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Question about performing REM

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I will soon receive a new titanium cShell with 0.6mm diam. vent (I hope so) for my Audeo Infinio Sphere 90 only in my right ear.
Unfortunately, that audiologist fit only Beltone hearing aids (with ).

I have a few questions:

  1. Is it possible to bring my laptop with Target 10.1 software and use its TargetMatch 2.0 with his/her REM setting? Or Target MUST be on her laptop?

  2. For what I know, there must be performed:

    • /REOG for knowledge of earmold and venting characteristics
    • (for G50, 65 and 80 stimulus)
    • REAR90 for establishing
    • REUG (less important when REAR instead of REAG and ), but I am curious what’s the acoustic of my ear canal and what are the gains hearing aid providing me.
  • are and RETSPL necessary?

Are there any other actions that should be taken? For example, does it make sense to check the REAR:

  • when maximum directivity is established (Speech in Noise in my Sphere 90), for what I know, there could be less gain in some frequencies compared to omnidirectional mode - does their correction make sense bearing in mind I’ll have cShell with 0.6mm diameter vent?
  • with Spheric program turned on?
  • in another condition?
  1. Does relying on AutoREMfit is enough or there are the situations where manual adjustments are better?
6 people in this conversation8 min readJump to latest

How might Beltone compare with Phonak?
Possibly you could give him some experience with your unit, that he could use for others who might want Phonak? ( Meaning you could SELL him on the benefit of the experience he is getting with you )
You must have had some communications with him already?
Have you been emailing and discussing how this will work with him?

If they do a with your hearing aid - once done - would you be able to use Target at home on your computer with that REM, so the REM would still be useful to you - right ?

In reply to @StataHA

@StataHA said:

I highly doubt the audiologist wants you to self fit right in front of them.

Maybe yes. However, I’d prefer to gain knowledge if that situation described above is technically possible before I ask him/her.

@IGZO said:

How might Beltone compare with Phonak?

I simply don’t know.

@IGZO said:

Possibly you could give him some experience with your unit, that he could use for others who might want Phonak? ( Meaning you could SELL him on the benefit of the experience he is getting with you )

I think it’s Beltone, because they are more affordable for the patient group here (mainly retired people with limited money to spend).

@IGZO said:

You must have had some communications with him already?
Have you been emailing and discussing how this will work with him?

Until now, only for ordered earmold and info that they haven’t Target software. I didn’t inform them that I am DIYer.

@IGZO said:

If they do a REM with your hearing aid - once done - would you be able to use Target at home on your computer with that REM, so the REM would still be useful to you - right ?

Sort of. I’ll get good points (or target lines) to start. However, we should bear in mind that adjusting gain by 1 in Target without probably isn’t the same as 1 in REM-based fitting.
Nevertheless, these are minimal adjustments more difficult to spoil.

You seem to have some technical understanding of sound and hearing science.
I would think that is far less useful to a DIYer, than to the average Joe.

You can play a variety of YouTube or pre-recorded TV or an audio recording you made on your phone of a sound scene you experienced live. Then playing it on two computer connected speakers about ten inches from your ears with your hearing aids unmuted and connected to Target - you can make real time tweaks. Those tweaks would not be made one bit differently if you had REM or not. You would be varying the gain for LMH as you experiment to get better results overall. Right?

How does REM being input to the fitting software, constantly guide the behavior beyond what the software fitting tweaks direct it to do. That I don’t know and would be my reason for trying REM again now. It was a frequent thing for a decade with me and I never knew if my aid performance benefitted from it. In fact that doubt was a thought introduced to me by my .

@IGZO said:

You can play a variety of YouTube or pre-recorded TV or an audio recording you made on your phone of a sound scene you experienced live. Then playing it on two computer connected speakers about ten inches from your ears with your hearing aids unmuted and connected to Target - you can make real time tweaks. Those tweaks would not be made one bit differently if you had REM or not. You would be varying the gain for LMH as you experiment to get better results overall. Right?

Yes, I do in that way now. However:

  • it is HUGELY time-consuming
  • non-validated
  • even if you buy calibrated sonometer it is less accurate
  • it’s a bit like moving through a fog - there are many possible combinations; helps to limit them, saving much time.
  • still, you don’t know in situations like: Should you get more gain at, e.g., 1.5–3 kHz, which is now uncomfortable and makes the sound sharper, but after a few weeks or months of getting used to it, that gain will provide better speech understanding?

With or 5.0, it is highly probable that if I acclimate to their initially uncomfortable loudness or harshness, improved speech understanding will likely result, gratifying me for initial nuisance. But first, I must know does that incovenience make sense? The REM provides me answer for it.

If you’re a ’er who will tweak settings, won’t be that effective.

In any case, it’s helps the fitter make sure the the prescribed gain. No need to bring your laptop in. I don’t know why you would need to.

@Bimodal_user said:

Is it possible to bring my laptop with Target 10.1 software and use its TargetMatch 2.0 with his/her REM setting? Or Target MUST be on her laptop?

I don’t use the TargetMatch, but I think it would need to be her system. You could ask her to do it manually off of yours but it’s a big awkward ask and why would you? You can just read off the settings when you get home.

That’s some pretty tight venting for your loss, but I forget what you’re used to. Occlusion is going to be okay?

I’m not sure is that important given that you are not trying to NOT occlude yourself. and yes, although 55, 65 and 75 is also common. /s/ verification if you can get it; I’d take that over REAR 75 if I had to choose. REUG not the important. is important. RETSPL is not something you need to worry about–it’s a value used on the audiology side during calibration not a measurement you run as part of .

Probably not to other conditions. has noise targets but NL2 does not.

AutoREM is fine if all factors are perfect, but the robot cannot adjust for physical fit issues the way a human can.

@Bimodal_user said:
    • REOR/REOG for knowledge of earmold and venting characteristics
  • REAR (for G50, 65 and 80 dB stimulus)
  • REAR90 for establishing MPOs
  • REUG (less important when REAR instead of REAG and REIG), but I am curious what’s the acoustic of my ear canal and what are the gains hearing aid providing me.

Why not just perform using speech and maybe throw some loud sounds in the mix?

Tweak the aid and repeat.

The rest is just an exercise in redundancy.

In reply to @Neville

@Neville said:

You can just read off the settings when you get home.

So it is possible. Thanks, that is also useful information. I was thinking about tweaking based on data from the printed results.

@Neville said:

You could ask her to do it manually off of yours but it’s a big awkward ask and why would you?

You’re right. I simply tried to see one of possible solution.

@Neville said:

That’s some pretty tight venting for your loss, but I forget what you’re used to. Occlusion is going to be okay?

Definitely yes, I have no problem with the occlusion effect. The impression was quite deep, it surely reached the bony part of the ear canal. I am also tired of not-so-good noise reduction, directionality, and even , because a lot of noise enters through the vent.

The extreme case was over 10 years ago when I didn’t get any benefit from SmartLink+ with DynamicFM technology. I didn’t know then that ventilation could be a problem and no one told me and helped about it.

I find it very interesting that I can achieve directionality not only in the mid to high frequencies, but also in the low frequencies where I have the most useful hearing. This is only possible with fairly closed fittings.

Another problem is that it is quite possible that the P receiver is too weak for my ear canal volume (in I reached the gain limits), but I am not suitable for UP. It is quite possible that the potential Naida Infinio PR could be better, but I realised this only recently, during my first and later steps with DIY. My hearing loss is fairly stable.

There is my recent gain with P receiver with power domes (tweaked 5.0 Pediatric, I have loss since 4 yo):

image

image

@Neville said:

I’m not sure REOR is that important given that you are not trying to NOT occlude yourself.

Good point. However, I plan to use my cShell partly as an earplug due to many unwanted >120 noises from tuned cars (mainly BMWs)/motorbikes, which scares me. I have no problem paying Audi extra for the time it takes to measure the effect of an earplug.

@Neville said:

REAR and MPO yes, although 55, 65 and 75 is also common. /s/ verification if you can get it; I’d take that over REAR 75 if I had to choose. REUG not the important. RECD is important.

I heard also about 55, 65, 75.

Female /s/ I can hear in Target software records with even 20/100 loudness level on my laptop, especially when I changed the length of receiver wire from 2 to 0 - fits perfectly with no discomfort. Overtuning helps me a lot while I know that it isn’t optimal.

Thank you for the thorough explanation.

In reply to @Um_bongo

@Um_bongo said:

Why not just perform REAR using speech and maybe throw some loud sounds in the mix?

I am aware there is many approach to get the done. You have had real speech in mind? If so, I have more trusting to validated recorded speech stimulus than live speech. If I could talk only with my (potential) wife for weeks and no one else I would try that.

@Um_bongo said:

The rest is just an exercise in redundancy.

My other purpose of REM is to get quite a lot of information about my ear characteristics. For example, why I manage relatively well in quiet without , which was the case when I was 4-11 years old with the same loss.

It would be unbundled, so it would be paid appropriately by me for the time spent.

In reply to @Bimodal_user

@Bimodal_user said:

You have had real speech in mind? If so, I have more trusting to validated recorded speech stimulus than live speech.

Why? The level should be calibrated by the VU meter. Use recorded speech if you like, live speech has better dynamic characteristics and (in terms of spousal interaction) is more convenient and relevant to the individual. Also unless you have a multi-track system, it becomes slightly more complicated to evaluate vs. a restaurant background noise track for example.

Hm, I must read more about it. Thanks for providing some interesting news. I work in the medical profession, so excuse my inherent skepticism about unvalidated stimuli used in live …

I wonder how much difference there would be between, for example, ISTS and live speech. It would mainly be in , regarding the dynamics you mentioned?

What about speaker placement during ?

On videos I often see it in front of the patient, at 0° horizontal azimuth, but well below the line of sight, about a minus dozen ° vertical azimuth…

Theoretically it should be zero everywhere, but I am quite tall and often look down when listening to someone, so maybe it is beneficial to have loudspeaker quite below zero?

In reply to @Bimodal_user

As long as the average of the signal sits near 65dB during presentation, the signal is valid. The far-field mic on the probe tube assembly is constantly calibrating/ratifying the presentation level. So speech is valid as long as it’s at the right level or ISTS or recorded speech.

The zero azimuth argument holds if you’re testing directional functionality. You used to present the speech stimulus from 0 with alternative background or speech sounds at differing angles. It’s less relevant now because hearing aids can utilise multiple nulls and resolve multiple noise sources - imagine the polar plot to resemble a dartboard, with both angular and angular/frequency noise segregation, with calling the shots.

Also your other point: yes, highly valid, both for speech orientation and noise sources: probably optimally you have up to about 15 degrees above and below the operating horizontal level of your hearing system. More than that and the ability of the hearing aids to resolve the directional pattern diminishes pretty quickly. So you either tilt your head forward or like a good skiing coach will tell you: ‘you must bend zee knees’………

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