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Thread: Best Practices?

  1. #31

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    Quote Originally Posted by 1Bluejay View Post
    TOTALLY agree with these posts here!! F'instance: the eyechart example. Very simple and effective to tell if a patient's Rx glasses SEE the letters better or not in a split-second!

    But after a tinkering session where several frequencies are increased in gain, and maybe noise reduction reduced, and perhaps a TV streamer SOLD and whatnot, we are sent packing to try these improvements out on our own, and then come back again and again till it's just right. No wonder I feel like my aud-guy and his two wonderful front office gals are like family to me. I see them more often than ... family!

    I even chided my aud-guy saying, "You know if you continue to sell these TV streamers, you should have a TV in the exam room here where we can see how it's set up and HOW IT WORKS before going home, pawing through a manual and trying to monkey through it on our own." Another good example is having a dedicated phone program vs Autophone. Which one's better? Well, to try it out, I literally dial Anthem Blue Cross insurance right in the exam room before leaving! There is no human (as far as I can tell) throughout that organization till you go thru about 50 steps of robo-attendant. It gives me a good 5 minutes of hearing what someone (or thing) sounds like on the phone, after which I could say: yea, nay, go away.

    But really, with aids ON, why can't we be given the exact same hearing test in a soundproof room to once again measure our tonal response and word recognition? Is it cuz headphones would cause irritating feedback? Then leave them off! Have the person sit with their brand spankin' new aids on and then do the test, A to Z. It's never been done for me in all the decades I've been buying aids.

    To actually SEE the level of improvement (slight, significant) would not only give the audiologist more credibility in the fit, but also the customer would go away knowing it was money well spent - or end the trial right there with PROOF that the HAs recommended were not optimal. Perhaps we need to organize a 10-person march (not exactly the Million Woman thing yet), and make our wishes known.
    While not for everyone, I believe I made the best decision by going the self programming route. I've have my new aids for almost 2 month now and I've made about 16 minor adjustments. I can't even fathom the costs and time if I had to go to the audiologist office for this. The best part is that I've been doing these adjustments in the real world. Just last week, I took my laptop & hi-pro setup in the car while my wife drove, as I wanted to adjust the compression a little for the background noise. Try doing that in an office!

  2. #32
    Join Date
    Dec 2014
    Location
    Adelaide, South Australia
    Posts
    83

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    Quote Originally Posted by 1Bluejay View Post
    TOTALLY agree with these posts here!! F'instance: the eyechart example. Very simple and effective to tell if a patient's Rx glasses SEE the letters better or not in a split-second!

    But after a tinkering session where several frequencies are increased in gain, and maybe noise reduction reduced, and perhaps a TV streamer SOLD and whatnot, we are sent packing to try these improvements out on our own, and then come back again and again till it's just right. No wonder I feel like my aud-guy and his two wonderful front office gals are like family to me. I see them more often than ... family!

    I even chided my aud-guy saying, "You know if you continue to sell these TV streamers, you should have a TV in the exam room here where we can see how it's set up and HOW IT WORKS before going home, pawing through a manual and trying to monkey through it on our own." Another good example is having a dedicated phone program vs Autophone. Which one's better? Well, to try it out, I literally dial Anthem Blue Cross insurance right in the exam room before leaving! There is no human (as far as I can tell) throughout that organization till you go thru about 50 steps of robo-attendant. It gives me a good 5 minutes of hearing what someone (or thing) sounds like on the phone, after which I could say: yea, nay, go away.

    But really, with aids ON, why can't we be given the exact same hearing test in a soundproof room to once again measure our tonal response and word recognition? Is it cuz headphones would cause irritating feedback? Then leave them off! Have the person sit with their brand spankin' new aids on and then do the test, A to Z. It's never been done for me in all the decades I've been buying aids.

    To actually SEE the level of improvement (slight, significant) would not only give the audiologist more credibility in the fit, but also the customer would go away knowing it was money well spent - or end the trial right there with PROOF that the HAs recommended were not optimal. Perhaps we need to organize a 10-person march (not exactly the Million Woman thing yet), and make our wishes known.
    all of the above can be done by a clinician. I regularly make phone calls using my phone in office to assess benefits of adjustments / new phone programs. Have a TV streamer set up out front to demo benefits of TV streamer (Both of these take a couple of minutes to set up so no excuses there). I always make time at the end of the day to go to the patients house to set up their TV device for them, both for their benefit as well as mine (to make sure it is actually working!). Most manufacturer software has sound clips to simulate different listening situations and 'aided testing' can be performed (speech tests) as well as aided threshold testing using a speaker set up rather than headphones. I don't do aided threshold testing as don't really see the benefits of how loud and soft one can hear pure-tones generated by their hearing aids when this is a rarely identified listening goal by the patient - At the end of the day the most important thing is how well the patients hears things they want to hear in their day to day listening environments. Speech testing and aided threshold testing may help to demonstrate improvements, but there is no substitute for real world testing. That sound clip of a woman/man speaking in traffic is never going to be quite the same as the patients own spouse speaking over traffic on their own street so it is still important to get out there and wear them to see how they sound for you! I'm pretty sure that JustinHIS, posts here has a pretty sophisticated setup for assessing aided benefits in the office post-fitting and adjustment so if you're the type of patient who wants this sort of clicnician then do your best to seek one out (which is not always possible I know for those in more remote areas etc.). I suppose what I'm trying to get at is there is some great clinicians out there and on the flip-side some all-mighty shoddy ones, its just a matter of finding those good ones amongst the not so good! And sometimes a good clinician for one personality type is not as good for another. I.e the hard-nosed tell it how it is clinician with all the fancy equipment may be great for someone that needs to have it put in that way, but the little old lady who is umming and ahhing about hearing aids may be put off completely by this approach and intimidated by all the equipment and testing procedures. Though a really good clinician can accommodate for all types of personality types and patient needs. Word of mouth is probably the most powerful method of finding this information as a consumer, but ideally its also about identifying what you want as the patient before walking into that first hearing test and being upfront about it. (but perhaps not sending emails outlining how much profit they are allowed make on the sale and paying 25 dollars per appointment as it probably ain't gonna be received that warmly!)
    Last edited by MFAUD; Yesterday at 06:40 PM.

  3. Default

    You are very lucky to have that kind of technical skill to program your own aids. I think I may find that daunting, but then I've never given it a try! I suppose I'd want a VERY quiet room in which to make the changes - then go out and about and see what the results were. I have a Macbook Pro, but where do you buy the hi-pro software - would it work for Oticon Opn RIEs?


    Quote Originally Posted by jbender4 View Post
    While not for everyone, I believe I made the best decision by going the self programming route. I've have my new aids for almost 2 month now and I've made about 16 minor adjustments. I can't even fathom the costs and time if I had to go to the audiologist office for this. The best part is that I've been doing these adjustments in the real world. Just last week, I took my laptop & hi-pro setup in the car while my wife drove, as I wanted to adjust the compression a little for the background noise. Try doing that in an office!
    HAs from 1985>Starkey>Phonak>Oticon Agil Pro ITE>Oticon Opn miniRITE Trial (11/16)

    KHz 0.25...0.5...1.0...2.0...3.0...4.0....6.0...8.0

    Left ..65....80....80....65.....65....60....65....90
    Right 65....80....80....75.....75....70....65....90

  4. Default

    MFAUD, you sound like you're in a class of your own with such caring & personalized service! I would've LOVED to have my aud-guy simply show me how the dang streamer unit is set up, but I had to go home and read the manual and figure it out, based on my TV and the multiple cable/connection options that came with my device. Bit of rocket science till I got the job done and my aids paired up with the unit.

    I totally agree that the tonal testing is pretty much useless for my real-life environment. But a word comprehension test and even comprehending voices over noise would be a very good test that could be done at an audi's clinic, I should think.

    Well, beggars can't be choosers, and given my location, I am lucky to have my aud-guy even in his current capacity! There is Costco too ... but I just feel that relationship trumps cost. Thanks for your input here!

    Quote Originally Posted by MFAUD View Post
    all of the above can be done by a clinician. I regularly make phone calls using my phone in office to assess benefits of adjustments / new phone programs. Have a TV streamer set up out front to demo benefits of TV streamer (Both of these take a couple of minutes to set up so no excuses there). I always make time at the end of the day to go to the patients house to set up their TV device for them, both for their benefit as well as mine (to make sure it is actually working!). Most manufacturer software has sound clips to simulate different listening situations and 'aided testing' can be performed (speech tests) as well as aided threshold testing using a speaker set up rather than headphones. I don't do aided threshold testing as don't really see the benefits of how loud and soft one can hear pure-tones generated by their hearing aids when this is a rarely identified listening goal by the patient - At the end of the day the most important thing is how well the patients hears things they want to hear in their day to day listening environments. Speech testing and aided threshold testing may help to demonstrate improvements, but there is no substitute for real world testing. That sound clip of a woman/man speaking in traffic is never going to be quite the same as the patients own spouse speaking over traffic on their own street so it is still important to get out there and wear them to see how they sound for you! I'm pretty sure that JustinHIS, posts here has a pretty sophisticated setup for assessing aided benefits in the office post-fitting and adjustment so if you're the type of patient who wants this sort of clicnician then do your best to seek one out (which is not always possible I know for those in more remote areas etc.). I suppose what I'm trying to get at is there is some great clinicians out there and on the flip-side some all-mighty shoddy ones, its just a matter of finding those good ones amongst the not so good! And sometimes a good clinician for one personality type is not as good for another. I.e the hard-nosed tell it how it is clinician with all the fancy equipment may be great for someone that needs to have it put in that way, but the little old lady who is umming and ahhing about hearing aids may be put off completely by this approach and intimidated by all the equipment and testing procedures. Though a really good clinician can accommodate for all types of personality types and patient needs. Word of mouth is probably the most powerful method of finding this information as a consumer, but ideally its also about identifying what you want as the patient before walking into that first hearing test and being upfront about it. (but perhaps not sending emails outlining how much profit they are allowed make on the sale and paying 25 dollars per appointment as it probably ain't gonna be received that warmly!)
    HAs from 1985>Starkey>Phonak>Oticon Agil Pro ITE>Oticon Opn miniRITE Trial (11/16)

    KHz 0.25...0.5...1.0...2.0...3.0...4.0....6.0...8.0

    Left ..65....80....80....65.....65....60....65....90
    Right 65....80....80....75.....75....70....65....90

  5. #35
    Join Date
    Dec 2014
    Location
    Adelaide, South Australia
    Posts
    83

    Default

    Quote Originally Posted by 1Bluejay View Post
    MFAUD, you sound like you're in a class of your own with such caring & personalized service! I would've LOVED to have my aud-guy simply show me how the dang streamer unit is set up, but I had to go home and read the manual and figure it out, based on my TV and the multiple cable/connection options that came with my device. Bit of rocket science till I got the job done and my aids paired up with the unit.

    I totally agree that the tonal testing is pretty much useless for my real-life environment. But a word comprehension test and even comprehending voices over noise would be a very good test that could be done at an audi's clinic, I should think.

    Well, beggars can't be choosers, and given my location, I am lucky to have my aud-guy even in his current capacity! There is Costco too ... but I just feel that relationship trumps cost. Thanks for your input here!
    Yeah if anything I find speech testing and word recognition testing is a good way of opening up the conversation regarding limitations/ realistic expectations of hearing aids as well as the implications of the patients hearing loss in terms of speech etc. Glad youre happy with your Aud, but next time when he/she sells you something make your you tell them to show you how to use it! Should be a given when you're paying good money for the product and it only takes a few minutes of the clinicians time!!!


  6. Default

    Quote Originally Posted by 1Bluejay View Post
    You are very lucky to have that kind of technical skill to program your own aids. I think I may find that daunting, but then I've never given it a try! I suppose I'd want a VERY quiet room in which to make the changes - then go out and about and see what the results were. I have a Macbook Pro, but where do you buy the hi-pro software - would it work for Oticon Opn RIEs?
    I learned all of what I needed from this forum. Start by reading the DIY section. There is a lot of useful information there, including information about the software. Software itself is pretty intuitive.

    Don't get me wrong. I do think clinics has an important value, but I think the process of getting aids adjusted is very outdated.

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