Audiologist "doesn't do" REM?

1, This is a reverse slope loss and (again) the manufacturer’s software isn’t really optimised for it.

2, REM would obviously show any shortfalls, but the physical shape of the moulds/receiver size is likely to play an important part in the fitting success.

3. Experience with both the (off-track) fitting possibilities and the willingness to hand hold you through a few (localish) appointments is likely to be necessary too.

Neither of the recommendations above (Costco or that independent) would be on my radar; it’s not the kind of fitting that wants a ‘sheep-dip’ approach tbh.

@tappenden I would personally defer to the comments made by @Um_bongo above as he is an expert and has been on this forum for many years helping a lot of people. And also @Neville

Thanks. I’m going in this afternoon, but I only have a few minutes. I’m planning to just swap the closed domes for power domes. Reluctant to rush any settings changes before going on holiday next week, in case they make things worse. I’ll go back in on the 7th for adjustments.

Keep us informed of the results after post-holiday fitting. I am interested about outcomes of doing that in reverse slope hearing loss like yours.

P.S. You’ll be in Valdemossa in Majorca?

I’ve just had power domes put on. They are a little trickier to put in my ears, but they aren’t causing any discomfort so far.

I also had frequencies below 2K turned up a little.

Sound is richer and I can definitely enjoy music more. Results on speech are mixed so far, but it’s not bad… Literally only been an hour and I haven’t had many opportunities to test yet.

There is an interesting article about fitting reverse slope hearing loss. However - read it with a grain of salt, what was good for the patient described may not be good for you, @tappenden.

Complex versus Standard Fittings: Part 2 - Article 218366

From the Part 1:
Complex versus Standard Fittings: Part 1 - Article 216626

Part 3:

Complex versus Standard Fittings: Part 3 - Article 219971

Glad to read about visiting Valdemossa!

I’m glad they work for you.
However, they were not comfortable at all for me. In the last instance I had one power dome lost in my right ear for a couple of weeks. It had come off…I didn’t know. Silly of me. I work late most nights.

My hearing practioner found it when I went into his office with an ear-ache…I’ve had domes come off in my ear several times.

DaveL

Edit: Sunday March 30th. Bit the bullet. Changed to 2 Power Domes first thing this morning. Heard better.

@tappenden said:

“boost the frequencies that work, and stop trying to compensate for the ones that don’t”,

Yeah, absolutely. Arbitrary targets and rationales don’t sit well with reverse slopes.

If you’ve got the option: nearly occluding fitting (1mm vent), music program and subtle gain with a volume control. Build it up 10% week on week until you get to where you need it.

Understand.
Mine was a Large Phonak Power Dome.

What amazed me was I didn’t know that it was there! How dum is that!
I used to work for 3M. I can’t image how little it would cost to make a million of those domes. And how much they can screw up the performance of my hearing aid. My dispensing audi had me in open domes for a year and I complained a whole bunch of times that I couldn’t hear. And got a whole bunch of excuses

I had an in the ear hearing aid as my first HA. It spent a lot of time in my pocket. When it hurt, I took it out. I could hear wonderful behind, but not in front of me. Now a drive to my wonderful hearing specialist is a hundred bucks. He’s worth it! Because he gets results.

DaveL

Changed. 2 closed domes off. 2 Phonak Power Domes on. Heard better all day.
Appointment with my Practitioner April 10th.

Yes. It is important that you really get to know your instruments. The hearing aids, do nothing for your vision… important that you are equipped with the necessary eyewear to see them clearly.
Are the domes fully seated? Straight on, not pitched crooked?
That they are clean… no debris stuck on their tips.
I try to keep my ear hair shaved frequently to avoid the hair from smearing stuff on to the speakers.

AND you should practice to be able to remove a dome from within your ear, using a long nose plyer. Guess you could use a tweezer, but I have ample experience with tools so more comfortable with long nose. Not too long, not too stubby and chunky. The right slim size, and how to use an inside finger to intricately control the opening and closing. It takes a second when done right. But if you never have done it, can be scary to think that dome is stuck in ear, and not wanting to push it further in, nor do without aids.

Consider that if you did not know it was in there, you could have pushed it further in, say with a Qtip. I imagine that if it was up against your eardrum it would be painful.

Sales reps are denying requests by audiologists? That’s got to be illegal in at least some country.

I searched Philips as an example and could find the official download.

Audiologist "doesn't do" REM?

This is ready bad advise for a lot of people. When a patient comes in right away it’s usually pretty easy for us to get a dome out. When they’ve let a loved one wrangle around in there with tweezers first, it can get very difficult. I appreciate you have maybe done it, and actually I’ve done it, but for most people–your clinician can typically have you in and out in a few minutes day-of with no charge, just let them know what’s happened. What amazes me is that you haven’t been moved to custom…

Yes Neville, I figured someone would caution.
But actually, nearly any good advice can be bad for some people.
Yes, I Have on several occasions had to extract a dome.
And I would far better have been educated to think of it, IN ADVANCE, than panicking on a Friday night.
I would have much preferred my AuD, say… hey look at this… see this dome can occasionally come out. See how it is shaped, study this… now let me show you your ear… see this is the otoscope of your ear… just the outside… so I am not suggesting you do this, and most person just stop using their hearing aid on that side, and rush right back here… takes literally seven seconds, and we just pluck it out. BUT YOU DONT WANT TO PUSH IT IN IF YOU CAN AVOID IT.

Of course, most who know me, would think I would probably want to just get it out myself.
Important thing is to stay calm, practice the three finger method on the long nose plyer, choose a plyer, both thin and short, and just practice opening and closing the jaws, as well as feeling for the ear insertion point… takes lot more time to describe it here than to do it. And it does feel great to solve problems!

@Neville said:

When phonak was the Kirkland device, you could just hook it up to the regular phonak software for example. Same when signia was Kirkland. But now that Costco is no longer rebranded standard models but off-brand dupes we can’t do that.

Not quite sure why not, Rexton Connexx would be available if you had Signia Connexx, Sennheiser is Target and Jabra uses SmartFit, but most simply won’t do it even when they have the software unfortunately.

@tenkan said:

Sennheiser is Target and Jabra uses SmartFit,

Thanks, that’s news to me. I haven’t seen the Sennheiser. It was the Phillips we were refused and I had thought Jabra was the same. Glad to know I’m wrong.