4 year bilateral cochlear implant review

I’ve just had my 4 year review of my cochlear implant hearing. My hearing is a straight -20db after turning down the volume a little, and it feels natural now to have such super hearing.

I work from home a lot these days; I can hear the neighbours on one side when they argue and the neighbour’s TV on the other side. Hearing well is not always a good thing! My new hearing dog Bailey has a very loud bark so all in all, it can get very noisy sometimes! This “overload” of sounds has been the hardest thing to get used to and I do like to take the processors off occasionally so I can get some peace!

I pick up the phone now and again when it’s an emergency or I’ve had to make a call and there isn’t a hearing person around to ask. Using the telephone takes a lot of confidence and interestingly the most difficult ones are where I had to phone people in Southern Ireland and struggled with the accents (I’m Northern Irish so didn’t expect this!), the easiest ones are where I listened to a digital voice and had to take down a pin number (and got it right! Wowser!).

Red: My hearing in 2016 with bilateral cochlear implants

Blue: My hearing in 2010, before receiving cochlear implants

 

 

CUNY lipreading test – 24 sentences of varying length and complexity presented in auditory and visual condition – lipreading with sound

BKB sentence test – 32 short sentences of simple syntactic structure presented in auditory alone condition

 

I’ve been able to converse with a relative stranger when she was talking to me from the next room, because her voice was loud and clear enough for me to follow, and she wasn’t speaking too fast. I take great pleasure in understanding public announcements on the London underground, on trains, and in train stations.

The most surprising sound was water dripping from the ceiling to the kitchen floor when the builder forgot to secure the radiator flow upstairs – I was in the lounge! I was able to react immediately and run upstairs to alert the builder.

Another sound was (hearing this from the lounge again) water dripping from the kitchen sink into a bucket below, inside a cupboard. It sounded like a double popping sound. Investigating this, I watched – the first pop was the water drop hitting the surface of the water, the second pop was the water bubble bursting. Awesome!

Being able to hear sounds well has made me much more relaxed about communication, and I now understand why hearing people don’t really comprehend the complexities of deafness. When you can hear well, it is so effortless and easy, it’s like breathing. Many hearing people don’t understand that hearing well is not just about volume. It’s about clarity, understanding, processing the sounds that you hear and knowing what a sound is, being able to translate heard sounds into speech and making sense of them.

The most frustrating thing is I still need communication support as many speak quickly and mumble, many environments are too noisy and have poor acoustics, and I am just not used to processing sounds into speech. I will always be deaf. But hey, that’s okay.

Some people speak too fast for me to listen to them and decipher what they’ve said, or they are simply too far away – lipreading is often a much easier tool for me to use. I had some people visit recently to give me quotes for roof repairs, and they all had (hilarious) cockney accents. Listening and lipreading, I had the pleasure of understanding every word they said and trying to keep a straight face at how they spoke. Recently I’ve travelled to the Midlands and the north of England, Paris, Gibraltar, Granada, Barcelona, Budapest, and Qatar – I have enjoyed experiencing and listening to all these accents and easily understood everyone I spoke to, without worrying about whether I would be able to or not. Communication is now enjoyable, and that has been a truly amazing gift.

2 year bilateral cochlear implant review

So I’ve been bilateral for two years. Two amazing years.

Life has taken over and I’ve been so busy that I haven’t made much time for focused rehabilitation exercises. I asked for my Advanced Bionics processors’ programming to be adjusted to include Clearvoice High with threshold levels reduced to zero, to improve sound in background noise. I asked for T-coil so I can use this with an FM system, the Phonak Roger pen system which I’m really looking forward to using in meetings. The sound field audiometry testing produced threshold responses at 10-20 dBhl, so I have excellent access to the full range of speech frequency sounds at normal conversation levels (and I can hear my neighbours next door cleaning, tidying up, talking, and their TV!). My next review is in 2 years time. I’ve been instructed to replace my T-mics every 3-6 months and the headpiece every year. Below is a comparison of my hearing before I got my cochlear implants (in blue, without hearing aids) and my hearing as it is now, with 2 cochlear implants (in red).

How have my speech perception skills changed over the last 2 years? I was tested with the sequential right-sided implant only, and I was really quite tired on the day so I probably could have done a bit better.

• CUNY lipreading test – 24 sentences of varying length and complexity presented in auditory and visual condition – lipreading with sound
• BKB sentence test – 32 short sentences of simple syntactic structure presented in auditory alone condition
• AB word test – 30 single words of one syllable presented in auditory alone condition and scored phonemically

I am continuing to make good progress with the second implant. The BKB sentence score when using both left and right implant is 87%, comparable to one year ago. I am very happy with both implants and prefer to wear them both at the same time. It is lovely though to have an “off” switch and relax at the weekends or after a long day.

I am still using realtime captions in meetings with my little mini iPad – it’s on 4G so I can get captions anywhere I go. I love it. (You can get this remote speech-to-text service from 121 Captions) I have tried some small meetings of up to about 4 people, and can manage without captions, but it is quite tiring – and the speed at which people talk!!!!!! OMGosh!!

My tinnitus is much better than it was before implantation, and it is quite different now. It has changed from musical hallucinations and a never-ending loud barrage of random sounds to a quiet motor hum, which gets louder when I am tired, and even disappears occasionally. With my cochlear implants on, I usually don’t notice the hum. I have purchased a travel sleep sound therapy system and pillow speakers from the British Tinnitus Association. The idea is that rather than putting up with loud tinnitus, I have a short nap with my cochlear implants on, and listen to soothing sounds to reduce the tinnitus. I’ll review this sound system soon. Here’s a useful  visual guide to tinnitus.

I continue to be amazed by what I can now hear. I can tell when it is raining, when I am sitting at my desk with the window closed. No need to stick my hand out of the window any more. I can hear the photocopier running, two rooms along. I can use the phone, calling automated systems and listening to digital voices, but strangers speak so fast that they need to be asked to slow down. The phone is still a tricky one and a lot depends on my confidence rather than my ability to hear and understand. I can hear my pesky neighbours NO PROBLEM lol. I can hear the wind outside during the recent bad weather spells.  The waves on a beach are so loud, they still shock me. I can hear traffic a few streets away, so sitting in the garden is not as quiet as it would be for a hearing person, as I am so sensitive to sound. I can hear plants growing (just kidding on that one!). I could hear the change in my dog’s breathing when he became ill. I can hear food cooking and burning, which helps my cooking skills 🙂

I am still working out some sounds, I think I have pigeons or something weird on top of my chimney – no idea what that sound is! The heating system frightened me with loud thumps until I reset it (and figured out what it was, once I had calmed down). I enjoyed running the London Marathon with my iPod and listening to crystal clear music, and chatting to strangers in the cheering crowds. I’ve been to rock concerts and really enjoyed them. Everything is still quite overwhelming but the sharp edge has come off and 99% of sounds are now bearable. I still don’t like screaming babies….uggg. Interestingly, nothing is too loud, nothing hurts and makes me cringe from the volume like the hearing aids did. The loudest sound I have heard is a thunderstorm in Gibraltar, which scared the **** out of me and I hid under the table – just like my dad used to do. I have learned that you don’t actually have to *like* a sound, and you can love a sound too. My favourite sound is the rain, it’s like a sprinkling of musical tinkles.

I use the following resources for rehab, as well as unabridged audio books. My favourites are apps targeted at non-native English speakers, which I use on my iPad or laptop. These have British accents and have very clear speakers.

• British Council – Learn English
• Smooth Radio
• BBC World Service – 6 minute English
• BBC World Service – The English we speak
• Listen to English – learn English!
• LACE
• Auditory Verbal Therapy
  • Elementary Task Listening: Student’s Book / Teacher’s Book / Audio CD – or try Barnes & Noble

The overall effect of being able to hear well is being much more relaxed about communication and meeting strangers. I can lipread and listen, and communicate with strangers very well. I have attended events and found some people very difficult to lipread, and was forced to listen to them, and surprised myself by how much I can understand. The problem I have seems to be with distance from the speaker – the further away they get, the more difficult they are to hear. I am not permanently exhausted as I used to be, and I really value my mental and physical health.  My other half is a hearing person, he doesn’t care that I have cochlear implants at all – which is a double edged sword. He’s a surgeon so he is used to all this medical mucking around. Before you ask – no, he’s not a cochlear implant surgeon – damn, I missed out on a freebie upgrade in the future! He is only too happy to use text messaging instead of the phone, he doesn’t look at me when he’s talking, and he likes to whisper sweet nothings into my ear – and in Arabic as well! (ohhhhhhh the rehab! LOL) So I have some work ahead to improve my listening skills, to keep my auditory attention “on” and try not to lipread so much. Isn’t it difficult to stop a habit, when lipreading is like breathing? It’s good to keep the challenges coming and to keep trying.

Reach for the stars, and you just might catch one.

– FYI my neighbours have just started drilling holes somewhere in their house. The CIs come off NOW! 😉

Happy New Year everyone xx

Green-yellow cheep cheeps

Last night, as I walked along the bank of trees on the green next to my home, the sun was shining and I could see the Shard glinting over the rooftops. My dog was having fun chasing his ball. Green-yellow birds swooped in and out of the trees. I could hear a cacophony of birds chirping to each other, it was surprisingly loud but nice to listen to.

Do you know what it’s like to not hear the birds properly? Here’s a demonstration of hearing birdsong with a moderate hearing loss.  With a profound loss … *shrugs* – but with bionic hearing, the birds are crystal clear.

As I walked along the bank of trees, I realised the sound of screaming chirping birds was noticeably louder on my right (where the trees were). I turned around to experience the binaural effect. I continued to walk and I listened to the chirping get louder in my right ear. I followed the sound until it got softer, then turned around and moved until the sound was equally loud in both ears, and stopped. I was looking directly at one tree and searched for the screaming rogues in its branches. I spotted a congregation of birds in that tree top. Bingo!

I walked away smiling at the wonder of it all.

It’s amazing what you can hear with binaural bionic hearing. However! Having been born deaf, I don’t have a vocabulary of sounds in my head. I could see the birds but have no idea what they are, so I couldn’t name the bird breed and the corresponding sound just meant ‘cheep’ or ‘sqawk’ to me.  You can check the RSPB bird identifier and then click on the bird to play its sound. It turned out my birds were a charm of greenfinches.

Bilateral cochlear implant language development

This is a fascinating look at Lily’s language development from 9 months (pre-implants) to 48 months in a series of videos. Lily received bilateral cochlear implants at 10 months.

Lily at 9 months:

Lily at 12 months:

Lily at 15 months:

Lily at 18 months:

Lily at 21 months:

Lily at 24 months:

Lily at 30 months:

Lily at 36 months, receptive language test:

Lily at 42 months, language test:

Lily at 42 months, sounds:

Lily at 48 months, language test:

Lily’s mom says –

They show how language develops, the amount of language (most of it strategic) we put into Lily’s daily routines and how with the right supports CI kids can communicate remarkably well at a very young age. I think the videos could also give a lot of hope to parents when they first received a diagnosis.

Certainly it helps that Lily was bilaterally implanted at 10 months, that we have great audiological and speech/language/listening resources, that we chose AB and that Lily’s Dad and I are a little language and listening obsessed (especially in the early days – 30,000 words at a minimum).

These videos are from a longitudinal study in the Language Development Lab at Boystown National Research Hospital, directed by Mary Pat Moeller, Ph.D.

Please leave comments on the original post – I’m sure Lily’s mom will appreciate them! The original post has audiology reports and write-ups to add to the story. These videos may get captioned at some point, so check back. Aren’t these videos a treasure, and an incredible memento for Lily in the future.

1 + 1 = 3

Imagine you were born with no legs. Years later, you are given an artificial leg. It works perfectly, but you have to learn how to walk with it. When you’ve never had a leg before, you’ll struggle to learn how to walk. You have  spent a year learning how to walk with the first leg. It’s not perfect – but with a crutch, it is so much better than having no legs at all. Then you’re given a second leg. The first leg helps the second leg to learn the movements necessary for walking, so the newer leg learns at a much faster rate and helps to improve the ability of the first. Each leg helps each other. The combined input of two legs is greater than one leg alone. Two legs are much easier to walk with, requiring less effort and being less tiring than managing on just one leg.

So it is with bilateral cochlear implants.

My ability to understand speech has changed significantly in the four weeks since activation of my sequential cochlear implant. It’s been a very different experience from my first cochlear implant, with a very different outcome.

Within two weeks, voices shifted to a lower tone and Donald Duck left the house very quickly. He took eight months to leave last year! I reached full volume after three weeks. My tinnitus has disappeared from my newly implanted ear, buzzing in my first implanted ear only when I’m tired. I can detect environmental sounds but not always recognise them …. yesterday, I got confused between a crow and a reversing truck! I’ve been so busy since activation that I have not done very much specific rehabilitation work.

+ Summative effect

The learning curve of the sequential cochlear implant has been much quicker than the first, as my brain already knows cochlear implant sound. The older cochlear implant is helping the newer implant as it learns, and the newer implant is helping the older implant by giving it a boost with more sound. The summative effect has reduced the effort it takes for me to listen, and makes speech comprehension easier.

+ Localisation of sounds

Two weeks after activation, I was in a lift (elevator) exiting the underground, and it was packed full of people. A man was talking to his son in a loud voice, and I was able to detect where he was – behind me and to my left. HA HA – brilliant! That was the first time in my life I was able to localise a sound. Since then, I have enjoyed being able to work out whether sounds are coming from my left, right, or are in front of me. If a sound is coming from the side, it sounds louder on that side. If it is in front of me, it sounds the same in both ears. Recently, I went to a cafe and sat there nursing a coffee, listening to the sounds around me and working out where they were coming from. I got annoyed when two women sat near me as they had such loud voices – all very definitely in my right ear! The chef was definitely chucking pans around in my left ear – peaceful it wasn’t!

+ Speech in noise

I have noticed an improved ability to hear speech in noise. However, I’m still lipreading full time! It’s now easier to concentrate on a speaker in a noisy environment but this is still pretty difficult.

+ Head shadow effect

With one cochlear implant, I was unable to hear sounds on my opposing side as my head acted as a barrier. It was weird to have excellent hearing on one side and nothing on the other.

+ Binaural hearing

Unilateral hearing was such hard work. I could understand the odd few words here and there, but never enough to pull a string of sentences together. I feel that the past year has been such a struggle. It was worth it, but it’s been a struggle nonetheless. My remaining ear was very poor and deteriorated further over the last year. I felt as if I was about to fall over into the abyss, I was walking on a knife edge with white light on one side and darkness on the other, my world was so unbalanced. Now, everything feels right again. I say ‘again’, because I always wore hearing aids in both ears, even though my left aided ear didn’t help me at all, it just gave me a little bit of balance to my world. Wearing a hearing aid on my second ear made me feel ill, as the sound signals were so different, and competed against each other for attention. Having two good ears feels natural and although one cochlear implant on its own sounds flat and odd, the two together give me sound that is somehow ‘whole’. I am already ‘centering’ sound, it doesn’t feel like I am wearing two separate hearing devices. It feels like I am wearing one device somewhere in my head. Two implants make the world seem whole and solid, I feel as if I am ‘centred’ within my sound environment, and everything sounds much more natural. One cochlear implant on its own sounds wrong and skewed, whereas two together sound balanced and … just right. Whooo. I am just LOVING stereo sound!

I wondered whether the outcome would have been different, had I chosen to implant my better ear first. My audiologist says it wouldn’t have mattered. Hearing is a brain thing. Once the brain knows cochlear implant sound, the second implant is clued in much more quickly.

+ FM system

I tried an FM system last week. I had used one at school until my hearing deteriorated too much to hear with it. I remember it giving me a clear voice, directly into my ears. If the teacher forgot to take off the transmitter microphone and wandered to the other side of the school, I would clearly hear every word until I found her! Every September, I would hear unintelligible mush until suddenly one day I would wake up, my brain had ‘sorted it all out’ and I would understand every word for the rest of the academic year. The long summer holidays were always my downfall, and in September I would have to learn to hear all over again. With excitement, I charged up each piece, connected the system, and prepared to listen. Complete stone-dead silence. I checked all the pieces were switched on and set correctly. Still nothing. I thought my cochlear implant batteries must have died, so I switched them for a fully charged pair. Still nothing. I checked all the settings again.  I plugged into my iPhone’s radio …. silence. I couldn’t understand it. I was getting really frustrated and starting to panic. Then I had a lightbulb moment. I switched the processors from one ear to the other, and hey presto! there was sound. I almost hit the ceiling with how loud it was, with the volume at the lowest setting possible.

Remember to wear the correct processor on each ear! I now colour code my (L)eft magnet with a b(L)ue cap.

+ Hearing test (October 2011)

A hearing test was carried out on my right cochlear implant only (red line), and then with both cochlear implants together (blue line). My audiogram proves that my hearing with two cochlear implants is better than with just one!

+ Speech comprehension scores

Speech was immediately easier to understand with two implants. On my way to my first mapping session after activation, two days after switch-on, I was listening to Stephen Fry talking on my iPod – using only the new ear.  I didn’t have time to look for the correlating printed book so thought ‘Ahhhh I’ll just do without’. I was able to understand bits of sentences …. amazing. Just amazing. In the speech discrimination tests, I scored 85% with single words and 100% on sentences. I got most word pairs and discriminations right (e.g. nip/lip : distinguish which one is being said).

We compared the second implant at one month old against the first implant at one month old. In the testing booth I scored 19% in word and sentence tests, which was much better than my first implant which scored pretty much zero! We then tested my speech perception in a more realistic setting as my speech therapist read a story to me, The Emperor’s New Clothes. Last year, with one implant, I scored 83%. This year, with two implants, I scored 93% – against the background noise of road works in the street outside.

I’ve been having conversations with people I know well – ENTIRE conversations. !!! No lipreading! Both on Skype and in real life. It’s not easy and I don’t get every single word, but it’s certainly much easier with two implants. *screams in delight*

+ Music

I was tested on Cochlear’s Sound and Way Beyond software and scored 97% in music and melody perception on my new ear alone. Already, music sounds quite good, and I have only listened to around six hours of music since activation. Advanced Bionics don’t offer a binaural direct connect lead so I bought a splitter from an electronics store to enable me to listen to my iPod with both ears. (More on this in another post.) Bilateral music is just …….. awesome.   *sobs*

The only hitch I’ve had is feeling as if sound was quieter and less complete with my new implant, in comparison to my older implant. We eventually realised the implants had different IDRs (Input Dynamic Range). The older implant is set at IDR 70 and the newer implant was set at IDR 60 – once the IDRs were set to the same level, the world sounded much better. I tried them both at IDR 60 for a few days, then both at IDR 70 for a few days, and couldn’t really tell the difference. Two implants are giving me so much more hearing that I am happy enough with a lower IDR – but I just decided to stick with IDR 70 for both. Both implants have IDR 80 for music. – I’m a sound junkie!

I’d recommend Arlene Romoff’s book, Listening Closely: A Journey to Bilateral Hearing. She offers a lot of great insights into what it’s like to have two cochlear implants. My cochlear implant team have seen very few bilateral adult recipients. The evidence of the benefits of going bilateral is thin on the ground in the UK, particularly for those who, like me, were born profoundly deaf.

Here is a comparison of my hearing before I started my cochlear implant journey, and now, with bilateral implants. Amazing, isn’t it?

Going bilateral has been absolutely incredible. It’s been better than I’ve dreamed and hoped. I didn’t even need all my mapping sessions as I progressed so fast. I’ve never been able to hear well with two ears nor benefited from bilateral hearing, but wearing two hearing aids all of my life, lots of rehabilitation work, Auditory Verbal Therapy sessions, and the cross-over training of the sequential implants have really set the scene for my success. If you’re thinking of going bilateral and you’re hesitating … don’t wait one second longer! Go for it and grab it with both hands! You’ll LOVE it!

*Crying buckets of happiness while doing the longest Snoopy dance ever*

Sequential cochlear implant surgery

I had a second cochlear implant put into my head last week. It’s been quite a different experience, which tells me this might be quite a different journey from the first one. I just can’t imagine what it will be like to be able to hear in both ears.

l dreamed a strange dream last night Tina. You emerged from behind a pillar on the stage, a big grin on your face. You crossed the stage to a male actor and ruffled his long black hair. Most bizarre. But it came to me a few minutes ago what the dream meant. The stage is the theatre you’re going into Thurs, the pillar is the operation you emerge from and the shaggy-haired guy is Smudge! lt augers well m’dear, all will be fine! M

I walked into the hospital ward early in the morning with my hearing dog,  was  given a private room and completed the required paperwork. A year ago, I’d found it difficult to communicate with the nursing staff, as they weren’t deaf aware and communicating appropriately, and this really stressed me out at the time. I had written a letter of complaint to the matron about access for cochlear implant recipients, on a capital city’s cochlear implant ward For Gawd’s Sakes! and it seemed to have had a magical effect. This time, all the staff communicated using a write/wipe toy (brilliant idea), pen and paper, they showed me their name badges, they spoke clearly without mumbling, and looked at me when speaking. I was given a printed dinner menu to read from. It really made a huge difference to how I felt and it took my stress levels right down.

I was quite nervous when I had to sign the patient consent form. The attending surgeon’s explanation of the risks brought it home to me that this is actually major surgery. On the form where it states ‘Serious or frequently occuring risks’ the surgeon has written : Bleeding, infection, tinnitus, dizziness, taste change, facial nerve damage, scarring, there are a couple of unreadable words, and something that looks like ‘dance problems’ …. lol.

I laughed my way through most of my stay. I giggled with the attending surgeon, danced with the nurses, and laughed out loud all morning with my bedside buddy Michael (who just happens to be a trained nurse with the obligatory sense of humour). I’m sure the nursing staff thought I was nuts, as I giggled more than I talked.  By the time I walked up to the operating theatre, I was very merry and we were laughing over the nurse assuming Michael was my father (LOL). I had no nerves at all! At lunch time, Michael shot off home with my hearing dog, and I hopped up onto the operating table and joked around with the anaesthetist – the nurse asked me if I thought he spoke funny, was his mouth lopsided, could I lip read him? The surgeons must have wondered what was going on, we had quite a party going.

I had a different anaesthetic this time; one horrible shot made me very dizzy but not sleepy. The anaethetist was running to and from the monitor, looking worried, and I asked him to make sure it works ok and to be sure to wake me up afterwards. I then had a second shot which, thankfully, put me out for the count. The operation lasted 4 hours and I woke feeling on top of the world.  It was the best sleep ever! I was put on morphine and enjoyed this thoroughly 🙂 I didn’t see the surgeon, I guess he went to bed without seeing me … I guess no news is good news.

Do red fingers make me Star Trek material?

I spent the rest of the evening chatting to Rashed, sitting up for 6 hours …. this resulted in a bleed under my skin from the surgery site down to the mouth, not uncommon in facial surgery, and I look as if I’ve been punched in the face.  Not pretty … but I’m past caring. Tip: Lie down after surgery and don’t sit up chatting to nice men!

The next morning the bandage came off and it was such a relief, I could put on my other cochlear implant and communicate more easily. I was sent to a day ward upstairs and it was a shock – they all mumbled then scowled when I couldn’t understand them, and the nurse asked Michael to leave when he came in with my hearing dog. He kept talking to Michael, and Michael had to keep telling him to talk to ME and not to him! Talk about being ignorant. It transpired that Michael had also been arguing with reception for 30 minutes as they wouldn’t allow a hearing dog in … into a national cochlear implant / hearing aid centre / ear hospital?! Then I discovered one of the nurses had mocked Michael’s Irish accent by mimicking him – to his face…. !!

My surgeon's superb work

I left the hospital feeling absolutely great. It had been a much easier and better experience than my first cochlear implant – very little pain, no awful wall of tinnitus like last time, no dizziness or weakness. I’d had so much happy juice that I didn’t crash until I got home after a 4 hour commute and sat down with a cup of tea, then the tinnitus hit me quite badly. If that level of tinnitus was permanent, I would have been suicidal. The tinnitus went away after a day then came back, but quieter. I woke up this morning to silence, then it snuck back quietly as I started to move around. Faithful friend.

My ear had been leaking a little but this has stopped. My neck has swollen up and feels as if they drove a truck over it, and reversed. And reversed again. I’m quite happily dizzy. I’m trying not to scratch at my scar – which is tiny and just creeps around my ear. Such beautiful work.

It’s great that Advanced Bionics is back in business and I’m the first bilateral adult recipient in the UK to be implanted since the recall. My surgeon and I have every confidence in the Advanced Bionics cochlear implant and we’re really looking forward to my activation.

Boot up: September.

lm sure everything will go swimingly well Tina – l had a vision remember? But just in case, can l have your flatscreen tv? (haha) M

Bilateral implants

I’m enjoying being able to hear with my implant but as my hearing has improved, my perception of sound has shifted in my unimplanted ear. The hearing aid makes life sound truly awful now – if I can hear anything at all. The difference between my two ears is stark.

Last Thursday I wore my hearing aid all afternoon. [Do I get 5 stars?] The earmould burned my ear for 30 minutes but I kept it in. I wanted to explore the difference between the cochlear implant and hearing aid. Wearing them together in my silent office, nearby sounds suddenly seemed too loud, low and harsher. Putting my mug on my desk sounded like a crash. Ugh.

This is my first ‘hearing’ autumn, and it’s BEAUTIFUL! I took my dog to the park for a walk. With my implant, I was able to hear the autumn leaves crunch crisply and beautifully beneath my feet, the trees rustling in the wind, the traffic driving past the park, people talking and laughing as they walked past me, aeroplanes flying overhead, my footsteps on the path and other footsteps approaching and receding, my dog panting, the clicking of his nails, his ball *thunking* on the ground, the soft swish of grass under my feet, the birds sweetly tweeting.

I flipped the implant off and switched my hearing aid on.

Flashback to seven months ago.

All I could hear was the faint sound of my own footsteps. Around me was silence.

I felt so disconnected. So alone.

On the outside, looking in.

Just like I used to.

I put my implant back on and the rainbow came back. Some days I really do feel as if I have half a head of hearing. I feel as if I have an abyss on my right side. There’s nothing there to hear. Sometimes it feels as if I’m not really present. Disconnected. Unreal. So I’m thinking of getting a second implant. In the UK, this means paying for it myself, either here or abroad. Sooooo …. what’s it gonna be? An implant or a house deposit? An implant or a Porky? I’ve not yet met a bilateral user – I only know of two in the UK. Meeting a unilateral user was my tipping point a few months ago. I’m wondering what’s going to be my tipping point this time. Too much furniture? My crap driving?

The next NICE review will be in February 2011. I’m hoping they will approve bilateral cochlear implants for adults in the UK, but I’m not holding my breath. A second cochlear implant gives the user localisation of sounds, improved listening performance, and improved listening against background noise. Advanced Bionics are offering a webinar on bilateral cochlear implants tonight.

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Advanced Bionics press release –

It’s no surprise that two ears hear better than one. Just as we are born to hear with two ears, using cochlear implants in both ears (bilateral cochlear implants) gives you or your child the best opportunity to hear more naturally. Whether you are considering implants for the first time or have used one implant for years, today’s cochlear implant candidates and recipients experience many benefits of hearing with two ears. Find out if you or your child may be a candidate for bilateral cochlear implants. Hear first hand accounts from those who know best, cochlear implant recipients and their families.

REGISTRATION AFTER THE JUMP

Online. Oct 19, 2010. 6pm Pacific/Los Angeles (9pm EST/New York, 2am GMT/London)

Contact: hear@advancedbionics.com

Captioning will be available.

Research: Cost effectiveness of bilateral cochlear implants

Can you help with some vital research that started at the University of York in Oct/Nov 2009?

The NICE Guidance issued in Jan 2009 stopped short of recommending bilateral implants for adults. However, the Guidance recommended that further research should be carried out to establish the cost effectiveness of bilateral implants for adults and that this should be done in time for the next NICE Review which will start in February 2011.

Professor Quentin Summerfield is seeking volunteers with unilateral or bilateral implants to participate in evaluating new tests and apparatus in the pilot phase of this all important research project.

Volunteers would need to travel to York to take part but expenses will be refunded and, for those travelling from afar, the costs of accommodation will also be covered with a subsistence allowance.

If you are able to help, send an e-mail message to p.kitterick@psych.york.ac.uk, or get in touch by phone (Padraig Kitterick : 01904 432 883; Quentin Summerfield; 01904 432 913).

Cochlear implant research

A research study has been carried out at the University of York, England. The study compared the spatial listening skills and quality of life of children with unilateral or bilateral cochlear implants.

Spatial listening is the ability to attend to one source of sound in a mixture of sources in order to determine where it is located, in which direction it is moving, and what information it is conveying. These abilities are singular achievements of normal hearing. They allow listeners to know where to move to avoid hazards and where to look to see who is talking. They are crucial, therefore, for participation at home, for success at school, and for survival outdoors. Their breakdown is a major cause – possible the major cause – of auditory handicap in young and old age. (Source: University of York)

The following results from the research study were given on 13 April 2010 by Rosemary Lovett and Quentin Summerfield.

Children with unilateral or bilateral cochlear implants: Spatial listening skills and quality of life

There is worldwide interest in whether severely-profoundly deaf children should be provided with bilateral cochlear implants (two implants, one in each ear) rather than a unilateral cochlear implant (one implant in one ear). Potentially, implanting both ears rather than one could improve children’s spatial listening skills, meaning the ability to work out where sounds are coming from (by comparing the intensity and timing of sounds arriving at the two ears) and to understand speech in noise (by listening to the ear that gives the clearer speech sounds).

We assessed the spatial listening skills of 35 children with bilateral cochlear implants and 20 children with a unilateral cochlear implant. On average, children with bilateral implants performed better than children with a unilateral implant on tests of sound-source localisation and speech perception in noise. This study demonstrates, more rigorously than previous studies, that bilateral implantation for children is associated with improved spatial listening skills.

The group of children with bilateral implants included children who received both implants in a single surgery and children who received two implants in sequential surgeries. These two groups of bilaterally-implanted children showed similar listening skills, on average. However, the groups differed in age, so further work is needed to compare outcomes for simultaneous and sequential bilaterally-implanted children.

The study also obtained estimates of the quality of life of children with unilateral or bilateral implants. Measurements of quality of life contribute to the cost-effectiveness calculations that are used by policy-makers to decide which healthcare interventions to fund. Thus, the question of whether bilateral implantation improves quality of life has implications for healthcare policy. Judgements by children’s parents revealed no difference in quality of life between children with unilateral or bilateral implants. A follow-up study presented a group of adults (who were not the parents of deaf children) with written descriptions of a hypothetical deaf child with either unilateral or bilateral implants. The adults judged that the child with bilateral implants had higher quality of life than the child with a unilateral implant. The difference in quality of life between the two descriptions was large enough to mean that bilateral implantation would be considered a cost-effective use of resources within the NHS.

Evidence from these studies was taken into account by the National Institute for Health and Clinical Excellence in forming their guidance, which recommends that deaf children should have the option of receiving bilateral implants through the NHS. This work was reported in the Archives of Disease in Childhood and Ear and Hearing. These studies were supported by Deafness Research UK and Advanced Bionics.