How To Perform Real Ear Measurement (REM) | Using Natus Aurical PMM

[@rstewarthome]

I like how you adjust the loud, average and soft sounds separately. I was trained to adjust all of them at the same time and I always feel like I go back and forth so many times to get things just right between the levels. Thanks for sharing!

[@parfl]

Thank you for putting these videos on KZbin. I was tested last Monday 5.23.22 with 20% hearing loss and white noise at 3000db. My husband knows sound from being the sound guy. He has helped me understand some things. Your videos explains what he was testing me for in the sound booth and the real ear testing he did with and without the hearing aid. Fascinating. He tested speech sounds in a variety of settings. Sometimes I didn't hear at all and some I did. Quite interesting watching these videos after the test.

[@jso1350]

You are wonderful. This is a very high quality informative video that you have shared with us for FREE. Thank-you doctor!

[@DrCliffAuD]

You are so welcome!

[@epoulos108]

I thank you so much. I just made an appointment with a company that has REM and more of your big 5. You’re a like saver. There are no hearing up providers in the Bay Area or I would have chosen one. I

[@nealthomson9505]

Dr, thank you for sharing your knowledge concerning our profession and helping us to give our patients the ability to get the most out of the equipment that we have chosen for them to use. I know that i will be applying some of that which you have shared and that what i do not use will always be in the back of my mind, ready for the time its applicable. I realise that most of your content is geared towards the end consumer but i know for a fact that there are a lot of hearing care professionals out there looking at your videos because they are definitely helpfull. Since i introduced your channel to my partners, I know that my whole group keep a close eye on your channel for these and many more reasons as we are all passionate about giving our patients the best care out there. Would it be possible to make a few more videos specifically aimed at we professionals. I appreciate your consideration. TGC Blessings in abundance :)

[@TheBestEpicProGamer]

Thank you very much for sharing your knowledge! I tried several hear caring professional and found the best one because of you! It‘s a life changing difference now

[@jeromewhelan6723]

Just formed an opinion after watching several videos discussing hearing aid fitting and adjustment: Your's is the best! I am a retired engineer and your video here has had value to me, another offeror on the same topic served three videos which seemed like "word salad", I didn't learn nearly as much there as I did watching your video here. In particular, the adjustment of variable levels of compression was interesting.

[@stephenhiam5375]

Wow, in all my hearing test and hearing aid fittings I have never been offered REM as part of the service! Thank you for the information in helping me understand I should demand a better service from my hearing care professionals!

[@Natalia-rm5co]

I really enjoyed this video! I love learning about why things are done the way they are & understanding the process as a patient. Thank you!

[@DrCliffAuD]

Glad you enjoyed it Natalia. Out of my 200+ videos, this one is my favorite!

[@VLiviu]

Dr Cliff, you are amazing! Thank you for sharing this online

[@milkdropmo]

This is very interesting and addresses my fear of hearing aids amplifying the many sounds that are already normally too loud for me!

[@jer3131]

Thanks Dr. Cliff for that informative video.

[@doctorem]

Wow! Although not an audiologist I am a physicist and a musician and I pride myself on knowing a LOT about sound, acoustics, and psychoacoustics. I also suffer from moderate high frequency hearing loss and have been thinking about a new pair of hearing aids and stumbled across your video collection in the course of my research. I've now been binging on your videos for a couple of hours and am simply blown away by how much I've learned. I swear, you ALMOST make me wish I lived in Phoenix. ;-) THANK you!

[@rodgerbrown7803]

Wax filter

[@davidcrandon2329]

Wouldn't it make sense, if you are trying to get the curves as accurate as possible, to make sure to start with a curve that represents the patient's hearing loss as accurately as possible? By this, I mean performing an audiogram with more than 6-7 data points? If the hearing aid I use has a capacity of 15 channels (frequency bands of the Widex Moment 440 for example), then wouldn't it make sense to measure at 15 different frequencies from perhaps 250Hz to 10kHz or so? As an audiophile, I would cringe at taking only 6-7 frequency response measurements of my loudspeakers in my listening room, and then adjusting them. I would want to measure more frequencies to make sure all the dips and peaks are as accurate as possible. Doing the REM is analogous to what an audiophile does with Room Compensation Equalization (Audyssey is the industry leader) to make their audio system as accurate as possible. Not being limited by processor power, Room Equalization curves such as Audyssey use FIR filters that could essentially have several tens of thousands of frequency points, each individually adjustable for level and Q, etc. I know we can't do that with the limited processing power that can be stuffed into a small HA, but if we have the potential for adjusting 15 separate channels (frequency bands) in a HA, then shouldn't we be measuring at least 15 frequency test points in the audiogram? I have a feeling that the average Audiologist, even if they DO REM, is only using 6-7 frequencies to measure, although they may have 15 possible points of adjustment. I assume this would increase the time spent on the audiogram significantly as well as the REM.

[@digitraxanr]

​ Very good question. Is the 15 point, or higher, calibration used after a set adaptation period?

[@kaylasmusic]

@doctorem - What devices do you use?

[@Sean-me4fv]

@@davidcrandon2329 The most frequencies I ever measure is 10, but I usually measure 8. I agree with you, it will be more accurate the more data points you have as a reference. It's scary to see some people fit aids with only 4 frequencies tested.

[@fredfarnackle5455]

Good video, thanks for posting. Makes a lot of sense.

[@michaelwood8071]

This is awesome. I had no idea it was so involved.

[@Elephantine999]

Wow, that's really thorough.

[@daveladd7046]

Really nice video Doctor Cliff- thank you..

[@eftitube01E]

As with your other infodeos, excellent information! Specific and actionable! Actionable in that we (hearing aid current and prospective users) are able to recognize true professional Audiologist by their "Actions" prior to and during evaluation and post fitting.

[@dagrinchi]

So, I was using my hearing aids wrong for my last 12 years, but I have a question, I am a native Spanish language, My hearing aids configuration may affect to learn another language like English? Your videos make a lot of sense, Its why I never understand other people in English unless has subtitles. Thanks for knowledge. Hugs from Colombia

[@marcoalff]

Thank you. Very helpful information and video.

[@marcelkoppel4890]

I really enjoyed watching this video but there is one thing I didn't understand: How do you create the NAL-NL2 Prescriptive method for each patient. I understand the process of adjusting the hearing aid to the prescriptive method but not how to design the prescriptive method for the patient. Marcel Koppel

[@ynotjf]

Dr. Cliff, what assurance does a consumer have that the audiologist has used the REM correctly and fine tuned the hearing aids for maximum benefit? My audiologist makes adjustments based on REM but I always feel the hearing aid performance decreases rather than increases but the audiologist says “it takes the brain time to adjust”. I’ve lost confidence in my audiologist ability to fine tune my Phonak Audeo L90 but as a consumer have no way to verify my concerns. Oh and by-the-way, just try to get another audiologist to verify the programming on hearing aides they didn’t sell..

[@Kansas-Paul]

I have hearing aids and real ear measurements were not done at the fitting. The last time I was in for the 6 month cleaning I mentioned real ear measurements to my HIS and she actually discouraged it saying it would make them too loud. So now I’m wondering what I’m missing out on since I do still have some problems with missing words and sounds. Much much better but no where near 100% happy by any means.

[@shawnamorgan6846]

Is REM performed by placing the hearing aid in a box with a probe as well?? I think this is how my professionals do it

[@GaryStanden]

Thanks again for a very informative video! I am back in to my ENT on the 29th to recheck my hearing loss/change since finishing chemo. The Tinnitus is loud and constant, has not changed and my asymmetrical cookie bite hearing loss is still with me. So it is looking like I will be in the market for a set of hearing aids.

[@DrCliffAuD]

Well Gary, I wish you the best of luck. After watching this video you are definitely better informed on what to expect!

[@garnikderian8085]

Gary I ended chemo 3 months ago without hearing aid. I have had tinnitus too. My oncologist put me on adult dose Aspirin 325 mg that raises it. consume tree nuts, help combat cancer. Fortunately I'm using Dr Cliff's video to my advantage just in the nick of time. Good luck on your journey, and Thanks Doc!

[@Lucy-rm1il]

I’m being fitted for hearing aids on December 21 what can I expect and can you help me on what happens at the appointment many thanks dr cliff and I am watching a lot of your video’s

[@pablogutierrez4642]

Thank you doctor for such a great explanation... I have a question is there for any chance that that procedure can make online... I am writing from Bolivia and my father has a loss hearing so can you help please, He had a device but the doctor and it was one of the best didn´t do anything what you taught us... and now he does not use the device because it can´t hear properly... I hope you can help us

[@hillary707]

Is it possible to perform the test in the presence of fluid in the ear? in a type B ? THANK YOU

[@Mike-g9o2r]

Is there a phonak dealer in Las Vegas NV that uses best practices??

[@Mont_Blanc_Photography]

I've just had my first hearing aids fitted, and the audiologist didn't do anything like this to do a fitting, so no feedback microphone, or testing different speech patterns and decibels...none of it! So now I'm worried that what I'm getting is a bit of a feel in the dark rather than a correctly measured fitting.

[@ocbojm]

same here, when i got my c&G 7ax, they didnt do this... it is here in Ottawa. I have my next appointment after 2 weeks, i will ask them about this test.

[@carolfox7162]

I just went to get hearing test. After the hearing test She did the adjustments. She did a calibration. I ask if that was real ear measurements. She said yes. She didn't put a probe along with the hearing aides at all. Not real ear measurements at all.

[@Brother-Luke]

My HCP just fitted me with a Widex Smartric 440. They performed a situ and then REM afterwards and used autorem for various loudness levels. It showed lines from the insitu and then the rem adjustment lines above, which provided more amplification. They then set to inexperienced user to reduce amplification for a couple of weeks while I get aclimatised. Is this correct? They used an Aurical machine.

[@dalepritchard3335]

I go in to pickup and get fitted for both ears next week. I will ask about the REM test if they don't offer it. Thanks

[@venkataramanravikumar1572]

Hi Cliff, Thank you for this wonderful informative video. I am venkat from India, Tamilnadu, Chennai and my son aged 4 is having hearing loss of moderaely severe in right and severe to profound in left ... i am having signia motion charge and go sp x hearing aid... can you make measurements for him remotely like a telecare...I ask you because you show these technical care analysis of real ear measurement so if you can check his audiogram and see if the hearing aid is properly calibrated as per the report..

[@karinadiaz5679]

Dr. Cliff really called some of us students out by saying "and performing it well". Lol *takes notes*

[@DrCliffAuD]

😂

[@margieherring355]

How do you find an audiologist uses REM for correct fitting?

[@DrCliffAuD]

the best way is to go to my website HearingUp.com and use the provider locator.

[@airborn65]

Dr. Cliff, how to keep the average speech level 65dB within the prescriptive target once the loud and soft level speech are subsequently adjusted? I noticed that any adjustment on the loud or soft level speech gain will change the average 65dB as well. This is what I noticed in the Target fitting software.

[@davidcrandon2329]

Wouldn't it make sense, if you are trying to get the curves as accurate as possible, to make sure to start with a curve that represents the patient's hearing loss as accurately as possible? By this, I mean performing an audiogram with more than 6-7 data points? If the hearing aid I use has a capacity of 15 channels (frequency bands of the Widex Moment 440 for example), then wouldn't it make sense to measure at 15 different frequencies from perhaps 250Hz to 10kHz or so? As an audiophile, I would cringe at taking only 6-7 frequency response measurements of my loudspeakers in my listening room, and then adjusting them. I would want to measure more frequencies to make sure all the dips and peaks are as accurate as possible. Doing the REM is analogous to what an audiophile does with Room Compensation Equalization (Audyssey is the industry leader) to make their audio system as accurate as possible. Not being limited by processor power, Room Equalization curves such as Audyssey use FIR filters that could essentially have several tens of thousands of frequency points, each individually adjustable for level and Q, etc. I know we can't do that with the limited processing power that can be stuffed into a small HA, but if we have the potential for adjusting 15 separate channels (frequency bands) in a HA, then shouldn't we be measuring at least 15 frequency test points in the audiogram? I have a feeling that the average Audiologist, even if they DO REM, is only using 6-7 frequencies to measure, although they may have 15 possible points of adjustment. I assume this would increase the time spent on the audiogram significantly as well as the REM.

[@lauraleekeating5355]

I bought my hearing aids from Beltone and when I pick them up and had my first fitting I asked about REM.The hearing specialist said the REM was not as go as ....the way he had them programmed because he was in the business for a long time and he knew better.He showed me the two graphs on the computer one was REM and one was his settings.He said see mine is better

[@DrCliffAuD]

Insert eye roll

[@michaelkebede741]

Hey Dr. Cliff, I wanted to know if doing REM in patients using trimmer hearing aids could be beneficial, and if adjustments made using the trimmer can result in better sound quality for the client.

[@sabinfine506]

Doctor Olson, thanks for the very comprehensive info. How do I find someone in my area (Ft Myers Fl) that does a comprehensive fitting?

[@basa820]

Kristin at Coastal Hearing in Bradenton is part of the hearing up network.

[@mrc2165]

I have had real air measurement performed a few times and it has never seemed to improve hearing over standard fit adjustment. And each time I've had to go get numerous adjustments to bring it into adequate levels. Is that just the audiologist doing poor rem fitting or do some people just not benefit from rem, because I'm not impressed at all. Tnx

[@jimgerace]

Can you recommend a few Audiologists in the Fayetteville, Bentonville Arkansas area?

[@StopLossLOL]

My closest audiologist is using the manufacturers sensogram instead of Real Ear Measurement. Is that a viable alternative, or should I look for a different audiologist? TIA

[@margaretmele843]

Do all audiologys do this test? Im on my first week & I go back in a week. Should i ask for one, if they dont bring it up??

[@jacklemarr6088]

Tinnitus. Has gotten worse from one of the KZbin videos audiologist pure tone, and jet engine tone. Including pressure both ears, and balance issues here lately . I have no idea which is worse the ringing or the pressure.

[@karenokeeffe8359]

Thank you for this REM information, I'm getting Phonak Paridise 90 hearing aids my first hearing aids. I watched your videos first then chose them, they seem to be a very good choice, thank you for your help if I lived in Phoenix I'd go to you, but I live in Ohio. Karen O'Keeffe

[@DrCliffAuD]

Are you going to a Best Practice Pro in Ohio?

[@tomlester8681]

How do I find someone near me who does this? I picked an audiologist because they said they did Real Ear Measurement on their site, but when I got their, they said they didn't and preferred to just tweak it over 4-6 weekly visits. It appears that this is very difficult to find. Any recommendations would be great.

[@jajajajaja168]

What the difference between real ear measurement and fine-tune your new hearing aids ?

[@chrismyers5409]

This was a very interesting video, this test came up on this Facebook forum today and thought to check it out: Hearing Aid Forum: Hearing Loss, Hearing Aids, and Cochlear Implants. It looks like a REM is something you go through after the hearinng aid purchase or before ?

[@DrCliffAuD]

REMs are done at the hearing aid fitting appointment.

[@kristianderton651]

I think I'm ready for my first pair of hearing aids. Do you have any recommendations for Audiologists/Hearing aid providers in Northern Utah (SLC or Provo area) who use best comprehensive practices such as those I have learned about thru your videos? I receive so many ads from different providers and I have no idea who to select or what questions to ask while investigating who to go to. Thank you!

[@mstinamichele]

He has a Resources tab on his web site where you can find a provider in your area. I tried it an there werent any in my area.

[@mclark8522]

Excellent and extremely useful information!!! Thanks!!! Can you please indicate if there are any hearing providers that do these type of measures in the Southeast US since I do not live in your area?

[@DrCliffAuD]

What state do you live in?

[@mclark8522]

@@DrCliffAuD Atlanta currently, but moving to NC near Charlotte in a couple of months. Much appreciated!!!

[@DrCliffAuD]

@@mclark8522 You'll want to see Dr. Melissa Karp. drcliffaud.com/providers/melissa-karp

[@mclark8522]

@@DrCliffAuD I need a hearing aid, but want to wait until I am in NC. Once I make an appointment , I will make sure to tell her that you recommended her. Thanks much Dr. Cliff! I've learned a lot from your videos!!! Be safe!!

[@lydwinaofschiedam2685]

M Clark. OMG - amazing!!! I just saw Dr.Karp in Charlotte based on Dr. Cliff’s provider recommendations (he has a list if you haven’t seen it), and Dr. Karp was AWESOME. Thorough and careful - and a great “bedside manner.”

[@CharlesJFiore]

Dr Cliff, HELP !!! I am in Naples Florida, where you can find a Hearing Aid store or Audiologist on almost every corner... and yes, we also have Costco. My head is spinning trying to choose a qualified person or place I can trust. Any recommendations would be greatly appreciated. Many Thank CJ

[@DrCliffAuD]

That's a tough one. Closest provider that I'm aware of that follows Best Practices is all the way up in Sarasota. Perhaps got to DrCliffAuD.com and print the Best Practice Checklist and start looking for a provider who follows as many Best Practices as possible.

[@stephensmith1034]

So - let me make sure I understand how this process works: A prescription is written by my hearing exam, and then I can purchase my desired Hearing Aid online, and provide them with my prescription, and they in-turn make all these adjustments? And then send me the Hearing Aid(s)? This is a very confusing process; one that I think ought to be talked about. Thank you.

[@DrCliffAuD]

Nope. While a hearing loss prescription is based on your hearing test, it is impossible to ensure you are actually receiving the correct amount amplification if that prescription is only uploaded into a set of hearing aids. Real Ear Measurement is a prescription verification procedure that ensures you are receiving the correct amount of amplification. This procedure must be performed by taking measurements inside of your ear canal using probe microphones inside of a Hearing Clinic. It is not possible to send your hearing test to a hearing aid company and have them "pre-load" your prescription and have it be accurate. Everyone's ear canal sizes and shapes are different which is not taken into account when a hearing test is uploaded into a hearing aid. This is why Real Ear Measurement is so critical to make further adjustments to the hearing aid programming to ensure your prescription is being met.

[@stephensmith1034]

@@DrCliffAuD Thank you, Dr. Cliff. I just had an exam with Miracle Ear. They showed me that I have hearing loss, which I already knew. I've never been down this rabbit hole of considering a Hearing Aid before. Miracle Ear's Hearing Aids are very expensive (Premium) and I need to know that I'm getting the care, and product, that I'm paying for. The problem is... I get little to No information out of Miracle Ear. They only talk about their testing. I get better information from watching your youtube videos. I'm just not comfortable using Miracle Ear. Do you have any suggestion of what other facility I might want to use here in the K.C., MO. area? Thanks for your help and all that you do.

[@lcollins2731]

Dr. Cliff, Is there anyone in Southern California that uses your methods? I have a pretty profound hearing loss and am trying to be realistic about what hearing aids can do. But my current hearing care provider really doesn’t do much in terms of what you are discussing here. Thx, Linda

[@DrCliffAuD]

Where in Southern California?

[@lcollins2731]

Doctor Cliff, AuD 90815 area code.

[@davidcrandon2329]

@@lcollins2731 Linda, I am very interested if you found an Audiologist you like. I live very near you.

[@PT121551]

Can you recommend an audiologist who does this kind of measurements in my area- San Francisco Bay Area (Oakland/Alameda)?

[@epoulos108]

Sf audiology in Walnut Creek doesn’t.

[@crys_o]

Would any hearing care professional be able to have access to the ISTS plugin for the REM test and how common is it? I've think I've only ever heard the frequency sweeps and static sounds during my REM tests. Is the ISTS a more effective way to maximise HA performance or is it more to do with personal preference of the audiologist?

[@DrCliffAuD]

It's personal preference. Both are speech weighted signals.

[@kennethgarrison521]

It is unclear how many times actual repeated measurements are done in your process (or any correct alternative process) as opposed to just ONE measurement at first with the software used to make all subsequent assumptions and adjustments. I ask because my provider does the one up front and says no more are needed after that unless my audiogram changes. Also, another audiologist's office that I called does it the same way.

[@DrCliffAuD]

In general, REMs don't need to be repeated unless changes are made to the programming or physical characteristics of the domes/earmolds. Ear canal size and shape change over time as well which can change the need for amplification.

[@kennethgarrison521]

@@DrCliffAuD Thank you doctor. There are a lot of different sizes and shapes of the domes, so what about that? Is the REM only applicable to the domes I first was wearing?

[@donnakauhn3740]

Does REM help for profound hearing loss?

[@DrCliffAuD]

Probably even MORE for a Profound hearing loss to ensure audibility.

[@donnakauhn3740]

@@DrCliffAuD Thank you we live in Chandler, AZ Do you know any one who will do REM in my area?

[@dgale1023]

Dr. Cliff my audiologist was going to have me try out new hearing aids and I havent had a hearing test for 10 years. My hearing aids are close to that age. Should they have performed that test? It was in a booth with me pushing buttons. Is that test viable? I can live without the aids in a quiet setting not not in a noisy environment. Thank you

[@DrCliffAuD]

REMs are extremely important for hearing in background noise. You need the booth test first, then REMs.

[@dgale1023]

@@DrCliffAuD thank you

[@philjungels7617]

How is the VA at using real ear measurement, and best practices?

[@DrCliffAuD]

Each VA location is different. Even different providers inside of each VA location can be different when it comes to administering REMs and Best Practices.

[@philjungels7617]

@@DrCliffAuD Thank You!

[@johnstuckey2589]

Old familiar, sad story. I have experienced bad fittings/service with one parent and myself for decades. I finally found an AuD that knows what they are doing and have turned my junk Evoke 4s into magic. I suggest that the ones of you who are in it for getting it right form an organization akin to board certification of MDs and DOs. That way the buying public can find good service in your field.

[@onthego6889]

Please recommend what hearing aids to use to pair with a stethoscope. I have read about using a streamer to pair with thinklabs ONE devise. Are all manufacturers of hearing aids offering these type of streamers? Please advise. Thank you.

[@DrCliffAuD]

You should be able to use any bluetooth hearing aid to use the Thinklabs One stethoscope with.

[@ТарасСтецько-н5щ]

What is RECD?

[@DrCliffAuD]

Real Ear Coupler Difference. It creates a correction factor to be able to custom program a hearing aid without wearing it. It does require an in-person measurement to obtain.

[@OK-om7ru]

Great video Dr Cliff. Would you mind your way of using the rainbow passage in more detail? I guess you would ask about the clarity of it and fine tune it if needed? How would you usually fine tune it ? Thanks in advance.

[@DrCliffAuD]

This gives me an idea if soft speech (at 50 dBHL) is audible. If not, the question becomes: can we add more compression and add more soft level amplification? If not, then it turns into a discussion of realistic expectations. Sometimes, you just can't make really soft speech fully audible. However, until we guage subjective perception, we can never know for sure.

[@OK-om7ru]

Doctor Cliff, AuD Thanks so much for your reply. Even if ISTS(50 dB spl) is meeting the target, you still would like to check if rainbow passage (50 dB spl) is meeting the target? Can you please explain the rationale behind the this a bit more ?

[@jeffsweeney312]

This is good. Thanks. It is interesting that audiologists intentionally 'misfit' the programming by lowering volume with the expectation that a user will return again and again until their hearing is optimized. I don't think users understand this. I know I certainly never had this explained to me. Some of us are stoic and will not return again and again feeling that the audiologist did their best and that their hearing is as good as it is going to get. Also, these repeated trips to the audiologist are time consuming and we all have busy lives.

[@DrCliffAuD]

There is software that will do a progressive increase in amplification up to your prescription. You also have remote care services to reduce in-office visits to accomplish this task as well. Something I don't talk often enough is spending enough time with a patient to understand your level of willingness to approach treatment in this manner. There can always be accommodations made for individuals with particular circumstances.

[@fallsdp]

I have never had this done to me...not knowingly anyway. Of course I have been wearing hearing aids and playing with them longer than Doc Cliff has been alive. I got my first aid in 1976. I had the same audiologist from 1976 to 2013. Then found my current one from the 1st one's recommendation. Both were and are PHENOMENAL.

[@jefferyhicks3678]

Have you treated people with Meniere's?

[@Spekt3r]

Can you make this measurement after a hearing aid has been bought and programmed?

[@KayeTiller]

Yes

[@scottdementd.c.4048]

I have SSD and some tinnitus. Would you recommend just a cross or bi cross. I’m leaning to bi cross. I do find I have to turn the TV up with watching. REM is needed with the cross systems? Thanks.

[@DrCliffAuD]

Yes, REM should be mandatory for nearly 100% of hearing aid fittings including CROS/BiCROS

[@gartrusselle5043]

Is there any issue with the testing if I have a pacemaker?

[@DrCliffAuD]

No

[@papamanari]

hummmmmm

[@themacker894]

That Phonak fitting you showed us in the video looked awful. Why use such an obviously junk fitting as your example?

[@6855mike]

I've watched about ten videos so far and this is the BEST yet. So important to be able to fine tune my device so that it is accurately matching my prescriptive targets. Thanks!!

[@lynnew09]

My audiologist does not do REM! I just got new hearing aids Phonak Paradise P90. Where can I get tested properly. My zip is 10547.Thx

[@JohnPeterson-n2l]

Your site has cleared up a lot of what I didn't know, I didn't know four years ago. Now I'm really, really pissed about what I didn't know four years ago. An insurance company referral to a third party to cover most of the cost. Now it's clearly the reason why they were the cheapest. Thanks for your time you have spent on your site. Cheers Jack

[@rodcarlo7047]

You're awesome, Dr. Cliff. This is very helpful. May I know what would be the curve if the eardrum is perforated? What do you do for those types of loss in regards to real esr measurement?

[@S88Chris]

good way to do it, I would additionally recommend the "open rem" feature 😊👍

[@AKrv-mp4ch]

REM's features use the audiogram, but if your hearing is measured by headphones, without a RECD measure, it is not accurate at all... Do you use insert earphones ?

[@janwillemdevries17]

Dear Doctor Cliff, I am an an audiologist from Holland. Like your video about REM, doing this for a couple of years now and the results are great. The last 6 months i have been practicing RECD with my clients. Can u tell me something more about RECD. What's the added value of this measurement can be and what to watch out for? Thank u in advance.

[@AndyCouldwell]

Well, I can see what you do, but the logic escapes me. You do the hearing test between headphones and brain, and then check the hearing aid with a microphone next the eardrum. It would however be logical to do the hearing test with a microphone next the drum and then use REM to check the aid settings. Anyone agree?

[@Yvonne-vy2su]

Dear Dr. Cliff, I am your fans from Taiwan. Wish I can some of your advise for brand of REM. My question is have you every used Trumpet REM from Inventis company? Is that a common REM brand in your country? Asked this is because we are going to open a new hearing aids company in TW and now searching for REM product with high C/P value. If I decide to buy this one, my store is going to be the first one to use this REM in TW. BTW, most common brands in TW are GSI/AudioScan. Thank you!

[@kaylasmusic]

there’s a lot of people that cannot describe how they sound, but there really should be a set standard, which is probably what the target is.. i think of it as being put on a medication,… when a doctor prescribes it, there’s 1) the right type of medication 2) the right medication brand 3) the right amount and dose of it.. if any of those things are messed up, the medication will not work.. Such as with hearing aids, you must choose the right type, the right manufacturer, and it must be fitted the the correct amount of amplification and settings.. if one of those things are off when it comes to fitting hearing aids, the totally will fail, and there would be no success with treatment..

[@MrGzuzero]

What a sadness not to know in Mexico, who can carry out this study

[@alwayslearning3130]

Excellent information and feedback! I am shopping for my second set of hearing aids and on my next visit I will be asking about REM. I have a request. I am trying various brands with one the goals being quality of sound for music listening. Yes, I am an audiophile and I still want to get the wow while listening to my stereo. Have you produced any videos discusing about hearing aides and music enjoyment?

[@alsjogren7890]

Well done. Watching your videos convinced me to pursue treatment. Question: Have you seen some videos in Spanish or a guide to the vocabulary of Audiologists in Spanish? I live in Guaymas, Sonora, Mexico half the year (Seattle the other half) and if I need hearing aid service I need to be able to understand the specialized vocabulary of the industry. My native language is English.

[@JustAnotherDronePilot]

Hey Dr Cliff. I know you probably don't cycle back through videos like this, but I really dig the real ear measurement software. Think you could do another video once you've figured everything out? Would love to see another one of these from start to finish.

[@jameseubanks1509]

Thanks for the information, Dr. Cliff. This answered several questions about REM and what the procedure is meant to do. You are the best!

[@DrCliffAuD]

Glad it was helpful!

[@roywied]

Inning is

[@roywied]

One l,

[@HearingTracker]

This is my favorite REMs equipment 😁 - Abram

[@DrCliffAuD]

I've use a number of different units and the Aurical PMM is by far my personal favorite.

[@fallsdp]

@@DrCliffAuD - Is the Avant Arc any good?? It has the audiometry and the REM in one machine.

[@casi-casitrillisclub8066]

Thanks Dr.Cliff! You are always giving us the accurate information!

[@michaelbleazard3179]

i always wondered, if my parents payed so much for hearing aids, i always feel it could be better. so why not have the software downloaded to my computer to adjust my hearing aids over time, of course its not possible since i am not an audiologist. but this video makes me feel like audiologist can actually help me. i always felt hearing aids is ok. i just have to wait for the next hearing aid to improve just a little(that what it feels like) but this video feels like it fills a gap i have been missing my whole life(im 23, deaf since birth, and even considered cochlear multiple times, never did the work to get evualted). i will try to find an audiologist that have this

[@bobnoce8018]

I am confirmed VA eligible. Outstanding guidance from the two videos I watched--VA and Costco. Much thanks!!!! Any suggestions re: Indianapolis VA still has no system for on-line appointments, yet the NEVER answer their appointment request calls, and rarely answer the voice mails that follow. Any "secrets" as to how to actually speak with a human at Indianapolis VA., or is my 29 years as a Navy pilot without any benefits?

[@DrCliffAuD]

Hey Bob, glad you enjoyed the videos. Unfortunately, I have no insight or influence inside the VA system. I might be able to pull some strings for the Phoenix VA with some audiologists I know, but wouldn't be much help in the Indianapolis area.

[@WilhelmVonBaz]

How are skull simulators used for fitting?

[@sdcoffeeroaster]

I have a copy both my hearing test and my REM test from CostCo. Since I have an unusual 45 db loss @250 Hz I am seeing an ENT soon. And at the other end @ 8 kHz I am almost 20 db high for all sound levels in only the left ear. Is this normally ignored? I ask because I've noticed more noise which I think is hi freq distortion in that ear. And with the aid of your descriptions I can see that for soft speech I'm under amplified by 7-10 db @1kHz in both ears. Maybe that might be why I'm still having issues understanding my soft spoken wife, lol. At any rate I plan to talk about these things with the fitter at Costco at my 2 week check up. I have the Rexton BiCores and I'm pretty frustrated with noise, artifact static sounds (maybe with movement), directional focus not really doing much that I can perceive and the inability to make any changes that I'm in control of or save any special programs I can tweak on my own (until they sound right for the situation). This app (and HA..spec is an exact match) seems to be exactly identical to the Signia 7AX so they use a neural network to make changes undefined to the user and you must keep or discard right on the spot before you can really test them out. There's nothing like being armed with as much information as you can understand and you are THE source of information for so many of the hearing challenged. Keep up the great work and if you ever move to San Diego.....book an appointment for me, lol.

[@sdcoffeeroaster]

Quick question for you Dr Cliff. If a receiver is replaced would you do a repeat to verify the REM? How about going from open to tulip domes? I'm thinking the latter case would change the REM. They made both changes at CostCo my last visit but did not repeat the REM but will bring that up on the next visit. Thanks

[@williambuckley6128]

Dr. Cliff, I lost confidence in my audiologist who sold me a set of hearing aids, after failing a HINT. He doesn't do REM. Can I use my Anthem Blue cross with your company to get aids optimize? William

[@DrCliffAuD]

Hi William, sorry to hear that. To answer your question...possibly. We are out of network with BCBS. If they have coverage for OON providers then you could get reimbursed for whatever percentage they cover.

[@williambuckley6128]

Thank you for your response. I have one last ditch effort to find a REM in Los Angeles before I make the trip.

[@DrCliffAuD]

@@williambuckley6128 check out my list of Best Practice Pro Network members on my website. There are several providers in the LA area. DrCliffAuD.com

[@inovacijaplus7238]

Mr. CliffAud, I have a question for you. When we go to examine hearing, we enter a cabin that is soundproofed from outside sounds. We put on the headphones that are inside and raise our hand when we hear the slightest tone. And the audiologist records this on a chart we call an audiogram. The question is, why don't we do it with hearing aids? Let’s say we walk into a booth, hearing aids are connected to software, and we raise our hand when we hear the slightest tone. So we can bypass the hearing measurement (rem) and we have immediately measured the exact hearing for those hearing aids we have chosen. Could this be more accurate than the previous method?

[@ChangesOneTim]

Answer came there none! Anyway, my audiologist used desktop controls to do 'aid-in' tests as part of the fitting process for my Oticon Opn1s nearly four years ago, and showed me afterwards how close the aid-in performance is compared to my prescription. I would have thought that this is a different means to the same end.

[@davidcrandon2329]

This is essentially what REM is. The reason it can't be done with only one measurement is that HA's are not standardized, and each one will produce different responses under different circumstances with different patients. Think of wanting to make the frequency response in your music room at home as flat as possible. You have to measure its frequency response, then apply correction, then measure to make sure you got the correction right, and fine-tune it.

[@emostorm7]

So chances I'll pick an audiologist who is very good at this, is, well, according to Cliff it's about 40% chance I'll find an audiologist who even _knows how_ to do a proper hearing aid programming, and then the percentage decreases when facturing in how many of that 40% _that know_ how to actually do it _will actually provide_ that level of service. Great. I don't suppose there's a super secret question I can ask to know if the audiologist I'm trying to see knows what they are doing is there.

[@tonyt7372]

I am thinking of purchasing new hearing aids and have subscribed to your channel. I take down notes and try to learn as much as possible to make a well informed decision on what I need. Thank you so much for your helpful and knowledge information.

[@donnaraines4303]

I went to an audiologist and was tested and handed a prescription but was never offered a "fitting". The hearing aids began at $4,500 and increased to $7,500 for the Cadillac version. Adjusting the the settings from the manufacturer's standard was never offered... I did not purchase any at that time. How do I find an audiologist who will perform the adjustments to the software to maximize my hearing benefits?

[@billweathers2858]

Thank you for your very informative podcasts. perhaps you can help me with a dilemna. I have been wearing Resound Linx Quattro aids for 2 years and like them mostly. I still have problems from time to time with feedback and whistling and feel as though I still have problems with discrimination of words, so says my wife. (I am 80 yrs old but in excellent health and very active.) Another hearing specialist wants me to try the Phonak Audeo Paradise risk free for 30 days. Should I do this, or should I look into the Resound One with my former audiologist? Cost is not an issue. Thank you very much.