2 year bilateral cochlear implant review

31 12 2013

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).

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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.

2013 review

  • 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.

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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.

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

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New cochlear implant processor from Advanced Bionics

19 01 2013

AB's next gen BTE

The next generation cochlear implant processor has been rolled out by Advanced Bionics, enhanced with Phonak’s high-performance hearing aid technology, achieving an industry first in bimodal technology. The processor will be launched in the UK within the next few weeks, so it will be some time before it is actually available as the audiology clinicians will require training prior to provision – this processor has the most exciting list of goodies!

The new processor is 40% smaller than the Harmony, Advanced Bionic’s previous BTE processor – in the photo below, the Harmony is on the left, a hearing aid is on the right, and the new processor is in the middle. It’s thinner and lighter – it is smaller in size, but larger than life in performance. The processor is available in lots of colourways.

Colour wheel

Size

Features

UltraZoom – The user can focus on a speaker in front of them in a noisy environment.

ClearVoice – Sound is automatically analysed to filter out environmental sounds from the speech signal, improving understanding of speech in noise by up to 55%.

The SNR (Signal to Noise Ratio) is how much louder a voice is in relation to other background noise. Children need a speaker to be 15 decibels louder than background noise in order to be easily understood. Adults only need a SNR increase of 4 to 6 decibels. When UltraZoom is used with ClearVoice by a unilateral user, up to 6.5 dB SNR is obtained. The future capability of these combined features mean bilateral users will benefit with up to 70% improvement in understanding speech in noise.

HiRes Optima – Advanced Bionics’ newest sound processing strategy optimises battery life.

T-Mic – The unique T-mic is a microphone situated at the ear canal, utilizing the ear’s natural capability to gather sound for optimal listening.

HiRes Fidelity 120 – This is the only sound strategy in the cochlear implant industry that uses 120 spectral bands to deliver five times more sound resolution than any other cochlear implant processor. This means sounds are richer, fuller, and more natural.

AutoSound – The widest range of sounds, from softest to loudest, up to 80 IDR (Input Dynamic Range), are automatically adjusted to.

WIRELESS CONNECTIVITY

Matt has a Harmony processor, a Oticon Safari 900 SP hearing aid, and an iConnect. He wants to pair his laptop to his Harmony via Bluetooth – he hates wires everywhere and wants to do his auditory rehabilitation at his desk in a noisy open plan office. The easiest solution for Matt is to use a Phonak Smartlink with an MLXi FM receiver, but this is expensive. To access Bluetooth, the iConnect is needed to attach the processor to cables, neck loop, or Bluetooth headphones. Advanced Bionics advised Matt that the best solution is to upgrade to a Phonak hearing aid and the new Advanced Bionics processor with all its connectivity options…..

Phonak ComPilot – With the ComPilot, Matt can link wirelessly to a wide variety of devices such as mobile phones, computers, Bluetooth, media players, TVs, navigation systems, and FM systems.

Phonak RemoteMic – Speech is streamed directly and wirelessly to both ears, making it easier for Matt to listen to speech in noisy places.

Phonak TVLink – Audio is streamed directly to Matt’s cochlear implant processor so he can listen to the TV.

Advanced Bionics myPilot – With this remote control, Matt can change his processor settings.

*** Bimodal Technology ***

For the first time, Matt is able to wirelessly and simultaneously stream sound to a Phonak hearing aid and an Advanced Bionics cochlear implant processor. This is a hugely exciting stride forward in cochlear implant technology, merging the technologies available from Phonak and Advanced Bionics.

Phonak ComPilot

Phonak RemoteMic

Phonak TVLink

AB myPilot

BILATERAL HEARING

The new cochlear implant processor is very exciting for bilateral listeners – such as me! Phonak Binaural VoiceStream Technology™ will allow me to hear speech and phone calls, adjust volume, and change programs – simultaneously.

Features

ZoomControl – I will be able to focus on a speaker situated on either side of me, to help me hear better in noisy places.

DuoPhone – My phone calls can be automatically streamed to both ears so I can hear voices in stereo, with a higher level of speech perception from binaural hearing.

QuickSync – Both processors can be adjusted instantly at the same time.

Future Developments

There is yet more to come from Advanced Bionics – WindBlock, EchoBlock, and SoundRelax.Windblock Echoblock SoundRelaxCochlear implant processors are entering an exciting phase of development as all manufacturers are expected to come out with new processors this year.

Watch this space!

Advanced Bionics
Brochure: Next Gen Processor
Phonak: Dynamic FM