Hearing Loss in Percentages and Decibels [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

For years, I’ve been mystified when hearing people refer to their hearing loss in percentages. “I have lost 37% hearing in my left ear.”

Since I was thirteen and had my first audiogramme, that is how I’ve been thinking of hearing loss. In decibels, presented as a graph of how loud a sound needs to be so I can hear it, at various frequencies. I’ve showed my audiogramme on Open Ears already but here it is again:

Steph Audiogram

As you can see, at 500Hz I don’t hear sounds below 50dB, but at 4000Hz (higher pitch sounds) my left ear has almost “normal” hearing, as I can hear sounds as soft as 20dB. As is the case for most people, my hearing loss is not the same at all frequencies.

Hence the mystification: how could one express this with only one number? And how would you convert decibels (a logarithmic scale, where 20dB is 10 times as loud as 10dB) into percentages?

Many months ago already, I wanted to write a blog post about this. I did some research, asked some people, and stumbled upon a formula which didn’t feel very convincing (maybe this one). At the time already, it seemed to me that there was more than one method, which kind of discouraged me from further investigation.

A couple of months back, there was a consumer advocacy piece on Swiss TV where they sent somebody with hearing loss to various audiologists to see what solutions where recommended (and at what price). The surprising part was that the “hearing loss” of the test subject, expressed in percentages, varied wildly from shop to shop.

Anyway, this put me back on track to figure out how on earth they converted audiogrammes to percentages. Despite hearing people talk about their hearing loss in percentages all these years, I’d never been given a percentage value myself for mine.

I roped in Pascal to investigate and thanks to him finally got some satisfactory answers. Here are my take-aways.

First, the proper way to describe hearing loss is the audiogramme. As one can guess based on the results of the Swiss TV programme and the discussion around Christina’s article about “cheating” the test, taking somebody’s audiogramme is a bit of an art-form, although technically it is a rather simple procedure. Done well, it should produce the same result independently of who is measuring it (assuming your hearing is stable). This is, by the way, my personal experience with my audiogramme, done and redone over the years by three doctors and at least as many audiologists.

Second, there seems to be no end of formulas to “convert” audiogrammes to percentages, even in the United States alone (now extrapolate that to the rest of the world). And the results vary. According to one method, I have “25.3%” hearing loss. According to another, the one used by the doctors in the Swiss TV programme (CPT/AMA table reproduced below), I have “48.7%” in one ear and “40.7%” in the other.

AMA/CPT Table

Does this really mean anything? Does it make any sense to say I am missing “roughly half my hearing” or “a quarter of my hearing”? The first formula uses a kind of weighted average where you multiply the “good ear” by 5 — why on earth by 5? Quoting the article I just linked to: “Notably, while a five-to-one weighting is common among hearing impairment calculations, there is no research basis for this particular proportion.”

Third, again referring to the very interesting discussion in the same article, the need for a simple way to express hearing loss “objectively” seems to have its roots (at least some of them) in the compensations for work-related hearing loss. If you’re going to give money to a worker because of hearing lost on the job, there has to be an objective and simple way to determine how much. Which, when we realise that even an audiogramme is a rather poor indicator of the real-life impact of hearing loss. Two people with similar audiogrammes may feel differently impaired in their life by their hearing loss. Quoting again:

Few studies have found evidence for any of the several arithmetic hearing loss calculations in current or recent use in the US, as an effective measure of real-world hearing difficulty. More significantly, a literature review was unable to identify any study that has used appropriate statistical methods to evaluate the relative strength of association between these hearing impairment calculations and self-report measures.

Well, there we are. Measuring hearing loss is a hairy affair, and percentages don’t seem to me a very useful way of expressing it, as the calculation methods vary, seems sometimes pretty arbitrary, and apparently don’t correlate well with the real impact hearing loss has on our lives.

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When Do You Wear or Remove Your Hearing Aids? [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

As somebody with mild/medium hearing loss, I guess wearing hearing aids are more of a choice than a necessity for me. I mean, I functioned without them for nearly 40 years. Today I wouldn’t give them up for anything in the world, of course, and I really prefer wearing them for anything resembling human interaction. But I can get by without. (An audiologist I had a chat with one day told me I’d be surprised at how people with much more hearing loss than me “get by just fine” without aids. Anyway.)

So, when do I wear them, when do I remove them? As a general rule, I wear them when I leave the house. (My cats aren’t all that talkative.) I remove them when I get home. Since I got my V90 aids though, I often forget to remove them when I get home.

I don’t wear my hearing aids to watch TV.

skiing-022515-940x492

I’ve been watching TV so long with headphones that having “ambient” sound on actually makes me self-conscious about bothering my neighbours with it (this is Switzerland). I used to always remove them to listen to music or podcasts. Now that I have the ComPilot Air II I sometimes keep them in (more for podcasts than music, with open tips there are frequencies missing for the music). If I’m travelling or wandering around on my own and not really expecting to interact with people I might take them out, too.

At judo training, I usually keep them in for warm-up and maybe the first rounds of “light” practice. Then I remove them so that I don’t have to worry about paying attention to what’s going on around my ears.

For skiing, I keep them in, despite the helmet. With my old Widex aids I’d given up on that (they really didn’t cope well with the helmet), but my current ones are fine. When driving, I sometimes wear them, sometimes not (depends if I was wearing them just before taking the wheel or not, I guess).

I also ended up removing my hearing aids once at a very noisy party. Even with the highest “speech in noise” setting, I actually managed better without them. But that was really an exceptional situation.

What about you? Do you put them in first thing in the morning and take them out last thing at night, or are you like me, sometimes in, sometimes out? And when? I’m curious to hear how other people do this. I suspect our wearing vs. not-wearing habits are also linked to how much hearing loss we have.

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So Many Failed Fittings [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

Again and again, when I talk about my hearing loss and my role as Open Ears editor, people tell me about their relative, acquaintance, or friend who has hearing loss of some degree, got hearing aids, but never wears them. This is a well-known problem in the industry, of course. I haven’t done checking out the existing research on the topic, but after an umpteenth discussion — and a failed fitting in my history — I do have a few thoughts to share.

failed_fitting

If I go back to my personal experience, there was a major difference between my first (failed) fitting and the one that got me wearing hearing aids on a daily basis three years ago: the first time, I was sent home with “perfectly tuned” hearing aids and that was it. In my memory (though it might be failing me), no follow-up appointment. The second time, I was sent home with barely amplified hearing aids and clear follow-up instructions.

Of course there are other differences. I was 13 at the time, 25 years older at my most recent fitting. Technology had evolved. I’d had time to accept the fact I have hearing loss. As a teenager, I was “told to go”, whereas as an adult, I made my own decision.

But I can’t help but think that sending newly fitted people home with hearing aids on “full blast” is a bad idea for a first fitting. Everything I know about habituation and resistance to change screams against doing that. Baby steps is usually what it takes for lasting change, rather than huge sweeping revolutions. Remember those new year resolutions you never keep? Yeah.

Have you been fitted with hearing aids that stayed in a drawer, or do you know somebody in that situation? I’m curious as to what other people’s hypotheses are regarding the reasons for all these failures, I have to say.

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About Being Confused [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

Over the last couple of months, I’ve been trying out a variety of hearing aids as part of my newly-found “guinea pig” position at Phonak. As a geek, I love playing with new technology and trying things out. As a person with hearing loss, I’m curious about how good things can get for me.

One of the challenges I’ve come upon trying out hearing aid solutions is confusion. You know what happens when you’re shopping for perfumes, and after a (short) while you can’t distinguish smells anymore? That’s a bit what it feels like with sound. Maybe it has to do with the rather strong “habituation” component there is in the way we process sound.

Some situations are clear-cut: for example, after trying out the Bolero Q90 hearing aids for a few weeks, I switched back to my Widex Clear 330 ones to see if I could spot a “reverse difference”. One situation where there was no debate was at the vet’s: I’d been going there regularly throughout my Bolero trial, and when I went back with my Widex aids in, I really struggled to understand what my vet was saying. The room is a bit echoey and she speaks quite fast. To make extra sure I wore the Boleros next time around.

hearing-aid-confusion-phona

I did recall that I’d always found it difficult in that room. Switching programmes, even turning my hearing aids off. But I completely forgot about all this as soon as the situation stopped presenting difficulties with the Q90 aids. See how it goes? We’re prompt to forget and get used to what we have.

Another situation was singing. I sing in my car a lot. With the Widex aids, I’d get “scratchy” noises on some notes when the anti-feedback mechanism kicked in. With the Boleros, no scratchy noises, but annoyingly vibrating notes (anti-feedback mechanism again, I’m told). With Venture, no scratchy noises or vibrating notes — a huge, huge improvement.

A few weeks back I tried “slim tips”, a light type of custom mold, so that I would have better music quality when streaming with my ComPilot. For that, it worked, but when I was singing, I couldn’t hear myself well enough at all. So that was also a clear-cut situation. (We still might be able to improve it, I haven’t abandoned the idea of a more closed fitting altogether.)

But most of the time, specially when we’re tweaking settings, it quickly gets really hard to know if things are better, worse, just different, or even, not different. My poor brain can’t follow.

One problem I identify is that comparison relies on memory. And also that the hearing situations we have problems with are often “out in the real world” and not in the audiologist’s lab. Maybe some form of distance fitting will help solve that — but the fact that we get used to what we’re listening to very fast seems to be here to stay.

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Tired of Batteries Falling Out of Your Hearing Aids? [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

Maybe it’s because I’m a newbie (less than three years) hearing aid wearer with mild-to-medium hearing loss, but this has been a subject of continued annoyance for me.

Of course, my batteries aren’t falling out of my hearing aids when I’m wearing them. No, they tend to fall out when stuffing them into pockets, bags, drying boxes, jewellery boxes, and all the other various places I put them (shhh I know it’s bad) when I take them out of my ears. Which happens, because I like my deafness when I’m alone at home, don’t need extra volume on noisy fellow travellers when I’m in public transport, and use my earbuds quite a bit for phone, music, and podcasts.

Caveat: all this might be way less true now that I’ve tasted Venture.

In any case, even if I don’t change my nasty habits, it seems that now that I’m carrying these V90s my battery-falling-out days are over. Look at the photograph closely (it’s not easy to photograph, and easy to miss):

V90 battery compartment design

Do you see how even when the battery compartment is fully open, there is still a tiny overlap of the casing over the battery? Maybe it makes more sense if I hold the hearing aid upside down:

V90 battery compartment design upside down

The battery would like to fall out, you can see it trying to sneak away, but it’s held in by that tiny tiny overlap. If you want to change your batteries, all it takes is a tiny nudge to get the battery out. But it doesn’t fall out when you don’t want it to.

I noticed this design detail during my fitting the other week and asked Simone about it. She told me that indeed, batteries kept falling out during the fitting process…

I just love this kind of attention to detail.

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Trying Venture: It’s Smooth [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

A surprise was waiting for me on my last trip to Phonak headquarters in Stäfa, 10 days ago: Venture.

I had an appointment to try some Audéo hearing aids and tweak a few things that were bothering me with the fitting and the settings. As I arrived in the building, I bumped into Ora. I excitedly told her, “Do you know I’m trying Boleros? And I like them, there are really situations where they perform better than my old hearing aids.” She answered that she was delighted to hear that. I mentioned some of my beef with Soundflow. “You should try Venture! Are you going to try Venture? Tell them to make you try Venture.”

Venture? Phonak’s new platform (chip, software) for Audéo.

I headed towards the audiology lab and was welcomed by Michael and Simone. Here is what they had for me 🙂

Audéo V90 and ComPilot Air II

Venture! I didn’t even have to ask. They had planned it all in advance. I was pretty excited, I had to say. New functionalities, resolution of the Soundflow switching issues that had annoyed me in my car, smaller BTE. No purple, or pink, sadly, but I decided I wouldn’t be fussy about the colour and be happy with the silver that was offered me.

The fitting went smoothly and I got to know Simone, my audiologist for this visit. We did things wirelessly (I was wondering about that in my first post: both options exist for Phonak, it really comes down to the audiologists preference), selected some new programmes, and — even more exciting! — tested the ComPilot Air II and got to see the RemoteControl smartphone app in action.

Two and a half years ago, when I got fitted, I was dreaming about this. My initial assumption once I got over the wonder of hearing more was that there should be a way to interact with my hearing aids directly from my phone. I was shocked that it wasn’t possible. I was also shocked that the device I was provided with to “connect” my phone and hearing aids was so… 2001. With the ComPilot Air II, I feel we’re really getting there.

ComPilot Air II

Steph on Train with ComPilot Air IIIt’s not direct phone-to-hearing-aid connection, but the device is small, looks good, is actually wearable, and has an autonomy that makes it usable. About 4 hours of streaming, I’m told, versus 1 hours for the M-DEX I tried two years ago. And the app, though it is still quite simple, is also really on the right track. Unfortunately, due to iOS8 Bluetooth problems, I’m going to have to wait a bit for it to be available on iOS so I can really try it out (get it from Google Play though). While we’re talking about “in the right direction”, I can’t wait to see what EasyCall is like — a flat device that fits on the back of any Bluetooth-enabled phone and boasts upto 10 hours of talk time.

The ComPilot works really well. I got to try it for a few real-life phone calls, and once we had set the default behaviour to “mute the room” when streaming started (who on earth would like surrounding sounds to be amplified too while trying to make a phone call?!) it managed to be at least as good as my default “earbuds and no hearing aids” solution. I used it on the train home to listen to podcasts. Now I get to look even sillier when I laugh all by myself on the bus, because I don’t even have earbud wires dangling from my ears.

The smartphone app connects with the ComPilot and allows things like changing programmes through the app instead of cycling through them with the hearing aid button. It also allows control of the general amplification volume (up/down), and with the Speech in 360 programme, you can “lock” amplification in one direction if you desire, instead of letting it automatically determine where the speech you want to listen to is coming from.

In addition to the Speech in 360 programme, I got a dedicated Music programme with no Soundrecover. I also added a simple Calm Environment programme as a fallback if ever the automatic programme was doing things I didn’t want it to (I had been burned, but I needn’t have worried).

One little snag I hit with this new pair of hearing aids was linked to the little bend that has been added to the RIC part of the aid. It actually improves fitting — meaning it’s possible to fit more people with that bend. Sadly it’s not a good thing for me, as I seem to be one of the small number of people for who the bend makes things uncomfortable (outright painful actually!), but Simone managed to find some “old” unbent ones for me. And Michael told me that the bend could be tweaked by the audiologist — so no big showstopper. Just a snag.

It bends!

I really like that they now make the open tips black instead of transparent. Even if you’re squeaky-clean, the transparent ones always become yellow with time. No problem with black 🙂

We decided to take some imprints of my ears to prepare custom molds for me next time. Even though I don’t like the idea of “occlusive” molds, I did give them a fair chance with my Widex aids, and I’m willing to give Phonak a chance too. So, stay tuned, next time is probably going to be about that.

My ear!

It was a really exciting morning. I left the audiology lab with a huge smile on my face and a lot of hope for the future.

After a week or two of use, I am totally in love with my Audéo V90s. They’re smooth. I don’t notice them. We’ve solved all my physical comfort problems. I don’t need to take them out when I get a phone call (with or without ComPilot). I don’t hear any transitions between programmes. The sound around me feels completely natural. I never hear anything “weird” coming out of them.

The ultimate test: in the automatic programmes that come with Venture, there is a new one designed specifically for car noise, so I was curious to see how that would play out. Answer, a few days later: great. I had music on full blast, on the motorway, and I was singing at the top of my voice — on the automatic programme. And I never heard my hearing aids misbehave. It was as if I wasn’t wearing them, but could hear.

They’ll have to pry them out of my cold dead hands.

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Forgetting [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

In the same day, I both forgot that I was wearing my hearing aids before jumping under the shower, and that I should maybe carry spare batteries before going to a family gathering.

P13 Hearing Aid Batteries

As I live alone, I usually put on my hearing aids before leaving home as opposed to first thing when I jump out of bed. As I have a friend visiting these days, my hearing aid routine has changed — I’m not a morning person to start with, so add “no ears” on top of that and you get a very poor morning communicator.

So, Saturday I actually climbed into the shower, turned it on, and was about to raise it above my head to wash my hair when it suddenly dawned on me to make sure I didn’t have my hearing aids in. A niggling doubt. A close shave, too, because there they were, sitting on my ears.

Later that day, after a rather frantic morning running around, we headed out to a cabin in the woods (a “refuge” as we call them here in Switzerland) for a big family party to celebrate my aunt’s 70th birthday. An hour in, I hear the ominous beeping coming into my right ear.

“Oh no! I hope it lasts long enough for me to enjoy the rest of the party!”

My Widex aids give me two warnings and then go dead. If my memory serves me right, I have an hour or so after the first warning at the most.

With Phonak, they seem to chime every half-hour or so (again, I didn’t time it, writing this from memory). And the first time I reached the end of a pair of batteries, I had the feeling they lasted forever after the first warning. Hours, if not half a day. But the last time I reached the end of my batteries I was surprised to have one go dead pretty soon after the first beeps. Maybe I missed the previous ones in the noise?

All this to say that when my hearing aids started telling me “battery’s going”, I didn’t really know if it would be fine for the rest of the afternoon, or if they would be dead 20 minutes later. I had the niggling suspicion I hadn’t brought any replacement batteries with me.

My “Phonak batteries” are bigger and last longer than my “Widex batteries” (I know they’re not Phonak or Widex batteries, but that’s how I think of them). I got used to always carrying my smaller batteries around with my Widex aids because I couldn’t really go a week without changing them. With something like 10 days or more between each battery change with my Phonaks, it’s easy to get sloppy and stop carrying batteries. Specially when the hearing aid warns you (normally!) well in advance.

I got caught once already two weeks ago without spare batteries: on a trek in the mountains, which I finished hearing-aid-less (because honestly, if most of what I’m doing is walking and panting, one hearing aid is more annoying than none).

My niggling suspicion turned out to be correct, once again: I went through my bags, and indeed I hadn’t brought spare batteries. I had even taken my little “emergency pouch” out of my handbag to make space before leaving.

Then my first hearing aid went dead. I took it out, opened it, closed it and put it back in. Got a grand 5 minutes of extra hearing time with it. It wasn’t even 2pm and the party was going to last until early evening…

I ended up jumping in my car and heading back home to pick up some batteries, cursing my lack of foresight. Luckily I didn’t live very far from the “refuge” and the batteries were in the very “emergency pouch” I had discarded earlier, so it took me about 15 seconds to find them.

Thirty minutes later, I was back with my family, vowing to never go anywhere again without spare batteries! (Which, of course, I promptly did the next day, as I had just changed my batteries. Right?)

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Impressions on New Hearing Aids [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

As promised, here are my impressions of the Bolero hearing aids I’m currently trying out (hoping I don’t get any of the technical stuff wrong here, do tell me if I did!). They have open tips, like my Widex ones have, but are BTE (entirely behind-the-ear) rather than RIC (with the receiver, the part that produces sounds, directly in the ear canal — this would be the Phonak Audéo model, which I might try in future). My Phonak audiologist Jennifer tells me it doesn’t change much, acoustically: a RIC just moves some of the technology away from behind the ear, allowing the part that sits there to be smaller — important for those, who, like Steve, appreciate when their hearing aids are invisible.

Phonak Bolero Q90

The first thing that struck me with these aids was that there was less ambiant noise. Or less operating noise. Or different. I had the strange feeling I wasn’t really wearing hearing aids. There was probably a little less amplification than what I was used to, but clearly something in the sound texture too.

Voices felt a little tinny/reverb-y at first. Mine, Jennifer’s. Not unpleasant, but a little bit weird. Jennifer told me it was probably due to SoundRecover, which compresses high frequencies into a lower frequency region so we can hear them better. She warned me it would take some time getting used to. I don’t notice anything strange with voices nowadays, so I guess I did indeed get used to it!

I discovered that with Phonak there is a whole list of programmes the hearing aids can switch back and forth from, and which can also be set manually. I left my “main” channel in automatic mode to see how that worked, and for the other ones picked StereoZoom, which is optimised for speech in noisy environments, with a lot of noise reduction and a very narrow beam for amplification, speech in wind (for sailing), and a phone programme (right ear). The last position is a “mute” mode (indispensable for me).

The buttons on both aids have different roles: they can either be used to turn volume up or down, or switch programmes. The catch is that the left button is the “volume down” one, and the right button “volume up”. So as I wanted a “volume up” button, I had to have my programme switch one on the left — whereas it would have made more sense for me to have it on the right. I’m right-handed, and switch programmes more often than I increase volume. Oh well.

I can’t say I’ve used the phone programme much. I tried it, and it works, taking the sound from the right ear (the phone one) and channeling it into the left ear too. It’s pretty neat. But it requires positioning the phone in such a way that the hearing aid catches the phone sound (takes some getting used to) and pressing the phone against my ear with the hearing aid in it ended up being a bit too uncomfortable. So, for long planned calls I’ve reverted to my trusty earbuds. For impromptu calls I still tend to switch to mute, because background noise sometimes interferes with the phone mode (i.e., gets amplified too) and I don’t really feel like experimenting with acoustics when I’m on a call. I guess I should probably run some test calls to really try that mode out.

Given the lousy weather this summer, “speech in wind” has also been largely left aside, as it’s the programme I was planning to use when sailing. I like StereoZoom, though I sometimes have trouble determining if I should use it or leave the hearing aid in automatic mode, specially as automatic mode has a whole bunch of different programmes it can switch to and even blend.

While it’s nice to have a hearing aid that recognises the acoustic environment and chooses the best programme suited to it, it’s sometimes frustrating in practice. I’ll be in my car talking to a friend, and suddenly the quality of the sound changes and I have more trouble understanding speech. And then it changes back. Or I’ll be listening to music in the car, and one ear seems to be treating sound differently from the other. I find the whole concept of a hearing aid intelligent enough to know what it’s listening to fascinating, and would love to know more about how to the tech/programme works, but the control-geek in me would like to be able to have some kind of indication telling me which mode I’m in, and an easy way to override it.

I haven’t yet put my Widex aids back in my ears, which in my opinion points to how comfortable I am with the Phonaks. There’ll be a little tweaking to do next time I go to headquarters and see Jennifer (one ear is slightly less-amplified, and maybe I need a smaller size tip in one ear, we’ll see), and I’ll probably change my selection of programmes, including at least the music one.

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Trying Something Different [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

It’s no secret that I’m not a Phonak customer, despite being the editor-in-chief of this blog. It could be argued that this is a good or a bad thing, but right now I’m actually not convinced that it’s all that important.

Fitting some Phonak hearing aids

Anyway, since I started working with Phonak, it’s been (kindly) joked about that something needed to be done about my hearing aids. To tell the truth, I’m very happy about my current hearing aids, and not just because of their colour. I like the sound quality, I like the way my voice sounds (important! I speak a lot!), I even find their operating noise soothing. They allow me to understand people so much better and have really changed my life.

My complaints? Well, restaurants, mainly (who doesn’t complain about restaurants?) and the crackling sound they make when faced with loud noises. Oh, and the phone.

Last time I went to Phonak headquarters in Stäfa, we arranged an appointment with one of the audiologists there (Jennifer) so I could try out some Phonak hearing aids. This would allow me, well, to try out their technology and maybe talk about it (what I’m going to do in a bit), and also to play around with Phonak accessories. After all the horrible things I had to say about the M-DEX (and I’m not alone), my Phonak colleagues kept saying “oh, you should try the Roger Pen”. Well, my current hearing aids don’t let me do that. So, first step in that direction: for the last few weeks I’ve been walking around with Phonaks on my ears.

Overall, I like them. I’ll write another post about the acoustic/hearing stuff, but what I want to talk about now is differences. Differences in audiologists, fitting process, hearing aids. Is different good or bad? The answer is probably in the eye of the beholder.

First, I had a really interesting discussion with Jennifer about how to take an audiogramme. Jennifer is from the UK, and the process taught and used there is different from the French/Swiss one I’d experienced until now. She starts with a loud sound, so I know what I need to listen to. Then she makes it softer and softer. When I don’t hear it anymore she goes back up until I do again. Then back down until I don’t. In this way she pinpoints the exact spot where I lose the sound. I have to say this makes it less stressful than the “usual” (to me) beeping-sound-getting-louder process. Hearing tests and sound-proof booths are great environments for drowning in your tinnitus, and I always ended up realising that I’d been hearing the beeping sound for quite a bit before I actually realised I was hearing it (if that makes sense). “OMG that was a real sound!”

Now, does it make a huge difference in the resulting audiogramme… Not certain. But it was interesting to see that the way certain things are done is really a product of culture.

Steph all plugged in :-)Second, to program my hearing aids Jennifer plugged wires into the back of them. It felt strangely cyborgy, in a cool way. But in my opinion it’s a bit more cumbersome than a wireless solution. With Widex all I had to do is wear a kind of big necklace which connected wirelessly with both the computer and the hearing aids. (To be honest, I can’t remember if Phonak fitting is always wireful or if this was because we were in a test/trial/development environment.)

Third, the in-the-ear sound measurement sound is different: Widex uses some kind of breathy rythmic burts of noise (not very pleasant), whereas Phonak has a combination of background noise and human voices speaking a mash of languages. Pretty surreal to listen to, because bits and pieces feel familiar but the whole thing is of course unintelligible. A kind of audio “lorem ipsum“? As somebody with a strong interest in languages I found it quite fascinating.

At this stage, I feel a bit like somebody switching from Mac to PC or vice-versa. Change in ecosystem!

We all know that hearing aids require habituation. So I’ve left “my” hearing aids in a drawer these last weeks and stuck to the Phonaks. What I want to do (soon!) but am apprehending a bit is swap back. I’m used to the Phonaks now, and I have kind of forgotten what my Widex aids sound like. To compare, I need to go back to them.

Why the apprehension? Well, I feel a bit in a “damned if I do, damned if I don’t” situation. What if I prefer my old hearing aids? What if I prefer the test ones? But to be honest, I have the feeling it’ll be more nuanced. It’s not a clear-cut 10 to 1. But still, I’m apprehensive. I’ll probably do a first write-up before the swap, and another one afterwards. Interesting, no?

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Mimi Is Making Me Dream [en]

As the founding editor of Phonak’s community blog “Open Ears” (now part of “Hearing Like Me“) I contributed a series of articles on hearing loss between 2014 and 2015. Here they are.

When I did my frustrating trial of the M-DEX two years ago, I kind of gave up on using my hearing aids with my phone. I have a mute programme for when I need to put the phone to my ear (I have open tips), but most of the time, I take my hearing aids out, put my earbuds in, and crank up the volume.

Here’s what I wished for at the time:

I can’t believe there isn’t a simple “equalizer” software or application for my phone which I could feed my audiogram to and which would then amplify the frequencies I need. Clearly it wouldn’t be as good as a proper hearing aid, but I’m sure it would help a bit. If you know more about why this isn’t done, I’m all ears (!).

A few weeks ago, Vincent sent me a link to the Mimi launch announcement. It’s worth taking a few minutes to watch the video below:

I was almost jumping up and down with excitement. If they pull this off, I think it could be pretty cool. Let’s unpack a bit.

Mimi announces it’ll do exactly what I was wishing for two years ago! A lot of my “sound input” in life comes from my phone (conversations, music, podcasts). I’m impatiently waiting for Mimi to be available through the Swiss iTunes store, but if you live in the US, you can already get an early version of Mimi. I’m not sure it does the “equalizing” bit yet though, but works already as an application to measure hearing loss. Those already exist (remember Anna’s post about them?), so that’s not really new, but Mimi will be able to do much more.

These last days I’ve been reading through some of the results of MarkeTrack, a global US survey around hearing loss and the hearing aid market. One of the things the survey tries to figure out is what the obstacles are to hearing aid use. It’s complex, as you can imagine (and that reading would have come in handy as I was thinking about why we underestimate hearing loss) but one of the elements that stayed with me is that getting an objective measure of your hearing loss is one step towards getting fitted. If you never get tested, you never get fitted.

This actually fits with my story: during those years where I was “coping” and thinking that maybe I’d give hearing aids another go at some point, one pivotal moment was when I walked past the “hearing bus” and decided to drop in for a test. I’d already had an audiogram made, quite a few times, but it had been a while and I was in this phase of thinking that my “hearing problem” wasn’t very serious. The bus guy changed that perception for me: at most frequencies, I couldn’t hear two out of the four sounds, and he told me that when only one was missing he referred people to an audiologist. This is the moment when I started taking my hearing loss more seriously.

So, couple a “hearing test” app with a feature that will already let you benefit from adapted amplification when you’re using the phone, or use your phone as an amplifier: that might give some people a preview of what it is like to hear more sounds — and for people like me, who don’t want to deal with cumbersome intermediaries between phone and ears, and “get by” removing their hearing aids to use the phone, well, it might just be the little magic app we have been waiting for.

There is certainly much more to say about Mimi: the cheap subscription model they are working on for a Bluetooth “hearing enhancer”, or the fact that these are players who are approaching the hearing tech market using the smartphone as a starting-point, and thus tackling some long-standing issues from scratch again. But that sounds like material for another post.

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