant the woman's doctor son flew in, sold her home and car, packed up what HE felt she needed, and moved her across the country to his home, leaving behind most of her possessions and all of her friends.

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@joyces

Reply to nla5625: I'm a very satisfied Costco customer. One great plus is that you can go back as many times as needed without any additional fees. That, along with the fact that their aids are roughly half what they cost elsewhere and their solid 30-day trial and two-year guarantee are all good reasons to consider Costco. My Costco aid is a Bernefon, but I've learned that it's made by Oticon; I assume all Costco aids have a Costco-specific brand name that's different from whatever the mfg.'s name is. I've heard that they do carry a line of Phonaks, renamed, of course. I stumbled into the nearest Costco (over an hour away) and lucked out with a fitter who has taken the time and effort to learn about hearing and hearing diseases. She knows more than not only many audis but the surgeon at the CI center about my particular disease (Meniere's). I had some radical changes in hearing when I went bilateral over a year ago, and she was very patient explaining what she could and could not do. As a result of changes, I've had many appts. to make my $1,500 aid more effective.

I have heard that some Costco fitters are just that: mere fitters who know little. However, after having appts. with two audis at the really big hearing center two hours away that does CIs, I learned that neither of them knew as much as the lady from Costco. Further, one of them advised me to trash my "crummy" Costco aid and spend over $6,000 to buy a pair of Phonaks…and come back in six months for a second hearing test to see if I would then qualify for a CI. Imagine: spending $3,000 for an aid that might only be useful for six months! The second audi at the same center gave Costco high points and told me to stick with what I have.

The other thing I'd advise is to take lots of time to choose what to buy. Don't be too quick to buy something because it's a hot, new thing. I dumped my IPhone, switched to a Samsung Android just to be able to use Live Transcribe…and then found that it didn't really work well for my situation (meetings filled with tech terms). You'll never be able to learn enough, but you should learn as much as possible. Every place selling aids has reasons why they may want to sell a certain brand or aid; those reasons may not mean you should buy that aid.

I've avoided the nearest audi, only 40 minutes away, because she does lots of advertising, big ads that cost real money. She found my older friend (94 but extremely sharp) a great source of income, sold her aids that never really worked well. She always had tech reasons why things didn't work, was ready and willing to sell something to make things better. Then she flushed my friend's ears, resulting in severe vertigo that meant the woman's doctor son flew in, sold her home and car, packed up what HE felt she needed, and moved her across the country to his home, leaving behind most of her possessions and all of her friends.

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@joyces. Thanks so much for this good advice. Before purchasing anything, I will definitely take time and continue to do research until I actually visit audiologists and the hearing center at Costco later this spring or summer and feel confident what I'm getting is what I need. Being in three high risk groups for Covid, I'm postponing visits to dentists, eye doctors, mammogram technicians, etc where even masked people come in such close proximity to my face. I'm really excited about the possibility of hearing more easily in the future; but I can wait for a few more months. Thanks again for helping me in my research phase! Nancy PS I found this video by the fellow I think Tony recommended regarding Costco hearing aids
https://hearinghealthmatters.org/theaudiologycondition/2019/costco-hearing-aids-good-bad-ugly/ I'll definitely be watching more of his great videos.

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@awilst when you write about "attack and release" you are getting into something the typical audiologist does not have time to adequately evaluate… but really cognitive … thinking capacity.. is a very individual problem….. from children to adults teachers observe differences in cognitive capacity.. some get it and some do not… Hearing affects how fast we can parse a sentence… to get it…. the trick is can an audiologist evaluate how fast people think when they get a new hearing aid that eliminates the mental confusion of making sense of a group of words… Having enough fortitude to tell those speaking to slow down is also widely individualistic..
I found this introductory paragraph to a study… of a particular brand.. "In the past 15 years, research has suggested that people with hearing loss might benefit from either fast or slow compression depending on their cognitive status. This article reviews the concept of compressor speed and its possible relationship to cognitive capacity and also looks at how the Variable Speed Compressor (VSC) used in the BEYOND hearing aid may allow optimal speech understanding for people with all cognitive backgrounds." What do you think about a solution to this problem… As a university teacher for 20 yrs.. cognitive capacity was a constant problem even among those who were smart enough to enroll… Ken

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Response to nla4625: In short, Look Before You Leap! FWIW, if you have Part F supplemental coverage instead of an advantage plan, visits to an audi or hearing center are covered 100% as a medical expense. (Just another reason to opt for the higher expense of Part F!)

I never felt I was being pushed in any way by the fitter at Costco. She wouldn't let me just buy the aid I purchased a couple of years ago (to combat age-related deafness in my "good" left ear…she insisted on fitting the aid and had me walk around in the store for at least a half hour to ensure that it would help. I then paid for the aid, but it had a 100% return for 30 days; I could have returned it for all that it had cost, no questions asked. Even though the two-year warranty had expired, she fitted me with a larger ear piece that delivers more sound directly to my ear, at zero expense. Regardless of where you buy, Costco is THE place to buy batteries: $8.99 for six packs of eight, which is almost a full year's supply. Pharmacies charge that much or more for a single 6-pack.

In contrast, the one audi at the hearing center just stated flatly that my Costco aid is junk and I absolutely needed to pony up thousands for a pair of "better" aids–in spite of the fact that I've been told for decades that my right ear isn't aidable due to recruitment. This was at the same appt. where she recommended that I return in six months for an additional hearing test (at the expense of my ins.) because she was certain that I'd qualify for a CI…making one of the two very expensive aids redundant. I was very disappointed by the entire hearing clinic experience. I had gone there, thinking that they'd know far more than the lady at Costco…but I was wrong.

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