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Thread: New and feeling overwhelmed

  1. #1

    Default New and feeling overwhelmed

    Good Morning!
    I apologize for the length of this post, and if these questions have already been asked. I stumbled upon this site and have perused the topics, so much information and everyone seems so helpful I thought I would reach out with some questions. I have been all over the Internet and am in information overload.
    I had 2 evals, one with an Audi, one with a HA Dispenser. Both recommended RITE, Audi Resound (didnít say which) and HAD Oticon Opn 1. The HAD was wearing the Opns herself and formerly worked for Oticon (idk if any incentive/kick back). The Audi has no affiliations and ďwould like to get me into any aid I am comfortable with, both fit and price.Ē Trial periods are 60days for either, however $1800 difference, in price comparing apples to apples with HAD cheaper, however HAD has $75/ha restock fee (I called Audi to question price of Opn after HAD visit). Leaning toward Oticons based on research, however honestly donít know, thatís why Iím here.
    I have noticed I absolutely have delayed audio processing in speech recognition. Audi says word recognition is 96% bilaterally, HAD said 85%, could that be due to different voice tones? I am a flight nurse (helicopter); I take my helmet on and off and work in noisy chaotic environments. I also work both trauma and recovery rooms, and ride motorcycles. Clearly, hearing speech in background noise is impt. Prior to my appointments I really wanted the smallest IIc however I was told my ears are too small and the technology isnít there as compared to RITE. (want to be able to direct stream and adjust from phone). I work 7p-7a and wanted to be able to rest (sleep) on shift without having to remove aids (listening for radio and partner). Only other coworker I know with HAís said she liked her in ear more than the RITE she has now.
    My questions are:
    Is an Audi better than a HAD? Or would it be better to go HAD who is wearing them herself? (I felt more comfortable with the Audi, but that could just be in my head)
    Are there other options I should consider? Costco? Starkey? (suggestions)
    Is one brand any better than others? Review link: HA brands 2017
    Does anyone have thoughts on Zpower? zpowerhearing (Iím a tree hugger, environmental considerations of disposable batteries)
    Anyone ever use Hearing Care solutions or Amplifon, thoughts?
    Open fit, closed fit, domes, molds, I donít understand any of this or what I should be looking for (clarity of speech in noise)
    Truly lost, looking for general help/advice/suggestions
    I honestly donít know what I should be looking for
    Thank you so much!

    Report form Audi:
    Otoscopic exam WNL
    Audiogram= mild sensorineural hearing loss through 1khz sharply sloping thereafter to an essentially moderate loss thereafter bilaterally
    Speech reception thresholds were obtained at 25dbhl in both ears and corroborate the pure tone averages bilaterally
    Impedance testing revealed type ďaĒ tympanograms bilaterally: normal middle ear function
    Distortion product otoacustic emissions were obtained bilaterally from 1khz-8khz. Responses revealed reduced/absent responses bilaterally suggestive of outer hair cell dysfunction bilaterally.
    New to all this
    KHz 0.25...0.5...0.75...1.0...1.5...2.0...3.0...4.0... 6.0...8.0
    Left ...30....25.....22....20.....45....45....45....50Ö ..65.....80
    Right .30....25.....25....25.....40....50....50....50... ..70....65

  2. #2
    Join Date
    Nov 2016
    Location
    Central California
    Posts
    555

    Default

    I'm not sure I'm understanding your desired wear pattern. It's certainly fine wearing RITEs (aka as RIC (receiver in ear)for a nap. I wouldn't recommend wearing them 24 hrs a day as I think you increase risk of irritating the ear. You (like myself) seem to like to research extensively and make the "BEST" choice. That's nigh impossible to do with hearing aids because the objective data just isn't there. If you want direct streaming to iPhone (not currently available with Android), all major brands except Phonak make that a possibility with at least some of their aids. I think Oticons or Resounds are viable choices. Costco has a slightly older version of the Resounds available for about $2600 if you want to throw that into the mix. Basically you need to make a choice (pick some criteria, or choose randomly--really doesn't matter) and try it out. If you have some doubts as the 60 day trial nears and end--try something else. (Costco by the way offers 180 day trial) Hope this helps. Welcome!

    Quote Originally Posted by DmQ View Post
    Good Morning!
    I apologize for the length of this post, and if these questions have already been asked. I stumbled upon this site and have perused the topics, so much information and everyone seems so helpful I thought I would reach out with some questions. I have been all over the Internet and am in information overload.
    I had 2 evals, one with an Audi, one with a HA Dispenser. Both recommended RITE, Audi Resound (didnít say which) and HAD Oticon Opn 1. The HAD was wearing the Opns herself and formerly worked for Oticon (idk if any incentive/kick back). The Audi has no affiliations and ďwould like to get me into any aid I am comfortable with, both fit and price.Ē Trial periods are 60days for either, however $1800 difference, in price comparing apples to apples with HAD cheaper, however HAD has $75/ha restock fee (I called Audi to question price of Opn after HAD visit). Leaning toward Oticons based on research, however honestly donít know, thatís why Iím here.
    I have noticed I absolutely have delayed audio processing in speech recognition. Audi says word recognition is 96% bilaterally, HAD said 85%, could that be due to different voice tones? I am a flight nurse (helicopter); I take my helmet on and off and work in noisy chaotic environments. I also work both trauma and recovery rooms, and ride motorcycles. Clearly, hearing speech in background noise is impt. Prior to my appointments I really wanted the smallest IIc however I was told my ears are too small and the technology isnít there as compared to RITE. (want to be able to direct stream and adjust from phone). I work 7p-7a and wanted to be able to rest (sleep) on shift without having to remove aids (listening for radio and partner). Only other coworker I know with HAís said she liked her in ear more than the RITE she has now.
    My questions are:
    Is an Audi better than a HAD? Or would it be better to go HAD who is wearing them herself? (I felt more comfortable with the Audi, but that could just be in my head)
    Are there other options I should consider? Costco? Starkey? (suggestions)
    Is one brand any better than others? Review link: HA brands 2017
    Does anyone have thoughts on Zpower? zpowerhearing (Iím a tree hugger, environmental considerations of disposable batteries)
    Anyone ever use Hearing Care solutions or Amplifon, thoughts?
    Open fit, closed fit, domes, molds, I donít understand any of this or what I should be looking for (clarity of speech in noise)
    Truly lost, looking for general help/advice/suggestions
    I honestly donít know what I should be looking for
    Thank you so much!

    Report form Audi:
    Otoscopic exam WNL
    Audiogram= mild sensorineural hearing loss through 1khz sharply sloping thereafter to an essentially moderate loss thereafter bilaterally
    Speech reception thresholds were obtained at 25dbhl in both ears and corroborate the pure tone averages bilaterally
    Impedance testing revealed type ďaĒ tympanograms bilaterally: normal middle ear function
    Distortion product otoacustic emissions were obtained bilaterally from 1khz-8khz. Responses revealed reduced/absent responses bilaterally suggestive of outer hair cell dysfunction bilaterally.
    .25 .5 1 1.5 2 3.0 4.0 6.0 8.0

    15 15 20 30 30 55 75 90 NR ​KS7
    10 10 20 15 25 35 65 85 95 WRS 100/92@45/40

  3. #3
    Join Date
    Feb 2015
    Location
    NW Indiana
    Posts
    2,543
    Blog Entries
    13

    Default

    I take it you take off the helmet to use your stethoscope. There are scopes that use Bluetooth so you could operate with the helmet/sound-protection still available. There are a number of doctors/nurses here that can advise you on that.

    Motorcycles contribute to hearing loss and you should work with the audiologist/fitter on a best solution to not suffer further loss.

    In your case, rechargeable might be a poor choice. I imagine you have long days at times and the smaller aids use the 312 battery which, at best barely make it through a normal day. A larger aid with the size 13 battery would work. There isn't a lot of ecological benefit to avoiding replaceable aid. The battery contains a small amount of a zinc compound that is oxidized by air into zinc oxide. You'd likely use 50 to 80 of them in the course of a year. That very little in weight.

    As mentioned, Costco has a Resound aid (Cala8) for $2600. A couple of months ago, it was the current model -- version of the Linx2 -- that was replace by the 3d model. With a Bluetooth scope, it would need the $200 BT adapter call the Phone Clip. That also can stream from additional BT devices. The 3D your audiologist is recommending would use that device also.

    You are fortunate to only have a mild-moderate loss. But the noisy environment for work and play are going to make that worse if you don't work hard to prevent further loss. You might want to talk to an ENT or Um Bongo here about what can be done to halt further loss. Um Bongo is a fitter and has an EE degree that makes him a good one to get such advise from.
    Hidden Content
    KS6's w. Phone Clip +

    Visit my blog here for post that I think valuable -- especially new members.

    There is nothing either good or bad, but thinking makes it so. -- William Shakespeare





  4. #4

    Default

    Don't be afraid to leave your hearing aid in and on while you nap. I've even worn my aids a couple days non-stop before. No big deal. As for battery life, even with the tiny size 10 batteries my old CIC took, I'd get 5 days (80 hours) out of them.

    If BT capability is important to you, you pretty much are out of the CIC market and into a behind the ear style of some sort. I prefer audiologists. Others up here are OK with Costco or other retail shops. I've only ever gone to an audiologist, I just can't bring myself to trust my hearing with a big-box store or a cheesy strip mall store-front.

    Brands, styles, and dome type are all unique to individuals, you'll have to determine what works best for you. Do NOT expect any HA to restore normal hearing or normal speech in noise capability though.
    ..250..500..1000..2000..4000..8000
    L:75....75....70.....75.....65......60
    R: no hearing

  5. #5

    Default

    Audis have considerably more education. But the fact that the HAD wears Oticon and worked for them would personally sway me in the direction of the HAD. The word recognition testing should have been done with recorded voice for the result to be more reliable.
    Tony
    ---------------------
    Oticon OPNs
    Previously: Bernafon Juna 9s with Soundgate 3
    ----------------------
    55 55 50 10 60 25
    250 500 1000 2000 4000 8000
    55 60 45 15 20 10

    Word Recognition, 60% at 70 db (left), 96% at 65db (right)
    <Tested 1/2/17>

  6. #6

    Default

    One other thing. If you ride your motorcycle with a passenger, Resound has a wireless mic that can be clipped or worn by the passenger which would deliver their voice directly to your ears.

  7. #7

    Default

    Quote Originally Posted by DmQ View Post
    My questions are:
    Is an Audi better than a HAD? Or would it be better to go HAD who is wearing them herself? (I felt more comfortable with the Audi, but that could just be in my head)
    Are there other options I should consider? Costco? Starkey? (suggestions)
    Is one brand any better than others? Review link: HA brands 2017
    Does anyone have thoughts on Zpower? zpowerhearing (Iím a tree hugger, environmental considerations of disposable batteries)
    Anyone ever use Hearing Care solutions or Amplifon, thoughts?
    Open fit, closed fit, domes, molds, I donít understand any of this or what I should be looking for (clarity of speech in noise)
    Audis have more training in audiology than HAD/HIS but it doesn't mean they'll automatically do a better job fitting you every time over an HAD because the HAD should have enough training to perform the fitting job just as well. It's kind of like asking who's better, doctor or nurse. But better at what? Dressing a wound? Either doctor or nurse should be able to dress wounds equally well.

    Costco is a good option if you want a long trial (180 days) and/or good price/value combo.

    No brand is better than others. It depends on what you're looking for and how a model may be able to fit your need better.

    Zpower doesn't make economical sense yet, and environmental impact due to disposable batteries is negligible. Only advantage of ZPower is if you don't want to get the battery low warning notice while in the middle of doing something. You charge them when you go to sleep and it's supposed to last you during your waking hours. Of course you'd not have to take batteries in/out often so for people with dexterity issue it's an advantage for them.

    Open fit minimizes occlusion but is bad for direct streaming in the low frequency range because low frequency streamed sounds leak out of the vents so the streamed sounds become tinny -> perceived low quality sound. It also reduces the effectiveness of noise blocking that your HA is trying to do, if any, because the vents can't block out noise. Closed domes (or closed custom molds) or with single tiny vent help with noise blocking, and prevent low frequency sound leak from direct streamed sources -> streamed sound seems to sound better. But closed domes/molds have occlusion. A tiny single vent instead of wide open vents is a compromise between reducing occlusion and retaining the positive traits of closed domes/mold

    Resound ? and the OPN 1 work differently in giving you clarity of speech in noise. You need to be in noise program in Resound so it blocks out surrounding noise (most effective if you don't wear open domes) and directs you to the speech in the front. But speech has to be in the front only for noise program to help. There is no noise program in the OPN. You hear everything but it does help clean up speech in front for better clarity. Your brain learns to tune out the rest of the noise and focus on the speech.
    HA wearer since the 1990's > Rexton Insite+ CIC (2011-2016) > Oticon OPN RITE (2016)

    KHz 0.25...0.5...0.75...1.0...1.5...2.0...3.0...4.0... 6.0...8.0

    Left ...10...10....10.....30.....70....75....80....95.. ..90....80
    Right .25...30....40.....55.....75....85....90....90...1 00...100

  8. #8

    Default

    First priority is to protect your hearing so I would suggest muting or removing aids while riding a motorbike. They probably won't provide any benefit in that type of noise anyway.

    I wear RIC HAs and work 24 hour shifts in an ICU. I take my HAs out at night to attempt to get some sleep - definitely cannot sleep on my side with them in. They are quick and easy to replace when I need to get up and attend to patients. I make sure phones and alarm clocks are set to full volume. I use my Cardiology stethescope with my HAs muted - biological sounds are all pretty low frequency and my HAs are open fit (open domes) to let in those frequencies. I am able to use the stethescope with my aids in place. I use a remote to mute the HAs so surrounding noise is not in my ears to interfere with my hearing through the scope. There are some other threads where we discuss stethescopes and their use including digital electronic scopes. Just search up stethescope on this site. Your audiologist should also help you find the best solution for you. If you are going to try to sleep with RIC aids in then try a travel pillow or Hearing aid pillow with a hole or groove for your ear. Personally I don't find them that comfortable but you may have more success.

    Hearing in noisy environments is always a challenge but HAs definitely help. Finding the right person to fit and program the aids is more important than the actual brand. If you feel comfortable with the fitter then that is a good sign. Audiologists have much more training and knowledge than dispensers but some dispensers can do a very good job also and some people have had bad experiences with an audiologist. A clinic which prefers/sells one brand should be cheaper for that brand and know its features and programming well. Clinics that deal with all brands offer more independent advice but may be less experienced with some of those brands and may not be receiving volume discounts so they may be more expensive. Costco is a cheap option for quality HAs if money is an issue. Experience with them seems to be variable - just like everywhere else.

    Brands - all the big six make quality HAs. Phonak do not do direct connection to iPhone yet. Made for iPhone HAs still need a streaming device for most android phones. Direct streaming to HAs is very useful and not having to carry around a remote as well as a phone/beeper etc is convenient. Of course the most important feature is to hear well with the HAs so put that first. Some people also find one brand more comfortable than others or one brand of domes a better fit. In the end all you can do is try them. The higher the level of the aid the more features and claims for hearing in noise. Your dispenser/audiologist should tailor a solution to fit your hearing loss and advise on issues like open vs closed fit. Generally speaking open fit is more comfortable and convenient if it is suitable. Domes are easily replaced and come in a variety of sizes and shapes. Molds are custom made and tend to be more occlusive and sit deeper. They are harder to replace but should be comfortable.

    Make sure you know all the conditions:
    Do you have to buy to try then refund within the trial time limit? "Restocking" fees?
    How long is the warranty? Expect 3-4 years on a premium aid. Is there insurance for loss of an aid?
    What is included -replacement consumables like wax guards, domes, batteries and for how long?
    What services are included - first fitting, follow up appointments for adjustments and for how long?

    Some places will do a trial without money up front. This enables you to focus on how much benefit you are obtaining before you get too bogged down with committing money.

    Good luck!
    Carol

    Linx 961>Linx2 961> Phonak Audeo V90 312T L&R
    Hz 250 500 1K 2K 3K 4K 5K 6K 8K
    L 25 25 15 35 40 40 60 60 55
    R 25 25 15 30 40 35 35 55 50
    Speech
    L 83% 40dB, 100% 50dB
    R 80% 40dB, 97% 50dB

  9. #9

    Default

    Thank you all very much for your responses, very informative and I truly appreciate your time. Iím making some notes with questions to ask providers.

    I take my helmet on and off multiple times during a flight. Helmet usu stays in aircraft and I use earplugs under the running blades and on the chaotic scenes. I was concerned they would stay in place, potential pulled out and lost on scene, and using the earplugs. Guess Iíll figure it out once I actually have to do it, right.

    Thank you for clarifying Zpower and the non-environmental impact of batteries, that makes me feel a lot better. Not gonna hurt the enviro and save some $. Win/Win

    Carol, I too do 24ís on occasion, sleep on my side, and (knock wood) have never had an issue hearing with my littman cardiology J; TY for sharing how you use yours. Unfortunately, I need to hear the radio to wake up for pt care and we share the crew room. Yes, another set of ears, but everyone has bad days where you sleep through the tones. If I put the radio where I can hear it my partners would hate me. As suggested by Jeff, not gonna worry, just gonna try J. Ill keep the travel pillow suggestion in mind too.

    I try to protect my hearing now, wish I did earlier. I would welcome any suggestions Um Bongo may have, when I figure out how, Iíll message him.

    For my Harley 883 I have a great ĺ helmet, ride with my shield down, earcups tight, and earbuds in, which are connected to our Sena 20 communicator, which Bluetoothís to my phone as well, I should be able to Bluetooth the sena directly to the aids, which would be cool. (then ill never get my husband out of my head, lol) Or would it be better not to use them on the bike and keep on doing what I have been?

    Do Haís have, idk how to word this, an automatic shut off for too loud sounds? If a sound is above a certain decibel they automatically Ďshut offí until sound is again under the cut off threshold?

    The doctor/nurse analogy hit home, as did the explanation of the domes. TY

    Are Costco products different now that they are no longer partnered with GN Resound and Silvantos has won the contract (siemens/signia/rexton)?
    Thank you for helping me realize Brand is not something I should be overly concerned with, more fit and function.
    I was also afraid to Ďtrialí multiple types, I was under the impression a practioner suggested one and that was it. I now realize itís a big purchase and I may need to try a few before I find what will work for me, and I shouldnít feel bad about that.

    Glad you mentioned the ďconditionsĒ I surfed their websites and found:
    Do you have to buy to try then refund within the trial time limit? "Restocking" fees?
    Yes to both with HAD/ $75/aid restock fee. No to both with Audi
    How long is the warranty? Expect 3-4 years on a premium aid. Is there insurance for loss of an aid? 3yrs both. $315 HAD / $210 Audi
    What is included -replacement consumables like wax guards, domes, batteries and for how long? I know batteries 240 HAD/ 180 Audi, will have to ask the rest
    What services are included - first fitting, follow up appointments for adjustments and for how long? 1 year, both

    Based on that, Iím thinking Costco and the Audi are my best bets? Perhaps Costco first and see how it goes?

    Thank you all again for such great information and your willingness to help!
    Dar
    New to all this
    KHz 0.25...0.5...0.75...1.0...1.5...2.0...3.0...4.0... 6.0...8.0
    Left ...30....25.....22....20.....45....45....45....50Ö ..65.....80
    Right .30....25.....25....25.....40....50....50....50... ..70....65

  10. Default

    Quote Originally Posted by DmQ View Post
    Based on that, Iím thinking Costco and the Audi are my best bets? Perhaps Costco first and see how it goes?
    There's another channel to buy from that's getting more and more popular that you may want to investigate and explore. That's the online route (such as BuyHear.com or FactoryDirectHearing.com). You can get latest technology/premium HA brands and models online for better pricing compared to your local audi or HIS, if you want certain premium models that may not have the equivalent rebranded ones at Costco. They will do fitting remotely for you if needed by sending you the programming device to plug your HAs to it, then they adjust over the internet.
    HA wearer since the 1990's > Rexton Insite+ CIC (2011-2016) > Oticon OPN RITE (2016)

    KHz 0.25...0.5...0.75...1.0...1.5...2.0...3.0...4.0... 6.0...8.0

    Left ...10...10....10.....30.....70....75....80....95.. ..90....80
    Right .25...30....40.....55.....75....85....90....90...1 00...100

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