Jan, I'm here, but I've been doing more lurking than contributing lately - because there are so many "TransEarXperts" who are knowledgeable and regular contributors. I'll jump in on the "hard to fit" label. I'd prefer to say "different to fit," because TransEar is a hearing aid that is not acoustic. That throws some otherwise capable audiologists and dispensers for a loop, and if they are set in their ways and "know everything already" (as reported numerous times by members here), they are sometimes closed-minded and difficult to train. In fairness, they spend 99% of their time with air conduction hearing aids, so taking time to learn about the other 1% would be hard on any of us.
That having been said, most audiologists are driven to help their patients, even though it might mean learning new tricks. To be fit with TransEar, once a hearing evaluation supports candidacy, the audiologist will take two impressions of the dead ear with a squishy silicone material that firms up in a few minutes. Once removed, it is exactly the shape of the ear canal at that point in time. When we receive the order, we choose the best impression of the two, trim it, then scan it with a 3D, non-contact scanner. The scanned image is manipulated in special software that would fit into a Star Wars episode, then sent to a machine where it is crafted from liquid plastic by a laser beam into an exact replica of your ear. We then take the shell (which we call a transfer unit), embed our transducer/vibrator in it, add the faceplate and connectors, and send it to another part of our lab where it is tested with the processor and connector wires on an artificial mastoid. Of course, that's the short and simple version, but it works as an overview.
Note my use of the words "at that point in time" in the paragraph above. That's because ear canals can change shape, especially when chewing or talking, so even though the impressions taken by the audiologist are exact replicas, when you go in for your TransEar fitting the ear canal might have changed ever so slightly. Since the business end of TransEar sits against the bone, those slight changes in size can squeeze that 0.2 mm (8/1000") layer of skin against the bone, causing discomfort - usually at a single point. The audiologist then takes a special sandpaper we provide and removes a tiny bit of the shell at that spot, and that typically eliminates the discomfort without compromising bone contact.
Sometimes a TransEar user will leave the office with a comfortable fit, then develop a sore spot or spots a few days later. This is generally a sign of the ear canal changing size or direction when talking or chewing, and we recommend returning to the audiologist for fine-tuning of the fit. If the discomfort level is high, do not continue wearing the TransEar, but DO put it back in an hour or so before seeing the audiologist. The presence of a red/sore spot will allow them to see the precise point where pain is occurring, making the adjustment very easy. Every user is different, and there are some who simply can't stand anything in their ear, or who don't have the physical dexterity to insert the transfer unit, or who don't have an audiologist with the time or patience to work through any issues that arise.
I've left out programming of the digital processor, which should occur at the first fitting, and it can be adjusted by the provider at any time. Adjusting the internal volume, which controls how much vibration is provided, is the recommended first step, following by "shaping" the frequencies to the user's preference for more or less volume at any of the 12 adjustable frequencies. (Typical users will only notice adjustments to 6 or 7 of those.) So once the provider gets the hang of it and realizes that it is different from their normal programming, an experienced TransEar fitter can complete programming in as little as ten minutes.
Solecleansing, I've probably given you more than you wanted, but that's how I see fitting a TransEar, and it is consistent with how we train audiologists who are fitting TransEar for the first time (and who want to be trained).
Best regards,
Rick Gilbert
VP & GM of Ear Technology Corp/TransEar
