Stuff we have to go through to get new Sphere ultra's programmed the right way

Continuing the discussion from When will the Phonak Ultra’s be able to order:

Curious how Phonak Sphere users like the new 2.0 software. Please share.

On my 3rd programming visit my provider and I get on a call with the second Phonak audiologist to try and set up the Manual Deepsonic voice in loud noise program because not many providers know what to do, nor do many of the 25 Phnak audiologists they provide to our providers. When I go to that program I am expecting to be locked in to forward facing voices with not much else to hear but clear voice. This past visit we made progress, but some settings and volume topped out. It turns out because i have a unusual smaller left ear canal Phonak recommended my vented slip-ups be in a custom mold shell because attenuation was a concern. Reason for some of the problems is Phonak shipped the Sphere Ultra’s with the wrong receivers in the shell. I needed a P and got something weaker. So another three weeks lost, then I go back and get the remade customs with the correct receivers and must see how current settings and feastures work with correct power. I am a power user at 105% with moderate loss. I will contact Phonak again to assure that a senior programmer with Complex programming experience is on our call. These devices are amazing, it would just be nice to walk out of the providers office one of these visits knowing I am set up the right way. So hearing fatigue and frustration, you betcha. Phonak needs to do a better job training providers and providing clinical services/ audiologists with real world complex program experience that actually help us. They should be embarrassed, but I think $ is always first like every other manufacturer. The Ultra’s are great, but still waiting for my very loud restaurant ah ha moment. On we go for meeting no 4.

There’s often communication problems that lead to more visits and remakes. The patient does not always know when to be insistent. Audiologists rely on Phonak to make the molds correctly but Phonak can make the wrong choice if given any wiggle room. Some patients could benefit from different configurations and trial and error is needed. Phonak does not offer every configuration. Then there are fit issues stemming from how the impressions and/or molds are made. One can see why domes are easier from the audiology business perspective as there are fewer variables.

Can you explain the custom program in more detail? You want spheric to be front facing only?

For anyone newer to this (and to answer TonyF’s question more plainly):

REM = Real Ear Measurement — microphones are placed in the ear canal to verify the hearing aid is actually delivering the prescribed sound levels at the eardrum, rather than relying only on software targets.

Coupling refers to how the aid physically connects to your ear — domes vs molds, venting, tubing, and receiver strength all change the acoustics, which is why switching to a more powerful receiver or different mold usually requires reprogramming and verification.

In most cases the fitter can start from your existing settings and then adjust for the new hardware rather than rebuilding from scratch, but REM is the best way to confirm everything still matches targets after the change.

Forums like this work best when people who’ve been around a while translate the jargon for those still learning — most of us started out asking exactly these kinds of questions.