Rippah Ultmuncher (rippah) wrote in hearingaidhacks,
Rippah Ultmuncher
rippah
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Widex Clear C4FSBR - the good and the bad

Context
After ten years of using my GN Resound Canta 7's, I was informed by my audiologist that the manufacturer would no longer repair them even if I pay the extra for an out of warranty servicing.  Each time I sent them in to be repaired, I basically got new hearing aids back as they typically replace the entire thing.  My right hearing aid was either not fitted well or it was starting to wear out after 18 months of use, so it was time for me to buy new hearing aids -- especially as professional necessity required that I communicate far more over the phone and in group settings than before.

It was not a purchase that I wanted to make at that time, as $6,000 out of pocket is an extraordinary expense -- I had investigated new hearing aids at points in time over the last decade, but did not judge that the improvement in quality worthwhile enough for the cost.  In my perception, hearing aid technology did not improve enough to match the experience of a quantum leap that was going from my Phonak digitally programmable analog hearing aids to my digital Canta 7's.  I have a severe-profound hearing loss with a SRT of 90-92dB, but yet I have a low tolerance for loudness and intensity, so I was a challenge to fit.

I am an audiologists' worst and best patient at the same time.  I do not have the professional training, nor do I have anecdotal experience of fitting patients, but I know and understand the technology and science behind signal compression, and psychoacoustic models.

I have divided the the rest of this post into three sections, written from the perspective of a major technology geek who is Deaf.

Audiologist
I have not mentioned my audiologist directly previous to this, as this is primarily a hearing aid technology review.  But a good and conscientious audiologist is essential to the best fitting -- a good hearing aid can sound terrible, and an average hearing aid can sound great depending on the skill of the practitioner.  There is a definite difference in perspective and skill set between a 'hearing aid dispenser' such as the ones you find for the Miracle Ear ads, or at a Costco, and a licensed audiologist with a doctoral degree.

I have had an extremely positive experience with Lori McCorrry with the Audiological Consultants of Atlanta.  She took the time to have a detailed discussion about the merits of various manufacturers and to determine my needs.  There was a lot of humor involved, and I was an interesting specimen due to my outlook on hearing loss, and the need for hearing aids -- I am culturally Deaf, married to a deaf woman with whom I communicate primarily in American Sign Language.  I told her, "I only wear hearing aids when I have to communicate with hearing people."

One of the things that I wanted to determine was if going with the top of the line hearing aids would give me a substantial improvement over a new mid-line hearing aids.  The hearing test she performed helped determine that due to my intolerance for loud sounds as well as my hearing loss being all over the place, she was going to need a lot of control over the instrument to fit me exactly.

Earmold impression were made, and a follow appointment was set for two weeks later.  She was solicitous about the earmolds being so deep in my ears, and kept asking if they hurt -- it was an adjustment  After inserting the hearing aids for the first time, I could hear the quality difference even with the conservative initial settings the instruments were set to.  Much to my surprise, I was able to comprehend and understand a substantial portion of the audiologist's speech without looking at her.

The fitting process was quite involved, and it was really neat to see how the tools of the trade have improved.  On the screen of the computer, you can now see a near-realtime graph for each instrument what the actual output across the frequencies are, which makes adjustments much easier.  She also inserted some probes into my ears, which was a challenge with how deep the new earmolds were -- the audiometric tools have also improved dramatically, and we were able to see what the actual measured output in my ears were at various frequencies.

After about an hour and fifteen minutes, we arrived at a good first pass fit.  She walked me through some of the functionality of the remote and the programs that were set up on it. When I left, I was quite pleased with the service I received.

Widex Clear C4FSBR
The first major change for me was that the new hearing aids are RITE (receiver in the ear), rather than BTE (behind the ear) and transmitted down a hollow tube into the mold.  I'd been using silicone earmolds for a long while, and they did not go very deeply into the canal.  It was an unusual feeling for me to have something hard and immobile reach so deeply into my ear to park the receiver next to my eardrum.  The audiologist was repeatedly asking me if it hurt.  It didn't, although it was odd to feel an unyielding pressure on my ear canal bone when my expression changed, or my jaw opened.  With my silicone earmolds, when they shift, my first reaction is to push them in -- because breaking the tight seal at the high gains that I hear things at can cause severe feedback

By parking the receiver so close to my ear drum, the signal quality improves due to not having to bounce through the tubing of the old  BTE and mold combinations -- my understanding is that it improves the high frequencies especially.  There are some other cool technologies like the hearing aids able to communicate state and determine which sounds to focus on, and the Bluetooth bridge/remote.

The quality of sound and the jump in speech intelligibility was a quantum leap over the older Canta 7's I had, especially when combined with the superb job that Lori had performed in fitting me.  Especially now that I am married to a deaf woman, I do not wear my hearing aids as much as I used to, and so I had de-acclimatized to the high gains of the Canta 7's -- this meant that it became bothersome to hear after a while.  I do not have this experience with these new hearing aids.

My own speech quality and intelligibility has improved, as I am able to hear my own voice better -- much to my amazement, I am able to hear my wife's voice.  She is extremely soft spoken, and we do not need to speak with each other -- this is more a testament to the quality of the aids themselves.

When I listen to devices via the M-DEX remote control, it is quite clear -- I am able to hear nuances of sound effects and tone in films  that I play on my computer or iPad.    These are superb hearing aids, and I cannot be more happy with them.  The only caveat is that I am going to need to go back and add a few more programs for noise management, as I am able to hear entirely too much now.

M-DEX
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.

First, let's start with the good things:
  • FreeFocus -- being able to tell the hearing aids in what direction to focus on.  This is very useful.
  • Bluetooth pairing with iPad -- when I pair it with my iPad to watch a film, the quality is remarkable as I have noted earlier.
  • Direct audio input - if I run a cord from my device to the M-DEX, it works well.
  • Changing programs -- this is moderately useful, though I am able to change it directly on my hearing aids.
However, these are the only positive things I can say about the M-DEX.
  • When a Bluetooth device drops a connection, such as my iPhone or iPad doing so when not actively playing sounds, it switches to the Master program, and loudly announces it.  So the cycle happens like this:  The program on the iPhone or iPad plays, the bluetooth connection is brought up, a beep emanates from my hearing aids.  When it stops, it changes back to the Master program.  Every time this happens, this announcement is made.  Repeatedly.
  • Further compounding this issue is that the 'room off' which mutes my hearing aids microphones turns off, and unmutes every time the bluetooth connection drops.   If I am listening to a movie, and I exit out of the film to check on something, I get the loud announcement, 'Master program', and a blast of environmental noise.  I then have to re-mute.
  • Further compounding the unacceptable state of affairs, it does not work well as a headset or headphones.  The Widex engineers obviously did no testing or quality assurance outside of mobile phones.  It does not work at all with my Mac laptop or my Mac desktop -- when I attempt to play sounds through it, the M-DEX believes it to be a phone call for the duration of the sound effect and then disconnect.  This causes the computer to no longer play sound effects through the Bluetooth connection, as it is disconnected.  Most of the time, it does not even work -- the computer tells me that there was a Bluetooth error.
  • The M-DEX barely works with the iPad and iPhone outside the context of a phone call -- as I have mentioned before, it works as a hands-free profile, and a headphone profile.  But it does not work as a headset with a microphone.  Skype on my iPad and iPhone is a no-go due to this -- I briefly get a connection and then it drops.
  • The microphone quality on the M-DEX is poor -- I would have imagined that Widex with its state of the art research into microphone and signal quality, would be able to put some of this technology into the M-DEX.  This is a $350 device that is surpassed by a $10 piece of electronics.
  • Effectively, the only way I can do phone calls with the M-DEX is as a handsfree headset for phone calls.  Which is unfortunate, as my mobile phone quality is far inferior to what I can get over VoIP which is important to me as a Deaf person.  I need every bit of call quality I can get, and this device cripples me.
  • The user-interface is extremely poor.  I am a software engineer, and I get a little confused as to how to get to certain functionality.  How is a normal non-geek supposed to use this device?
  • Also rage-inducing is the fact that this device only pairs with one bluetooth device at a time.  If I have it paired with my iPad and want to use it with my iPhone, I have to go through the whole pairing process.  Logitech with its cheap headsets is able to support multiple bluetooth pairings!
It is obvious that the people who worked on the M-DEX have no understanding of people with hearing loss and their actual needs.  This is perhaps due to being an entirely different product and project than the hearing aids themselves which are wonderful.

The following naive assumptions were made:
  • That other devices would maintain a Bluetooth connection throughout the life of the session.  This is only true for mobile calls.  In every other context, Bluetooth connections are dropped, to conserve battery.
  • That the user would want the program to actively change when the Bluetooth connection drops.  Again, this is only true for mobile calls.  If an user is using this device for other purposes, the user does not want to hear the loud announcement that the program has changed.
  • That the user would only want to use Bluetooth for phones.  This shows a shocking lack of creativity, vision and initiative.  Bluetooth is much more versatile than that, and they should have expected that an user would want to use this device with their computer or to watch films on a mobile device with.
  • That the user would not care about his own voice quality with the shoddy microphone -- sometimes, those of us that have hearing loss need every bit of clarity that can be transmitted to the other party, due to accents or inflections.  Did they actually test the microphone as a deaf person?
  • That they do not need to put thought or effort into the user interface of the device -- the paths to some of the functionality are simplified to the point of being un-simple to use.  Any good human interface person would have spotted these issues.
It is extremely unfortunate that with all the careful engineering and thought that Widex put into the hearing aid instruments, to see them fumble so severely with the M-DEX.  The whole experience is basically like getting a flawless one-hundred yard pass for the touchdown, and then suddenly fumbling and going back thirty yards.
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