widex – Climb to the Stars

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.

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.

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?

Histoires d'oreilles [fr]

[en] Sharing my hearing and hearing aid story -- and opening a francophone facebook group for people who don't hear that well, whether with or without hearing aids.

L’autre soir, comme souvent dans des situations acoustiquement difficiles, je parle de mes oreilles et de mes appareils. En face de moi, le hasard veut qu’il y ait deux personnes à l’ouïe “pas top”. On a donc parlé longtemps, et j’ai raconté toute mon histoire.

J’ai toujours été un peu sourde. C’est familial. Mon frère aussi. Mon père aussi, probablement. Bref, dans la famille on est durs de la feuille.

Première tentative d’appareillage quand j’avais 14 ans. Fin des années huitante, gros appareils “intra” couleur chair qui se voyaient bien, inconfortables, réglage pour mon gain “idéal” très probablement, filles de la classe qui se fichent de moi: j’essaie deux jours puis ils vont finir leur vie dans leur boîte.

Je m’en sors très bien sans. Je sais que j’entends “pas très bien” et je le dis — mais je me rends compte aujourd’hui que je n’avais aucune idée à quel point j’étais sourde. Il a fallu que mon frère fasse le pas d’un appareillage, qu’il me parle un peu du processus et de la différence que ça faisait pour lui, de “bien entendre”, pour que j’y pense à nouveau. Aussi, je commence à me rendre compte dans mes activités professionnelles que mon ouïe m’handicape. Je n’entends souvent pas les questions des étudiants ou du public quand je donne une conférence. Je dois faire répéter. Ça devient un peu lassant.

Il me faudra encore quelques années pour passer à l’action. Je trouve le côté geek des appareils auditifs et accessoires fascinant. Je pose des questions à mon audioprothésiste dont il doit chercher la réponse. Ça lui change du quotidien…

Mes appareils sont roses. Ils sont derrière l’oreille, assez petits pour ne pas être très visibles (enfin quasi invisible sauf quand je relève mes cheveux, ce que je ne fais pas normalement car ils sont courts). Le micro est dans l’oreille, avec un embout “ouvert” plus confortable que le moulage fermé que j’ai quand même testé. Un “compromis”, dit mon audioprothésiste (parce que la qualité audio est censée être meilleure avec le moulage), mais je peux vivre avec ça.

Ils ont deux micros chacun et ils communiquent entre eux. Ça leur permet de savoir d’où vient le son et d’introduire cette variable dans la façon dont ils le traitent, de répercuter dans mes oreilles les décalages qu’on entendrait normalement et qui nous permettent de localiser un son.

J’ai choisi la taille “pas mini-mini” pour avoir un bouton “programme”. J’ai quatre programmes différents: un normal, un pour environnements bruyants, un pour les situations calmes avec légère suramplification, et un “silence” pour quand je suis dans le train avec les gosses qui crient à côté 😉

Il y a des tas de choses à raconter sur mon aventure auditive: comment ça a changé ma vie, comment se passe l’adaptation, comment on minimise toujours l’importance de sa surdité (“j’entends pas bien mais c’est pas si grave, je m’en sors sans appareils”), le look des appareils en 2013 (et leur taille!), les situations “impossibles” comme les restaurants, l’absence de communauté de hackers dans ce domaine (on a besoin de nos appareils, et à 6500 balles la paire on va pas s’amuser à les démonter “pour voir”), les anti-larsens, l’habituation, les acouphènes…

Bref, de quoi écrire une bonne demi-douzaines d’articles de blog, ou d’ouvrir un groupe facebook — ce que j’ai fait.

Pour le moment c’est un groupe secret, mais je pense que ce sera pour finir un groupe fermé: contenu inaccessible aux non-membres, mais listing des membres et descriptif du groupe visibles. Si ça vous intéresse de rejoindre le groupe pour partager vos histoires d’oreilles (avec ou sans appareils) ou écouter celles des autres, faites-moi signe et je vous y invite!

3e #back2blog challenge (1/10), avec: Brigitte Djajasasmita (@bibiweb), Baudouin Van Humbeeck (@somebaudy), Mlle Cassis (@mlle_cassis), Luca Palli (@lpalli), Yann Kerveno (@justaboutvelo), Annemarie Fuschetto (@libellula_free), Ewan Spence (@ewan), Kantu (@kantutita), Jean-François Genoud (@jfgpro), Michelle Carrupt (@cmic), Sally O’Brien (@swissingaround), Adam Tinworth (@adders), Mathieu Laferrière (@mlaferriere), Graham Holliday (@noodlepie), Denis Dogvopoliy (@dennydov), Christine Cavalier (@purplecar), Emmanuel Clément (@emmanuelc), Xavier Bertschy (@xavier83). Follow #back2blog.

More About the M-DEX, and a Cool Blog: Hack and Hear [en]

[fr] J'ai trouvé comment faire marcher le M-DEX correctement! C'est pas si mal!

I have just listened to the really interesting talk on audiology, hearing aids, and hacking them embedded below. Helga (@helgarhelgar), the speaker, is a friend-of-a-friend, fellow geek (probably geekier than me!) with hearing aids. And she has a few years’ headstart on me exploring the tech. I’ve just started going through her blog, hack and hear.

Midway through her talk, I was inspired to give the disappointing M-DEX another chance (I wrote about it in my previous article about hearing aids).

Lo and behold, I figured it out, and it doesn’t work too badly!

Here’s the trick:

first of all, it increases the general volume of the hearing aids, so the horrible crackling sound I heard when I tried to use it with the phone is actually (mainly, as far as I can tell) outside sound: muting the “room” (with the mute button) takes care of that
second, music sounds like crap, even on the music programme (the M-DEX music programe — as far as I’m aware my aids don’t have one yet); this is maybe because of my hearing aid settings or programme, and understanding better how compression works and feedback loops are countered, I’m also understanding why my hearing aids behave badly during my singing rehearsals => so I’m sticking to voice for the moment
third, the M-DEX user interface is pretty crap, it’s hard to figure out which button to press when to obtain a desired result: what I do now is first mute, then press the middle button to get to the bluetooth menu, then enter that; however, if bluetooth is on and the device is selected (on my computer for example), it “switches on” when I start playing sound. Pressing the red button when listening to sound from the phone/computer and when on mute goes back to the main programme and un-mutes (if you’re just on normal mute it doesn’t do that). Very confusing. It’s probably going to take me some time to learn when not to press on which button.
fourth, it’s possible to pair the M-DEX with more than one device (I mistakenly thought it wasn’t) — to prevent the M-DEX from kicking into gear unexpectedly, I turn off bluetooth on the devices if I’m not using them, or turn off the M-DEX
fifth, the M-DEX needs to be pretty close to the hearing aids (which is why they provide a lovely strap so you can hang it around your neck like a necklace), or at least somewhere that is at a stable distance — if you move it around it crackles really annoyingly, and if an ear gets out of range the sound in it dies.

So, I might end up keeping the expensive toy after all if I settle on the Widex hearing aids! Still need to test it with a real phone call though, which I’m not going to do while in Spain.

Update: looks like I’m not alone in thinking the M-DEX is suboptimally designed!

After the glowing review of my hearing aids and my audiologist, it is unfortunate that I have to be so negative about the other component in question. The M-DEX is a piece of shit — I am a software engineer and architect, and I have never seen such poor interface quality or assumptions about the listener.

More About Hearing Aids (And Geeking Out a Bit) [en]

[fr] Des nouvelles de mes aventures au pays des appareils auditifs: réflexions pour geeks et moins geeks, tant l'expérience humaine que la technologique sont passionnantes!

I got my hearing aids a month and a half ago, and I thought I’d write a bit more about some of the techy aspects as well as what it means to (a) be wearing hearing aids and (b) be hearing better.

Past the initial shock of “OMG do people really hear sounds this loud?!”, I’m really appreciating how relaxing it is to understand pretty much every word people say to me. Even in “good/easy” situations, I realize how much of my hearing is actually “deducing” — specially on the rare occasions nowadays when I talk to people without ma aids in.

As my brother aptly put it when we compared notes as I was coming out of the audiologist’s, it’s “as if sound were coming to me, rather than having to go and fetch the sound”.

Physically, my hearing aids are really comfy now, and I am generally not aware that I’m wearing them. Like a pair of glasses (or a bra!) — you know they’re there if you think of it, but they’re not drawing your attention to them all the time.

The model I’m trying now (I’ll be moving on to my second trial when I get back from holiday, more about that below) is the Widex Clear220 C2-PA (here’s the Widex product page, but it’s not nicely linkable, you’ll have to click around to see the once I have). It’s a mini-BTE (“behind the ear”) with the receiver in the canal (RIC). I’m still learning the terminology, and I have to say “receiver” sounds like a very illogical word for what is in fact the “loundspeaker”.

There are two microphones on the top of the piece that lies behind the ear. My audiologist told me that in noisy environments, the second one kicks in and the aid then reduces the sound coming from the sides and back to focus mainly on what comes in from the front microphone (theoretically: the person I’m speaking with).

The two hearing aids also communicate wirelessly with each other, and do fancy stuff to help with sound spatialisation (ears do fancy stuff too, but with RIC the hearing aid is sticking sound directly in your ear canal, so it needs to mimic what your ear does to sound before that).

The aids also clip loud sounds so that they don’t go above (a) potentially damaging volume (b) the volume above which sound becomes uncomfortable for me (I think).

If you look at the line around 80-100dB, that’s where my discomfort to sound is. It’s quite common that people with hearing loss also have a low tolerance to noise. That means there is less “bandwidth” for the audiologist to work with.

Oh, and you know one of the things associated with hearing aids? The Larsen effect? You don’t really get that with digital hearing aids, because they’re programmed to detect that kind of sound and remove it.

So, what about the less exciting stuff? Well, I was lucky enough to have a car on loan during the first weeks I had my aids. That gave me a chance to test their reaction to loud singing (!) at different frequencies ;-).

Here’s where it gets interesting: my left hearing aid (in theory the one with slightly less amplification) would clip or chirp at certain frequencies (understand: me singing at the top of my voice as high as I can go — only in the car, people). It’s annoying enough to hear sound that seems to be coming out of a saturated loudspeaker, but when it’s only in one ear, it’s quite maddening.

Other than that, during my first few weeks of test, I had one or two occurrences of chirping. Chirp! You’re walking around in town, and suddenly one of your ears chirp. It happens so fast it leaves you wondering if you dreamed or if it really happened. I’ve actually managed to produce some frequencies (in the car, not reproducible elsewhere ;-)) that reasonably reliably make it chirp, but other than that I’ve had trouble reproducing the problem.

Early on, another problem I had was that I had the impression my left hearing aid wasn’t amplifying some frequencies. The symptom was I felt as if I had a blocked ear, or cotton in my ear — but it was very mild. It felt as if the receiver was maybe not in the right place (but it was, my audiologist checked). So we did a few tests, and during one of those, one of the frequencies we tried sent the aid into a long continuous beep that didn’t stop until we opened the battery casing to turn it off. I had to pull it out of my ear, and my audiologist was able to witness the sound himself (he has a stethoscope with a special attachment that allows him to listen to what is coming out of a hearing aid). Bug, he said! That hearing aid will be going back to the manufacturer at some point…

We never did completely pinpoint what it was that caused this “muffled” sound, but spatial orientation tests showed that I was slightly disoriented towards the left. So we boosted the right ear by 1dB (counterintuitive… but oh well, audiology is an experimental science). I suspect that the “muffled” feeling could in fact be due to the pressure of the tip in my ear (my left canal is smaller than the right) or something like that. Later on, I discovered that the top of the BTE casing was a tiny bit loose, and we changed it. Right now I have to say I feel this “muffled” problem has completely gone away. Either I got used to it, or something we did made it go… Don’t know.

A couple of weeks back I got an extra 2dB (I started at -8dB, and my audiologist usually starts people at -4dB). It was loud, but bearable. However, the clipping got worse, and worse than that, I found myself having trouble understanding people in situations where it seemed to me I should not be having so much trouble. Restaurants, hallways, noisy places. Back in the office, we actually tested this: word recognition in noisy environments. And the verdict seems to confirm my experience: I understand more words with less amplification. One more reason to try another hearing aid before making any final decision.

I walked out of the office with an extra toy: the M-DEX. The M-DEX does a bunch of things:

it connects to your phone by bluetooth and allows your hearing aids to function like a bluetooth headset, streaming sound directly into your aids
it’s a remote for the hearing aids (sound up, down, left, right, zoom, mute, music/voice programmes).

As far as I’m concerned, the phone bit (what makes it so expensive) is a complete fail. Pairing with the phone is not a problem, and I manage to get sound into my hearing aids, but the sound quality is much much worse than if I simply put the phone to my ear or stick in my earbuds. This reminds me to mention that I can actually fit my earbuds in my earn “over” the hearing aids. They’re a bit loose and fall out easier, and the sound doesn’t really get amplified by the hearing aid, but it works. For the moment my preferred option is still “earbuds and no hearing-aid” for the phone.

I tried with music rather than phone, and I have the same problem: a huge amount of static background noise, and volume so low that even at maximum setting I have trouble recognizing the song that is playing.

The M-DEX comes with a jack cable, so I tried connecting my phone to it with the cable rather than bluetooth. There is much less static, the sound is much better, but it’s still not really loud enough or clear enough to be an interesting alternative to simply wearing the earbuds, even over the hearing aids.

I have to say I’m pretty disappointed about this bit: I use the phone quite regularly, and listen to a lot of music and podcasts. 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 (!).

One thing I’m really happy with, though, is the remote function of the M-DEX. Given the problems described above in noisy places, it really helps to be able to bring amplification down a notch (both for troubleshooting and better hearing). I’ve toyed about with the zoom function a bit (selectively amplify sound from behind, left, right, in front) but for the moment I haven’t found a real use for it. Same for selectively amplifying left/right ear.

I absolutely love the “mute” button. Even though I’m trying to wear my aids as much as possible to train my brain to adapt to my new sound environment, it’s quite a relief to be able to just switch them off when it gets too noisy, or when I want to concentrate on something (reading on the train, working in the office), without having to physically remove the hearing aids.

One other annoying thing about the M-DEX (this is a comment I saw somewhere, can’t remember where) is this idea that the M-DEX is going to be the device you interact with rather than your phone. You can dial from it, pick up calls, hang up. Well, OK, maybe this makes sense for technology-confused people, but as far as I’m concerned I’d rather have, as the author of that same comment suggested, an app on my iPhone to control my M-DEX. Leave it to phone manufacturers (or Apple) to make phones.

Leaving aside the tech, one of the effects of wearing hearing aids is that I hear my tinnitus more. Luckily, it’s not bothersome: “white noise” type, not too loud, and not an annoying sound to me. It’s a normal phenomenon: while wearing hearing aids, I’m training my brain to tune out other ambient sounds which are louder than I’m used to, and as everything is louder, my brain doesn’t spend the whole day tuning out my tinnitus so I can hear stuff. It’s relaxing, but it means I’m “out of practice” tuning out the tinnitus, so I hear it more when I remove the hearing aids. No biggie, but I thought I’d mention it, because it’s an interesting phenomenon.

And as far as sharing online goes, I stumbled upon the Hearing Aid Forums — a lively online community of hearing aid users and professionals.

So, where am I, overall? I’m now pretty much “habituated” to hearing better (still -6dB from my “ideal” settings), and if you give me the choice between giving back my hearing aids and keeping them, with the glitches, I am definitely keeping them. But maybe the next trial will give me something even better!