April 11, 2016
How’s that new map, anyway?
Two posts in six days, after a hiatus of a year! Must be something exciting happening, and yes, there is!
First,I’m using that new map, and so far, it’s more than “so good”. I’ve found that I am hearing speech in noisy places somewhat more easily than I did before. I’m finding it a bit easier to hear conversation from a distance, and the high notes in music are more distinct, giving music a little bit more life.
This map would most likely not have been the best for me when I was initially activated, as with my history of profound hearing loss, I had not been hearing those high frequency sounds at all, and the CI, suddenly introducing those high sounds, would have sounded too “tinny” and harsh. But, after three years, my brain is ready for those higher frequency sounds, and they are quite comfortable.
Yesterday, I met another traveller on the CI journey, a chap who’s considering getting a CI. This man, profoundly hard of hearing, was approved for the operation a few years ago, but was talked out of it by his partner. Now, he’s reconsidering, and as part of his decision-making process, he’s talking with others who’ve had a cochlear implant. During the conversation, it was soon obvious that he does not hear well at all with hearing aids, and his hearing aids are new, power aids, and state of the art. I tried to impress on him that this was his decision to make, and that he had only one person to please: himself. He mentioned that he cannot use the telephone, and that the only music he can still enjoy is music he sings himself. I left him an open invitation to contact me whenever he wanted chat a bit more. I’m optimistic that he would greatly benefit from a cochlear implant, and I’m further optimistic that he will choose to go ahead with the implant.
So that’s my journey for the past week or so, and yes! it’s a great trip.
April 5, 2016
The Journey Continues, but With a New Map
The journey’s been going along just fine, so what’s this about a new map? And if things have been good, why change the map? And why now?
With a cochlear implant, the programming done by the audiologist is called a mapping. And, I think my original mapping, done by the audiologist who got me started on this journey, was a great map. If you read back to April 2013, when I was initially activated, you will see that I could hear extremely well, “right out of the box.” That original map was done, after some discussion, with two principal objectives: to maximize my ability to hear speech in a variety of situations; and to produce a sound quality that was not excessively “tinny” or uncomfortable. And it was very successful, as I’ve been able to enjoy conversations, telephone calls, and music under a variety of situations. So much so, in fact, that it was appropriate to describe the outcome as “life changing.”
So here we are, 3 years later, and a whole year since my last post, and as you’ve probably surmised, I’ve just had a change in my mapping. In the last year my original audiologist, has moved to a different position, and we’ve gone from having a professional-to-client relationship, to being friends. But before she left her position, she handed my file over to another audiologist at the same clinic.
Yesterday, I went in to meet the new audiologist, and to have my annual testing and tuning session. After some get-to-know-you conversation, we started with a test with tones that was designed to establish some thresholds. After this, the audiologist explained that he had changed the map to put more emphasis on the higher frequencies, to allow me to better hear speech. Of course, I was apprehensive about the changes, as I thought the result would be that tinny sound again, and that it would be fatiguing. To make sure that the new map did not make me worse off than before, we did some sound booth testing with sentences in quiet, and sentences in noise. The results were 97% and 84% respectively, which are really outstanding, so the map definitely works.
To be sure, we left the original map in another program slot, but so far, I’ve not had any reason to switch. Battery life with the compact batteries seems to be well in excess of 15 hours, which is great. I spent some time listening to classical music on the CBC yesterday, and I was not disappointed with the sound quality at all. If you’ve read the blog posts from way back, you’ll know that I use a hearing aid in my left ear, which is programmed in such a way that it emphasizes the low notes, and this, together with the CI, gives a nice balance to the sound of music. And, to get back to the hearing speech, it is definitely easier for me to hear speech, both in person, and on the television or the radio.
Those who travel frequently know that on most journeys, meeting and chatting with new folks on a trip often leads to changes in plans, going to new places, seeing new things, and enjoying unexpected events. So, I’m on the same journey, I’ve encountered a new audiologist, I’ve been given a different map, and things continue to delight and amaze me.
My Cochlear Implant Journey
March 17, 2015
Use the technology, or my brain?
I’ve always believed that our brains, if given enough auditory stimulation, can “learn” how to hear. It can learn how to separate the needed information, the signal, so to speak, from the noise, so that we get the warnings we need, the information we need, and the hearing pleasure we desire. To that end, I’ve always advocated that CI users avoid using assistive listening devices whenever possible, and “force” their brains to learn to discriminate the signals from the noise.
When I used two hearing aids, I could not hear without assistive devices, so I had a special bluetooth adaptor for my cell phone, an FM transmitter/microphone combination for hearing in restaurants and lectures, and a television and audio assistive device that transmitted the sound to my hearing aid using radio technology. Once my CI was activated, I found that in general, I did not need to use these sorts of gadgets, snd so I forced myself to hear without them. This was largely successful, and not having to worry about and deploy these devices was a big load off my shoulders.
Fast forward a bit, and I now have a new slate of these devices, which were provided by the manufacturer of my new hearing aid. The TV and audio listening device enables me to hear audio without anyone else knowing, or being bothered by the sound. The “mini-mic” makes it easy for me to hear Lynn in a noisy restaurant, or with a connecting cord, to hear the sound from the entertainment system on an airplane. I can stream the music from my iPhone to my hearing aids wirelessly while mowing the lawn, or going for a walk. And all of this stuff works wonderfully well.
I asked the audiologist yesterday about whether using these assistive devices might make my brain “lazy”; whether it might not be better for me to continue to listen just like everyone else. The response was that if the devices made life more enjoyable, why not use them? We agreed that after two years of using my cochlear implant without assistive devices, my brain had probably done as much learning as it was going to do, so for now at least, I’m giving my old brain a bit of a rest, and using the new technology.
March 13, 2015
They Don’t Build Them Like They Used To
A while ago, I mentioned that I had purchased a new GN Resound Enzo hearing aid, and I did this in order to take advantage of the wireless connectivity, so that I could listen to my music, or to the television while Lynn was doing her own thing in the same room. A week or so ago, I got up, and went down to the kitchen to make a pot of coffee. As usual, I put my CI processor and my new hearing aid in my pocket. In order to hear the kettle, I put on my processor, and because i felt sort of lazy, I left my hearing aid in my pocket.
A little later in the day, I wanted to hear with both ears, so I reached in my pocket for the hearing aid, but could not find it. For the next little while, I made a point of looking for it, re-tracing my steps for the day, but it just didn’t show up. Lynn began to help, but despite lots of worry on my part, and diligent searching by Lynn, it just did not show up.
Worry comes easily to me, and I began to imagine life with my old hearing aids. No wireless music! No hearing the movies on the plane!
In the afternoon, it was time to start making dinner, and I started by opening the dishwasher to put the clean dishes away. And part way through emptying the dishwasher, I spotted my new hearing aid, hanging on the bottom rack. It had fallen there from my pocket, and was certainly the cleanest hearing aid on the planet. I was sure it would be kaput, dead, broken, but just in case, I put the hearing aid in the special dryer I have for my processor and my hearing aid.
Eight hours later, I took it out of the dryer, put it on, and darn if it didn’t work, just as good as new. I called my audiologist, and learned that the hearing aid had a special nano coating, on both the exterior shell, but also on the internal components. That nano coating repels water, and it sure works.
I know from hard experience that you could not immerse an old technology hearing aid in water, and expect it to work, those old hearing aids were just not built as well as today’s new aids.
March 4, 2015
Entering Stealth Mode
Do you ever wish you could just escape whatever you’re doing, and listen to your favourite music without anyone else knowing, using a stealth mode, so to speak? I’ll tell you how I do that, but first, some background information.
My two-year follow-up appointment at the CI clinic took place this morning. My fantastic audiologist first put me in the sound testing booth, and we discovered that I heard sentences, with the CI only, with a 96% score (apparently, I goofed one word in the first sentence). Hearing single words, again with the CI only, my score was 76%. The next test was listening to sentences in noise. First, with the CI only, I could hear sentences when they were 8.5 DB louder than the noise; but with the CI and the new Resound hearing aid together, I could hear sentences when they were only 3.5 DB louder than the noise.
The audiologist and I were well-pleased with these scores, and had a bit of a conversation centred on whether those with normal hearing would do much better.
Then, the moment I’ve been waiting for since I got my Nucleus 6 processor, she updated the software in my processor and my remote assistant, so that I can take advantage of new wireless accessories, and in the case of the remote assistant, allowing me to take advantage of the opportunity to adjust more variables, such as separate bass and treble controls, something I’ve wanted for a while. I can also adjust the ratio of sound I receive from the processor microphones, and the wireless accessories, a distinct advantage in some situations.
To describe this, I have to go back two paragraphs, where I mentioned that I have a new GN Resound hearing aid, the Enzo 7. Along with the new hearing aid, I received two accessories, a “mini-mic”, and a “Phone Clip II”. Amongst things, these accessories allow me to stream music wirelessly to my hearing aid on one side, and my CI on the other, without using wires, and with nothing hanging around my neck. In addition, I can plug the audio from my stereo or the TV into the Mini-mic, and hear it while seated across the room, or when I walk to the kitchen for a snack. The Phone Clip II connects to my iPhone wirelessly, using Bluetooth, and then passes the signal along to my processor and my hearing aid, using 2.4 GHZ radio signals. Of course, I can also use the device to receive and make phone calls, but I do not need to do that.
Cochlear Corporation, the maker of my CI, and GN Resound, the maker of my new hearing aid, worked together to develop this wireless system, and my so-far brief trial has indicated that the engineering is very successful. The sound quality and convenience are both excellent.
And hey! Who doesn’t enjoy entering “Stealth Mode” from time to time?
March 4, 2015
New Toy Syndrome
About two years ago, the local cochlear implant clinic sent me home with a brand new toy: my processor, that linked to my implant, and opened up a world of sound. Like any little boy, I couldn’t wait to enjoy the toy: I couldn’t believe all the new sounds I heard, many of which I could not identify. “What’s that sound?” I would constantly ask my wife. And the more new sounds I heard, the more I listened.
I tried to see how far away from people I could be, while still being able to hear them. I tried carrying on conversations with Lynn when she was upstairs and I was downstairs. The sounds of the car intrigued me, I went out and bought some quality audio gear so that I could enjoy music, using the new toy, of course!
But, eventually, after many fantastic “wow!” moments, the fun of the new toy, as it always does, began to wear off. I was no longer constantly tuned-in to the sound environment, trying to discover just how well I could hear. In fact, I began to take my hearing for granted. Now, unless there are special circumstances, I do not listen for every bird, nor do I pay attention to the sounds our cars make, and I’ve stopped trying to carry on conversations with people in other rooms. This all just happened, there was no conscious decision on my part to stop being so tuned in to the world.
And so, my hearing behaviour has sort of become the same as that of those with normal hearing. But to my wife, who’s been my biggest supporter, it appears to be a regression, change in my hearing which she perceives as a deterioration. She wonders why I do not hear her as well as she remembers from the toy days. She enjoys conversation, and I think she is concerned that because I don’t carry on room-to-room conversations anymore, that my hearing is deteriorating. I hope I’ve convinced her that all is normal, and that when it’s time for a conversation, it should be face-to-face, in the same room.
December 1, 2014
In Silence, there is Sound
Last weekend, my wife took two teenaged granddaughters for a weekend getaway, and I found myself enjoying the house to myself. And, I also found the house to be very quiet, almost noiseless, until I started to pay attention to my sound environment.
I was sitting in the living room, reading near the fireplace, when I became aware of a repetitive popping or “lip burst” sound. After a bit of sleuthing, I was able to identify it as one of the noises the gas fire makes. Something I’d never heard before. I also discovered that when I light the pilot flame, it makes a soft rushing noise. Didn’t know that before either.
I make coffee with one of the original Melitta coffee makers, the type that includes a carafe on the bottom, and a conical filter holder on the top. To make coffee, you put a filter in the cone, add coffee grounds, then boil the electric kettle and pour the boiling water into the filter. And lo and behold: a soft tinkling sound comes from the little stream of coffee falling into the carafe. Another “never heard that before” moment.
During one of the two nights on which my wife was away, our neighbourhood suffered a power failure, as a wire up the lane came down, and the resulting short circuit took out two of the power transformers on our block. Of course, I kept all the doors and windows tightly closed to conserve the heat in the house. While sitting and listening to the fireplace, I became aware of some sort of soft beeping noise. My immediate reaction was that it was the signal that the fridge door was open, or that the clothes dryer was finished, but of course, with no electric power, that was not possible. I listened carefully, and there it was. So, I got up, and took a look out the window, and discovered that a hydro service truck was backing down the lane behind the house. I’ve never heard that in the house before.
The power came back on, and with it the heat pump and blower fan. Since I’ve had the CI, I’ve always been aware of the rushing air sound from the blower. But with my interest in sounds awakened by the silence, I started to pay attention, and discovered that there’s more than just the rushing air. The fan motor makes a whining noise, and some of the ductwork makes a kind of repetitive noise, one that I can recognize, but cannot describe.
Our world is full of interesting sounds, sounds that I never noticed with my poor hearing, but the the CI, I’m able to notice and identify a whole new world of sounds, sounds that everybody else takes for granted, but that fill me with a kind of wonder, at least for now.
November 13, 2014
The Triumph of the Cyborgs
A dear friend of mine received her cochlear implant a year ago, at age 94. This remarkable woman struggled with a profound hearing loss for decades, before she received her implant. She was activated in November of 2013, and has done remarkably well with the implant, to the extent that I can now talk with her on the telephone, and we can actually understand each other!
But that’s not the story here. You see, my friend was recently in the hospital for about a month, and while she was there, one of the hospital personnel inadvertently managed to break one of the batteries for her implant. When she returned home, she asked if I would drop by and help her with her hearing aid, and to see what could be done about the broken battery. Before heading over to her place, I decided to go by the Western Institute for the Deaf and Hard of Hearing to pick up some disinfectant and a can of compressed air to help clean the instruments.
Before heading over, I called the hearing instrument technician to arrange a time to pick up those items. We had a lively conversation, and finally finished by arranging a time for me to pick up the supplies.
After visiting my friend and helping her with the hearing aids and CI battery, I headed back home, and suddenly realized, while driving, that both the technician and I had cochlear implants, and that we had enjoyed a perfectly normal telephone conversation without the use of any extra communication aids. We CI users often refer to ourselves as Cyborgs, and a sort of Star Wars style reality distortion field moment occurred for me as I thought about this, and about the fact that before we received our implants, we could not have talked to each other on the phone, and in fact, would have had some difficulty talking face-to-face.
Definitely the Triumph of the Cyborgs!
July 13, 2014
Set it and Forget it?
Lately, along with hundreds of millions of other people around the world, I’ve been watching the FIFA Football World Cup games on television. Football, known as soccer in North America, is a beautiful game to watch, and the enthusiastic crowds at the games, along with the announcers, produce a difficult sound track. Nonetheless, I enjoy listening to the commentators, who, on the CBC at least, tended to have British accents.
While listening to the games, I became aware that the sound would occasionally change, becoming louder, and somewhat hollow sounding. Then, just as mysteriously, it would change back to the normal quality and volume. At first, I ignored the change, believing it was something to do with the telecast. But the more it happened, the more worried I became. What if there was a fault with the external processor; or worse, the internal part? Maybe the chemistry of the fluid in my cochlea is undergoing changes that affect the performance of the CI?
Finally, I became concerned enough to fish out my remote control unit, also known as the remote assistant. This device not only allows the user to change the program, the volume, and the sensitivity of the processor, it also reports the status of the processor, and does basic diagnostic routines in the event of trouble. I rarely use the unit, preferring to leave my processor in the same program and volume settings at all times.
The Nucleus 6 processor I use has four program “slots”, and a variety of available programs for different listening situations. There are programs for quiet situations, conversation in noise, music, conversation in a group setting, and so on. I tend to put the unit in ‘SCAN”, which allows the processor analyze the sound environment, and to select the most appropriate program for that situation. In fact, I have left it in this mode for months now, with no changes.
Keeping my eye on the screen of the remote, I watched, and sure enough, when the sound underwent that mysterious change, it was simply the processor, moving from the program for speech to the program for noisy situations. I was quite relieved to discover that there was nothing wrong, either with my head, or my CI device.
As a result of this I’ve resolved to take more advantage of the technology built into my cochlear implant, and not just “set it and forget it!”
July 10, 2014
Making up for Lost Time
For most of my life, I adapted to my hearing loss by avoiding lots of situations, things like television shows that everybody else seemed to enjoy, movies, social events with lots of conversational interactions, school concerts, and the list goes on. Tomorrow morning, I’m going to a recital at which the two little girls next door will be performing musically.
Our two little neighbours, aged 6 and 7, are participating in a summer music camp for kids, and the recital has them all excited. They invited Lynn and I, and of course, there is no way I’d say no to them. In the past, I would have tried to find a way to avoid attending such an event, because I would not have been able to hear the introductions, and if the performance involved any dialogue, I’d miss that too. But now, I’m looking forward to going and supporting them, and in fact, from the music I’ve heard through the window at practice time, they are going to do a good job.
And a couple of weeks ago, we had our annual Block Watch BBQ, a fun gathering of all the neighbours over a two-block area. From a hearing perspective, this is a difficult event. It’s outdoors, there are about eight kids having fun, and several conversations happening at the same time. This year, I found myself enjoying the event, and noticed that the stress that comes from straining to hear was just not there. I’m actually thinking of planning an extra event, a winter wine and cheese get-together.
But, it’s not just about events. I’m one of the dying breed of folks who still mow my lawn the hard way, with a push mower. This puts me out in the yard, and of course, when the weather is fine, there’s a steady parade of people out walking, riding bicycles, or training their dogs. With the CI, engaging in casual conversations with people who call out, even from across the street, is not the challenge it was before, a challenge I used to duck whenever possible.
There are lots of other events, small and big that make life so much more interesting, and I’m making up for lost time, enjoying every minute.
June 16, 2014
Those Most-Dreaded Moments
Lynn and I are just back from a month-long trip to Europe, a trip which included a cruise on the Rhine River. We enjoy river cruising, the boats are much smaller than ocean vessels, and there’s much interesting to see and do during the voyage. For those with an interest, our cruise line was Uniworld, and they did a fantastic job.
Two situations on a trip of this sort that can cause discomfort for those with hearing loss are following the guide’s talk on a shore excursion, and following the conversation in the often noisy dining room and lounge. Uniworld use a very sophisticated communication system on the excursions. It is called Quiet Talk. I was pleasantly surprised to discover that they offered a neckloop option, which took the place of conventional headphones, and which worked extremely well with my CI and my hearing aid. I really never missed a word as we went through some wonderful Alsatian wine villages or through the Cathedral at Cologne, amongst other places.
For most of my adult life, I’ve had trouble in noisy social situations. No matter how hard I tried, it was just too difficult and very fatiguing to try to follow conversations when in a room in which everyone was talking at once. On this trip, we formed friendships with three or four other couples. We enjoyed dinners together with them, and enjoyed our times in the lounge after dinner. Now, I’m not going to say that I could hear perfectly, but with the CI, I never felt as though I was missing the conversation. In fact, I felt as though I was hearing as well as anyone else in the group, able to participate fully. That makes such a wonderful difference, and is in stark comparison with my experiences in similar situations prior to receiving my implant.
Reflecting back on the trip, I became aware that these situations, along with many others noted earlier in my posts, have made a wonderful difference in my sense of satisfaction with life. I have more confidence, and am much more likely to venture out into new situations. I suppose you could say that there are far fewer dreaded moments in my life now.
March 25, 2014
It’s a Matter of Trust
Let’s say that you’ve taken some trips in an old and not so well-maintained car, and there have been a couple of occasions where that car has broken down. It would be quite natural for you to have a lack of faith or trust in that car–to decline the offer of a long trip in that car.
Well, so it was with my hearing. After making many embarrassing mistakes in hearing due to my profound hearing loss, I learned that I could not trust my hearing. I usually knew about my hearing mistake by the bemused looks on the faces of those around me, and I even learned to laugh at my own hearing mistakes. There were countless times in the past when I asked someone to repeat what they had said, only to discover that I had actually heard correctly the first time, but because I could not be sure, I did not trust my hearing. Those mistakes that I’d made with my hearing,
The outstanding characteristic of a successful cochlear implant procedure is vastly improved speech understanding. For those of us who’ve been through this process, the improvement is difficult to describe with words. Simply put, you hear and understand speech at a level several magnitudes higher than was possible with hearing aids.
So far, so good you say? Well, that old lack of trust is still lurking in the recesses of my mind, and the result is that I still find myself not sure whether to trust my hearing from time to time. I find myself asking my wife, Lynn, to repeat herself, or to clarify what someone else has said. And, I find that in almost all cases, I actually did hear what was said. I’m sure this is annoying to those around me, and I’m also sure that as time goes by, I’ll come to have better trust in my hearing.
And thus summer I plan on driving my 65 year old English car on a 1000 mile road trip to Yakima Washington. Every year, my nephew who loves these road trips, and I take such a trip, and each time, we’ve made it home. It’s about trust!
March 16, 2014
Maestro!
Music has been an important part of my life for as along as I can remember. When I was in grades 5 and 6, I remember rushing home after school to listen to Radio Station CJOR, and DJ Al Jordan with his Teen Canteen show. In those days, we had a large wooden radio, I think it was a Philco, it stood about 42 inches tall, had a lovely glowing dial, and a very mellow tone. Listening to Buddy Holly, Pat Boone, Elvis Presley, Fats Domino, Little Richard and others was an involving experience for me.
Later, I remember building a Heathkit Hi-Fi amplifier, and constructing a large speaker cabinet which went into the “rec” room at our house. As a young adult, I followed the herd, and bought a stereo setup when I was around 20 years of age. For me, it was all about LOUD!
Slowly, my hearing deteriorated, and although i continued to listen to music, things deteriorated to the point that I needed to use an assistive device in order to enjoy music. I remember selling my beloved Marantz 2330 receiver to a fellow in Los Angeles that really wanted it, and from that time on, using a Phonak iCom to hear music from my iPod through my hearing aids.
Fast forward to February 2014, and I found myself buying a new amplifier and pre-amplifier, a Sansui BA-5000 and CA-2000 combination for those of you who follow audio. As I write this, I’m streaming CBC Radio 3’s , at CBC.ca “Smooth Jazz” channel through the stereo, and enjoying the music immensely. In fact, I ended up buying another setup, so that I can listen in our basement family room when Lynn wants to watch the television. Lynn is actually delighted that I’ve brought this audio equipment into the house, because she knows that means I’m enjoying my hearing, and because we like to dance together.
The combination of the CI and the hearing aid delivers a full-range signal that feels “centered” in my head, delivering a satisfying sensory experience, probably not unlike that which I heard as a youngster. When it comes to music, it seems that the best words to use are “Play On, Maestro!”
March 16, 2014
The New Normal
A week or so ago, I was at the CI clinic for my one-year follow up and mapping session. Yes, it was a bit early, but I was glad to go in for the evaluation, and re-mapping.
First, the testing revealed that my hearing continues to improve, and in terms of speech comprehension, I’m doing much better than I did with my hearing aids–in fact, so much better that there’s no comparison. No sense boring you with numbers, but on some of the tests, the audiologist remarked that I was doing as well as she would expect persons with normal hearing to do.
Back in her office, we were discussing the quality of the sound from the cochlear implant, and while I was searching my brain for a comparison that made sense, one that would give meaning to the term “normal”, I suddenly realized that the hearing I experience with the CI is in fact normal. I understand not only what is being said, but I can pick up the emotional content from the tone of voice; environmental sounds: birds, air conditioners, wind, running water, etc., all make sense, and are easily identifiable; the doorbell is recognizable, even when I’m in the basement; and I can hear the little girls next door practicing the piano.
Before my activation, I often found myself thinking about what things would sound like with the CI, and whether they would sound normal. Now, I realize that with my profound hearing loss, I did not really know what normal sound was. Analyzing it, I guess that I heard everything with the treble attenuated to a substantial degree, rendering sounds sort of “bassy” or lifeless. With the CI, normal means the sound is “bright”, with the bass attenuated. But just as I thought what I heard before the implant was normal, now I realize that normal is what you actually experience when you listen to the world.
In my case, the “new” normal is a situation that allows me to better understand speech, and to enjoy music to a degree that was not possible prior to receiving the implant. Besides that, I’m much better able to hear such sounds as the phone ringing, the doorbell, a siren approaching, and even the “fluff-fluff” of the gas flame in the fireplace. Some normals are better than others I guess, but the secret is to accept the normal that you experience, and not to beat yourself up wondering what normal is anyway!
January 6, 2014
It’s been a long while since my last post, but now, with a new processor, I thought it might be a good idea to update the blog, just a bit. This new piece is all about the new Cochlear N6 processor, an upgrade which I received about two months ago.
All new, all over again!
In early November, my audiologist advised me that Cochlear Corporation, the makers of my Nucleus 5 implant, were giving me a complimentary update to the latest processor, the Nucleus 6. The new processor, with a much more capable chip, offers wireless connectivity, and an intriguing “hybrid” mode, in which it provides stimulation both electrically, via the implant, and acoustically, with an integrated hearing aid component.
Exciting? For sure! On Thursday, the big moment came. The audiologist had already installed my maps on the new processor, and we spent some time going over the new program options, and how to use the new Remote Assistant. I said goodbye to my old Nucleus 5, the processor which had opened up the world of sound for me, and we switched on the new one.
What did I get?
First of all: What was in the box? The new processor, model CP 910, was there, of course, as well as two of the compact-sized rechargeable batteries, which I ordered. As well, Cochlear included the two new remotes that were introduced with the processor, the CR 230, the advanced Remote Assistant, and the CR 210, the key-ring sized basic remote unit. Also in the box, the recharger for the remote control, a complete documentation package, the headpiece (coil), the headpiece cable, a USB cable for the remote assistant, the magnet, and a set of replacement microphone protectors. I was able to keep the old headpiece, and all the other accessories which came with my N5 processor, as they are all compatible with the new unit, a wonderful bonus.
What’s new?
So, what’s new with the new CP 900 series processors? The principal point of change is a new custom microchip, which gives the new processors some advanced capabilities. Other changes are a small reduction in the size of the processor, a new ear hook system, and some minor cosmetic changes.
Cochlear have developed a new “SCAN” program, which is essentially an “automatic transmission” for the processor. Just as an automobile transmission has a number of gears which are each suitable for different driving situations, so the processor has a number of different programs, each of which is suitable for different listening situations. There are programs for QUIET SITUATIONS, SPEECH, SPEECH IN NOISE, WIND, MUSIC, and one called FOCUS, which utilizes zoom microphone technology. SCAN constantly analyzes the sound environment, and chooses which program is most suitable for the situation.
In addition to this new processing strategy, the CP 900 series of processors have wireless connectivity built in to the chip, using 2.4 GHz technology. Cochlear have teamed up with GN Resound, a Danish maker of hearing aids, to use the same technology and series of connectivity devices, and this will be available by way of a software upgrade, as soon as approval for release is obtained. As well, these processors can operate in a hybrid mode, which offers simultaneous electrical stimulation and acoustic stimulation with a plug-in hearing aid component that replaces the standard ear-hook.
How does it sound?
My audiologist has requested that I use the SCAN program, and that I provide some feedback for her, and so that’s what I’m doing. After about a day and one-half, I’ve gathered a few observations, but first, my overall impression of the sound quality is that it’s quite significantly improved over the older model. Voices have a “fuller” sound, and the sound quality in the high frequencies is still crisp, and precise. The Remote Assistant, which communicates bi-directionally using 2.4 GHz radio technology, has an informative screen which tells which of the programs the processor has selected.
As I left the clinic, I walked out into a busy downtown urban street. The NOISE program came on almost instantly, and much of the traffic roar was reduced substantially. However, at the same time, the unit reduced the apparent volume of my own voice, and presumably would have reduced the volume of the voice of any person with whom I had been conversing. I got on my bicycle, and rode home, and noted that the WIND program was invoked, and that it did reduce the wind noise frequency bands significantly. At home, the unit sometimes had trouble deciding whether it was a quiet situation, or whether, when my wife and I were talking, it was a speech situation. As it turns out, it didn’t matter, as I was able to follow the conversation without any difficulties.
Yesterday morning, I went to the local community centre for my weekly dose of Tai Chi. The room has a noisy ventilation fan, and I noticed that when the unit switched into the noise program, the voice of the instructor was attenuated a bit more than I’d have liked. I used the remote to switch to the EVERYDAY program, which was my go-to program on the old unit. That restored the instructor’s voice to the normal level. Thinking about it later, I could probably just upped the volume a notch or two. And finally, last evening, I chose to watch the evening news on the television. In our open-plan house, my wife was watching something else on the kitchen television, and the unit decided that I was in a SPEECH IN NOISE situation. Again, the television voice sounds were attenuated, so I once again switched to the EVERYDAY program, as I had done at Tai Chi.
Today, I took some time to listen to music with the new unit. I did so using the SCAN program, and noted that for most types of music, the unit switches to the music program quite quickly. The exception seems to be some forms of choral music, which can sometimes confuse the unit, as it reports out on the remote assistant that it is in a noisy environment, or a speech in noise environment. The new processor does a better job than the older one at pulling individual voices and instruments out of the total sound environment, and reproduces the sound so that familiar melodies are rendered accurately. As with the older unit, and indeed with most CIs that I’ve read about, the sound is weak in the bass registers, resulting in an overall “thin” quality. Despite this, my music listening experience was enjoyable.
Initial Summary
I’m generally well-pleased with the improvements in the quality of sound. The SCAN program generally works as intended, but I am left wondering whether I might not be better off to let my own brain, which has proven quite plastic, to make the adjustments itself. Perhaps the SCAN program feature is intended for those who have more difficulty hearing with a CI than I do. And something I haven’t mentioned yet is that with the new compact rechargeable batteries, I’m seeing 17 hours of continuous use per battery. As these are considerably smaller and lighter than the standard batteries, I’m well-pleased with the life, and as a bonus, the lighter weight on my ear is a welcome change.
Would I recommend this upgrade to others? For anyone using the older Freedom processor, for sure! For those with a Nucleus 5, the improvement in sound quality is closer to evolutionary, rather than revolutionary. But, the upcoming wireless connectivity, and for those whose hearing loss is appropriate, the hybrid mode offer real advances. All in all, I think Cochlear have done a great job of advancing the technology and feature set in their processor, and for those who are upgrading from the N5, the compatibility with the older batteries, coils, cables, etc., is most welcome.
August 18, 2013
A Journey Without End?
I recall listening to Nana Mouskouri singing “Outward Bound” when I was in my early twenties. In that beautiful song, she sung of a “journey without end”, and while I’ve no doubt that my hearing journey will continue, I’m also sure that the most interesting points have already been visited. And, with a feeling that I’ve been in my new world of hearing for some time, I’m finding that I’d prefer to spend my time participating in the world, rather than writing about “the journey”.
There has been a gratifying response to my blog, even though I did not set it up properly to allow search engines to find it easily. Over 2900 different views have been recorded, and I’ve received some heartwarming comments, along with some encouraging e-mails. There were some suggestions that it might make a good e-book with a little organizing work, something that might be helpful for those who are thinking of a cochlear implant, or for the family and friends of those with severe hearing loss. Let me figure out how much work that would be, bearing in mind that the blog totalled around 44,000 words, and was rather disjointed.
Would I take this journey again? In a heartbeat!!
On Friday, I went to Via Tevere, a fantastic Neapolitan-style pizza joint near Commercial Drive in Vancouver. Crowded, with a lineup on the sidewalk. Noisy, full of hard surfaces and folks having a great time. Prior to the cochlear implant, not my kind of place, but now, I had no trouble being part of the conversation with our group of six.
I remember being somewhat self conscious about watching peoples’ lips as they talked, rather than their eyes. I had to do this, because I depended so heavily on lip reading. Now, with most people, I can watch their eyes when they talk.
Before, when I chose to watch television, I was often frustrated by the cantankerous nature of my bluetooth audio system that I absolutely needed to hear the announcers. Now, I just turn on the TV, and I’m good to go.
And using the phone, something I avoided ( the telecom companies did not offer a plan with only 20 minutes a month, all I needed) is so easy. I just hold the phone up to my ear, and voila! I can hear the other party.
And most importantly, I remember that there were countless times when my communication with my wife, Lynn, was short circuited by my hearing loss, forcing her to repeat herself, or just give up. Now, I can hear Lynn even when she’s in another room.
Of course there are things that could be better: the sound from a CI tends to have a pronounced high-frequency emphasis, and I’d like a “fuller” sound. And I can’t wear it while I’m sleeping, as it would brush off, so I am not aware of possible important sounds at night.
We began with the first blog post on January 13, and the journey has been wonderful beyond my wildest expectations. And that brings me back to that same Nana Mouskouri song:
“So farewell, adieu, so long, vaya condios
May they find whatever they are looking for
Remember when the wine was better than ever again
We could not ask
We could not ask for more”
August 13, 2013
Adapting
Over the course of 40 plus years of living with a severe, then profound hearing loss, I learned and practiced a set of adaptations, most of which were simply subconscious behavioural changes
Perhaps the simplest example is that I rely on reading, rather than listening to gather news and information With that in mind, the internet has been a godsend, allowing me to read several newspapers, do basic consumer research, and keep up with my hobby interests, all without having to rely on my hearing.
A second example that springs to mind is that I watch very little television, and in particular, I do not watch sitcoms, reality, and drama shows, principally because I cannot hear well enough to follow the shows. Sitcoms, in particular, are very difficult, as the rapid-fire dialogue, interspersed with the canned laughter, meant that I missed all the jokes. Reality shows, again, are difficult if not impossible to follow. And with drama shows, often the characters speak while not looking towards the camera, speak with accents, or speak in low voices, all of which make for a deal killer. I’m sure most would say that missing sitcoms and reality TV is no great loss, but there have been some good drama series that I would have liked to enjoy.
So, why not simply use captioning? For various reasons, I do not enjoy using captioning. I find that reading the captions distracts from my enjoyment of the show, particularly in that it takes my focus from the speakers’ faces, which leads to a not inconsiderable loss of meaning.
But those adaptations extend beyond just information and entertainment realms. My hobby is, when I find the time, working on my 1949 MG. In general, this is a solitary activity, which means that except for the odd curse on my part, I do not have to be able to hear to enjoy my time with the hobby.
And similarly with bike riding. I love to ride from my home down to the beach, and along the seawall, taking in the sights, and enjoying the physical exercise. Again, when I ride by myself, no need to hear people talking.
Now I do enjoy working on the car, and riding the bicycle, but now that I can hear much better, I have the option of engaging in other activities, activities of a more social nature.
Before I received the cochlear implant, I never thought about these things, but now, with the new options available to me, I can make new decisions about the things I really want to do. I suppose it’s a form of rehabilitation or adaptation that I never saw mentioned in any of the material I reviewed while researching cochlear implants.
Simply put, it means unlearning my previous ways of adapting to the world, and learning some new ways. And no, that does not mean I’m going to start watching sitcoms and reality TV!
August 10, 2013
It takes more than hearing
Something interesting happened on the way to the forum.
You could say that on the way to the allegorical forum, I just happened to have a cochlear implant. I showed up at the forum with hearing that is much better than I’ve been used to for the past 40 years. So you’d think I’d just walk right in and take part in the conversations, just like those folks with normal hearing do.
Well, I’ve found it’s not quite that simple. For one thing, I’ve had a long-time habit of giving up when conversation was difficult. If it was tough for me to hear a conversation, perhaps due to noise, or because I found the speaker difficult to understand, I would just tune out, perhaps finding something else to do, or else by just sitting there, looking as though I was listening.
So now I’ve got a cochlear implant, and much better hearing, perhaps not as good as those with normal hearing, but pretty close. But guess what? I often find myself in difficult listening environments, the most common of which is the situation in which two or more people decide to talk at once. Because of my hearing history, I have a tendency to “give up” early on these conversations, following my old and well-developed habit. I noticed this last night, as we had a group of 18 people over for a dinner at our house to celebrate such things as three birthdays, an engagement (my daughter’s!), and the fact that we had some out-of-town guests from my wife’s family with us.
After dinner, while we were just sitting around, I became aware that I was not participating in the conversation, and that got me thinking about the why. First of all, there were a couple of side conversations happening during the main conversation. This always makes it tough to follow the main conversation. Secondly, it was often the case that two people were speaking at once. So, we have the typical difficult listening environment. But those with normal hearing were generally all participating.
What had happened for me was that when faced with the difficulties in following this conversation, I fell into my old habit of giving up early. And, once I had done that, it was difficult to get back into the conversation, as I had not followed all the threads and topics. My feeling on this is that conversing is more than just being able to listen and talk, it’s about becoming aware of participation skills, such as knowing when to join in, and when to allow others to carry the thread, so to speak.
Unfortunately, the little microchip that is implanted in my head as part of my cochlear implant system, doesn’t have any means of facilitating that set of skills, so it’s up to me to develop that skill set, and add it to my new-found hearing ability, so that I can go to the forum, so to speak, and take part in the interesting conversations that take place there.
August 4, 2013
Smackers
With almost four full months of bionic listening under my belt, a sense of perspective is developing as I journey through this new world of sound.
First of all, we live in a very, very noisy world. The noise was there before my implant was activated, but I didn’t hear very much of it. Here are some examples of the noises I hear now.
The transit buses in Vancouver use compressed air to activate the brakes, and to raise and lower the bus for passenger loading. Frequently, the air system on the bus vents a blast of compressed air, with a distinctive and quite loud hissing noise. And some young drivers take pride in fitting loud exhaust systems to their cars, and many motorcycles on the street appear to have no mufflers in their exhaust systems.
Construction noise is tough to escape, and much of what used to be done manually in the past is now done by machinery, such as concrete pumps, air-powered nailers, and stone and tile saws. And in our neighbourhood, there are very few folks left who mow their own lawns with a hand powered mower. Most people hire a contractor to tend to their lawns, and the sound of gasoline-powered mowers, trimmers, and blowers never seems to end.
Restaurants often have an open-kitchen plan, but restaurant kitchens are noisy places, with powerful vent fans, the clatter of cooking utensils and serving dishes, and the cooking staff talking loudly. But, and I think I’ve mentioned this before, those wonderful restaurant managers love to try and drown out the kitchen noise with music systems playing music that I suppose is the favourite of someone on the staff, someone a lot younger than me!
The heating and air-conditioner blower fan in our house makes a sound, as does the blower in the oven. Everyday objects make noises too, such as the crinkling of plastic bags, the noise of water running in the pipes, and the microwave oven’s rushing noise. And then, my favourite noise: the sound of people making smacking noises with their mouths as they eat or talk. Before I had an implant, I never heard this sound, but it certainly jumps out at me now, and yes, it’s very annoying. Why can’t they find a way to open and close their mouths without that smacking sound?
Now, I’ve been tempted from time to time to just take off my processor, and enjoy the silence, but I don’t do that, because I am trying to become used to the noise, just as those with normal hearing are used to it. And, there are two program slots in my processor with special mapping to help eliminate noise, but for the same reasons, I do not generally use those programs. Simply put, I want to become so used to all that noise, that my brain learns to simply tune it out.
To bring perspective to this world of sound, the best plan would perhaps be to point out that despite all this noise, and despite my reluctance to use the special noise reduction algorithms built into the CI processor, I can hear conversations, even in those noisy restaurants, very well, so I’m not complaining about the performance of my cochlear implant. The problem is when there is no conversation, just those smacking sounds from people’s lips.
Perhaps the next big advance in cochlear implants will be a special program called Lip Smacking Suppression.
July 31, 2013
Oops, Now I’ve Done It!
If you’ve been reading along, you’ll be aware that I have a cochlear implant on my right side, and that I wear a hearing aid on the left. My audiologists suggested that I continue to wear the hearing aid, as the two devices worn together, provide better directionality, allow the left hand side of my auditory system to continue to receive stimulation, and provide a sound with a better balance between bass and treble. Wearing both a cochlear implant and a hearing aid is usually referred to as bi-modal hearing.
Because the sound from the implant is so good, I’ve taken to not wearing the hearing aid, sometimes for a day or two at a time. But today, with a few errands to run, and a couple of people to meet, I thought I’d better wear both. So, I picked up my hearing aid from the coffee table, and that’s the last I saw of it. Eight hours later, I still have no idea where it is. I did not put it on my ear, so I suspect it’s somewhere in the house, but after extensive searching, I’ve not yet found it.
So, today I operated on just the CI, and did surprisingly well. I drove to meet friends, and got out of my truck to go into a building, when I heard my name being called. I looked around, and then I heard someone say “behind you”. And sure enough, there they were, standing outside. As I mentioned above, directionality with just one ear in operation can be a problem, as basically, my brain thinks every sound is off to the right.
Later, I watched the news on television, again, using just the implant. I do not use captioning, or any other assistive device, and I heard the news with little difficulty. After the news, I put a soccer game on, and because of the accent of the announcer calling the game, I had quite a bit of difficulty following what he was saying. Enjoyed the game nevertheless.
But hey! Losing something like that makes me feel somehow off balance. I’ve retraced my steps, looked in all the usual places, and lots more besides, and that hearing aid just refuses to be found. A friend told me that it will just show up when I’m not looking for it, but in the meantime, I can’t enjoy music as I usually do, and I can’t stop worrying about it. But at least I can hear!
And, as the old saying goes, it’ll be in the last place I look…
July 30, 2013
I Didn’t catch That
Prior to receiving my bionic ear, I doubt anybody ever heard me utter the phrase: “I didn’t catch that,” meaning, I did not hear what you said. For some reason, those of us with hearing loss tend to do almost anything to hide the fact that we fail to hear something. Bluffing, guessing, changing the topic, or just ignoring the situation. Of course, most of those around us know right away that we haven’t heard what was said, and being the good souls that they are, they just ignore the situation, or help us out with hints, or by repeating the words, or answering for us.
And, for far too many years, that’s how I went through life, afraid that admitting that I couldn’t hear properly was akin to admitting that I was somehow a second-class sort of person. Of course, when I was operating in the cognitive, rational mode, I knew that this was not true, but there’s a lot of emotion involved in the development of our sense of self worth, and emotion often wins out.
A week or so ago, I was talking with a good friend in Ottawa using Skype, and I missed something he said.
“I didn’t catch that,” I said.
His response was that he had not heard me use that phrase before, and he further opined that I probably faked more often than not prior to receiving the implant. I gathered from his comments that he was glad that I could now admit that I did not hear something.
And I’m glad that I can admit that now, because the cochlear implant has led me to focus on how my hearing has impacted my personality, my sense of self-worth, and the quality of my interactions with others.
Oh, and did I mention? I don’t miss nearly as much now that I have my bionic ear!
Brothers in Arms
Last week, my nephew Paul and I set off on a short road trip to the Oregon coast in my trusty 1949 MG TC. We left his home in Chilliwack, BC, at 7 AM on Thursday, and wound our way over the backroads, including the renowned Chuckanut Drive, south of Bellingham, WA, to Whidbey Island. Here, we had to wait two and one-half hours for the ferry to the 1890s city of Port Townsend, on the Olympic Peninsula.
We wandered through Port Townsend for a while, then motored down the west side of the Hood Canal, to Shelton, where we stopped for the night. Next day, we crossed the amazing bridge across the mouth of the Columbia River to Astoria, OR, founded in 1805. Onwards we went, first to the beach at Seaside, then further south to Cannon Beach, a very beautiful beach resort town, with a truly fantastic stretch of sand anchored at each end by spectacular “haystack” rocks.
After lunch at a local eatery, we headed back up to Olympia WA, and after checking into our hotel, went down to the Budd Bay Cafe for dinner. After taking our seats, I looked up, and noticed that the gentleman seated at the next table was wearing the same cochlear implant processor that I wear. I noticed that he was conversing with two other people at the table, despite the fact that the cafe was large and very noisy.
This was the first time I’d ever noticed another implant user outside of a clinical or association setting, so I went over to his table, and introduced myself. He seemed genuinely glad to meet another bionic ear, and we compared notes on our experiences. He had been activated in December 2012, and was extremely pleased with the outcome. Like me, he was able to hear speech well right from the day of activation. Both of us marveled that we were able to enjoy conversing in such a noisy environment, and both of us had ear-to-ear grins as we formed the sort of bond that results from shared experiences.
Afterwards, I found myself regretting that I had not thought to exchange contact information with him, but that feeling of regret was short lived, as I realized that just living life, participating fully, was a much higher priority than getting together to discuss how cochlear implants impact our hearing and thus our lives.
For a brief moment, that gentleman and I were brothers in arms. But fortunately, we are no longer fighting the old battle of not hearing well enough to participate fully in life, and each of us moved on to things more fulfilling.
July 18, 2013
By the Numbers
Earlier this week, I had a three-month followup and mapping visit with the audiologist. As usual, we started off in the sound booth, sitting in the precisely-placed chair, facing the calibrated speakers. And I have to say it: Those speakers are impossible to lipread!
Test number one was listening to single words, using just the cochlear implant. My score on this test was 85% correct, which compares very favourably with my score of 16% prior to receiving the implant. From there, we moved on to listening to sentences. The first test was sentences without noise, and on this test, I scored 100%, and prior to receiving the CI, my score with both ears using hearing aids, was at best, 85%. Sentences are easy for me, because I can usually piece them together from the context.
This was followed by listening to sentences in noise. Basically, the equipment plays a soundtrack of what sounds like 20 or 30 people all talking at once. While this non-stop babble is occurring, different speakers read sentences, with their voices being 5 DB louder than the noise. I find this test miserable, and learned that at the one-month test, I managed to score 4%. The audiologist did not complete the scoring before I left my appointment, but she assured me that I did considerably better this time. I sure hope so…
Finally, the audiologist performed a set of threshold audiogram tests, to measure my residual hearing in each ear, and the performance of the implant. These test results indicated that my residual hearing, while still classified as a profound loss, is not deteriorating, and that the implant is doing the job.
She then adjusted my mapping, or the programming for the cochlear implant, making it a bit louder, and evening out tones across the frequency band. The changes made were small, and although my hearing is a little better, it’s certainly an incremental change.
So now we come back to the sentences in noise test, and my dissatisfaction with my results. First, it is a difficult test, no question about it. I think many people who do not have hearing loss would find it tough to “pull” those sentences out of the babble. And, although I can appreciate that it is a standard test, probably normed for statistical purposes, I do not think it is an accurate reflection of the real world. I say this because I am finding it fairly easy to engage in conversations with people in noisy restaurants, but I concede that I have the advantage of being able to see the speakers’ faces, and do some lipreading.
Having said that, I sometimes find it difficult to hear the television, or my phone, when Lynn is nearby, and talking on her phone, or talking with someone in person.
At three months, there’s no question that my hearing is improved over what it was prior to the cochlear implant, vastly improved, in fact. And, according the audiologist, and from what I’ve learned from my research, it will continue to improve. I’m due for a checkup and testing at six months, and I’ll most certainly post the numbers when I get them.
July 14, 2013
Two States of Hearing
It’s now approaching three months of listening using the cochlear implant, and I’ve become aware of an interesting, but perhaps unsurprising phenomena.
I’ve become aware that I have two listening modes now. The first one is when I’m just going about my daily living, conversing with people, listening to music, watching the news on television, driving in traffic, or being involved in a myriad of other activities. The second mode is when I’m actively paying attention to the cochlear implant while I’m listening.
Dealing with the second mode first, when I do pay attention, or when the workings of the CI are at the level of consciousness, I notice that there is not enough bass, or low frequency information in the sound, I notice that unfamiliar voices tend to sound alike, and I notice that there is a great deal of random noise, much of it quite shrill, in our world. There’s a certain artificial quality to voices, not exactly “Mickey Mouse”, or robotic, but rather sort of reedy, Speech, probably because of this high frequency emphasis, is very easy to understand, something that makes me reluctant to ask the audiologist to make changes, changes that would perhaps produce a more balanced sound, with more low-frequency emphasis.
And in this mode of awareness, music, while pleasant, lacks the fullness that results when the low-frequency sounds are present. It sounds pleasant because the harmonics of stringed instruments, the sounds of cymbals and brushes, and the higher notes of the piano all make their presence known, and add so much that was always missing when I listened to music. Lyrics are much easier to distinguish, and choral works are no longer muddy.
In the first mode, when I’m oblivious to the fact that I have a cochlear implant, things sound normal, whatever that means. Lynn, my wife, sounds just as she always did, only I can hear her better. Folks on the telephone sound as I remember them. Airplanes overhead sound as I remember them, and so do things like air compressors, lawn sprinklers, the neighbourhood kids, and household appliances.
I visited a neighbour today to discuss hiring an arborist. We only converse infrequently, so I cannot say that I am used to the sound of her voice. Afterwards, I became aware of the fact that the conversation was perfectly normal, with no hint of the CI sound.
There seems to be a sort of seamless slipping from one mode to another, there is definitely no conscious effort made, except when I decide to concentrate on the CI sound. It strikes me that the natural process of rehabilitation to this new way of hearing is simply moving from one state to the other, from concentrating on listening with the cochlear implant, to just listening as you live a normal life. Our brains are really incredible in their ability to make these sorts of adaptations.
July 10, 2013
Born too soon?
As near as anyone can tell, my hearing loss began when I was around one and a half years of age. When my hearing loss was first diagnosed, at age seven, the itinerant audiologist from the school system referred us to the family doctor, who determined that there did not seem to be any problem with my outer ear. The next stop was at a well-known local Ear, Nose and Throat specialist, Dr. B W Tanton. He determined that I had sensorineural hearing loss, and after some discussion with my mother, his best guess was that my hearing loss stemmed from a bout of the measles. Perhaps it was the fever, perhaps an ototoxic drug was to blame?
During my pre-school years, I recall a couple of incidents which really ought to have been a clear indicator of hearing loss. I was notorious for not coming home when called for lunch or dinner. And, I remember having a great deal of trouble learning to pronounce words such as magnificent, which I thought was magnicifent! And, in grade one, I was constantly being chastised for not doing what I was told in class. But this was in 1950, and in those days, there was a different attitude towards diversity and disabilities.
From grade two on, I sat in the front of the classroom, and my parents learned to yell at me! Unfortunately, Dr. Tanton had advised my parents that it was probably best if I did not wear a hearing aid, using the rationale that as a young boy, playing rough house with other kids, I’d just break it!
However, from Grade seven on, I had a genuine Zenith body-worn hearing aid, and I can recall that some teachers, thinking it was some sort of radio, demanded that I take it off and give it to them. My high school classmates thought the hearing aid was most definitely un-sexy, but they really enjoyed the classroom scene when I made weird feedback sounds with the device, moving the earpiece closer and farther from the microphone.
University was a different game. First year classes sometimes had 200 students in large lecture halls. There was no accommodation policy or practices, and hearing in those halls was next to impossible. Despite the fact that I had a hearing loss classified as severe, I was still required to take two years of a foreign language, which actually took me four years to complete. As I said, there was no accommodation at all in those days.
Despite all this, I did graduate, in 1967, and my marks were not all that bad. But, it was a real struggle, and I look back at my experience, which must have been similar for many others with similar problems, and I’m so glad that the world has changed. First of all, there are legal requirements to provide reasonable accommodations to those with disabilities. And, the assistive technologies used by those with hearing loss have improved to levels incomprehensible only 20 years ago.
During my career years, I worked as a public school teacher, a communications officer with the government, and for a short while, as a communications aids specialist with the Western Institute for the Deaf and Hard of Hearing. Using the telephone became increasingly difficult as my hearing loss progressed, and hearing at meetings was very much “hit and miss”. I’m sure that my hearing loss negatively impacted on my career, and again, it was often necessary to fight, and not always successfully, for workplace accommodations.
And so now, the thought running through my head, fairly frequently since my CI was activated, is just how different my life might have been, if the technology I employ now, had been available when I was a youngster. Would I have followed a different education path, or been better able to manage my career with better hearing?
I think yes, and my best guess is that those with hearing loss reading this blog would probably say the same for their own lives.
July 4, 2013
Do you hear what I hear?
Coming up on three months of bionic hearing, and certain phenomena break through into my consciousness, shedding light on the bionic hearing journey.
Simple example: today, I was dragging the canister vacuum cleaner around, and noticed that the sound of the air rushing through the hose changed from time to time. Observation revealed that the hose does occasionally become kinked, partially blocking the air flow, When this happens, the sound changes, something that I never noticed prior to receiving the cochlear implant. No wonder the floor seemed so dirty!
With warm summer weather here, we are often outdoors, or we have opened many windows in the house. As I mentioned earlier, it’s a very noisy world, and at this time of the year, bird songs, and lawn maintenance machinery are almost constant. Sometimes, I’ll hear something, say a bird call. I ask Lynn what it was, and she simply hasn’t heard it. Obviously, her brain has learned to tune out all sorts of non-threatening noises, but mine hasn’t mastered that art yet. She doesn’t hear what I hear.
Often, CI users report that voices sound “robotic”, or “cartoonish”. For me, some do, and some don’t. If the voice is someone I know, and if I have had some time talking with them, they sound normal, whatever that is. New voices tend to sound cartoonish at first, but people I know sound about right, indicating to me that the auditory memory function in my brain is “substituting” the sound I remember, for the sound the CI is delivering. A good thing I guess, especially since I still hear the high pitched sounds so necessary for speech processing.
And now, one I don’t really understand: sometimes, I have trouble hearing in noisy situations, something that seemed to be resolved a bit earlier. An example would be trying to hear the news anchor on the television set, while Lynn is talking on the phone. To be fair,this usually happens when I am using the CI without a hearing aid in my other ear, which is a simulation of single-sided deafness. I am told that people who have SSD have trouble in noisy situations, even with good hearing aids. The only reason I can see for this is that the brain has an ability to use the two ears as dual microphones, and “zoom” in on the sound we want to hear.
Another observation is that my implanted ear has retained quite a bit of its residual hearing. If I put my old hearing aid in that ear, I do hear. The sound is totally lacking in treble, but some of that is due to the fact that with the CI, I’m now used to hearing a lot of treble, so anything else sounds very “flat” and lifeless. I’m delighted to know this, because the next generation of sound processor from Cochlear Corporation has a hybrid capability–it includes a hearing aid component that sends sound acoustically to the middle ear through the ear canal. This could be a game-changer in the CI industry, as it should allow a CI user to hear much more low frequency sound, overcoming the bass rolloff that is characteristic of CI hearing.
And finally, my neighbour, a graduate of the Juilliard School of Music, told me about a great app for my iPhone. It’s from Canada’s CBC, the national public broadcaster, and it’s all about music. So, today I downloaded the app, plugged my iPhone into my music system, and began to stream “Smooth Jazz” into the living room. Most of the pieces were new to me, and while listening, I did wear my hearing aid in the non-implanted ear. The music sounded really good, very enjoyable, confirming that one of the fears I entertained prior to the implant surgery was unfounded. I can and do enjoy music! We both hear beautiful music.
Do I hear what you hear? The best answer is probably “Yes and No, it depends.”
June 25, 2013
Thanks Mom!
My Mother died today, triggering a wave of emotion, followed by a drift into introspection, as my mind wandered into the what might have beens, and the what will becomes.
Mom, also known as Granny, was 93 years of age, and her death was painless and peaceful. She was married to my Dad for 67 years, had two children, five grandchildren, and six great-grandchildren. For 85 of her years, she maintained her health, served her community as a volunteer, and remained connected to a circle of friends.
Despite all this, she developed a debilitating medical condition, dystonia, which progressively robbed her of her life. And it did so slowly and insidiously, taking away first her mobility, then the use of her hands and arms, rendering her wheelchair bound, and unable to care for herself. As if that was not enough, it then took away her ability to speak, to express herself.
Despite these setbacks, she was able to smile and laugh until three months before she died. It was difficult, painful in fact, to visit with her. All I could do was tell her what was happening in the lives of those in the family, show her pictures and videos, and even sing to her. That, and recall the vibrant woman she was before this condition took hold of her.
So what’s all this doing in a blog about cochlear implants and hearing loss? Well, when you think about hearing loss, you think about the loss of communications ability, and the subsequent problem of social isolation. For those with hearing loss, and for those around them, it’s all about the problem caused by the hearing loss. My mother was always very concerned about my hearing loss, and how it would affect my life.
But hearing is part of the receiving end of the communication process; speaking is part of the sending of the message. Not being able to express oneself verbally is just as difficult and damaging as not being able to receive the expressions. Because I was always absorbed in my hearing problem, I never thought about the other side of the equation, until my Mom showed me this when she lost her speech.
As luck would have it, my CI activation, back on April 16th, came after my Mom had lost her ability to speak and smile. I remember visiting with Mom shortly after the successful activation, eager to show her and tell her about the CI, and how it made my life so much easier. But, it was really too late, because she could not talk to me, nor could she indicate that she understood, and was glad for me. I was left with a hollow feeling, because understanding how important my hearing was to my Mom, I wanted to let her know about my new hearing, and I needed to hear her confirm, to let me know she understood and was happy about the change.
So now that my Mom is free, I can remember the most important communication that any human beings can enjoy. Both of us, on many occasions, were able to say and hear the simple words “I love you.” I know she heard me tell her that right to the end–she was able to respond with her eyes. Wonderful!
June 23, 2013
Singing in Tune
While visiting my Mom in the care home yesterday, I decided to sing to her, something she’s always liked, even though it is universally acknowledged that I am not a singer. As I finished, I noted another resident of the home was smiling. Now, was my singing that bad? I asked Lynn about it, and she remarked was that I was in tune.
Now, after all the horror stories I’d heard in the past about CIs and music, I was surprised that I could hear the notes well enough to sing in tune. Mind you, that does not mean that the record companies are in any great hurry to offer me a recording contract.
Yesterday evening, Lynn and I watched, me for the first time, the videos she took at my activation. My attention was first on the faces of those around me, Lynn, Emily, and the audiologist, Cindy. Emily certainly looked apprehensive in the moments leading up to switch on, and I could tell from her voice that Lynn was nervous as well. The audiologist was extremely patient, doing her best to ensure that my expectations were dialed in so that if the sound was not good, I’d not suffer a huge letdown.
It was most interesting to compare my reaction to what I heard at switch on, to how I feel about my hearing now, a little over two months later. When the device was first switched on, I was conscious of a constant whine and buzz, as the device rendered environmental sounds, such as the air conditioning fan in the office into a “sound” for my brain to decode. Cindy noted that the brain is always listening, that hearing/listening is our primary safety sentry, but that once the brain was satisfied that the sound was not something that needed attention, it would begin to attenuate the sound, and it would not be at the level of consciousness. Well, that has certainly turned out to be true.
In that first hour after switch on, lipreading was still a big part of my attention to speech, but even at that first appointment, the audiologist was testing me by holding a shield over her face so that I could not lipread, and I was able to hear much of what she said.
Words with the “s”, “f”, and “sh” sounds were particularly easy to hear, while I stumbled badly over the word “pool”. I guess the “p” sound and the “l” sound are lower frequency sounds, explaining that difficulty. Despite this stumble, I could tell that both Lynn and Emily were overjoyed, and very relieved. Lynn said she’d be waiting 15 years to be able to talk to me without the usual hearing loss difficulties. And Emily, I think, had fears that somehow the new technology would not work, leaving me worse off than before the surgery.
And now, even though things are much better than they were on day one, there’s still a ways to go. We had a solstice party the other night, sitting around a fire, with painted faces, and eating wonderful barbecued food. Afterwards, we sang campfire songs, and then played a word-association game. The word-association game was difficult for me, as it was not predictable who would speak next, and in the excitement, everybody spoke very quickly, and sometimes not very clearly. The reality is that even with the amazing technology of the cochlear implant, the current state of the art, and the fact that I have only one implant, means that I do not hear as well as a person with normal hearing.
But that’s not the comparison that’s most relevant. The best comparison is how do I hear now, compared to how did I hear prior to receiving the implant? The answer? I am overjoyed with how much better I hear now! I hear so well, that I can even sing in tune!!
June 21, 2013
Progress Report
Most would agree, I’m sure, that my experience with a cochlear implant has been very positive. Upon activation, at which I expected to hear strange sensations and electronic noise, but at which I heard voices clearly, I knew that the surgery and device fitting had been exceptionally well done. Most people were very surprised at just how well I could hear, and to tell the truth, I too was pleasantly surprised. That’s my idea of an understatement.
Since then, there are times when I’m not aware that I have a cochlear implant, life just goes on, and I am glad to be part of it, in a way that was not possible before the implant. At other times, I find myself consciously evaluating the sounds I am hearing, trying to determine if my adaptation to the device is changing.
First, there’s what I can hear, or not hear. Two days ago, I was lying on a couch on the sun deck, just relaxing. I noticed that I could hear someone talking on the telephone, and wondered who it was, as I could determine that it was not Lynn in our home. It turned out to be the woman next door, conversing with someone in her family. That’s something I was never able to hear before. Later, I noticed a cruise ship leaving the harbour, and called to Lynn to take a look. She was upstairs in the house, and I could easily converse with her, although I was downstairs on the deck, we were not in visual contact.
I’ve previously mentioned that I enjoy the music at Lynn’s church, and I returned there on Sunday to give it another listen. I’ve also mentioned that my hearing aid has been re-programmed to ensure it is working in a manner that is more complementary to the CI. Now, in my opinion, when evaluating how well music sounds, it is best to listen to music with which you are not familiar, and the music at the church fits into this category. After just over two months, choral music sounds “right”, and is truly enjoyable; a trumpet solo made musical sense, and a piece on the pipe organ sounded full and rich, quite a contrast to just four weeks ago. Granted, this was with the combination of the CI and the hearing aid.
Sometimes I listen to music with just the CI to see how things are progressing. First off, the music is recognizable, and sounds in tune. Having said that, the music has a hard, almost metallic quality, the result of the fact that the CI does not do a good job of producing low notes, or bass. My brain seems to somehow fill in the lower notes, as if it is constructing them from the information in the harmonics. If the piece of music is one that I know, I can almost always identify the singer, while if it’s a piece with which I’m not familiar, I can often, but not always, tell who is singing.
Prior to receiving the implant, I enjoyed music without generally being able to follow the lyrics; an enjoyable sound, but I never knew what the song was all about. Now, for most songs, or at least those written for civilized folks, I can follow the lyrics, and I guess this compensates for the lack of bass notes…
I suppose I should mention that the spoken portions of the church service were all easy for me to hear without straining, and without using any assistive device.
So, two months in, I can say that the progress, added to the initial activation experience, is far exceeding my expectations.
June 17, 2013
Gadgets and Gizmos
Last evening, I attended the meeting of the North Shore Branch of the Canadian Hard of Hearing Association. The speaker at the meeting was Dan Paccioretti, an audiologist with Phonak, and Western Manager of their wireless products division.
Dan gave us a very professional presentation, first outlining some of the new technology in the latest Phonak hearing aids, and then presenting a first look at Phonak’s new Roger wireless connectivity line of products. Phonak have put a substantial investment into research and development in an effort to allow those with hearing loss to hear in difficult situations. Hearing speech in noisy environments, and using the telephone are two major challenges, and the new strategies address these problems with two major strategies.
One of these is wireless voice streaming, in which the two hearing aids work together to deliver the sound from one aid to the other aid, so that the user hears the best possible sound in both ears. And with four microphones available using two aids, the new devices can use beam-forming algorithms to block noise from all sources save those directly in front of the user.
The second strategy is frequency compression, which compensates for the fact that a large proportion of those with hearing loss do not hear high frequency tones, even with properly programmed hearing aids. The aids capture the high frequency notes, and move them down the frequency band to the point where the user can hear them, thus enabling them to better hear speech sounds, such as the “s”, the “f”, and the “sh”, all critical for understanding.
Roger, the new wireless system, uses the 2.4 GHZ frequency band, and packet technology to, in essence, move the listener closer to the sound source. This technology will replace the personal FM systems that have helped those with hearing loss up until now, and offers several advantages, such as the ability to use more than one microphone with each Roger transmitter, better privacy, and more reliable communications in difficult circumstances.
I have always had a high regard for Phonak products, and these new developments look very positive for those who depend on hearing aids.
As I listened to this, I realized that now that I have a cochlear implant, I really do not need these new technologies. The CI does such a fantastic job of delivering crystal-clear high frequency sound, that speech is very easy to hear, even in quite noisy environments. In fact, during the presentation, I glanced over to another CI user in the audience, and we exchanged silent signals of triumph, as we both knew that all of the problems that Dan was describing, problems which previously made our lives more difficult, were now behind us.
At the end of the meeting, we had a brief conversation, and we noted that neither of us uses any of the gizmos and gadgets which we need before we received our implants.
June 13, 2013
Winning the Little Battles
You’ve probably heard the expression about winning the battles, but losing the war.
Prior to receiving my cochlear implant, I remember celebrating the little wins that compensated for the big losses I experienced as a result of my hearing problem. Two things stand out: listening to music, and using the telephone.
When I depended on two hearing aids, I had what I called “My secret weapon”, a small electronic device called a streamer, that I wore like a pendant. The streamer was made by Phonak, a major manufacturer of hearing aids, and was called the iCom. That enabled me to hear music, and in-flight movies fairly well. For music, I used the bluetooth feature of my iPhone to send music to the streamer, and then on to the hearing aids. The sound was reasonably good, and it was in stereo. On a long flight, or when working around the house, it was really a treat to be able to relax and listen to music, all wirelessly. And, on aircraft, being able to plug my streamer into the armrest of the plane to pick up the movie soundtrack with a simple connecting cable to the streamer not only let me enjoy the movie, it got rid of most of the jet noise as a bonus. In both cases, nobody around me had any idea that I was wirelessly plugged into music or the movie.
With hearing aids for communication, using the telephone was always difficult. I dreaded having to phone unfamiliar people because more often than not, I would not be able to hear them very well, especially when it came to picking up names and numbers. Amplified telephones made the sound louder, but not clearer. What worked for me was binaural hearing, and the best system was using a wireless bluetooth connection from my cell phone to my iCom streamer. The streamer relayed the sound wirelessly to both hearing aids, and, at the same time, shut down the sound coming into the microphones on the hearing aids, thus largely eliminating the background noise. This worked reasonably well, but there was still a major lack of high frequency sounds, so consonants were hard to hear. And, unless I told them, the people around me had no idea that I was on the phone, they just wondered why that “fool was talking to himself.”
The cochlear implant I have is not compatible with the streamer, so for now, I’ve lost those little advantages I enjoyed previously. At the moment, I have to listen to music using loudspeakers, although I think I could buy headphones and use the telecoil feature on both the CI and the hearing aid. Buying T-Links or silhouettes would help, but that would leave me with wires leading from the iPhone to my ears. For those not familiar with T-Links or silhouettes, they are a small device worn behind each ear that convert the sound from the headphone jack to magnetic fields that the telecoils in the CI and the hearing aid can pick up, and turn back into sound.
When the next generation Cochlear processor, the Nucleus 6 is available to me, I will be able, I think, to enjoy a wireless connection to both ears, as it uses 2.4 GHZ RF to send the signal from an iPhone to the processor, and it will work with a compatible Resound hearing aid, which I’m currently looking into.
So, hopefully, in the near future, I’ll once again be able to hear my music wirelessly, with no one around me any the wiser. I liken it to acquiring a new secret weapon, and I look forward once again to winning those little battles.
June 11, 2013
Do I Really Want to Hear This?
Lawn mowers, aircraft, outboard motors, string trimmers, excavators, compressors, skill saws, motorcycles, sirens. And this is just a partial list. It’s a very noisy world we live in, probably noisy to an unhealthy degree. This is something that did not penetrate my awareness before I received my cochlear implant.
Our society has somehow allowed for the proliferation of what really ought to be considered as an unacceptable degree of noise sources. Cars with very loud sound systems thump as they cruise around, motorcycles announce their presence with loud exhaust systems, construction sites come to life at 7 AM with compressors and air tools, float planes travel over residential areas at low altitudes in order to take the shortest route, landscape maintenance workers use two-stroke gasoline-powered blowers to move grass trimmings and leaves to the road, and demolition crews use large excavators to crunch old buildings to rubble.
Now that I have better hearing, I’ve become aware of all this noise, noise which some people believe may be harmful to our health, as well as to our hearing. In Vancouver, where I live, I’m sure there are bylaws and regulations to control noise, but if there are, they are either inadequate, or there is insufficient enforcement. A few years ago, I took my daughter to see the Rolling Stones in concert at the local football stadium, a building which at that time had a dome roof. Without hearing aids, the noise level was painfully loud, and remember, my hearing loss is classified as profound. It would seem to me that this sort of situation ought to be regulated, as there is a hearing-health issue involved.
Not far from Vancouver lies Cultus Lake, a beautiful small lake, surrounded by cabins, campsites, and permanent homes. Sounds idyllic, but on any summer weekend, the lake, which is the centrepiece of a Provincial park, is humming with waterski boats, jet skis, and other noisy watercraft, such that by the end of the day, it is not unusual to see a blue haze of two-stroke exhaust smoke over the lake. The noise of these boats makes the idea of relaxing by the water, or enjoying a day of sailing on the lake, a hopeless idea.
There is a proven link between exposure to excessive noise and hearing loss, and to the best of my knowledge, there is a link between exposure to noise and fatigue and stress. Reducing unnecessary noise is not something that is technically difficult, but as a society we do not seem to have the will to take on this problem. Internal combustion engines can be made to run quietly, leaves can be cleaned up with rakes, lakes can be designated as motor free, and construction sites can be regulated to reduce noise.
Those who have suffered hearing loss as a result of exposure to noise know first-hand the damage that exposure to excessive noise produces. Perhaps it’s time that organizations concerned with helping those with hearing loss took a more active role in lobbying for change on the noise front.
June 6, 2013
Becoming Balanced
I’ve mentioned what a wonderful audiologist I have at the implant clinic here in Vancouver, but I don’t think that I’ve mentioned that I have a couple of great audiologists at the Western Institute for the Deaf and Hard of Hearing. And yesterday, one of them, Charles Fontaine, spent an hour going over my hearing aids, and re-programming them to make them more compatible, or dare I say, synergistic, with the implant.
Previously, the hearing aids were set up to do the best possible job of processing speech, which essentially meant emphasizing the high frequencies, reducing noise, and setting the dual microphones to zoom in on the speaker. Now that I have the CI, high frequencies are loud and clear, so the hearing aid that I wear in the other ear has been re-programmed to provide better bass, and perhaps less treble, to help counter the feedback. In addition, the volume level has been moved a bit higher, to bring it more in line with the output level of the implant.
The result has been excellent, with the combination giving me a much fuller sound, and with a better left-right balance than I had before the programming. Voices now sound more as I remembered them, and music is even more enjoyable. And, at lunch today, in a noisy cafe, I was able to hear the table conversation with no difficulty, and could even hear the server as she took the order, allaying my fears that the extra bass would make it more difficult to hear in noisy situations.
When I arrived back home, I put on a CD of Haydn string quartets so that I could discover whether the changes had enhanced the enjoyment of music. As you’d expect, the cello notes tended to be located on the hearing aid ear, and the higher violin notes in the implanted ear. This produces a sort of artificial stereo effect, but on the whole, it’s quite a pleasant experience, with richer and more balanced sensation, and as I become more used to it, I expect it to improve further.
In my opinion, not enough attention has been paid to the benefits of hearing with the combination of a cochlear implant in one ear, and an appropriate and well-programmed hearing aid in the other. The two devices complement each other quite well. The CI does an excellent job of providing clear, strong high frequency information, so necessary for processing and understanding speech. As well, this high frequency information adds a dimension of enjoyment to music listening that hearing aids alone cannot provide. On the other hand, the hearing aid does an excellent job of providing low and mid range frequency information, filling out voices and music, and helping with locating the source of sounds.
So, hearing, like all things in life, should be balanced, and with the re-programming of my hearing aid, my hearing has been brought into a much more balanced state.
June 5, 2013
Progress Check
Yesterday, Tuesday June 4, marked the end of seven weeks of listening with my cochlear implant. Lucky seven?
Let’s see what, or how I’m hearing and then make the call. How about starting with how Sunday went. I decided to go to The Canadian Memorial United Church, the church that Lynn and her family attend. They have a fantastic musical director there, and this, along with other factors would help provide a real mile-marker on my hearing.
A few weeks ago, I attended, and found that the live-music listening experience was not as good as I had hoped it would be. The choral voices were “muddy”, and it was almost impossible to follow the words. And, I remember that the piano had an unnatural sound, while the pipe organ low notes were missing, and the higher notes were muddled.
Yesterday, there was definite progress. The piano was much closer to what I remembered before the implant, while the organ, which was used only sparingly, still did not sound very satisfying. But, the choral voices were much, much better, with the words clearly discernible, and the melody lines well defined.
There were three or four speakers during the service, all of whom were easy to hear and understand, even in this large and echoey venue.
After the service, there was a social gathering in the reception hall, attended by perhaps a hundred or a hundred and fifty people, and as anyone with hearing loss could guess, they all talked at the same time. This is where hearing loss, even with hearing aids, really frustrates. Trying to hear one voice, while surrounded by other voices, is extremely difficult. But yesterday, I was able to hear names, and follow conversations in this environment without much trouble at all.
Lynn’s son, Todd van der Heyden, is standing in as the anchor on CTV National News some evenings this month, and of course, Lynn is extremely proud of him. Last night, after the news, she phoned him to talk about the experience. While she was downstairs, I could hear her, and understand many of the words and phrases, even though I was upstairs in the living room, watching another show on TV. Unthinkable for me prior to the CI!
On the other hand, while I was investigating cochlear implants, perhaps two years ago, I had lunch with a CI wearer, and during the lunch, he took his CI off to show me the different parts. He put it back on, and did it quickly, with the processor linking up immediately to the implanted components. After seven weeks, it still takes me a bit of fiddling to do that. So, although my hearing progress with the implants has been gratifying, there are obviously still areas for improvement.
June 3, 2013
Looking ahead
On April 16, I was handed a shiny new Cochlear Nucleus 5 processor, and an attache case full of accessories to go with it. These accessories included a remote control, rechargeable batteries and the associated charger, carrying cases, connection cords, and much more stuff. The processor does an amazing job of restoring my hearing, and the accessories are generally very well-designed and functional.
Last December, Health Canada approved the next generation Nucleus 6 for use in Canada, and this new processor promises some significant functional improvements over the one I have now. The newer processor has, at its core, a much more capable chip. This means it can process more information in a given time, and consequently can give me better sound. The new processor also has the ability to function in what is called “hybrid mode”. This means it can send sound to me in two ways, simultaneously. On the one hand, it can send sound to me electronically through the implanted electrode. On the other, it can also send sound to my ear canal acoustically.
Since I have retained much of my residual hearing in the implanted ear, the acoustic signal should, in theory, help fill out the sound I receive, by adding low-frequency information to the mix, something that’s not possible with current implant technology.
The last new feature that intrigues me is wireless connectivity, using 2.4 GHZ radio-frequency technology. This has been designed to be compatible with GN Resound hearing aids, and should allow wireless connectivity, not only between the processor and such audio sources as the television, a home audio system, and a device such as an iPhone, but also between two implants, or between an implant worn on one ear, and a Resound hearing aid worn on the other.
Now, while I do not need the wireless connectivity to listen to the television, or hear the music system in the house, I am looking forward to being able to hear the music in my iPhone when I’m out mowing the lawn, walking around, or traveling in an airplane.
Because I am part of a clinical study, and the study was approved for the Nucleus 5 device, I am not able to upgrade now, but I am hoping that Cochlear will see fit to upgrade me when the study has been completed.
May 31, 2013
Panning for Speech
Watching a good baseball game has always been one of my favourite ways of relaxing. When the game is on television, there are usually two or three commentators, usually one of whom is a retired major league ball player. The producers of the program have an audio engineer, a guy who mixes the various sound sources, including the crowd noise, and sends it to be broadcast with the picture. The same practice is followed for hockey.
With my sensorineural hearing loss, the voices of the commentators were usually very difficult to hear, as the crowd noise drowned them out. My adjustment was generally to turn the sound down or off, and just watch the game in silence, telling myself that the commentators’ comments and narrative were generally just fluff, and not worth hearing. Two or threee days ago, I watched the Toronto Blue Jays play the Atlanta braves, in a game which saw the lead change a few times, before the Braves won it in the 10th inning with a home run. And I’m sure you know what I’m going to say now: I could hear the commentators quite nicely using just the cochlear implant, and normal volume on the television set.
My wife and I are members of the local community patrol, and yesterday afternoon, we set out in light rain to do our assigned patrol areas. After an hour and a half of walking through the rain, we decided to go to the local pub to have dinner. Previously, dining at this “joint” was not as enjoyable as it should have been, because I had to work so hard to hear the people at the table with me. But not with the CI. Without making any program adjustments on the processor, I was able to follow the conversation with Lynn without difficulty. Just to see whether adjusting to the noise program made a difference, I switched to that program, and adjusted the input sensitivity. These adjustments made hearing the conversation even easier.
Those treble, or high frequency sounds are akin to nuggets of gold when it comes to mining speech in noisy situations. With sensorineural hearing loss, the usual cause is damaged hair cells in the cochlea, and in particular, at the outer end of the cochlear, the area that responds to high frequency sounds. When the loss progresses to the severe or profound level, hearing aids are not able to compensate for the loss of high frequencies, making it impossible to clearly distinguish between consonant sounds. Those consonants are critical to understanding what’s being said, and CIs have the ability to pick those sounds out of the sound field around us, and send them directly to our brains.
Similar to swirling a pile of gravel in a pan, and picking out the gold nuggets.
May 29, 2013
Counting my blessings
The rain is pouring down in Vancouver as I write this. A good day to stay indoors, at least for most of the day. But that’s ok, because I can hear the raindrops hitting the window, something that’s new for me.
While doing some tidying around the house, I chose to put a playlist of jazz singers on the music system in the kitchen. As I listened to Katie Melua, Norah Jones, and Melody Gardot, it suddenly occurred to me that I’ve been extraordinarily lucky, lucky to be able to enjoy this music, but more importantly, lucky to be able to hear the voices of those with whom I come in contact each day, lucky to be able to hear the birds, the wind, and other environmental sounds I did not hear before, and lucky to hear such things as the phone ring, the doorbell, and the footsteps of Lynn coming down the stairs each morning.
For a period of my life, I identified myself as a person with hearing loss, perhaps that was my way of justifying the personality traits I had adopted to compensate for my hearing loss. While I did not like the fact that my hearing was terrible, I would say that I had accepted that fate. And that acceptance contributed to my earlier lack of enthusiasm for cochlear implantation. Vanity was another reason: 10 years ago, cochlear implants were considerably larger, and fairly utilitarian looking, to say the best. And besides that, cochlear implants had a reputation for sound that was not normal, and not very good for music.
With all this, I found myself hoping that my hearing would not further deteriorate, and that hearing aids would continue to improve. Well, hearing aids have improved, but my hearing continued to worsen, to the point where discussions with my audiologist turned from “if” to “when” when the topic of the cochlear implant arose. But during these conversations, it was usually agreed that although I’d probably benefit from an implant, it appeared that I did not meet the criteria to receive one, at least not at that time. Nonetheless, I was referred to the cochlear implant clinic, tested, and found not to qualify.
It was at this point that Lynn, who’s never shy about pushing for what she wants, for herself as well as for those in her life, became involved. As well, the cochlear implant clinic audiologist, knowing that a clinical study was coming up, filed my name away in a corner of her mind. With Lynn’s gentle persuasion, I returned to my regular audiologist, who made some calls, discovered that one of the key screening tests had been changed, and put in another referral. Perhaps this referral arrived at just the right time, as the clinical trial had just received approval to go ahead. And so here we are.
Right now, Artie Shaw, surely one of the best clarinet players ever, is playing “Begin the Beguine” and I can assure you, the clarinet has never sounded better to me than it does right now. And, for that matter, so does the whole world. The cochlear implant with all those high-frequency sounds I have not heard for decades, brings a new dimension to speech, to music, and to all of nature’s sounds.
I am truly blessed to be where I am, with perhaps even more to come.
May 27, 2013
Remedial Lip Reading?
It had to happen sooner or later. Yesterday, I attended a memorial service at a suburban church, a service which was so easy for me to hear that I was kind of smugly congratulating myself for going ahead with the implant. The service was followed by a reception, during which everyone talked at once, but at which I was able to hear conversation without too much difficulty. What seemed like the perfect validation of the decision to go ahead with the implant was suddenly jarred by the low-battery warning beeps of the processor.
Oops! No spare battery–I had left it on the dresser when I changed for the service. With my processor, the low battery warning means just that, and within a half-hour, there was no sound from the processor at all. Of course, those around me were urging me to go to the supermarket or drug store, and buy another battery. Not that simple, I’m afraid, as the battery is a special custom-engineered device, and the nearest replacement was in Toronto, or failing that, Colorado.
The next four hours–the reception, then a barbecue at a family home, were interesting to say the least. My single hearing aid sounded decidedly less than adequate, but I didn’t want to be left out. And so it was that I found myself relying on my lifetime-honed lip-reading skills. Soon, my wife Lynn was testing me, covering her mouth to see if I was lip reading, and when she did so, I found myself unable to understand what she was saying.
For the rest of the evening, I re-experienced the world I had prior to the activation. At the reception, I could hear in small groups, but only if the speakers were fairly close to me, and facing me. I was not able to be part of the conversation in the car on the drive home, because I could not see the speakers’ faces. I once again experienced the fatigue that comes from working to hear, and as I mentioned, I found myself relying on my lip reading ability.
My audiologist has asked me to wear a hearing aid in the non-implanted ear, and for good reason. I wonder if she’d recommend going without the cochlear implant from time to time in order that I can maintain my lip-reading skills?
And while I’m sure maintaining my lip-reading skills is a great idea, I think a better idea is ensuring that whenever I go out, I make sure that there’s a spare battery in my pocket.
May 25, 2013
New Map, Same Journey
As I mentioned, my audiologist changed my processor map during my last visit, and as all new CI recipients surely do, I ventured out from her office with heightened expectations of hearing success. Out the hospital door, and into a horrific cacophony of unidentifiable noise. Not what I expected, not at all!
Venturing towards the street, I discover not one, but two construction crews, one pouring concrete for a new sidewalk, the other using some sort of truck-mounted water jet excavating system to dig out a storm sewer catch basin. That explained the noise, but this was most definitely not the introduction to the new program that I had expected.
Away from this extreme noise, I ventured into some shops on my way home, and found that the voices of those around me did have a more natural sound, but it was not until Lynn arrived home that I had the first real test. The new map does render her voice more as I remembered it before the implant.
Next test, the evening news on television. Definitely easier to hear. As an aside, prior to the implant, I listened to the television set by means of a wireless Bluetooth transmitter coupled to the set, and a Phonak iCom streamer with a Bluetooth receiver. This device then transferred the sound wirelessly to both hearing aids, giving me decent sound quality, and binaural to boot.
I’m happy to say that since the implant was activated, I have not used these devices at all. I can hear the announcers reasonably well, and now, with the new map, even better. In fact, last night, we watched a British mystery show on television, and I was able to follow the dialogue without much strain. And boy, those voices are sounding much more natural now.
I mentioned earlier that the audiologist has requested that I continue to wear a hearing aid in my non-implanted ear. The two devices really should complement each other, but it does sometimes seem that they are working at cross purposes. However, with the new map, the integration of the sounds from both devices does seem to be better integrated, rendering listening into a more pleasant activity than it previously was.
There are still many environmental sounds that I cannot easily identify, and some sounds that I thought my brain would have “tuned out” by now, such as that wonderful old mantel clock in the living room, but that’s work for my brain, not the audiologist.
So, the journey continues, but with the new map, it’s become a little bit easier to follow the path.
May 23, 2013
The Treasure
If you’ve been reading this for a while, you’re aware that I’m delighted with how well I can hear with the cochlear implant. Subjectively, speech is much easier to follow and understand, the telephone sounds just fine, even on a busy street, and music, often frustrating with a cochlear implant, makes for a good experience. Sounds as though I’ve found a treasure, doesn’t it?
But what about objective measurements? Good timing on the question, as I had my one-month followup appointment with the audiologist today, and this followup included extensive testing of my hearing. The audiologist started by measuring how well I could hear single words in the sound booth. Out of 100 words presented, I managed to score 78 correctly. That compares with 16 out of 100 using my hearing aids prior to the surgery. She next measured how well I could hear sentences in quiet, and I’m happy to report that my score here was 100%, up from 78% as near as I can recall. The next test was hearing sentences in really bad noise. The sentences were read by both male and female speakers, and were only 5 DB louder than the background noise, which was mixed up speech. On this test, although I do not know my score, I did not do very well, and the audiologist was kind enough to keep my score to herself, and to tell me that the test was very difficult.
Threshold testing using tones demonstrated that my residual hearing has improved since my last test, and does not look all that different from the hearing in my non-implanted ear, at least up to around 750 HZ or so.
Clearly, the objective measurements confirm my subjective judgement.
After discussing these results, the audiologist proceeded to go through some re-mapping of my processor with me, with a view to giving me a bit more low frequency information, and a bit more volume. The end result is that the sound is a little bit “fuller”, and there is a better balance between the perceived loudness from my hearing aid on one side, and the CI on the other.
We finished up with conversation about such things as the possibility of going bilateral, the next generation processor which was formally announced this morning, and my results, compared against how I heard before. Bilateral implantation is a possibility for me, and something I am considering seriously. There is a wait list here in BC, and I asked to be put on that list.
The new processor, the Cochlear Nucleus 6, has a much more capable microprocessor chip than my existing unit, as well as some interesting wireless capabilities, and the ability to function as a hybrid unit, combining the functions of a hearing aid and a cochlear implant, something that, with my residual hearing, may be a distinct advantage. I am hopeful that I will get an upgrade.
Finally, we agreed that my results, thus far, were really rather extraordinary, and we both took some pride in that. I have an audiologist who is truly a treasure, and I will forever be grateful.
May 22, 2013
Adjustments on both sides
When I did not hear well, I heard some things, and I missed some things. I’m talking about things, as in things people said to me. Because my hearing was hit and miss, to say the least, I tried, sometimes not very successfully, to let people know whether I’d heard them or not. Probably, there were countless occasions where I simply gave the wrong answer, or didn’t answer at all, not knowing that there was a question or statement directed at me. I’m sure this frustrated those around me, but I’ve been blessed to have family and friends who put up with me in spite of this.
Now, I hear much better. In fact, I’ve a strong belief that I hear much more than I miss now. But old habits die hard. I have learned over a lifetime not to trust my ears, so now, even when I hear something, I have some doubts. And, of course, those around me have learned that they cannot trust that I’ve heard something. The result is that those around me are still not sure that I’ve heard them, and they expect me to confirm what they’ve said.
Obviously, it was incumbent upon me to confirm that I’d heard when people spoke to me when I had a hearing issue. If you were to ask those around me if I was good about this, I’m afraid they would say not as often as I should have been. And they are right–I often found this routine very tedious, or I was anxious to move on to the next topic, a favourite strategy of those with hearing loss who want to know what the topic is, so that they can get a word in, and feel as though they are part of the conversation.
Now, I’ve tried to demonstrate to those around me that I can indeed hear, yet it is true that it’s tough to break old habits, and they are used to doubting whether I’ve heard them, so they are looking for me to confirm, just as they did when I had the profound hearing loss. But, because I am pretty sure that I hear almost as well as anyone else, I’m reluctant to do this.
Clearly, adjustments are needed on both sides here. And just as clearly, this is going to take some time.
May 21, 2013
Everybody’s different
If you explore the internet, you will easily discover many sites and blogs where those who have received a cochlear implant tell their stories. And these stories tell of a range of outcomes on initial activation, from “I only heard beeps and electronic noise.” to “I could hear and understand voices right away.”
Fortunately, most of those who start with “the beeps” go on to hear much better than they expected, but still, one is left to wonder why there should be such significant differences upon initial activation of the implant.
Some of the variables include the choice of electrode design, the placement of the electrode by the surgeon, the mapping of the processor done by the audiologist, and likely the most important factor, the hearing history of the implant recipient. I put the emphasis on this last point because I truly believe that our brains are very adaptable, very plastic. If the auditory nerve and the auditory processing centre of the brain have been without auditory stimulation for a significant period of time, I believe that the brain “re-assigns” those neural tissues to other tasks, such as thinking or reacting to touch, for example.
If, suddenly, we introduce stimulation by way of a cochlear implant, the auditory nerve has to re-learn its task, and the auditory processing centre has to learn how to interpret the signals, in just the same way as an infant learning to hear.
Thus, a person without a recent history of hearing, or a person with little or no history of hearing, will face a much more daunting task, a steep learning curve, in learning to interpret sounds. On the other hand, a person who was able to hear, albeit not very well, with hearing aids, or a person who has been recently deafened, will have a much better probability of hearing well quickly upon activation of their cochlear implant. For those people, some sort of structured rehabilitation will most likely speed up the re-learning process.
The good news here is that in almost every case, those who have received a cochlear implant go on to hear much better than they ever hoped.
May 17, 2013
Doing the hard work
Despite the fact that the activation of my cochlear implant produced hearing quality far beyond my expectations, I have not forgotten that the rehabilitation of my auditory processing is an essential element in learning to hear as well as possible.
At the end of the initial programming and mapping of my processor, my audiologist told me to start wearing the hearing aid in my non-implanted ear. Three reasons for this are that she wants to see that ear continue to receive stimulation, so as to maintain the hearing function that it has, to allow me to hear with both ears, as nature intended, and because the stimulation from the hearing aid tends to emphasize lower frequencies, and the brain blends the two types of sound, giving a more natural perception of sound.
It took about three weeks, but that blending has now largely been accomplished, and the results are particularly positive when listening to music. So where does the hard work come into this? Lately, I’ve been listening to music that I know with both the CI and the hearing aid. I listen a couple of times, then take off the hearing aid and listen again. What I’m noticing is that while the music sounds “thin” and lacking in bass without the hearing aid, it is not so thin as it was. Essentially, the brain fills in the missing notes, and the music regains some of it’s original quality. I fully expect this improving trend to continue.
With speech, I’ve noticed the same thing. Over time, voices have become more and more as I remembered them prior to receiving the CI. So again, I began removing my hearing aid while talking with familiar people, and as you’ve probably anticipated, the voices still sound quite natural.
Now I’m not going to stop wearing the hearing aid, there are just too many reasons to keep it on, including the ones mentioned above, but also to help eliminate the “head shadow” effect in conversation, and to provide a sense of direction to sound. But, down the road, there is always the possibility that I might have the other ear implanted, and to help with that decision, I’m trying to discover just what sort of sound I will hear with two implants. Although I cannot be sure, I believe that with two implants, voices and music may be thinner than with the combination of an implant and a hearing aid, but the other benefits from full binaural hearing will outweigh that small sacrifice.
And finally, a confession: this is not really hard work. I understand that for some CI recipients, the rehabilitation process is not as easy as mine has been, and they do have to work hard to regain their hearing. In most cases, time, patience, and practice, also known as hard work, deliver on the promise of the cochlear implant. Perhaps the success stories of others provide motivation for those still working to achieve the hearing they desire.
May 14, 2013
It’s time for a comparison
Although I’m sure my hearing with the cochlear implant will continue to improve, I’m just as sure that it’s fair to make some comparisons now between my new hearing world and my old hearing world.
Let’s start with listening to speech. Before my implant, I used two of the best hearing aids available, Phonak Naida IX UPs. Note that the UP stands for Ultra Power, and even with that, I missed a lot of speech. Whispering? forget it? Hearing speakers across the room? Ditto. Two people talking at once? Hopeless. With the CI, I can hear whispering, because the CI does a fantastic job with high frequency sound, the basis of whispering. Speakers at a distance are now much easier for me to hear, not perfect, but getting there. And when two people speak at once, I can often pull one voice out of the crowd, essential in today’s social world. That’s a huge improvement for me.
And before I forget, I can hear speech in noisy environments, and I can hear speakers in the back seat of the car when I’m driving, both big wins.
If you’ve been following this blog for a while, you know that I enjoy all types of music. Well, perhaps not rap! Before my implant, listening to music was enjoyable. A bit of detail here will help. Listening to music usually involved calling up the music on my iPhone, sending it wirelessly to the streamer that was part of my hearing aid system, and listening, often without anyone else aware that I was listening. This worked on airplanes, in my vintage car, while out in the yard, or wherever. The sound was full, it was in stereo, and it had a decided treble roll off, which is to say, it did not have much high frequency information.
With the CI, I listen through speakers just like most folks, using my hearing aid in the left ear, and the CI in my right ear. There’s plenty of bass notes in the left, and wonderful treble in the right. I hear cymbals, brushes, violins, and stringed instruments as I’ve never heard them before. Because the hearing aid and the CI do not share the streamer feature, I cannot listen as I did previously. I could get a set of what are called silhouettes, or music links, and use the telecoils in the hearing aid and the CI prodessor to hear the music, but I’d still have a wire leading to each ear. On balance, I’d have to call this a draw. The music sounds better with the CI, but the convenience was better in the old world.
And then there’s the telephone. Previously, I listened to the phone using the Bluetooth streamer, and both hearing aids. Considering that I had a profound hearing loss, it was OK, but I certainly had trouble picking up words that were not in context, such as a name, or a number. Now, I hold the phone up to my ear, and listen just as everyone else does. Because there is so much more high-frequency response, I hear words and speech over the phone better than I ever could. No contest here: the CI world is the hands-down winner.
The final point of comparison here has to be hearing speakers in large venues, such as a keynote speech, or a speaker at a large rally. In the old world, if I had the chance, I’d take my FM microphone/transmitter up to the podium or the speaker, and listen via FM. Inconvenient, but it worked. Couldn’t hear folks up close to me though, as the FM unit disabled the microphones in the hearing aids. Now, although I’ve had only limited experience, I find I can hear speakers in large venues fairly well. I’d have to say that the CI world is the winner in this department.
So, there you have it, and I don’t think you have any doubt as to which hearing world I prefer.
May 12, 2013
Putting it all into perspective
Very well, thank you! As I mentioned previously, that’s how things are going overall. But that’s not to say that all is perfect, or that things can’t be improved.
For example, I’ve just worked four 12-hour days in a large room, totally hard-surfaced. My observation was that I could not hear conversations across the room as well as those with “normal” hearing. I could hear those close to me without any difficulty, though, something that was not always the case prior to the CI.
And then there’s the “head shadow” effect. With an implant on one side only, it is more difficult to hear those who are on my non-implanted side than I’d like, so I often have to turn my head towards the sound source. This is with a hearing aid in the non-implanted ear, but here in British Columbia, Canada, the medical plan does not currently cover bilateral implantation, so perhaps I’d better just learn to live with this.
Now here’s one of those hard-to-describe phenomena, but I once saw a documentary about how movie sound effects were produced. To mimic a howling wind, the producers rigged up a canvas belt and crank arrangement. They turned the crank to drag the canvas over a barrel, and the resulting sound was just like a howling wind. Sometimes, when listening to voices, I hear a bit of that “howling wind” as a sort of layered over tone, with a hint of time delay, like an echo. I’ll discuss this with my audiologist when I return for my first follow up on May 23, and perhaps a bit of tweaking with the settings will tame this. But then again, perhaps it’s just one of those things that will go away with more practice time.
And, I’d be remiss if I failed to mention that although they are improving, voices often still sound ‘thin’, or high-pitched. But this is a funny one, because often I don’t notice this unless I listen for it. So there is a sort of inconsistency in the sound, something that’s manifest in music as well. Sound seems to sometimes have that artificial quality that I associate with the cochlear implant, while at other times sound is just sound. My guess is that this is just my brain slowly adapting to this new way of hearing, which is just what everyone told me would happen when I was waiting for the surgery and then the activation.
And, when a microphone is situated in a windy environment, it often produces a “wind roar” sound. In broadcasting, the sound engineers place a foam shield or “sock” over the mic to eliminate this noise. Cochlear implant processors, and hearing aids, do not have an easy way to eliminate this roar, and perhaps this is just one of those things that I’ll have to live with.
So, yes, although things are going very well with the implant, there are some things that could be a little better, and hopefully, with a bit of mapping and more rehabilitation time, they will be.
Science is truly marvelous, but nature’s inventions are just so much better.
May 10, 2013
And how’s it going?
Probably the best way to answer this is to simply say that usually, I do not notice that I’m hearing through a cochlear implant.I just hear speech, birds, motor vehicles, and all the rest of ordinary sounds without any hint that those sounds are coming through in some new way. When I listen to music, I am aware of the implant technology, but it does sound better now than it did in week one.
So, let’s try some examples. To start, I’ve been working for the last three days, working in a very large room with really poor acoustics. I can easily hear my co-workers when they speak to me, and I can hear when one person speaks to me from a distance of say, 15 feet. But, in this environment, when three or four people are speaking at once, it is difficult to pick out conversations. but, when I have to deal with clients, I am sure I hear just as well as my co-workers.
Another example: when Lynn is in the kitchen, talking on the telephone, I can hear what she’s saying as I sit in the living room. I surprised her when I heard her talking about me on the phone, and she was quite surprised, as this was something I could not do prior to the implant.
And the last example I’ll give for now? We have two young girls living in the house next door, aged 6 and 4. They have those typical little girl voices, quite high pitched, and not very loud. When they call out to me now, I can hear them, and turn their way, and acknowledge them, something that rarely happened prior to the implant. And this is outdoors, where voices were always hard for me to hear.
If you are someone who works, or who lives with another person, or has little kids living next door, none of the above likely seems noteworthy. But if you are that same person, but have a severe or profound hearing loss, the scenarios above probably seem like wishful thinking. For me, having transitioned from having a profound hearing loss, to having a cochlear implant, these same scenarios are in the “dream come true” department.
My guess is that you already know the answer to my opening question: It’s going very well, thank you!
May 5, 2013
Two Thoughts
After almost three weeks of listening to the world, its voices, its music, its wildlife, and all its other noise, that for want of any other term I’ll call pollution, I’m not sure just what normal is when it comes to sound.
Let’s take voices for a start. Prior to my cochlear implant surgery, I thought I knew what voices sounded like. The sound of those voices, my wife’s, my daughter’s, and those of my friends, were piped into my ear through my trusty digital hearing aids. And they had a familiar, reassuring sound, when I could hear them. Now, those same voices are wired into my auditory neural system via my cochlear implant, and they have a different, albeit familiar sound. They are basically, higher up the frequency register, with a pronounced treble emphasis. So the question is: What is the way these voices really sound?
A hard question for me to answer, as the damage to my cochlea gave those voices, even with hearing aids, a pronounced bass emphasis (technically, a rolloff in the treble). So that sound wasn’t right at all. But, with the cochlear implants, the electrode array, for physiological reasons, does not reach the innermost part of the cochlea, the part that responds to bass tones. This gives the voices that high-frequency emphasis I mentioned. Obviously, the true sound of those voices is probably somewhere in between the two modes.
But, does it really matter? I don’t think so. What matters is that I can clearly understand what people are trying to tell me now, even in noisy environments. And, as my listening time with the implants increases, the sounds become more and more normal sounding to me.
The same goes for music. I now hear much more high frequency information in recorded music, things like brushes, cymbals, and the overtones of stringed instruments. This adds a delightful dimension to music, something I haven’t heard since early childhood. My hearing aid, in the “other” ear, transmits the bass information, so music sounds pretty darn good, especially in view of my profound, but corrected, hearing loss.
With that, it’s time to move on to the second thought. Do I want to hear all the new sounds? As a society, we’ve tacitly allowed ourselves to be surrounded by a pervasive atmosphere of sounds, most of them unpleasant. Motorized equipment does all manner of jobs that used to be done manually. Airplanes fly overhead almost constantly, at least where I live. Amplified music players, in cars, parks, and private yards compete with each other. And motor vehicle noise forms a constant backdrop to all the other noises we collectively produce.
Before the implant was activated, I did not notice these sounds the way I do now. Yes, I realize that I will come to tune them out, but I am left to wonder why we, as a society, have let this situation develop to the point that it has.
I’m sure I’m not the only one who thinks this way.
May 2, 2013
As Time Goes By
The theme song from one of the world’s favourite films, “Casablanca”, and a song I happen to enjoy very much. Lee Wiley, an American jazz singer from the late 30s to the 50s, released a particularly pleasing rendition, and as I was listening to it, I noted that as time goes by, the sound from my cochlear implant is becoming more “natural”, to the point that unless I stop to think about the sound, I don’t notice the quality, just the music, or what is being said.
On top of that, I took some time today to listen to Vivaldi’s Four Seasons. I chose this, because it was the first piece of music I listened to with the CI. At that time, I could recognize the melody, but the sound was not as pleasing as I would have liked. After two weeks, the music sounds much more as I remembered it prior to the implant. Bu still, it does not sound the same, not at all. For one thing, I perceive much more high-frequency sound information, and that’s both good and bad. The good is that there are lovely violin notes and harmonics which add immensely to the enjoyment of the music. On the flip side, the implant does not transmit the low frequency information in the music to my auditory processing centre. To compensate, I wear my hearing aid in the un-implanted ear, and invoke the “music” program. This brings in bass notes, but not much treble. That leaves my brain to put it all together, and if I adjust the volume levels of the two devices, it does so fairly well.
And, as time goes by, the treble, which at first was annoying, with every speaker sounding very sibilant, is beginning to add a measure of improved quality to music, and even to things like clock chimes, and doorbells. Cymbals, and brushes, sounds I never heard, do make music more complete, and I’ve already mentioned the violins. At the same time, the sibilance is either diminishing, or else my brain is tuning it out.
But having said this, there are some shortcomings with the way things sound, at least right now. The sound is “thin”, lacking the body that comes from the low frequencies. This is apparent in both speech and music. The hearing aid on the left side definitely helps, although the integration of the sounds from the two devices is still a work in progress. Some music melodies appear to have notes drop out, and sometimes, if the melody is being formed by chording, the lower notes are not present, giving the chord a different sound, and thus changing the character of the melody.
But, let’s be fair here: my device has been activated for only 15 days. From what I understand, my progress has been extremely good, and perhaps we have to let a little more time go by, and as the song says, go “..on to hope and glory!”
April 29, 2013
Challenging Myself
Probably the single most difficult hearing situation for me has been listening to the service in the Church. The high, vaulted ceilings, the distance from the minister, the hard surfaces, and multiple PA speakers combine to make it extremely difficult to understand what is being said. Even with an assistive listening device, it was difficult to hear what was transpiring at a typical church service.
With the recent successful trip to the movies under my belt, I decided to attend church with Lynn and her granddaughter, Eva on Sunday. When I arrived, the choir was singing, accompanied by a pianist, and it was very difficult to hear and enjoy. I suppose the echoes and complex vocal sound combined were more than I was able to handle at this stage of my cochlear implant rehabilitation.
At this church (Canadian Memorial United Church of Canada), there is a relatively sophisticated sound system, with each of the speakers having a microphone. When the first speaker introduced the service, I was able to hear her much more clearly than I had been able to in the past. I did not hear every word, but perhaps neither did many of those with “normal hearing” who were in attendance. As the service progressed, I found that each of the speakers was fairly easy to hear, but the choral and instrumental music was definitely challenging for me.
All in all, I thought my hearing was significantly better than it was prior to the CI, but that there was still considerable room for improvement.
This evening, I found myself listening to the sensational Welsh young men’s choir, Only Boys Aloud. I found them on You Tube, and sent the signal to the television set, a situation that I thought would be much more amenable to listening than the situation in the Church earlier this day. And, although the sound was better, and even enjoyable, I realize that choral music is going to be a difficult listen, although it will surely improve with time. And yes, I realize they were singing in Welsh!
Perhaps I’m expecting too much, too soon. Hearing speech as well as I do has set me up to hear more complex situations, including live music, and voices in acoustically challenging venues. Those challenges remind me that in any endeavour, a period of training and learning is usually a prerequisite to strong performance, and I’ve only been “training” for 13 days. Let’s see how these challenges go after I have more experience hearing the CI way.
April 27, 2013
What’s life like in the new hearing world?
A week and and a half after activation, how has my life changed? For starters on this, let me give you a simple example that just occurred. I sat down in the living room to compose this post, when I heard the washing machine beep beep beep to let me know it was finished the cycle. Now normally, I would have had to get up and go look two or three times to see if it was time to put clothes in the dryer, as I simply could not hear the beeps if I was not in the same room as the machine. Now, I hear the beeps like any other person.
Yesterday, while working to get the garden ready for spring planting, I heard my cell-phone ring, something I would have missed prior to receiving the cochlear implant. On top of that, I walked over, picked it up, and talked on the phone without difficulty, without using the telecoil or any other assistive device. And last night, I attended the annual general meeting of the Western Institute for the Deaf and Hard of Hearing, and was able to hear the speakers on the normal PA system, in a room that has bad echoes.
Then, I drove out to the airport to pick up my daughter and her partner, who were returning from attending a wedding in Mexico. On the way to the airport, I listened to music on the CD player, and on the way back, I was able to talk to Emily, who sat beside me, and her boyfriend, Kevin, who sat in the back seat. I could hear all that he said, without difficulty. That was simply out of the question in the past.
And last night, we went to see the movie “42”, the story of Jackie Robinson, the first black player to play in the major leagues, and Branch Rickey, the manager of the Brooklyn Dodgers, who made history by bringing Robinson into the major leagues. Normally, I use the “captiview” captioning system at the theatre, and just to be safe, I requested the captioning. Five minutes into the movie, I realized I did not need the captioning, and I turned it off. By the way, I found this to be a good film, and I’d recommend it to anyone looking for a good human interest story.
After the movie, three of us went to Earl’s Restaurant, one of a chain of restaurants that I’ve always found too noise for me. Not only could I hear Lynn and her granddaughter at the table, I could hear the server, something that’s always been very difficult for me.
Reading over what I’ve just written, (hey! somebody has to read this stuff!) I’m struck by just how normal all the anecdotes are–for anybody with reasonably normal hearing that is!
April 26, 2013
What Gear Has Replaced my Natural Ear?
I mentioned earlier that I was receiving my new cochlear implant as part of a clinical study, a study that was sponsored by Cochlear Corporation, and specifically, by the North American arm of Cochlear, Cochlear Americas.
Instead of an outer ear, middle ear, and cochlea, I now have a Cochlear Nucleus 5 processor, a CI124RE implant, and a nifty little remote control. The implant has probably the best reliability record of any implant available, a factor that the local clinic considers to be highly important. It has 22 platinum electrodes that have been inserted, carefully I understand, into the cochlea, the hearing equivalent of the retina in the eye. Bear in mind that the cochlea, a pea-sized organ wound through two and-one-half turns, does not allow room for error in the insertion process. These electrodes, which are placed in close proximity to the auditory nerve, are connected by 22 tiny wires, each about as thick as a human hair, to the internal electronics. There are two more electrodes, which serve as grounds to complete the electrical path.
The processor, which is worn over the ear, consists of a battery pack, two microphones, and an electronic chip, which receives the sound signals from the microphones, and after processing them, sends them on to the internal circuit by means of a pair of matched coils, one inside the scalp, the other held to it by a tiny magnet. An engineer would call this a form of inductive transmission.
And now, while I find the system to work extremely well, it must be remembered at all times that each person is different, and the results of the CI therapy differ for each patient. I am in the camp that believes that the outcomes from the CI process are more dependent on the user than on the actual device, but there are differences between the devices manufactured by the four major makers, and anyone contemplating a cochlear implant would be well-advised to do some research, talk to recipients, and consult with a cochlear implant clinic, or two or three, in jurisdictions where this is possible.
The skill of the implant surgeon and the audiologist fitting the processor can make a huge difference to the outcome of the process, and I think it’s most important to ensure you are happy with the team that will look after you.
I’ve only been wearing my Bionic Ear for a little over a week, and while I am astounded at the quality of my new hearing, I understand that as by brain adapts to these new electrical stimuli, things will continue to improve.
A positive attitude, strong motivation, and skilled professionals are essential to ensure that these bionic bits and pieces successfully replace natural hearing.
April 23, 2013
The Law of Unintended Consequences
The dramatic change in my hearing totally took over my consciousness for the first week after activation, but slowly that miracle is making way for what is perhaps a more profound change. And that change is the change in how I approach the world, now that I have more confidence in my hearing. The shift in consciousness became apparent yesterday, as I was driving to a meeting.
A small but simple thing: when the phone rings now, I’m not hesitant to pick it up. I don’t need to worry about whether the bluetooth link to the hearing aids will function correctly. Another change is that I’m more comfortable talking to people in crowds, so I can look forward to meetings and social gatherings, and not, as in the past, with a feeling of trepidation.
On Sunday, after the Vancouver Sun Run, Lynn invited her daughter, her son-in-law, and two granddaughters over for dinner. All together, there were seven very talkative people around the table. Now, in the past, this was a situation which I very much did not enjoy. I simply could not participate in the conversation due to my hearing. But at this dinner, I was able to enjoy the conversation, hearing almost all of it. Simply a fantastic feeling.
People who have hearing loss are usually very adept at developing coping skills. Avoiding situations which pose hearing difficulties is a great example of a coping skill, but unfortunately, the unintended consequence of avoidance is a strong possibility of isolation. Perhaps this is an example of “the cure is worse than the disease”. Unfortunately, my guess is that it’s an all too common phenomenon.
Of course, old habits die slowly, but I’m going to try to cultivate this nascent confidence, try to grow into a person not afraid to venture out there, and try new things, enjoy new experiences, and grow more confident, thanks to the fact that I have much better hearing.
While I was considering whether to get the cochlear implant, my thoughts were centred on the risk assessment process, and the improvement in hearing that I anticipated. To be perfectly honest, I did not make the mental leap to consider just what the improved hearing might mean to my life. Yes, I expected to be able to hear conversation more clearly, and I did anticipate that I’d be able to hear soft sounds that I cannot hear now. But, I did not make the connection to the change in my confidence level, and what that implied for my quality of life. Now I know, and I’m left wondering what other “unintended consequences” are on the horizon for me.
April 21, 2013
It’s a Matter of Trust
I’ve never trusted my own hearing. Even when I heard something, I was afraid to act on what I’d heard, just in case I’d got it wrong. I bet that’s a fairly common phenomenon for those with severe or profound hearing loss. If you think you heard something, you either did hear it, or you missed it. If you missed it, and responded, inappropriately as it turned out, you looked foolish. So, you played it safe, and didn’t hear a lot of things you really did hear.
Now that I can hear consonant sounds again, I don’t miss nearly as much as I used to, but I’m still not trusting my own hearing due to my lifelong habit of not trusting my own ears. Hopefully, with time and practice, I will learn that I really do hear fairly well, perhaps not as well as a person with normal hearing, but all things considered, reasonably well. And then I have to make that leap to trusting my own hearing.
Meanwhile, on the other side of the equation, there are long-time friends and family members who act as though they do not believe that I can now hear as well as I have said. Yesterday, I received two phone calls from long-time and dear friends, both of whom wanted to “hear” for themselves, that my outcome was the success that I’ve declared it to be.
The first call came from Victoria, and I was able to enjoy the call, and don’t believe I missed anything my friend had to say. It was a real pleasure for me to just pick up the phone, and talk to him normally, rather than having to make sure my bluetooth streamer was connected.
Then, a friend in Ottawa called. He opened by telling me that he had to “hear” for himself in order to allay the suspense. Now this guy is a hard listen. He’s got an extensive vocabulary, he’s well-read, and he talks extremely quickly. At the end of the call, I felt that I had gone a long way towards dispelling his doubts. And you know what? I enjoyed this call too.
I drove to my nephew’s home in the afternoon for a dinner. He has two sons, one of whom is about 9 or 10 years old. He has a tendency to speak very quickly, and of course, his voice is fairly high, so in the past, I’ve not had much success hearing him. But last night, I could hear him very well. The smile on his face was most rewarding.
The people around me will now, I think, trust me to hear them. Now, all I’ve got to do is learn to trust my own hearing.
April 19, 2013
Anything Wrong?
It’s been a bit since I last posted. Is something wrong? Have I become disenchanted with my new Bionic Ear. I mean, I was posting twice a day there for a while–what happened?
The answer is that I’ve been too busy enjoying life. When the phone rings now, I pick it up, unless it’s one of those 1-800 numbers. I have found time to sit quietly and listen to Norah Jones singing the lovely songs on one of her early CDs, Not Too Late, and I”ve been listening to the television news, all without any assistive devices. I went out to a local coffee shop with a buddy I’ve known since university days, and part way through the conversation, we concluded that he was having more trouble hearing me, than I was hearing him!
At my last activation appointment, on Thursday, the audiologist asked me to start wearing my hearing aid in the left ear. So, I put it in, and found that the hearing aid made it harder to hear clearly. She suggested I remove my new processor, and just listen with the hearing aid. Ughhh! Terrible sound compared to the bionic ear. She assured me that soon, that poor overworked brain of mine would learn to use the information from the left ear, and integrate it with the bionic information, to give me even better auditory information. It’s just starting to work that way now, although it often sounds like I’m listening to two things at once.
The “Elmer Fudd” cartoon effect is slowly wearing off, (Be vewy, vewy quiet, I’m hunting wabbits.) People’s voices are slowly starting to sound the way I remember them, and male and female voices are now easily distinguished.
Chicken on the barbeque makes a nice quiet sizzling sound, I can hear Lynn when she comes down the stairs for coffee in the morning, and I’m now used to the new sound of the microwave beep, the clock chime, and the sound of rain. When I move, I hear the rustle of my clothes. Plastic bags make an awful din, and I can hear people breathing.
In one sense, my hearing journey has come to an end. I’m so close to where I want to be, that I’m fairly sure that the sound will continue to become more natural as I just go through my life using my sense of hearing, and practicing my listening. But in another, the journey has only just begun. I’ve so many things I want to hear, starting with the birds, the sound of the ocean waves, and this summer, the sound of a campfire.
One interesting adjustment I have to make is to come to terms with how people’s voices really sound. Remember, for the past 50 years or so, I’ve been listening to those voices with badly damaged cochleas. Most of the treble information in their voices was simply lost. Now, I’m hearing that treble information, and their voices sound different. There are still intonations and speech habits that identify them, though. So, which of the voices is the true voice? And does it really matter?
If you’ve followed this blog to learn if a cochlear implant is right for you, or someone close to you, I think you’re probably equipped with more information than you were before, and the information I’ve tried to convey here is not technical, or brand comparison information, but information more related to the human experience of hearing as it impacts the quality of life. For me, it’s been a very successful journey. I’ve had fantastic support from my wife, Lynn, and my family and friends. My surgeon, Dr. Brian Westerberg lived up to his superb reputation, and my audiologist, Cindy Gustin, demonstrated wonderful professional, interpersonal, and communication skills. I could not have asked for better care.
April 18, 2013
Every Journey Needs a Good Map
Yesterday: another map! Also, more testing of my hearing, including testing for residual hearing in the implanted ear! In addition to the new map, I received two new programs, including one for music.
Finally, Cindy, my CI Audiologist, handed over the complete kit of gear, which included two rechargeable battery packs, a large pack of disposable batteries, the processor itself, the remote, the chargers for both devices, and numerous connecting cables, power adaptors, extra ear hooks, protective/decorative covers for the processor, spare coil cable, manuals, DVDs, instructional CDs, and so on. Whew!
Came home, mowed the lawn with my trusty hand mower (man is that thing noisy!), and visited my daughter at her work in order to wish her bon voyage for her trip to Mexico which starts tomorrow. It was nice to be able to talk to her and her co-workers, despite the noisy environment in the shop. Later, I drove downtown to pick up Lynn, and I found no difficulty talking to her in the car. I can also hear her from room to room in the house now.
Listened to the television news tonight, and it’s much improved over yesterday. I can distinguish male and female voices, and can follow the news stories without using any assistive devices, and with more practice, it’s only going to get better. And all this with just one ear, as I’m following instructions which are to not used the hearing aid in my other ear for at least two days.
Another phone call today. I could hear the speaker just fine, knew it was a female voice, but could not tell for sure who it was.
And the music? Well, with one ear, and one day of practice, Patsy Cline sounds a little tinny, to say the least, but I can recognize the melody lines, and hear the words!
All in all, a pretty fine day, and guess what? I get a new map today!
April 17, 2013
For Whom the Clock Ticks
As I write this, activation day is not yet over. I’m in the so-called quiet sanctuary of my living room, in a house which has been owned by my family since 1948, 65 years I guess. On the mantle, is a wind-up clock that’s been in the family since at least 1910, perhaps longer, no one is really sure, except those who have long since died. Prior to taking up residence in this house, the clock lived at my grandmother’s home, at 1617 Tenth Avenue East, in Vancouver. I love the clock, but boy, is that tick-tocking loud.
The clock is really trying to tell me something very simple: this is one noisy world. Turning on the tap gives me cause to jump back quickly. Unwrapping chewing gum creates a fantastic crackling sound. And don’t you dare flush the toilet without warning me first, ok! After years of being a gearhead, owning a succession of noisy hobby cars, I’m about to jump on the electric car bandwagon. Anything to get rid of this noise.
Just identifying the source of much of the noise is a major challenge. If I can see the activity that generates the noise, say for example, a concrete delivery truck unloading concrete into a chute, I know what that sound is. But sometimes, I can’t see the source of the sound. A good example was the steam generator in an expresso machine today. Whew! total sound blackout for me!!
What’s happening, of course, is that for most of my life, and for the last 50 years for sure, I haven’t heard these sounds. The rest of you hear them everyday, except that they don’t register, because your brain has learned to tune them out. You see, your sense of hearing is your primary safety warning device. The brain is constantly analyzing all the sounds that come in through the auditory system, and evaluating those that you need to hear. For example, while driving in your car, the sound of the tires on the road, the engine, and the wind rushing around the car body are all suppressed, but your brain hears a siren, and tells you to pay attention.
For me, that learning process hasn’t happened yet. I have to learn what all these new sounds mean, then once they are processed, my brain will, quickly I hope, learn to suppress the sounds that are not necessary for my well-being.
After today, day one of listening with a CI, that learning process cannot come fast enough. Just the sound of the laptop keyboard is quite annoying.
Meantime, for whatever reason, that old clock keeps hammering right into the centre of my consciousness. Almost like there’s a little guy in there with a small hammer: Tick-Tock-Tick-Tock-Tick-Tock.
April 16, 2013
There are Moments In Every Life
What a day it’s been, and it’s only 2:41 local time here!
At 9:00 AM, Lynn and I met my daughter, Emily, at the hospital coffee shop, and proceeded to the audiologist’s office. After hellos, and a brief recap of how the surgery went, and how I’d managed in the interval since the surgery, we had a brief introduction to the hardware. At that point, the audiologist, Cindy, began the preliminary mapping/programming work. I listened to tones, which ranged up to almost 8,000 Hz, as the audiologist set the comfort levels.
At 10:00, she mentioned that she had been reading my blog, and since my daughter and Lynn were with me, whose voices did I want to hear first??
She did the switch-on, and through the awful electronic noise, I could hear my daughter and Lynn, sounding as though they were computer-generated facsimiles of cartoon voices! But, I could hear them, along with my own weird voice. It did bring tears to my eyes, for sure, but you know they were tears of joy. I was able to talk with Cindy in order to confirm loudness levels, and some further details on using the processor controls, and at 10:25 we took a break.
We walked out into the street, and passed a road construction site, but I could hear the voices of my wife and my daughter. Just a fabulous feeling, fabulous!
Back to the audiologist at 10:45, and she proceeded to work for a while to set the threshold levels, with some further testing. The noise, and cartoonish timbre continued, but suddenly I noticed that I could tell Emily’s voice from Lynn’s. And then, I couldn’t resist: I took out my cell phone and called the government weather service. And I could understand the voice at the other end. Press 1 for service in English; Press 2 for service in French; for the weather forecast, press 1; and so on.
Then, Cindy proceeded to give me some word- and sentence-recognition tests, covering her mouth so that I could not cheat by lip reading. As near as I can tell, I aced these exercises. All the while, the electronic noise was becoming less prominent, and the voices were “separating” from the background noise.’
After more than one friendly warning from the audiologist to try to keep my expectations in check, we went over the routine for the rest of the week. My job is to keep my hearing aid out of my other ear, leave the CI on as much as possible, and get involved in lots of conversations.
At 12:30, we figured we’d done all we could do for one day, and Lynn had to get back to work anyway. We walked down the street, again through some horrendous downtown noise, but I could clearly hear both of them as we walked along.
Emily and I went to a reasonably noisy restaurant for a light lunch, and she remarked that I was hearing her better than I did when I wore hearing aids. And this was with my hearing aid out, at the direction of the audiologist.
There are days in every life that will never be forgotten, and for me, this one is right up there!
April 15, 2013
Before and After
Just 11 hours before my activation, sometimes referred to as initial stimulation, there’s much I can say about the world I’m in now, a world that is significantly defined by the fact that I have a profound hearing loss. Some of it is good, and I’ll get to that in a bit, but mostly, it’s bad news. For example, I can’t hear my grandchildren when they ask me a question, and I miss a lot of what Lynn, my wife, is trying to tell me. I usually miss the punch lines in jokes, and those neat Microsoft/Apple Macintosh ads totally baffle me.
I’m sure I’ve lost a lot of money because I do not hear coins drop, and I guess I’m at risk for losing my keys for the same reason. Whispering, one of life’s most important forms of communication is not available to me, because I do not hear high frequency sound. Outdoor voices at a distance are simply out of the question, and so is most of the dialogue in TV shows and films, especially if the characters use an accent, or speak quickly. And, I do not hear announcements on PA systems because they are often too garbled, or if the receptionist is calling for me at appointments, or the doorbell when I’m not in the same room. I don’t hear the smoke alarm at night because my hearing aids are not in. I can’t tell when the cat is meowing at the door, or when I’ve left a tap running, or whether the engine in my old MG is knocking.
And, believe it or not, I can’t enjoy a Rolling Stones concert because it is just too loud.
And, as promised, here’s the good stuff: I can have silence when I need it or want it, and I have a ready-made excuse for not doing things (hey! I didn’t hear you ask me). And of course, I can sleep no matter how noisy it is. And, I think I’ve mentioned this earlier, but I don’t hear much of what politicians say in those sound bytes, and I’ve learned to enjoy watching sports without the commentators telling me how such and such a player hit over 300 just last season, before being traded. Imagine! Trading people!!
Another positive thing about my hearing loss is that I really can’t hear those folks from offshore call centres who are trying to sell me something, or get my opinion on some issue. Elevator music doesn’t register with me, and neither does the sound of the air conditioning system in the house. And finally, if the neighbours have a party, I usually don’t know about it until someone else mentions how loud it is. I’m sure that I miss a lot more, but how can I tell? I can’t hear whatever it is!
So, that’s a brief look back at the world I’ve faced for years, and perhaps I’m just being philosophical, but I really don’t feel that I’ve had such a bad life so far, just that with better hearing, the rest of my life, my new world, just may be much more enjoyable.
April 15, 2013
Attitudinal Evolution
With tomorrow’s initial stimulation, or activation, tantalizingly close, I find myself reflecting back on just how this journey unfolded. And as is so often the case, the journey was as much about changing my own attitudes, as it was about the proposed change in hearing technology.
In the 1990s, as my hearing loss continued to progress, the topic of having a cochlear implant occasionally came up with my audiologists. I remember rejecting that option in my mind for some reason, probably not yet willing to believe that there was something so seriously wrong with me. And, at that time, the technology was not as advanced as it has become. In the 2000s, the discussions around the possibility of receiving a cochlear implant became a bit more serious, usually ending with the notion that someday, I would need a CI, but that because I was doing well with hearing aids, I was not yet a candidate.
Working at the Western Institute for the Deaf and Hard of Hearing in the mid 2000s, brought me into contact with a few implant users. I remember CI users, often people who had been pre-lingually deafened, telling me that they could hear voices fairly well, but that they really could not enjoy music. And, I have to admit that I reacted negatively to the “clunky” look of the processors, and really did not like the idea of the wire and coil stuck on my head. Vanity!
However, by 2010, discussions with my audiologist evolved to the point that I realized that it was not whether I would get a cochlear implant, but when. At that point, I became much more serious about gathering information, talking with CI recipients, and just thinking about what it all meant. I remember talking with and observing two members of the local Canadian Hard of Hearing Association who had been implanted, whose quality of life had been dramatically improved. I certainly remember experiencing a shift in my attitude towards cochlear implants, and deciding that I would do whatever it took to become a candidate.
My audiologist referred me to the CI clinic, and I underwent a comprehensive hearing evaluation. At the end, the audiologist there told me that I did not yet meet the criteria for approval. She clearly understood that although I could hear to a certain level in the clinical setting, I could not do nearly that well in the real world, but she was bound by the outcome of the clinical test.
That evaluation was in early 2011, and both Lynn and I were disappointed, to say the least. Local folklore held that it would be appropriate to try again after about 15 months, so I again approached my audiologist, Grace for another referral. She put the referral process in motion, but before that process was underway, I received a letter from the CI clinic asking if I would be interested in being part of a clinical study which would involve receiving a cochlear implant. Intake testing revealed that I was accepted into the trial, and now, four months later, I am about to enter the world of bionic hearing.
Excited is hardly the word for it!
April 13, 2013
What DOES Music Sound Like
I mentioned in an earlier post that despite the surgeon’s warnings, I have retained some residual hearing in my CI ear. I mention this because I was also warned that CIs are optimized for speech processing, and that while some CI recipients enjoy music, that I should not count on success in this area. Only time will tell if this warning about music is borne out.
Now I happen to enjoy listening to music. I have very eclectic tastes in music, ranging from Gregorien Chant, Baroque, Jazz, particularly older jazz vocals, and on to some Gospel and Western music, provided I get to choose it! In return for better communication, I am most willing to give up listening to music, but not without a fight!
For the last four weeks, I’ve been listening with one ear. Music certainly sounds different than it did with two ears. And that got me thinking: What does music really sound like?
I suppose there are as many answers as there are people who listen to music, we really are all different. As I was listening, through one ear, today, to some familiar music, I thought that although this is not the same as the sound I enjoyed before the surgery, it is nonetheless still pleasant. The stereo effect is not there, and the sound is not “centred” in my head as it used to be, but nonetheless, I can recognize the melody and the beat, hear the vocals, and enjoy the sensation.
Now, back to the residual hearing. I decided to put a hearing aid on my implanted ear. And then, using my Phonak iCom streamer, listen to the same music. A definite improvement. Not the same as pre-surgery, but not terrible, either. The implanted ear gives sound of lower volume, and with a pronounced low-frequency emphasis. For some music, that helps to centre the sound in my head, and add a fullness. As an aside, it’s a good thing that in symphonic music, the strings tend to be on the left hand, implanted side, the side that does the best with high frequencies, at least for now.
With activation coming up soon, I’m going to find yet another way to listen to music, and yet another way for music to sound. While familiar music may never sound the same as it did prior to surgery, I have a hunch that I’m going to enjoy what I do hear. And, since cochlear implants are designed to do the best job with speech, I just may find myself cueing up more Gregorien Chant when I decide to relax with some music.
April 11, 2013 (Five days to Activation!)
Unexpected Wayposts on the Journey
The allegory of a journey is so apropos for the cochlear implant experience. It literally is leaving one world, the world of silence, and entering another world, the world of sound. And, just as many travelers keep a journal of their various trips, many cochlear implant candidates and recipients keep a blog such as this, to record their experiences, note the milestones, channel their emotions, keep their family and friends informed, and have something to look back on when, and if, the journey comes to an end state.
Sounds simple, but that ignores the fact that the journey takes on a life of its own, deviating as it were from the preconceived notions held at the beginning. We discover unexpected mileposts (I really prefer wayposts), meet other travelers on similar journeys, and discover things about ourselves that are often surprising. The salient point of this journey is that although we know where we’re going, we don’t really know what to expect when we get there. I suppose the three major events on the journey are making the decision to have the implant, the surgery, from which there is no turning back, and finally, the activation, which, although it sounds like the end of the journey, is rather more in the nature of a passport control check. This is where we enter our new worlds.
And, of course, at any given time, there are many others on the same journey, and they too, do not know what to expect at the end. Quite naturally, we seek out others on the same journey, perhaps feeling that there’s something in the nature of safety in numbers. And thus, through the various forums and blogs on the internet, friendships are born, and these friendships are truly the greatest wayposts of the journey. As those who have come before record their experiences, they provide us with reassurance that we are still on the right path. When they post that they are not sure if they are on track, others offer suggestions and support.
The forum sponsored by Advanced Bionics, appropriately called “Hearing Journey” is perhaps the best meeting place, and the members of that forum truly exhibit the most wonderful aspects of humanity, offering encouragement, support, and knowledge to those on the journey, irrespective of which brand of implant they have. In one sense, it reminds me of staying at a youth hostel, where you can meet new travel companions, and pick up tips on the best places to visit, and how to get there.
In a future post, I’m going to mention some of the unexpected wayposts I’ve noticed on my journey, but the most important one of all is that on this journey, you are not alone, there are so many new friends on the road, all wanting to help as you make your way along the road.
April 9, 2013
Activation Day, One Week to Go!
Somehow, this is shaping us as an event similar to graduation day. But it’s a lot more than leaving behind the halls covered with holly and ivy, of course. Although the ceremony is called commencement, graduation is saying goodbye, an end to student days. On the other hand activation day is really a beginning, a saying of hello to a new sort of life. Yes, that’s really just a statement of my attitude towards the two events, but that’s how I feel.
Like graduation, tickets for family and friends are limited. That’s because there’s only so much room in the audiologist’s working space. I remember when I received my Masters degree at UBC. My wife, daughter, son, and my parents were there. And after the parade across the stage (“I admit you,” said the Dean), and the photos, I think we all went out for dinner somewhere nice. And then it was all over, except for the memories.
I’d really like the same people here for the activation, but that’s hardly possible. My father passed away about four years ago, and my mother, at 93, is not able to be there. My son, Michael, lives and works in Ottawa, and it’s not realistic to expect him to fly out. My wife, Lynn, is working that day, at a new job, but she’s managed to wangle some time off, and I’ve heard that my daughter, Emily, can be there. I’d really like them to see this new beginning, and, fingers crossed, I’d like to hear them first.
There’s a host of others who’ve been sending me good wishes and letting me know that they are wishing me a wonderful outcome. Of course, the real wonder does not typically occur on day one, but only after some practice and rehab. So, when the time is right, I’m going to see those folks in person, show them the bionic hardware, at least the visible part, and then hopefully, just carry on as if I had normal hearing, or something close.
As for the activation, what we’ll do is follow the graduation formula, but with a difference: we’ll wait until I’ve adapted to the CI, then go out for a celebratory dinner, at some nice place of course. And I’m hoping I’ll hear what the people around the table are talking about, something that I really couldn’t do at the graduation celebration dinner.
April 7, 2013
More Equal than Others?
Equality. Now there’s a word that can get the emotions going!
You’ll remember that in George Orwell’s “Animal Farm” there was a sign on the side of the barn at Manor Farm: “All animals are equal, but some animals are more equal than others” Well, so it is with hearing issues. The objective of all accommodation strategies is to create a situation in which the person with the hearing loss is as close to equal to those without a hearing loss as is possible.
But, those with severe or profound hearing loss, such as I have, will attest that even the best hearing aids, meticulously fitted, are not able to correct hearing to anything approaching equality with normal hearing. And so much human activity depends on communications, as often as not oral communications. Think of meetings, theatre entertainment, lectures, presentations, and so much other human activity. Some accommodation can be achieved by using assistive listening devices, but even here, the problem of inequality persists.
In my case, I gradually dropped out of some activities from which I derived a great deal of enjoyment. My Toastmasters public speaking club is a good example. It was simply too difficult for me to hear other speakers well enough to participate. For years, I belonged to a Kiwanis Club, twice serving as club president. It was very difficult for me to run the meetings, as I missed too much of what was being said. For this, and other reasons, I chose to leave the club. I know of people who’ve left good jobs because the job required them to use the telephone, and with their hearing loss, they felt that they could not continue. Our personal lives, and in particular, the relations we have with our partners, family, and friends, all depend on good communications.
In common with most others who have chosen to receive a cochlear implant, I did not rush into the decision. I personally spoke with half a dozen people who had received implants. I read of many more experiences online. Each of the recipients had different results, but all of them were more than satisfied with the outcome. One resumed employment, using the phone normally; another went back to activities connected with her church; another is working as an audiometric technician, a job which requires good communications; and yet another works as a consultant with a school board.
In my estimation, these people have achieved a level of equality that they could not have reached without their cochlear implants. This technology, coupled with the plasticity of the most amazing technology of all, the human brain, is helping people with hearing loss achieve a level of equality that was unheard of (sorry!) a few years ago.
April 5, 2013
Little Things Golden
The wait for activation, down to 11 days now, continues, and in the meantime, my mind continues to deal with the suspense in ways that probably give rise to raised eyebrows.
The other day, before heading out, I made sure to pick up my pack of spare hearing aid batteries. The pack seemed to be too full, until I realized that with only one aid in use, my hearing aid battery use has dropped by 50 percent, I guess. Wow! What a saving!, and less used batteries ending up in the waste stream to boot. A small thing maybe, but every little bit helps.
My hearing loss is such that I require a great deal of amplification from my hearing aids. This in turn, calls for very snug-fitting earmolds in my ears to help prevent that whistling feedback sound. Well, those snug-fitting earmolds become hot, itchy, and just generally uncomfortable after a long day. Well, at least my right ear is enjoying relief right now. Another small thing.
And of course, I hear less well with only one ear, so rather than face frustration, I’ve just sidestepped some situations. I let my wife make all the phone calls to arrange appointments, deal with inquiries, and the like. I don’t hear young people talking on their cell phones in the bus as much as I used to. I always wondered why they talked so loudly on their phones, until a friend of mine told me that they must all be long distance calls, so they had to shout to be heard. Now, I don’t hear them quite so loudly.
I gather that often I completely miss sounds coming from the right-hand side. There’s that head-shadow effect again. While some of these sounds probably signal something fairly important, I bet a lot of them fall into the category of “interruptions”, questions for which I don’t know the answer, and general comments on the passing scene. All small stuff!
Another little thing is that when they interview politicians on the news, I don’t even bother to try to hear them. I can’t believe how much this has improved my attitude and feeling of general well-being. The same goes for the hosts on those television sports channels, such as TSN. Although I’m not a regular watcher of hockey on TV, I have been subject to the occasional bombast from Don Cherry. Not hearing him at all is a blessing.
And that brings me to the point I’d like to make here. All the research, the energy, and the emotions that have gone into this cochlear implant journey are focused on trying to hear more, to remain connected, and to be part of the world. And while that’s a good thing, it’s also important to remember that many of the sounds in our environment are essentially just pollution. There are so many sounds we don’t really need to hear, so many people saying things that do not add anything positive to our lives. So this journey has produced some little things I did not expect, and a lesson to take to heart: Sometimes, silence is truly golden.
April 2, 2013
Adjust that Stereo, would you?
Since my surgery, I’ve been listening to speech and music in my one ear. Certainly not as satisfying as binaural hearing in stereo. And come activation day, I’ll begin hearing in a sort of hybrid, binaural mode–with the cochlear implant in the right ear, and a hearing aid in the left. Sometimes this is referred to as bi-modal hearing. I’ve been told by more than one person, that this “system” can produce quite pleasing results once your implanted ear is adapted to the new way of hearing.
This is because CIs are optimized for speech processing, and because the electrodes that are inserted into the cochlea do not extend deeply enough to stimulate the auditory nerve in the area that is associated with low notes or bass. Consequently, the ear with the CI receives predominantly high frequency information. Hearing aids, on the other hand, tend to work best with lower frequency sounds. And apparently, the human brain is able to integrate the two types of stimuli to produce a natural sound. I can’t wait to see if this is the way it is.
But there are more factors in play with this binaural hearing model. With a hearing loss of 105 – 120 DB, I require a lot of amplification (gain) to hear. However, acoustic feedback, which is difficult to prevent with hearing aids, makes it difficult to provide enough gain to compensate for the hearing loss. If you increase the gain of the amplifier, you will induce feedback, that whistling sound so characteristic of hearing aids. The cochlear implant does not suffer from acoustic feedback, so more gain can be provided. This, along with better high frequency response, is what makes the CI better for speech processing than a hearing aid for people with profound hearing loss.
If the implanted ear is louder, is the brain smart enough to adjust the “balance control” to put the sound in the centre of your head? I believe that inside the brain, there are controls just as there were on those great stereo amplifiers from the 70s: bass, treble, balance, and volume. Once they are adjusted, the sound ought to be beautiful. Time will tell, and if you’ve read this far into this post, you must surely think that I’ve got too much time on my hands.
April 2, 2013
SSD
Until activation, I will be hearing out of only one ear. I had always been told that single sided deafness (SSD) was a difficult situation to live with, and now I know. Picking out voices in noisy environments is extremely difficult, and trying to figure out where a sound is coming from is pretty well impossible.
I suppose that when I wore only one hearing aid, from about 1957 to about 1992, I lived with a mild form of SSD, as I could always hear a bit out of the unaided ear, until the late 1980s, when my hearing loss, measured by my threshold of hearing, progressed to what is known as a profound loss. Without hearing aids, my world is totally silent, with a couple of exceptions.
One exception is an all out rock concert, such as the Rolling Stones concert to which I took my daughter about 6 years ago. It didn’t matter whether I wore hearing aids or not, the sound was a deafening blur of distortion. The other exception I can think of is a loud emergency vehicle siren sound when the vehicle is within a 150 feet or so. That, I can definitely hear.
When a person is diagnosed with single sided deafness, it usually means that even if a hearing aid is worn in the bad ear, there will be no useful perception of sound. Some people with SSD wear a “bi-cros” system, in which a microphone is placed over the bad ear, and connected wirelessly, or with a cord to the hearing aid which is worn on the good ear. This helps eliminate the “head shadow” effect, and may provide a sense of direction, although I’m not sure how that can be, since all the sound is, in effect, coming in the one ear.
Another solution, but one with which I am not familiar, is the BAHA, or Bone Anchored Hearing Aid, which requires a surgical intervention to implant a stud into the bone near your ear. This may be a solution that applies only to those who suffer a conductive loss on one side, but again, I’m not sure.
In the meantime, I have a new awareness of the challenges facing those with SSD, and am left wondering whether, at some time in the future, I will be advocating for another cochlear implant so that I will have good bilateral hearing.
And speaking of bilateral hearing, in my next post I’m going to be musing about the situation I will face after my single CI is activated.
March 29, 2013
Bunny Ears
Went for the post-operative appointment with the surgeon Wednesday, and thanks to the high-tech gear in the examination room, had an interesting look inside both my ears, as well as at the now-healed incision behind my ear. The surgeon was well-satisfied with my recovery, and noted that the only thing left in terms of healing is for the remaining blood trapped behind my right ear drum to drain out.
And, the clinical audiologist contacted me by e-mail (smart woman!), to let me know that I have a four-day activation appointment set for April 16 to 19, inclusive. She advised me to book the entire days, so I guess there’s going to be some fairly intense mapping and programming going on.
But then, she said: “Have a good Easter…you can eat one ear off each bunny so you don’t feel alone.”
And I thought do I go out and buy my own Easter Bunnies? or will I wake up on Easter morning and find bunnies hidden in the house? What if there are no bunnies? Am I then doomed to a life of loneliness?
And then I remembered just how particular I was about chocolate, and chocolate bunnies in particular. I have always preferred dark chocolate over milk chocolate, and don’t even think of white chocolate as being worthy of being called chocolate. As for the bunnies themselves, those hollow things in the cardboard and cellophane containers that one finds for $1.98 at dollar stores and the like probably contain more artificial ingredients than the health authorities consider the normal daily allowance for an unhealthy adult, and taste terrible to boot.
So, just to be safe, I’m going to a quality chocolatier, on the sly of course, and buying a couple of dark chocolate bunnies….
And before I forget, the activation–the next 17 days are going to be the days of the one-eared bunny eater!! Either that, or live a life of loneliness.
March 28, 2013
You do not have to be alone
The other day, I noticed a story posted on BBC News. Apparently, a recent study has determined that older people who are isolated from friends and family are 26% more likely to die over a seven-year period than those who are engaged. And, it seems intuitive, to me at least, that hearing loss easily leads to isolation. Voila!
When I worked at the Western Institute for the Deaf and Hard of Hearing, I encountered people with hearing loss who were very frustrated because their family and acquaintances found it difficult and frustrating to communicate with them, particularly by telephone. Some of those people said that friends and family made less effort to keep in touch, or even stopped altogether. In some cases, it was evident that the hard of hearing people felt that the “blame” for this situation rested with them, as they were told to “turn your hearing aids up”, or “go get a better set of hearing aids”. Some simply chose to withdraw, spending their time alone.
In my case, hearing on the phone became quite a problem about 20 years ago, but it was not until about 7 years ago that I found some effective ways to use the phone, using both ears, instead of one. Remember that the telephone does not have good frequency response, with a typical range of something in the order of 300 Hz to 1500 Hz, which leaves out a lot of the information we need to discern consonants. Using only one ear compounds the problem for the hard of hearing. By using either a wired connection to my FM or my Bluetooth transmitter, or even better, a wireless connection from a bluetooth enabled cell phone, I was able to hear passably well.
In spite of this, I noticed that some of my friends found it frustrating to converse with me on the phone. With my wife and my daughter, sending texts became the best communication strategy. This works for other people as well, but some things are best handled by normal conversation, and for those of us with severe or profound hearing loss, that’s a problem.
With respect for the researchers quoted by the BBC, we’ve known for a long time that isolation can lead to health problems for seniors. Hearing loss simply compounds that problem. Fortunately, cochlear implants have enabled tens of thousands of people to become engaged with society again.
The BBC story, for those who are interested, is at: http://www.bbc.co.uk/news/health-21929197
March 25, 2013
Who can hear that noise?
Apparently, the world is a very noisy place. Taps hiss, clocks tick, fans hum, cars roar, wind whispers, water gurgles, gas fireplaces breathe, bicycles whirr, meat spits in the frypan, and so on. Two kinds of people on this earth miss all this: those with good hearing, and those who are hard of hearing or deaf.
And no, this is not a contradiction. Those who are hard of hearing or deaf really do not hear all this noise. It is simply too quiet. On the other hand, those with good hearing can hear the noise if they focus on it, but normally, their brains “tune it out”.
But there’s yet another kind of person who DOES hear this, and that’s a person with a cochlear implant who has just been activated. And apparently, it’s tough to listen to, and tough to deal with. And the reason for that is that those folks who are newly activated have not had enough experience listening to all this noise to allow their brains time to learn how to tune it out. And therein lies the problem that will be one of the first that I face when activation day finally arrives.
A friend of mine who has a CI implant went so far as to tell me that for the first few days after activation, I should not spend my time concentrating on trying to hear the voices, but rather I should spend the time listening to the noise, identifying the source of the noises I hear, and then giving my brain time to learn how to tune that noise out. Only then, when the noises are tuned out, will I be in a position to concentrate on voices and speech, and learn to hear again.
Now, the audiologists who program and map implants know this is a problem, and it is my understanding that one of the strategies that they employ to help new CI users deal with all the noise is to set the processor to deliver a fairly low volume of sound the first day or two, and then gradually increase the volume with each new mapping. And the reason that they do this is to avoid the situation in which a newly-activated CI user gives up because of all the noise, and takes off her or his processor. And taking off the processor, or drastically reducing the volume is the wrong strategy, because if this is done, the brain does not get the chance to learn how to tune out the noise.
Now putting the noise ahead of the voices sounds the opposite of what seems natural or intuitive, but if you think about it, it does make sense. Of course, it is one thing to realize this at the cognitive level, but quite another to deal with it, especially when it induces feelings of frustration and perhaps anger. Anger that the CI is not an “instant fix.” But in life, there are very few instant fixes. What is true is that anything worth having usually involves a lot of hard work, and that includes hearing.
So, on activation day, which by the way can’t come soon enough for me, I will have to remember all this, and just roll up my sleeves, and immerse myself in the wonderful noise.
March 23, 2013
Great Expectations
If my cochlear implant audiologist, or an online friend, Celtic Lass, has been reading this blog, they are probably wondering if I’m setting myself up for a disappointing crash. Both of them have, very wisely I might add, told me to have high hopes, but reasonable expectations. Nature’s design of the human ear utilizes thousands (at least) of tiny hair cells, vibrating in fluid, to produce the electrical impulses that give us hearing. We are going to replace this incredible design with only 22 small platinum electrodes. So, although many CI recipients report almost miraculous improvements in their hearing, I’m sure that the CI does not come close to what nature intended.
But it is human nature to have, as Dickens said, Great Expectations. Why else would we buy lottery tickets, when most of know the odds of winning are in the millions to one? And I confess, I too secretly, or not so secretly, harbour the same high expectations. And as I write to channel my emotions, as well as inform my family and friends, I’m sure that those expectations of what to expect upon activation, can easily be read between the lines.
I suppose by being aware of this, I’m going part way to dealing with the issue of unmet expectations. In my working life as a communications consultant for a large organization, I remember that we spent a great deal of effort to ensure that our front-line staff did not give our clients unreasonable expectations, because managing expectations was a large part of the job of creating client satisfaction. Now I realize that I have to work this same process with myself.
I believe that if I have reasonable expectations at the beginning of the process, it is more likely that those expectations will be met. And that, in turn, will help instill the belief that the CI is delivering on its promise. And once that belief takes hold, the resultant positive attitude will help build further success. And as I’m sure you realize, that will create a self-fulfilling situation, in which success builds on success.
Now, I just have to learn how to put all this into play as activation day approaches. Perhaps I should go back to the day, when as a 12 year old, I came home with my first hearing aid. I remember wandering into the kitchen before dinner, and hearing a very strange sound. Sort of a spitting and hissing noise. After trying to figure out what I was hearing, I asked my Dad, who happened to come into the kitchen. I couldn’t believe it when he told me it was the sound of pork chops frying in a cast iron pan on the stove! I’ll just have to remember that incident each time I hear some new strange sound, instead of the unrealistic perfect hearing that would be expected with unreasonable expectations.
March 21, 2013
Time to Reflect
So, here we are, 10 days after the surgery, and reflecting on what it all means. Certainly, I can never go back to where I was before. And for the moment, my hearing, on one side only, is not nearly as good as it was before the surgery. It’s a time to be careful, careful with my feelings, because, there is nothing certain in life other than the usual two items.
Yesterday, very dear family members came over for dinner. My nephew, Paul, his wife, Alica, and their two boys. We sat around and conversed, then had dinner together. Surprisingly, I was able to handle quite a bit of the conversation, and did not feel isolated, or out of it. Certainly, I missed more of the conversation than I did before the surgery, but I could live with what I have now. And, although it’s been more difficult to converse with Lynn around the house, we’ve been managing the situation.
By the way: I just discovered that I have some residual hearing in the ear that was implanted, which somehow is quite an uplifting thing for me. It tells me that my surgeon managed the electrode insertion without excessive trauma to the cochlea. Not that I want to go back to using the hearing aid in that ear–I just couldn’t stand the feedback whistling any more.
Managing. Getting by. Those terms describe my hearing and my life prior to the decision to have the cochlear implant. And, the difference between my hearing loss before the operation, and after the operation, is simply a matter of degree. Both situations are unacceptable in the face of the prospect of much better hearing with the implant. Better hearing should bring about a marked improvement in my quality of life. But I’m not there yet.
I see the surgeon next Wednesday for the followup examination, which I predict is going to show that all went well. Then, he’ll pass a message to the audiologist to schedule me for activation and the first mapping. To be honest, the suspense is starting to weigh on me, but I think Lynn would agree that if there were such a thing as an Excitometer, she would be higher on the scale than I am.
Perhaps I should remember the old saying: “Silence is Golden”, and just enjoy this period in my life when things are much more quiet than usual. And maybe that’s what it’s all about: appreciating what we have at the moment, and not constantly wishing for more.
March 19, 2013
20 – 20 Hearing?
Many people with hearing loss assume that “fixing” hearing is like “fixing” vision. They know that if you are far sighted or near sighted, you can have eyeglasses made that will correct the problem. You put on the glasses, and voila! you can see clearly again.
So why is it that when you buy a hearing aid, you don’t suddenly hear clearly again? The answer requires a bit of thought. Common vision problems are usually related to the shape of the eyeball, or the shape of the lens at the front of the eyeball. If either is not right, the light is not focused on the retina at the back of the eyeball. Put on a corrective lens, and the light is now focused sharply on the retina, and you’re good to go. The problem was not with the retina, the information-gathering component of the eye.
With hearing, the most common problem is damage to the tiny hair cells in the inner ear or cochlea. The sound waves still cause the fluid in the cochlea to vibrate, but the hair cells are not able to generate the tiny electrical impulses that travel to the brain, and allow us to hear. Hearing aids make the sound louder, and this helps, but does not give us the sort of correction that glasses provide for those with vision problems. The cochlea, the information gathering component of the ear, is damaged, and will never work as well as it should.
With hearing loss, sound becomes less loud. But more importantly, with hearing loss, people lose the ability to pick out the sounds they want to hear from the background noise. With damage to the cochlea, the ability to discriminate between sounds is degraded. The best example of this is the problem of trying to hear a conversation in a noisy room or restaurant. Even the best hearing aids only provide limited help for those with severe hearing loss in these situations.
In a few weeks, my new cochlear implant will be activated and “mapped” to my needs. This will be the first of many mappings I will receive as my audiologist works to give me the best hearing possible. With the activation, I will suddenly hear a lot more noise than I have for decades, noise my brain is not used to working with. Things such as the hiss of water flowing from the tap, the roar of the vent fan in the kitchen, the rushing sound of the gas fireplace, even the ticking of the clock on the mantle. Quite possibly, this is going to be overwhelming, and definitely frustrating, but it’s normal. If I work at it, my brain will gradually learn to “tune out” the noise, and allow me to concentrate on what I want to hear, the signal in engineering parlance.
Like many other CI recipients, I suppose I was getting too excited about the activation, expecting to just go out there and hear like anybody else. My friend Michael, who has an implant, noticed this, and sent me a message to bring me back to reality. The rehab process starts with the brain learning to recognize and suppress unwanted noise, and then goes on to learn how to interpret the things we want to hear. And it takes work, time and patience.
March 17, 2013
Moderne Burger
While I’ve been obsessing over my cochlear implant surgery, my wife, Lynn, has had her own medical crisis to contend with. On the Thursday before my surgery, she went in for what she thought was a routine cataract surgery. And so it seemed, until last Saturday, two days before my surgery, she became aware that something was not right with her eye. It turned out, after a day spent at the eye care centre here in Vancouver, that she had a serious infection in the eye. Fortunately, it was treated well, and she learned a week later, that her eye suffered no damage, and she’s well on her way to recovery.
So last night, we decided to go out for a small celebratory dinner. Now every once in a while, I develop a taste for a hamburger, and Lynn is always up for fries, so we decided to go to Moderne Burger, a beautifully done period piece restaurant in Vancouver. The owner has done a fantastic job of replicating a 1940s era restaurant, complete with the counter and stools, the jukebox, the milk-shake machine, the wall speakers, and gorgeous Art Deco lighting fixtures. Every surface in the restaurant is hard, from the floor to the stainless steel applique on the walls, to the high ceilings. The jukebox was “moaning a Dean Martin tune”, and anybody with a hearing loss was, well, lost!
I knew this going in, as I’d been there before, but we went anyway because we just wanted to. We were able to communicate, because the table in the booth was small, and I was able to use a directional microphone program on my one hearing aid. And, yes, the celebration was worth it. I even had a Root Beer Float, something I haven’t enjoyed for decades.
Since the surgery, I’ve been following the advice I’ve received from just about everybody: take care of yourself. Eating well, resting, doing light exercise, drinking plenty of fluids, and the rest of that boring routine.
But taking care of yourself means more than just the stuff in the last paragraph. Taking care of yourself means knowing when to reward your soul, and when to ignore the things you can’t do much about. Moderne Burger to the rescue!
March 16, 2013
Limbo Time
With the surgery behind me, and the recovery coming along much better than I had expected, I find myself in a state of hearing limbo. As I mentioned many posts ago, I have a profound sensorineural loss in both ears. In fact, threshold test results indicate that sound has to be about 105 to 120 DB louder for me to just perceive it, than it does for a person with normal hearing. That’s a lot of sound difference, in fact, 120 DB represents a ratio of 1,000,000 to 1.
With two hearing aids, I liked to think I was “getting by”, all the while realizing that getting by was not really good enough. Now, with one hearing aid, I’m really not getting by, and this serves to remind me why I’m having the implant done.
Right now, with one aid, I’m very wary of the telephone. And, it’s difficult to have a conversation with Lynn, although I did break out my old Phonak FM unit yesterday, and we used it with some success in the car. But what a pain to use! First, I have to be sure the Smartlink is charged. Then, I need to plug the FM receiver, MLX, into the iCom. Turn on the FM, and if all goes well, I can hear Lynn talking to me. As often as not, though, if I do not turn off the Bluetooth in the iPhone, the iCom produces a Beep….. Beep…… Beep in the hearing aid.
This is the result of what I call “Dumbing Down” of the devices by the manufacturers, who are hoping that technophobes will buy them if they are “easy to use”. If the iCom had a selector system to let me choose FM, Audio In, or Bluetooth, I’d be totally happy, and so would Lynn. As it is now, it turns out to be a “hit or miss” situation, and too often it’s a miss, leaving me in limbo, and not really getting by at all.
And that brings me back to why I chose to have the cochlear implant: I’m hoping to be able to function without any of these gadgets and devices that clutter my life, and frustrate me more often than not. My hoped for end-state in this process is that I put on my processor in the morning, and hear Lynn, hear the phone, listen to TV, and possibly, listen to music, all without extra devices, sometimes called Asistive Listening Devices, or ALDs. Just like everybody else.
And you know what? That’s what the people around me want as well, as they can be pretty frustrated by my “not getting by.”
March 14, 2012
The Aftermath
So, what happens after you let a guy cut into your head right behind your ear? Then drill into the skull and the mastoid bone? And finally, insert a tiny silicone and platinum electrode into your inner ear? Surprisingly, the after effects are not as severe as you’d think, or they’re not in my case anyway. Here we are, three days on, and feeling pretty good. Still have not used the pain meds, but taking the antibiotic, of course.
Of course, there’s some discomfort. It feels as though my right ear is plugged, or perhaps as though it’s full of water, as sometimes happens when swimming. There’s a minor level of swelling around the area, and for a day, it looked like the bruising might extend to my right eye, but that appears to have subsided. There are the beginnings of itchiness with the incision, and there’s been some muscle stiffness in the neck, presumably because my head was turned in order to allow the surgeon to do the job.
Sometimes, I get short, very localized pains right in the ear, and occasionally, short bouts of tinnitus. So far, neither has been anything more than temporarily annoying.
All of these symptoms appear to be subsiding now, and I’m cautiously optimistic that things are going to continue to improve. However, the biggest impact has been on my ability to hear. I’m now operating on one ear, using a behind-the-ear hearing aid. The sound is not very good at all, and I’m sure that the people around me are going to go crazy. I’ve tried three telephone calls, using the bluetooth hookup for my HA, and was able to understand two of them. There is simply not enough high frequency information to make speech comprehensible with some speakers. The sound is probably best described as muffled and distorted.
So, while this is just a temporary problem, until my new device is activated, it is going to be a challenge. I’m going to have to pick my situations out carefully, avoiding any that require anything special in the way of hearing. And in the meantime, I have to remember to give thanks to the surgeon, who appears to have done a remarkable job.
March 12, 2013
Where’s the Monster?
Didn’t hurt as much as that Total Cranial Liposuction I underwent last year. Caffeine withdrawal? Anesthesia withdrawal? Hearing frustration? Niggling pain? All of the above, but the monster has not shown up, at least not so far. Last night, I wanted to go visit the two little girls next door (ages 4 and 6) and show off my monster head bandage, but a majority vote in the household convinced me of the error of my ways. I still think they’d have loved it!
Aftereffects? Bandage came off by itself in bed on first night. Velcro failure. Still a bit lightheaded 2:15 next day. More aware of minor pain of the actual incision. trying to remember to take it easy, no heavy lifting, keep head higher than heart. Some minor swelling in area behind the ear. Trying to remember to avoid touching that area in case that could cause infection. Taking antibiotics twice daily as prophylactic measure. Throat mildly sore due to the tube which was inserted into my throat.
Getting by with hearing in one ear, but not that well at all. It will be interesting to see how much better it gets before the activation. In the meantime, Lynn’s fears that we would not be able to talk have been largely alleviated. I can hear bustling and voices in the kitchen, but conversation really has to be face to face. On the phone, using the Bluetooth hookup afforded by the Phonak iCom, I can hear surprisingly well, leaving me wondering just what the right ear was contributing. But, judging by how music sounds now, it was definitely making a large contribution.
So many calls, texts, and messages from friends, family, and folks in the cochlear implant and audiology communities. I did find this moving. Got on the computer last evening and this morning, and sent off some messages to let them know I was doing ok. Called a dear friend in Kamloops, who chooses not to use a computer or smart phone, and was she surprised to hear my voice on the phone. I could hear most of what she said in return, so that was re-assuring for me.
Received a message from my daughter, Emily, wondering if I had a bandage on my head. I took a picture with the iPhone, and sent it back to her. Nuff said!
So, all in all, not nearly as bad as I feared, and in fact, better than I expected! How’s that for a sentence? Maybe the monster will only mess up my grammar skills…
March 11, 2013
Looking Like a Silent Move Monster
Back home at 6:45 PM, after what was apparently successful surgery. Feeling a bit weak ‘n’ Woozy, but hey! that could be due to pre-surgery starvation.
Lynn has gone off to the pharmacy to pick up two prescriptions, one for pain, and the other a precautionary antibiotic. So, if waking up is the biggie, I can also report that food tastes normal, so far, and I do not have vertigo, although that may come later. No way right now to tell if there is any residual hearing in my implanted (right ear), but we’ll find out when the healing has progressed, and I can try a hearing aid in that ear.
The surgery took a little under two hours, recovery to moving around was about an hour, and then lying around in precautionary mode, another hour, then home in a cab with Lynn, and her sister, Sandy, who’s come to visit for a bit.
So, let’s see what’s next, who knows? if the pain gets worse I might not only look like a monster, I’ll start acting like one!~
March 10, 2013 (Last day before surgery)
And now for the real suspense
With surgery Monday, I’ll cross that Rubicon, and like Caesar so many years ago, I begin my march to Rome, spelled a-c-t-i-v-a-t-i-o-n. And that is a four-to-six-week march. During that time, I’ll be in suspense, wondering what lies in store.
But before that time, I’ll have to deal with a couple of things. For one, the surgeon told me straight out, that I will lose my residual hearing in the implanted ear. And although the audiologist told me that this is not always the case, I have to be prepared to hear with one ear only until I’m activated. Perhaps I better line up a pile of good books to help pass the time.
On the chance that I do retain some residual hearing in the implanted ear, it is apparently ok, once some healing has occurred to try using my hearing aid in that ear. Of course, no one can predict what I will hear, or the quality of the sound. We’ll have to wait and see on that.
So, I’ll have to make the best of this situation, and this is where I’m going to draw on my “arsenal” of assistive devices. For example, I’m going to have Lynn use the FM microphone, and I’ll hook up an FM receiver to my Phonak iCom. That should help, but it will still be monaural hearing, and thus, not ideal by any stretch of the imagination. I can also use my TV Link to send the TV sound to the left hearing aid, again using the iCom. Again, it will be monaural.
I stress monaural, because hearing binaurally makes, for many people, a huge difference in the ability to understand speech, and also enjoy music.
And, we’ve been playing around with our iPhones and the speech-to-text capability that comes pre-installed in the “Notes” app. It works very well, and allows Lynn to talk to her phone, and present me with text of her spoken words. We can do the same thing on our MacBooks, but they’re bulkier and heavier. An iPad would be best, and perhaps there’s a better dictation program out there. Or is that an excuse to run out an buy that iPad I secretly want?
And all the while, I’ll be in suspense, waiting for activation day, and the chance to finally learn just how the CI works for me.
March 9, 2013 (One more day till surgery!)
Cochlear Implants and Depression
Yesterday, my wife stumbled across an on-line article with the headline:
Cochlear implant recipients and their spouses have elevated levels of distress
Needless to say, this sent up a warning flag, until I had a chance to actually read the article. The gist of the article was that candidates for a CI and their spouses suffered from elevated stress due to the communication difficulties posed by the candidate’s hearing loss. Note that this refers to candidates, those who have not yet received the implants.
Well, what did they expect? How much were the researchers paid to produce this report? Did the reporter even read the story?
But, it does draw attention to an issue that does not get much attention: the impact of severe hearing loss on individuals and on their relationships with others. Further, it should focus attention on the criteria used by funding agencies, such as governments and insurance companies to govern implants. If the bar is set too high, perhaps in an effort to save money, do the negative effects of withholding this therapy outweigh the savings?
I can conceive of situations in which potential CI candidates are refused because they “can hear too well with hearing aids”, but then go on to suffer other health issues because of the stress that results from their communication difficulties. And, of course, it’s entirely conceivable that those same health issues go on to cause higher costs for the health-care providers in the long run. And that ignores the positive benefits that the implant would confer on the recipients.
And that brings me to my own situation. I am one of those people who do exceptionally well with hearing aids, despite having a profound loss. More than one audiologist has remarked that my speech recognition scores surprised them in view of the extreme hearing loss demonstrated by my threshold testing. And, I want to stress that I do well on speech recognition tests in clinical sound-booth settings. I cannot do that in the real world! But, the clinical testing is what is used to determine whether or not one receives an implant, and I was turned down.
However, the audiologists privately recognize that this process may not lead to the best candidates receiving implants. And so, I am part of a clinical study, which is seeking to determine if those who do not qualify under the strict criteria, might actually be the better choices to implant, because their rehabilitation outcomes are potentially better.
Or, to put it another way, perhaps we ought to be providing cochlear implants to people with deteriorating hearing before they become too distressed, and while they still have good rehab prospects.
March 8, 2013 (2 days to go!)
Travel Guides
I’ve been traveling through the world of hearing loss since age 2, and along the way, many wonderful hearing professionals have done absolutely fantastic work to make sure my journey was the best it could be.
Although I was diagnosed with a moderate to severe sensorineural loss at age 7, by Dr. B.W. Tanton, of Vancouver, it was not until I was 12 years of age that i acquired my Zenith Royal body-worn hearing aid. As near as I can recall, my parents bought it at the optical department of Woodward’s Department Store in downtown Vancouver. I seem to recall that it cost about $150! Allowing for inflation, that would be about $2,250 in today’s dollars. And by the way, I hated that thing, as the other students at Lord Byng High School were fond of grabbing the cord, thus pulling the earpiece out.
In 1972, while working as a teacher in Kamloops, BC, I met Chris Rose, who was the principal at a special needs school in the district. Chris took an interest in my hearing, and had the equipment and skill to evaluate my hearing, and recommend a BTE hearing aid that more closely met my needs. I believe he worked through the BC Ministry of Health to obtain the hearing aid for me.
I know I’m skipping quite a few steps, and some wonderful travel guides here, but let’s face it, you’ve not enough time to read too much detail.
Next on the memory trail is Janet Cody, an audiologist in Vancouver who convinced me that I absolutely needed binaural hearing aids, even though I was absolutely convinced that my left ear could not perceive any information of value. It was only after wearing them for a while that I realized just how right she was. Those aids were Widex Sensos, early BTE digital aids. Because they had no volume controls, I actually bought the programming unit for them, so that I could make adjustments that I needed. And, over the next few years, my left ear underwent a rehabilitation so that it is now my better ear!
Grace Shyng and Charles Fontaine, of the Western Institute for the Deaf and Hard of Hearing in Vancouver are both remarkably skilled audiologists, very knowledgeable on all hearing issues, and adept programmers. Not only that, they are fantastic human beings, with superb communications skills. These two were able to allow me to function in the world, despite my hearing loss now having progressed to the profound category, with a typical loss of 105 to 120DB . You simply can’t ask for better travel guides, I will be forever grateful for the life they have given me. And, I’m happy to say, they’ll continue to be a vital part of my hearing health, as I’ll be wearing a hearing aid in my left ear.
But the journey’s not over yet. The team at the Rotary Hearing Clinic at St. Paul’s Hospital have outstanding reputations in the CI world, and I’ve already met the surgeon and the audiologist who will be my guides on the CI side of life. And, I’m already very confident that I’m in good hands.
And, as any seasoned traveler knows, a good guide can be the difference between a trip and “the experience of a lifetime.”
March 7, 2013 (3 days to go!!!)
The Last Supper
With just 4 more days till surgery day, I’m finding myself making sure that all sorts of things get done beforehand. Stuff like making sure the bills are paid, that there’s nothing heavy to be lifted or moved in the days after my surgery, and that I’ve lots of stuff to read while I wait for any pain or dizziness to subside, although I’m not sure if I can read and be dizzy at the same time. That’s called multi-tasking, I guess!
So, last night I went out for dinner with my daughter. Her company is very enjoyable, and since she’s a sommelier at Vancouver’s (arguably) best restaurant, we always seem to enjoy fine wine with our food and conversation. And it’s the conversation that’s important to me, because once the surgery is done, there will be a 4 to 6 week wait for activation, and then the rehab process might add even more time before I can engage again. So, last night was a “last supper”, but unlike the biblical last supper, there were only two at the table, because that works best when you have hearing loss as I do. Because of the noisy environment, and because the voices were unfamiliar, I could not hear the servers, but we were just two, I was able to manage the conversation. And yes! It was a fantastic dinner, with a really nice Italian wine from the Tuscan Coast.
But where is it written that “Thou shalt have only one Last Supper?”
And with that thought, I’m hoping to tear my wife Lynn away from the telly, and the Canadian Men’s Curling Championship, also known as the Brier, and waft her down to one of the small restaurants we enjoy, or perhaps one to which she’s not been before. Again, there will just be the two of us, and we’ll be able to converse and enjoy the time together. I know that I’ll enjoy this Last Supper, and since my Son lives in Ottawa, about 3,000 miles away, I’ll not have this opportunity with him, although I’d like very much to have one more Last Supper.
So, with these details taken care of, I can go into the surgery at peace, and with hope, hope that once my CI is activated, and I’ve had a bit of time to become accustomed to the new way of hearing, I’ll be able to enjoy dinners with larger groups, something that I understand is difficult for most people who are hard of hearing. I’d also like to be able to hear the servers, as they run through their spiels. I’m sure that because I do not hear them, I’ve missed some food experiences that I’d have enjoyed. From what I understand, this is not an unreasonable expectation with a CI, as some recipients with whom I’ve spoken report that they can hear in group situations much better than they could with hearing aids.
So, unless Lynn has another Last Supper planned for me, I can go into the CI world looking forward to my “First Supper”, a supper where I can hear the servers, and talk with a reasonably-sized group.
March 5, 2013 (5 days to go!!)
Imagination run Amok
With my surgery date now only 5 days away, I’m finding my thoughts focused increasingly on what to expect.
All I really know is that I’m to phone the surgeon’s office the day before the surgery, and I will be assigned a time for the surgery. I know that I’m to report to the day-surgery suite two hours before that time. I know that the surgery typically takes two hours, and I know that it takes a couple of hours in the recovery room before a release to go home will be given.
And, while this is day surgery, it is done under total anesthetic. From this, we know that the actual surgery, as a friend of mine pointed out, is painless. Those who have undergone this procedure report varying experiences with post surgical pain, ranging from those who did not have to take any pain medication, to those who experienced significant pain for a week or so after the surgery. I am reminded that we are all different.
And then the wild card of dizziness or vertigo. Again, any reading I’ve done indicates that the incidence of vertigo ranges from none at all, to nausea and prolonged dizziness.
After all this, my mind needs a break! And when my mind needs a break, my somewhat weird sense of humour comes to the rescue. I have a strong belief that I’ll be released from the hospital about 3 hours after the surgery. I imagine I’ll have a head bandage on, and perhaps look a little the worse for wear. I’ve heard that some folks develop a black eye after the surgery.
So, I thought, why not….
…go to a theatrical make up shop, and pick up some white and green grease paint, and a neat stick on scar, and voila! Dr. Frankenstein’s Monster lives, right here in Vancouver.
Imagine the headlines: “Monster seen boarding bus in downtown Vancouver!” Perhaps my friends will tip off the local TV stations! Who knows where this will lead.
And so, just like that, all thoughts of pain, dizziness, and whatnot just disappear!
Yes, we are all different!
March 3, 2013 (8 Days to go!)
iPhone to the Rescue
Coming up is that window of time, between surgery and activation, during which time I will be hearing, if you call it that, out of one ear only. Already difficult communication will become even more challenging.
A couple of weeks ago my wife and I took a couple of hours to try some communications with no hearing aids at all. After a lifetime of hearing loss, I have developed my lip reading skills to the point that with familiar people, who do not have large mustaches, I can generally understand what is being said. And, during that experiment, Lynn was amazed to see that I could pick up most of what she was saying.
This was encouraging, but obviously not perfect. For reasons that have escaped most men since the beginning of time, women want to talk, and be heard when they talk!
With one hearing aid, I do much better, but it helps considerably if Lynn gets my attention first, and if there is no “head shadow”. In other words, it’s best if she’s on the side that has the hearing aid. I did discuss hearing using my implanted ear in the time between surgery and activation. In addition, the surgeon, while making no promises, may be able to retain some of my residual hearing in that ear. And apparently, there should be no ill effects arising from using a hearing aid in the implanted ear during that window in time. We’ll have to wait and see on that.
Thus encouraged, and just in case I can’t wear a hearing aid at all in the day or two after surgery, we turned to the iPhone. Using the “Notes” application, and the speech recognition facility built into the phone, we practiced creating speech-to-text notes. And boy, do they work. In a reasonably quiet setting, the phone almost always returns a totally useable text file. Amazing! I suppose an iPad would be even better, because the larger screen would allow the device to be read without the necessity of passing it back and forth. This sure beats passing notes back and forth as we did in high school.
Obviously, this is all about coping strategies, and interestingly, most hard of hearing people have already developed an arsenal of coping strategies, some subconsciously, others by design. And many of those coping strategies can work for people going through the CI process.
And finally, just in case it was not obvious, Lynn most definitely does NOT have a mustache.
March 2, 2011 (9 days to go till surgery!)
Defining the New World
“Keep your hopes high, and your expectations reasonable.” Those were the words of the audiologist after the evaluation testing that indicated I would be receiving a cochlear implant. But how do you keep your expectations reasonable after so many CI recipients tell you their amazing success stories?
Managing expectations is probably the most important preparation for a cochlear implant. If one’s expectations are unreasonably high, there is the possibility that at activation, or switch on, the sound may not measure up to those expectations, leading to disappointment, and a possible attitudinal difficulty with the rehabilitation process.
So it was with delight that I read a message I received on the Cochlear Community Forum the other day from another CI recipient. Her advice: have two visions of the outcome:
The first vision is of the ideal outcome–sort of a wish list;
The second vision is an image of what outcome you could live with.
So, here goes! Ideally, I’d like to hear people who are calling me from say half a city block away. I’d like to hear birds, and be able to identify the species. I’d like to hear music, I’d like to be able to follow sitcoms on TV, hear in the cinema, hear whispers, and hear what people are saying behind my back! I could add more, but I’m sure you get the idea.
But I could live with hearing people around me without have to ask them to repeat. I could live with hearing on the phone using the telecoil. I could live with knowing whether an unseen speaker is male or female. And I could live with recognizing music I remember from the past. Of course, I’d like to hear the phone ring and the door bell from another room. Again, I could add more.
My “Switch on” will not take place for about seven weeks. And the rehabilitation takes an unpredictable number of months, even years after that. Only then will I discover what the “new world” sounds like. Will I end up with my ideal outcome, my wish list of great hearing? Or will I end up with the “what I can live with?” Looking again at the description of what I could live with, I’m at peace. My hearing of speech would be better than that which I currently enjoy, and music would be not quite so good. That’s a win, and certainly makes the very small risk worth taking.
We’re beginning to define the world I hope to find at the end of the journey.
February 28, 2013
The World I Hope to Leave Behind
Because of my hearing loss, I have developed certain life habits that, in general, make sense and serve me well. These habits, taken together, define my world.
An example would be my reliance on printed media for receiving information. I’m much more comfortable reading the news, either on line, or in paper form. Another habit I’ve developed is using texting on my phone, rather than making voice calls. A voice call only works for me if I use binaural hearing (Phonak iCom and Bluetooth), and if the person on the other end of the call speaks reasonably clearly. I’m totally lost when the caller is an ESL person, for example, or if the caller speaks quickly and indistinctly.
My choice of leisure activities has also been dictated somewhat by my hearing loss. I enjoy cycling, but cannot talk to other riders. Working on my old car is another activity that works for me, as it does not want me to talk to it while we are together in the garage. (And, it does not mind if I suddenly swear at it if something doesn’t go together properly.) Writing is another preferred activity, and of course, writing goes best when things are quiet.
As for entertainment, I like to watch sports on the television, and often do so with the sound turned off, as I do not need to hear the often frivolous commentary to understand what’s going on. Listening to music still works for me, as long as I am alone, or stream it to my hearing aids using the iCom. Otherwise, it would be too loud for the rest. And, while my wife chillaxes with British Mysteries on the television, I usually read, or sometimes go to my workshop and perhaps do some “puttering”.
There are lots more examples of how my hearing loss has dictated my lifestyle, but I’ll only draw attention to one more. Gatherings, such as family celebrations, or trips out to restaurants, do not work for me unless they are small, say six people or less, and the restaurant has to be reasonably quiet as well, something that’s getting harder and harder to find these days. If the gathering is large, or the restaurant is noisy, I “zone out”.
Having detailed this, the question I’m wrestling with is just how much the cochlear implant may change my lifestyle, and hence, my world. Do I even want to change some of these habits? Or, perhaps changing habits will improve my rehabilitation process? Who knows?
The journey continues…to an as yet undefined new world!
February 27, 2013
Ticket for Two
While I’m sure that there are some people who prefer to travel alone, even enjoy doing so, I also believe that there are some journeys that are best when taken with a supportive partner. So, today, Lynn and I went down to visit my CI audiologist, partly to view first-hand all the parts of a cochlear implant, including the implanted electronics, the coil and magnet, and the embedded electrode. And while we were there, we enjoyed a question-and-answer session that filled in most of the gaps in our knowledge.
Lynn was originally educated as a nurse, and now has a Masters of Health Administration, so she has a strong interest in medical affairs, and I wanted her to see and touch the actual implanted parts so that she would have a better understanding of the surgery and the technology. At the same time, we had an opportunity to handle the external processor, the coil, and other associated parts like battery packs. My impression was that Lynn appreciated this, but even more so, she appreciated the chance to ask the audiologist a few questions.
“Why do you wait four to six weeks after the surgery to do the activation?” was her first question. The audiologist replied that the wait was to ensure complete healing from the surgery, and because of the operational requirements of the hearing clinic. Lynn had other questions, including how I will hear in the interim, and about whether my residual hearing in the ear to be implanted will be lost. She also was interested in the risks associated with the surgery, and about the activation appointment, and the frequency of follow-up mapping appointments. All of the questions were answered, with some of the answers leading to re-assurance, and others, principally round the rehabilitation time, and how well I’ll be able to communicate during that time, giving some apprehension.
Oh! I almost forgot: together we decided that I’ll get a black processor, not one of those dull grey or flesh-tone ones!
But back to the bigger picture here: being involved in this way is helping Lynn to feel more comfortable with the cochlear implant decision, and the process. More importantly, this sort of involvement helps her set realistic expectations about the outcome, and helps her understand ways that she can help help me on this journey. And believe me, she does want to be there for me.
And, as far as I’m concerned, this is the sort of journey that will be much more successful with a supportive partner, one who knows beforehand what the journey involves.
February 26, 2013
It’s not about me
As we all know, with any journey, it’s always re-assuring to know that those who have come before are there to help.
Most anyone reading my various posts realizes that I’ve been borrowing almost every idea that’s been presented here. I certainly do not claim to be the authority on CIs, nor have I any experience. My role has been to gather ideas, relate them to my own situation, and try my best to integrate those ideas into a form that not only helps me come to terms with the cochlear implant, but into a form that might help others on the same journey find their individual ways.
Those who have traveled this route before tend to be somewhat evangelical, for want of a better word. Having benefited from the “miracle” of the cochlear implant, they would like to encourage others to seek out the same procedure, and to encourage them in the rehabilitation process. The internet provides the communication medium that brings us all together. There are “forums” sponsored by the major implant manufacturers, where encouragement, support, information, troubleshooting, and anecdotal entries are provided by a host of wonderful people.
Every once in a while, I notice a posting that leads to an “ah ha” moment! The other day, a musician who’s received an implant was mentioning that her speech perception is wonderful, but music is not yet where she’d hoped it would be. In a message exchange, I mentioned to her that a piano player had detailed how she’d forced herself to play chromatic scales until she could distinguish the individual tones, and that she was subsequently able to go on to play again. The response I received really hit home: She noted that the senses work together, and that the pianist was using both her hearing and her hands, and may have also been following sheet music, thus using her eyes. When the senses of hearing, touch, and vision all work together, the brain seems somehow to create its own breakthroughs in perception. In the case of the pianist, the plasticity of the brain was such that she re-learned to distinguish close tones.
The insight of the musician who contacted me, along with the collective wisdom of the many other contributors to the forums has combined to give me not only a better understanding of the concepts and technology behind the cochlear implant, but has also fostered a state of emotional readiness and a positive attitude, both of which I believe are prerequisites for success in this journey.
I only hope that in some way, I am helping others on the journey find their way.
February 24, 2013
Name that Tune!
When I was a kid, listening to teen top 40 radio, the local radio stations would sometimes run a “name it and claim it” contest. They would play a few seconds from a popular song, and the first person to telephone in the correct song title would win a copy of the forty-five!
My problem was that while I could often name the song, I couldn’t hear on the phone to call in the answer! What frustration. The only thing worse was not being able to hear the girls on the phone.
But back to music. I’ve always enjoyed music. My dad was a disk jockey at a local radio station, CJOR, and he often brought home a few surplus records for my collection of ‘Forgettable Faves from the Fifties’. As I grew up (some say not enough!) my tastes in music broadened. I even took a wonderful course in music appreciation at UBC, given by Harry and Frances Adaskin. A great couple, and a great way to learn the intricacies of classical music. However, aside from a few piano lessons as a disinterested kid, I’ve never learned to play an instrument.
Now, I find myself listening to all sorts of music, (but not hip-hop, rap, or heavy metal). I listen using my iPhone coupled to my hearing aids using the Phonak bluetooth streamer, which produces a very satisfying high-fidelity, stereo signal. Over the years, I’ve lost a considerable amount of perception, particularly in the treble ranges, but the brain is remarkable, and I think creates some of the harmonics all on it’s own.
While I recognize that the cochlear implant is primarily designed to process speech, modern devices can sometimes produce surprising results with music. Some musicians are able to go back to playing music, and many who enjoy music find themselves listening again, with varying degrees of satisfaction. I think I mentioned earlier, in the post called Rehab Toolkit, that I was planning to acquire a keyboard, or a keyboard app for an iPad, and practice playing notes until either they sound good, or until I realize that I should just give up, and move on to something else that is a success, and there will be successes to celebrate.
And that brings me to a point that I think is vitally important in this process. Another CI recipient, a musician, in fact, told me that the best way to manage my expectations was to have one set of expectations that represent my ideal outcome, and a second set that represents that with which I can live. Pretty good advice, I’d say, and perhaps those thoughts could form the basis for one of those corny old country and western songs!
And with that, time to relax a bit, maybe put on some Patsy Cline, and just enjoy!
February 21, 2013
YouTubing It
There’s no doubt in my mind that the biggest moment in the entire cochlear implant journey is the moment that your audiologist “activates” the implanted device, and your brain is stimulated with sound. Trying to guess the sensations ahead of time must be the single most dominant thought of those undergoing CI therapy for hearing loss.
No surprise then that YouTube has scads of videos of folks at the moment of activation, or of young toddlers hearing their moms’ voices for the first time. And what a range of reactions there is!
Not surprisingly, most new activees are accompanied by family and close friends, and not surprisingly, many of them break into tears when they hear the voices of those around them. Even some of the accompanying friends and family break into tears at the moment that the subject realizes that he or she can hear again!
But what of the sound? Again, not surprisingly, the results varied widely, with some subjects reporting hearing beeps, echo-like sound, and computer voices. Others could actually distinguish voices, and answer questions, with many of those using lip reading to help. A couple said they noticed some vibration, pain, or dizziness upon activation.
There seems to be a correlation between the recent hearing experience of the subjects and the initial results at activation. In general, those who had been able to process speech with the aid of hearing aids just prior to the surgery were best able to hear speech upon activation, while those whose hearing experience, either because of prolonged deafness, or unsatisfactory hearing-aid use, did not experience the same success initially.
The audiologists at the activations were always careful to point out that the initial hearing experience, just after activation, was not the same as the long-term hearing experience. This is because the human brain is very “plastic”–able to adapt and learn on the go. As the brain become used to the new stimulation provided by the electrodes, it resolves that stimulation into meaning. Some new activation subjects report that all voices sound similar, but after some listening experience, they learn to distinguish between speakers.
So, with still two and a half weeks to go for surgery, and probably four weeks more to activation, I’m just as excited and curious as anyone else about what lies ahead. “Everybody is different” is a standard mantra in this field, and therefore, no one really knows what my outcome will be. However, my wife, after watching the YouTube videos with me, has decided that she’s going to video record my activation moment, and perhaps, we’ll figure out how to post it to YouTube, so the next bunch of folks going for an implant can take a look, and try to satisfy their own curiosities.
Stay tuned, as they say!
February 20, 2013
Milestones
I received a call from the CU surgeon’s office about a week ago to schedule my CT scan. And so, February 15 became another milestone on the CI journey. And I guess as the surgery approaches, I’m getting more excited, as I realized that these events really were milestones.
The first milepost, back on December 19 was the date for the evaluation testing that determined that I qualified to receive the implant. Since then, there have been appointments with the surgeon, trips to the doctor for vaccinations, a trip to the lab for blood testing, and there are more little milestones to come.
On February 12, I had a visit to the audiologist for “baseline” testing, which comprehensively tested my hearing as it is now. This is to provide a basis of comparison which will be used to determine the extent of improvement in my hearing after the CI.
But that’s jumping ahead. The actual surgery is scheduled for March 11, and then the really big milestone: Activation day. Right now, I do not know when that will be, except that it is “four-to-six weeks after surgery”.
Of course, the journey does not end there. From that point, most CI recipients go on to record all sorts of milestones, or as some call them, “Wow Moments”. Some are seemingly insignificant, except to those who’ve had major hearing loss. An acquaintance of mine noticed one day that some noise was at the forefront of her consciousness. It turned out to be an electric wall clock! For a while, she turned the clock off, but now can tune it out, just like everyone else.
Another wow moment for many CI recipients, is realizing that they can pick up the phone and hear the caller clearly. Another milestone that I’m anticipating is being able to hear people who are situated away from me. For example, it will be a real Wow Moment for me if I can, while standing on the sundeck, hear people down in the yard. Or, while I’m in one room of the house, hear someone speaking to me from another room, something I cannot do now.
Another set of milestones will be hearing sounds that mean nothing to me, then discovering what those sounds are. I’ve heard mention of the sound of a cat lapping up water, and one that I thought was quite funny was told to me by a CI recipient who heard a strange sound in her house one night. She could not figure out what it was, but was somewhat worried. She called her daughter over to the house, and together they discovered that it was a hearing aid that had been put away still turned on, and it was making that characteristic whistling noise!
I’m hoping for many of those Wow moments or milestones, and I hope to record them as they happen, and put them down in writing, because in that way, I’ll get to re-live them again when I go back and read the story of my journey, from one life to another.
February 19, 2013
Hold it in your hands
There’s something about the way that using your hands helps you learn. Holding an object, turning it over, feeling its texture, squeezing it, and even brushing it against your face, can give you more information than hours of reading, looking at diagrams, or watching videos. And so it is with the cochlear implant. My audiologist has arranged for my wife and I to go into the clinic to look at and hold an actual cochlear implant, as well as to study a model of a human head that has a CI.
Years ago, I did get my hands on an actual inplant when I was attending a conference on hearing loss, but that was at least 6 or 8 years ago, and now that the CI is much more relevant to me, I’d like to have another look and feel. I know that my wife Lynn, who’s very interested in all things medical, and particularly in cochlear implants (Gee, I wonder why?) will get a lot out of actually holding on to the electrode, the inserted electronics and coil, and checking out the behind-the-ear processor.
I’ve really no idea how many hair cells there are in a typical human cochlea, but my guess is somewhere in the millions. Someone please let me know if I’m way off base here. Today’s CI devices produce remarkable results using somewhere from 16 to 22 electrodes, plus a couple of grounds, and although the results are remarkable and life-changing, I’m not sure that modern technology can ever equal nature’s incredible creations. I think seeing just what is involved, and mentally comparing that to nature’s original design might help both of us to keep those expectations under control.
This upcoming encounter with the implant will represent one more stop on the journey to the surgery, and really, to keep things in perspective, we’re still very close to the start. The major stops on this journey seem to be the approval decision, the surgery, the activation, and then what? Others have told me how they are doing, and I’ve done a lot of reading, but I think that somehow, like holding the implant in your hand, the high points of the upcoming journey, from one life to another, are going to be known only as they are experienced.
So, I guess I better learn to hang on, and enjoy the journey, wherever it may take me!
February 19, 2013
Dancing Gorillas
A day or so ago, the press carried a story about radiologists, during an experiment by a Harvard psychologist, who were able to pick out tiny anomalies in scans of patients’ lungs, but completely missed an implanted image of a dancing gorilla!
As part of the lead up to my CI surgery, I underwent a CT scan of my head last Thursday. And apparently, there were no dancing gorillas in there. A couple of my friends had stated that they’d be surprised if there was anything at all in my head!
However, my wife, who came to the radiology unit with me, was able to sit with the tech and watch the image. The tech pointed out my cochleas and apparently they are in the right place, and formed properly, so there should be no issues that would negatively impact the surgery, which is scheduled for about three weeks from now–Monday, March 11 to be precise. Interestingly, the radiology technician had a friend whose daughter was born deaf, and subsequently received a CI at age one, so she, the tech, was quite interested and informed on the CI process.
These little stops along the way, all seemingly minor, have a way of boosting our spirits as they occur, probably somewhat like the “wow moments” that so many CU recipients report after activation.
And that leads me back to the road map. The next big event, of course, is the surgery, and 4 or 6 weeks after that, the biggie, the activation. I’ve already spent some time with the audiologist discussing the mapping process and timetable, and I gather that the older routine of frequent visits has been supplanted by less frequent visits with more time to allow the brain to adapt to the new stimuli between visits. But the stops on the journey that most interest me are the ones I don’t know! They are the moments of discovery and wonderment at hearing new things and things I haven’t heard for decades, assuming that all goes as I hope. And, I guess that’s the same as for all journeys–we have to learn to keep our hopes high, and our expectations down to earth.
Maybe, sometimes, it’s ok to not know exactly where the journey will take you!
February 15, 2013
Road Map
If you’ve just stumbled upon this blog, you might find it difficult to wade through this seemingly disjointed mass of information.
I confess: I am not good at managing this web page. I just can’t quite figure it out. But, I CAN give you a bit of a road map as to where we’ve been, and where this journey is heading.
Early in January, I realized that my upcoming cochlear implant was going to make a major change in my life, and I wanted to make a record of the process. Doing a blog offered that chance, as well as a chance to keep my friends and family updated on the journey.
The journey started with learning that I’d been accepted for an implant, then progressed to learning how to manage the emotions and expectations around that fact. After that, I detailed how I brought my family in, let them know what this was all about, and probably most importantly, let them know how I felt about the implant.
That led, logically I thought, to a bit on the risks associated with Cochlear Implants, and my reactions to those risks.
The blog then moved on to how my hearing loss had shaped my self-identity and personality, and how I anticipated the changes I would face. And, of course, that led up to my own personal vision of what the outcome state would look like, feel like, and how that would affect my adaptation to the world.
My visit to the surgeon and what transpired during that visit came next. Then I tried to summarize the research I’d done, particularly how I viewed the “success factors”. Crossing the Rubicon was the title of the next edition of the blog, and it dealt with the emotions I felt realizing that there’s no turning back in this process. That led to a piece on dealing with the stress in a humorous way, and that led to a re-iteration of the important reasons for having the implant.
Some time later, I dealt with the reaction I’ve had from a couple of acquaintances who were of the opinion that I should “leave well enough alone!” Well, the way things are now with my hearing is simply not “well enough”. And that brings us pretty close to the now, with a bit about communicating with the audiologist, and the emotional support I’ve received from friends and family.
So, hopefully that makes it a bit easier for any of you to find what you want in the approximately 8500 words below. Next edition, I’ll try to give you a map as to what’s coming up, and yes, I really should learn how to organize this web page!
February 12, 2013
Baseline Test Day
Today, my new audiologist, the woman who will be looking after my processor fitting and mapping, performed a series of “baseline” or pre-tests of my hearing. Because I am one subject in a North American study, a study designed to assess whether those who have previously been turned down for an implant on the basis that they are doing “too well” with hearing aids, might in fact hear better with an implant, the series of tests may not have been typical for those undergoing an implant assessment.
My implant will be done on the right hand side, the ear that hears less well.
The first test was to repeat words using both ears with hearing aids. The test was then repeated, this time using only my right ear with my hearing aid. The next test was listening to sentences with lots of background noise, again with two ears aided, then using the aided right ear only.
This was followed by a test to determine whether I could tell the gender of a speaker in noise, and this was done, as before, with both ears aided, then the right ear only. A further test was designed to reveal how well I could hear vowels. Finally, the audiologist gave me a test which presented me with musical tones, and I was to specify which of the two tones was the higher pitched. And, as before, this was done with both ears, then with the right ear only.
At the end of the testing session, I completed a series of questionnaires on a variety of topics, including hearing situations that are difficult, how my hearing affected my education and my career, the financial aspects of hearing loss, and so on.
I’m pretty sure that I will be undergoing the same testing a few times, at specified intervals, after the implant has been activated. And when I learn the difference that results from the implant, I’ll be sure to post the outcomes for those of you that may be curious.
Those listening tests are a lot of hard work, work which causes the brain to use a lot of oxygen. Trying to do the best possible job of listening is important to ensure that the test results are meaningful, but the work can really raise your temperature!
The day ended on a high note, as I had the opportunity to choose the colour of the processor, battery pack, and coil/magnet assembly–we’re getting closer!
February 11, 2013
Warm and Fuzzy
When people speak to me about my hearing, or about my upcoming cochlear implant, or when they spend some time reading the blog, they find ways to send me wonderful messages of support. Messages that many folks call warm fuzzies.
This was driven home the other day when my wife’s sister commented on my blog, and I realized that my hearing struggles, and my hopes for the CI reached her at the emotional level. And still within my family, my daughter has been listening and reading, and she’s making sure that I’m OK with the whole process, and letting me know that she’s hoping for the best outcome. My son, who lives across the country in Ottawa sent me a message of support, and had some questions. Earlier, I mentioned my wife Lynn, who is very excited about the prospects, and is constantly thinking of ways she will be able to support me during the rehab process, and even in the 4 to 6 week period between implantation and activation. I think it’s fair to say that I might not have pushed so hard for the CI if I had not been so sure of her support.
Lynn’s family of four kids, well, they were kids once, all find time and ways to let me know that they are excited about the possibilities and wishing me a future without the problem of hearing loss. I think each of them would like to be able to communicate with me better than is possible now.
Many close friends and acquaintances, including some who have already received an implant have come forward to offer encouragement, and to voice their opinions about the wisdom of my decision. A former co-worker, now living in Montreal sent a heartfelt message letting me know that she’s thinking about me and hoping for a wonderful outcome.
There have been a couple of folks whom I’ve never met, people interested in the cochlear implant process, that have sent very positive messages about what they’ve been through, and offering me support for my hearing journey. Those messages from strangers are very touching.
And you know, with the risks involved, admittedly small, those words of encouragement mean a lot. Because, the whole idea behind hearing and language is the idea of being connected in meaningful ways to the people in your life, and the people who might someday be in your life. And what all these warm and fuzzy messages really mean is that there already is a meaningful connection, and that each one of those people is hoping that with better hearing, the connections will get better.
And I can’t see any reason why that won’t be the case.
February 9, 2013
Communicating with your Audiologist
My father started his career as an electronics technician and audio engineer in the radio broadcasting industry. As well, he was a Radio Amateur, or Ham Radio hobbyist. Because of this, I grew up in a house full of amplifiers, transmitters, test equipment, speakers, recorders, and so on. I learned the lingo, and the concepts around amplification, gain, frequency response, signal-to-noise ratio, decibels, automatic gain control, compression and dynamic range, etc.
OK, I promise not to use words like that again, if you’ll just keep reading, OK?
But, knowing what all those terms and concepts meant, allowed me to communicate effectively all my life with audiologists as they fitted me with hearing aids and programmed them to give me the best hearing possible. As a result, even though my hearing loss is classified as profound, I’ve been able to enjoy a successful career, bring up children, and I enjoy lots of community activities.
Mapping the processor for a cochlear implant is not the same process as programming a modern digital hearing aid, but I believe the success of the mapping process, and therefore the success of the hearing rehabilitation, depends on just how effectively you can communicate with the audiologist doing the programming. I plan on keeping a journal of my hearing experiences, and then sharing that information with my audiologist, using terms that hopefully will help ensure that the mapping leads to the best possible outcome.
Modern cochlear implant design is focused on maximizing speech understanding, Hearing consonants and suppressing background noise are two keys to success here, so I’ll be paying attention to these as I describe how speech sounds for me. More and more, CI recipients are able to enjoy music again, and here, I plan to play around with tones and listen to music, and let the audiologist know how things sound.
I’m convinced that a good outcome depends on building a good, trusting partnership with the audiologist doing the mapping through effective communication. And communication, as, is the key to success.
February 7, 2013
Rehab Toolbox
Speech rehabilitation programs are provided by the cochlear implant companies, usually programs that run on a personal computer, and consist of structured listening exercises designed to help your brain learn how to extract meaning from the new stimuli provided by the electrode that forms the heart of a CI system. And, I’m looking forward to using the one I’ll be receiving, and prepared, if necessary, to hook the sound output of my laptop up to a small amplifier and a set of decent small speakers.
From what I hear, there’s only so much time you can put into such a program each day before fatigue sets in, so I‘ve picked up a few other ideas. For example, an electronic keyboard application for an iPad. I got this idea from reading about a piano player who, during her rehab, played chromatic scales over and over until they sounded “right”. She was then able to go back to playing the piano and enjoying the melodies.
And, while rummaging around in my night table drawer the other day, I found my old mechanical watch. A 17-jewel wonder, that apparently makes a rapid “tick tick tick” noise as it does a fair job of keeping the time. I want to hear that, so I’m going to have a local shop put a strap on it, and I’ll wear it to my activation visit.
A buddy of mine enjoys watching the birds in his yard, and has an app on his tablet that includes audio clips of the songs of hundreds of different birds. The bird songs are something I can’t hear now, but I remember some from when I was young, and decided I want to have that app available after my implant is activated.
And, down in the basement storeroom, I have cassette tapes of my two children talking as young children. They are talking in high-pitched voices, quickly, and not all that distinctly–perfect for the hearing impaired! I plan on listening to these once I have been activated, and hopefully, with a little practice, I’ll be able to understand what they were saying.
And, does anybody know whether carbonated soft drinks make any noise as they fizz in the glass?
February 5, 2013
Raised Eyebrows?
“Are you sure this is the right thing for you to do?”
That was a reaction I heard a few times when I let people know I was attempting to qualify to receive a cochlear implant. And I understand the reaction. First of all, in many situations, I was able to function fairly well with my hearing aids. People said I was a “poster boy” for the use of FM and Bluetooth to help cope with my hearing loss.
An ENT (Ear, Nose, and Throat) specialist simply told me that I wouldn’t qualify, because I was doing ok with hearing aids.
“It’s all about risk management”, is the way an audiologist put it to me, explaining that with hearing aids, in a sound booth, I was doing better at sentence recognition than some people who had received a CI. So, why take the risk? It was, and is, possible, that my hearing in the implanted ear may actually deteriorate. Obviously, I don’t think it will, and the risk, which I believe is very small, is worth the potential benefit.
In addition to that, I was told that eventually, I would qualify, as my hearing got worse with age. “Be patient.”
So, why wasn’t I just patiently waiting? Well, simply put, I believe that the success of the rehab depends to a large extent, on how well the brain has been able to process speech prior to the implant, and that the implant should occur before the brain loses the ability to process speech.
And so, why do I think this way? Well, for starters, I did exhaustive research, online, speaking with audiologists, and speaking with quite a few people who had received an implant. I found that those who were successfully processing speech just prior to receiving the implant tended to have better outcomes than those who had poor speech-processing or those who had suffered a lengthy delay between hearing loss, and receiving an implant. Not scientific, but convincing enough for me.
Every recipient’s experience and outcome is different. And, I can honestly say that positive outcomes are the norm, with very few disappointed recipients. It is possible, I suppose, that those who are disappointed do not give voice to their experience, choosing to remain silent, but I doubt it, as the internet forums are of the “self-help” variety, and many do ask for assistance with rehabilitation problems. Having said that, most recipients are very happy, or better, with their outcomes. And, for those with whom I spoke in person, without exception, every recipient is doing better than before, and most are overwhelmingly positive.
So, in answer to the question above: “Yes, this is the right time for me to take the plunge.”
February 4, 2013
Groundhog’s been and gone!
And here we are in February. Getting closer to surgery date (March 11) all the time, and today, I saw not one, but two people on television with cochlear implants!
First, Malala Youfsazai, the courageous young woman from Pakistan who was shot by a Taliban gunman for speaking out for women’s and girl’s rights, particularly the right to an education. As part of her recovery from the head injuries she suffered when shot at close range, she has received a cochlear implant, in order that she will again hear in her left ear. The television newscast showed a graphic animation of the cochlear implant components and how they fit into the ear. And what an example of courage and determination!
On the same newscast, a commercial aired for a local television children’s charity campaign, and one of the featured children was a young child wearing a cochlear implant. Of course, she was smiling!
While I would not go so far as to say that CIs have become routine, they have certainly become much more mainstream in the last decade, as the technology has improved, and as more government and private funding agencies realize the benefits that CIs confer. Not only for the individual recipients, but for society as a whole, as people are able to enter or re-enter the labour force, and become contributing members of their communities.
And today, I had lunch with a retired surgeon who pioneered cochlear implants in the Vancouver area, and it was wonderful to hear some of the success stories he related to me as we talked about my upcoming surgery.
And yes, it was certainly an uplifting day, even if our local groundhog forecast six more weeks of winter!
January 31, 2013
What Kind of Journey is it, Anyway?
Over brunch with a friend who received a cochlear implant 18 months ago, I picked up on the fact that this CI recipient no longer views herself as a person with a hearing disability. It was not one thing she said, but rather a bunch of little things which added up.
For example, when I asked about a local support group for those with a CI in Vancouver, she said that there was such a group, but that she’s not interested, because: “Why would I want to sit around and talk about my CI? I’ve got a life to live.” And, she also mentioned that she chooses not to use the assistive listening devices she once did, as she can just turn on the television and watch the news like those with normal hearing. And, besides all that, she’s been able to return to a job which she had to leave because, with her hearing loss, it was simply not possible for her to continue.
In short, it would be fair to say that she’s “moved on” from being a person with a hearing loss, to being a person who lives life just as everybody else does. She can hear people speaking from another room; she can tell when someone is approaching her from behind; she can hear birds outside her window; and she drive and talk to her passengers, without taking her eyes off the road to lipread.
She did mention that the rehab process, was quite a bit of hard work, and that at 18 months after switch-on, she’s still finding things getting better. She still has to focus and concentrate in order to ascertain the source of sounds, and in noisy situations, she uses her phone on telecoil. But she’s able to work at a demanding job involving plenty of telephone conversation, and she can go out with friends to noisy restaurants, and participate in the conversation around the table.
So, although we try to live life by the maxim: “Life is a Journey”, I think it is fair to say that with a successful CI and rehab process, the journey really takes you from one world to another; from the world of coping with hearing loss, to the world of participating like those without hearing loss.
In that sense, the journey has, if not an end, at least a major transit, from one world to another–from a world of diminishing opportunities to a world of endless possibilities.
Try to buy THAT sort of journey from your friendly, local travel agent!
January 26, 2013
Communication and Connectedness
There’s no question that hearing loss can negatively impact the relationships you have with friends, family, and most importantly, your life partner.
There are some things that just aren’t the same if they have to be repeated. The spontaneous spoken words that convey so much meaning and emotion really need to be heard in the moment. And when they are, a sense of intimacy in the relationship is fostered. Just ask my wife, Lynn, how important this is.
She’s very knowledgeable about hearing loss, and knows how hard I work to understand. And she knows that at the end of the day, I’m very tired of listening so hard, and that my hearing aid earmolds are uncomfortable. And yet, there are times when she just wants to talk to me, and she’s faced with the problem of whether to ask me to “do more work” to hear her. I don’t envy her.
Another CI recipient in the Vancouver area told me that she felt that her hearing loss was isolating her from her family, and that it was frustrating them as they tried to communicate with her. Although she did not say it, I felt that the number one motivator for her in the decision to have the implant was the desire to be closer to her family. And now that she’s had a couple of years of rehabilitation, she is delighted with the changes in her family life.
And so it is with me. Lynn is very spontaneous, often speaking to me from behind, or even from another room. And when I tell her that I “missed that”, she’s quite happy to wait until we are in the same room, or face-to-face, but the spontaneity is lost, and with that, some chance to be connected. I’ve no doubt that it takes a very special person to live with a person with hearing loss, and Lynn is that kind of person.
But just as importantly, it is my responsibility to do the best I can to help make the relationship as strong as possible. We do some wonderful things together, Greek Island Cruise, a trip to Egypt, vacations in the BC wine country, and so on. But, none of that can replace the connectedness that comes from good communications. When the opportunity to have the cochlear implant arose, I jumped at it, because just as I do not want to be isolated by hearing loss, I do not want my wife and family to be isolated because of my hearing loss.
And that, to me, is the number one reason to do whatever it takes to get the implant approved, and to make it work.
January 25, 2013
And the real reason is…
You may be wondering, after that last post, if I’m really serious about this cochlear implant. I mean, how can we deal with such a serious subject by talking about weird hairstyles?
So, back to basics. Yesterday, I went with my daughter, Emily, to a busy restaurant on West 4th Avenue in Vancouver’s Kitsilano neighbourhood. A few moments after we were seated, Emily asked me if it was too noisy for me. And, while it was very noisy, I could hear her, probably mostly because I am familiar with her voice and can lip read her very easily. But then, our server came by. She immediately launched into a rapid-fire spiel about the specials of the day. And of course, I didn’t hear a word of it. And so, as usual, Emily repeated what the server said, and I was good to go. This happens all the time.
Or, how about last night’s Board of Directors’ meeting for the Western Institute for the Deaf and Hard of Hearing? I set up my FM microphone by the interpreters’ places, and proceeded to switch back and forth from FM to the microphones in my hearing aids. I have to admit that I “got” most of what was said, but it was a heckuva lot of work.
But wait! There’s more!! I have three grandchildren under the age of 11, and I’d like to hear what they are trying to tell me in their high-pitched, rapid voices, as they look anywhere but at me. It is a major disappointment for me that I have never really been able to have a meaningful conversation with my grandkids.
You want more? How about not hearing the dialogue in movies? Ditto for stage productions? Not hearing the lyrics in songs? Not hearing whispers? Can’t hear other riders when I go for my weekly group bicycle ride? And the list goes on…
I think we can all understand that the examples above show that even with high-end hearing aids and excellent audiologist service, my quality of life is not what it should be.
Now, although there are no guarantees in life, most CI recipients to whom I’ve spoken report significant improvements in their lives. Many report being able to talk on the phone when they could not do this prior to the implant. Many report being able to hear people speaking behind them. Many report being able to carry on conversations in noisy gatherings without using their old FM systems. And the list goes on.
Finally, I’d like to wrap this post up by saying that this goes well, there are some folks who better think twice before they talk about me behind my back!
January 24, 2013
Ministry of Funny Hairdos
Have you ever had the feeling that things are just too much? Too serious, too much pressure, too close to home, or whatever way you want to put it.
My upcoming cochlear implant surgery is that sort of thing. A kind of Rubicon, which once crossed, can never be crossed back. And there’s that element of the unknown…
Making light of serious business has a place, and it’s something I’m good at. And, I believe it’s important to let the pressure out, to find creative ways to relax, in order to maintain your sanity. And so it is with the cochlear implant.
The notion of having a Bionic Ear leads to mental images, and the thought that with this coil and wire arrangement on my head, there are going to be reactions from some folk that might lead to awkward moments, unthinking remarks or other reactions. And so, the notion of disguising the implant came to mind, in a very light-hearted way.
Hairdos! That’s what came to mind. How about the Albert Einstein look? I’m certainly old and grey enough, and I could grow a moustache to complete the look. Then, my wife suggested a more youthful and less serious approach: Ronald Macdonald! Grow my hair longer, use a home perm kit, then the ever-fashionable bright-red hair dye, and voila!
Not to be outdone, the dreadlocks look came to mind. Sort of an elderly Bob Marley, only grey; and still on a musical theme, the early British Rock Star look, a la Keith Richards or Ringo Starr was another idea. My own favourite is the Dame Edna look, but I just know my wife Lynn will ask for a divorce if I go that route. When someone suggested Hagred, from the Harry Potter series, I knew we’d accomplished our goal. I was laughing so hard, all stress was gone, and I had that incredible lightness of being that I hope is a precursor to the sort of feeling I’ll have after I’ve been switched on.
Wow!
January 21, 2013
Crossing the Rubicon
When Julius Caesar crossed the River Rubicon leading his legion from Gaul to Rome, he knew there was no turning back. Once the river was crossed, he had to live with his choice. A military conflict was highly likely, and could lead to his destruction. As it turned out, the ruling powers in Rome fled before his army, and a civil war was averted.
And so it is with a cochlear implant decision. For some, who have no hearing in the ear to be implanted, the choice is clear. What is there to lose?
For others, those with some hearing in the ear, albeit perhaps only with hearing aids, there is a more difficult choice. This is because the implant process can and sometimes does, destroy the residual hearing in the ear. All this for a promise: that the CI implant will lead to better hearing in that ear. And while it usually does, there are some exceptions. Hence, there is the unknown–and the fear.
Just as Caesar could not have been sure of victory in his campaign to take Rome, neither can we be sure that a CI will lead to the victory we seek. So we do our due diligence, talking to our audiologists, our family doctors, our Ear, Nose, and Throat specialists, and those who have already received an implant.
Perhaps we search the internet, logging into forums, medical websites, and the websites of the CI makers. Nowhere will we find that the CI will absolutely make a major improvement in our own hearing. We can learn that most others receive a substantial benefit, but there’s always that gnawing fear that in our own case, there will be disappointment.
For those with this fear, and I too am sometimes in that camp, I think there is comfort in knowing that by choosing a good surgeon and audiologist team, and by going into the process with a positive attitude, there are extremely good odds that the process will greatly improve your hearing. I feel that this process is something I owe myself, and I’m confident going in that I will have a very good outcome.
History records that as Caesar crossed the Rubicon, he uttered the famous phrase: “alea iacta est” (The Die is Cast)! And so it is in my case.
I hope to be saying: Veni, Vidi,Vici: I came, I saw, I conquered! when it is all over. Do any of you know the Latin for “I came, I heard, I conquered”?
January 20, 2013
Technology and Success Factors
Although I mentioned the technology behind the cochlear implant in a previous post, this blog is not about the technology, the programming strategies, nor the relative merits of the different brands of cochlear implants. And for those that are interested, there are many good sites on the internet that have all the technical data about cochlear implants and the different devices produced by the major players in the industry. A simple search on AB, MedEl, and Cochlear will bring up the sites of the manufacturers, and each has a forum where users and candidates can exchange information. There really is no need for me to go into that sort of thing in this blog.
Having said that, I was concerned that I understood the technology, and that I made an informed choice. There are significant differences in the brands, and the implanted components are going to be with you for many years, if not decades. There are significant differences in the electrode arrays that are threaded into the cochlea; the internal electronic devices have differing capabilities; and the external sound processors again differ, not only in aesthetics, but also in electronic capabilities. Future upgradeability is something to consider as well.
The device is only one part of the picture. There is also the surgeon, the audiologist, and perhaps most importantly, the end user. The surgeon and audiologists at St. Paul’s hospital have superb reputations, and I have the utmost confidence that I will get the best care possible. The program under which I will be receiving the implant is sponsored by Cochlear Corporation, and I will be receiving the latest Cochlear device. I have spoken with many people who have received the Cochlear implant, and they are typically extremely satisfied, often breaking into tears as they explain what a difference the device has made in their lives.
Finally, I firmly believe the success of this process is primarily dependent on the attitude and dedication of the recipient. I am sure that when my device is “switched on”, I will find that the sound is not familiar, probably not pleasant, and perhaps not even recognizable. But I’m even more sure that with reasonable expectations, and a fair amount of hard work, I’ll be delighted with the outcome. And in fact, from what I’ve been able to discover, the outcomes for all the brands of implants are essentially the same, and are primarily dependent on the quality of the mapping, which I’ll explain later, the hearing experience of the recipient, and the attitude and perseverance during the rehabilitation process.
And that’s all for this post.
January 17, 2013
My Birthday Today
Time to stop and reflect on the fact that it’s never too late to change direction, learn new things, go to new places, and hear new things!
Out for dinner this evening with my wife and my daughter. Restaurant was quiet, and we had a wonderful talk about the upcoming CI. And once again, I was reminded of just how important it is to prepare those close to you before you have the surgery. All the risks should be out in the open, as well as the work and possible long duration of the rehab process. It was obvious that even though I thought I had gone over the risks and the process carefully with my daughter, that I had missed somethings. She likes to hear things directly from me, rather than to read them on the blog, and I don’t blame her. Face-to-face communication is the only way to go, so our dinner was a great way to put every body on the same page.
Digression: my daughter, who’s knowledge of fine wines would put many sommeliers to shame, ordered a bottle of Bordeaux, Chateau Lilian Ladouys, Vintage 2000 that was exquisite, and our meal, with raw oysters as an appetizer, was very tasty.
During the dinner, my daughter remarked that I had an excellent memory, and I began to think of the sounds that I cannot hear now, but that I can recall from my childhood. Small birds chirping, watches ticking, kettle boiling, and so on. And I’m hoping that will help me learn to hear them again when I’m “switched on” as they say in the CI business.
And then the talk got around to an app for the iPad that simulates a piano keyboard, and whether that might help my implanted side learn to hear music again. After so many years of not hearing properly, it’s natural to be excited about the possibilities, which of course, led me to think that I’m forgetting what the audiologist told me a few weeks ago about managing my expectations. Perhaps keeping it simple is one of the keys to a successful rehabilitation. I’ll have my neighbours, friends, and family sing happy birthday for me one year down the road, and see how it sounds.
And that’s it for 69 years!
Visit to the Surgeon
January 16, 2013
Just back from my first visit with my CI surgeon, and it would be quite an understatement to say that I’m pumped!
A review of the audiological report, followed by what must be the one-millionth otoscope examination of those sadly deficient ears of mine, then a run down of what is involved in the surgery, (the slice, the drill, the insertion) the various risks (no, the metallic taste in the mouth does not automatically lead to a loss in weight), and then it was question time.
And the answers were: Yes, you may lose what residual hearing you have in the ear which will receive the implant; Yes, if a CI is indicated, it’s probably better to get it sooner than later, as your rehabilitation is likely to be better; No, you shouldn’t plan to travel for the first six weeks after the surgery; No, you shouldn’t bang your head on the coffee table during the recovery; Yes, should the implant be affected by an infection, it can be removed and replaced; No, there is no reason why this implant on the right side could negatively impact on the possibility of having one on the left side in the future; and YES! all indications are that the implant will lead to better hearing than I now have!
Forms, forms, and more forms. A CT scan is scheduled. Visit to my General Practitioner for blood tests and a meningitis vaccination.
And, the moment I’ve been waiting for: Your surgery is scheduled for March 11, 2013.
Home, and a glass or two of some really nice wine with my wife to celebrate. Of course, I did not hear the wine being poured into the glass, but that should change, eh?
Wow!
What I’m Hoping For
January 16, 2013
To be just like everyone else on this planet. That’s a bit of a stretch, since one of our world’s most beautiful attributes is that we are all different. To narrow it down, what I want is to be able to hear, as much as possible, like those folks who have “normal” hearing.
In order to do that, I’m going to have to accept a new “bionic ear”, and learn how to process the stimuli that it produces, turning it into the sorts of sounds normal folks experience.
Bionic? What does that mean in the case of a cochlear implant? Do you want the long or short version of how the ear works? I’m going for the short version:
Sound is vibrations, usually in air. The ear turns the vibrations into electrical impulses, by vibrating fluid in the cochlea which in turn moves tiny hair cells. When these hair cells vibrate, they produce small pulses of electrical energy. The electrical impulses are carried through the auditory nerve to the brain, where they are transformed into meaning.
With sensorineural hearing loss, the hair cells become damaged, and do not generate those electrical impulses. A cochlear implant works by implanting a string of small electrodes into the cochlea, putting an electrical device below the skin behind your ear, and “firing” the electrodes in such a way that electrical signals are sent along the auditory nerve.
A sound processing unit, usually mounted behind the ear, receives the sound through one or more microphones, converts it into an electrical signal, and transmits that signal to the electrical device (receiver) implanted below the skin.
And yes, it does look “bionic: with a device held to your skull by a magnet, and connected by a wire to the processor.
But hey! Better to look “bionic” than not to be able to hear!
Change? What are we Talking About?
January 15, 2013
After three editions, you’d think I’d have covered all the preliminaries on my upcoming cochlear implant, right?
Not really. You see, after 60 some odd years of being a hard of hearing person, I think it’s fair to say that my personal identity was that of, well, you know, a hard-of-hearing person. The guy with the hearing aids and associated gadgets. The guy with the weird coping strategies, such as changing the topic all the time, (so I’d know what was being talked about), interrupting during conversations, withdrawing from social gatherings, because it was too hard to hear, being flaked out by 9 o’clock in the evening, because listening was such hard work. And the worst thing? Being the guy who always missed the punch line when a joke was told. And you know, whenever there was some sort of communication breakdown, it was always easy for everyone to blame me, saying things like “I guess you didn’t hear me”. Hey, they meant well!
As a profoundly hard-of-hearing person, I’m accustomed to dealing with hearing aids. I’ve got the best aids for my type of loss, Phonak Naida IX Ultra Powers. And, I have an excellent audiologist, who takes the time to program them correctly. Despite this, I am still plagued by that whistling noise called feedback, even with brand new ear molds. The feedback is the results from using a lot of gain in the hearing aids, necessary because I have such a profound hearing loss. And I get to wear a device called a streamer around my neck, which allows me to use Bluetooth to hear on the iPhone. And, I’ve got an FM, so that I can hear in noisy places, and I’ve got a TV Link, so I can hear the TV without blasting the rest of the neighbourhood.
Quite frankly, I’m tired of all this stuff. I had lunch recently with a cochlear implant recipient, and couldn’t believe he could carry on a conversation perfectly with NO GADGETS!
I fully expect my cochlear implant will lead to a change in my personal identity. I’ll no longer have the same old excuses to be the old me. Just who will I become? Well,I’m hoping that I don’t change much at all. I’d like to be the old me, only able to participate in more of life. Better able to take part in conversations in noisy environments, better able to hear people talking to me without facing me, better able to be part of things like Toastmasters, where listening is every bit as important as speaking. I’d like to be able to go to the movies, to plays, and take questions from the group!
That’s who I want to be, just like everybody else on this planet! The guy who hears all the punch lines.
Getting Everybody on Board
January 13, 2013
And welcome back to the third edition of my cochlear implant blog.
Once the initial shock of learning that I was indeed going to receive a cochlear implant wore off, it was time to let my family and friends know what was coming down the road. Since my wife, Lynn, had been present during the hearing testing session, she had learned much about the implants, the surgery, and the rehabilitation process from the audiologist. she had a fairly good understanding of what a cochlear implant is, how it is implanted, and how it works. She also knew that “switch on date” would not be the same as putting on new glasses and seeing clearly; there was a period of adjustment and rehabilitation that would quite possibly be frustrating.
Next on the list, I let my daughter, Emily, and my son, Michael, know about the implant. I was concerned that they have peace of mind, and to that end, I not only spent some time explaining just what a cochlear implant was, and what it could potentially do for me, but also went over the various risks associated with the process, wanting to let them know that I understood those risks, and was happy to take the risks for the potential benefit.
Whoa! Risks? What risks? Well, yes, there are some risks associated with cochlear implants. In no particular order, they include the risk of infection, including meningitis, the risk associated with general anesthesia, the risk of device failure, and probably the most important: the risk that my hearing would perhaps not be as good after the procedure than it was before.
The risk of a meningitis infection is serious, but fortunately,a vaccination prior to surgery will mitigate much of that risk. There is always a risk associated with anesthesia, but since I have previously been under general anesthetic, this is not a risk about which I’ll worry too much. As for device failure, the various makers of cochlear implants, as well as the American FDA, maintain comprehensive records, and device failures are extremely rare.
It would not be an understatement to say that the risk that worries me the most is the risk that somehow, I will not hear as well after the procedure as I did before. Prior to making the decision to go ahead, I spoke with quite a few people who have received an implant, and I did a large amount of online research. What I found is that almost every person who receives an implant is doing much better than they did prior to receiving the implant, and typically made such statements as; “I would do it again in a heartbeat!”; or “I just couldn’t stop crying when I heard people’s voices.”
I think what this edition is all about is the importance of making sure everybody close to you is “on board” with the decision, and more importantly, that if you are thinking of having an implant, you must know what to expect, and must “buy in” to your own decision.
Why a Cochlear Implant?
January 13, 2014
In the first issue, I told you how excited I was to be scheduled for CI surgery on March 11. Not only excited, but also curious, and yes, a little bit fearful. Of course, something as potentially life-changing as a cochlear implant is bound to bring out those emotions, and learning to live with and even ride herd on those emotions is one of the keys to making this as positive as possible.
“Keep your hopes high, and your expectations reasonable” was how the audiologist at St. Paul’s counseled my wife Lynn as I as she wrapped up the screening testing. That didn’t stop us from jumping for joy when we later heard that I was going to be receiving the implant. So, I’m going into this not thinking I’m going to be able to hear sparrows whispering in the pine trees the same day that they switch on my processor, but rather that like every other person I’ve spoken to who has received an implant, I’ll hear way better than I have for the past 30 or 40 years. And I know it won’t be an instant thing, but rather a process during which my hearing will improve as my experience with this new way of hearing grows.
My history of being able to process speech despite a profound hearing loss is a testament to my brain’s ability to adapt and to “rehab”, something that’s always stood me in good stead. Let me give you an example: in 1992 I think it was, I began wearing a hearing aid in my left ear, the ear that had received no stimulation for approximately 20 years. I remember telling the audiologist that there was no point in fitting an aid to the left ear, because although I could sense noise, nothing sounded like speech or music. It took a while, years actually, but now the left ear is better able to process sound than my so called good ear, the right one.
And that, I think, is why I’m confident I’ll do well with the implant: I can persevere, and my auditory processing centre has proven it can adapt to new stimuli.
From One Life to Another: My Cochlear Implant Diary
January 13, 2013
Good morning World!
This is Rick Waters reporting live from Vancouver, BC, well, at least as live as you can be with a profound hearing loss.
But not for long, I hope, as I’ve been scheduled for a Cochlear Implant surgery on March 11, this year. Excitement? Fear? Curiosity? Just some of the emotions I’m experiencing as I wait for what I expect will be a life-changing experience, not only for me, but for my wife and kids as well.
Hard of hearing since somewhere around two years, not diagnosed until the beginning of second grade, progressively worsening over the years, as exposure to industrial noise in summertime jobs at a pipe factory, sawmill and fish cannery before the era of hearing protection awareness, lead me to where I am now: profoundly hard of hearing in both ears.
Oh, I’m getting by, with Phonak Naida IX Ultra Power BTE hearing aids, but getting by is not doing the trick. So, about three years ago, I discussed this with my audiologist, and eventually was referred to St. Paul’s hospital for a Cochlear Implant evaluation. I did not meet the criteria, as I have excellent coping skills, and was able to piece the sentences together.
“Tried too hard” everybody said.
A year and a half later, I was re-evaluated as part of the intake process for a new clinical study being sponsored by Cochlear Americas, and Lo and Behold: I was accepted as a candidate, so now I’m doing the mental preparation for what I expect will be a brand new life. So, hear we go, on what promises to be a fantastic journey!
Rick Waters 
Good-morning Rick! I have often thought about your courageous decision to choose to have this cochlear implant. Courageous because you can never know the outcome of the procedure until you have actually had it. In part, you are trailblazing for others. I so much appreciate all you have done and are doing for the hard of hearing community. You have touched our family in a profound way with your assistance and generosity. I am grateful for this opportunity to follow your trail to your cochlear implant.
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Rick, I love hearing about your journey and feeling such a close connection to you. We are on the same path. I have a scheduled date for bilateral implantation just 3 weeks ahead of you. I, too am trying to blog about my experiences with a new label (Suzanne’s Amazing Auditory Adventure) on my existing blog (Roots and Wings). I am blessed with a long time marriage of 38 years, and a wine “aficionado” daughter, too, and love to write about all aspects of my life. We are more than just our ears, right? Best of luck in your journey, I will be watching and learning.
~Blessings to you, Suzanne
I am thoroughly enjoying reading your blog. It is giving me a much better understanding of the whole process-including the emotions involved. As your sister-in-law I have seen some of the struggles that you have been through-but usually with a very positive attitude. We are here to help and enjoy your journey .
Love Sandy
What a wonderful day you must have had! Hopefully a precursor to many more.
Lynn
I am already getting “goose bumps’ when I thik about you hearing sounds again and some for the first time. It is quite mind blowing !!!
I am already getting “goose bumps’ when I think about you hearing sounds again and some for the first time. It is quite mind blowing !!!
I have been watching You Tube videos of people at the moment the device is activated. WOW !!!! I am beginning to get a better understanding of the emotions that you must be feeling at this time. We are just so excited for you and Lynn-actually for all of us . We are here for you as you travel this remarkable journey.
Sandy
You are awesome!!
I tuned in today with some trepidation – would things be okay with you? I loved what I read – a very honest description of what you are experiencing – and it is definitely not all a bed of roses. You are a wonderful writer – bringing the whole process to life for me – both the good and the bad. I did love your description of your hamburger and chips for the soul!
You are a very lucky man to have Lynn on board with you. She is such a special woman.
Don’t you worry ….I will buy you some dark chocolate bunnies.
Love Lynn
Hello fellow CI friend. Yippeeeee! Brought tears to my eyes! It sounds just as I had hoped it would for you. Just wait until you realize that toilet paper makes a crinkly sound! Big smile. PS….. I bet your shoes will match again now!
We were afraid to look at your blog today – but then, if you had the courage to go through with the CI, we should have the courage to look! Wonderful news! I’m sure you’ll face some “trials and tribulations” in the days ahead but – you are moving towards a better future. It couldn’t happen to a nicer person – and as not only that, to someone who will continue to advocate for others! Look forward to your follow-on posts. Nan and Wayne
Rick: I can’t tell you how thrilling it has been for me to read your blog over the past few days. I had no idea that these devices can really work that well. I suppose I had some sort of expectation that you would be able to hear a loud but distorted version of the audio signal which you would then have to struggle to learn to decode in a lengthy, laborious, and frustrating journey. Then, once you had generated your new decoding scheme you would be able to “hear” again. I was worried whether, with your new hearing, music would sound beautiful to you.
Man! Your news has shocked and astounded me. It brings tears to my eyes. Imagine Nora Jones! If I am astounded with the result cannot imagine how you feel about it. It must be unbelievable! As they say “down under”….good on yer mate!
By the way, as a celebratory gesture I’ll be asking for a donation from you to the Rob Ford re-election fund.
Regards,
Wayne
HI Rick
Thanks for the kind words on my blog. After reading your blog I have to tell you that it was a major compliment because to me your writing was waaaay better than anything I have written. I am glad you are enjoying mine at any rate and look forward to keeping up with yours as well. Welcome to the CI world and please don’t hesitate to ask me any questions.
Connie
PS I love Vancouver.
I just want to mention I am all new to blogging and definitely liked this blog site. Almost certainly I’m want to bookmark your blog post . You definitely come with fabulous stories. Regards for sharing your web-site.
Rick,
I have been following your comments with great interest since we have similarities with hearing aid experiences. I have been working as counselor with a profound hearing loss by using Exelia SP’s and assistive devices including captioning for TV and phone. I am being implanted tomorrow morning; thank you so much for your insights.
Jeff, I hope that our similar hearing histories are a predictor of a great outcome for you. As I’m sure you are aware, I’d have this implant again in a heartbeat!
I am scheduled for the inplant surgery for two weeks from now. Can’t wait!! Have no expectations it will be a light went on. Ready to work long and hard at it.
Hi Rick,
I enjoyed reading your entire journey during the last 2 days. You are not only hearing well, but also writing very well. I felt that I was connect to you in some magical way. Your journey has inspired me to go ahead with my CI surgery on Dec 4th.
Thanks for sharing,
Hi Rick,
I read your blog and have really enjoyed reading your journey. Your sense of humor really lightens things up. I am scheduled for a CI on March 10th and I need to decide on the CP910 or CP920. I noticed you have the CP920. At the moment I am wearing the Naida 9 Ultra Power hearing aids and it seems like my loss is very similar to yours. I have not used the FM system since I was fitted for the Naida 9 (which is approximately 4 years). Is the FM necessary with the N6? I do not use any accessories. If I am not using the FM or an ipod would the CP920 be sufficient? Are you using a cell phone with your CI and if so what make? Does it work well?
Thanks for your help and for sharing your story.
Hi Joe,
I chose the 910, the one with the accessory socket, just in case I ever wanted to plug an accessory into the device. I used to use two Naida 9 ultra power HAs, and I needed all the assistive device help I could get. I used the iCom and later a ComPilot for the cell phone, and for the TV link. I also used a Smartlink FM at meetings.
Since I received the Nucleus 5, and now the 6, I’ve not used any assistive devices at all. I use an iPhone without the telecoil–just hold the phone up to the processor, watch TV normally now. I miss some dialog on fast-moving comedies, or on shows with accents, such as British mysteries.
The Nucleus devices have been much better for understanding speech than any hearing aid I ever had, just no comparison. Of course, there is no feedback problem, and never any sensation of pain from sound that is too loud.
Now, if I was making the choice, despite the fact that the smaller size of the 920 is attractive, I’d choose the 910, just for the versatility should I ever need it. I use the compact re-chargeable batteries, they last about 17 hours, they’re small and light, and work for me. Your audiologist can tell you approx battery life.
Good luck and please keep in touch–I’d be interested in your experiences.
-Rick
Hi Rick,
I really enjoyed reading your blog. As a Nucleus 5 wearer myself (switched on in 2011 April, http://mybionicear.wordpress.com/2011/04/28/storysofar/), I can acutely feel the ride you went through.
As I was browsing through your (very) articulate blog recently while on travel last week, it brought back memories and made me rethink on my own experience with listening to music.
I use the “every day” mode which does active noise and volume management. This works fine for most situations and I have adjusted well to this sound. I notice that it works quite well in loud settings such as in crowded locations, party halls or just plain outdoor traffic (it does get noisy on Bangalore’s roads). I notice that when sitting in a stationary car if you raise your voice to the point of shouting, ambient noises fade away and roar back after you have finished! But when you turn up the volume to listen to music, loudness management works again, not so endearingly this time. For example, when volumes go up after a period of quietness in the song it sounds great. A couple of seconds later, it sounds soft again. This appears to be an algorithm that kicks in after a threshold of loudness is crossed. My other two programs for noisy environments adapt this behaviour with an element of directionality.
My last visit to the Audiologist six months back gave me a new program dedicated to music. I was told that this mode would be “flat” without any of that suppression that was happening. The most obvious difference is that music doesn’t sound full anymore. It feels robbed of that essential bass and mid range. Voices sound lifeless and some sounds are even inaudible. I adjusted the volume on my device both ways to see if there was a sweet spot, without much success.
I think there is scope for plenty of improvement. Do you have any experiences here? How did you enhance your listening experience?
Thanks
Arvind
Thanks for the thoughtful contribution. I used the “Everyday” program almost all the time with the Nucleus 5, and noted some of the same behaviours that you note. It behaves like “automatic gain control”, or AGC. And it can be annoying. With one set of hearing aids I wore a few years ago, I noticed that when the audience applauded after a performance, the applause would die away each time I clapped, then come back up in volume.
With the Nucleus 6, I use the “Scan” program most of the time, as it really works. I have had the audiologist set up two versions of the Scan program, one has fairly active AGC, the other not so much. When it switches to the music program, the sound becomes more “tinny”, with a lack of bass or fullness apparent, just as you described. I can force the CI to go to other programs, but I don’t bother, because I get all the bass I want from the HA in the other ear.
I have noticed that if I take out the HA, the CI sounds quite thin or lacking in bass, especially at first. If I listen with just the CI for a period of time, this seems to change to a better sound quality, with more bass. It takes a while for my brain to adapt, though.
I’m going to the audiologist for the one-year check and adjustment. Will discuss all of this with her, and see if she has any ideas for a program without AGC, but with a fuller sound than the music program provides.
Thanks Rick. I will also discuss this with my audiologist when I visit him in a couple of months. I didn’t know that the AGC settings were tweakable. I have the same situation as you – with my hearing aids providing the left ear with bass.
When I attend meetings in a largish room with unfamiliar people on a round table I have difficulty in spotting the speaker. When a random person starts speaking I make a surreptitious scan to figure out whose lips are moving!
Another thing worth mentioning is that this has been a real game changer for me at work. I have moved from dreading conference calls over the phone to being able to conduct meetings with diverse english accents.
I jusst found this blog and find it quite interesting from a Canadian to boot. I am in the process in getting an implant but being in Ontario, I am on a waiting list of 18 – 24 months. This is good news. It has taken me 6 years to get this process to accept me. Everytime I have gone in to see if I meet the critira I just keep failing. This last testing got me on the list. I realized that you live next to the facility which makes it easy for you go to back and forth, I live 2 hours away from my facility and was wondering how intense is the first 8 weeks.
Hi Michael. I have to start off by saying that everybody is different, and each CI recipient is on a unique journey, which will be different from all the other CI journeys. (In other words, your results may vary) In my case, I had a fantastic activation, and I could not believe how well I could hear from the moment of switch on. I had anticipated a period of robotic sounds, with cartoonish voices, etc. This did not happen for me, but it is not uncommon.
Because my activation was so successful, the days following were not intense at all, except that I was hearing so many sounds which I did not recognize. Fortunately, my wife, and my daughter were very patient in answering all my questions about what I was hearing, including birds, fans, fridge motors etc. The only way this was intense was that I had to go to the clinic for three straight days while my initial map was adjusted, and then the follow up appointments were spaced out until they ended up being every 6 months, and later, every year.
I do want to encourage you to go through with this, as the vast majority of CI recipients apparently do much better with the implants than they did with hearing aids. Keep in touch, I am at rwmgtc@shaw.ca