For a while now, like the last 15 to 20 years, since hearing aids went DSP, I had not been much impressed by each new generation. At the risk of sounding like a bit of an advertisement, that changed this year.

I have the new Oticon Intent. RIC style aid. They have some of the best spatial awareness I've experienced. They're capable of quite a lot of directionality - accelerometer and three microphones in each. I had to have the intensity of the directionality turned down a bit. It was startling me when I turned my head and I wasn't hearing things behind me enough. But that's at the expense of less signal due to more environmental noise.

The machine-learning based noise reduction is an improvement over the previous generations, too.

They have a music mode. It drops all the speech remapping and noise reduction and just makes it feel loud. It's some sort of perceptual algorithm: in my case as I turn up the volume it gets more and more treble, because only at the loudest volumes would I hear those high frequencies. All while being power limited at 95 dB SPL so I know I'm not blowing my ears. I used to wear over-the-ear headphones for that but I now prefer the hearing aids. It's nice to not worry about if it's too loud.

Perhaps this is just the limit of her hearing capacity. Or do you think she should not settle for this and push for something better?

This is where my normal hearing is now. My assumption is the "some I understand clearly" is base very much on what frequency their speech is in.

I'm meeting with a hearing aid doctor this week, actually.

Does she have primarily high frequency loss? High frequency loss is the most typical in the elderly and also from damage from noise exposure.

Different people have different voices. I usually find it easier to understand men because I hear the lower frequencies better, especially without my hearing aids but also with them. And it's always easier to understand people you know well compared to strangers.

I find small speakers to be awful. The high frequencies are distorted and tinny. Scratchy is a good way to put it. I have a very hard time understanding anything played through a smartphone or tablet speaker. The speaker is too small to reproduce the bass frequencies I can hear the best, and so it's just TSSST TSSSSSZZT sounds through my hearing aids.

I cannot wear my hearing aids at full volume at the dinner table or while working in the kitchen for this reason. Metal, plastic and paper are also common offenders. CLINK. CLINK. CRSZZST. It's almost painful and headache inducing if I'm tired.

Unfortunately those high frequencies are what carry speech sounds like sh, t, ch and so on. Without those it's like the adults talking in the Charlie Brown cartoons. "wah-womp-wah-wah-mhuh??"

Hearing aids can do two things for this: one is to take some of that high frequency information and remap it to lower frequencies. This is part of why they say you won't like wearing your hearing aids when you first get them. They're systematically distorting what you hear -- but in a way you might eventually learn to interpret.

The other is just to make it loud enough that it can be heard. And as you suggest that may be the limit of the hearing capacity if there's very little at the high frequencies the only way to make something high frequency to be perceived, is to hammer the ear with a 90 or 100 dB level of sound.

It's absolutely worth having them adjusted a bit. Also every manufacturer uses a different algorithm for speech frequency remapping. Some people have strong preferences by brand as to the hearing aid sound. (Phonak and Oticon certainly have different "feels" in my experience.)

Almost all hearing aids allow multiple "configuration profiles" where you can switch through them with the app or buttons. I have four: general, lecture, comfort, music. Comfort mode just nukes the high end and cranks up the noise reduction. That's what I use if I'm just reading alone in the living room, or when out at the grocery store, etc.

As to large groups, personally I've simply conceded I can't do large groups. If I try I will feel left out and get depressed over it. If people want to see me at a family reunion, for example, after I do a brief tour to say hi to everyone, they'll have to join me for a small group chat in the den or whatnot.

As a parent with a child with mild-to-moderate hearing loss it is heartening to know that the hearing aid technology is progressing, and progressing well!

He's been using a pair of Phonak Skys since infancy, and while they can be tuned by the audiologist I sometimes wonder what it'll be like if and when he gets his next pair.

The newer tech is definitely worth it but spendy. There are times though when I'm a bit jealous, too! He can turn them off when he doesn't want to hear and can listen to anything on his phone over bluetooth, as well as take calls. And he never wakes up at night because of noise :)

I'm using a pair of 8 yr old phonak BTEs, which have various levels of directionality focusing. (Actually, I'm down one HA; 8yr old on left; 13 yr old left one one on right ear... getting new ones in January) I too prefer a lower level of directionality as my default.

I assume your HAs are doing bluetooth for the music setup you describe? Or are you describing a setup with speakers at home?

But at home I often use telecoil. It's one of the killer features for hearing aids that no one seems to know about. Short-range (inches to a few feet) baseband analog radio.

I have a transmitter set up in the living room. If I come within a few feet of the couch I'll hear the television. Got another at my desktop computer in the office. I also have a loop I put around my neck when I play my electric guitar. Telecoil transmitters will plug into any standard line audio source.

https://hackaday.io/project/1406-bluetooth-headphones-for-he...

Sadly, it seems modern Phonaks (and probably everyone else) no longer makes DAI "boots" for their BTEs.

I'll probably be ok with the transition, but it's going to annoying having to recharge hearing aids during the day. Right now, I can get 6+ hours of music/podcast/meetings/phone calls on my (5+ year old) headphones batteries, and can take those off and charge them when not using them. (and other perks...)

I'll have to refresh myself on telecoil to see if it's of use. (My BTEs still have it, iirc)

Standard IEMs isolate you from the world, which is the opposite of what a hearing aid does. However, a specific category called "Active Ambient" IEMs bridges this gap. These are IEMs with embedded high-fidelity microphones on the outer shell. They pick up the sound of the room (bandmates, crowd, conductor), amplify it, and blend it with your monitor mix. The accompanying bodypack or app often includes a multi-band EQ and Limiter. You can boost specific frequencies where you have hearing loss (e.g., boosting highs to hear cymbals or speech clearly) and set a volume ceiling to protect your remaining hearing. I have no ownership/sponsorship in the product, but I personally LOVE the ASI Audio 3DME (powered by Sensaphonics), which is the industry standard for this. [1] It allows you to use an app to shape the ambient sound to your hearing needs.

The Pros: It provides hearing protection + monitoring + hearing enhancement in one device.

The Cons (Why they aren't daily hearing aids):

1) Form Factor: You are tethered to a belt pack. You likely won't wear a wired bodypack to a grocery store or dinner party.

2) Social Barrier: Wearing full-shell custom IEMs creates a "do not disturb" look that discourages conversation in social settings. This can be more socially alienating than a comparatively inconspicuous hearing aid.

3) Battery Life: IEM systems typically last 6–8 hours, whereas hearing aid batteries can last days or weeks.

[1] https://www.sensaphonics.com/products/3dme-custom-tour-gen2-...

Audio gear isn't made to last long on batteries, it's made to be reliable for the hours a show typically lasts. I worked part-time as a sound tech (paid hobby) for 15+ years, and I never started a show without fresh batteries, regardless of what the indicators on the transmitters/receivers told me.

Hearing aids run on tiny voltages (typically ~1.4 Volts). They are designed to amplify speech (a small frequency range) at moderate volumes. An IEM is designed to handle the massive energy of a live drum kit without distortion. To do this, the internal amplifier needs Headroom. It likely steps up the battery voltage significantly (internally converting to higher voltage rails) to ensure that when a snare drum hits 120dB, the amplifier has enough electrical height to reproduce that spike without clipping.

Hearing aids use microscopic balanced armature receivers that require almost zero power to move because they are only moving a tiny amount of air near your eardrum. IEMs use dual-driver miniature subwoofers and tweeters that are physically larger and heavier. It takes significantly more electrical current to push these drivers back and forth.

Hearing aids often use aggressive battery-saving tricks, such as lowering the sampling rate or "sleeping" processes when silence is detected. The processor of an IEM is running wide open 100% of the time. It is constantly digitizing the world at a high sampling rate to ensure zero latency. If it tried to save battery by "sleeping" between notes, you would hear a delay (latency), which would make it impossible to play in time.

A fancy passive IEM quotes:

> Sensitivity: 114 dB-SPL (@ 0.1V)

That’s on the high side for an IEM. Let’s be conservative and say it’s actually 100dB SPL at 1mW (which is on the low side) and that the user has hearing loss and the IEM is actually outputting 90dB continuously (I’m not an expert but this seems high. Certainly I would not set an active IEM anywhere near that loud, even at a concert). That’s 0.1mW of electrical power to each IEM, for 0.2mW total. This part could run for days on a small battery pack.

A modern amplifier might as well be 100% efficient, although that body pack could easily be some wildly efficient Class A design.

Let’s suppose the DSP is processing 96kSPS (might as well minimize latency and the need for a complex antialiasing setup and let’s assume it’s using a duper-high-fidelity FIR filter that’s a whole 100ms long, i.e. 9600 taps, and that the FIR implementation is pure brute force, so there are 9600 times 96k FMAs per second. That’s about 2 billion FMAs per second for both ears. (Again, this is a ridiculous way to do this.) The fancy nonlinear compression stuff will be negligible in comparison.

From some quick Googling, you could easily spend a whole watt on the DSP. And there’s where all that battery charge goes :)

I bet that someone who really cared about optimizing this could put some software engineering into getting DSP power down below 50mW. Either use an FFT to optimize the filter or use a much lower complexity filter bank.

Is there a little computer doing DAW work inside the earpiece?

Yes, and likely always running all filters at high fidelity rather than power-saving whenever there isn't something to amplify.

As a workaround, some artists performing outside wear a thin, acoustically transparent beanie or headband over the ears effectively acting as a pop-filter/windscreen. This breaks the wind before it hits the mic while still letting mid-to-high frequency sound (speech/music) pass through. Not exactly a hearing aid alternative.

I [recently wrote an article][0] going over my journey, but the recent technology that significantly improved my life has been live captions in glasses. Specifically, the ones from [Captify][1]. Not a paid sponsor at all, just a very happy customer.

Between the glasses for IRL settings and bluetooth/live captions on meet/etc, I've felt much more empowered in my working life.

  [0]: https://upsun.com/blog/tech-accessibility-hard-of-hearing/
  [1]: https://captify.glass/

FWIW it is far from perfect but it is helpful - and better than any paid apps that we've encountered.

I was at a meeting earlier this month where the Zoom live captions were displayed on-screen. This is not something I ever use or had much need for but they were quite good. It handled different English speakers, with some distinctly different accents, very well. It got a couple of words wrong here and there, usually proper names or acronyms but it was generally quite impressive, and much better than the "text to speech" efforts last time I really tried them years ago.

Your recommendation has made me think I should finally take the leap on live-caption glasses, which I've been watching for a while now. It sounds like they've finally got to the point where they're effective.

A question: how do you find them in conversations with multiple people? Do the glasses help you distinguish speakers by breaking out text from different voices, or is it all just a stream of words? What if there are multiple conversations going on - do the glasses manage to "focus" captioning on the one you're closest to, or do other conversations creep in?

The captions on google meet have been useful for me as well, although I do wish they were more configurable, e.g. being able to give the captioning model a list of technical phrases, internal company terms, or acronyms that are likely to come up. There also seems to be a gap still between real time transcription, which is good, and after-the-fact transcription, which is excellent. (You can also use an LLM for the latter and prompt it yourself with extra context, although that may not be the best model.)

It's been great to see so much progress in this area in the past few years. I am hoping the current (over-)investment in AI at least has the side effect of improving the tech still further.

It really depends if people are talking at the same time or not. If in a close group (space matters, the mic only goes ~2-3m), one person talking at a time, then they're great. That's the setup I most often have at conferences, so it's been great there.

In evenings/parties, it's a bit more chaotic, and the glasses tend to fall off for sure.

Regarding distinguishing different speakers etc I haven't needed that, I use the glasses as a helper, they fill in the gaps. So it's "just a stream of words", but it has been enough to already help a ton.

The directional mic does work quite well, but sometimes you have just 2 conversations happening in front of you and it's not working at all. In other setups (especially professional ones), people usually speak one at a time and it works great.

Looks and seems great, always felt like a no-brainer use case for the smart glasses. But considering the kind of hardware they most likely are using, how is the captioning actually happening? I'm really scared of getting hardware that is 100% cloud dependent, as eventually the company gets bought or shut down, and then you end up having to repeat the process of figuring out what to buy next, and sometimes that just one or two years in the future.

They are not making it clear how the captioning is happening, but since they don't claim it'll continue working even if the company disappears/shuts down, one can be safe to assume it's a cloud product, meaning it won't actually be a good fit for most people out there with a limited amount of money to spend on things like these.

Edit: I realize now this product is not at all for people like me, "Boost caption accuracy up to 98%" and "More accurate translations" are locked behind a $15/month subscription, kind of disgusting how they hide making the product work as it should behind a subscription.

I just want some simple glasses that can caption what people are saying without ripping me off, I guess we're too late into capitalism for that to actually be made for consumer.

https://support.apple.com/en-us/123720

I'm rarely an apologist for subscription services vs outright purchase but those features sound like ones that are going to use cloud services instead of working on-device only. If it's associated with an ongoing cost it's perfectly justifiable to charge an ongoing fee, IMO. That said I’d much prefer an option tied to how much you actually use it.

It's so horrible to find a product, it works and functions great, almost a life-saver even, and then Google buys the startup, the founders get a pay day, and they shut down whatever servers the product used and you sit there with some useless plastic that used to be great, but now isn't even a good paperweight.

That said, the paid subscription has some useful features, but I personally don't care about multi-languages translation. The rest of the conversational improvements seem to help but I don't think they're necessary... although I don't know what they mean with "Boost caption accuracy". Maybe using more expensive models?

I have Phonak Audeos paired over bluetooth with my iPhone. A few years prior, I used to have Oticon, also paired with my iPhone.

With the Oticon, if I made a cellphone call, the iPhone would use the default iPhone microphone while the audio would stream to my hearing aids. It was good that way because in a noisy environment I could hold the iphone right up to my mouth and the other party would be able to hear what I was saying.

With the newer Phonaks, I was very disappointed to find that the new hearing aids would only use the microphone input that is built into the hearing aids themselves, and not the iPhone mic input. I discovered this when I realised that talking directly into iPhone mic did not make it any easier for the other party to hear me.

I complained to my Audiologist who explained that yes, the new hearing aids were copying the behaviour of Apple AirPods, which also have the mic input on the earpod itself, and that there was no way at all to configure the Phonaks to use the iPhone mic input instead.

Why is this a problem you might ask? Because my hearing aids are Behind The Ear (BTE) and thus the mic input on the hearing aid is a good 4 inches away from my face and thus my voice cannot possibly sound as clear as when I could speak directly into an iPhone mic.

When I next replace my hearing aids, I shall look for aids that do not mimic this crappy AirPods behaviour...

During a call, swipe down for the control centre. You’ll see an option at the very top to adjust the audio options. Mic input is just there.

I don't think there's a way around it on the iphone, but I was able to cobble a fix for my macbook at least. It uses Shortery to run a Shortcut whenever my HA connects. The Shortcut runs a shell script that uses https://github.com/deweller/switchaudio-osx/ to determine the built-in mic and switch back to it immediately:

BUILTIN_MIC_ID=$(switch-audio --list-input | jq 'map(select(.name == "MacBook Pro Microphone")) | .[0].id') switch-audio --set-input="$BUILTIN_MIC_ID"

And AirPodsSanity (& SoundAnchor) offer polished options here. Maybe using that same script underneath!

I think the Macbook does some more advanced beamforming stuff to filter out sound coming from other directions.

It does, and that also gave the Asahi Linux team some serious headache when trying to get the microphones working on the ARM MacBooks - the team involved in that had to delve deep into DSP black magic to get usable sound working out of the three microphones [1].

[1] https://news.ycombinator.com/item?id=43461701

HA mics are not designed/oriented to pick up your own voice; if anything, they might be tuned to avoid it. After all, you know what you're saying.

Conversely, I'd expect laptop mics to be highly sensitive to the voice of the user.

In practice, before I got my scripts set up, people would complain I sounded distant, muffled, or tinny, when the HA mics were being used.

They were Phonaks.

I guess I'm glad to hear that it's not intrinsically a hearing aid thing, and I may find a better experience with other brands.

Mine were exactly like this to start with and over time the effect goes away such that you don't notice. I'd recommend if you do actually have hearing problems, sticking with it for quality of life improvements.

We ended up with Phonaks rebranded as Sennheisers. The audio quality during calls may not be as clear as a separate mic (what i believe you refer to as oticon), but from a user experience its nice to not have to fish out your phone to answer a call or wonder why you can hear the other person but they cant hear you.

Note that my complaint here is specific to Android support.

I personally use iPhone and I do prefer to leave phone in pocket for my phone call. But it does seems like a massive oversight to not make this configurable.

Settings > Sound & Haptics > Input > change from "Automatic: ..." to "iPhone Microphone"

This does seem to let me enable voice isolation though, which seems to work very well.

The difference is that the Oticon supports the "Made for iPhone" hearing aid settings which means you get fine-grained control over which microphone is used.

Apple should give that control to all devices, including standard bluetooth headsets.

It’s a brain thing, my hearing itself is above average for my age (40), so I’m not sure what exactly can be done, but there was an article many years ago about someone (Bose?) working on aids for that issue, no idea what came of it. I guess all modern hearing aids have some focus mode.

[0]: https://en.wikipedia.org/wiki/Auditory_processing_disorder

edit: In case there’s an airpod suggestion, I’ll also need to know if that feature works on Android, it’s not crippling enough to make me use an iPhone.

The newest HAs have AI that helps in noisy environments. The ones I have are the Phonak Audéo Sphere Infinio I90s. I've worn HAs for 40 years. It's truly unbelievable in noisy environments. I know it's easy to think it's all marketing garbage, but some great demos on YT of the technology. I keep them in AI mode all the time when I have them on, and charging them for an hour at lunch is enough to get me the necessary runtime.

But it’s cool that this stuff is now integrated, hopefully those advancements will eventually trickle down further, from what I’ve now read, the AirPod Pro feature is a bit of that trickle.

The traditional solution is an FM system where you give the person speaking a microphone linked to your hearing aids. There are dedicated ones like Phonak Roger. You could probably also use your phone as a microphone if it's bluetooth connected to your headphones or hearing aids.

The tech for isolating a speaker at conversational distances exists. You use half a dozen microphone transducers (minimum; Crappy microphone transducers are cheap and quality is expensive, so just use a bunch of them), and through a combination of phase and intensity they decode relative location, and amplify that phase expectation while suppressing everything that isn't phased like that. Sound is slow, and readily susceptible to real-time triangulation. The math/processing is much easier if the parallaxes are fixed (eg the microphones are arranged in a line array on the top band of a rigid pair of smart glasses), but with a little latency it's not prohibitive for a deformable array to solve for its own relative position as well.

Often people who lose their hearing want to be able to hear in social situations such as restaurants and family gatherings. In this context, the signal and noise have similar properties and are coming from the same direction. Directionality helps but can only do so much. Noise reduction can make hearing aids more comfortable to wear but don't necessarily improve comprehension in challenging situations. Progress here is fantastic -- at the same time it helps to have realistic expectations.

Putting the mic on the person speaking sidesteps the problem -- it's like the rest of the room isn't there.

People rely on the (usually very large) dynamic range of hearing to be able to understand in those situations. In people with typical hearing the brain filters out the sounds too loud or too quiet to be what they are trying to listen to. But hearing aids act as compressors reducing the dynamic range.

___

1. https://github.com/kavishdevar/librepods

>When your AirPods Pro are connected to your device, you can use Conversation Boost to focus on the person talking in front of you. This makes it easier to hear in a face-to-face conversation.

https://support.apple.com/guide/airpods/use-and-customize-tr...

librepods appears to support this feature

Hah, this made me find the subreddit /r/AudiProcDisorder where people discuss those and others for exactly that reason.

edit: Damn, tool requires root because of a bug :/

https://support.bose.com/s/product/hearphones-conversationen...

I absolute loved them, but unfortunately lost them, and they are irreplaceable.

I also liked that there was a neckband - easy to take the buds out when not needed and leave them hanging, and of course more power in a larger battery.

They sure seem to be marketing in your direction. No idea how well they work though.

But thanks, and I'll say loops are amazing for the price for concerts.

I also very much appreciate that they can natively connect to iPhones (this is also essentially the main reason I have an iPhone). This makes phone calls and music and podcasts very easy. (Whereas up until 2017, I used to dread phone calls.)

I actually tried Phonaks briefly in 2022 and hated them. Lots of controls to fiddle with (some with oddly unintuitive names), but that meant I was constantly trying to adjust it and was rarely able to just exist in the moment. I found them markedly worse in noisy environments - I basically couldn’t have a conversation in a restaurant.

As for technology, they use bluetooth low energy to connect to the smart phone, which works really well, with the caveat that the range is quite low and if it is in the pocket and you are moving around, media sound will often disrupt or desync intermittently. On the plus side, they last well over a day even with media use (WIdex says they last 37 hours without bluetooth use and that checks out). The case provides charge for about a week, and has wireless and usb-c charging.

They are quite pricey, but there are several options (110, 220, 330, 440), and the 220 were more than enough for me. The app has several modes, including directional focus mode, and you can define your own. I sometimes use a different mode for listening to concert music, that disables most filters such as volume protection.

I am wearing them for 9 months now, and there was no situation (concerts, traveling, work, sports, etc) were they gave me any issues whatsoever.

With that said, my recommendation are the new Phonak Infinio Sphere devices with with their "Spheric speech in noise" feature. It's a complete game changer in terms of speech perception in loud noise. Activating this program in a noisy situation feels like turning off the background noise, leaving only (nearby) voices.

The caveat is that to achieve this they use a separate, power-hungry processor and compensate by increasing the battery size (making the whole hearing aid bigger than other, similar hearing aids). The upside to this is that if you're _not_ using the spherical program, you'll have really good battery life. I use mine for exactly 16 hours a day and if I'm careful I can make them last almost three full days. The charger is much better than the previous ones; they use magnets to keep the devices in place instead of relying on plastic friction.

The Oticon Intent and new Starkey AI aids are also great. You should always try more than one model before you make a decision.

Happy to answer any questions!

The one thing that I find absolutely essential is using ear molds instead of domes. My cousin hated ear molds and gave up on them, but I definitely prefer them.

Incidentally, I would recommend the HA/hearing loss subreddits (r/HearingAids and r/hardofhearing) over HN for this discussion. The HA group can get a little rigid, but I really like the community at HoH.

I do participate in the Reddit subs but am interested in the technologists view of HAs I might get here. They are fascinating, necessary devices for myself.

In any case it’s a periodic high pitched burst. I wonder if that was what caused your issue with the phonaks. Seems like it would be a rather common issue in suburbs that should be considered in hearing aid design.

If it lost bluetooth connectivity as well, that could have been a fail state, but that seems less likely.

Oticon just announced/released their 'Zeal' product - a non-custom CIC, with seemingly all the bells and whistles, including bluetooth. Planning to try them soon.

I have tried a few aids before (Starkey and some older Phonak) and I do really like the Oticon 'sound'. They work for me, but of course YMMV. I think many aid manufacturers (many of them the same company - WDH!) do 60 day trials. Worth a shot.

My only dislike is the new fad, particularly of Oticon, of stopping disposable batteries and only going rechargeable. Disposable zinc-air cells have great life (I'd get a week on the Opns at least, with a few hours streaming per day). I travel for work a lot, so carrying a couple of tiny 312's in my wallet or keychain was perfect. The Zeal look to have what Oticon think is a 'compact' charger - but it ain't small. My kingdom for a charger the size of the AirPods Pro case...

I also travel a lot with work. So far, the estimate of 20 hours battery seems genuine - but you’re right, the charger is not small. What I didn’t know though, is that the charger holds three full charges worth of capacity. Meaning it doesn’t need to be plugged in for three nights in a row.

Due to my level of loss (80db), I need the custom mold option. This seems to be primarily to reduce feedback. I’m swapping between the custom mold and the standard tip to see which is best for my use case.

So far though, I’m impressed.

My Phonaks are like that, and I will say, rechargeable-only has been a boon for reliability, at least. They're more water-resistant, and the battery well never gets dirty, which required some repairs on previous models.

Though now that it's been 5 years, they no longer hold a charge all day, which is annoying.

One of the engineers I had lunch with actually used their own product and he seemed to like it. I get the impression it's a more premium tier kind of thing that may not be covered by insurance, though.

The big differentiator for me wasn’t the brand, but the quality of the automatic scene-classification and how fast it adapts between quiet → speech → noisy environments.

Phonak and Oticon both do this well, but if you haven't tried devices with real-time binaural processing and multi-band directionality, it's worth demoing a pair. The jump in music clarity and spatial cues is noticeable even for moderate loss.

Also, don’t underestimate how much the fitting + REM session matters - the same device can feel completely different depending on how thorough the audiologist is.

For one, unless you use Med-El's Rondo processeor, you're going to have a thin cable connecting your processor to the coil. Taking off your CIs and putting them back on (as one does every day) is going to put stress on the cable. Sometimes the cable frays and you find that out with sound cutting in and out. There's nothing you can do until the manufacturer sends you a replacement cable in exchange for your frayed one. If you want a backup, be ready to shell out $250 for each cable.

Another UX issue is that processors depend on gravity to stay on your ears. Since there's no earmold to anchor to, processors can easily be jostled off and left hanging precariously. Wearing hearing aids, I never had to worry that my hearing devices would fall off if I rode my bike on a bumpy road. Also with cochlear implants, high-intensity interval training requires some kind of hat or bandana to make sure that the processors don't fly out.

Battery life is another disappointment. Rechargeable batteries don't last a full day. If I put them in at 6:30a, they'll last until about 4:30p. With disposable zinc air batteries, I can squeeze out about a day and a half, but then I'm having to dispose batteries. And while I can track processor battery levels with the rechargeable batteries on my phone, disposable batteries are opaque to the app.

One new thing that would be useful in terms of UX would be an configurable indicator, e.g., a blinking LED, signaling that audio streaming is occurring. It's awkward to find oneself in a conversation that already started and having to excuse oneself to turn off the stream.

Don't get me wrong, I'm glad I have my cochlear implants, but they're way behind hearing aids in terms of UX.

UX for a lot of assistive technology is iffy at best. Repeating some of the comments others have made, I'd love it if Apple would make a full on hearing aid that "just worked". Or someone would do a good AI integration that could notify you of things you probably should focus on - like someone trying to get your attention, or emergency vehicle sirens, etc.

Marketing too. But it's nice to see some vendors starting to actually make their devices visible and fun. HAs are a bit like glasses ages ago, when it was kind of this shame thing to get teased about when you were 8 years old. Selling them as "discrete" and with colors designed to match your skin or your hair is just continuing that perception of them being something you should hide.

My daughter has the Cochlear N8 and the rechargeable battery lasts 20 hours

> Sometimes the cable frays and you find that out with sound cutting in and out

Is there any way you can know about this, e.g. from the app? I'm asking because my daughter is 1 and if this was happening she'd currently have no way of communicating that to us

I have an Advanced Bionics Naida. Battery life has consistently been around 8h for a few years. Then recently, my batteries decided they wanted to work part-time.

> Is there any way you can know about this, e.g. from the app?

As far as I know, there isn't a way to verify sound connection issues within the app. They happen too quickly, but usually the giveaway is that the part of the cable that connects to the coil feels like it's about to fall off. It's at the ends, usually, that most of the failures occur.

https://www.etsy.com/listing/870982894/cochlear-implant-cabl...

I know somebody who really dislikes the over-the-ear type devices and swears by the all-in-one kind.

She seems to get a full day of battery out of hers, but I don’t know what kind they are and I imagine usage patterns make a big difference.

No, I have not, but from what I've heard, the sound processing isn't as strong because with the BTE (Behind the ear) models, the microphone is unobstructed and can pick up sound coming from the front. With the all-in-one devices, the microphone sits slightly behind the head and has a horizon (and hair) obstructing the audio.

If I'm wrong and the sound processing is actually decent, I'll be willing to give it a shot provided my insurer decides to carry Med-El.

I actually know a number of people with CIs, but everyone else is at ASL club, so we’re not doing a lot of speaking. I’ll have to ask folks what they’ve tried, if only for my own curiosity.

For what it's worth in the UK the NHS no longer provides the off the ear models (at least for children) as they say they have too many problems with them

And don't get me wrong, I'm grateful for the technology. For example, I can now hear hummingbirds and squirrels chirping. Speech in noise also makes it a lot easier to hear in noisy environments.

What is the best thing for people with no hearing loss but need help in noisy environments?

My partner and I both have difficulty listening to conversations in crowds.

Logic tells me that there must be some noise cancelling devices with directional mics that let you hear just what is in front of you, but querying staff in stores gets me the same bemused look as when I asked about Arm laptops before Apple did one.

Rather than noise cancelling headphones, I’d be happy with an audio recording that has my loss applied to it. Anything to demonstrate what it’s like would help awareness and understanding.

IMHO rechargeable models are not worth the extra cost. With a typical 5 year replacement cycle the batteries will no longer hold the early levels of charge. 312 batteries are cheap and easy to carry spares.

I finally got (very expensive) hearing aids, and made several trips back to the audiologist to have them tuned. Then I wound up not wearing them, because most people think they're speaking English, but it's some kind of mumbly slobbergobble with incorrect, missing, or mispronounced words. The aids just turned "mufuh dogga baytaaa" into "MUFUH DOGGA BAYTAAA."

Yeah, I heard that just fine without electronic assistance.

Paying attention to how often people with "normal" hearing said "what?" to each other was a revelation. Yes, I have a problem. But it's a small problem; the big problem is that a large number of people may as well be trying to communicate by interpretive farting and tap-dancing, because "the words what are coming out of their mouth" are mostly gibberish.

In terms of hearing quality, for me, it's been solid, with the caveat that it took a while to get the fitting right. I think my audiologist was a bit old school, and was sticking to settings he'd known to be good in the past rather than fitting for what the aid is capable of. I've recently had its prescription type updated to the native Oticon one, and it's been a revelation in terms of clarity.

My hearing loss is relatively recent (About four years now) so I will caveat this that I've only used Oticons, so can't really compare to anything else.

The hearing aid has certainly given me back most of what I loss, but it took some time to come to terms with losing my hearing on that side.

https://stonecharioteer.com/writing/2019/the-sound-of-music/

https://stonecharioteer.com/writing/2020/ear-one/

I tried a set of Phonaks for about a fortnight, but I found them tinny-sounding (which I'm told you get used to), and their automatic mode switching (for when you walk into noisy rooms) was incredibly frustrating.

A month later, Apple dropped the Airpods Pro hearing-aid mode software update and I have never looked back. The feedback from my family has been overwhelmingly positive, which more than offsets any qualms I had about them being so visible when you wear them.

My (obviously subjective) view is that the sound quality of the AUD$400 set of Airpod Pro 2s completely smokes the AUD$5,000+ set of Phonaks, and that's before you account for all the UX niceties you get from Apple when you play in their ecosystem (virtually seamless transition between phone, computer and TV (with AppleTV box)).

The fact that you can run an on-demand hearing test on your phone for free, giving you the ability to track any decline yourself without having to front up to an audiologist is just the icing on the cake.

I tried the Starkey ITC ones a couple of weeks ago, but found the performance in noisy environments to be sub-par.

The Oticon Zeals seem good so far, but it has only been a few days. One thing they seem very strong at is the Bluetooth connectivity.

Thanks to recent iOS changes, I can use the mic in the Oticons or the iPhone for calls - and I’m tempted to try a DJI mic on my lapel as the mic. Although, so far during testing it seems that the Oticon mic might actually be good for phone calls.

In terms of size - I don’t know what they were thinking. I’m considering doing a 3D scan of the charger shape and trying to make my own. I’m sure every customer will compare it to the AirPod case. It’s small enough to throw in my laptop bag, but I won’t be keeping it in my jeans pocket anytime soon.

Seems like a holding page for now though!

I've tried some OTC hearing aids (Sony & Sennheiser) but its been hit or miss. I'm going to try whatever the hearing aid tech at my ENT proscribes.

For example, driving a car without the aids makes my tinnitus really bad (due to the background noise of the car/engine/wind/road). With aids it's a lot less of a problem.

One fear I have is if hearing aids cause even more hearing damage (after all, what they do it inject amplified sound into you ear... the exact same thing that most doctors tell you NOT to do to avoid hearing damage)... Experts tell me they don't, but without any reasonable explanation.

But I found a great comment on HN recently about Tinnitus. Was quite helpful for me.

https://news.ycombinator.com/item?id=37855888

Mother uses hearing aids since end of 90s and most of the time it was in-the-ear but recently due to increased hearing loss she had to pick a new behind-the-ear device - still with button battery tho.

Woman who accepted the order for replacement mold said that production plant uses now some kind manufacturing with printing and they also replaced soft silicone for this firm stuff. In fact it's the second new mold and despite her detailed notes on how and where to cut it so it wouldn't damage the ear, it seems they just did the job and sent it back to us.

Not that one ever should have to do such for medical equipment, but wonder if someone could grind down the firmer stuff on the first new mold, assuming it was kept...

(Not really useful anecdote:) I remember circa 25 years ago, my audiologist had a benchtop grinding/buffing wheel that she'd take the earmolds to a few times when modifications were needed. Even at that young age, it was clear that grinding soft materials didn't work very well.

Especially since the hardware is not upgradeable without another surgery, assuming it's upgradeable at all.

If you have HAs and wait, 1) the implant tech may get better, or 2) medical science may be able to regenerate inner ear hair cells. For #2 in particular, cochlear implants may prevent that from even being an option, since iiuc, they damage the cochlea.

The live listening mode is very good. I can hear my kid trying to quietly walk past 10pm :) There are a lot of features however you cannot selectively choose to lower / raise certain frequencies. I wish it had an equalizer I could use.

The ANC is fantastic, sometimes I even forget fans around me are on. Only issue is that when I use live listen mode and everything is super clear, people still treat me like I’m using full noise cancellation.

From the other side, it’s night and day. We can have conversations. He can hear my kids. The TV volume is set to reasonable levels.

Sample size of one, but it’s been a tremendous improvement. A lot of places are closing out the second gens right now for $140. I’d give it a go. It’s a pretty low price of entry for something that could literally be life changing.

I don’t ever hide my hearing aids but the discrete nature of them is great.

https://youtu.be/uykq5aJCwBw

In your situation they could be a low stakes way to get someone to try a hearing aid and sell them on the idea, while still being a useful thing to have around even if they do upgrade to something more purpose built.

For me, I need a real hearing aid to hear a person that is at my right shoulder.

If both ears are about the same, I think the hearing aid volume (separate slider from general volume) could be adjusted to get past the “designed for moderate loss” limitation.

But irrespective of any capability to act as hearing aids from the acoustic perspective, I don’t think they are the same.

For me hearing aids are glasses for my ears. Like glasses they need to be “put them on/in and forget about it”. If AirPods would not fall out of my ears when I walk or put on a hat or pull on/off a sweater, I might consider them.

I wake up in the morning, grab them from the nightstand and put them in. And they stay there all day until I go to bed. Only come out if I’m taking a shower or in a loud environment.

My understanding is they are pretty good hearing aids, but they don't have the battery life that purpose-built aids do (4-5 hours vs 18-24) so they're not optimal for full-time use. This is fine for her use case, since she only uses them when she wants to talk to someone, but could be an issue for someone who wants to wear them all day, every day.

https://www.costco.com/f/-/jabra-brand-showcase

Backup:

Airpods Pro 3 with hearing test through iPhone.

The Airpods are perfect for lowering the background noise and elevating the speech.

And since I use them anyway for music and podcasts, I don't have to remove my aid to listen to music and vice versa.

Interestingly, they work well for the realtime audio adjustments for music - but sadly not well enough for external speech.

I will keep trying them with every new software and hardware release though!

Currently using rechargeable Phonak Audeo with an air fly for connecting to any device other than my phone to avoid Bluetooth switching chaos.

I wish iOS had better control controls over microphone routing but with iOS 26 you can change the microphone during a call to be the phone microphone, even though the hearing aids have their own microphone.

I have some hearing loss (suppose moderate) only in my left ear. As this is only on single one I think I am coping enough with the right for now. With regular "ha , sorry, what?" moments.

In your experience should I be investing in one immediately or trying my best with current coping situation for now?

One drawback is that I can't listen to Bluetooth music because it only comes through the one side. It's good enough for podcasts, through.

Mine is a Costco one (manufactured by Phonak, I believe). Nothing really fancy, but only $1,000 -- and the Ontario government covered half of that.

I kind of resisted getting a hearing aid for a long time -- even though I used to date an audiologist -- but it's a significant improvement to my quality of life.

- The car washing scene in Cool Hand Luke

- Raquel Welch in a swimsuit

adjective 1. having a high degree of heat or a high temperature.

Hope that helps!