Round 3; DING!

You can check about audiologist with REM in HearingUp website.

@Zebras said:

My friend from Pakistan bought her Dad over to the UK as the UK is way cheaper to get HAs then over in Pakistan.

Paying for the flight and the HAs, was cheaper by far, then getting them in Pakistan.

@Dranaskhan, maybe that info would be useful for you.

@Bimodal_user said:

HearingUp

I apparently can’t make the site jump; https://hearingup.com/2 has no reference I saw to REM, let alone which providers had it; there are 3 members with the closest being 90 or so minutes away…

@Skip said:

has no reference I saw to REM

It has, although it is hidden under name “best practices”.

@Skip said:

has no reference I saw to REM

@Bimodal_user said:

https://youtu.be/z4EvtVbDw2s

It has, although it is hidden under name “best practices”.

Right; I think I saw that on further digging - though no reference to LSM.

But: Does inclusion in his roster mean that any such included provider does REM? The only one anywhere near me ironically is at the other end (long road) of the same road as my Beltone rep, so getting there, while over an hour, is at least do-able. They, as noted, do Phonak, what I’m currently trialing, so it might be worth ponying up whatever they’d charge for a full assessment and then a REM-aided adjustment.

If getting the very best from a Sphere-enabled Phonak can’t beat the mike-enhanced Beltone speech recognition, there’s no point in not recovering my $2500 copay and just living with the reality of “miked wife” until a few more generations of aids come out.

I took a look at LSM and now realize I was wrong. I was thinking about speech mapping.

LSM is not much better that the old “how does that sound” question from the fitter.

Good luck

Hmmm.
I was thinking of Speech Mapping as well. What’s LSM that I’ve apparently mislabeled when I meant live speech mapping? The link I found thought that Speech Mapping was a large step up from REM, a much older technology.

I’m easily confused, but this is bothersome in that any REM/LSM will involve serious travel for me and if it’s not an improvement, there’s no point in making the trip…

As to REM, they’re scarcer than hen’s teeth anywhere in well over an hour from me, so far as we’ve been able to discern.

And no Beltone in the states adjacent, nor GA, has REM, per my contact 90 minutes away. Again, like other brands, cost citation as to why not. And if you don’t have the Solus Max software, one cannot tweak the fine points of Beltone aids, so far as I’m aware.

Sigh..

Younger clinicians often use REM and LSM interchangeably. Early REM used a tone sweep instead of speech I believe (before my time) and the change to speech was “LSM”, but almost no one uses the tone sweep anymore but many still just say REM. REM can also include any other “real ear measure” like occlusion measures or /s/ measures or on ear directionality checks, etc. Anything that puts a tube in the ear and measures at the eardrum.

If there’s a pediatric clinic near you you could ask if they also see adults or if they know an adult provider who uses REM. All pediatric spots SHOULD be very competent with REM and probably have recommendations for their Pediatric patients who age out of their care. I would think…

Well, I changed my mind about doing the drop-in to the other outfit in Gainesville yesterday:

Unfortunately, as I suspected, when I spoke with the Phonak vendor, I got “I don’t really know all that much about these; please call the Phonak tech support line” as how to deal with the Sphere.

As I consider it politically incorrect to jump off this just-saddled, UnitedHealthCare funded, horse, I’ll have to go to the one in the town a half-hour further away from me to get the REM/LSM tweak and setup, and pay whatever the per-visit cost would be.

I have an appointment in the same town, on the opposite end of the same street, ironically, as Beltone, to get my former best-yet speech understanding profile restored to them, and I’ll do a drop-in to the REM/LSM equipped Phonak provider after I’m out of the restoration.

In the meantime, I’ll call the Phonak support line and see if they can either guide me or enter a remote session and get my Sphere functional.

(As to Beltone, the only point to that trip will be a valid comparison point to the Phonak gear. And if it weren’t for the almost-$1600 surrender cost to trial the current version, I’d give Beltone a shot, too. OY!)

Sigh…

@Skip said:

when I spoke with the Phonak vendor, I got “I don’t really know all that much about these; please call the Phonak tech support line” as how to deal with the Sphere.

I support your decision to not return or return as you see fit, but after a response like that I wouldn’t feel much loyalty.

@Skip said:

Unfortunately, as I suspected, when I spoke with the Phonak vendor, I got “I don’t really know all that much about these; please call the Phonak tech support line”

Good that they were honest. I’d rather hear, “please be patient with me as I learn about this…” than that. The amount of money involved isn’t small. You drive a long way to get what you need. Sounds like they can’t go out of their way to take care of you or keep up with their profession. Why did they sell them?

Drop’em like they’re radioactive? Up to you, but…..

A couple years ago I dropped in on a different clinic than where I have been going hoping they had a part I needed. I was at the facility anyway to see another provider and hoped they could help me. They told me up front that they didn’t know anything about Phonak aids. Full stop. They did a different brand. One brand. (Chuck would have been at home!) They thought that was best. I thought they were kidding, but no smiles…. They looked at my aids like an intellectual curiosity. Called everyone not with a patient in to look. I told them my story and what I was looking for. They said I should go back to my regular clinic. And here I was, trying to save a 1 hour + round trip. They at least were honest with me up front.

WH

@Skip said:

“I don’t really know all that much about these; please call the Phonak tech support line” as how to deal with the Sphere.

A question for any providers looking on:

I went knowing that my provider was the closest to me handling Phonak and covered under my United Health Care program.

In the course of a different search metric than I’d used before (searching ENTs), and looking solely for REM, I discovered a Phonak vendor a half-hour further away from me; they offer LiveSpeechMapping, which, as I understand it, is an enhanced version of REM, the gold standard for programming hearing aids, according to everything I’ve seen here.

So, I currently, for about a week, have the Audéo Sphere Inspiron I70s (UHC doesn’t cover the 90s). The only reason for visiting this provider was that they had Phonak, and I needed Sphere. As seen earlier in this thread, the best I can tell is that it’s not enabled.

My titanium molds are in; I’m going to get them today. If I can’t get the Sphere working, I presume that REM/LSM - AND the implementation of Sphere, achieved at the other provider, will make my speech issues go away, as, other than the noise clamping of Sphere, the speech portion of my aids is superb compared to the best Beltone could do.

With all that as background, what’s the politically correct way of backing out of my current provider and moving to the one which has the LSM tweak?

As it’s a UHC trial, I’ve not yet been charged, though I will have to pay for the full titanium molds today - which then also presents a conundrum, as my current silicone molds took 3 tries to get right with Beltone. What happens if my first go-round with these new titanium molds doesn’t go well, and I’ve changed horses, however it’s appropriate to do so?

Thanks!

Do you have time within your return policy to consult with the other provider and ask them?

I had a situation a while back where a patient came in with some new hearing aids that were a good choice for them but were set up very, very badly. Very badly. Not just professional differences, objectively a bunch of big errors resulting in almost no benefit. I provided them with both the information about what it would take/cost to switch over to our clinic whether they just wanted reprogramming or wanted to repurchase, but ALSO all the information they needed to take back to the first clinic and have their problems resolved as well as my information so that they could contact me to discuss the case should the other clinician wish to. And then I left it up to the patient. I did feel a bit bad about potentially interfering with the other clinic, but my first role is to advocate for my patient. If you can meet with the other professional, you’ll probably have a better idea of the direction you need to go, whether it’s just refitting with REM or totally switching clinics. Who knows, maybe you won’t like them.

If you can’t do that prior to the end of the trial it’s maybe trickier. You can keep the titanium molds and tell them you’re not ready to purchase the devices, you need some time–they can return them and reorder for you later or may just be able to hold them for a bit. But if the titanium tips don’t fit well you may or may not need to pay a remake fee if you switch providers.

Hi, Neville, et. al. looking on:

Yes, my 60 day return cycle (funded by United Health Care, my insurer; no money has changed hands yet, as it’s a co-pay for the aids themselves) is only a couple of weeks old; I had to buy my titanium molds, on which, more, anon.

I’m cautiously hopeful:

Update for both Beltone and Phonak molds and settings:

First run:
I’ve had the Phonak high power titanium molds for 2 days, now.
Other than wearing my Beltones with their silicone molds (used as a kludge for my Phonak medium power RIC aids while I waited to get the high-power titanium molds), in order to restore the previously great (I thought) Beltone setting for speech, done yesterday, they’ve been in my ears non-stop for waking hours.

Unfortunately, and we’ll see if it mitigates or gets worse, the left mold is uncomfortable. But when I was in for my fitting and to pick these up, with some guidance to the fitter, I was able to get some better settings in general. So far, I’m encouraged.

Tomorrow at church will determine the efficacy of the music setting, for which I asked for flattening of the compression (which distorts the frequencies heard, particularly for percussive sounds like a live piano), but so far, my Automatic setting (and at the advice of the fitter, nearly universally, rather than shifting between that and the individual Music, Restaurant, and TV settings) has done well. He advised me to not muck with the Music settings until the Automatic was proven insufficient. But the Beltone guy did flatten the music setting in those, yesterday, so I’ll swap between the two to see how we do in that regard.

Stand by for whether my left ear gets happy or unhappier with its titanium mold than it is currently, and if my music acuity returns along with the apparently successful, but if not,VERY much improved speech performance, including in a restaurant last night! While I DID see an amazing disappearing act of the restaurant background noise when I went to that setting, my understanding of Lydia, 2’ away, wasn’t better than my relatively-wide-focus of speech in my Automatic setting.

Thus far, I’m very impressed with the Automatic. We watched our usual two episodes of an Amazon series last night, and while there’s a TV setting, I didn’t find it superior to the Automatic setting. Notably, the ads, without the captioning, were understandable, and, closing my eyes to remove the scroll resulted in my largely (not entirely) understanding the dialogue in the actual series episode.

I’m cautiously optimistic. And despite my earlier enthusiasm for the level of speech clarity I had with the Beltones, now restored to that setting, the Phonak clearly trumps the Beltone decisively.

Baby steps…

How’s it going with the hearing aids and your molds? “Enquiring minds want to know!”