Dr. Wright's Blog

Dealing with Domes

Hearing aid users with receiver-in-the-canal (RIC) hearing aids are likely familiar with domes, the soft silicon tips that cover the hearing aid receiver, or speaker. Domes come in various shapes and sizes, and changing from one dome to another can have a significant impact on sound.

The first consideration when selecting the size of dome is the hearing aid user’s physical comfort. If the dome is not comfortable, it will be difficult for the person to regularly wear the hearing aid. Hearing aid users with particularly sensitive ears may have to use smaller domes or custom-fit tips, which can be made after taking ear impressions.

When selecting the type or shape of dome, we look at the degree of hearing loss that a person has and the subsequent risk of feedback, the whistling sound that we typically associate with older hearing aids. While modern hearing aids have sophisticated algorithms to digitally reduce or eliminate feedback, over-relying on digital feedback reduction can impact sound quality and hearing aid performance. Reducing the risk of feedback as much as possible by selecting the appropriate dome is essential before relying on digital feedback reduction.

After selecting a dome that is comfortable and appropriate for the degree of hearing loss, we then perform real ear measures, the gold standard when it comes to verifying the fit of a hearing aid. Real ear measures will tell us exactly how the hearing aid is amplifying different sounds. We can use that information to make adjustments to optimize speech clarity and comfort.

As a person’s hearing changes, we often change from one dome to another in order to provide the appropriate amount of amplification. If your audiologist has changed the domes on your hearing aids and reprogrammed them, be sure to use the new domes whenever you replace them. If you put the older style of dome on, it might cause your hearing aids to start whistling, sound tinny, or make things sound too loud or soft.

While they may seem insignificant, domes are a key ingredient to hearing aid success. To help keep your hearing aids working optimally, you should clean the domes with a cloth or tissue every few days and change them every 2-3 months. If you are running low on domes or are unsure which domes you should be using, drop in to either of our locations and we can help you out.

Next Generation Marvel Hearing Aid

December 2018 was the launch of Phonak's new Marvel hearing aid.  We have had lots of positive feedback about this new technology and wanted to update you about where this hearing aid is headed. The Phonak Marvel is a very versatile hearing aid offering connectivity for both iPhone and Android users.  They also have the 2.0 version of frequency transposition so for those who have severe high frequency hearing loss, this is an excellent feature.  Rumor has it that this new fall product launch will allow users of the Phonak Marvel to have a more seamless connection to Phonak's esteemed Roger technology.  Roger is the name they use for their FM system.  FM systems were historically used in classrooms, where a teacher would wear a microphone and stream their voice into the hearing aid of a child in the classroom (providing a much better speech to noise ratio).  This technology has gained popularity thanks to the Roger system.  More and more people find that using an additional (or remote) microphone can aid their ability to understand speech in a noisy environment.  It works because it isolates the voice of the primary speaker and sends that voice directly into the hearing aids. This technology is for some people cumbersome, because it requires them to carry and use an extra device.  Other people find the benefits of this extra microphone well worth the effort of asking another person to use it.  The new 2.0 version of the Marvel software will allow us to open up the hearing aid to receive the signal from the wireless microphone.  This keeps the hearing aid smaller and more seamless.  A breakthrough for sure.

This fall Phonak will release the Marvel 2.0; adding more features to the Marvel hearing aid. If you have already bought the Marvel, you can also enjoy this new set of features such as noise canceller, in the myPhonak app.  Please be aware, you must come back and see your audiologist so we can update the firmware in your Marvel in one of our offices in order to access these new features in the app.

The new software is set to be released on August 27, 2019, so give us a call so we can update your hearing aids to take advantage of some of these new features.  If you are interested in testing out the Phonak Roger microphone, just ask your audiologist or email erin@broadmeadhearing and I am happy to tell you more about it. 

The Importance of Assertive Communication

An often-overlooked aspect of managing a hearing loss involves the person with hearing loss changing their communication style. A hearing loss can cause some people to become passive, limiting their participation in conversations or avoiding social situations altogether. Others can be aggressive, dominating conversations to avoid having to listen and potentially mishear what other people say. The ideal communication style is to be assertive.

The two scenarios below show the benefits of changing from a passive to an assertive style of communication:

Scenario 1 - A passive approach to communication

Jim, a person with hearing loss, had lunch with a group of friends at the Med Grill.  The dining room was loud, and he hadn’t been able to hear well. Not wanting to embarrass himself by mishearing what someone said or saying something that was completely off-topic, he spent most of the meal sitting back, smiling, and nodding, not participating much in the conversation.

A few minutes after they finished eating, the waitress asked Jim a specific question. After asking her to repeat herself three times, Jim still could not understand her. He decided to venture out of his comfort zone and guess what she might be asking. Seeing that she was holding a pitcher of water and his glass was empty, he assumed that she had asked if he wanted a refill.

“No thank you,” Jim said.

The puzzled look and smile on the waitress’ face and the laughter of his friends told Jim that his response had been unexpected. Jim smiled and laughed along with them, trying not to draw any more attention to himself. As he saw his friends pull out their wallets, he realized the waitress had been asking if they wanted “one bill,” not a 'refill'. Though not what he intended, Jim realized that his response made sense as a deadpan joke.

“I had to make sure I was hearing you right,” Jim said, leaning toward the waitress and gesturing to his friends. “I paid for these guys last week. Not a peep from any one of them until I said I wasn’t going to do it again. You think one of them would step up? Not a chance!”

The group laughed as the waitress passed the bills around to everyone.

As he was driving home, Jim felt relieved that he had been able to cover up his inability to hear the waitress. He had even made the situation funny. Still, he was anxious about what might happen next time. Everyone had loved the food, and when one person suggested they make it a weekly thing, they all agreed. He began to think of a way to avoid the weekly lunch.

The above scenario shows some of the common issues that a person with hearing loss encounters. Things that a person would once look forward to, like lunch at a busy restaurant, can become sources of anxiety and frustration.

Scenario 2 – An assertive approach to communication

Jim, a person with hearing loss, had lunch with a group of friends at the Med Grill. Knowing that getting stuck at a table in the middle of the restaurant, surrounded by noise, would make for a less-than-enjoyable social outing, Jim called ahead to reserve a table. He mentioned his difficulty hearing in restaurants and asked when the restaurant was quiet (the answer – never, but it was quieter between 2:30 and 4:00 pm). Jim asked if there were any booths or corner tables available, preferably away from the kitchen or front door. There was a corner table available at 2:45.

Jim called two of his friends to let them know about the reservation, so they could pass the information along to the others. One of them complained about the late reservation time. Jim told him that he had trouble hearing in restaurants, and that the manager told him it would be quieter at 2:45. His friend said that he hadn’t thought of that and mentioned that he also had trouble hearing in background noise, and that it would be nice to have a conversation without shouting.  

Jim arrived at the Med Grill fifteen minutes before his reservation. He told the hostess that he had a reservation under his name. After waiting for the table to be cleaned, she led Jim to a table for six in the corner of the restaurant. Jim chose a seat where his back would be facing the bulk of the restaurant, which, in his case, would be the source of noise he did not want to hear. A few minutes later, Jim was joined by one of his friends, and shortly after, a waiter arrived with water and menus.

“There will be six of us,” Jim told the waiter. “Before it gets too busy, I wanted to let you know that I have trouble hearing what someone is saying when it gets noisy. I know how busy you are, but if you could speak slowly and clearly, while facing me, I’d really appreciate it.”


In the first scenario, Jim was worried about others noticing his hearing loss. His only active participation came in the form of a bluff, when he misheard the waitress multiple times and decided to guess at what she was saying. In that case, the bluff served its purpose – Jim was able to continue to hide his hearing loss. In the long run, however, bluffing is not a good strategy. It involves a lot of effort and reinforces the belief that hiding a hearing loss is more important than hearing. Eventually, the person with hearing loss will guess wrong, and it will be obvious to everyone involved.

There are a few examples of Jim being assertive in the second scenario. The first thing he does is control his environment. Instead of leaving his seat up to chance, Jim calls ahead to reserve a table in a quieter area of the restaurant, after the lunch rush is over. He also arrives early, allowing himself to choose where he wants to sit.

Good communication takes practice. Changing from a passive to an assertive approach to communication is one way to limit the frustrations associated with hearing loss.

If you are interested in learning more about communication breakdowns and different strategies that can help improve communication, sign up for one of our monthly Communication Strategies classes by calling us at 250-479-2969. The next date for this class will be at the Broadmead Hearing Clinic on Tuesday September 10th.