Your Audiologist is Wrong: Real Ear Measurements are ESSENTIAL for Your Hearing Aids to Work Well

@tenkan said:

too bad REM can’t actually “hear” what I hear or what the brain is processing.

My thoughts too.

I can’t get my Audiologist to perform REM, because I’m my own Audiologist, and won’t spend thousands to buy the kit (or know what to do with it). I’m happy with Phonak’s Audiogram Direct, as that definitely creates a link to the actual hearing aids performance, as it uses the hearing aids speakers to re-measure your loss.

Interesting thread though

This discussion has become extremely interesting. I had not realised that there were so many variables involved even in just getting REM done. I had naively thought it was as simple as sticking that needle into the ear and it uses sound waves to measure what your ears receive! Very interesting the last dozen or so posts.

One thing that I would add - to all those in the forum who are audiologists. Give your customers the opportunity to try out different hearing profiles like NAL-NL2 etc, instead of sticking with the default hearing aid sound profile. In my case (and I believe in many others), it makes a massive difference. I wore my previous oticon hearing aids for about 7 years with the Vac+ profile. It seems such a waste of years, when I think that most of the problems I had with the previous aids could have been resolved if the previous audio had the wit to try me out with NAL-NL2.

Thankfully I will get to enjoy many years with my new aids that I have just bought with NAL-NL2 and in the very near future, I will be going for that REM and the Word speech recognition tests that the other audio offers and hopefully walk out wowed!

Don’t discount the value in asking your customers to try out different sound profiles and see which one they prefer. It really does make a difference.

I don’t know why Vac+ doesn’t work for me, especially as I seem to be the only one that suffers from a volume/sharpness mismatch between the two ears using Vac+, but with NAL-NL2 this problem has completely disappeared and I can now hear in the car!

Another benefit is finally much easier changing gains for much Roger program yesterday (in Paradise 90-RT, I still don’t have licence in my Sphere due to having RogerOn V1 non-In).

I would never have thought that even 1-2 “dB” in the 1-1.4 kHz range could make such a difference between comfort and audibility.

Without REM I wasted about 2 hours setting up a month ago, without much success. I say that despite having to increase the lows, 860-1k7, and then 1-1k4. There was much less guesswork, though.

@Roberto said:

Don’t discount the value in asking your customers to try out different sound profiles and see which one they prefer. It really does make a difference.

Sadly, I find one profile helps me best with speech (Adaptive Phonak Digital 2.0), and another better with Music/Streaming (DSLv5 Adult). I’ve manually made a compromise music programme with APD2. Unfortunately, I get upwards masking with speech whilst in these programnes.

To me, all these fitting programmes are a compromise, which may work perfectly for some. They certainly don’t work for me.

Hello, good morning. I’m going to try the Phillips 9050 in a week, and I see on HearSuite that it comes with NAL-NL2, firt4, and DSL5. Will the firt4 be Philips’ own?

Yes all manufacturers have their own proprietary fitting formula’s, will these be your first HAs?

No, now I wear Signia In-Ear headphones. I’ve always used ITCs, but I’ve never been happy with them. I only used the first one, because my hearing was better. I work with voice-guided pickups, and the In-Ear headphones were better than the RICs, but worse for positioning the headphones.

Yeah, before I was fitted I asked the fitter at Costco if he would do REM, and yes it was SOP (standard). He’s been fitter there for 7 years and 3 as head of the department. Myself, I do notice a difference in my ears. My Rexton Reach, a few seconds after turning them on in the morning (automatic as I remove them from charger) they play a melody. The left one sounds louder than the right and it sounds like the fidelity is a lot better. My audiologist told me that the left is only slightly better, it looks almost the same on the chart (you can see that in my audiogram posted here).

An odd thing happened. I was sick in August and my oral thermometers produced beeps. I couldn’t hear them even with my HAs in except when I used my Music Program, which I’d had them tweak up a couple times in the high treble. I installed a utility on my Pixel 8 that showed me that the beeps were around 6300 hz. I asked my fitter at Costco if he could tweak my Automatic program so I could hear that and he said if he did it would badly impact my ability to hear conversation, it would be too shrill. He was emphatic so I said OK.

That’s probably not why the beeps are inaudible. At that kind of frequency your feedback manager is almost always going to assume that they are feedback peaks and cancel them down before they become audible to you: however loud your aid is tuned up.

The music program, which does reveal the 6k beeps distinctly, sounds wonderful with percussion instruments particularly. And it most certainly does provide the 6300 hz beeps. But it doesn’t sound so great in lower frequencies as the automatic program generally speaking and even for music I think. I don’t have firm ideas about it.

I just don’t know if boosting the highs above, say, 5k would be something I’d like for the automatic. Fitter said don’t do it, I took his word for it. If I don’t think about it it doesn’t bother me. TBH, I listen to music from my stereos and it sounds fine to me even if I don’t have my HAs in. I don’t even know sometimes. If I thought to myself, “do I have my HAs in” I probably would realize if I don’t though.

It hasn’t been long since I went to the ENT doctor, but I asked the audiologist not long ago and he told me that they weren’t going to recommend me because with my good ear I understood 80% of the words. I’m in Spain, and with hearing aids I can still get by.

@delta74 said:

they weren’t going to recommend me because with my good ear I understood 80% of the words

80% of word through the right ear or left ear separately or binaurally (both ears concurrently)?

If one ear (probably right) has WRS in quiet below 60%, it’s an indication to at least CI evaluation for getting more accurate informations about your hearing.

Just because you have 80% in better ear/binaurally doesn’t mean your worse ear isn’t eligible for CI.

Look at my audiogram - I have 90-100% in WRS in better ear, but still I was eligible for CI because of my left ear.

Many audiologist (I mean people who do fitting of hearing aids) aren’t familiar with the CI guidelines, because they aren’t experienced in that matter as CI audiologist.

I’ll make an appointment with the public health otolaryngologist and see what he says.

Not all places consider ears individually yet. It’s really only been in the last decade that I’ve seen a slow transition where I am towards implanting patients even though the other ear is still functional.