Noble Audio - the Wizard returns!

mython said:

Average_joe does his own impressions but for 99.99999% of people, I would very strongly advise against DIY impressions, because it's extremely tricky to get the foam dam in one's ear canal to exactly the right position and (more importantly) it's almost impossible to know if the dam is successfully placed so as to prevent silicone from squeezing past it. There is a very good reason why a qualified audiologist will use an otoscope to check the positioning of the foam dam, prior to injecting the silicone. If silicone gets past the dam, then the dam is useless and you risk the silicone sticking to your eardrum and your eardrum consequently being ripped out of your ear canal when you withdraw the cured impression from your ear.

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It doesn't stick, but yes harm can be done. A vacuum could form, and in theory damage could be done during removal. Worst cases I have been remotely involved in, the silicone passed over the dam, interred the middle cavity via a hole in the ear drum....

This happened in Thailand, so no lawyers were involved

And no it wasn't me, I just got a phone call from a person in a panic asking what to do about this situation

One word response... Hospital

fullcircle said:

It doesn't stick, but yes harm can be done. A vacuum could form, and in theory damage could be done during removal. Worst cases I have been remotely involved in, the silicone passed over the dam, interred the middle cavity via a hole in the ear drum....

This happened in Thailand, so no lawyers were involved

And no it wasn't me, I just got a phone call from a person in a panic asking what to do about this situation

One word response... Hospital

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OK, thanks for the correction/clarification.
 
End result is (potentially) the same, though, so the conclusion is... just pay the fee for an audiologist who knows what they're doing. It's just not worth pinching a few pennies when one is risking delicate parts of their anatomy.

mython said:

OK, thanks for the correction/clarification.

End result is (potentially) the same, though, so the conclusion is... just pay the fee for an audiologist who knows what they're doing. It's just not worth pinching a few pennies when one is risking delicate parts of their anatomy.

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I went to the largest hearing aid chain in the country, they do a million impressions, a year. But, he used the wrong concoction.

kh600rr said:

I'm going right to the source, gonna try to hit,The event in Chicago next week, if I can't make that, I'll head out to San Diego. I'll have Brannan do them. I'm not gonna pay, a arm & a leg on impressions & shipping, over and over again, till some yahoo, finally gets it right.

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Is Brannan a qualified audiologist? As to why I ask, I'm just curious.

kh600rr said:

I went to the largest hearing aid chain in the country, they do a million impressions, a year. But, he used the wrong concoction.

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That's certainly unfortunate, but, with the greatest of respect, it's not sufficient reason to go the DIY route. Don't take that personally; it's nothing personal at all - all I'm saying is that if an audiologist does a bad job of your impressions, then it'd be better to find a more competent audiologist than to take the process into your own hands, given the serious risks of damaging your ears.
 
As I've remarked previously, in the post I linked-to about impressions, earlier in this thread, it is important to have a very clear understanding of exactly what you require before you approach an audiologist. A surprising number of audiologists do not truly understand the specific requirements of impression-taking for the purposes of CIEMs, because they may tend to be mostly accustomed to making impressions for hearing-aids, and hearing aids don't necessarily occupy as much of the ear as CIEMs do. This applies to the deeper parts of the ear canal (past the 2nd bend), and also to the outer parts of the ear (such as the crus of the helix).
 
Although I have great respect for the profession, generally, I have personally experienced an audiologist flippantly saying "yes, yes, I know how to take impressions for musicians earpieces", and when I questioned him very specifically, it turned out he was bull$h1tt1ng me and didn't have a damn clue (he was just used to doing hearing-aid impressions). That's a real experience, not made up, and it takes confidence and certitude to stand up to that kind of audiologist, and (politely, of course) 'demand' it be done to a certain specification, which is why one really should take the time to learn exactly what is required before approaching an audiologist.
 
 
If you don't know exactly what your requirements are, then you shouldn't really expect the audiologist to automatically know (or to be open-minded enough to actually take heed of the fact that there may be a difference in specification of an impression for the purposes of a CIEM rather than for a hearing-aid).
 
At the very least, it is worth printing-off the audiologist instructions provided:
 
http://nobleaudio.com/support/impressions-instructions/
 
And, there are lots of pictures, videos, and discussion in the oft-mentioned dedicated thread, here on Head-fi:
 
http://www.head-fi.org/t/578855/things-to-consider-before-getting-your-custom-iem-impressions-done-the-perfect-fit
 
 
You could perhaps print these photos as an example, to show an audiologist:
 

 

 
 
 
.

chiman said:

Is Brannan a qualified audiologist? As to why I ask, I'm just curious.

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Wiz would know.

mython said:

That's certainly unfortunate, but, with the greatest of respect, it's not sufficient reason to go the DIY route. Don't take that personally; it's nothing personal at all - all I'm saying is that if an audiologist does a bad job of your impressions, then it'd be better to find a more competent audiologist than to take the process into your own hands, given the serious risks of damaging your ears.

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I'm with you a 1000%, I would never attempt it my self.

Reminds me of a friend that tried telling me pouring cement into my ears and letting it harden would be a great idea. He was serious.  

chiman said:

Is Brannan a qualified audiologist? As to why I ask, I'm just curious.

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No, I am not an audiologist. That being said, I can take earmold impressions and I know what we need to do our job.

travis9 said:

 

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Reminds me of a friend that tried telling me pouring cement into my ears and letting it harden would be a great idea. He was serious.  

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LOL.

kh600rr said:

Wiz would know.

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Ok, lets get into the meat of the matter....  legal stuff
 
Legally there is nothing preventing Brannan taking ear mold impressions for the purpose of CIEMs.
 
The act is deemed a "medical" procedure, if the ear mold impressions are done for the purpose of hearing aids. 
 
Even then, the act is really not protected under the laws if the act is done by the person himself. (we see this in denistry from time to time as well)
 
 
Now if the impression is done for the purpose of Hearing aids, essentially Four people can do so under the laws:
 
1) Audiologist (10-12 years of college)
2) Board Certified Hearing aid dealer (zero college, but must not have a felony record, and must at least have a GED......   the qualifications of a tatoo artists are higher)
 
3) A physician, in any field....  OBGYN, to a proctologist....  it makes no difference they are instantly qualified due to the laws
4) A person "delegated" by a physician to perform a medical procedure/task etc.  The last time I checked the deffinition of "delegated" means that the physician must at least be in the building, where the procedure is performed
 
 
 
Ok, move that to the side:
 
An audiologist is clearly the best bet when getting ear mold impressions for CIEMs.  The trouble is, hearing aid technology has made the requirement for perfect ear mold impressions obsolete.
 
Stay with me:
 
The problem with hearing aids, is that the older ones suffered from "feed back" as the microphone and driver (spearker) were close to each other. The out put of the speaker was driven directly into the ear canal, but if there was any leak of the out put, that reached the microphone.....  the result would be a hidious squeal.   (feedback)  
 
Well the newer hearing aids on the market today have digital phase cancelation systems in them. So the feed back issue is taken care of digitally rather than "physically" via a tight fitting ear mold/hearing aid
 
 
 
So when one walks in and asks for an ear impression.....  Folks go in to "automatic mode" and do what they understand or are used to doing.
 
 
 
Now the question was, is Brannan a qualified Audiologist?
 
The answer is no, he is not....  
 
But he doesn't need to be, and the odds of him doing a better job than a audiologist that has a "hearing aid only" mind set.....   are higher.

I'm totally Kool with Brannan doing it, if I can catch up with him.

Enough with all this talk about being an Audiologist etc etc. I am not an Audiologist, but I did stay at a Holiday Inn Express last night. I can do them.

kh600rr said:

I'm totally Kool with Brannan doing it, if I can catch up with him.

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Just remember to take some Rohypnol along with you - you won't feel a thing   

Kh, if you're in the Dallas area of Texas, there's a fantastic audiologist who owns CIEMs herself over in Flower Mound. Used her 3x so far and she's been flawless and extremely helpful.