Sorry for all the questions, but I am trying to get my head around the fitting step of the KS8 HAs that I have on order. My understanding is that there are various fitting formulas to set up a HA, with NAL-NA2 being one of the standard generic ones? And the alternative may be a Kirkland-Rexton-Siemens specific model set up method? Does it not make sense to use a fitting method that is specific to the hearing aid rather than one that is generic?
Depends on the fitter, but they will likely use SmartFit instead of NAL-NL2 even though when they do REM it’s based on NAL-NL2. The key thing is that they do REM and be “close.” Unfortunately in my experience, their definition of “close” is pretty loose. The “problem” with manufacturer’s fitting formulas is that there’s no real standard to compare to. You can find arguments for both ways though. To the more credible ones side with using NAL-NL2 (or DSL-5), but search on the forums and via Google and see what you think. And to answer your title question-- yes, they use Connexx 8.
Thanks for the info. Perhaps I will just ask her what she is using and if it is the best option. From what I can see they are using Otosuite software to connect their equipment too. I gather it supports Connexx 8 as well as other software. They seem to be using Aurical Freefit for the REM process.
I have not found a Connexx fitting guide which is up to date and uses the Rexton terminology that Kirkland uses also. I found this document which seems to be using the same hardware for a product line in Germany.
Would the overall process described on page 38 (and in more detail on pages 42-47) of this document with three steps be representative of what I should expect out of Costco?
Level 1: First Fit
Level 2: Basic Tuning (AudioScout)
Level 3: Fine Tuning
Would it be normal to do the critical gain test before the first fit?
Or, is there a better document more applicable to the Connexx used for the KS8?
I think every manufacturer has their version of the fitting formula and they are probably based on NL2. But, none of that is something you need to worry about or even ask about at this point. The time you get for your initial adjustments should be spent on real issues “on the ground” to help you hear better, in my opinion.
If you sidetrack the pro on other issues it will take away time for your detail adjustments. Later, if there is an unsolvable issue that you think, in your research, might be helped by a change of fitting formula, you could bring it up then.
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I say kudos to Sierra for all the research and learning they’re doing so as to know what to expect and what to look for.
But Don nails it. Let them do their business. The whole point of this adventure is to hear speech. Music, phones, telecoils etc all secondary. What brought us all here is speech.
When that is still not satisfactory (and it’ll never be perfect) then go into all these details with the fitter.
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I second this. If you really want a feel for how Connexx is used, listen to Audiology online videos on using Connexx 7. Out of date, but useful. You can find different recommendations on critical gain from yes, always run it to only run it if you have feedback issues. I truly don’t know which approach is best. But ultimately, sit back and enjoy the ride.
Just to be clear I am not going to tell the technician how to do her job. I just want to be informed enough to know she is doing a good job, and be able to make the correct decisions in real time. It seems to me there will be a point where it will have to be decided whether or not vented click sleeves are suitable. And I also want to be sure that she is not skipping any necessary steps to ensure the best fit. Kind of the way I have it figured at this point is that the vented sleeves will be tried first, and if they are suitable from a feedback point of view then the final adjustments will be made with the REM process?
I think you will like the vented click-sleeves. They were comfortable to me and stayed in better than click-domes. And no occlusion.
They are different than any other domes I’ve tried for this reason; there is a specific orientation. They have to face a certain way and I’ve forgotten, so don’t quote me, but I think the dot faces forward. My pro had no idea and for the first few times I just stuck them in like domes, without regard as to the orientation.
If I remember, the diagram on the back of the pack was not really clear and it took some trial and error to get what the diagram was telling me.
I suspect the vented click sleeves will work well for my right ear, but may be a problem with my left ear. If that turns out to be the case, is using a non vented click sleeve in my left ear and a vented click sleeve in my right ear an option? I’m thinking the software may only allow for one selection of the dome/sleeve type for both ears? Or, is it by ear?
On the orientation the Signia backgrounder document on the sleeves says:
"For best results, connect the Click Sleeve to the receiver
so that the oval shape of the sleeve is “standing up” when
seated in the ear canal. It is also important to instruct the
patient regarding the proper orientation of the sleeve
when inserting the hearing aids."
I’m thinking this means the oval should sit taller and less wide in the ear canal? But, this must be an individual ear thing to some degree.
You can pick any sleeve, dome or mold you want for each ear. When it gets into custom molds you can even select the venting. Have you checked out the DIY section and taken a look at the Connexx software? (Search PVC, click on avatar and read the links associated with him)
No, not yet, but I will. I watched one video and while it was helpful it was a bit too basic. Is using one vented and one non vented sleeve a reasonable thing to try?
Listen to you! Been here less than a month and already things are sounding basic to you. 
Well, I would say I am not there yet. The video I watched was so basic they showed how to enter somebody’s name, e-mail, and phone number…
Edit: I watched part of it again. Yes, I guess he was just doing a demo for the right ear, so I presume if he did the left ear, it could be fitted differently.
Yes, it’s reasonable to try one of each.
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Yes, oval should be vertical, taller rather than wider. But also, the oval has an orientation of front or back. I think there is a dot and the dot should face forward instead of backward (I think, can’t really remember). The first ones I got swiveled easily but the second batch did not swivel easy, which was actually better. So if your right hand was holding the right click-sleeve, oval up, so you are gripping the thin portion of the oval, with your thumb and index (almost the same look as if gripping a cup of tea), right at your right ear, the dot would be under your index.
Do KS8 click-sleeve wearers agree with that?
The oval is not exactly symmetrical so I guess that’s the reason for the front/back orientation.
Thanks for that tip. I will try to remember to get the technician to show me the dot and how it should face.
OK, so I downloaded the Connexx 8 fitting software and blundered around in it a bit. I got these two fitting graphs SmartFit and NAL-NL2 and vented sleeves in both ears. But, what does it mean? If the fitting curve goes into the gray area is that bad? Closed sleeves seems to make it worse… How far can I go in simulation mode with the software?
