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!)





Dancing into a new life

29 03 2010

It’s been four days since switch-on and my bionic hearing is changing quickly. On Wednesday, I was able to detect a few sounds but they were all beeps. I started to pick out people beeping around me like little birds, items being banged set upon my desk, pages being turned in a series of beeps, the phone ringing in a beep. I had been given three levels of sound on my processor, which was expected to easily last me until my next visit to the audiologist’s, in five days time. On the second day, the volume of the beeps was getting quieter and quieter, and I kept increasing the sound. I started to detect my work colleagues’ voices, with an accompanying beep. I was able to detect a glass being filled with beepy water and draining down the sink’s plug hole, a kettle boiling in mini beeps and switching off with a ping, a crisp packet being beepily rustled. I was getting rather beeped off!

By Thursday evening, I didn’t have any more volume to add on my processor and I didn’t want to wait until Monday’s audiology appointment and miss out on any progress. So there I was on Friday morning, banging on my audie’s door, and she gave me a big increase in sound levels on the processor. She can’t believe how fast I am progressing and has told me to slow down, that my brain needs time to take it all in or I might hamper my progress. She thinks it is because I have done so well with my hearing aids that my brain is very well developed at listening so is able to make sense of the new cochlear implant sound more quickly. My audie said a lot of people take a month off after switch-on to relax at home and take in the new sounds, then they have a shock getting used to their usual routine when they go back to work. Considering I am facing a month of crappy sound whilst my brain adjusts, I reckon returning to work is the smartest thing to do. Just before I left the audie’s office, I realised she wasn’t beeping when she was talking to me.

*hurrah!*

It was Friday afternoon and I was back in the office. I was shocked to find that I could make out my colleagues voices without beeps over the top, their voices sounded distant, in high tones, but I could make them out. It was happy tears all round and a very emotional day. I was amazed that I was able to hear through a computer in my head.

I received a very kind gift from Patrice, Bob and Kirby – a pretty seashell for my New Ear Day, very appropriately reminiscent of a cochlea – and beautifully polished until it shone. I have spent the three days since activation working as normal and that means listening and taking in sound from clients all day, chatting to my interpreter, colleagues and friends, going to the usual noisy cafes for lunch. I think all this has really helped me to ‘acclimatise’ to listening through a computer. It was wonderful to hear a voice and not a beep, and it really helped with my lipreading – which I found a lot less stressful.

Voices now sound quite weird as my brain adjusts to the new sound, and I am having great difficulty understanding what is being said today. I expect to go backwards sometimes as I adjust but to carry on moving in the right direction. I can see that there are so many different shades of hearing. Moving from silence, to sensations or beeps, to detecting some environmental sounds, detecting voices and life around me, moving on to comprehending sounds and then – finally! – understanding speech. My Holy Grail is to understand speech without lipreading. A bonus gift would be to enjoy music. I’m on Advanced Bionic’s HiRes-S with Fidelity 120 program and will get an additional program in May 2010 called ClearVoice, which is revolutionary in having the ability to reduce background noise or the ‘cocktail party effect’. So now I have my goal in sight.

My sound database is now constantly being populated with a drip-feed of familiar, new and sometimes surprising sounds. Familiar sounds I can now hear are the dog barking next door, cars passing me, and sometimes footsteps. When I walk through a busy place such as the cafe in our office building, I don’t experience the usual wall of indecipherable echoey loud white TV noise that hurts my ears and makes me want to scream very loudly, but instead I detect the quiet chirping of people’s voices. (I know from Amanda, the cutlery will become my new sound from hell). At the moment my window of sound is still quite small, because I would not be able to cope if the audie let me have it all at once. It is a mountain that I have to climb slowly, take a rest now and again, acclimatise myself bit by bit. So at the moment, I am only able to hear high frequency sounds that are not too far away from me. I have tried listening to my iPod and music sounds absolutely rubbish, however the volume is set much lower (my hearing aid required the maximum iPod setting and hearing aid setting). I’ve bought my first audio book, Harry Potter’s first book, and find that very hard to listen to as the sound makes no sense – what I am hearing sounds like a long wail with gaps. But I’m holding the faith! Here’s why ….

New sounds from my cochlear implant are the Blackberry / Mac / remote control keys clicking, cutlery on plates, plastic bags rustling, scissors cutting plastic, clicking fingers, bus doors thumping shut, my dog panting and whining (he sure whines a lot!), using an eraser, the bathroom door lock and light clicking from the room next door, the doves and pigeons making a racket in my chimney, my own breathing and sniffing, zips, Amanda’s jaw cracking every time she opens her mouth – all these tell me that the cochlear implant is already outperforming my hearing aid. And it’s only been FOUR DAYS! I am realising that when something moves, it makes a sound. The first sound I could hear clearly, sounding normal and without any pesky beeping, was my shoes scraping on the tarmac when I walked my dog yesterday morning, and I took great pleasure scraping my shoes (and dancing) all around the park. Unfortunately, I now need a new pair of shoes.

I am amazed that I put up with such crappy hearing for so many years.

Bye bye, Crappy Hearing Aid.

Hello, ‘Borg with new shoes.

New, polished, and shining with pride. ~ Come dance with me!