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Did you prefer your Real Ear Measurment (REM) or initial fit better? How was it different?

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This is primarily directed at people who have had Real Ear Measurement (REM)4 performed or providers who have performed them. How did your measurement differ from your non-REM fitting? Did you prefer one over the other? How do you feel about REM? Do you think it is important? For the providers, what has your experience been with your patients?

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I prefer my 2nd fit, with . To be fair, it was done after changing from open domes to vented domes, and having my audiologist increase bass tones. I was getting almost no bass when listening to any audio via Bluetooth until I switched domes and she adjusted the bass input.
Fortunately, my audiologist considers the initial fit to be merely a starting point, with finer tuning to follow as needed. She’s employed by the healthplan, so reprogramming doesn’t take away from earnings as compared to the pressure to make sales in a commission-based clinic.

I had 3 fittings, the second after 2 weeks. He generated differing sounds within the aids and used the mics to analyze the results. It took about 20 mins. The difference was amazing! I use open domes and yes, the bass is not as prominent; however I have high end loss, not bass. If I close them off it is like headphones. I dont wear my aids as headphones, I need the hearing adjustment which I might add is a major improvement. The other fittings were minor adjustments including own voice changes. The additional fittings were included as necessary (anticipated by the audiologist). I have been told that what he did was “not ” but I see very little difference since it is a microphone picking up audio generated inside the ear canal as well. The results are hugely different when adjustments are made. I want to get the benefit of having my , not doing so seems wasteful of my money and time. I forgot…I had 4 fittings, oops.

Edited

I have my before and after gain numbers:
The REM adjustments (a) +2db (left) +3db (right) at 2K (b) +5dB (right) at 4K.

This was done at Costco with Rexton ; I performed in-situ measurements afterward, and the results matched the numbers except at 4K (right).

In my opinion, not everyone may need REM, but since it’s impossible to determine who will benefit from it, it should always be included. It’s like checking the tires pressure of your car after being inflated and putting more air as needed.

Curious, what differences in have the other seen?

My first fitting WAS a fitting. When she put them on my ears the first time, it was only after putting the little REM mics in my ears. So I couldn’t say.

WH

@monke said:

For the providers, what has your experience been with your patients?

I think not providing is unethical.

In my experience, most patients do better when sound is actually audible to them which is what REM ensures. In pediatrics, language outcomes for hard of hearing kids are directly related to how far off of prescriptive targets their hearing aids are.

@monke said:

How did your REM measurement differ from your non-REM fitting? Did you prefer one over the other? How do you feel about REM? Do you think it is important?

My first 3 sets of aids (Siemens Pure, Oticon OPN, OPN S1) were fit without . When I asked to update from the OPN S1 after using them for 3 years, my medical insurance (1 pair of aids per year up to $5000 per set) directed me to a new provider. I was told they used REM by default. My More 1 (and later Real 1) were fit with REM. I was told that I had been significantly underfit with the OPN S1 and that I would find things MUCH louder. That was true and I got used to it quickly. My understanding, especially for soft and/or high pitched voices was improved with REM and it was better for listening to natural sounds when hiking and walking. For me, REM was a real help. I think it should always be done - otherwise your expensive aids are not necessarily set to the appropriate level (and were not in my case).

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