Considerable Difficulty Outside & Restaurants and Speaking with People

Yipes. I know that Oticon makes state-of-the-art aids that utilize a more “open” hearing paradigm, but when I tried a pair of their OPNs about 5 yrs ago I simply could not make sense of ANYONE talking: at restaurants, cashiers, in the doc’s office, places where HVAC roared in the background, outside with WIND, it was just exhausting.

My audi was a very caring, patient guy, who had me try Phonak by comparison. I found that model (Audeo B, Marvel, now the Lumity Life) is the kind of hearing experience I need for my cinderblock ears. Yes I have high freq loss … along with mid and low! So I was very happy to try these out and have stuck with the brand!

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That’s what I was thinking. The open fit of the Oticon may have been the wrong choice.

Since the aid is probably beyond the return period. I would try to see if the audiologist can tighten up the openness.

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You should be doing daily auditory training exercises. An app such as Hearos can help wonders.

Hearoes app

Hope this helps. Thanks for the suggestion I shall try it too.

DaveL

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I use the partner mic for my wife and try to sit with my back to a wall

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I think @user990 is probably right that the Oticon aids with their open paradigm is probably the wrong choice for you, because it seems like you don’t want to make the brain hearing work to sort out what you want to hear and focus on it, but you simply want the hearing aids to “spoon fed” the speech to you instead of developing your brain hearing.

Oticon makes all sounds around you available, balance them up a bit to favor speech (how much in favor of speech depends on your personal settings in Genie 2), but you must be willing to work and develop your brain hearing to sort out all the sounds presented to you and learn to focus on what you want to hear (usually speech) and ignore the rest. That’s how normal hearing people listen anyway, because they can hear everything and they have no choice but to sort things out.

An analogy is to make all things on a photo sharp and clear for you so you can see whatever you want to see better, but you must do the work to scan through everything and pick and choose to focus on what you want to see. People who like the open paradigm tend to care about being able to hear more than just speech. They want to have a better sense of awareness of everything around them, and be able to hear all those things. They just don’t want those things to overpower speech. And Oticon delivers them all that.

The traditional paradigm is different. It aggressively blocks out everything behind and on your sides to let you focus on the sounds in front of you better. It’s like putting blinders on a horse so it can only see up front. Now if you want to hear the person on your left, you must turn your head toward the left before you can hear that person. People who like this approach usually don’t care about hearing anything else but speech in a noisy environment. To them everything non-speech is noise and is not important to them. They would rather have more comfort and less listening effort at the expense of not having full awareness of the surrounding.

But sometimes it’s not a matter of choice. Like @1Bluejay shared with you, she tried in earnest with Oticon aids and simply couldn’t get them to work for her. But the Phonak aids work out better for her. So sometimes it’s a matter of limitation in your hearing loss and not just a matter of choice. Her hearing loss, however, is much much worse than yours. My hearing loss is also worse than yours, although not as bad as @1Bluejay . But I’m doing OK with Oticon aids, simply because I’m the type who prefers to be very aware of my surrounding, even in noisy surroundings.

Because of this, I’m guessing that you seem like the later type of people, based on you post. it doesn’t seem like you want to have to sort out the sounds to focus on what you want to hear, you just want to hear speech and don’t care about anything else.

You asked if a different brand of HAs make a difference? I would say Phonak aids will probably work better than Oticon aids for you. Furthermore, Phonak seems to have come up with a new solution to solve this “blinder” issue with their Speech Sensor technology, which will detect where speech comes from and automatically adjust the width of the beam forming accordingly (see screenshot below).

The advantage of this is that you don’t have to turn your head to hear the speech coming from behind you. But the disadvantage is that now you don’t have a narrow enough beam forming to help you if you have multiple speech cues coming from all directions (the middle scenario). For the scenario on the right below, the beam forming is adjusted to be a bit wider than the scenario on the left, so now you will have to turn your head a bit to the right to hear the person speaking on your right, and your beam forming field becomes a bit wider, thus you’ll have to put up with more noise compared to the scenario on the left.

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@Volusiano

I’m from the Oticon camp, of wanting to have full situational awareness, to the extent that I have my Phonak P90s default to “Music” and have removed the blinkers to enable 360⁰ input. I’ve minimised things like windblock and noiseblock, and reduced whistleblock as much as I can, as they just remove high speech frequencies. I don’t always face speakers, as in meetings and restaurants, people are speaking all around. There are very few examples of where I find their Autosense an improvement. I can switch it in if needed though.

Great post by the way.

Peter

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Thanks for your input, @PeterH . Before I started wearing Oticon aids (and I’ve been wearing aids for 30 years), I was used to the noise blocking approach, so I struggled a lot to get adjusted to the open paradigm, but eventually I did. There’s nothing wrong with either camp, some folks like to have full awareness, other folks prefer the comfort of more quietness because the full awareness can be exhausting or annoying to them. So it’s really just a matter of preference. But if you’re used to the comfort camp and you want to switch over to the awareness camp, it takes a lot of positive attitude in addition to time for the brain “training” to get your level of acceptance adjusted.

The level of their hearing loss can also dictate whether they can even have the option to be able to get the full awareness or not. If their hearing loss is high (severe or profound), especially across the board, the dynamic range of their hearing can be greatly reduced, so there is not enough range to differentiate the subtleties in the volume of the various sounds anymore. In this case, almost everything gets amplified to sound almost equally loud, so it makes it extremely difficult to differentiate and sort out and focus certain sounds and ignore other sounds. In this case, the only choice really is to block out the unnecessary sounds aggressively enough to help them focus on the more important sounds in front.

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Hi Volusiano:

Thank you writing an extremely detailed response.

The Oticons do allow me to hear more from the general environment. Birds chirping and sounds that I could never hear. It would be a shame to sacrifice that. But I cannot distinguish speech from the background noise. The moment, I am at an event, I cannot hear comprehend the voice of people even a few feet away. The same thing on the subway in New York City. I have had Oticons for three years so I am not sure if my brain could ever be trained. That being said I see an audiologist once a year at most and maybe that is not enough. Do you think the Oticons can be adjusted to perform much better?

Your observation that:
“not enough range to differentiate the subtleties in the volume of the various sounds anymore. In this case, almost everything gets amplified to sound almost equally loud, so it makes it extremely difficult to differentiate and sort out and focus certain sounds and ignore other sounds” is exactly the way I perceive the sound from my hearing aids. There is just too much data and I can’t interpret it and understand speech when there are other sounds in the environment.

If the Phonaks work noticeably better with speech I should probably give them a try. At this point, I am avoiding public events, groups of people, restaurants and social settings. Even if I can function it is unpleasant.

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I think your situation is unique in that you actually have a pretty mild hearing loss up to 2 KHz, and beyond that, it’s only a moderate and not severe or profound loss. So I’m kind of stumped to see that you struggle so much in complex listening situations.

It makes me wonder if you have some kind of undiagnosed hearing conditions beyond your hearing loss, like maybe hyperacusis or recruitment. It kind of jives with what you’re describing here about how everything sounds too loud and they just overtake each other until everything sounds equally loud and takes away your ability to recognize the sound dynamics to differentiate and separate them. I’m no ENT or audiologist to be able say anything intelligent beyond mentioning a couple of these words above. Have you complained about his to your HCP? Did they say anything?

I’m not sure if Phonak would work better for you either, if you actually have some undiagnosed hearing condition beyond the hearing loss. But I don’t think it would hurt to try, as long as you can just try first before buy, or have a trial period with a no hassle return in writing.

To OP @alan1 - Aside from seeing an audiologist, have you seen a neurologist and/or speech therapist? Are your age and/or medical history such that you might have a history of a stroke or other neurological condition? Hearing aids help with hearing; might you have difficulty with language rather than hearing? Has this been the case your whole life or has this started only recently?

Hi Volusiano:

I haven’t had my hearing aids adjusted by a HCP for 18 months so it is time to go back.

I looked up “recruitment”, and that very much describes my experience. That in any situation with background noise, I have enormous difficulty making out people’s speech.

I have no history of stroke. My difficulty in group settings/background noise settings has gotten worse in recent years gradually. I am 62 years old and healthy for my age.

I am 100% fine in one to one settings with no background noise, fine on the telephone. Some difficulty with group dinners at a table. Restaurants with many people creating background noise make it very, very difficult when people are more than 3-3.5 feet away.

Yesterday, I was at a reception where 60-70 people attended at a buffet, and trying to speak with a friend 3 feet away. It was almost impossible.

Strange thing is that my speech recognition test at my audiologist are very good (had a test last April, but hearing aids not adjusted for 18 months). I think I scored about 92% in speech recognition. But it seems that the moment the environment is not ideal, that number plummets.

Oddly, other things that can cause difficulty, are interpreting speech on iPhone video calls when the phone is more than 12 inches away (even difficult at that distance).

What you are saying is very concerning. How can “recruitment” be managed?

No clear-cut answers but some options might include:

  • Noise generator hearing aid to treat tinnitus if it is hyperacusis rather than recruitment

  • Lower amplification in noisy restaurant type situations, combined with remote microphone. [If you have an iPhone the “Live Listen” feature is a simple but effective version of a remote microhpone]

  • High end hearing aids which can be programmed to address specific frequency ranges- such as Phonak Lumity or Paradise or Starkey Genesis

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As a late-model Phonak wearer and DIY fitter this post piqued my interest! I will investigate compression of high frequencies. Meanwhile, I’m curious about which programs, er, programmes, you do use?

I do find that the new Phonak Lumity Life aids seem to help focus on speech even when I don’t have them in the dedicated “Speech in Loud Noise” program, but there are places where truly NOTHING works: like in the back seat of a car trying to hear what folks are saying up front. Even in that dedicated program, it lowers ALL volume down too much to grasp what’s being said. I’m hoping that if I keep the Roger V2 device on me, I could whip it out of my purse, point it at the speakers and go from there.

I’m on the road right now, so the Roger is in the hotel in it’s cradle. I’ve tried it out in restaurants, but not in that back-seat scenario yet.

@brec
P90s: I have the music programme as default, and comfort on echo as a 2nd setting. Autosense 4 is the 3rd setting. In all streaming settings (I’ve reduced the settings that are directional or reduce noise/wind/whistle)
M70s: Music as default, Speech in Noise 2nd, Autosense 3 3rd. Same with streaming as above.

Peter

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@1Bluejay
I’m going to play around with the Speech in Car setting as I’ve just had my 3rd midlife crisis and bought a BMW Convertible. My wife tells me she doesn’t expect me to live until 126, so I may be getting too old for it :slight_smile:

Windblock will be the key here, but I expect it to be a double edged sword, in removing both wind, and speech frequencies. We shall see

Peter

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I really empathize with your struggle to hear. I do a reasonable job hearing in absolute quiet. But any background noise really makes it hard for me to understand speech. And if that background noise IS human speech, I lose comprehension of the speech I’m trying to focus on. This happens even with Phonak hearing aids set to very tight beamforming. The assistive listening device I use, a Roger Pen, helps a lot. I use frequency shifting algorithms so some content from high frequencies becomes audible. Finally, earmolds with smaller vents than recommended by the audiogram prescription recommends help because the smaller vents block out more ambient sound. I hope this information is helpful.

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The Live Listen feature on my iPhone has been a miracle for me. It’s the only way I can hear conversations or the TV.

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Hey good luck to you in that 3rd MLC and the Speech in Car! Let us know if that works for you,

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