This is such a great thread. I’ve come to realize that Puresound is not recommended for much of my hearing loss. I’m currently using Philips 9030’s and considering the Widex SmartRIC and the Philips 9050’s if they ever are available at Costco. Huge price differences. I’ve done some DIY and have recently combined two music program attempts that seems to work, although I still lower the gain in the app by two steps (5dB). Obviously there’s not much being applied at that point but seems to be a bit better than no HA and much better than the general program for my guitar playing. The 9040’s and 9050’s look to be a lot better for noise in general but not sure about music. I’m not really an audio expert like many of you and much of this conversation does go a bit over my mechanical engineering head, lol. Here’s the live music program I’ve arrived at (all noise and feedback off of course). I’ve had some guidance from others here but feel maybe there’s more to be gained to enhance what I’m hearing without making the the distortion I do hear (at higher note, bending, etc). Any advice would be appreciated. Thanks
Lifelong musician/audio engineer dives into trials of HAs...here's my story and experiences thus far
That feedback measure makes me cry. Do you have an option to have custom tips made?
LOL, yes me too. I am getting a lot of feedback these days and almost like it just started along with some hiss. I dialed things back to 90% and even did the feedback calibration program (measure) to adjust. I’m not sure what’s going on and I had the open bass dome from the start. I got a set to double bass domes to try and them could help a lot I guess. I only get feedback when I’m near something with my ear but maybe the hiss is related to feedback? I don’t get any feedback in the music program though and the feedback control is off there. So to read the feedback it’s how close the blue shaded area is to my gain curve?
Ears full of wax maybe? Unless you’re suddenly not getting them all the way into your ears.
The dotted lines are your prescriptive gain targets and keep in mind that unless you have very small ear canals the manufacturer targets tend to be under what you need, so you are currently way under target. The shaded area is the feedback zone. In a good fit, the shaded area shouldn’t overlap the gain targets. Open domes probably aren’t great for you, but closed domes may also not be.
No wax and an audi looked at them last week. I made an appointment to have a hearing check at Costco in two weeks and in meantime I’m using the double bass dome. I did an in situ test for the first time too. Set the aids for 100% and ran the feedback program. This time it bumped the midrange on the right ear down, left is still close. Before I ran the measure program, graphically it looked like I had very little blue area and lots of margin but I did have more feedback when I put them in. The Insitu boosted the highs and lowered the lows but the problem area seems to be mid-range. Had to redo my music program a bit too. I do have still have feedback but only when I touch the HA. I can just lower in the app and get these reset in two weeks. Funny thing is that when I tested the Widex which were set to my audiogram and then she did an insitu, I had zero feedback or hissing and I liked how the Widex handled wind, outside noise and voices as I walked around with them. And the audi gave me open domes too. Will see a 2nd audi on Wednesday that takes my $3K insurance and says the SmartRIC 440 will only cost me $1500. more
In Situ is better if you can get someone else to run it for you. If you know when the beeps are being presented it will naturally give you better thresholds than an audiogram, but that’s not really the definiteion of a threshold.
Some manufacturers have better feedback management than others.
Widex 440s have one of the better wind noise management systems currently available, and the smartRIC adds to that.
Yes so I tried to be conservative with the insitu and maybe too much so. Way too much high freq gain. The 9030’s are terrible with wind and the new 9050 are much fatter like the Oticon intent but the SmartRIC is very comfortable and thin. Fit perfect for me first try and no feedback even with open domes. Speech seems very clear in my short test of them and Puresound was even better to my ears. If the quote of $4500. I got is for the 440’s and not the 220’s I’ll probably get them since I have $3K off of that. I did ask for a 440 quote but the price sounds too good. I have to probably go back and reduce some of the gain on my Philips for now to make them bearable.
How far into hearing aid use are you? It’s very common for new users to experience appropriate high frequency gain as too much high frequency gain. I’m my experience, engineers in particular are likely to ignore the wetworks–the brain adapts over time. Has anyone done REM for you? Do you know if you are hiring high frequency prescriptive targets?
I’m about 2 years now and I can confirm even at 80% in the beginning it was painful. I doubt my brain will go much further but it did happen very slowly to the point where up until recently 100% was mostly tolerated well. It took about 1 to 1 1/2 years to go to 100%!!! And REM was done in the beginning but then they changed domes without re-doing that which the fitter said was not necessary. I tried to tell her it was but she was a bit stubborn and cranky if I asked or suggested anything (did that gently to try to not offend her, lol). I am using the different fitter at Costco now that is going to retest me in 2 weeks to include REM and reset the aids so we can determine if the receivers need to be changed or the HA have some issue. I took a pretty accurate online test that said my hearing was close to the same but there is some additional loss at 3K-5K where my hearing is just into “severe”, maybe 5 dB worse in one ear. That might be why the insitu settings were way too uncomfortable for me and loud. I suffer from hyperacusis as well as many of us do so adapting probably is more limited for me.
So your comment about maybe I need molded inserts got me to thinking more about this. I’ve been investigating different domes as well as molds. Seems like with my 20 dB loss at 500 hz in the right ear I probably NEED open domes of some type. For the 25 dB loss in the left ear I need venting of 3-4 mm all to avoid feeling occluded which I hate so again maybe a dome not completely open might work. I experienced occlusal effect with my airpod pros and you just can’t talk comfortably. And open domes obviously are feedback prone for me. So looks like I need dome that is more occluded than the open or open bass. A double bass Oticon barely works and a single bass does provide some margin but I don’t know if I’ll feel occluded with it.
I don’t normally hear feedback with my open domes but maybe I am hearing some artifacts at times, hiss, that is the feedback mgr at work especially in the left ear when I’m around loud noise like next to the freeway today. I’ve thought this was a bad receiver or HA and maybe it’s just the fact that the feedback mgr is hard at work??? This is all with my existing Philips 9030’s. Having them checked in a week.
Now that I’m going to Widex they have these ball shaped domes with either single or double vent and either one works except for one small area around 2500 hz and looks like the Compass wants me to use the power sleeve dome which has lots of margin. The sleeve vented ear tip also has a lot of margin as well. I don’t know much about the Widex domes and will ask about trying the open dome before they do REM to how bad they might sound. I just don’t want ANY occlusal effect to make my own voice sound any more weird to me with HA. I can see why you said " maybe I need the molds and maybe not", lol.
I suggested custom tips less because of feedback issues and more because the feedback manager is limiting gain such that you appear to be dramatically underfit in the highs nuless you have unusually teeny ear canals. But if the feedback manager is working hard it will definitely cause some weird artifacts.
What will be best depends a lot on your ear. If your ear canal is big enough, you can get a pretty open vent with a custom tip but still have better feedback management than an open dome. But that’s if your ear canal is big enough. It’s also worth playing around with domes. WSA has some vented and even “occluded” sleeves that are pretty good in terms of improving fit and feedback management without occlusion. In a pinch, power domes can be snipped a bit to add some venting. Or power domes become vented domes if they are smaller than snug in your ear. It’s all just different slightly chaotic levels of venting depending on the fit when you are working with domes. You’re looking for the most occluded fit that you can comfortably tolerate. Occlusion is a physical fit issue separate from just too much low frequency amplification, so just turn off the hearing aids, grab some different dome options, grab an apple, and chomp away with different domes to see what’s bothersome. Occlusion usually comes with crunchiness, breathing sounds, sometimes footsteps, and a weird boomy quality to your own voice. “Plugged” or “dull” doesn’t count as occlusions, that’s just having something in your ear and it can be overcome with sufficient gain to replace what is being muffled.
Great advice and information, thanks. I have 8mm size open domes now and they go in pretty easy but 10mm is too much I think. They did start me with 6mm and that was a joke, lol. Won’t have the Widex until I go in for a fitting on the 5th so I might try to get some oticon domes for my Philips in the meantime. Thanks again. This a whole other side of HA I had not contemplated until I started to hear some feedback and investigated. I think I asked for the open domes when they gave me the double bass domes…and even the doubles have feedback so will try the single bass next. And of course the setup, REM needs to be redone but I can try the insitu again in meantime.
Oticon grip tips are sometimes a better fit in the canal too.
The hearsuite program lists open and closed grip tips. I just noticed that it only list the double bass and not the single bass domes for the 9030 options. The double bass shows I have a lot of margin for feedback. I’m also getting some hiss and the left of really can’t handle noise like the right one. My hearing is the same as it was 1 1/2 years ago too accorded to the test I had this week. In the past month or so I found the 100% setting too much, microphonic and more artificial sounding to me along with that hiss I can hear at times (maybe in a quiet environment). I’m going to ask Costco if they can run them thru their test box rather than just send them back. I get the Widex ones on the 5th and Costco was going to retest me on the 7th and do a new REM so I can use these Philips as a backup for a while.
How are you judging that?
The single and double bass domes were nearly identical, so they’ve gotten rid of one but you can use either.
I’m looking at the how the the hearsuite program illustrates how close the shaded area is to my correction curve in the hearsuite program. And the program marks which dome is best for my hearing loss without feedback, which is the double bass. I’ve worn the double bass all day and really hate the boomy sound of my voice. One seems to slide out a bit too over time and when I push it back it sometimes the hiss gets pretty loud. I’ve had to pull it out twice and reinsert it. I don’t really get feedback unless I put my hands over my ears or get close to a wall or door with my ear and then it feedbacks where even my wife if close by can hear it and that’s with the open and double bass. Not something that really bothers me and I would prefer open domes overall even if they do this small amount of feeding back.
I play mostly electric guitar and have tube amps but have been using my Roland Blues Cube solid state amp a lot. I was complaining that it’s supposed to have lots of head room before it distorts and I can’t seem to hear a clean tone at low volumes. Well I removed my left Philips HA today and viola, clean tone, put it back in and took out the right one and very distorted. I’ve suspected both have issues but I’ve also thought the left was way worse not doing very good in noise like driving or standing 100 feet or so from the freeway. Now I’m convinced something is up with that left one for sure and I’ll try to get Costco to replace the receiver is they won’t put it on their test box (rather than just send it back to Philips).
I"m a bit confused with the Compass Software which I’ve been running in demo mode. I have my audiogram entered and the data displayed under fine tuning shows zero insertion gains for loud sounds but the actual curves are NOT zero. Maybe I’ll post this in the DIY section.
With your level of loss you don’t need to hear loud sounds “loud” you’ll notice that different formula give different outputs as well, and of course different acoustics.
I agree and yet the numbers don’t match what the curves show. They do match in HearSuite and are not zero. I tried other rationales and while not zero in the data region the insertion gain curves are always higher for loud sounds than the numbers displayed unlike the Philips where they match. Is there a setting cutting back on loud sounds beyond the “rationale” selected in Widex but not Philips? Maybe I should try cutting back on the loud sound gains in Philips then?
