I have had 3 different molds made for my right ear because each time they were uncomfortable and irritated my canal. Each time I got a new one from Phonak, my audiologist performed a test. I’m on my 4th mold and it fits pretty good, but I told my audiologist I wanted to wait for a REM test to see if these will fit perfectly. Is a REM test really necessary after a new mold is created since no adjustments were made on each of the previous ones and each test cost me $65?
I’ve had Phonak make more than a dozen from the same ear impression. Each one came out slightly different with some extremely different including the size and path of my vent hole drastically changing.
I have had 3 different molds made for my right ear because each time they were uncomfortable and irritated my canal.
My initial mold was comfortable but the audiologist didn’t like the fit so she ordered another one. That one made the bottom of my ear canal sore. She ground a bit off the bottom of the mold but it was still not comfortable, so I’d been using the initial one. A new audi. said I didn’t have the new one pushed in enough at top. She was right: Pushing in in more helps – almost (but not quite) as comfortable as the initial one.
BTW, I am a cochlear implant user with Advanced Bionics and Nadia Link .
That may depend on whether one purchased bundled services as well as what services are included and for how long. I had a place try to include only two rem sessions for example.
In my experience, even Costco provides free tuneups for the length of the factory warranty.. usually three years where I live. But then, I guess audiologists are beginning to compete with online sales and big box outlets.
You don’t know what you don’t measure, so my initial reaction would be confirming with real ear any time you are changing the acoustic coupling. Even if I order an earmold using a scan on file, and even if I feel that Phonak is solid at making earmolds, if I don’t verify then I’m just “hoping” that everything is okay.
People change domes all the time with the same size and style without REM rests
I’m trying to wrap my head around the whole concept of when a test is recommended.
Do they use the same receiver in the different custom earmolds?
Right now, I’ve got . When they change the receiver wire they end up changing the receiver. Is a test required then? What if they change the wire length which would reposition the microphone position?
What about changing dome styles? E.g. Tulip to closed?
Oh, but maybe it would have been more comprehensive. For example, length of the mold/proximity of the receiver to the eardrum makes a difference too. So I said that changing open tips wouldn’t make a difference, but if a larger tip were holding the receiver further out that it otherwise would have been, that would make a difference too.
I think it’s fairly common, especially in new users, that I will complete on a hearing aid that I have inserted (and it is largely necessary for me to insert it, so that I can keep the probe mic in place) and then when the user inserts it they don’t manage to get it in as deeply. So they would have less gain than they are supposed to, largely at lows and highs. Or new users will actually pull the receivers out a bit to reduce gain on purpose. Custom tips are nice for their stable gain.
Gaining or losing a lot of weight can require REM as changes in the ear canal will change the venting. Ideally the custom tip should be remade, but that requires REM as well. Changing from a pediatric to an adult tube or vice versa can have dramatic impacts on the gain.
Sometimes the gain changes are really small though. That’s why I say to work out the fit first and THEN check the REM again, rather than re-doing REM every time. Although, that doesn’t always work either because sometimes a big change will make is sound junky and if you are trying to decide whether to keep something during a trial, junky sound isn’t great. So can be a bit of a judgement call.
Thanks for taking the time to give a more detailed explanation. It gets confusing. Between each of your posts about the need for hopefully most will get the idea. It’s simple but it’s not.
Texas Hill Country
