Jumping the banana

8 04 2010

Having been assessed as deaf enough for a cochlear implant, and passing the associated tests, I was wondering how much of an improvement in hearing the implant has given me.  Lots of new high frequency sounds have been popping up whilst low frequency sounds have only just started coming back. It has been exactly two weeks since my cochlear implant has been activated and my world has certainly changed in that short time.

I went for another mapping session to increase the volume and tweak the settings. I can hear music fairly well, rock and piano music sound scratchy with the singer sounding as if he has laryngitis. Not a good sound. However, I discovered that opera sounds good and there is plenty of that on YouTube. I am able to follow a melody and detect when there are words, but not understand them. Japanese music also sounds passable at the moment. I spent a long time on iTunes trying out different styles of music to discover what was pleasant to listen to, as I believe in the power of music to help achieve great things. I have purchased Ravel’s Bolero, Grooploop – Piano (Japanese Animation: Studio Ghibli Soundtrack), John Kaizan Neptune & Také Daké : Asian Roots.

Remember my activation video, two weeks ago, when I couldn’t hear the bells? I can hear those bells now, no problem! I can hear the blackbirds in the trees outside my house. I am now hearing the trains and traffic that have been missing for the past two weeks, as my brain focused on the new high frequency sounds. The tinnitus has largely disappeared in my bionic ear but is still present in my unaided ear (mostly mad musical performances).

Today, I had a hearing test, and I’m jumping bananas. Speech bananas, that is. Whoop!

A speech banana is the shape on the audiogram of all the sounds of speech or phonemes of all the world’s languages. I have never been able to hear most of the speech sounds within the banana, even with hearing aids, so I relied on lipreading and became very good at this.

My new audiogram had my jaw hitting the floor in shock. For once, I was speechless.

***

Blue circles : my left ear as it was up until two weeks ago.
Green circles : bilateral hearing with hearing aids (Note: bilateral scores higher than unilateral)
Red circles : left ear with cochlear implant.
NR : No Response

I have yet to be tested wearing a cochlear implant plus hearing aid together, which will increase my speech comprehension scores.

CUNY test (lipreading with sound) > Nov 2009 : 91%

CUNY test (lipreading with sound) > Apr 2010 : 85%

BKB test (listening only) > Nov 2009 : 24%

BKB test (listening only) > Apr 2010 : 18%

As everyone still sounds like Donald Duck, I was not expecting to do very well in my speech perception tests. With daily practice at listening, these figures will improve. I also have yet to receive a lot more increase in sound stimulation, I’m about half way to my target in this respect. So …. *shrugs*

So why am I showing good results in the hearing test, yet a poor performance in speech perception? And how do these results translate to the real world? A hearing test is always carried out in a soundproof room. A hearing test is performed using pure tones, but speech is made up of complex sounds. Add background sounds in the real world, and speech perception becomes even more difficult. Add the cocktail party effect, and it’s not easy to manage in noisy environments with a hearing loss, as you then lose the ability to discern speech in noise. Such measurements however do offer audiologists a way of measuring progress. I now have a baseline to start from (BKB 18%, CUNY 85%) and can monitor my progress against my new figures. Later on, I also expect to be tested in noise. In the real world, Advanced Bionic’s new ClearVoice software is going to help me with the cocktail party effect, and I expect to get this next month.

Donald Duck aside, it is going to take some time for my brain to decode the new stimulation, especially in the high frequencies where I had no sensation before.  An analogy would be (re)learning the roman alphabet, only to have written French instead of English on the page. According to my audiologist, the best strategy to manage this is to practice daily listening to an audio book and follow the unabridged text at the same time. I have collated several links for such rehabilitation work on my cochlear implant rehabilitation page. My audie says, the more work I do, the more new pathways my brain will create, and the better my brain will become at deciphering the strange new sounds. For someone who was born deaf, like me, this process can take up to two years. I need to remember three key things – patience, persistence and practice. It really has helped to have a mentor throughout the whole process to ask questions of, to give you encouragement at every stage of your cochlear implant journey. You can find a UK mentor here and a US mentor here.

My world is opening up and all the colour is flooding in – at last!

(I still can’t get over that darn audiogram!)

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29 responses

8 04 2010
Paul

Good show, Tina, and after just 2 weeks. My hat is off to you (mostly because wearing a hat has become difficult with the Ci headpiece!).
An visual analogy for the speech comprehension in comparison to the tone test. Eye exams (using Snelling charts) measures visual acuity (sharpness). While this test does a good vetting out of visual focusing it doesn’t measure your ability to sense contrast or changing scenery. Remember the old subliminal message testing for films where a totally different picture is inserted for a couple of frames? Most people never catch the “new” pictures yet their vision is 20/20. But I digress! Your chart looks like mine back when I had the stapes replaced in 1966. Fantastic!

8 04 2010
Liz

I think its great when you have a mentor at th side of you. And you’re doing so well. 🙂

8 04 2010
Ruth Campbell

Yes, the audiogram looks wick*d! It’s better than mine!

I’m sure speech perception will follow – and the audiobook with text (and, I guess, TV with subtitles AND sound) looks like a good strategy to ‘train the ear’. From what I can find in the recent scientific literature (refs to follow, if wanted), your lipreading skills will be retained (rather than wither away), and so, too the influence of vision on your speech hearing. This could be another useful skill – especially in noisy, cocktail-party settings, and in ‘ear training’ for different people’s voices.

It does look as if CI ‘resets’ the brain’s sensitivity in its ‘auditory’ and ‘visual’ regions – even when not listening or looking *. All that hard work is leaving its trace on your wiring. No wonder it feels so tiring.

Cheers
Ruth

* http://www.ncbi.nlm.nih.gov/pubmed/19805418

8 04 2010
funnyoldlife

Hi Ruth, Please do send me any refs – much appreciated! I like to learn as much as possible.

I followed the link you posted and came across the McGurk effect – it’s interesting to note that “CI users maintain a high level of speechreading, even after several years of recovery of auditory speech comprehension. Altogether, our results suggest a cross-modal reorganization of speech comprehension in cochlear-implanted patients that might recruit more strongly than in normal hearing subjects the visual and visuo-auditory brain areas involved in speechreading.”

http://www.ncbi.nlm.nih.gov/pubmed/18062941

8 04 2010
Nanna

Three month post activation. Talk about being tested in Real Time.

Went to a lecture tonight! Sounds like a plain everyday kind of thing to do, right? Wrong! I know a lot about the subject, which is literature in the medieval town where I live. The professor was incredibly interested in the subject and her lecture interesting – I think.

For the duration, I had sworn to all available gods that I wouldn’t leave, I heard, “And…ah…well, [noise] Wittenberg, [five word sentence unconnected to the preceding sentence which I hadn’t discerned], allegory, cathedral, history…and…ah…well, [an eight word sentence that hung together and made total sense] followed by pure noise and several very long and fancy words, each of which I understood, but would have enjoyed more had they not been completely out of context.

All in all an interesting experience…

8 04 2010
funnyoldlife

Exactly what I was thinking, Nanna. It’s going to be Hard Work! Well done you, for giving it a good go. When’s the next lecture? 😉

8 04 2010
Nanna

The next lecture? Weeellllll

I am pleased that I understood so much without lip reading…but this experience tells me that I must prepare better and ahead of time if I am going to attend a lecture without a writing interpreter.

Reading up on the very specific subject would have been the smart thing to do – instead I relied on my memory…

9 04 2010
cyborginafield

Hey, I am amazed at your audiogram, that really is incredible!!

You should check out this music- Bach unaccompanied cello suites: performed on a double bass- Edger Meyer. Its very low but beautiful.
Have you heard of “Dead Man” its a film, musical with speaking in between, but only a few actors(Iggy pop). Neil young does the soundtrack. Its fab.

Have fun x

11 04 2010
funnyoldlife

Hey Soozie, I am not really able to follow low frequency sound at the moment as my brain is still too excited about the new high frequency sounds coming in, and is still overwhelmed with them. The lows are starting to come back, I have been hearing the train, bus and tube for the last 3 days, so I will try the music when it comes back a bit more. Thanks!

10 04 2010
Howard Samuels

Tina, that’s just smashing! I’m chuffed!

OK, so the first promise I made you a couple of months ago has come true – you have plenty of sound, you just have to make sense of it. It’s great to see how dedicated you are in your rehabilitation. But darn it, just let go some time, and go about your day. Sooner or later you will be posting WOW moments. They just happen. Then they happen more frequently. And after a while, they happen enough that you won’t even consider them WOW moments. Maybe wow moments for a while. But it really, really, does keep getting better.

Nanna, did the lecture involve a large, echoey room? Even without background noise, that has its own special challenges. The echoes, for one, and the time delay between the visuals (either direct view of the person, or a screen projection) and the sound.

10 04 2010
Jeremy Freeman

Fascinating, amazing, incredible reading.

Very inspiring. You should consider yourself as a mentor for others considering a CI.

10 04 2010
Dan Schwartz

Tina is on track to be in the second group of BEA-UK Mentors!

10 04 2010
Nanna

Yes, Howard. The room was too large and had too muh echo. I thought I would be able to manage if I sat up front where I could lip read. So went my thinking.

It was a good experience, though. I just have to be better prepared.

We just have to barge ahead and not worry that sound will keep hiding from us -it won’t – and with a lot of patience and willpower we’ll catch up to sound…

10 04 2010
Paul

Tina — your last audiogram (blue circles) looks almost identical as mine just before implant. I’ll get my first post-implant hearing test at the next mapping on 4/19. Now I’m curious how mine will compare. They checked for any residual hearing at the last mapping and there is none. Maybe that’s why it gets soooo quiet when I take the Ci off. For once, silence is bliss. 🙂

Nanna — that’s exactly why I had stopped going to meetings and most group functions (pre-implant)…I’d hear some words clearly but key words seemed to always fudge over and nothing made any sense. By the time I pieced enough together to figure out what the subject was they changed subjects! Very frustrating and absolutely no fun at all. It was all work! I’ve gone to church since activation but not to any meetings in big rooms/halls. Comprehension is getting better, slowly but surely (Shirley?).

11 04 2010
Bluesky

Tina, would you have still gone for an CI if you were completely bald??? for the whole world to look at?

Im thinking it’s okay for you woman with means to cover the ugly thing up. Men with a complex about hearing aids would scream at the site of a CI on the back of their heads.

Women cyborgs rule. LOL

11 04 2010
funnyoldlife

Yes I would still have gone for CI if I was bald. I actually like the look of mine and change the colours. I was showing it off to all my friends at City Lit’s Deaf Day yesterday, hadn’t seen a lot of them for ages, and they were all interested and wanted to know more about it. I’m happy to sit there on the train and tube, take off my CI and switch out the microphones in front of everyone so I can listen to my iPod, I don’t care if everyone knows I am wearing a CI and nobody has stared. I’m so happy to be able to hear that I’d wear rabbit ears or whatever.

I have a friend who is bald and I think he looks very sexy with his CI. But then, a good attitude is attractive as well and he’s got bagfulls of that. Some friends have very short hair and you can clearly see their CI(s) and they look just fine. Why do you think it’s ugly? I reckon most people wouldn’t know what a CI is if they saw one, it looks like a futuristic bluetooth device, not a beige hearing aid which screams ‘old’ and ‘deaf’ and all the associated messages and reactions. I’m amazed at the technology, I’m a bit of a geek anyway, and I’m proud to be a cyborg. I am really rebelling against putting my hearing aid back in my other ear and am putting that off as long as possible. Basically because I know it’s a step back to crappy hearing. And if I was bald, I wouldn’t wear a hearing aid. But I would wear my CI. In fact, I want another one. *grins*

11 04 2010
Bluesky

Hi Tina,

I think they look ugly, because of the magnet thing that is stuck on the back of the head. It screams Weird,..Odd and Freak to me at least anyway. Also as deafness carries a huge stigma, some people like myself absolutely loathe all the labels that come with it.

It’s a harder cross for me to bear in particular, as I used to hear fantastically well, before menieres came along and took most of my hearing away from me. And the business..the money..the confidence..all gone.

I would now be far happier if I was turned into fertiliser instead. LOL

11 04 2010
funnyoldlife

Hiya,
I have friends who get people asking them about their CIs, and most of them don’t know what they are – reactions have been positive. Only you will know that it’s a magnet. And when wearing a CI, you’ll be a hearing person, not a deaf one. I don’t like the labels either but I don’t see a CI as branding me deaf. I’ve long ago reached the stage where I say “I’m deaf. Deal with it.” if someone’s got a problem with it.

If you were hearing, would you wear a bluetooth phone device, you know those new things that stick out of your ear? I view the CI as being like that, and the ultimate gadget.

Someone with 2 CIs told this story (I loved this one). Her butcher was standing behind her in line at the grocery store. She had her hair pulled back and she noticed he was looking at her processors – he was kind of leaning from one side to the other to get a view of each. She told him she had cochlear implants, artifical hearing and his comment was, he had wondered what kind of phones she had on and the big question was why she would need two.

I think part of the hearing journey is acceptance of hearing loss. It only took me 20 years, mostly due to other people’s attitudes. It must be so much harder for people like you, who are deafened and can appreciate what you have lost. In the last 6 years, I have developed coping strategies such as learning BSL, meeting other deaf people and building up a supportive network, having support put in place at work, so I felt very comfortable being completely deaf between my CI operation and activation (not wearing my hearing aid), also when I wanted a break from hearing aids. I think this has really helped me to deal with the fallout of the communication cycle breakdown.

12 04 2010
Howard Samuels

You know, for a few years after my first implant, I rarely saw another person with one. And I don’t see my own headpieces in the mirror. Then one day I went to a meeting for CI users to listen to music. It was slightly jarring to see those magnets on other people’s heads, even though I had a pair of my own. That passed quickly, and I’ve always been proud of my implants.

In fact, shortly after I was first activated, my brother came to visit and see how I was doing. I had put one of my boys’ magnet toys with blinky LEDs on the headpiece. My brother was smiling with his mouth, and not his eyes, congratulating me on being able to hear again. He kept trying to slip over to my side and look at the blinky lights. I was doing my best to keep a straight face.

Finally he told me that he had seen one other guy with an implant, and it looked, um, different than mine. I lost it at that point and took off the lights.

Still, I wear my hair reasonably short, and my headpieces are clearly visible. And I know a guy who shaves his head for the Borg effect. I know it is something to get used to, but the balance on one side is an occasional stare (which you can use to start a conversation, getting a lot of ‘That’s amazing’ comments) versus not hearing. It’s a no-brainer for me. If I were concerned about the aesthetics, I’d probably take up wearing a hat. Make a fashion statement, why not?

12 04 2010
deaflinguist

LOL Howard! I’ll have to try that one out!

I know what you mean Tina: I’ve been ‘I’m deaf: deal with it’ as long as I can remember, and I would quite happily shave my hair off and make a statement about it except it might be a bit cold in winter . . . It wouldn’t surprise anyone if I did! I was quite attracted to a white one at first but white does have a nasty habit of discolouring, going by what white TVs do, so instead I’m going to order some funky covers.

I sent an e-mail to a friend at work on activation day explaining what I’d got already. He forwarded it on to the entire office and apparently there was a huge CHEER which suddenly went up.

12 04 2010
Nanna

What happened psychologically when I lost all my hearing three years ago was so jarring and so scary that I almost couldn’t bear it. I had been HOH for some years before that, but I had more than enough hearing to support lip reading and thus, I was able to communicate – be a part of life.

Suddenly, I am living inside total silence. Lip reading was extremely difficult, and I am a real pro at lip reading. People lost patience with me. I stopped communicating and instead worked my fingers to the bone in my home office, all in an effort to stay afloat emotionally.

The CI is the next best thing to sliced bread. Does it look weird, ‘Hell yes!’ Do I care? No!

And Tina, next time I chat with you on Skype, I’ll take out the copyright to my funny lines… :-O

12 04 2010
Bluesky

Hi Tina and others.

Good to hear your input, thanks.

I’ll keep reading your blog and marvel at all the new sounds you can hear. It would real funny if you could hear what your next door neighbour gets up to during the night. LOL ( Sorry, couldn’t resist : )) )

12 04 2010
funnyoldlife

Neighbours? Oh that would be the foxes rooting around in the garage 🙂

15 04 2010
Dale

Hey Tina this is absolutely fantastic! I’m really happy that you’ve found access to this other dimension the world has to offer!!!

25 04 2010
funnyoldlife

Thanks Dale. Is a CI something you’d consider? It’s a whole new bag of tricks to learn but should be worth it in the end.

17 04 2010
Ian

Interesting, very interesting comments here. You know, I commented privately to you Tina but will repeat it here: I think women are much better at dealing with this aspect of life. In some ways I can relate to Bluesky, my initial (and I do mean ‘initial’) impressions are much the same regarding a CI. But like Blue I had normal hearing until my mid teens and a whole lot of family issues didn’t help but dealing with this has been difficult in the extreme. I realise that this is slightly off thread but I value the comments from all.

At work, I recently made use of a notetaker for a presentation. I was sat up front, with a reserved place a large screen and somebody to type in the speech. There is no way I could have followed the variety of new speakers si it was very useful. The speakers were supportive and I did say to them I got a lot out of it that would not have happened without the support worker. What bothers me is that I felt ‘odd’ in that I was sticking out. However, it was an occasion to signal to my workmates that I do have problem and this is how it can be solved. However, In general day to day work I am at a real loss. In a typical meeting I may as well not be there! But unlike Tina I do not get things sorted out so I can take part.

But to get back to the point, it is great that you have such a good audio response! Keep up the good progress and good luck.

25 04 2010
funnyoldlife

Ian, it’s time for you to kick some butt!

18 04 2010
Bluesky

Yes Ian, Women have it easier cyborg wise. LOL Also, careerwise I think. Not so bad if you are a live at home mum either…takes the pressure off communication issues at work.

I work in the construction industry and I think it’s the worst place to be in if you’re deaf. Nevermind having a CI..the hard hat would probably move the magnet. LOL

25 04 2010
funnyoldlife

Bluesky, I make sure my life is as easy for me as I can make it. I wouldn’t agree with a stay at home mum being easier – I really can’t lipread kids as they don’t speak clearly and are all over the place, whereas I can ask my colleagues to slow down, speak clearly etc and they can comply.

I don’t know about CIs and hard hats … any readers out there care to give their expert opinion on this?

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