Hi Dr. Cliff. I did go to your HearingUp website and found one of your providers (since my ENT doctor and audiologist did not offer a Real Ear Measurement (REM)). I sent an email to the HearingUp provider requesting a REM. They replied and scheduled an appointment for me to come to get the REM. I brought my recent Hearing Test and hearing aids to the appointment. The specialist was very helpful and explained each step in the process. He checked my ears for earwax to help ensure a good REM. He spent over 1.5 hours with me performing the REM, fine-tuning the settings to maximize the hearing aid performance. I do go to my ENT annually to get a Hearing Test, and my hearing test results show moderate hearing loss and Tinnitus in both ears that have been stable for several years now. I am now very pleased with the results and my hearing aids now work the best they have ever been. I’m very grateful for you and your many videos and helpful hearing information. Many thanks !!! 😊
Dear Dr. Cliff - Well done! I do hear a bit of frustration on your part, however. Understood. To my knowledge, I published the first REAR and RESR probe-tube measurements against ear canal SPL targets in a 1987 article. If you are feeling frustrated, imagine how I must feel!
My experience with hearing tests is they don't give much information to the patient about what's being done. During my most recent test, the hearing aid specialist said he did Real Ear Measurements, but I didn't know what that meant and how it affected the result. Perhaps testers don't say much because they don't want to bore patients with technical information, but for those who are interested it would be nice to be educated.
I recently jumped into a new clinic, and found myself doing cleanup with dozens of clients from the last two years, where the previous clinician preferred to only do SREM (started to do it during COVID, didn't stop doing it after COVID became less of an issue). I personally always do WRECD and REMs, with targets bang on, up to 4k-5k. Your video on the importance of verification measures being done correctly is what drives me to always do it, every time, even if the appointment is just a reassessment and adjustment! Combining fantastic REMs with adjustments based on client feedback on what they're experiencing, has been a solid recipe for success, for me.
The one problem with the REM is that the target isn’t always the correct or ideal fitting.. it’s only just a set point for a given target.. Its what people think it should be but its not always the case. There are many software settings that can be used to match target but it doesn’t always mean it’s correct
There is such a wide range of abilities when selecting a provider to work with in your hearing loss journey. I don’t know if my journey is unique but finding a qualified provider that i could work with took 6 months and I started my homework at least 6 months before that. I reviewed my insurance, stand alone hearing insurance coverage and shopped for price ranges. I watched TH-cam videos. I listed out the pros and cons of each brand of hearing device. I programmed my airpod pros so i would have something to assist me until i could find a provider. It was difficult getting an appointment as most providers were scheduled 6 weeks out.. I brought what I thought were pertinent documents to my appointments. The first two appointments were not what I expected. The visits was no way comprehensive and i felt like i could talk my way into whatever device I thought i needed without the benefit of the provider’s experience. I then checked the Hearing Up network and found Dr.Frink. He was everything i had hoped for as far as being knowledgeable, personable,loved his job and was someone I thought i could work with longterm. I am not an easy person to work with. I ask a lot of questions and not computer savvy. I mess up every electronic device I touch. I was given a thorough examination and explanation of what to expect. I’m happy to have found Scot Frink in your network and hope to continue working with him in the foreseeable future.
Why and how real ear measurements are so important compared to open field tests (i.e.: test using speakers while wearing your hearing aids in an acoustic cabin). At the end of the day, it's not about decibels in your ear, it's about your brain interpretation of the acoustic signal.
My audiologist said he doesn’t want to use REM because it involves loud sounds and he doesn’t want to risk making my tinnitus worse (it is already very bad and causes me a lot of distress). Is this reasonable? They are definitely a reputable company
The errors you describe essentially constitute malpractice. I would like to hear an AuD explain on the witness stand why he/she didn't provide the full and correct treatment for the patient.
But, Dr. Cliff, the Audi disappears into another room and how do we know if they auto-tune the prescription (instead of customization) or apply the REM at all?
I asked for REM for my bernafon zerena 9 HAs and she said REM is part of the Bernafon setup program and showed me some soud graphing that looks similar to what you show in your videos. Is she really doing REM?
Hi dr. Cliff, here a question from the Netherlands. Here in my company it is common practice to perform REM measurement. But do you prefer a measurement with the software from the hearing aid manufacturer or a stand alone application ? Thanks in advance.
hello can you share your company or center name and is it located in Amsterdam? I desperately searched for a center in my country and near countries for REM but it is not available.
Hello, nice vid, ty for sharing. A quick question: After 8 years of using hearing aids, i changed them and tried out a new pair during 40 days. This new pair made my tinnitus increase a lot. I stop using them and returned them, and back to my old ones. After 8 months i'm better, and the tinnitus had been decreasing again over time. But why the hearing aids I tried greatly increased my tinnitus?
Well the 2nd time I went to the VA Hospital 14 months after getting my Phonak the audiologist noticed my hearing aids was off a little and made the adjustment so I hope this July when i go for testing and get the upgrade the make the adjustment the 1st time I hope
The only analog hearingaid i fit is Lyric. And well i think her is rem Not the way to go... First of all, the remaining volumen of the earcanal is so small that the messuring tube lead to a massive problem in accuracy. And lyric is not interfering with the Natural reug
I just got fitted for my Oticon real 1 hearing aid. My Audiologist used the measurements against my 15 yr old Analong aid. I find that distortions has always been a problem in these digital aid and end up suffering with my analong aid all over again. I hope the Oticon Real 1 will be a deal breaker for me. My question is. How can the real ear measurements be accurate using a very old analong aid verses the digital ones? Aren't they built differently?
Hello, Canadian hearing instrument specialist here! What REM does is measure the way the sound from a hearing aid is behaving inside YOUR ear canal vs what the programming software estimates for the average 2 cubic centimetre adult ear canal and is a standardized process no matter the make, model, style, or age of the hearing aid. Factors like the canal volume, shape, and resonance are unique to each ear and can affect the way sound pressure hits the eardrum, so we need to verify that the amplification you are receiving at each frequency is actually meeting your hearing loss targets and giving you maximum benefit in terms of gain and output. In a nutshell, REM is measuring the amplified sound in your ear, not necessarily the hearing aid function or sound quality. If you have concerns with distortion, ask your provider to run a HIT test or electroacoustic analysis on the devices and compare the findings against ANSI specifications for that hearing aid to identify or rule out noise artifacts in the device itself. Hope this helps!
Hi Dr Cliff - following on from your recent Australia trip when do you believe you might have some practitioners in Australia (particularly Tasmania) that follow your principals? Or am I just jumping the gun. I have mild hearing loss (industrial deafness from my time as an apprentice Boilermaker in the 60's) when there wasn't anything done about hearing protection. Cheers
If you live in Tasmania, and you are seen under the Hearing Services Voucher program, as a starting point your hearing aids will be fitted to a prescription. Some form of verification will be used (either REIG/REM, or alternatively a test box).
@@19833891 Thank you for the info, I had a couple of tests some years back with two independent providers but I got the feeling they just had an agenda that had many $$K's attached. Maybe that is what it costs so I will try again if I can find a provider not aligned with a manufacturer. Cheers
When I was fitted with my hearing aids I went with the resound Omnia 9 and they went with an open dome. It worked but my streaming sound quality was horrible to the point of painful. I have on my own changed to a vented done and it is great. I go back in July for a follow up and wonder if I should ask to do the real ear again being I changed domes.
Hi Dr. Cliff. I did go to your HearingUp website and found one of your providers (since my ENT doctor and audiologist did not offer a Real Ear Measurement (REM)). I sent an email to the HearingUp provider requesting a REM. They replied and scheduled an appointment for me to come to get the REM. I brought my recent Hearing Test and hearing aids to the appointment. The specialist was very helpful and explained each step in the process. He checked my ears for earwax to help ensure a good REM. He spent over 1.5 hours with me performing the REM, fine-tuning the settings to maximize the hearing aid performance. I do go to my ENT annually to get a Hearing Test, and my hearing test results show moderate hearing loss and Tinnitus in both ears that have been stable for several years now. I am now very pleased with the results and my hearing aids now work the best they have ever been. I’m very grateful for you and your many videos and helpful hearing information. Many thanks !!! 😊
Does real air measurement work with over the counter hearing aids brought online such as eargo and others?
0ops, I meant Real Ear measurement, not real air measurement.
Dear Dr. Cliff - Well done! I do hear a bit of frustration on your part, however. Understood. To my knowledge, I published the first REAR and RESR probe-tube measurements against ear canal SPL targets in a 1987 article. If you are feeling frustrated, imagine how I must feel!
My experience with hearing tests is they don't give much information to the patient about what's being done. During my most recent test, the hearing aid specialist said he did Real Ear Measurements, but I didn't know what that meant and how it affected the result. Perhaps testers don't say much because they don't want to bore patients with technical information, but for those who are interested it would be nice to be educated.
Your advice on REM prompted me to switch audiologists. And they did make some small adjustments based in the test!
I recently jumped into a new clinic, and found myself doing cleanup with dozens of clients from the last two years, where the previous clinician preferred to only do SREM (started to do it during COVID, didn't stop doing it after COVID became less of an issue). I personally always do WRECD and REMs, with targets bang on, up to 4k-5k. Your video on the importance of verification measures being done correctly is what drives me to always do it, every time, even if the appointment is just a reassessment and adjustment! Combining fantastic REMs with adjustments based on client feedback on what they're experiencing, has been a solid recipe for success, for me.
The one problem with the REM is that the target isn’t always the correct or ideal fitting.. it’s only just a set point for a given target.. Its what people think it should be but its not always the case. There are many software settings that can be used to match target but it doesn’t always mean it’s correct
There is such a wide range of abilities when selecting a provider to work with in your hearing loss journey. I don’t know if my journey is unique but finding a qualified provider that i could work with took 6 months and I started my homework at least 6 months before that. I reviewed my insurance, stand alone hearing insurance coverage and shopped for price ranges. I watched TH-cam videos. I listed out the pros and cons of each brand of hearing device. I programmed my airpod pros so i would have something to assist me until i could find a provider. It was difficult getting an appointment as most providers were scheduled 6 weeks out.. I brought what I thought were pertinent documents to my appointments. The first two appointments were not what I expected. The visits was no way comprehensive and i felt like i could talk my way into whatever device I thought i needed without the benefit of the provider’s experience. I then checked the Hearing Up network and found Dr.Frink. He was everything i had hoped for as far as being knowledgeable, personable,loved his job and was someone I thought i could work with longterm. I am not an easy person to work with. I ask a lot of questions and not computer savvy. I mess up every electronic device I touch. I was given a thorough examination and explanation of what to expect. I’m happy to have found Scot Frink in your network and hope to continue working with him in the foreseeable future.
Why and how real ear measurements are so important compared to open field tests (i.e.: test using speakers while wearing your hearing aids in an acoustic cabin). At the end of the day, it's not about decibels in your ear, it's about your brain interpretation of the acoustic signal.
Some pediatric audiologist don’t even perform REMs which hugely dissapoints me
My audiologist said he doesn’t want to use REM because it involves loud sounds and he doesn’t want to risk making my tinnitus worse (it is already very bad and causes me a lot of distress). Is this reasonable? They are definitely a reputable company
The errors you describe essentially constitute malpractice. I would like to hear an AuD explain on the witness stand why he/she didn't provide the full and correct treatment for the patient.
He’s done it before
The only thing i noticed at my local Audiologist office is they have a VeriFit 2 machine... can that be used for REM?
But, Dr. Cliff, the Audi disappears into another room and how do we know if they auto-tune the prescription (instead of customization) or apply the REM at all?
Got my REMs completed at last, lack of REMs due to lack of proper test equipment, makes a difference
Dr Cliff, question please. My audiologist is selling me widex. The REM need to be done with special equipment for widex or not? Thanks
I asked for REM for my bernafon zerena 9 HAs and she said REM is part of the Bernafon setup program and showed me some soud graphing that looks similar to what you show in your videos. Is she really doing REM?
Hi doctor can we replace rechigable battery for phonak p5 after failed
Unable to save the video! :(
Hi dr. Cliff, here a question from the Netherlands. Here in my company it is common practice to perform REM measurement. But do you prefer a measurement with the software from the hearing aid manufacturer or a stand alone application ? Thanks in advance.
hello can you share your company or center name and is it located in Amsterdam? I desperately searched for a center in my country and near countries for REM but it is not available.
@@MarmarR-2238the big red one. Glasses and hearing aids😉
Hello, nice vid, ty for sharing.
A quick question: After 8 years of using hearing aids, i changed them and tried out a new pair during 40 days. This new pair made my tinnitus increase a lot. I stop using them and returned them, and back to my old ones. After 8 months i'm better, and the tinnitus had been decreasing again over time. But why the hearing aids I tried greatly increased my tinnitus?
Will there be a Hearing Up in Europe?
Well the 2nd time I went to the VA Hospital 14 months after getting my Phonak the audiologist noticed my hearing aids was off a little and made the adjustment so I hope this July when i go for testing and get the upgrade the make the adjustment the 1st time I hope
The only analog hearingaid i fit is Lyric.
And well i think her is rem Not the way to go... First of all, the remaining volumen of the earcanal is so small that the messuring tube lead to a massive problem in accuracy.
And lyric is not interfering with the Natural reug
I just got fitted for my Oticon real 1 hearing aid. My Audiologist used the measurements against my 15 yr old Analong aid. I find that distortions has always been a problem in these digital aid and end up suffering with my analong aid all over again. I hope the Oticon Real 1 will be a deal breaker for me.
My question is.
How can the real ear measurements be accurate using a very old analong aid verses the digital ones? Aren't they built differently?
Hello, Canadian hearing instrument specialist here! What REM does is measure the way the sound from a hearing aid is behaving inside YOUR ear canal vs what the programming software estimates for the average 2 cubic centimetre adult ear canal and is a standardized process no matter the make, model, style, or age of the hearing aid. Factors like the canal volume, shape, and resonance are unique to each ear and can affect the way sound pressure hits the eardrum, so we need to verify that the amplification you are receiving at each frequency is actually meeting your hearing loss targets and giving you maximum benefit in terms of gain and output.
In a nutshell, REM is measuring the amplified sound in your ear, not necessarily the hearing aid function or sound quality. If you have concerns with distortion, ask your provider to run a HIT test or electroacoustic analysis on the devices and compare the findings against ANSI specifications for that hearing aid to identify or rule out noise artifacts in the device itself. Hope this helps!
@@feliciaenns2503 Finally, an actual description of what a real-ear test does and why you need to have it done. Bruce W
Hi Dr Cliff - following on from your recent Australia trip when do you believe you might have some practitioners in Australia (particularly Tasmania) that follow your principals?
Or am I just jumping the gun.
I have mild hearing loss (industrial deafness from my time as an apprentice Boilermaker in the 60's) when there wasn't anything done about hearing protection.
Cheers
If you live in Tasmania, and you are seen under the Hearing Services Voucher program, as a starting point your hearing aids will be fitted to a prescription. Some form of verification will be used (either REIG/REM, or alternatively a test box).
@@19833891 Thank you for the info, I had a couple of tests some years back with two independent providers but I got the feeling they just had an agenda that had many $$K's attached. Maybe that is what it costs so I will try again if I can find a provider not aligned with a manufacturer.
Cheers
Hillcrest Hearing in Dayton Ohio, the biggest provider in the area has never even heard of real ear measurement !
When I was fitted with my hearing aids I went with the resound Omnia 9 and they went with an open dome. It worked but my streaming sound quality was horrible to the point of painful. I have on my own changed to a vented done and it is great. I go back in July for a follow up and wonder if I should ask to do the real ear again being I changed domes.
Yes you should. How did you get past your fitting sequence without making sure everything was perfect first?
I think that each manufacturer must obligate each audiologist to perform REM.
That would be great. Unfortunately, this will never happen.
@@DrCliffAuD sad, in this way they will assure that each device is configured properly, they will sell more etc etc
I got the auto button five years ago.
Ahh ok so you’re trying to do reverse psychology on audiologists here,.. lol 😂