Hearing Aid Practitioner employed at Costco…Ask Me Anything!

@corona said:

But you can ask him anything

Sometimes asking the right question is more important than getting an answer

Dave_M

In reply to @AdamsHouseCat

@AdamsHouseCat said:

I believe that Rexton app works by sending (largely inaudible) tones to the HA’s rather than via a Bluetooth connection.

That is correct. I think this is common to the Siemens line. My new KS7’s work this way, same as Signia’s that I tried. The tone frequencies are approximately 14592, 15106, 15622, and 16136 Hz. Only one tone is sent at a time, but a message typically contains quite a few tones in sequence. I have found you can record these tone commands and play them back with an audio player and the ’s will respond. It is my belief that this is just a one way connection, and the HA’s have no way to reply back to the phone. This is why when you pair them, you have to tell your phone that the hearing aid has responded to the pairing. The aid has no way to directly tell the phone it is paired, you have to tell the phone that.

Assuming this is all true, it also has implications for how the app works. The phone can’t know the setting of the HA’s at any given time, it can only remember what it sent last. If you change it with pushbuttons on the HA’s, the phone does not know. Therefore, when sending commands to the HA’s, the phone has to send absolute commands, like 'set the volume to 7", not relative commands like volume up or volume down.

Dave M.

corona

That is just absolutely bizarre. I mean, I’m glad it works and everything, but don’t we have bluetooth, or at least something using radio waves?

Dave_M

I don’t see any claim by Costco that the KS7 itself has any bluetooth capability. It requires an external adapter. How that adapter communicates with the hearing aids is unknown to me, although I would suspect it is radio waves of some sort. Adding bluetooth to the hearing aid requires more power from the batteries. Listening for audio control signals does not add another device to be powered. Just some software overhead. I am not claiming that added software is free, or used no power!

KenP

NW Indiana

The original communication used between aids was magnetic resonance around 11M. When they added a Bluetooth device an antenna was used to capture it in the form of the lanyard that suspended the device. Only the device is Bluetooth.

Apple came up with a chip that operates at very low power which allowed BT to move to the aids, working with the minimal power available there. It has since been introduced in the earbuds they just announced. That chip was produced by a company they had acquired. Until a chip house comes up with a solution that can avoid their patents, it will only work with Apple products.

Mina

In reply to @fuhgettaboutit

I am new to this. What is ?

deafhammer

Hi there,

I’m hoping the Costco person here can advise on the Cala8’s for my needs? I know I need the Power but would it have the full feature set ie: communication between hearing aids etc. Also is the firmware upgradable as well?

Also, for the Cala 8, is the micro mic an accessory option as I don’t need the phone clip (Have a iPhone)

Here is my .
Fr 250 500 1K 2K 3K 4K 8K
L 85 93 95 98 90 95 80
R 85 90 95 98 90 85 72

Thanks and much appreciated!
deafhammer

Abarsanti

The Cala 8 is based off the Linx2. Here is the fitting range: Hearing aids by ReSound - rechargable and streaming audio directly from AndroidTM and iOS devices1

The phone clip+ is not necessary if you have an iPhone, but many state that it provides a more stabile connection to the aids. The micro mic and multi mic are both listed as available accessories on Costco’s hearing aid website for the Cala.

BlueCrab

In reply to @Mina

@Mina said:

I am new to this. What is REM?

Real Ear Measurement1

In reply to @bherring1964

@bherring1964 said:

Caveat Emptor applies to hearing aids for sure but I don’t want people to think most people in the industry want to rip them off and provide poor service to boot. That is not true.

I appreciate your balanced statement. Intentions of professionals in the industry are torn between the unbiased dispensing of medical devices and retail sales of a product with a substantial markup (to put it mildly). There are no “devils” or “angels” here. But, when hearing clinics lose their independence, whether through being purchased outright, accepting sizeable manufacturer loans, or choosing to trust manufacturer studies and marketing to be “gospel truth”, this results in a deviation from the ideals of the Hippocratic oath. If the hearing industry wants to be trusted by consumers, they must better model a set of ethical and quality standards.

Real ear measurements is important. But, is just one of a long list of proven best practices and ethical considerations that are not being followed in this unregulated industry. Public awareness, through sites like this one, is the key to positive change in the industry.

In reply to @Mina

@Mina said:

I am new to this. What is REM?

means “Real Ear Measurements” which refers to a set of various measurements usually taken during hearing aid fitting (but not always) using a probe microphone placed in the ear canal. REM is typically used to ensure the hearing aid is producing enough gain across all frequencies to meet the targets specific for each client (based on their thresholds and the latest and greatest fitting formula). Clinics (and internet hearing aid retailers) that don’t, or can’t, perform REM always miss with their initial targets. They hope that you will either 1) be satisfied with a “just good enough” solution or 2) contact them for multiple adjustments to let them continue to guess, over and over again.

Different “flavours” of are REM also used to verify directionality, noise reduction, or feedback management features of a hearing aid. What makes them all so important is the fact that each individual’s unique ear canals significantly “modify” incoming sound and, because of this, is an integral part of “the instrument”. Gain adjustments of 20db or more are not uncommon in certain frequencies based on REM results. As the db is an exponential measurement of sound pressure, this means that a difference of 20db is huge (close to 7 times the sound pressure, I believe).

There are probably 100 reasons to run from a sub-par hearing clinic. This is just one. When addressing hearing loss, the old cliche, “the chain is only as strong as its weakest link”, is very true. Public awareness is key to effecting positive change in the industry.

reubenray

In reply to #457

My Costco did on my Resound Carla’s.

In reply to @JustinHIS

@JustinHIS said:

As a consumer, how do you tell if a test was thorough or not? … what people think is thorough may or may not be.

Glad to see a “nubie” so committed to best practices. I find the split-track sound field and tests to be helpful during pre-fit consultation (discussing hearing aid model/style selection, features, and uptake). I also use them post-fit to demonstrate improvements in directionality and noise reduction.

In reply to @JustinHIS

@JustinHIS said:

Had three more people today who were underwhelmed by their KS6s. Fit all three with Oticon Ria2 Pros and all three were amazed at how much better they sounded. Just an FYI. Even did sound field and Speech in Noise benefit verification… All three did remarkably better with the Oticons.

Could it have been that the client’s KS6’s were not fitted properly? I guess we’ll never know. It seems a bit strange to me that “front-facing voice” directional features would vary so greatly between these two models. I’m assuming that’s what you were measuring with your “Speech in Noise benefit verification”. Both should offer around 5db to 6db improvement if fitted correctly.

In reply to @peterf1

@peterf1 said:

I find that the sound in my right (good) ear is not as rich or as crisp as the sound in my left (less good) ear. It seems quiter, restricted or muffled or just not what I am used to. Could this be a fine tuning issue?

I don’t mean to overwhelm you but there are a number of questions that must be asked here. Is the hearing loss in your LE conductive or sensorineural? What are the results of the electroacoustic testing for the LE hearing aid? Is your middle ear stable ( results)? Did the specialist perform real ear measurements to verify the fitting in your ear canals? Could there be retrocochlear issues at play? Are all LE sounds unsatisfactory, or just some? In which environments? Is the hearing aid free of debris?

If you pursue answers to some or all of these questions, you’re well on your way to identifying the root issue.

In reply to @taostrader

@taostrader said:

…I’m just awed by the KS6 aids.

Correction, it sounds like you’re awed by the ability of Phil, the quality practitioner, to fit you with your KS6 aids. KS6 aids fitted by your “average” practitioner may not meet the grade. Kudos to Phil. Congrats to you.