No she didn't , my 13 year old woke up on Christmas Day last year with sudden hearing loss in left ear, it took us 3 weeks to get to see an audiologist and they put her in this room but they didn't put anything in her ear like in your video.. They give her a Phonak cross aid that she hasn't use, we went last week and ask about the rechargables HA she said they would not work on her. Thank you for your awesome videos
No, this was not done before I purchased my hearing aids. I had sudden sensorineural hearing loss in my left ear in Dec 2017 and was finally taken seriously and treated 10 days later. I regained some hearing (loss in left ear is moderate) and it appeared I had some mild loss in my right ear (probably had bilateral mild hearing loss previous to the SSNHL). I got hearing aids in March and although I hear better by the end of the day everything sounds very tinny and I can't wait to take them out. I also feel like I can't hear very well with the left one. I have been back but there is no solution for me. Now the three month point where I can return them has passed. This makes me very upset. This probably would have resulted in a better result for me. Lots of money and now I am stuck.
I've been wearing hearing aids for 52 years and this addresses exactly the question I have always had and never been able to verify that the aids I am wearing are doing what they are supposed to be doing. The eye glass analogy is perfect.
Dr.Olsen, You have made a great set of videos that are truly honest, non-biased, and you aren't trying to sell me "your brand". You are a rare human being committed to education and are as honest as anyone I have ever met. I wish I lived in AZ so I could meet you. Thank you so much, Sharon
I whish I knew about you when I visited Arizona! I am wearing my hearing aids for 6 years and you're the first person to tell me about REM! I thought I found a good clinic before I started watching your videos. Greetings from Kazakhstan!
I want to give a huge thank you for doing these videos. I have been working with tru hearing trying to find a provider to get new hearing aids. There were only 2 local providers and neither said they could do real ear measurement. After I told them that was a deal breaker and cancelled they said one provider had the equipment in another office and could do bring that in for my fitting. Without your videos I wouldn't have known what to ask for and demand an appropriate fitting. THANK YOU.
Cliff: I thought I should put a plug in for you and your educational videos. I went in for my first hearing aid meeting with a local supplier. The audiologist was a tad stunned with the kinds of questions you helped me prepare for her. She told me it was quite refreshing and that less than 10% of her clients did enough preliminary research. I drilled her with questions from your videos and then she asked me where I was getting all my information from. I told her. She said 'ah Cliff ! Yes- everyone should make time to watch all those videos.' So there you have it, a professional with a masters in audiology recommending your materials. I should also add that the knowledge helped me to negotiate a much lower cost for my Phonak Marvels along with all the accessories thrown in. So thank you, and lets hope more people invest their time in seeking out your help. And best wishes for a growing business.
Alan, I did the same thing with prepared questions and my audiologist was stunned and pleased that I was prepared so well and he also knew about Dr. Cliff. LOL
I am currently in the process of getting my first Hearing Aid. I was lost until I stumbled upon your video series. Thank You for all the great information. At least now I have a good idea of what to expect and more importantly; what to ask.
I was just diagnosed today with severe hearing loss. I am in need of hearing aids. I have to say, I have binging on Dr Cliff's videos and learned so much in the last 3 hours. Thank you Dr Cliff! The audiologist I saw today didn't mention any type of followup with hearing aid selection, fitting or anything. I literally walked out the door knowing I have severe hearing loss and I was told I need hearing aids and that was that. I am so thankful that I found your video and website. Your "find an audiologist" was exactly what I need. The audiologist you suggested in my area looks great. As soon as I have a better idea of my insurance benefits and coverage regarding hearing loss, I plan to setup an appointment. Thank you again for all of your amazing information and guidance. If I lived in your area, I would for sure be visiting your office.
This is exactly my experience at my first audiologist appointment. I got my first hearing test and hearing aids at Costco. After awhile I wanted to visit a real audiologist and get their opinion. Gave me the test said you have hearing loss, and I need hearing aids. Lol. Thanks Dr. Obvious. The gal at Costco was was way more helpful.
Hi dear, I live in Maine, a phonax hearing aid is awesome to have, you go to a appointment and you need a cell phone they check your hearing and they set you up with a hearing aid they fit you with one or two depending on what you want, you can ask me anything you want to know, if I know the answer I'll fill you in, just trying to help, in my area they are around 1000. Dollars for one they could be a little more I'm not sure on two, my insurance paid for mine, have a wonderful day
Cliff, I just watched your review of the Oticon OPN S and found it very informative. As a wearer of Oticon OPN hearing aids, I regret that my desire for upgrading overwhelmed my life learned patience for new products. One comment not about the content but about the presentation. I presume many of your patients are elderly. After all, as we age the look of hearing aids is outweighed but the need to hear those around us. That said, the content you're delivering goes by so quickly that I often found myself a few sentences behind you. Thank you for providing this information. As a former participant in this industry, it appreciated and well done.
Hi Dr C & everyone. WOW! Repeat WOW! I came across your videos by chance. I've worn hearing aids in both ears for 32yrs - BTE, ITE, HS & 2x CIC. I've watched 12 videos so far, I have to say WOW! I've learned more information in ONE hour - How is it possible that I've not given (most of) these important information?
Very relieved to see after watching this video that my audiologists have always done real ear measurements. Which is a good thing since I've been wearing hearing aids since I was 5!
I am so grateful that you made this video, and steered me to view it. I am going for my hearing aid fitting Tuesday for my first time ever. I just downloaded, and printed best practices to take with me. And I downloaded your 2023 guide I am going to read when I wake up tomorrow. Everybody needs a Hero now and then. Thank you for being mine, Mandi
Dr. Cliff is spot on with REM. Having used REM for 33 of my 37 yrs...it has been more them helped to maximum the patients residual hearing...and yes the results are repeatable ...and it has helped to fix poor fittings...I would certainly insist your practitioner utilize this tool for proper fitting
Can someone on the site let me know how to get the REM test when my provider has the prescription and adjustments on his computer? I don't think they are "locked" which I just learned about today from the video. I have a secondary hearing loss from medication and although hear better, I do not necessarily have enough clarity to understand. I do not have that problem without hearing aids. Unfortunately I found Dr. Cliff and his wonderful information just after the trial period ended.
Kathleen, you should be able to call the hearing aid manufacturer and find providers in you area by zip code. Call the clinics given to you by the manufacturer and ask if they do real ear measurements. If not “locked” they can read your hearing aid settings into their computer and run real ear and make adjustments accordingly! Bringing a copy of your Audiogram(hearing test) is advisable. Please note: You should expect to be charged for those services since you didn’t buy the aids from them. Good luck to you. You could also google clinics in your area. Many times their websites will list what brands they carry and services they offer.
Wow.... THANK YOU for this. I've been researching like crazy the last month about how to treat my hearing loss. Your videos are so clear and concise that i'm starting to really understand what to look for with hearing aids and the clinics that prescribe them. I also have very poor vision so the part about having "good enough" care is so relevant to my life right now. I'm tired of just excepting "good enough" care and trying to research as much as i can before i make the appointments with the clinics. If i lived in Arizona, i would come to your clinic in a heartbeat. Again, thanks for the help.
You did a GREAT public service with your videos. Your videos are clear, concise and fair but most importantly, INFORMATIVE and ACCURATE. Thank you. I will share this with my brothers & sisters of MARINES-FIND YOUR PLATOON.
I'm getting hearing aids next week and I asked my audiologist if he did REM and he said it's compulsory in Australia. It's just as well because I mentioned Dr Cliff who'd said to walk away if rem isn't done. I mentioned I watched 'dr cliff aud' to acquaint myself on everything I need to know and he said that he watches him as well and was pleased that I'd researched as much as I had.
I am so thankful for your videos. I had my hearing test done yesterday and I had made several notes to take with me to the audiologist. I have pretty bad tinnitus and I also have severe hearing loss in the upper register. One of the questions was if she does real ear measures. She smiled and pointed to a box under her desk and commented that she had just gotten the equipment to do real ear measures and she intended to be trained in how to use it and be up and running with it in about a month. I chose the Phonak Audeo M-R 90 RIC rechargeable. We are going to do the fitting for the time being and just as soon as she is up and running with real ear measures, I will be back in the office for that fitting. I mentioned that I learned about how important this was by watching you on youtube and she grinned and said, yes, I watch him also. He is terrific. So...thank you so much for your very informative videos. I have learned so much...and so has my Audiologist!
Hİ, I am an Audiologist from Turkey.Your videos are really really wonderful.Thanks for sharing your experiences and informations !!! GREAT JOB 😊 I have just subscribed your channel.I am looking forward to see new videos 👏
He really does tell us what Real Ear Measures are beginning at 5:40. They are measuring the sound inside the ear to ensure the frequency response of the hearing aid matches the prescription frequency response when the aid is in place.
You are awesome! Thank you for taking the time to make such informative videos. My wife and I feel smarter and better prepared for our son's hearing aid fitting. Keep grinding my man!!
Thank you for this video. I already knew about REM, and select an audiologist who does them, but didn't know exactly what went on during the process. Thanks to you, I do now. 👍
This is a wonderful video. Thoughtful, well presented, and targeted at exactly the right recipients. The bottom line is to try to maintain an open mind in seeking the best hearin AIDS. Don't simply run to Costco, because of low prices. You may get a better result from an independent audiologist/retailer. Price is important, but should be down on the list of variables, not top of the list. I made the mistake of starting at Costco. For me....a bad decision.
I have been hearing impaired since birth, 73 years. In the last 2 years I have decided that the audiologist were not doing their best. This in mind I went to purchasing on line (auction) and programming them my self. I have found that I can do as good a job as they have done with far less money involved. I can see that with a REM unit I could probably come closer to obtaining the hearing solution for my self as humanly possible. The vocal power of suggestion does intimidate us the users in not speaking up because we believe the audiologist is the professional and has the degree and knows more than we do about our own hearing.
Luigi R. I helped a relative recently. I researched numerous options available. The best prices by far were available through Costco. Similar if not the exact same models that sell everywhere else for $6,000 to $8,000 can be purchased at Costco for $1,500 to $1,800. I don’t know what suction prices are, but I’m sure they don’t come with 100% money back guarantee like Costco has and their amazing service. I’m not affiliated with Costco, just a happy customer.
Due to insurance issues, I couldn't get new hearing aids from the only approved audiologist in the DFW area, so I chose one near my home that was approved by my insurance. The first thing I asked him was did he do real ear measurements, he said yes & pointed to a machine so I thought all was well. When I picked up my aids he did some adjustments on his computer & sent me packing. Having had REM before, I thought maybe there was another way to do it. So I watched a couple of your videos to verify that in fact he didn't do REM. I go in the morning to try a different set as these don't it me all that well, so I'll bring up the topic & see what he says.
I have been a sufferer of tinnitus for three-years disability-an But it does get better I think our bodies brain does heal it so we can liberate God bless all of you
Hi Dr. Cliff, AuD. You can thank professionalvideos for the fact that I just hit "like" and "subscribe" to your video. And the reason is, because, he LOST the argument and you were proven right! (in my eyes) I became hearing impaired due to brain surgery. Been to many audiologist and never heard of rem? However, I had appt. with new audiologist just yesterday and from your video i watched; she did the rem test. :-) Keep up the good work, looking forward to more videos! ps going to check out the Oticon opn cic? Am in phonak now bte.
A great video that clearly explains a very important process. Now i know that my audiologist didn't do real ear measurements. Nor did he programme any extra sound profiles into my resound smart 3d app. Oh dear.
DR CLIFF. YOU HAVE MY RESPECT.!!! THESE VIDEOS ARE AWESOME.. I THANK YOU,SO MUCH.. AND THANK YOU FOR LETTING US ALL KNOW ABÒUT ALL THE RIF-RAF GOING ON. IM NOW BUYING NEW PHONAK-P-90 . PARIDSE ADEOS. CANT WAIT.THERE BEING SHIPPED . AGAIN WE ALL NEED YOUR VIDEOS.. GOD BLESS YOU.!!! JOHN..MINNESOTA
My mother really needs hearing aids but doesn't want to spend the money. I think with the new technology I might be able to convince here, although she is not a smart phone user. This video was super helpful. Thank you!
Appreciate the video. I've been wearing hearing aids since 9 years old. I'm 24 now and I'm really starting to take an interest in the newer technology and how programming works. Thankfully I go to a clinic where the audiologist is more than willing to teach me what she knows and explains how she arrives at the proper prescription for my hearing loss. I have reverse slope hearing loss and she's always told me that she takes a little extra time with her patients to be 100% sure that we're okay with it. Since she's in the middle of a mall, what we'll do is leave the office and go into the mall and she'll have a short conversation with me to gauge just how well my prescription is working. I wouldn't ask for anything better.
for me, it is all about the performance of the hearing aid, we have our expectations of what we want for our investment, that is why it is important to trial the ones you think you would like or can afford, all aids describe their capabilities , but if not fitted or programmed correctly you are not going to purchase you just keep looking don't be bullied into purchasing if undecided, you are under no obligation to purchase if you are not happy with the hearing aids trialled hearing Aids they have to be right..
I really appreciate you posting this information. It is very helpful for a profound HOH person. I have a feeling that the next time I go shopping, I’m going to take a lot of time and gasoline finding a clinic that meets the REM standard of care. Why is this? Because it is cheaper and more PROFITABLE for clinics to skip this standard, and it is not mandated by our legislatures who are bought and paid for by the industrial health complex to not regulate these devices at a bare minimum standard. Why does the lay public have to know this information when professional health “care” providers spend years learning and honing their craft? As a healthcare provider, I hope that in addition to teaching the public, you are lobbying Congress for a fairer system.
Been wearing HAs for 15 yrs and have neve had Real Ear Measures. Asked my provider and he does not believe in REM, says he can do just as well with his questions and my responses, how does that sound? Will be going to Costco in a week foe my fitting for new HAs and very happy to know they always perform REM. Much more professional than my previous provider. Rally fortunate to have found your site, I have subscribed and look forward to more info.
Hi Bruce. I'm glad you like the videos. Did you leave your provider because they don't to REM? If so, good. The provider's response is typical for someone who doesn't do REM, however research consistently disproves his statement. Fittings without REM are never on par with REM.
@@DrCliffAuD Perhaps very rarely on a par and then only by chance, rather than never, though I have no intention to support anything less than best practice.
Sorry for another question: If I go to an audiologist to get measured, what should I make sure I walk out with? How do I know when it's time to get hearing aids? How do you recommend dealing with the embarrassment of wearing them? I have also seen men not hear at all when they start using hearing aids and for some reason they are not wearing them. Like the hearing loss got much worse.
This is awesome. I have just begun my search for hearing aids...let the fun begin. Thank you for taking the time to create this video. I have subscribed and I've already watched the three big lies...again thank you.
Thanks for this video. I can absolutely attest to the difference REM can make. I have hearing loss on the left side following brain surgery in 2008. Immediately following surgery I had no hearing and some weird tinnitus that sounded like a lawn mower circling a tree. Within about six weeks I noticed that the tinnitus was gone and I could faintly hear. (My neurosurgeon was shocked that I recovered any hearing.) An audiogram showed moderate hearing loss in lower and upper ranges, and 84% word recognition. At that time they did not recommend a hearing aid, and I adapted by using my right eye for the phone, making sure that speakers were to my right whenever possible, and so forth. The only time I really noticed a deficit was in large open spaces, but for the most part life was manageable. Fast forward 15 years and I noticed I was asking people to repeat themselves more often and scheduled another audiogram. This time it showed moderately severe loss rising to normal at 1000 Hz sloping to moderate at 8000 Hz. Word recognition had fallen to 68% for my left ear but fortunately still 100% for my right ear. This time the audiologist recommended a hearing aid to preserve word recognition. I was fitted for an Oticon Real 1 that was programmed according to the computer program suggestions. I began watching UA-cam videos and at my followup appointment asked whether I would benefit from REM. My audiologist enthusiastically said yes, the clinic had just gotten a machine and she would love for me to have one due to my unique situation. In my case some of the adjustments were greater than 10 decibels from the computer model (REM was run twice to verify). It's only been two days but there is a huge improvement.
OH MY GOD. I wish you were here in California. I'm on the cusp of buying new hearing aids and I wish I could visit your clinic immediately for a second opinion. I KNEW IT I KNEW IT I KNEW IT that analog hearing aids were better. I've worn analog hearing aids my whole life (since I was 3 years old; I am 39 now; single-sided deafness in my left w/moderate > profound loss in my right ear) up until around 8 years ago when I had to switch to digital because that's all they made and that's all my current audiologist I've been using for 20 years uses. I've never been 100% satisfied with my digitals especially in noise. I'm using the Phonak NAIDA Q-90 UP w/CROS H2O unit for my left ear. Most of the automatic programming is turned off because I cannot tolerate it and it is made to sound more like analog with linear processing. Which, of course, doesn't quite sound like the old analogs. Oh how I miss it so very much. AND: oh how I hate having to open and close the battery door to turn off the freaking hearing aid!!! Why can't I have a switch to turn it on and turn it off when I please? The manufacturers' decision in that regard was the dumbest thing I've ever heard of happening to hearing aids. Sigh. Amazing videos and I will for sure ask my audiologist about real ear testing. I'm usually doing testing in a sound booth for a general audiogram, but I doubt that's exactly the same as what you're referencing. Likely going to get the Phonak NAIDA B-90 and CROS-B.
I was diagnosed with severe hearing loss. My provider says they don’t do REM until 2 to 4 weeks after you start wearing them. He said the prescription was right for me based on my hearing test. Also that they wait so my hearing could get used to the devices. Is that true? Thank you. You are a Rock Star by the way. Thx!
Hi Adco59. Thanks for the Rock Star compliment! I'm not a big fan of the "first-fit" method followed by REM 2-4 weeks later. I personally like to know exactly what the sound is doing inside your ear, otherwise, I have no clue what you are actually experiencing. Basically, you are just losing 2-4 weeks of proper adaptation to sound. Seems like a waste of time to me, and I value time more than ANYTHING!
The other drawback to manufacturer programming first then meeting real ear is that the hearing aids may have an initial sound quality and curve that doesn’t match real ear much at all. When the patient gets fit to real ear, they may feel like they are completely different and may have to adapt all over again. Many professionals don’t realize that the hearing aid software will reduce gain using acclimatization based off the adjusted levels.
Hi Dr. Cliff. In this video, you performed a few rounds of tuning the gains to match the prescription. I watched the fitting tech at Costco struggle through this procedure, but she did eventually get the solid line to closely match the dashed prescription line. I think it would be very beneficial if these softwares would employ machine learning training algorithms to build these gain tables to match the prescriptions. A good AI algorithm (something coded with Tensorflow, for instance) could do in maybe 20 seconds what it takes the fitting tech to do in 20 minutes, and do it more accurately too!
Cliff: I have commented on several of your videos in the past and enjoyed this one as it hits on a couple of issues that I face. My hearing loss was diagnosed by an M.D. several years ago and 5 years ago I purchased a set of Siemens hearing aids from a retailer (bad choice I know). I have also had exams by 2 different Audiologists and another ear,nose & throat M.D. and at no time has anyone offered me a prescription for my condition and none of these have performed "Real Ear Measurement". I asked the last Audiologist about this and mentioned your videos and her response was the software that comes with the hearing aids is all that is needed. My Siemens hearing aides have never functioned to my satisfaction and are a real problem when I sweat (which is just about constantly). I clean and dry them several times a day and between sweating and earwax build up they are a maintenance nightmare! I few months ago the last Audiologist I visited let me try a pair of Phonek lithium-ion hearing aides with the molded ear piece. They worked better and stayed where they were supposed to. They also cost $7,000.00. Unfortunately every Audiologist or retailer I have visited only carries one brand and does not have the software required to work on or adjust other brands. Even with the Audiologists I still get the old line of "I bet that's a lot better right?" and at that moment it probably is. At the age of 75 I find that I am about ready to give up. Frustrated on Ohio.
Hi cplrey. I'm sorry you haven't had better success with treatment. As you know, there is no good excuse not to use REMs. There is also no good excuse to offer only 1 brand of hearing aids. All I can suggest is continue to look for a new audiologist who offers multiple brands and does REMs. Check out www.HearingTracker.com to find additional providers in your area.
great video. Wow where were you when...... Have Menieres Disease for 44 years. Yesterday the audiologist adjusted my phonak Audeo Q bought in 2014 after my REM. She showed me the Phonak B-Direct and a video of the Roger Select. Discussed with husband and will be fitted next week and try out for the next 45 days. Just want to be able to hear at social gatherings and out with friends and hope they work. Dr. Susan Miranda King neurotologist and audiologist Dr Robyn Shandley are it has taken 40 years to find this kind of help. subscribed and ready to stay connected. Thanks.
I have stage 2 Menieres Disease and have been researching hearing aids for the first time. At the moment the left ear hearing loss is stable but the right ear hearing loss fluctuates widely, and the recruitment can be terrible. My research indicates that self-programmable hearing aids are best for me. I would also get some training on how to programme the aids. What is your Opinion, Dr Cliff?
Your channel was the first to populate when I search hearing aid technology. Your videos are very informative, thank you!! I wish you had an affiliate in Dallas!! I’ve decided to seek treatment due to surgeries for antibiotic-resistant ear infections when I was little. I have tiny ear canals that most of my doctors over the years have said, “whoa, you’ve got tiny ear canals!” 😬
Hi Doctor Cliff! I just had a 3 week try of a hearing aid device from Signia NX12, I had it returned because I felt that it was not really helping me. This is my second hearing devices, I had for about 6 years a phonak audeo SM, which I barely used and when I really wanted to star wearing them, my audiologist told me that they were discontinued and can not longer be adjusted or re-programmded, so they recommended me this Signia RIC that I'm talking about; the other thing that prompted me to return the Hearing aid, was that after I had watched your video regarding the importance of the REM; I discovered that my audiologist did not performed this crucial Test, my biggest problem now according to the result of the test done, is that during these 5 or 6 years my word recognition went down from 77% to 44%. So I will star to look for another hearing device and try to wear them all the time, however my financial situation now is different to 6 years ago, I am a retiree now, without income, depending most of my pension and Old age and some savings, What do you recommend that I should buy. Doctor I had watched most of your helpful videos and I found them really really informative and educational for the "lay person" Thank You! Raul
Thank you for the advice! I got my hearing aids a week ago and feel pretty annoyed instead of excited because everything was too loud and weird.. and my audiologist checked and lowered some frequencies but i realise i didnt take a real ear measure..
Can you change the frequency of the music you use in the beginning and end. My dog hates it when it hears the high frequencies and wakes up. Your video's are very informative and thank you for taking the time to make them. I have learned a great deal about hearing loss and hearing aids due to your video's. Keep up the great work and thank you for being an honest health care professional. You truely seem to care for your patients. REM video is great! One of the most informative and very important aspect of treating hearing loss today.
LOL. Sure Ian, just send me a few 6-8 second "catchy" sound clips that I can use for the intro and outro and I'll give them a shot! Glad you enjoyed the REM video. It is the ONE thing that every hearing aid wearer should know about! Please share it!
This has been a revelation as i did no know that this test should be done as i have always had trouble hearing properly with my aid in one ear as it seems not to amplify as the other ear keep up the good work
Thanks for this. Going in for my first fitting for reverse slope next week ... hopefully it won't be awkward to ask if this is the method they're using. Do you know why 70% of audiologists don't do this?
Wish I had viewed this video before picking up my first set of hearing aids at the VA. A technician gave a class that showed how to care for the aids and then the audiologist ushered me out the door. I told her I was experiencing a stuffiness sensation and she said I would get use to it! Well after two weeks, I returned for a Walk-In appointment and the technician adjusted the fit but told me the other issue was a programming problem that had to be addressed by the audiologist. All of this could of been avoided if a Real Ear Measurement had been done at the initial visit. Now I have to wait over a month to see the audiologist. Thanks to your video, I know what to ask for!
Hi Vatalon56. It's unfortunate that you have to ask to have these basic fundamental best practices completed, but at least you will have them done eventually. 🙂
Vatalon, the VA requires every audiologist to use best practices for care, which include measures of benefit. Objective measures like real ear are required by many VAs, because the national VA is recognizing that subjective evaluations provide only a “better than nothing” response.
Big question: How much does the growing micro-intelligence in the newest Hearing Aids skew the REM based settings? From my research, it looks like each manufacturer has its own algorithms to automatically torque the individual equalizer settings based on the perceived environments and dynamic circumstances at each moment? Overlay those adjustments with features such as noise cancellation, focus, and impact reduction technologies and it is hard to understand how to use REM to accurately "SET" the instruments to a valid baseline setup. In the world of older technology HAs the value of Real Ear Measurement is easily understandable. In the new world of intelligent hearing aid technology wouldn't the particular hearing aids under test need a built-in recognition of an in-process REM test (much like Volkswagen's EPA testing awareness) and switch to a consistent set of control parameters while the test is underway? If so, it would seem that they must also have the ability to remember and use those REM derived settings as some sort of baseline around which all future real-world automation is built and controlled. At present, it appears that they only know about the momentary existing environments which must be compensated for. I know that some HAs claim to "learn" how to satisfy the user's needs over time it would appear that over time, whatever REM based setup was established at the Audiologist's testing will become distorted and eventually become unrecognizable and lost.
Hi Budd. Valid concern. Typically REMs are conducted with digital features turned off. The main goal of REM is to ensure audibility. Once audibility is restored, yes, digital features can alter the hearing aid output, but after measuring these features myself they have little impact on overall audibility, unless they are intended to, like with directionality depending on position. All tests indicate REMs are extremely effective and important even in modern digital hearing aids with a plethora of digital features active.
Cliff, just wanted you to know that I went to my audiologist for my first visit today in regards to hearing loss and tinnitus. I asked her if she did REM's, and she was taken aback. She said yes she does, and how did I even know about them? She also said I was the first patient that has ever asked her that question in 16 years of practice. I told her about your website, and she said she would check it out. She agreed that all hearing professionals should do REM's and that HA's aren't being utilized correctly unless they are done. She also indicated that her office (part of a hospital group, not private), and one other private practice were the only offices that did REM's in the area. I live in an area of 1.7M people and that is astounding. So, you're doing some good by educating a guy like me. Hopefully, it will make clinicians understand that they can no longer take shortcuts with patient's care and money. Thanks again.
I learned a few things.... I need to get my eyes tested somewhere else and I don’t believe anyone uses real ear measurements in the country where I live, looking at £2700 to £3600 for a CROS hearing aid and I’m shopping blind atm, I only get scant information on I would be purchasing. You have been a great educator Thank you
I never been to any other audiologist then the VA hospital and as far as I can tell they did right by me and when I picked up my hearing aids on Aug 17th he did the hearing test on them while they were in my ears and the machine hanging on my ears making the sound test and made the adjustment
First, Thanks for the informative videos. I always pause your videos so I can take notes. I'm a new hearing aid user and still in the trial period. Will my hearing care provider be insulted if I ask about 'real ear measurement'? My Medicare Advantage program has given me just a few professionals to choose from, so I don't know enough about her to ask her all these questions. I only know that at this point, my hearing aids aren't working for me. I hope she will be open to my informed questions and help me out. LG
Cliff, Im great full for your honesty in your videos. I followed your advice and obtained "bought!" the Kurkland. I bought an over the counter 125 dollar el cheap o! as an emergency back up on the internet..They say they are hearing aids, but theres no comparison with the Cost go ones!. just like you said, there Amplafiers! There is a play on words being used here. If i put my hands up and cup my ears, i can hear better! therefore my hands act as hearing "AIDS" because they are aiding my ears to here better! and my hands are amplafiers because they amplafy sound! Now make a video on how to keep from goling nuts!
This makes perfect hearing sense. We are tested for the hearing loss then given a hearing aid with the recommended correction but not retested if it is on pitch with what is actual to our hearing correction. I have wondered about this and appreciate learning what the best practice is for the those seeking out audiologists. Thank you!
I am watching this a few hours before my fitting appt. i am so glad I have seen this. I have a feeling the place I am going to is going to be crap. My insurance is sending me there.
I work in the industry as audiologist as well yet there are some different opinions then please let me ask about your opinion: 1) What do you do if your patient is not accepting HI after REM measurement? E.g. it's too loud or too sharp for him/her? Do you change the fitting to make it acceptable? 2) What about adaptation process for first-time users and how about REM measurements for first time users? (just to be clear - I'm asking about adults - pediatric fitting is a bit more complex as we know it) Worth to mention - although REM looks quite easy in fact it's a measurement that require certain knowledge and experience. It can be tricky (e.g. if probe will be pulled out from the ear between measurements you will get huge differences). It's super important to know how to do it properly yet I have feelings this knowledge is "disappearing". Don't you think?
Hi Rafal. Thanks for the questions. 1. The goal of REM is to get the patient up to their prescription. If they cannot tolerate that amount of gain, then we reduce the gain at that first appointment. Approx. 80% of my patients require some reduction at the first fitting. However, within the next 45 days, nearly ALL of the patients are able to accept their full prescription after acclimating. The ones who can't know they are not at their full prescription so if there is concern over their lack of hearing ability, there is a direct reason for it, not just conjecture. 2. REM is unchanged for First-time or Experienced users. Just about everyone adapts to the prescription, you just have to "baby step" their way to the full prescription. It usually takes several weeks. Performing REMs well is critical. You need to make sure you do it perfectly in order to get accurate results. I do not feel like REM knowledge is disappearing. Nearly all new AuDs are trained on how to perform REM, but if clinics they are hired at do not use them or have REM equipment, it's hard to perform them. Eventually all of the "old school" hearing care professionals that do not use REM will retire and hopefully their "how does that sound" approach to programming will retire with them.
This video my understanding is broadcasted 5-yr ago claiming that 70% of the hearing fitting places are not doing “real ear measurements”. Dr. Cliff, What are the chances today that one will get real ear measurement when the HA are not purchased in the hearing g p,ace where one goes to get better fit? Or majority of the hearing clinics today are doing real ear measurements? Ken
I got my first hearing aids last week. With the information from your videos I was able to ask very pointed questions and have a better understanding of the answers. When the Doctor did real ear measures. It was only once. I was expecting more of a process. When I asked she said, they only need one sample to program the units. Is this right?
Oh wow - thank you for this - no clue if you'll see this since this is an older video but I appreciate this soooo much. I'm going back for my second trial appointment next week and I see now I need to get those lines to match up! I'm new to this but now I know that I don't have to settle. Thank you! :)
I also wanted to say that even though they DID do a REM test, they left me at 80% below my upper line saying that it was good because it gave me room over the next five years in case I needed to get more amplified (I'm paraphrasing here)... This was before I watched your video. This is my first day with my hearing aids and I go back next week (same time same day) - so I should be making them line up my lines is what I'm getting from your advice. Correct?
@@DrCliffAuD AGREED!!! I keep thinking I'm nuts with this - like it's good but it's not great. I'm like that eyeglass analogy. I'm trying to think of that saying like 'almost but not quite there' - it escapes me. But at least I have perfect vision. Oy. 'Nice try but not a cigar?'
Hi Doctor Cliff, thank you for your video regarding REM, it is very informative. What if, the patient refuse or doesnt like the prescription done using REM? Sometimes they report of to loud, too sharp/ metallic sound, i really appreciate your advice. Thanks again.
Can you do a video on what you do for patient's that can't tolerate their hearing aids at target? You kind of skipped over that aspect. Just curious what your go-to protocol is for these types of patients.
Thanks for this video. I just had a hearing test today, and am returning next week for my first hearing aid fitting, so am doing a lot of research. The comments from this person who calls himself "Professional videos" are so upsetting, so I checked my audiologist's website to see if he mentions Real Ear Measurements. Was relieved and surprised that he states that REM and speech mapping are "required by NY State Licensing Guidelines. It is also recommended by American Academy of Audiology (AAA), American Speech Language Hearing Association (ASHA), and other hearing aid dispensing organizations."
Hi Dr. Cliff. As a retired Chiroprator I appreciate the quality explanations you provide to very confusing material. Question in the real ear measurements are you removing the hearing aids to do the staged adjustments to match the measurements? If REM is used will the client disturb settings when they personally make changes within the Makers Apps?
Hi Rich. Thanks. REMs are conducted inside the ear canal with hearing aids in place. Yes, a client can disturb the settings may making personalized adjustments in their remote control apps. However, the REMs set the foundation for any adjustments made and they can be reverted back to if necessary. In some cases, if a patient makes customizations that they prefer, I can use REMs to adjust the default programs to match what the customizations they have done in the app.
Does your hearing care professional do Real Ear Measures?
well, yes, but she couldn't get the probe into one of my canals. Is there a solution?
No she didn't , my 13 year old woke up on Christmas Day last year with sudden hearing loss in left ear, it took us 3 weeks to get to see an audiologist and they put her in this room but they didn't put anything in her ear like in your video.. They give her a Phonak cross aid that she hasn't use, we went last week and ask about the rechargables HA she said they would not work on her. Thank you for your awesome videos
No, this was not done before I purchased my hearing aids. I had sudden sensorineural hearing loss in my left ear in Dec 2017 and was finally taken seriously and treated 10 days later. I regained some hearing (loss in left ear is moderate) and it appeared I had some mild loss in my right ear (probably had bilateral mild hearing loss previous to the SSNHL). I got hearing aids in March and although I hear better by the end of the day everything sounds very tinny and I can't wait to take them out. I also feel like I can't hear very well with the left one. I have been back but there is no solution for me. Now the three month point where I can return them has passed. This makes me very upset. This probably would have resulted in a better result for me. Lots of money and now I am stuck.
Yes. And since it was at Costco the price was more attractive than other vendors. Your information does look very credible.
NO! And I want to find someone who does.
I've been wearing hearing aids for 52 years and this addresses exactly the question I have always had and never been able to verify that the aids I am wearing are doing what they are supposed to be doing. The eye glass analogy is perfect.
Dr.Olsen, You have made a great set of videos that are truly honest, non-biased, and you aren't trying to sell me "your brand". You are a rare human being committed to education and are as honest as anyone I have ever met. I wish I lived in AZ so I could meet you. Thank you so much, Sharon
obviously a biased comment
I whish I knew about you when I visited Arizona! I am wearing my hearing aids for 6 years and you're the first person to tell me about REM! I thought I found a good clinic before I started watching your videos. Greetings from Kazakhstan!
I want to give a huge thank you for doing these videos. I have been working with tru hearing trying to find a provider to get new hearing aids. There were only 2 local providers and neither said they could do real ear measurement. After I told them that was a deal breaker and cancelled they said one provider had the equipment in another office and could do bring that in for my fitting. Without your videos I wouldn't have known what to ask for and demand an appropriate fitting. THANK YOU.
Cliff: I thought I should put a plug in for you and your educational videos. I went in for my first hearing aid meeting with a local supplier. The audiologist was a tad stunned with the kinds of questions you helped me prepare for her. She told me it was quite refreshing and that less than 10% of her clients did enough preliminary research. I drilled her with questions from your videos and then she asked me where I was getting all my information from. I told her. She said 'ah Cliff ! Yes- everyone should make time to watch all those videos.' So there you have it, a professional with a masters in audiology recommending your materials. I should also add that the knowledge helped me to negotiate a much lower cost for my Phonak Marvels along with all the accessories thrown in.
So thank you, and lets hope more people invest their time in seeking out your help. And best wishes for a growing business.
Love it Alan! Looks like you struck gold with your new hearing care provider as well!
Alan, I did the same thing with prepared questions and my audiologist was stunned and pleased that I was prepared so well and he also knew about Dr. Cliff. LOL
I am currently in the process of getting my first Hearing Aid. I was lost until I stumbled upon your video series. Thank You for all the great information. At least now I have a good idea of what to expect and more importantly; what to ask.
I was just diagnosed today with severe hearing loss. I am in need of hearing aids. I have to say, I have binging on Dr Cliff's videos and learned so much in the last 3 hours. Thank you Dr Cliff! The audiologist I saw today didn't mention any type of followup with hearing aid selection, fitting or anything. I literally walked out the door knowing I have severe hearing loss and I was told I need hearing aids and that was that. I am so thankful that I found your video and website. Your "find an audiologist" was exactly what I need. The audiologist you suggested in my area looks great. As soon as I have a better idea of my insurance benefits and coverage regarding hearing loss, I plan to setup an appointment. Thank you again for all of your amazing information and guidance. If I lived in your area, I would for sure be visiting your office.
This is exactly my experience at my first audiologist appointment. I got my first hearing test and hearing aids at Costco. After awhile I wanted to visit a real audiologist and get their opinion. Gave me the test said you have hearing loss, and I need hearing aids. Lol. Thanks Dr. Obvious. The gal at Costco was was way more helpful.
Hi dear, I live in Maine, a phonax hearing aid is awesome to have, you go to a appointment and you need a cell phone they check your hearing and they set you up with a hearing aid they fit you with one or two depending on what you want, you can ask me anything you want to know, if I know the answer I'll fill you in, just trying to help, in my area they are around 1000. Dollars for one they could be a little more I'm not sure on two, my insurance paid for mine, have a wonderful day
Cliff, I just watched your review of the Oticon OPN S and found it very informative. As a wearer of Oticon OPN hearing aids, I regret that my desire for upgrading overwhelmed my life learned patience for new products. One comment not about the content but about the presentation. I presume many of your patients are elderly. After all, as we age the look of hearing aids is outweighed but the need to hear those around us. That said, the content you're delivering goes by so quickly that I often found myself a few sentences behind you. Thank you for providing this information. As a former participant in this industry, it appreciated and well done.
Thanks Jeff. I'll try to do better.
Hi Dr C & everyone. WOW! Repeat WOW! I came across your videos by chance. I've worn hearing aids in both ears for 32yrs - BTE, ITE, HS & 2x CIC. I've watched 12 videos so far, I have to say WOW! I've learned more information in ONE hour - How is it possible that I've not given (most of) these important information?
I sure wish I lived in Arizona! You are phenomenal!
Very relieved to see after watching this video that my audiologists have always done real ear measurements. Which is a good thing since I've been wearing hearing aids since I was 5!
I am so grateful that you made this video, and steered me to view it. I am going for my hearing aid fitting Tuesday for my first time ever. I just downloaded, and printed best practices to take with me. And I downloaded your 2023 guide I am going to read when I wake up tomorrow. Everybody needs a Hero now and then. Thank you for being mine, Mandi
Outstandingly clear description of Real Ear Measures, what they are and what the process of making them involves. Thank you for this information!
Do you have any recommendations for a professional in Austin TX?
You hit that one right out of the park! I really appreciate your fact-based approach. Thank You.
Dr. Cliff is spot on with REM. Having used REM for 33 of my 37 yrs...it has been more them helped to maximum the patients residual hearing...and yes the results are repeatable ...and it has helped to fix poor fittings...I would certainly insist your practitioner utilize this tool for proper fitting
Can someone on the site let me know how to get the REM test when my provider has the prescription and adjustments on his computer? I don't think they are "locked" which I just learned about today from the video. I have a secondary hearing loss from medication and although hear better, I do not necessarily have enough clarity to understand. I do not have that problem without hearing aids. Unfortunately I found Dr. Cliff and his wonderful information just after the trial period ended.
Kathleen, you should be able to call the hearing aid manufacturer and find providers in you area by zip code. Call the clinics given to you by the manufacturer and ask if they do real ear measurements. If not “locked” they can read your hearing aid settings into their computer and run real ear and make adjustments accordingly! Bringing a copy of your Audiogram(hearing test) is advisable. Please note: You should expect to be charged for those services since you didn’t buy the aids from them. Good luck to you.
You could also google clinics in your area. Many times their websites will list what brands they carry and services they offer.
Best info I have ever gotten in #4 years of wearing hearing aids. Acceptance is what I have always known growing up my whole life.
do you imply to accept aid, as it is and get used to it without hearing well?
Wow.... THANK YOU for this. I've been researching like crazy the last month about how to treat my hearing loss. Your videos are so clear and concise that i'm starting to really understand what to look for with hearing aids and the clinics that prescribe them. I also have very poor vision so the part about having "good enough" care is so relevant to my life right now. I'm tired of just excepting "good enough" care and trying to research as much as i can before i make the appointments with the clinics.
If i lived in Arizona, i would come to your clinic in a heartbeat. Again, thanks for the help.
Thanks Kenji. I'm glad you like the videos! If you have any specific video requests, let me know. Thanks, Cliff
I Received my Phonak V 90 Aids from Th VA . They don't do Real Ear, Can I go to another provider that will ?
You did a GREAT public service with your videos. Your videos are clear, concise and fair but most importantly, INFORMATIVE and ACCURATE. Thank you. I will share this with my brothers & sisters of MARINES-FIND YOUR PLATOON.
You are very welcome
Gold!!! Thank you very much for sharing this information with us Dr. Olson. There is a lot of very valuable information here!
Thanks! This is my favorite video.
I'm getting hearing aids next week and I asked my audiologist if he did REM and he said it's compulsory in Australia. It's just as well because I mentioned Dr Cliff who'd said to walk away if rem isn't done. I mentioned I watched 'dr cliff aud' to acquaint myself on everything I need to know and he said that he watches him as well and was pleased that I'd researched as much as I had.
I am so thankful for your videos. I had my hearing test done yesterday and I had made several notes to take with me to the audiologist. I have pretty bad tinnitus and I also have severe hearing loss in the upper register. One of the questions was if she does real ear measures. She smiled and pointed to a box under her desk and commented that she had just gotten the equipment to do real ear measures and she intended to be trained in how to use it and be up and running with it in about a month. I chose the Phonak Audeo M-R 90 RIC rechargeable. We are going to do the fitting for the time being and just as soon as she is up and running with real ear measures, I will be back in the office for that fitting. I mentioned that I learned about how important this was by watching you on youtube and she grinned and said, yes, I watch him also. He is terrific. So...thank you so much for your very informative videos. I have learned so much...and so has my Audiologist!
Hİ,
I am an Audiologist from Turkey.Your videos are really really wonderful.Thanks for sharing your experiences and informations !!! GREAT JOB 😊 I have just subscribed your channel.I am looking forward to see new videos 👏
Excellent Advice delivered in a common sense way. Cheers from Michael. Australia.
He really does tell us what Real Ear Measures are beginning at 5:40. They are measuring the sound inside the ear to ensure the frequency response of the hearing aid matches the prescription frequency response when the aid is in place.
thank you I was losing patience with this video..
Thank you for the 5:40!
You are awesome! Thank you for taking the time to make such informative videos. My wife and I feel smarter and better prepared for our son's hearing aid fitting. Keep grinding my man!!
Thank you for this video. I already knew about REM, and select an audiologist who does them, but didn't know exactly what went on during the process. Thanks to you, I do now. 👍
This is a wonderful video. Thoughtful, well presented, and targeted at exactly the right recipients. The bottom line is to try to maintain an open mind in seeking the best hearin AIDS. Don't simply run to Costco, because of low prices. You may get a better result from an independent audiologist/retailer. Price is important, but should be down on the list of variables, not top of the list. I made the mistake of starting at Costco. For me....a bad decision.
I'll get soon my first hearing aids. Your videos were very helpfull from the beginning of my journey. Thank you from France.
I have been hearing impaired since birth, 73 years. In the last 2 years I have decided that the audiologist were not doing their best. This in mind I went to purchasing on line (auction) and programming them my self. I have found that I can do as good a job as they have done with far less money involved. I can see that with a REM unit I could probably come closer to obtaining the hearing solution for my self as humanly possible. The vocal power of suggestion does intimidate us the users in not speaking up because we believe the audiologist is the professional and has the degree and knows more than we do about our own hearing.
Could you kindly tell me where you purchase them..the prices for a new pair are ASTRONOMICAL !
Luigi R. I helped a relative recently. I researched numerous options available. The best prices by far were available through Costco. Similar if not the exact same models that sell everywhere else for $6,000 to $8,000 can be purchased at Costco for $1,500 to $1,800.
I don’t know what suction prices are, but I’m sure they don’t come with 100% money back guarantee like Costco has and their amazing service.
I’m not affiliated with Costco, just a happy customer.
Due to insurance issues, I couldn't get new hearing aids from the only approved audiologist in the DFW area, so I chose one near my home that was approved by my insurance. The first thing I asked him was did he do real ear measurements, he said yes & pointed to a machine so I thought all was well. When I picked up my aids he did some adjustments on his computer & sent me packing. Having had REM before, I thought maybe there was another way to do it. So I watched a couple of your videos to verify that in fact he didn't do REM. I go in the morning to try a different set as these don't it me all that well, so I'll bring up the topic & see what he says.
I have been a sufferer of tinnitus for three-years disability-an But it does get better I think our bodies brain does heal it so we can liberate God bless all of you
Thanks for all the helpful info Doctor Cliff, having your level of expertise to listen to is a game changer.
Hi Dr. Cliff, AuD. You can thank
professionalvideos
for the fact that I just hit "like" and "subscribe" to your video. And the reason is, because, he LOST the argument and you were proven right! (in my eyes) I became hearing impaired due to brain surgery. Been to many audiologist and never heard of rem? However, I had appt. with new audiologist just yesterday and from your video i watched; she did the rem test. :-) Keep up the good work, looking forward to more videos! ps going to check out the Oticon opn cic? Am in phonak now bte.
I really enjoyed watching this video. It explains a lot of information that I would of never realized.
ਇਸ ਕੰਮ ਵਿੱਚ ਬੜੀ ਗੜਬੜ ਹੈ ਜੀ। ਕੀਮਤ ਬਹੁਤ ਵਧਾਈ ਜਾਂਦੀ ਹੈ ਅਤੇ ਲੁੱਟ ਖਸੁੱਟ ਕੀਤੀ ਜਾਂਦੀ ਹੈ ਜੀ।
Thank you so, so much for your formation I know I'm being lead to the right hearing aids ..
A great video that clearly explains a very important process. Now i know that my audiologist didn't do real ear measurements. Nor did he programme any extra sound profiles into my resound smart 3d app. Oh dear.
Glad it was helpful!
DR CLIFF. YOU HAVE MY RESPECT.!!! THESE VIDEOS ARE AWESOME.. I THANK YOU,SO MUCH.. AND THANK YOU FOR LETTING US ALL KNOW ABÒUT ALL THE RIF-RAF GOING ON. IM NOW BUYING NEW PHONAK-P-90 . PARIDSE ADEOS. CANT WAIT.THERE BEING SHIPPED . AGAIN WE ALL NEED YOUR VIDEOS.. GOD BLESS YOU.!!! JOHN..MINNESOTA
This should be a requirement for a hearing aid testing and fitting. Thanks
Agreed!
My mother really needs hearing aids but doesn't want to spend the money. I think with the new technology I might be able to convince here, although she is not a smart phone user. This video was super helpful. Thank you!
Dr. Olsen, thank you for instructing me on this new hearing aid world and foremost thanks for caring!
Take care
Thank you. That makes a lot of sense. Having lived a large portion of my adult life with a person having just this particular problem, I do understand
Appreciate the video. I've been wearing hearing aids since 9 years old. I'm 24 now and I'm really starting to take an interest in the newer technology and how programming works. Thankfully I go to a clinic where the audiologist is more than willing to teach me what she knows and explains how she arrives at the proper prescription for my hearing loss. I have reverse slope hearing loss and she's always told me that she takes a little extra time with her patients to be 100% sure that we're okay with it. Since she's in the middle of a mall, what we'll do is leave the office and go into the mall and she'll have a short conversation with me to gauge just how well my prescription is working. I wouldn't ask for anything better.
for me, it is all about the performance of the hearing aid, we have our expectations of what we want for our investment, that is why it is important to trial the ones you think you would like or can afford, all aids describe their capabilities , but if not fitted or programmed correctly you are not going to purchase you just keep looking don't be bullied into purchasing if undecided, you
are under no obligation to purchase if you are not happy with the hearing aids trialled hearing Aids they have to be right..
I really appreciate you posting this information. It is very helpful for a profound HOH person. I have a feeling that the next time I go shopping, I’m going to take a lot of time and gasoline finding a clinic that meets the REM standard of care. Why is this? Because it is cheaper and more PROFITABLE for clinics to skip this standard, and it is not mandated by our legislatures who are bought and paid for by the industrial health complex to not regulate these devices at a bare minimum standard. Why does the lay public have to know this information when professional health “care” providers spend years learning and honing their craft? As a healthcare provider, I hope that in addition to teaching the public, you are lobbying Congress for a fairer system.
Thanks for these educational video's. So very helpful! Wish you had a practice in the Philadelphia area!
Doctor, tank you for great info. I am will get one soon, and this info bring me up to speed about these
Thank you Doctor Cliff. The information you provide is of enormous help. This particular video has been the most helpful for me
Been wearing HAs for 15 yrs and have neve had Real Ear Measures. Asked my provider and he does not believe in REM, says he can do just as well with his questions and my responses, how does that sound? Will be going to Costco in a week foe my fitting for new HAs and very happy to know they always perform REM. Much more professional than my previous provider.
Rally fortunate to have found your site, I have subscribed and look forward to more info.
Hi Bruce. I'm glad you like the videos. Did you leave your provider because they don't to REM? If so, good. The provider's response is typical for someone who doesn't do REM, however research consistently disproves his statement. Fittings without REM are never on par with REM.
@@DrCliffAuD Perhaps very rarely on a par and then only by chance, rather than never, though I have no intention to support anything less than best practice.
Sorry for another question: If I go to an audiologist to get measured, what should I make sure I walk out with? How do I know when it's time to get hearing aids? How do you recommend dealing with the embarrassment of wearing them? I have also seen men not hear at all when they start using hearing aids and for some reason they are not wearing them. Like the hearing loss got much worse.
Thank you for this video..I was really curious on how this test works. It seems to be the key to good fit.
This is awesome. I have just begun my search for hearing aids...let the fun begin. Thank you for taking the time to create this video. I have subscribed and I've already watched the three big lies...again thank you.
Thanks for this video. I can absolutely attest to the difference REM can make. I have hearing loss on the left side following brain surgery in 2008. Immediately following surgery I had no hearing and some weird tinnitus that sounded like a lawn mower circling a tree. Within about six weeks I noticed that the tinnitus was gone and I could faintly hear. (My neurosurgeon was shocked that I recovered any hearing.) An audiogram showed moderate hearing loss in lower and upper ranges, and 84% word recognition. At that time they did not recommend a hearing aid, and I adapted by using my right eye for the phone, making sure that speakers were to my right whenever possible, and so forth. The only time I really noticed a deficit was in large open spaces, but for the most part life was manageable. Fast forward 15 years and I noticed I was asking people to repeat themselves more often and scheduled another audiogram. This time it showed moderately severe loss rising to normal at 1000 Hz sloping to moderate at 8000 Hz. Word recognition had fallen to 68% for my left ear but fortunately still 100% for my right ear. This time the audiologist recommended a hearing aid to preserve word recognition. I was fitted for an Oticon Real 1 that was programmed according to the computer program suggestions. I began watching UA-cam videos and at my followup appointment asked whether I would benefit from REM. My audiologist enthusiastically said yes, the clinic had just gotten a machine and she would love for me to have one due to my unique situation. In my case some of the adjustments were greater than 10 decibels from the computer model (REM was run twice to verify). It's only been two days but there is a huge improvement.
OH MY GOD. I wish you were here in California. I'm on the cusp of buying new hearing aids and I wish I could visit your clinic immediately for a second opinion. I KNEW IT I KNEW IT I KNEW IT that analog hearing aids were better. I've worn analog hearing aids my whole life (since I was 3 years old; I am 39 now; single-sided deafness in my left w/moderate > profound loss in my right ear) up until around 8 years ago when I had to switch to digital because that's all they made and that's all my current audiologist I've been using for 20 years uses. I've never been 100% satisfied with my digitals especially in noise. I'm using the Phonak NAIDA Q-90 UP w/CROS H2O unit for my left ear. Most of the automatic programming is turned off because I cannot tolerate it and it is made to sound more like analog with linear processing. Which, of course, doesn't quite sound like the old analogs. Oh how I miss it so very much.
AND: oh how I hate having to open and close the battery door to turn off the freaking hearing aid!!! Why can't I have a switch to turn it on and turn it off when I please? The manufacturers' decision in that regard was the dumbest thing I've ever heard of happening to hearing aids. Sigh. Amazing videos and I will for sure ask my audiologist about real ear testing. I'm usually doing testing in a sound booth for a general audiogram, but I doubt that's exactly the same as what you're referencing. Likely going to get the Phonak NAIDA B-90 and CROS-B.
I was diagnosed with severe hearing loss. My provider says they don’t do REM until 2 to 4 weeks after you start wearing them. He said the prescription was right for me based on my hearing test. Also that they wait so my hearing could get used to the devices. Is that true? Thank you. You are a Rock Star by the way. Thx!
Hi Adco59. Thanks for the Rock Star compliment! I'm not a big fan of the "first-fit" method followed by REM 2-4 weeks later. I personally like to know exactly what the sound is doing inside your ear, otherwise, I have no clue what you are actually experiencing. Basically, you are just losing 2-4 weeks of proper adaptation to sound. Seems like a waste of time to me, and I value time more than ANYTHING!
The other drawback to manufacturer programming first then meeting real ear is that the hearing aids may have an initial sound quality and curve that doesn’t match real ear much at all. When the patient gets fit to real ear, they may feel like they are completely different and may have to adapt all over again.
Many professionals don’t realize that the hearing aid software will reduce gain using acclimatization based off the adjusted levels.
Hi Dr. Cliff. In this video, you performed a few rounds of tuning the gains to match the prescription. I watched the fitting tech at Costco struggle through this procedure, but she did eventually get the solid line to closely match the dashed prescription line. I think it would be very beneficial if these softwares would employ machine learning training algorithms to build these gain tables to match the prescriptions. A good AI algorithm (something coded with Tensorflow, for instance) could do in maybe 20 seconds what it takes the fitting tech to do in 20 minutes, and do it more accurately too!
That technology does exist already but I find that they don't match prescriptive targets exactly when verifying after the Autofit.
Cliff: I have commented on several of your videos in the past and enjoyed this one as it hits on a couple of issues that I face. My hearing loss was diagnosed by an M.D. several years ago and 5 years ago I purchased a set of Siemens hearing aids from a retailer (bad choice I know). I have also had exams by 2 different Audiologists and another ear,nose & throat M.D. and at no time has anyone offered me a prescription for my condition and none of these have performed "Real Ear Measurement". I asked the last Audiologist about this and mentioned your videos and her response was the software that comes with the hearing aids is all that is needed.
My Siemens hearing aides have never functioned to my satisfaction and are a real problem when I sweat (which is just about constantly). I clean and dry them several times a day and between sweating and earwax build up they are a maintenance nightmare! I few months ago the last Audiologist I visited let me try a pair of Phonek lithium-ion hearing aides with the molded ear piece. They worked better and stayed where they were supposed to. They also cost $7,000.00. Unfortunately every Audiologist or retailer I have visited only carries one brand and does not have the software required to work on or adjust other brands. Even with the Audiologists I still get the old line of "I bet that's a lot better right?" and at that moment it probably is. At the age of 75 I find that I am about ready to give up. Frustrated on Ohio.
Hi cplrey. I'm sorry you haven't had better success with treatment. As you know, there is no good excuse not to use REMs. There is also no good excuse to offer only 1 brand of hearing aids. All I can suggest is continue to look for a new audiologist who offers multiple brands and does REMs. Check out www.HearingTracker.com to find additional providers in your area.
great video. Wow where were you when...... Have Menieres Disease for 44 years. Yesterday the audiologist adjusted my phonak Audeo Q bought in 2014 after my REM. She showed me the Phonak B-Direct and a video of the Roger Select. Discussed with husband and will be fitted next week and try out for the next 45 days. Just want to be able to hear at social gatherings and out with friends and hope they work. Dr. Susan Miranda King neurotologist and audiologist Dr Robyn Shandley are it has taken 40 years to find this kind of help. subscribed and ready to stay connected. Thanks.
Glad to hear you are now getting good help. Everyone deserves to have the best care possible. Hopefully most find it before 40 years!😮
I have stage 2 Menieres Disease and have been researching hearing aids for the first time. At the moment the left ear hearing loss is stable but the right ear hearing loss fluctuates widely, and the recruitment can be terrible. My research indicates that self-programmable hearing aids are best for me. I would also get some training on how to programme the aids. What is your Opinion, Dr Cliff?
That was the most informative video ever. I really appreciate the time he took to explain everything. Thank you so much!
Your channel was the first to populate when I search hearing aid technology. Your videos are very informative, thank you!! I wish you had an affiliate in Dallas!! I’ve decided to seek treatment due to surgeries for antibiotic-resistant ear infections when I was little.
I have tiny ear canals that most of my doctors over the years have said, “whoa, you’ve got tiny ear canals!” 😬
Hi Leslie. Thanks for the kind words. Yes, treating hearing loss with small canals is difficult but not impossible. Don't let that discourage you!
Great information and the public should know!
Hi Doctor Cliff! I just had a 3 week try of a hearing aid device from Signia NX12, I had it returned because I felt that it was not really helping me. This is my second hearing devices,
I had for about 6 years a phonak audeo SM, which I barely used and when I really wanted to star wearing them, my audiologist told me that they were discontinued and can not longer
be adjusted or re-programmded, so they recommended me this Signia RIC that I'm talking about; the other thing that prompted me to return the Hearing aid, was that after I had watched your video regarding the importance of the REM; I discovered that my audiologist did not performed this crucial Test, my biggest problem now according to the result of the test done,
is that during these 5 or 6 years my word recognition went down from 77% to 44%. So I will star to look for another hearing device and try to wear them all the time, however my financial
situation now is different to 6 years ago, I am a retiree now, without income, depending most of my pension and Old age and some savings, What do you recommend that I should buy.
Doctor I had watched most of your helpful videos and I found them really really informative and educational for the "lay person" Thank You!
Raul
been looking for a long time for my artillery-deaf brother-finally!
Mondo cool info. Reminds me of the old adage: "Trust (but verify)"
Dr Cliff
Exactly what is a “hearing loss prescription”? How is it determined?
Thanks so much
John from Texas
Thank you for the advice! I got my hearing aids a week ago and feel pretty annoyed instead of excited because everything was too loud and weird.. and my audiologist checked and lowered some frequencies but i realise i didnt take a real ear measure..
Can you change the frequency of the music you use in the beginning and end. My dog hates it when it hears the high frequencies and wakes up.
Your video's are very informative and thank you for taking the time to make them. I have learned a great deal about hearing loss and hearing aids due to your video's. Keep up the great work and thank you for being an honest health care professional. You truely seem to care for your patients. REM video is great! One of the most informative and very important aspect of treating hearing loss today.
LOL. Sure Ian, just send me a few 6-8 second "catchy" sound clips that I can use for the intro and outro and I'll give them a shot!
Glad you enjoyed the REM video. It is the ONE thing that every hearing aid wearer should know about! Please share it!
This has been a revelation as i did no know that this test should be done as i have always had trouble hearing properly with my aid in one ear as it seems not to amplify as the other ear keep up the good work
Thank you 🙏 for your information.
Thanks for this. Going in for my first fitting for reverse slope next week ... hopefully it won't be awkward to ask if this is the method they're using. Do you know why 70% of audiologists don't do this?
Wish I had viewed this video before picking up my first set of hearing aids at the VA. A technician gave a class that showed how to care for the aids and then the audiologist ushered me out the door. I told her I was experiencing a stuffiness sensation and she said I would get use to it! Well after two weeks, I returned for a Walk-In appointment and the technician adjusted the fit but told me the other issue was a programming problem that had to be addressed by the audiologist. All of this could of been avoided if a Real Ear Measurement had been done at the initial visit. Now I have to wait over a month to see the audiologist. Thanks to your video, I know what to ask for!
Hi Vatalon56. It's unfortunate that you have to ask to have these basic fundamental best practices completed, but at least you will have them done eventually. 🙂
Vatalon, the VA requires every audiologist to use best practices for care, which include measures of benefit. Objective measures like real ear are required by many VAs, because the national VA is recognizing that subjective evaluations provide only a “better than nothing” response.
Pure gold information, thank you.
Big question: How much does the growing micro-intelligence in the newest Hearing Aids skew the REM based settings? From my research, it looks like each manufacturer has its own algorithms to automatically torque the individual equalizer settings based on the perceived environments and dynamic circumstances at each moment? Overlay those adjustments with features such as noise cancellation, focus, and impact reduction technologies and it is hard to understand how to use REM to accurately "SET" the instruments to a valid baseline setup.
In the world of older technology HAs the value of Real Ear Measurement is easily understandable. In the new world of intelligent hearing aid technology wouldn't the particular hearing aids under test need a built-in recognition of an in-process REM test (much like Volkswagen's EPA testing awareness) and switch to a consistent set of control parameters while the test is underway? If so, it would seem that they must also have the ability to remember and use those REM derived settings as some sort of baseline around which all future real-world automation is built and controlled. At present, it appears that they only know about the momentary existing environments which must be compensated for. I know that some HAs claim to "learn" how to satisfy the user's needs over time it would appear that over time, whatever REM based setup was established at the Audiologist's testing will become distorted and eventually become unrecognizable and lost.
Hi Budd. Valid concern. Typically REMs are conducted with digital features turned off. The main goal of REM is to ensure audibility. Once audibility is restored, yes, digital features can alter the hearing aid output, but after measuring these features myself they have little impact on overall audibility, unless they are intended to, like with directionality depending on position. All tests indicate REMs are extremely effective and important even in modern digital hearing aids with a plethora of digital features active.
Cliff, just wanted you to know that I went to my audiologist for my first visit today in regards to hearing loss and tinnitus. I asked her if she did REM's, and she was taken aback. She said yes she does, and how did I even know about them? She also said I was the first patient that has ever asked her that question in 16 years of practice. I told her about your website, and she said she would check it out.
She agreed that all hearing professionals should do REM's and that HA's aren't being utilized correctly unless they are done. She also indicated that her office (part of a hospital group, not private), and one other private practice were the only offices that did REM's in the area.
I live in an area of 1.7M people and that is astounding.
So, you're doing some good by educating a guy like me. Hopefully, it will make clinicians understand that they can no longer take shortcuts with patient's care and money.
Thanks again.
Hey BeachGunner. I love this story. I completely agree with you that providers can't take shortcuts if the consumer knows what demand.
Thank you for this very informative video!
Real good info about real ear measures. Wish doc was in my area.
You probably have a good audiologist in your area. You just have to find them.
This is an incredibly helpful video. Thank you!
My pleasure Chris! Of all my videos, this is my favorite.
excellent video Dr. Cliff....i learnt alot...thank you
I learned a few things.... I need to get my eyes tested somewhere else and I don’t believe anyone uses real ear measurements in the country where I live, looking at £2700 to £3600 for a CROS hearing aid and I’m shopping blind atm, I only get scant information on I would be purchasing.
You have been a great educator
Thank you
I never been to any other audiologist then the VA hospital and as far as I can tell they did right by me and when I picked up my hearing aids on Aug 17th he did the hearing test on them while they were in my ears and the machine hanging on my ears making the sound test and made the adjustment
First, Thanks for the informative videos. I always pause your videos so I can take notes. I'm a new hearing aid user and still in the trial period. Will my hearing care provider be insulted if I ask about 'real ear measurement'? My Medicare Advantage program has given me just a few professionals to choose from, so I don't know enough about her to ask her all these questions. I only know that at this point, my hearing aids aren't working for me. I hope she will be open to my informed questions and help me out. LG
Cliff, Im great full for your honesty in your videos. I followed your advice and obtained "bought!" the Kurkland. I bought an over the counter 125 dollar el cheap o! as an emergency back up on the internet..They say they are hearing aids, but theres no comparison with the Cost go ones!. just like you said, there Amplafiers! There is a play on words being used here. If i put my hands up and cup my ears, i can hear better! therefore my hands act as hearing "AIDS" because they are aiding my ears to here better! and my hands are amplafiers because they amplafy sound! Now make a video on how to keep from goling nuts!
This makes perfect hearing sense. We are tested for the hearing loss then given a hearing aid with the recommended correction but not retested if it is on pitch with what is actual to our hearing correction. I have wondered about this and appreciate learning what the best practice is for the those seeking out audiologists. Thank you!
Thanks! Very helpful. I had no idea
I am watching this a few hours before my fitting appt. i am so glad I have seen this. I have a feeling the place I am going to is going to be crap. My insurance is sending me there.
I work in the industry as audiologist as well yet there are some different opinions then please let me ask about your opinion:
1) What do you do if your patient is not accepting HI after REM measurement? E.g. it's too loud or too sharp for him/her?
Do you change the fitting to make it acceptable?
2) What about adaptation process for first-time users and how about REM measurements for first time users?
(just to be clear - I'm asking about adults - pediatric fitting is a bit more complex as we know it)
Worth to mention - although REM looks quite easy in fact it's a measurement that require certain knowledge and experience. It can be tricky (e.g. if probe will be pulled out from the ear between measurements you will get huge differences).
It's super important to know how to do it properly yet I have feelings this knowledge is "disappearing". Don't you think?
Hi Rafal. Thanks for the questions.
1. The goal of REM is to get the patient up to their prescription. If they cannot tolerate that amount of gain, then we reduce the gain at that first appointment. Approx. 80% of my patients require some reduction at the first fitting. However, within the next 45 days, nearly ALL of the patients are able to accept their full prescription after acclimating. The ones who can't know they are not at their full prescription so if there is concern over their lack of hearing ability, there is a direct reason for it, not just conjecture.
2. REM is unchanged for First-time or Experienced users. Just about everyone adapts to the prescription, you just have to "baby step" their way to the full prescription. It usually takes several weeks.
Performing REMs well is critical. You need to make sure you do it perfectly in order to get accurate results. I do not feel like REM knowledge is disappearing. Nearly all new AuDs are trained on how to perform REM, but if clinics they are hired at do not use them or have REM equipment, it's hard to perform them. Eventually all of the "old school" hearing care professionals that do not use REM will retire and hopefully their "how does that sound" approach to programming will retire with them.
For number 2, I'd REM at target gain then reduce acclimatisation if necessary
This video my understanding is broadcasted 5-yr ago claiming that 70% of the hearing fitting places are not doing “real ear measurements”. Dr. Cliff, What are the chances today that one will get real ear measurement when the HA are not purchased in the hearing g p,ace where one goes to get better fit? Or majority of the hearing clinics today are doing real ear measurements? Ken
I got my first hearing aids last week. With the information from your videos I was able to ask very pointed questions and have a better understanding of the answers. When the Doctor did real ear measures. It was only once. I was expecting more of a process. When I asked she said, they only need one sample to program the units. Is this right?
You are amazing. Thank you.
Oh wow - thank you for this - no clue if you'll see this since this is an older video but I appreciate this soooo much. I'm going back for my second trial appointment next week and I see now I need to get those lines to match up! I'm new to this but now I know that I don't have to settle. Thank you! :)
I also wanted to say that even though they DID do a REM test, they left me at 80% below my upper line saying that it was good because it gave me room over the next five years in case I needed to get more amplified (I'm paraphrasing here)... This was before I watched your video. This is my first day with my hearing aids and I go back next week (same time same day) - so I should be making them line up my lines is what I'm getting from your advice. Correct?
I wouldn't wait years to get up to 100%. Why not get to your full prescription sooner?
@@DrCliffAuD AGREED!!! I keep thinking I'm nuts with this - like it's good but it's not great. I'm like that eyeglass analogy. I'm trying to think of that saying like 'almost but not quite there' - it escapes me. But at least I have perfect vision. Oy. 'Nice try but not a cigar?'
Wonderful informational video, Doctor Cliff. Kudos!!
Hi Doctor Cliff, thank you for your video regarding REM, it is very informative.
What if, the patient refuse or doesnt like the prescription done using REM?
Sometimes they report of to loud, too sharp/ metallic sound, i really appreciate your advice.
Thanks again.
If you are using a manufacturer's prescription formula, is there any point using REM when the REM target is based on a different formula (NAL-NL2)?
Can you do a video on what you do for patient's that can't tolerate their hearing aids at target? You kind of skipped over that aspect. Just curious what your go-to protocol is for these types of patients.
Do you have any recommendations for a clinic in Kansas City? Actually, that’s what’s needed. A national list of good clinics
Thanks for this video. I just had a hearing test today, and am returning next week for my first hearing aid fitting, so am doing a lot of research. The comments from this person who calls himself "Professional videos" are so upsetting, so I checked my audiologist's website to see if he mentions Real Ear Measurements. Was relieved and surprised that he states that REM and speech mapping are "required by NY State Licensing Guidelines. It is also recommended by American Academy of Audiology (AAA), American Speech Language Hearing Association (ASHA), and other hearing aid dispensing organizations."
Hi Dr. Cliff. As a retired Chiroprator I appreciate the quality explanations you provide to very confusing material. Question in the real ear measurements are you removing the hearing aids to do the staged adjustments to match the measurements? If REM is used will the client disturb settings when they personally make changes within the Makers Apps?
Hi Rich. Thanks. REMs are conducted inside the ear canal with hearing aids in place. Yes, a client can disturb the settings may making personalized adjustments in their remote control apps. However, the REMs set the foundation for any adjustments made and they can be reverted back to if necessary. In some cases, if a patient makes customizations that they prefer, I can use REMs to adjust the default programs to match what the customizations they have done in the app.
I would like to see you address the Medicare Advantage Co-Pay situation with hearing aids.
Very interesting video !