I went for my third mapping on Thursday 1st Dec, a week ago.
First, a warning: what you are about to read is quite long and technical, and therefore probably quite dull and uninteresting if you’re not a CI user yourself, or at least profoundly interested in the audiological science surrounding it.
Jacki, my audiologist, turned down the volumes of the higher frequencies, which were a little too sharp for my liking. But she also added in a new programme with the same moderated high frequencies but with a “smoother” sound scale. It seems that my previous map was based purely on what I could tolerate, which resulted in some simple inconsistencies in terms of the sound information the processor was sending to my implanted ear. When I listened to the “piano scale” of my 22 electrodes, two or three of the electrodes were a good bit out of tune. They were adjusted so that the scale is now smoother but still within tolerances. The result was better, although I couldn’t explain exactly why.
However, in the standard baseline speech recognition test that followed, I only got 26pc again – no improvement on my first test three months ago. A bit disappointing, but both Jacki and speech therapist Lesley were reassuringly philosophical. Jacki went as far as to say that if someone had told her a patient was using the phone and listening to audiobooks without too much trouble but only getting 26pc in the test, she wouldn’t believe it, which suggests that the standard speech recognition test they use is a bit one-dimensional. There are no words, just sentences. I do WAY better with context, and through earphones. Also some folk do far less well in these types of tests because they believe that they need to get all the sentences right, not just one or two words. Jacki thinks I exhibit some of the classic signs of that type of ‘test anxiety’.
Lesley ran through some exercises and confirmed that with some context, I score very well, possibly higher than average, but that the next stage is learning to listen to things without context, or open-ended rather than closed ended questions or information. I just need to keep working at it.
She also mentioned that the Beaumont team is working on developing another set of test measures to give a more holistic reflection of progress, such as the way I do with telephones and audiobooks, for instance.
Despite these reassurances and the knowledge that I’m progressing really well on a practical level, does this suggest the quality of what I’m hearing is as good as it could be? I wasn’t 100pc sure about the latest program, so Jacki offered to book me in again to see her a week later – if I wanted to – for a further tune-up.
After this appointment, I decided to try and just use the implant on its own for a while. One CI-using friend did this and swears that she saw her speech recognition improve dramatically after that. Still uses her hearing aid, but prefers implant, as is the case with most implantees.
After a few days of this, the exercise was useful in that it showed up what I’m missing – and which had been ‘masked’ to some extent by what I was hearing through my hearing aid. It was basically not as sharp as I wanted and quiet sounds are not coming through as much as I would have expected. My implanted ear, even though it feels the stronger, more dominant ear in general, still feels like its playing only a supporting role to my HA ear when it comes to speech recognition.
So I went back today to see the ever-patient Jacki, and explained some of this to her. She turned up some of the quiet sounds but also some of the higher sounds (I had used the example of not hearing fans very well, which turn to be in the higher ranges of the sound frequency spectrum). Result: much better again. Sharper, louder, fuller.
On the question of using just the implant alone, Jacki explained that the old school of thought was that you shouldn’t mix CIs and HAs when your CI is first activated until you’ve had a chance to get used to it, but now the school of thought (which Beaumont subscribes to) is to use both from the word go. The logic is essentially that two ears are better than one, and even if the sound information being received seems radically different from one ear to the other, it’s still better to have two ears giving serviceable hearing.
But it also turns out that Jacki is tuning my programs based on me having a hearing aid too. Programs can be tailored for an implant on its own, but if she did this, then it might be too overwhelming if I used the hearing aids as well because the implant output would be more powerful – it would be trying to do the work of two ears in as far as it can. So we’re sticking to the current plan and enabling a set-up that gets the best from both ears – in balance.
(exhales)
Tinny radio rocks!
It’s been just over four months since I was activated, so time for an update.
I knew that my soundscape would change as soon as I got the implant, but even after four months, it’s still changing.
If you’ve read previous blog entries, you’ll remember that I struggled to settle into a program that I liked or that sounded normal enough. Since my third mapping, in December, things had been much better. A few weeks after that, I felt that things, once again, weren’t improving an awful lot, and then it dawned on me that I hadn’t really experimented much with the sensitivity control on my processor. I had been gradually turning up the volume as I got more used to the electrical stimulation, and reached a point a few weeks ago where I think it’s now high enough. Then I started cranking up the sensitivity and – wow – it made another huge difference.
As you might expect, one consequence of cranking up the sensitivity is that various little sounds all around the house have become more prominent and instantly recognisable (as opposed to having to take a second or two to figure out what they were): the clicking of mobile phone keypads or a computer mouse, the soft hums of the gas boiler and the fridge, the rumble of cars’ tyres as they pass our front door etc etc.
I maintain my bicycle well, but it has, all of sudden, developed a cacophony of rattles and creaks that was, at one stage, unnerving to the point where I wondering if I would make it home on a couple of trips. My car, a noisy enough yoke, is the same, all clunks, rattles and whirrs – slightly worrying to my new ears because I’m planning on moving it on. Only my deep, enforced familiarity with the mechanics of this 37 year old car car reassures me it’s working perfectly fine.
But more usefully for me, talking on the phone is now a lot easier, even to the point where I have recently made a few of short, perfunctory calls to people I had never spoken to before and, in a couple of instances, people I didn’t know!
I can hear most of what is said in a short news report on the radio, but it still requires my complete concentration, as opposed to being something in the background you can tune in and out of.
In general, my implanted ear is now even more dominant than before, a sensation that reinforces itself when I hear anything that’s remotely loud, such as the doorbell, which is now identified as a tuneless, low-pitched dong-dong rather than ding-dong.
That’s the downside, in a way — the sound quality isn’t exactly high fidelity. For instance, group conversations in the house with visiting friends or family is a bit like trying to tune into a tinny radio – albeit one that’s turned up very loud. In fact, everything sounds a bit like I’m hearing it through a tinny radio.
But the important thing is that, after just four months, I’m not just hearing everything, but understanding more and more of it every day. I wouldn’t be without it. Tinny radio rocks!