Audiologists' experience with programming hearing aids

I’ve always felt a good audiologist earns his/her stripes if he/she has “hands on experience” dealing with various types of HA software. I’ve also felt good hearing aid dealers/suppliers are ones that offer several different HA brands to try. Not just one specific brand or two. People with hearing loss need choices and you can’t get that if limited to one brand of hearing aid.

General question though. Can you expect an audiologist who has never tested a specific HA software, to do it right the first time when programming a HA for a new patient? I have no idea if all aid software programming is similar in fashion and straight forward in practice. Or if software programming varies widely from one HA brand to another.

Certainly you want an experienced audiologist adjusting your aids be they new or used. But I’m just curious when an audiologist comes across “new HA software” or for that matter a “new HA”, should the HA user expect everything done “right” the first time, as far a programming/setting up aid for trial use. With the understanding there will be more changes made during return visits. Or is there going to be a learning curve for the Audi to go through since she/he has never worked with such software before.

Art vs Science. Art lost, Science won.

Ive been wearing HAs for 20 years, playing piano for 60 years. Watched the transition from great piano tuners with great ears to ones who now come over with little tuning machines and watch the screens. By the time I started wearing HAs, it was all looking at the screens. Years ago I could never have tuned my own piano, now with a good tuning machine I can. It is even easier to adjust my own HAs. If I had the right equipment, I could probably do REM at home.

Sure, there is always a learning curve. But today, it isn’t very steep.

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I wouldn’t expect everything done “right” the first time even with an experienced audiologist programming a hearing aid with which they’re very familiar. There are going to be multiple features that the audiologist won’t be aware of if using programming software unfamiliar to them.

If audi doesn’t use real ear measurement for verification, then you’ll mostly rely on the phrase ‘how do you hear me now’.

With REM, process from putting on aids to getting decent sound is like 30 minutes. Then some for fine tuning that first fit. Of course I have to go back even though I plan tuning them on my own. If I hadn’t experienced REM, I would just buy aids and try to fit them using various sounds and not sound proof office and ‘how does this sound’.

First ha to get decent sound but not great understanding, took around 2 months and once or twice a week for few hours (in the beginning) to get things out if them.

Same ha, another fitter wanted to do, after 4 or 5 visits I said to him to give me back my old setup. I don’t have nerves anymore. That’s why I decided for self fitting and in the last second I found someone who does REM.

First fit, autosense on marvels, and for the first time in my life I could understand my hubby who was walking on my right side, in the decently busy parking garage.
So yeah, I’m definitely vouching for REM now, after I’ve seen it in action.

So, prepare A LOT of patience and notes if fitter uses only manufacturer defaults and ‘how do you hear me now’ technique. And demand visits and adjustments.

With REM one, also demand adjustments, it’s just that decently working one you should be able to get from first fit.

And taking that into the consideration, if you don’t have HA fitted to you properly (eg that you get speech understanding through them), how on earth could we compare two aids, if both are fitted poorly? I have strong assumption now that I got some maybe even intentionally bad fits on some aids to ‘help’ me decide for another aids where they’ve put more effort.

And lastly, yes, you want fitter who regularly fits people with that brand and is up to date with fitting sw and HAs features. Errors and forgetting can happen even to those with practice, so those without it, are in risk of making more.

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I am still a baby hearing aid wearer in all this so caveat appropriately…

I don’t find REM as anything more useful than the baseline to start from. It’s the verification that the hearing aid is putting out sound in accordance with the software generated prescription based on the patient’s audiogram, in the patient’s particular ears. It’s got absolutely nothing to do with how the sound, well, sounds to the patient. It might be too quiet, it might be too loud, might be too much low frequency, etc. etc. You then start taking the patient’s experience into account. If you didn’t do that, you’d never need more than one annual visit (and your experience would be demonstrably worse). We don’t have a lot of folks who are satisfied DIYers around here for no reason after all.

It’s like putting your car on a dyno. You know how much power it’s supposed to put out, you now have a baseline for how much it is putting out, and now you can tune it to put out what you want.

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It is baseline, however miles more better than manufacturers defaults, in my experience.

And believe it or not, I was once told that any adjustment she’s making is out of her good will, because manufacturers say their program is the best, and she shouldn’t spend time on adjustments. Oh and they wanted double the price than the guy ‘how do you hear me now’ with a lot of patience and time for tweaking. Today I know both aren’t good fitters I want.

So, just because someone is working somewhere for years, with some sw that doesn’t mean they have a clue. So, I’d rely on reviews and those which mention how exactly they’re fitting, like not ‘he’s nice guy’ but ‘now I can understand speech at this situation’ or similar with which you can relate.

Of course, this goes mostly to original poster :slight_smile:

I think fitters who invest money in REM equipment are more invested in using it well and learning more about hearing aid fitting and reducing time spent on adjustments just to get good baseline.

phobos512,
I agree with you regarding REM. It is useful, but not conclusive. In my case, aids adjusted by REM to my prescriptive loss as determined by fitting software are not wearable. I am very sensitive to loud sounds, and aids set up with REM are just too loud for me to wear. No audiologist I have seen seems to get this. As a result, I don’t wear aids.

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Have you looked into frequency lowering?

Yes, frequency lowering is about the only thing that has helped. It seems to work fairly well for things like TV viewing, but not for human voices in conversations. Especially in noise.

I don’t know if this is even possible - can there be a program set up with lowering frequency - just for TV?

Yes you can make a custom program.