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Question On REM

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I have some and used to wear them to cut down on feedback. I find the double vent base domes more comfortable and still keep enough feedback noise at bay.

As long as you’re fine with poor low frequency audibility. Which you may be. Those lows often support hearing soft spoken people more clearly, but they also provide more car and road noise.

Maybe I’l give them a try again and see if it helps understanding my 3 and 4 year old grandkids. I do struggle with that.

In reply to @Neville

With less hearing loss are people better able to separate the compressed sounds?

What type of things should the clinician be doing beyond checking targets with ? We played around by increasing gains at 6K and I get more reverberation from her voice (that was with domes before trying cShells).

Isn’t the loss due to the aids small? And yet at high frequencies that can’t be overcome? I’ve been more focused on low frequencies and venting but perhaps it is high frequencies that are more of a challenge.

Sorry, I mean because if you have normal hearing out to 20 kHz hearing aids cannot work out that far. Within the hearing aid range, yes they can.

@user490 said:

With less hearing loss are people better able to separate the compressed sounds?

When there is a lot of damage in the ear you rely more heavily on temporal cues rather than spectral cues, and agressive compression messes this up. With less hearing loss you are less dependent on the temporal cues and so can tolerate more compression. There’s sort of a “sweet spot” for hearing aids between 20-55 of loss. A flat or gently sloping ~40 hearing loss is an audiologist’s dream because you know that they are going to get a lot of benefit.

is a tool that can be applied in other ways than just checking targets. Off the top of my head one of the things that I try to get my new clinicians in the habit is doing with the REM machine is just listening along with the headset and watching while they listen. Sometimes a patient will complain about a particular sort of weird artifact and you can hear it and/or see it on the screen as it happens which allows you to isolate and eliminate exactly what is causing it. The other day a patient complained of being unable to distinguish two phonemes during the carrot passage and we used the REM to measure response of those two phonemes (live voice) and were able to compare them, identify the overlap and adjust it to make the sounds more spectrally different and perceptually different for the patient. For insertion loss in particular, if you’re worried that it’s going to be an issue given a specific patient’s type of loss you can measure the unaided gain and then make sure that the aided gain is not below that.

In reply to @Neville

Replaced the bass domes with power domes yesterday. Rerogrammed them from scratch. I was surprised at the difference in low frequency hearing between the 2 types of domes when I ran In-Situ.

So far I like the results. The 8mm Power Domes feel as comfortable as the bass domes in my ears.

The real test will be when the grandkids come for a visit later this week. Although I believe I’m understanding my wife a little more clearly now.

Good news!

It’s very common for users to not understand how critical the fit of the dome is for the actual gain, they just think it’s a comfort thing. Open domes seem to grow on trees out on the wild and my patients show up with them wondering why they can’t hear anymore. :upside_down_face:

@Raudrive said:

My belief is us DIY people should absolutely follow software guidelines first. It usually works out best.

I found this to be true when I got my OPN1 and first started doing my own programming around 10 years ago

When I got my first hearing aids (first version of Phonak Audeo), I drove the poor H.I.S. crazy trying to tweak them in so they sounded good. I must have went back to him 8-10 times. We never did get them to where I was satisified.

Right now I’m having good results completing the Personalizaton Questions and then a little trial and error with the Fitting Assistant to do the tweaking for me. It’s working out real well for me.

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