 The Clarinet BBoard
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Author: alanporter
Date: 2010-11-20 19:13
I am a new user of hearings aids, costing well over $4000. I have just turned on the radio to hear an unfamiliar tune played by a wind instrument and orchestra, and at first I couldn't even tell whether it was brass or woodwind. On careful listening I determined it was woodwind but I wasn't sure whether it was clarinet or saxophone. If any members of the forum wear hearing aids can you tell me if this is a universal problem or have I been foisted off with unreliable aids from the orient ? Many thanks.
Alan
tiaroa@shaw.ca
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Author: GeorgeL ★2017
Date: 2010-11-20 19:34
I obviously cannot diagnose your problem, but I can tell you my symptoms. I have mild ringing in my ears and high frequency hearing loss which seems to be associated with exposure to loud noises, most likely from 30 years of playing in community bands. Without hearing aids I hear quite well in quiet situations (I do not need to turn the radio loud), but I have difficulty trying to decipher speech with a noisy background (such as a crowded room).
With hearing aids, I notice that I hear more high frequency sounds when I listen to the radio, and I can understand speech much better against a noisy background.
When I play in bands now, I usually leave the hearing aids at home and wear ear plugs instead. If I started with ear plugs in 1980, I might not have hearing aids in 2010.
Is it possible the woodwind you heard was neither a clarinet nor saxophone?
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Author: sdr
Date: 2010-11-21 03:59
This is a complicated issue. When people lose hearing, they can lose loudness or clarity or both. Loudness and clarity are analogous to the volume and tuner on a radio. The loudness is portrayed on your audiogram as the hearing threshold -- a plot of the softest sound you can hear at each of the 7 standard test frequencies from 250Hz to 8kHz in octave steps (roughly from one octave below middle C (C4) to 4 octaves above). Normal threshold is 0-25dB at all test frequencies. The clarity is portrayed as "Word Recognition Score" or "Discrimination" -- the percentage of monosyllabic words repeated correctly. Ideally the word list should consist of 50 words with a consonant 'envelope' and a vowel in the middle (You will say "hat". You will say "sit". etc) delivered from a digitally recorded standard voice at about 40dB above your hearing threshold. Normal scores should be above 90% correct.
Hearing aids make sound louder. Period. End of sentence. They do not improve clarity. Your hearing aids can compensate, at least partially, for your loss of loudness. However, if your hearing loss includes poor discrimination, the hearing aids will not correct that. It's like a radio station that doesn't tune in well -- turning up the volume does not improve the reception. Adverse listening situations, such as high ambient noise or a big reverberant room (e.g. a church or auditorium) are tougher for everyone, even if they have normal hearing. Add a hearing loss, and the problem is much worse. Hearing aids are most helpful in a quiet environment where the signal-to-noise ratio (SNR) is high. In a noisy place, the SNR is low. The hearing aid doesn't know what you want to listen to. It makes everything louder -- both the voices you want to hear and all the others that you don't. Your example of music on the radio may fall into this category -- there' a whole lot of overlapping sounds and your clarity may be down at a level that prevents you from discriminating them clearly. Not necessarily the fault of your hearing aid.
Best hearing aid fittings are accomplished by a licensed audiologist (with and MS or AudD degree) who takes the time to understand your listening needs, take a detailed and careful audiogram, and counsel you about realistic expectations. There's a great article on hearing aids shopping in the July '09 issue of Consumer Reports.
-sdr
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Steven D. Rauch, MD
Professor, Otology & Laryngology
Harvard Medical School
Mass. Eye & Ear Infirmary
Tel: 617-573-3644
Fax: 617-573-3939
Email: steven_rauch@meei.harvard.edu
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Author: BartHx
Date: 2010-11-21 15:09
I am currently in the trial period for a new set of hearing aids. My previous set was excellent for what I needed but, after many years of service, died within weeks of each other. The new set are clearly in need of further adjustment.
Unlike the previous set, the new ones have three settings. One setting is for "normal" use and a second is the same profile at a boosted level. Both of these settings do well so long as the sound source is highly directional. With omnidirectional sound, however, they have a sort of reverb that makes it difficult to understand speech and not terribly useful for anything else. The third setting is supposed to reduce background noise and is more directional. This setting solves the reverb problem but, when I am playing my clarinet, adds a sharp edge to the tone so that I can't hear what the instrument is really sounding like. We had two concerts this week and my solution, for now, was to wear only one of them and have it set for background noise reduction. In another week and a half, I have an appointment to make additional adjustments. We'll see what happens. My previous audiologist moved back to France and I was not terribly impressed with the time and care taken by the new one making the adjustments.
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Author: kimber
Date: 2010-11-21 15:38
An excellent response by SDR. Let your audiologist know you want a program set up specifically for music listening and what style of music. Most hearing aids can be adjusted infinitely, however it is often also secretly as the audiologist may move one slider (and several other features also readjust automatically - it's an exercise in patience to figure out what changed that you didn't want it to and if you can adjust it back.) If you are going to wear them in rehearsals, have the directional microphone aimed to your left (assuming you sit on the director's left) to better hear the rest of the band. Since you are having difficulty matching sounds of instruments to the processed hearing aid sound, spend some time retraining your brain with recordings you are familiar with relearning the 'new' instrument timbres.
Another good option is to take a cd of some music that is troubling sounding to you to the appointment, and have the adjustments done with the music playing.
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Author: alanporter
Date: 2010-11-21 18:28
Thank you all for your very thoughtful responses which are most helpful.
SDR, I am also an MD (family medicine) so your scientific explanation did not fly too high over my head !
This bboard never ceases to amaze me with it's value. Thank you again.
Alan
tiaroa@shaw.ca
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Author: Caroline Smale
Date: 2010-11-21 19:16
At 70+ I know that my hearing is definately not what it used to be.
My understanding was that the higher frequencies suffered most and I think that a lot of musical information is conveyed in these higher frequencies (e.g. many hi fi sets had a mono bass woofer since very little stereo information was held in the lower bass range).
I assumed that modern hearing aids could be programmed to restore the freqency balance so that what the brain received was essentially what would be heard by a younger listener. I was hopeful that this would be of practical benefit to an older practising musician. Is this in fact the case? (give me hope for the future!)
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Author: kimber
Date: 2010-11-21 20:00
Part of the problem with hearing aids is that people tend to wait too long (5-10+ years) to get them, if ever. Unfortunately, during all those years, the brain is slowly forgetting those 'lost' frequencies because they are not being stimulated anymore. Then, when a shiny new set of hearing aids comes, the brain hears these new sounds but doesn't remember how to make sense of them within the frequencies it is used to hearing.
The other thing to remember how hearing works, hair cells in the ear being displaced by a liquid 'sound' wave. Think of it as a plot tall grass growing on a beach. The grass next to the water's edge are the high frequencies, slowly moving to the bass frequency grasses growing further from shore. After a lifetime to pounding waves (loud noise exposures) on the beach, those high frequency grasses are reduced to stubs and mostly obliterated. Continued heavy wave action then pushes right over the damaged area and smashes against the exposed middle sections, etc.
So a hearing aid comes and is programmed to crank up the high frequencies in hopes that some of the not-completely disintegrated high frequency grass (hair cells) can still detect it or that some hair cells in that general frequency area might be accidentally stimulated by the additional wave power. It is programmed to distort the natural balance of frequencies to try to adapt to your particular hearing hair cell loss pattern. Obviously not as easy as adjusting to a new glasses prescription.
You have to go into it with the right frame of mind - hearing aids are a hearing prosthesis and think of learning to use them as such.
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Author: davetrow
Date: 2010-11-22 01:02
In college I had a friend whose hearing stopped at about 1-2 Khz--he had never heard a bird sing, nor did he notice when he dropped change on a concrete floor. Nonetheless, he was an excellent clarinetist. So don't give up hope--the human animal is almost infinitely adaptable.
Dave Trowbridge
Boulder Creek, CA
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