Anything Better today than REM testing?

Hearing Aids
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Just out of curiosity, and possibly to ensure that I am on the best track in DIYing.
I figured I would get a REM and possibly let them do some core fitting to compare with my own settings.

Called a well reviewed place - they say “REM testing is antiquated, only done in hospitals for children and people with SEVERE hearing loss”. Before I cross them off my short list of locals, figured I should just triple check on here that something has not come out in the last few days. Is there any other test that could measure up to a REM?

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You should ask them … there answer…" how does that sound ? " :wink:

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The next best thing is aided testing. However, you could argue that aided testing is even more “antiquated” than REM.

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Been trying to figure out your meaning GrayGhost?
How might their worded response make sense?
How does their fitted result, sound compared to … my own, or another using REM?
Could you please clarify what you meant?

When you say aided testing is the next best thing - are you saying that it is 2nd best, but even older, or are you saying it will be the NEXT THING but with older origins than REM?

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2nd best thing. Ah, the majestic ambiguity of the English language!

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Good question.
3 pairs of hearing aids.
First pair–remarkable; audiologist was exceptional. Retired
Second pair–so awful that they were dangerous. Audi sold the business
Third pair–good ha’s; audi was dangerous because his setup was awful.

Our users and posters include many that program their hearing aids themselves. Do they use REM?Don’t think so. However, I am impressed with their knowledge and skill. I wish I was in this group

As a “learning” ha user with only 20+ years of experience I think that there are simple mistakes in the way that HA’s are provided to the person that needs them. I understand that everyone’s needs are different.

How do we improve the service to the person who wears them? Me and others?

Yes I’ve had regular hearing tests. Sometimes they use REM.

I wish I heard better.

DaveL

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When fitting a hearing aid, two things should be done: verification and validation. REM is verification. If they are not doing that, ask them how they verify the fitting (other than “how does that sound” or “can you hear me now?”) In the past I have found that those who do not use REM are either to cheap to buy it or to lazy to learn how to use it properly.

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3-1/2 years ago I got new Phonak Audeo Paradise P90R hearing aids.
They were never set up right by the dispensing audiologist. We parted; they are setup better now by a new Practitioner.
It’s been 3-1/2 years! They should have been setup better when they were provided.
How could this be improved? I went a long time and couldn’t hear and communicate well.
I appreciate your comments.
I wish there was some way to contribute to change and improving service for the person who is hard of hearng.

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I did not go to school much.
My parents did not see the need to send me to school.
My father in particular, felt that most teachers don’t know more than the book.
And if I wanted to do well in school, all I have to do, is read the next chapter in the book AHEAD of class. For the most part, I have found that he was right!

Over my life and many “doctor” experiences, along with those of of friends and relatives, and the fact that a third of all my clients are in the medical profession, and in some small way I too dabble in medicine… I can say THAT for the most part, today, lives are saved by technology more than by technique. FYI - your blood work is reported on by the lab, and your doc just scans the quick overview in most cases.

You asked Dave how the outcomes could be improved. I believe this can only happen by educating the client to INSIST on better performance, more intricate and detailed tweaking, more time be spent finessing and exploring. I am not sure how to actually affect this change - practically speaking. Even if I consider very wealthy persons, who could hire a dedicated AuD - that practitioner has to care enough to keep trying. The patient has to dig deep to keep articulating problems.
In most cases, I don’t believe the instrument is actually producing anywhere near what today’s could do for the individual. I guess only by demanding better - always - along with a concerned partner in the way of a practitioner, could there be any better performance experienced anywhere close to the instrument’s capabilities.
Perhaps Ai will boost this by somehow participating on both sides of the instruments - the input, and the output sides, which would have to include the patient response characteristics.

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I appreciate you sharing.

I moved a lot my Father was in the Navy. I went to 13 schools by end of Grade 8. Two nations. So twice a year I had lots to learn. You see there was no continuity. Change Provinces or States. They had been taught different history, geography. Even different math. Frankly I thought I was stupid. I would hide so I wouldn’t be asked questions. I was small and bullied.

I loved reading.

I studied the Civil War in Maryland. Next year I studied it again. In Virginia. Two different wars!

And civil rights. Oh my. Such horrible violent times. So many lynchings.

I enjoyed 4 years in the States. But hated that people were treated so

Canadians are a smug lot. Maritimers are so poor. So many unemployed.

I’m a visual person. I’ve seen such beauty in the US and Canada.

My hearing is getting worse and worse. My first Audi was a hero of mine Perfect experience.

It’s hard to find an expert. They sell so many makes and models of hearing aids. And everyone has different needs.

Today I had two men come to fix my sprinkler system. I couldn’t understand them. We were outside. I had to be less than 5 feet away.

And I thought my hearing aids were better. I don’t know what program they were in. I didn’t think to go inside to get my phone and turn on. The APP

I read about AirPods 2 pro. Over the counter hearing aids. Built in hearing test. Adjust them yourself. But my hearing is too bad

I’ve worked hard to advocate for myself. Makes me so tired. And stressed.

DaveL

Edit

Changed both Cerustop wax guards. It’s a victory!

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I mean, don’t just cross them off your list for not doing REM, cross them off for lying.

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Exactly 100% why I posted the question. Because so often prospects are criticized for not going to a pro. For considering any NON pro alternative, like I am now DIYing, after decades as a patient. Got to tell you, that when my hearing was 30dB better across the board, I generally felt less satisfied with the AuD tweaks after a session, than the improvement I am experiencing week to week as I creep in on adjustments myself, based on my own experiences.

SO anyway, I just figured, it might be a prudent investment to give REM a chance again so I can KNOW that I am not missing out. Last time I went for the REM, with an AuD, where I had an appointment for REM, with my instruments, I get there and find that their REM machine was not working. Get this - it had not worked for months!!! And eventually, they decided, that it in fact was not needed in that location… so they moved it to another of their offices. What that tells me is either:
A] No one at this location cared enough or was competent enough to master it’s use.
B] They figure the people in this particular community ( their office’s, not mine) were undeserving of it.
OR C] That it really makes little difference.

This time, I have someone call around,… to set me up for an appointment and she comes back to me, with their comment that REM is antiquated. Thus my post!

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Hey, I can relate to that. BUT - which is more of an impediment Dave - diminished hearing, or diminished THINKING? Now you told them I am sure that you had poor hearing. That the noise made it more difficult, and maybe even, that you did not have your app, to adjust your aids, which no doubt were auto switching into less than the ideal settings.
YET they could not speak slower, clearer, and closer - why was that?
If a person moves from 5 feet, to 2.5 feet, you know they get FOUR times as loud - right? And at ten feet they are 1/4 as loud as at 5 feet. As they were speaking to you, were they rotating their heads all about, or were they aiming their voice directly to you?
Did they not have the mental capacity to s p e a k s l o w e r ?
Don’t feel bad.
You could get in the habit of having a clip board, for such situations.
Most landscaping vendors speak poor English.
Clipboard improves misunderstandings and forces performance of what was agreed.
Cupping your ear, makes a big difference too.

Now I have a technical question for you - is it better to have two men to fix one sprinkler or one man who works on two sprinklers? :grinning:

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Father and Son.

Actually 1 man!

I went inside and back to work at home. It bothered me.

So I wondered what had gone wrong with hearing aids.

I was due for a wax filter change. Successfully changed both. Later tonight I was still having issues. Checked. I had pushed a receiver a tiny bit out So I pushed each receiver into the slimtips.

I’m getting frustrated. At least I’ve found I can change the waxguards ona stick. I believe that they help a lot. I think I’ll get to increasing volume.

I’ve called the sprinkler guys back. One head sprays but it’s stuck in place. System is old. They didn’t install it

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I hate that it is such a struggle for patients to find clinicians who are skilled at using REM to optimize fittings. It’s also just bizarre to hear this over and over again on these forums because I came straight out of school and went into a practice where it had always been done since the practice opened in 1998 and have been doing it myself day in day out, multiple times a day, for the last decade. So I’ve never been in a situation where it hasn’t been used and it has never seemed like something that is unimportant, difficult, or dramatically time consuming. It is also constantly useful. It does take some skill, so I can sort of see how it might be difficult for a clinician out on their own with no mentors to support troubleshooting to develop those skills. But it is also preferred practice and any ethical audiologist should be going out of their way to develop these skills.

I don’t know the secret to finding the clinicians who are good at it. Audiologists who do pediatrics have to do it, so they should have some skill. (If people are fitting pediatrics without good REM skills, they should have their licenses stripped.) Costco requires it and while I have absolutely seen Costco fits where the clinician has “completed” it but not used it, you would think that if these people are doing it over and over again just out of requirement they would eventually develop some level of sheer pattern recognition that should support skill growth. You’d think. Eventually. Audiologists connected to a good audiology school program are probably skilled at it.

I saw a patient today who had been fit with hearing aids at another clinic. This patient was not in a position to communicate or advocate for themselves, but their care giver had noticed changes a while ago in responsiveness and was concerned about whether it was hearing or cognition (everyone else, including the other clinician, had attributed it to a decline in cognition). The premium level hearing aids were providing about 4% audibility. FOUR PERCENT. On a hearing loss that can probably support at least 75%. They weren’t broken. A couple of simple errors had been made in the fitting that are causing the problem. Errors that anyone could have made but that would ALWAYS have been caught with REM.

This isn’t really at all relevant to your situation, I’m just still pretty angry about it and so I’m venting.

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By all means… Neville, Please keep venting!

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@Neville

You are extraordinary and can vent. I’d walk on glass barefoot to be a client at your clinic.

Recall I work for the second largest school board in Canada. My treatment improved way back when I found the person who helped young young children who were hard of hearing or deaf.

She recommended an absolutely skilled and perfect audiologist and I was in her care. She sold her business (as she should) and that sale flipped or became Listen Up Canada. wikipedia used to have a great description of that person who owned Listen Up (IIRC) and some mattress company. It’s gone because it was shocking. 4 years in LK’s wonderful care. Used REM.

My second audi I found the same way. A partnership. The good principal retired. I took so much time the other principal would let me see soon-to-be graduates or new graduates from UWO. 8 years in their care. Used REM

I asked again and the fellow recommended to me was the most polite and he was in his late 50’s. He treated little ones. Yet although he used REM I couldn’t hear. When I moved on I asked and there were two small mistakes in his settings. my HA’s didn’t work. HE used REM. Until the last appointment when he erased them and did a first fit.

Your patient is extremely lucky. I’ve had that experience. Two clinics. 8 years for PA; 1-1/2 with CVA.

I’ve had the same issue as your patient. Cognition? I participated in a board group for people with disabilities. They wouldn’t use my info because I would be identified. The harassments and criticism goes on today.

My late Sister was Chief Commissioner of Canadian Human Rights. I know from what she taught me that your patient, and I, should have been treated better.

In my view, “$h{t happens”…

10 years ago I connected with a brand new employee who saw my hearing aids and the dongle I had hanging on it’s antenna, resting on my chest. 3 months ago she spent $3,500 on her hearing aids. She doesn’t wear them. It makes me so sad.

In the worst cases our “medical equipment” is sold like chiclets, or perhaps cars. Volume of Sales! Profit!
In the best cases the patient finds someone such as you.

We who are HOH are all on this “Bell Curve” of hearing aid sales. We don’t know if we’ve found the worst, or best performer until we buy our hearing aids. And it’s no easier/may be worse when we buy replacement hearing aids.

They ain’t medical equipment when they’re sold by the worst.

DaveL
Mississauga

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My regret…I don’t wish to vent. When I don’t give details here, I’m asked and have to explain. I don’t want to be negative. I wish there was a way on this forum I could put a link and explain…because there are answers somewhere in my experience. I come here looking for buddha to prevent suffering. Yet he/she is hard to find.