Help for Hearing Impairment

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Thought I should join in, being profoundly deaf (of the sensori-neural type). I'm awaiting a decision on cochlear implant funding at the moment from NICE - I'm borderline, so it's not guaranteed. In the meantime, I have two Nathos DP aids which make things manageable.

An implant is not for everyone, but given that I became gradually deaf, speak well, and have realistic expectations about what it can do, I am, on paper, an ideal candidate.

I'll update as I continue the process

browniej

I have a reverse slope hearing loss which is proving difficult to fit. For the last 8 years I have struggled with this and have found aids virtually useless in my work (teacher) as they amplify everything I don't want to hear and block out the children's voices.

Up until this last year I have coped by moving closer to children but recently have begun to struggle more.

My recent review at the NHS saw me fitted with 2 Oticon Zest P aids. Wore them at work and had terrible hissing in both with the left aid seeming as if it was cutting in and out. I don't think it actually was literally cutting in and out but what I think I was noticing was the hissing cutting in and out. However as usual the aids don't help me hear any better, even in a quiet class situation when all the kids are working and no noise. I struggle then to even make out what they are saying so something is far wrong. Previous aids were no better.

I have tried to tell the audiologist this but I'm told I'm the 2nd most difficult person to fit - the 1st being musicians.

My audiogram shows;

R - 30(250) - 45(500) - 40(1000) - 35(2000) - 30(3000) - 15(4000) - 15(6000)- 5(8000)

L - 70(250) - 70(500) - 60(1000) - 60(2000) - 40(3000) - 30(4000) - 20(6000) - 30(8000)

Tests on the mastoid follow Right ear results.

Anyone help me out please?

Hear-Hear

I would say that you have the THIRD most difficult type of hearing loss to deal with. In first place, Musicians (specific sometimes unachieveable outcome expectations) and in second place Engineers (who know 'everything' about how hearing aids work!). But in the first two cases, at least they had some choice. You don't have that choice.

Two pieces of advice for you. Firstly, join the Reverse Slope Loss group on Facebook. Secondly, do a google search and have a look at the Bizarre World of Extreme Reverse Slope Loss. You're likely to relate well to what the author has written, and you'll find plenty of information there to help you help your audiologist.
For instance, you say that you have been given the 'Zest P' aids, yet you will see why the fitting of 'Power' aids is often thought to be the correct approach, and why it is completely wrong for most reverse slope losses.

Personally, I prefer to fit RIC (Receiver In Canal) aids for reverse slopes, take away the low frequency gain that the fitting software suggests, and adjust the 'compression' to allow the client to make positive/negative comments with each tweak. You could suggest this ?

It really is quite a rare form of loss, so be patient with your audiologist.

browniej

Hear-Hear wrote: »

Two pieces of advice for you. Firstly, join the Reverse Slope Loss group on Facebook.

Thanks - I have joined now. Seems to be a lot of useful info there.

Secondly, do a google search and have a look at the Bizarre World of Extreme Reverse Slope Loss. You're likely to relate well to what the author has written, and you'll find plenty of information there to help you help your audiologist.

I had found this article around 3 years ago and did pass it onto my audiologist to read. Unfortunately he hasn't really said much about it since showing it to him.

Certainly did fit in with a lot of how I'm feeling.

For instance, you say that you have been given the 'Zest P' aids, yet you will see why the fitting of 'Power' aids is often thought to be the correct approach, and why it is completely wrong for most reverse slope losses.

They certainly don't help me at all. Wore them all day yesterday until I went to visit my son and daughter-in-law. Even sitting next to my daughter-in-law I kept having to ask her to repeat herself until she actually asked me what was wrong! I told her I was trying out new aids and she said they don't seem to be working. Took them out at that point! Then I could actually hear what she was saying with no problem except over distance. My son is more challenging as he mumbles.

Personally, I prefer to fit RIC (Receiver In Canal) aids for reverse slopes,

I have managed to get 2 RICs. One was a danalogic and the other Siemens. I still have both pairs. However each time they "upgrade" me they want to switch back to non RICs. The Siemens RICs have what I would describe as a reverberation problem with the left ear. This is what I wanted them to look at a couple of weeks ago when I asked for a review. Instead of listening to me they just wanted to swap them out. Of course I discovered later that NHS Scotland have dropped the contract with Siemens and are now fitting Oticon. This would be the reason for the change.

take away the low frequency gain that the fitting software suggests, and adjust the 'compression' to allow the client to make positive/negative comments with each tweak. You could suggest this ?

I shall certainly try. However could you possibly elaborate more on what you mean please?

Are you suggesting no low frequency gain and instead tweak the higher frequency gain?

It really is quite a rare form of loss, so be patient with your audiologist.

I think he genuinely does want to help me but of course the issue seems to be time. I know if I phone up to get another appointment it's probably going to be 6 weeks. Really doesn't help when the current settings are absolutley no use whatsoever.

Hear-Hear

Yes, I am indeed suggesting the counter-intuitive. It could be worth trying to reduce the low frequency gain and push up the high frequency gain. For reverse-slope losses, this can work wonders, even if it goes against the seemingly-obvious.

I would be challenged to explain 'compression' on here. Your first option is to google it, but be prepared for a long read. Second option is to ignore what it all means and simply ask your audio to tweak the compression ratios and knee points, and to run a REM after each tweak.

As you seem to have gathered, it's not so much what your hearing aids can and cannot do, and it's not all to do with the willingness of your audiologist. In your case, it's all to do with lack of time that is made available to you. On that basis, you may need to start thinking about going privately, and working hard with the audiologist over several weeks to achieve a result that is acceptable to you.

browniej

Hear-Hear wrote: »

Second option is to ignore what it all means and simply ask your audio to tweak the compression ratios and knee points, and to run a REM after each tweak.

I think this option may be the one I'll need to go with.

As you seem to have gathered, it's not so much what your hearing aids can and cannot do, and it's not all to do with the willingness of your audiologist. In your case, it's all to do with lack of time that is made available to you. On that basis, you may need to start thinking about going privately, and working hard with the audiologist over several weeks to achieve a result that is acceptable to you.

I did have a trial with Specsavers around 3 years ago. Tried their equivalent of the Starkey Zon aids. The audiologist worked hard with me over 5/6 weeks. In the end I asked for a refund as I was having exactly the same problems as with the NHS, only difference being i could get appointments quicker.

Can I ask your opinion please? The Facebook group you told me to join has brought up the inconsistencies in the results of the mastoid test. With the test done sitting on the left mastoid, they have noted the results as following the results of the right ear which is noticeably better than the left ear. I am being asked if tests were done to rule out a possible conductive loss in the left ear. I have always been told I have a sensorineural loss and nothing can be done.

All I ever remember is this test being done on one side only and being asked to press the buzzer if I heard any sound at all no matter which ear I thought it was coming from. The Facebook group is suggesting my right ear should be masked.

Is this a test normally done on the NHS?

Hear-Hear

Yes. Both the NHS and private dispensers are required to test air conduction (via the ear canals), and bone conduction (via the mastoid), in accordance with procedures set down in great detail by the British Society of Audiology. God help any audiologist who does not follow these procedures, which includes masking of the better ear where there is a difference in thresholds.

It's not always necessary to mask, but is REQUIRED when the difference exceeds the limits specified by the BSA. This applies equally to NHS and Private testing.

browniej

Hear-Hear wrote: »

It's not always necessary to mask, but is REQUIRED when the difference exceeds the limits specified by the BSA. This applies equally to NHS and Private testing.

Would my results fall within this requirement?


My left ear has always been worse than the right ear but in this last year I have noticed a big difference and my latest test seems to confirm this. I have also been having balance problems and pain around the left jaw and upper teeth which neither my GP or dentist can get to the bottom of. I'm wondering if there is some sort of relationship in all of this.

Savvy_Sue

browniej wrote: »

I have also been having balance problems and pain around the left jaw and upper teeth which neither my GP or dentist can get to the bottom of. I'm wondering if there is some sort of relationship in all of this.

I would be asking for a referral to an ENT specialist: I have no idea what this might be, but the balance at least might well be obscure and ear related.

browniej

Savvy_Sue wrote: »

I would be asking for a referral to an ENT specialist: I have no idea what this might be, but the balance at least might well be obscure and ear related.

I saw an ENT specialist about a year ago. He couldn't find anything wrong at that time. However since then I feel my hearing has to worse and still no further forward finding the cause.