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Hearing is Believing

I’ve been using Widex Inteo hearing aids for about six years now. One CIC (Completely In Canal) model, and one ITE (In The Ear) size. Prior to that, I had another set of earlier Widex digital hearing aids for around 7 years.

Hearing aids have an expected lifetime of somewhere around 5-7 years, perhaps a little shorter for models like mine that live inside the ear. I’m lucky that I don’t seem to get much wax in my ears, so I’ve been lucky that mine last reasonably well. I’ve still had to get them serviced periodically, and I did once have them fail in Turkey (but luckily I was able to get them repaired!).

Technology moves on, and hearing declines as we age. At a minimum, I need my current aids serviced, tested, and possibly reprogrammed for my changing hearing. But since my current aids are still working, I’m not in a hurry to get new ones. Instead, it’s a good chance to look at my options, including a changing to a different manufacturer.

To start off, I had a full hearing test conducted by Dilworth. This went beyond the usual “tell me when you hear the beeps” test, and included comprehension tests in noise, and electronic measurements. Apparently not only is my hearing worse in my left ear, but my eardrum responds differently. If only there was a simple operation that could fix hearing. Not likely in my lifetime though.

Once we had the results, the audiologist and I had a look at what my options are. I wanted to stay with CIC or ITE style aids, which is a bit tricky, since my left ear is marginal or outside the limits for most manufacturers, in that style. I like CIC because they are good with the wind, I can put headphones over them if I need to, and they’re reasonably discreet. I’m getting older now though, so I’m not quite so fussed on that last point.

Depending on development cycles, vendors jockey for position for “best” hearing aids. Even then, what’s best for one person will be terrible for someone else. This is in part due to different philosophies of different manufacturers, as to how best to help with hearing loss. If you haven’t dealt with this sort of thing, you may think that it’s simply a matter of raising the volume. Turns out that it’s far more complex than that.

Firstly, different people have different patterns to their loss. For me, my low range is poor, my mid frequency is worse, but going up it gets quite a bit better. This is quite different to typical age-related loss, where the high frequencies are affected. If you raise the volume across all frequencies, you will distort speech as that person perceives it. Apparently increasing levels in one frequency range can drown out perception in other ranges. This can lead to the situation where everything seems very loud, but you still can’t understand what people are saying. All you get is a headache. Not much fun.

Secondly, different environments require different sorts of help. In a quiet environment, you probably do want to hear the page turning. But if you’re in a noisy environment, you really want to be able to focus on the conversation going on right in front of you. The last thing you want is every conversation in the room coming through at full level. So manufacturers work hard to try and detect the environment they’re in, and adapt. Some aids have programs that the user can select, but many now are automatic. These will try and work out what’s going on, and how best to respond. One of the things they will do is to compress loud sounds, to ensure they don’t cause discomfort to the user.

Thirdly, some manufacturers have a philosophy of “speech comprehension is more important than anything else.” In some ways this is true, but this can make the adaptation phase harder for those using aids for the first time, or changing manufacturers. Others aim for more natural sound.

The other thing that plays into this is the user – you get used to a certain sort of “style” and changing can be very jarring. If you expect to hear a car door slamming sound like, well, a car door slamming, it’s very disconcerting when it sounds like a short clap. It’s also very odd to hear your voice changing. Takes a while to get used to.

Anyway, we decided that Phonak Virto aids would be the best for me to try. The specs said I could get two CIC aids, so we ordered those. Turned out the specs were a touch optimistic. Even with my good-sized ear canals, with the gain needed on the left ear, they just couldn’t make a shell that worked. In the end, we got a slightly larger aid than originally anticipated, but it wasn’t too bad. The initial moulding of the right ear was also a problem, with it being very long, and pushing on my ear drum. Very painful. Managed to get that one shortened though, and all was good.

The Phonak style is very different to the Widex style. Much more focused on speech, and to my ears at least, somewhat “tinny.” Huge amounts of echo too, until we got them programmed right. That’s the other thing with modern hearing aids – you hook them up to a computer, while they’re in your ears, and you have a million options you can change on them. You can also insert tiny tubes alongside the aids while they’re in your ear, then a machine plays a sentence to you, and shows what the aids are doing, along with recommendations on improving the settings. The only problem with having a million options is of course trying to work out which ones you actually need to change. Also tough when you’re doing it at the clinic, as there’s not that many different environments you can be exposed to.

The Phonak aids were strange to get used to, but I decided to only wear them for several weeks, and not fall back to my old aids. Turned out to be pretty tough going. I realised I was missing a lot of conversation, and my wife saw me missing more that I didn’t even notice. But it was in noisy environments that they were toughest. Shopping malls or parties were very tough, where they just gave me a wall of noise. In that situation, you tend to shut down, as it’s the only way to cope.

We tried making adjustments to them, but ultimately they just weren’t going to work for me. Maybe someone else, but they weren’t an improvement on what I had – they were worse – so there was no point paying the $7,100NZD. So back to the audiologist.

Now I’m trying some Oticon Acto aids. I had to go for an ITC Power style for my left ear, to get the gain I needed, but I’ve got CIC for the right ear. I’d rather have them the same, purely so they use the same battery, but hey, I’m used to this setup now. Initial fitting went well, and the tests on the machine show that we’re able to get these ones to pretty much exactly where the machine thinks they should be.

It’s hard to say what they’re going to be like – my brain is still adjusting to the changed sounds. They feel like they might be a little worse right now, but I need to give it a few more days before we’ll know. Hopefully these work out, otherwise I’m going to go back to my trusty Widex Inteo aids. They’re being serviced right now. Widex tells me that they’ve got new stuff coming out soon. So if I do go back to the Widex aids, then I’ll stick with them for a bit longer, and maybe in 12-24 months I’ll try again.

I’ll report back in a couple of weeks with progress.