Kirkland Signature 9.0 vs. Rexton Adore Li

@MDB said:

I wouldn’t encourage going to full REM immediately. Starting off low and gradually working up might be a better approach.

I think normal practice would be to set a “New” or a “%” level and still do the REM to the reduced target. The purpose of the REM is not to give a strong or weaker correction. It is just to make up for the error between what the computer thinks, and what you actually get. Here for example would be the target using the Rexton Smart Fit at the “New” level rather than the experienced.

When you do that, for sure you need a follow up appointment at some point to bring the user up to the optimum level. I know my fitter’s philosophy is to start at the Experienced level. I also recall a study which found that users that start at a “beginner level” often never get the gain adjusted to the optimum level.

Agree that it is a judgement call. I suspect fitters that are trying to “sell” a particular aid like to use the beginner correction, as it lowers the risk of a bad experience, and a lost sale.

You’re taking me out of context. The suggestion to not go to full REM immediately was conditional on personality. “Normal” practice? I think “normal” is not to do REM. “Normal” at Costco from my experience is to do it, but consider 10dB “close enough.” What I was trying to convey was that if his wife had a hard time adjusting to change, insisting on full REM might be counterproductive.

My point was, and is, that I think you are misunderstanding what REM is. It is not any kind of increase in gain, it is just a correction in gain from what the computer is telling you the gain will be to what it really is. A REM correction could be a reduction in gain. You either do a REM and know what the actual gain is, or you don’t do it, and don’t know what gain the user really gets.

The important part is the prescription curve the REM is being measured to. The curve could be low (beginner, 80%, or new) or high (the full prescription formula). Opinions vary on whether one should start with a low target or the full normal gain.

Avoiding doing REM is just a shortcut on the part of the fitter to save time, or save money if they have not bought the REM equipment in the first place.

I really appreciate the comments and we have some time to continue our education.

Thank you

You seem to think that wearing a hearing aid will “correct” your wife’s hearing much as wearing glasses “corrects” vision. Please understand that a hearing aid is an “amplifier” only. Although with newer technology they get better and better at picking WHICH frequencies to amplify - - they are still going to amplify all sound to some extent. In some cases (noisy environments) this may make understanding speech, if anything, more difficult.
I cannot recommend highly enough streaming from a cell phone over trying to hear from the cell or VOIP in normal mode. When I got my new aids 4 years ago, I thought I could hear just fine on the landline/VOIP and I would only use the cell streaming when not at home.
WRONG.
Once I experienced the streaming and how much clearer it made the speech . . . I only use the VOIP when I need my CAPTIONED phone because the other person has a strong accent!!!
Best of Luck!!

I agree that there’s little point in continuing discussion. I’ll take your word for it that that’s how you read what I said. That was not what I intended to say. I’ll have to think more carefully about my words next time. To repay the favor, you come off as saying that by all means insist on “perfect” REM regardless what his wife or the hearing aid professional have to say. Is that what you mean to say?

@MDB said:

you come off as saying that by all means insist on “perfect” REM regardless what his wife or the hearing aid professional have to say. Is that what you mean to say?

I may have misread the posts, but I did not see anything about being concerned with hurting the feelings of the user (wife) or the fitter. I just read that the fitter was 90 miles away and there was a desire to “do things right” to minimize trips back for correction.

Let me try and explain it another way. If you take your car tires in be replaced and the guy doing the work says that it is not necessary to check the tire pressures because he had been doing it for a long time and can tell by kicking the tires what the pressure is, would you let him away with it? I wouldn’t. The REM is the same thing. It is a target like a desired tire pressure, and the only accurate way to determine what you really get is to measure it. I don’t think it is optional if you want it done right.

Totally independent from that is the target that is set. That is certainly a discussion point to be settled between the user and the fitter. Some believe it should be set lower and then increased over time, while others believe it should be set at the full prescribed correction at day one. Certainly from a practical point of view if there is no initial bad reaction against the full correction in the office, it might avoid a future trip or two for adjustments over time. But, my point is that it doesn’t matter what target one sets, REM still needs to be used to verify that you get what it is supposed to be. Don’t just kick the tires, measure the pressure.

@Raudrive said:

As far as REM goes, it’s a good process but not absolutely needed.

Yup. There must be millions of happy aid owners who didn’t have REM. Whatever that number is, it’s about to go up dramatically when OTC takes off. Yet there will still be those who insist that going without is “risky,” or that the odds of the owner being happy are higher with REM. I’ve already added that and self-fitting to the list of things over the years that some folks have insisted will kill me or whatever.

@mdbee said:

Hopefully the initial set up/programming will go smooth. I have seen REM tests and have a reasonably good idea what the optimum might look like. If it appears to vary quite a bit from her audiogram, should I encourage them to “fine tune” it more?

I don’t think you have anything to worry about. Costco have high standards for fitting hearing aids, and unless you get a rogue fitter, they will do the best they can adjusting the gains using the REM process. You would probably get the most benefit by having a discussion with the fitter as to what they think the best fitting formula would be for your wife. With the Rexton there is the SmartFit proprietary option which can be set at new user or experienced. Experienced is the full gain, while New User is a temporary setting and you would have to come back to have it increased at a later date. Opinions vary on the best way to go. The other choice is to go with the NAL-NL2 formula. It also can be derated in gain by a set %. My thoughts would be to take the advice of the fitter on which formula and to what gain. But, whichever way you decide to go insist on a REM check and adjustment. It does not take that long, and they should do it without you asking. If you do not do a REM fitting you will not know what your starting point is. It is always best to start at a known and most accurate point.

We picked up the Rexton Adore Li about ten days ago. They seem to help quite a bit but of course we have no frame of reference as to how it should be.(or how to could be)

At the first fitting, I asked if the REM looked OK. The fitter said it was fine, as long the graph showed it was within a certain zone.(maybe not her exact words). I couldn’t see the screen so we took them and went home. I requested a copy of the test which I have attached. It looks to my untrained eye, the graph could be closer with some tweaking. “DR Cliff’s AuD” REM video seems to suggest it could be. Opinions? of anyone that knows?

REM video20

Thank you

I decided to go with the Rexton Adore Li for two basic reasons:

1. Rechargeability My hearing aid battery life has been totally sufficient for my needs. If I stream music or youtube, I still get a solid 17 hours of battery life, with about 10% left. If I don’t stream, I have only used about 60% maximum, with more times where I have over half the battery life left.

2. Iphone compatability I have an Iphone, so the connectivity, without having to pair and unpair becomes significant. I can use my phone as a remote mic as well, so no rogers device to purchase,

I paid about 500 CAD more than I would have paid for the KS9, but for me, the difference was worth it.