Can REM plausibly add 28 dB gain at a high frequency?

That’s what I would of thought, this is why we have the “fitting range” we already know when fitting ones loss (after the audiogram) that the higher frequencies can be met within the fitting range of the HAs, having it confirmed by REM certainty helps some.

REM with frequency lowering turned off is used to determine the highest aided audible frequency meeting a certain threshold of loudness.This in turn will be used to determine the upper frequency bound of the frequency range that will be the destination of the frequency lowering.

The audiogram provides frequency thresholds of unaided response. There’s no way to tell from an audiogram what should be the destination range of the source frequencies to be lowered.

@brec said:

The audiogram provides frequency thresholds of unaided response. There’s no way to tell from an audiogram what should be the destination range of the source frequencies to be lowered

That’s what the software does, after inputting the audiogram, different formulas will give you different outcomes, of course this can all be checked by REM and adjusted to suit.

@Raudrive said:

Why do REM twice? The first one without frequency lowering is a waste of time. Or am I missing something?

You complete REM without frequency lowering and once you have a good fit-to-targets you confirm /s/ audibility. If it is audible, then you don’t turn on frequency lowering–no point in introducing extra distortion where you do not need it. Even if you know you are going to need frequency lowering, you need to start with a good fit-to-target prior to adjusting for /s/ audibility.

@Neville said:

the pre-REM gain at high frequencies seems low relative to your loss.

How’s it sounding?

I never listened pre-REM except for the initial 10-minute walk around the warehouse on the first visit. The post-REM experience has been quite good! I’ve heard some sounds I’ve not heard before, even after 8 years wearing (no-REM) HAs.

Then your post REM settings are probably correct.

There can be some really dramatic differences between what the manufacturer software says hearing aids are doing and what they are actually doing, due both to how the manufacturers have set things but also to the shape of the ear and the acoustic coupling. I always think of the clinicians who are not doing REM when I’m seeing a difference like that, because they must simply never know that this is the case. I think that if a clinician didn’t have experience with how much REM can differ, it would be pretty scary to crank the hearing aids up that much–how would you know that you weren’t setting the hearing aids in a way that could be damaging?

IIRC the HIS said that the REM was to NAL-NL2. And the post-REM insertion gains look pretty close to (pre-REM) NAL-NL2’s. So yesterday I, a DIYer, made a couple of adjustments to the audiogram to make a judgmental average with two others that I’d had recently, and changed the rationale to NAL-NL2. Here are the diffs between what I ended with yesterday and the original post-REM fit at Costco (Costco audiogram, Fit2Speech):

So, if you were happy with his settings… Don’t reduce things. Especially not at 2k. Unless you were finding things uncomfortable or unbalanced.

OK, I’ll go back to the original post-REM. Thanks for the counseling!