Real Ear Measurement Worth the Cost?

I am considering getting new aids as I have a lot of difficulty with speech comprehension, especially on the phone and with people with masks. I currently have Oticon OPN 1 aides and I have recently learned about REM. My current audiologist does not do REM and 3 1/2 years ago when I went to two different local audiologist to try out the Oticon aids, the one I did not purchase from was $1200 higher in price than the place where I did make my purchase.
My current audiologist just sent out a promotion for the latest Phonak aids and after doing some research, I am somewhat interested but now that I have learned about REM, I want to find out if anyone with speech comprehension issues might have had their aids reset by someone who does REM after using them without having them adjusted by someone who does not have this equipment.
I am trying to find out if it is worth the extra money as I just learned that the audiologist that charged $1200 more for my current aids, does have REM equipment and I assume that their price for the same aids that I decide to purchase will be quite higher and I would not have an issue with this if it turned out to be worthwhile.
Any inputs will be greatly appreciated.

I would say it all depends on the audi. Maybe you can do a trial from the audi that’s higher and see what you think.

My most recent audiologist in Manhattan, KS used REM to adjust my current Phonak aids. She matched the curves generated between my hearing test and the REM measurements and adjusted my aids. That visit cost $185. It was terrible! She charged me $85 to reprogram them back to the original profile.

Now in Houston, I am looking for a new audi.

I am sure that a good audiologist would do a better job.

I would kinda concur with @tim4. And bad audi that does REM but still doesn’t know how to fit you successfully afterward is not necessarily better than a good audi that doesn’t do REM but still know how to fit you successfully afterward. Having said that, a good audi usually should embrace the good practice of doing REM in the first place. So unless you have had good first hand experience with an audi already in the first place, for an unknown audi who doesn’t do REM, that should be a red flag to you.

Whether it’s worth spending $1200 to go to an audi who does REM as opposed to one who doesn’t, assuming that hypothetically speaking, they’re both equally skilled, it depends on hindsight. If the REM result shows that no or very little adjustment is needed, then it’s cheaper to forgo the REM. But you don’t get that hindsight unless you get the REM, right? So it’s a chicken and egg problem.

If an audi who doesn’t do REM is skilled enough to make adjustments to make up for the deficits that a REM test reveals (not based on the non-existent REM result, but based on listening to your complaints), then that audi may not need to do REM. But in general, it’s much easier to adjust based on REM (if any) as a starting point, than to begin with a non-REM starting point, again, assuming that the situation reveals that adjustment is needed.

Anyway, I don’t think I clearly answered your question. But then it goes to show that this is a complicated question. $1200 is a lot, however, so it’s worth understanding the issue thoroughly to help you make an informed decision.

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Pretty close to the latest KS10 aids at Costco with proper fittings and a great warranty.

Do you have a Costco near you? Costco does do REM, and there is no additional fee for this. At my Costco, there are 3 fitters; one does not use the REM equipment, though.

Thanks for your feedback. Sorry to hear that you had a bad experience with REM, but this is the kind of feedback I am looking for. Much appreciated.

Volusiano, you pretty much hit the nail on the head. I really have no way of knowing if my current audi did a good, bad or fair job adjusting my aids. The transition from the Oticon Agil aids that I had before getting the Oticon Upn aids was so dramatic for me that even if I got a poor job of setting up my aids, it would have been hard for me to tell. As my current audi speaks very clearly, it is difficult for me to tell if there is any improvement when she adjusts my aids on my yearly visit.
Because of the virus, the volunteer work that I do has turned to using the phone a lot and now it has become a real problem for me with understanding people while using the phone.
Thanks for taking the time to respond with your insights.

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Freedom, my last experience with Costco was a real turn off for me another volunteer I work with has been unhappy with his experience at Costco. I have done a lot of research in the past week and I see that there are a lot of happy people with a great experience at Costco, so I guess it all depends on your hearing issues and fitter.

Tim,
An ideal situation for me would be to do a trial with both audi’s at the same time so that I could compare the same aids set up with and without using REM equipment. I have read on this forum years ago of some people doing this with different aids. But I am not at peace with doing this as it seems somewhat unfair to the adui. Right now I have an appointment with my current audi because of the promotion on the Phonak’s that she sent me. In my research of the Phonak aids is when I first read about REM. Almost all of what I read so far about REM, makes it sound like this is a must so I decided to post on this forum to get some insight into REM.
Thanks for your feedback.

Even though REM is one of the best practices that should be done, even some audis who have the REM equipment may choose not to do them. I don’t know if it’s out of laziness, time efficiency, or strategy. But that is what happened with my audi. When I got fitted with my OPN 1 by her, I didn’t know anything about REM, but later when I learned about REM, I realized that she didn’t do REM for me. So I asked her why she didn’t do REM for me and she said that she has the REM equipment, but if she was successful with a patient right away easily, then she would not do REM because it’s been her experience that many modern HAs are “up to snuff” right away and often don’t underperform. I guess it’s her way of saying that she used to do REM before but found that most of the times, adjustments were not necessary so she stopped doing it. If she has a lot of issues with a patient, then she would do REM next as part of verifying that the HAs are underperforming or not.

I don’t necessary buy her strategy here as it is a best practice that should be done no matter what, so I see it more of an excuse for being lazy, but it is her practice and it’s not my place to tell her what to do, unless if I had known it up front and insisted that it be done for me up front no matter what. But I didn’t know better to ask/require, and by the time I asked, it was already much later in the process and the fitting was successful done already.

I guess I could have still insisted to ask her do REM for me in the end, but by that time I was already well into doing my own programming of the OPN 1 and I was already happy with my own tweaks and really didn’t want to use her programming service anymore, except for repair or warranty service.

My brother got fitted at Costco with the KS8 and he said they did REM for him, but he added that it seemed like a very perfunctory task that they did just for the sake of getting it done. They didn’t mention that they found anything significant from the REM result that requires adjustment worth mentioning to him. Before my OPN 1 with this audi, I used to be fitted with HAs from Costco (at least 3 or 4 generations worth), and now that I know what REM is, I think they did do REM for me, but never once did they mention anything to me about finding significant discrepancy from REM that required them to make adjustments to make up for the discrepancies. That’s why I didn’t even know what REM was even though it was done several times at Costco for me.

I think the awareness of REM was raised a lot more recently by audis like Dr. Cliff on YouTube, so it became a bigger issue to consider nowadays. But even for a seasoned HA wearer like myself, I didn’t even know what REM was until maybe 3 years ago, when I started looking into doing my own programming.

I am new to hearing aids but am happy to say that my audi did perform REM on my and so far it seems amazing how quickly I am transitioning into them. I have been using the Phonak Paradise P70’s for a week and already I feel like I rarely notice them until I take them off then it suddenly is very clear how useful they are. Not sure how useful this info is but after this experience I can say I really wouldn’t want to go without REM based on some of the feedback here.

Well Volusiano you are certainly way ahead of me in your knowledge of REM and whether or not it is important in getting a “proper fitting”. I actually first learned about REM from watching one of Dr. Cliff’s YouTube videos on the Phonak aids that my audi is currently doing demo’s on and it seems like the skill of the audi in using this equipment is what determines the success of the outcome. I had to laugh to myself when reading about your doing your own programming on your OPN 1 aides as I purchased my Agil Pro aids from a fitter that was not an Oticon dealer but he had a connection at Oticon and they did a remote session to set up me aids and do any adjustments. I was amazed when the woman at Oticon told me how many hours a day I had the aids powered up and how many hours a day the aids spent in “quiet” time. So I leaned that this new generation of aids caught a lot of people who claimed that they wore their aids a lot longer then they actually did. So don’t try to BS your fitter with false claims about how many hours a day you wear your aids.
I became friends with this audi and he gave me a link to download the Oticon software and lent me the cables and the box (I don’t recall the name of this device, but I recall that cost about $650) and I started to play around making changes to my aids and I ended up making them worse and finally stopped playing around with them.
Well I am glad that I posted my question on this forum as my plan now is to follow through with my appointment with my current audi and do a trial with whatever aids she suggests for my hearing issue.
As I just had my second dose of the vaccine, I have a third week in April appointment with my audi.
Thanks again for taking the time to share your insights with me as they are greatly appreciated.

$650 is a bit too much for the hardware interface to do self programming. I’m assuming that he loaned you the HiPro since you mentioned the cables. The HiPro is the pro’s version, so that’s probably why it’s so expensive. You can get the miniPro which is the after market clone version for much less, maybe around $150. But the device to get nowadays if you think about upgrading to the Oticon More is the NoahLink Wireless (but it works for the OPN as well). They run for around $180 on Amazon. It works with the Phonak Audeo B Direct and Marvel so it’ll probably work with the Paradise as well.

The trick to experimenting with DIY programming is to save your starting point as a baseline in case you make things worse, then you can just restore to this baseline to branch out to a different path. As long as you save different good points along the way to revert back to, then you don’t have to worry about messing up.

Glad I found this post, was just looking into getting a REM as well. Watched a bunch of videos on youtube and wasn’t sure if it’s some sort of pseudo-science… but seems to be the general trend people are pushing for these days, the costco near me doesn’t have REM though, is it a common practice?

From what I’ve heard and seen so far, it’s common practice for most Costco places to do REM than not do REM. Outside of Costco, it should be common practice but apparently it’s not common enough that it would/should be done without saying.

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Most audiologists do not do REM. I did find one audiologist at a local hospital for 250 dollars. Dr. Cliff has a search list on his website for audiologists that does best practice similar to Dr. Cliff. You might find one that does REM in your area or nearby. Call that audiologist for a REM quote.

And if you let them know your in the market for new hearing aids and a audi that does REM, since your current audi does not, they might be quite responsible on their price. Let them do the REM fitting on one of the lesser used programs on the OPNs, then you could compare the REM fitting to the non REM.

I just had an audiologist say she does a type of REM that does not require the use of probes. Is this legit?

No.

…Oh my god, the forum is mad at me for not writing a complete sentence and will not let me post the simple answer to your question without all this.

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