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One of the issues using maximum gain is that your dynamic range will be reduced. Your threshold of pain remains roughly the same and each time you increase the gain the more limited your dynamic range will be for the sounds that you can still hear. So some that means you will need more compression in your hearing aids to fit the more limited dynamic range you have. It is a compromise in getting enough gain to hear and not to much output that will cause pain or cause compression distortion that will limited me in hearing in noise. I have been wearing hearing aids that set to give outputs greater that 130db as needed for most of my life and I glad that my hair cells were able to function at those levels for all that time. I used to be against CI for a long period since I feel that I was getting good benefit from hearing aids and did not want to learn to hear in a alternative sound environment. My friends were surprised about my about-face decision in getting a CI implant two years ago.
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