About Harriet Jacobster, Au.D. Expertise I can answer questions regarding non-medical treatment of hearing loss such as hearing aids and aural rehabilitation. I am also able to answer your questions regarding hearing testing, what types of tests are appropriate, what information a hearing test gives you and what it doesn't give you. As a classically trained musician, I can also answer issues dealing with hearing loss specific to musicians.
Experience I am a Board Certified Doctor of Audiology with over 25 years' of experience working with both children and adults. I have given lectures on Hearing Loss and Hearing Aids to several state chapters of national organizations for the deaf and hard of hearing. I also taught Speech Reading and Aural Rehabilitation both privately and for the Florida Deaf Service Center.
Organizations American Academy of Audiology
American Speech Language Hearing Association
Education/Credentials Au.D. Doctor of Audiology, Nova Southeastern University 2000
I am trying to decide which hearing aids to purchase. Two makes/models have been suggested for me: Phonak NaidaV - SP, and Widex Mind m4-9. I wonder whether Widex Mind m4-19 should be considered as well. I am often in complex hearing situations including noisy environments. Cost is not an issue as my insurance plan will reimburse 100%. I would appreciate your input regarding which of these hearing aids would be best for me, or any other makes/models that you might recommend.
Thanks very much!
Tess"
ANSWER: Hi Tess,
So much goes into deciding about which is the "best" hearing aid for any particular person. Although the thresholds of pure tone testing are a start, they are only part of the picture.
Before I could even venture into discussing amplification with you, I need to know the following:
What type of hearing loss? it seems sensorineural to me, but is there any middle ear involvement?
How is your speech discrimination in quiet and in noise?
What is your lifestyle? What is your work? What are your specific demands and needs? What is your age? What types of situations are you in? You say they are "complex." Complex how? Is music involved? What are your acoustic environments? What about the telephone?
Both these hearing aids are excellent; but before I can give any advice, I would need a lot more information.
Harriet B. Jacobster, AuD
Board Certified in Audiology
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QUESTION: Hi again Harriet,
I really appreciate your quick response!
I was surprised to learn that my word discrimination score was 85% in both ears in a quiet environment. The person testing me had a deep voice and he spoke very clearly, but still I felt I was guessing much of the time. I have not been tested for speech discrimination in noise. At work, I have the most difficulty during meetings in rooms with poor acoustics, (large rooms, plastic chairs, no carpet, fans running in the background, etc.). Talking on the phone is difficult, especially when talking to women, children, or people with accents. Talking on a cell phone is impossible unless I put it on speaker phone. Hearing in many public situations is difficult, i.e. trying to understand the cashier at the grocery store, having a conversation on the street with traffic noise in the background, etc. I avoid spending time in busy restaurants or coffee shops because I just can’t keep up with the conversation. This doesn’t do much for my social life! I used to enjoy live theatre but now find that I miss a lot of the story line. I would love to be able to hear bird songs better, as bird watching is one of my hobbies. My current hearing aids, (Resound Metrix MX-50 ITE), have a telecoil and directional microphones, but there never seems to be enough volume to meet my needs. I always have them turned up to the maximum volume possible without major feedback, and I still struggle to hear in many situations. That’s why I wondered whether I’d be better with more amplification – i.e. the Widex m4-19 perhaps, rather than the m4-9.
The assumption has been that my hearing loss is sensoineural. My MRI was normal. It has been speculated that cochlear otosclerosis may be causing my loss. My father has stapedial otosclerosis. I started having hearing problems when I was 32, and there has been a gradual but significant decline in my hearing since then. I am 49 now.
I hope this provides the information you requested. Thanks in advance for your assistance!
Tess
ANSWER: Hi Tess,
Thank you for the additional information. Both hearing aids are excellent...The Naida has helped many patients that had no luck with other hearing aids.
Before I make any definitive recommendations, I would like to do a little more research on both these aids and see how each would apply to your specific hearing loss.
I will get a more thorough answer to you in a few days.
Harriet B. Jacobster, AuD
Board Certified in Audiology
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QUESTION: Thanks for letting me know. I really appreciate the time you are putting into this! I'll wait for your answer.
Tess
Answer Hi Tess,
I did a little more research on both aids. I am not going to tell you which one to buy, but rather the features of each and how they would work for you.
First, about your hearing - from your numbers (you did not give me the corresponding frequencies, so I am guessing here), it seems that you really have no usable hearing above 1000 Hz. I say "usable" because once a loss goes beyond 60 dB or so, there is so much damage to the nerves in the inner ear, that sounds become very distorted, even with amplification. However, it is these high frequencies which give us the most important information for understanding speech. If your word discrimination was 85% in quiet, we usually assume this to go down as much as 25-30% - or more - with noise. So even with amplification in this region, the nerves are just too far gone to interpret sound.
So, in a hearing aid, you need to look not just at amplification, but a way to get as much acoustic information to you as possible so you can get better clarity.
Both hearing aids are state of the art, the Mind is a later model, however. Both have something called the frequency extender; that is, they are able to bring your "inaudible" frequencies into a frequency range that you can hear. This feature can be turned on or off on both. They both feature advanced noise cancellation techniques to cut down on feedback, and they both have digital processing to seek out speech signals.
Naida has bluetooth/wireless capabilities, Mind does not. Mind, however, has the fractal music programs - Zen - which you can switch on and it supposedly relaxes you. Naida is water-resistant, I do not believe Mind is.
So, as far your hearing loss, both these hearing aids will give you exactly what you need as far as power and frequency transposition/compression.
So, now you ask, which one to choose? Well, if wireless capability is important to you, and it seems to be since you mentioned the cell phone, then choose Naida. If hearing Zen music is important to you, then choose Mind.
Do realize, though, that most states offer a certain amount of time to try out the hearing aids. You may want to discuss this option with your audiologist; if you could first wear and use one model and, if not satisfied, try the second.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology
