Merry Bionic Christmas

23 12 2012

carol service

I’ve been getting into the festive spirit by attending christmas carol services. I was very intrigued as this was a first time for me, hearing hymns clearly – and in stereo to boot!

My first experience was in a large marble hall at Senate House London where a choir took the lead.  I was able to pick out the lead singer’s voice quite quickly as she was louder and richer than the rest. Her voice was just beautiful to listen to, and I could have listened to her sing all day. My friend, who had one cochlear implat, was having trouble following along with the words being sung, and I found it immensely helpful to look at the conductor and lipread him.

crib

Another carol service I attended was at the Swiss Church in London. This small church had just been remodelled Apple-style, and was very white and very beautiful. But OH!! The acoustics! There were no carpets or curtains to absorb the sound, and the hymns were echoey and far less pleasing than they had sounded in Senate House. Even my hearing colleages who attended with me, found it difficult to hear well inside this church. I was really very surprised at the difference in acoustics. Next time, I’ll bring carpet and curtains!

Mumford & SonsThen for a different kind of christmas spirit! I attended a concert headed by Mumford & Sons at the O2. I had attended a George Michael concert at the Royal Albert Hall recently – plush seating for 5,000 and lots of  curtains, with superb sound. O2 is a huge concert venue seating 20,000. I was worried the experience at the O2 would be like my experience at a U2 concert in Dublin – unable to see over the people in front of me (being petite in a sea of people standing up) and unable to hear over the noise of everyone screaming. At the O2, I was surprised to discover I could hear the music and singers very well indeed. Interestingly, my (hearing) friend said it was too loud, but I found it just right – thanks to Clearvoice and AGC (Automatic  Gain Control).

I’ve been blessed with a year of bilateral bionic hearing and look forward to the next one. Merry Christmas everyone.

mince pie





I can’t hear you!

30 09 2012

I went to the Royal Albert Hall in London last night, a concert hall with fabulous acoustics. I was really really excited about this concert as the singer was George Michael. As a child, I used to fall asleep every night listening to his music through headphones. Plus, this was my first concert with bionic hearing, and bilateral at that!

I played about with the 3 program slots and found that my usual music slot (IDR 80, no Clearvoice) made the orchestra sound mushy, kind of blurry around the edges. There was just too much stuff going on. My 3rd slot has Clearvoice high with IDR 70 and I really liked this one as it pulled out the vocals to the front, but the music was a bit quieter than I would have liked. I settled on my everyday slot, IDR70 with Clearvoice medium.

My favourite moment was when GM held out his microphone to the audience for them to sing a chorus. They did, then he shouted “I can’t hear you!” and held out the mic again. I actually understood what he said!!

My second wow moment came when he left the stage, and people started whistling for him to come back… I could hear all those whistles loud and clear!!

I loved the whole experience, it was simply brilliant, the music sounded wonderful and I am so glad I finally got to hear that amazing voice properly!





Can you hear this?

22 06 2010

How good is your hearing? Tee hee. This one’s a damn sight more interesting than the RNID hearing test.

This link takes you to a simple hearing test. Can you hear this? I thought this is an interesting one to do with a new cochlear implant. The site has a list of tones that go from 8Hz to 22,000Hz. It’s usual for people over 25 to not be able to hear above 15kHz. What Hz can you hear up to, or can you hear all of them? I was able to hear all of them. Woo woo! I thought 19, 20 and 21 kHz sounded horrific – I could practically feel them. They all sounded similar after 8Khz as the implant is only capable of a maximum 9Khz stimulation, but I was certainly picking up the sampling.

It is known that listening to iPods at loud volumes for long periods of time can damage your hearing to a profound level and permanently. It’s nice that I don’t have to worry about that one anymore. As we age, we naturally lose our high frequency hearing gradually. This is why, sometimes, you walk in on your mother and she has the TV on full blast and asks you to speak up as she can’t hear you (or the TV). Then swears blind that she doesn’t have a hearing problem.

It can be difficult to differentiate between loudness levels with a cochlear implant. My perception of sounds are different as they are new and so seem much louder. Turning the pages of a book seems louder than a speaking voice.  A ticking clock seems as loud as chucking a book on a table. It’s hard work listening to all this over-stimulation! This test has a series of sine waves – can you hear which is louder? I was very happy to be able to get Q1 and Q3 correct.

Here’s a harder test. Can you tell the difference between two MP3 sound clips, one recorded at 320kbps and the other at 128kbps in this MP3 sound quality test? Nope, I couldn’t tell the difference either!

On the subject of music, there is a new site for research into cochlear implants and music appreciation – swing right on over to Hearing Organised Sound.

And finally, here’s something for you hearies (and interested deafies). I discovered a hearing loss simulation for a cochlear implant and a hearing aid. A bit of environmental sound, a bit of speech, a bit of music. To me, a new kid on the cochlear implant block, and very used to using hearing aids, they sound like pretty accurate simulations. What do you think?

Time to get back to the headphones and rock on!





Music makes my heart sing

19 06 2010

I’ve just had my 3 month checkup. The first person I saw was my surgeon who is a very happy bunny. All looks good! My internal implant is a little sore along the side of the bump, this turned out to be where it touches the processor. I’ll need to hop along to my opticians and get the arm of my glasses (and sunnies!) adjusted so it doesn’t press against the area behind my ear and weaken the skin.

I then went to see my audiologist. She was also very happy at my progress. I had all my electrodes set again to maximum comfort levels and was given a slight increase in sound. I asked for ClearVoice (high) to be replaced with a normal program with a wider IDR (Input Dynamic Range) of 70 for music. With a wider IDR (explained here), you gain a wider range of sound. For the last two weeks, music has sounded pretty much perfect. When I listen to my iPod with the 70 IDR, it sounds even better, it’s so beautiful that I don’t want to stop listening. If I close my eyes, I can pretend I am hearing in stereo, as I sit enveloped in this wonderful sound that is in-my-face-listen-to-me, full and rich, swirling around my head and making me feeeeel the emotion. Vocals sound normal and some are so beautiful that they make me want to cry. Isn’t this what music’s all about?

I had a hearing test and have improved in the last 2 months so this was great news. The decibel range of zero going down  to -30db is considered to be a normal range of hearing for a hearing person (above the red line).

Red dots : My hearing 3 months after activation
Blue dots : My hearing 2 weeks after activation
Black dots : My hearing before the cochlear implant

My speech and language therapist tested me on my language comprehension, in the left ear with cochlear implant only. Here’s an updated progress chart from pre-implant through 2 weeks post-implant, to my current 3 month status. I’m aiming to get all speech comprehension scores close to 100%.

KEY:
Sentences in quiet = Listening to sentences without lipreading
Words in quiet = Listening to single words without lipreading
Lipreading & sound = Lipreading and listening to a speaker’s sentences
Lipreading in quiet = Lipreading a speaker’s sentences with no sound

The biggest change has been my ability to hear sentences in a soundproof booth, it has jumped from 24% with a hearing aid to 43% with a cochlear implant. If I did not have the cochlear implant, this ability would have continued to decline. I have been able to understand some words when listening to my Harry Potter audio book, it’s so exciting when I am able to pick out a bit here and there. It’s hard work, it’s almost like concentrating but trying not to concentrate too hard – like when you look at those magic eye 3D pictures and try to see what’s hidden there. My ability to hear words in quiet hasn’t changed, as this is very difficult to do without context to help.

My lipreading in quiet scores, at 43%, are very high. I spoke to a professor whose area of interest is forensic lipreading, and she said most people would score 5% in lipreading in quiet. Deaf people get to practise lipreading every day of their lives but as there are so many homophenes and unseen phonemes, it is not possible to score 100%. It’s great that I can still lip read well – and thank goodness I can, or I’d be stuffed trying to get through all of this! I’ve been worried that my ability to lipread would decrease as I learn to hear and try to break the habit, but my audie reassures me and academic studies show this is not usually the case. However, some of my implanted friends say they cannot lipread any more, discovered when they run out of battery power and are forced to rely on lipreading. So I don’t really know if I’ll be able to hang onto my lipreading ability.

I have experienced some new sounds in the last month. The beeping as the green man (walk/don’t walk) sign flashes when I cross the road, and I can hear it All The Way Across The Road. Amazing! I went to see a ballet, Swan Lake, at the Royal Albert Hall.  This was my first visit to a ballet. I was able to hear the orchestra very well and was surprised to see the ballet dancers enter and exit stage very beautifully and gracefully, but with an incongruously ungraceful THD THUD THUD THUD THUD THUD at the same time! I peeled a banana this morning and was surprised by the loud SSSSSSSSSSS sound it made. I then popped out to the shops and another new sound had me jumping in fright so much so that I almost threw myself into the nearest wall. I heard this very loud and deep roar right behind me, I could almost feel it and it jumped out of nowhere, I didn’t know what it was, and it frightened the crap out of me. I used to be scared of dogs that jumped and barked at me so maybe this is where that fright came from, apart from it being so loud and unexpected. I then saw a Harley Davidson go past, obviously it revved just before it reached me. SHEESH!

Although singing voices sound normal, speaking voices don’t sound normal yet (when people talk to me directly) although they are not far off.  I feel as if I am living on Planet Cartoon as people walking past still sound like Minnie Mouse or Donald Duck.

And my shoes squeak all the time! Bah!





The unbearable loudness of hearing

25 04 2010

It has been one month since activation and my world has changed beyond recognition and exploded into a kaleidoscope of sounds. Some are old sounds which sound different, some are completely new. The world sounds different through a cochlear implant and it is starting to sound much better.

Each time I have a mapping, my bionic hearing is adjusted – at the moment we are still focusing on increasing the volume. For the last week I have been listening in awe to the (surprisingly noisy) birds, the crackle and pop of rice krispies, my office clock ticking, the ssss of my perfume atomizer, the jangle of keys and my dog’s clinking collar tag, and all the little sounds my dog makes when he wants something! I am discovering that some things, heretofore silent to me, actually do make a sound. The photocopier touchpad beeps, the door of the room next door squeaks (and now annoys me immensely), my hands rasp when I rub them together and so does moisturiser when rubbed on my skin, running my fingers up my arm makes a soft rasping sound too.

I have been utterly shocked by the cacophonous ssshh of brakes and beeps of doors on public transport, the roar of traffic, people in the street, the sharp crackle of plastic bags and paper, the clatter of crockery, the flushing toilet, the microwave nuking food, and the kill-me-now roar of aeroplanes (unfortunately, I live near Heathrow). Last Saturday was the first day in my life that I was able to hear all the birds so I sat in the garden, in the sunshine, and listened. This also happened to be the first day of the airline stoppages due to the Icelandic volcano eruption and the skies were silent. I only realised how much noise airplanes made this week when the airports re-opened for business. Over the last three days, I have become quite overwhelmed by the loudness of some sounds, now that my implant’s volume is nearing an optimum level.

I went to a social event a few days ago and although noisy, I was able to pick out peoples’ voices more easily which made lipreading easier. I heard this strange sound behind me and turned around to see a woman playing a harp. It sounded totally different from what I expected, like a soft guitar.

The strange thing is that high frequency sounds seem much louder to me than other sounds. A person with a hearing loss cannot screen or ‘filter’ out sounds in the way that hearing people do, so everything seems loud. This is why noisy places are so problematic, as hearing aids and cochlear implants amplify all sounds so that environmental sounds are as loud as voices, and the hearing impaired person is unable to filter out the background noise (the cocktail party effect). Now that the high frequency sounds are so new to my brain, these seem extra loud to me, my brain is going WOW What’s This?, sitting up and taking notice, and is only now listening to low frequency sounds again. The world is starting to sound more normal. Voices still sound tinny so it’s a struggle to understand speech.

I can now hear the dial tone on the phone. I started off by listening to phone sounds (these work on both pc and Mac) and will next try listening to a script I’ll give to a friend.

There are four levels of auditory skill development according to Erber’s model – awareness of sound (presence v absence), discrimination (same v different), recognition (associating sound/word with meaning) and finally, comprehension (using listening for understanding). As I was born deaf and have been deaf for 40 years, I’m going to struggle harder and for longer to climb up this ladder.

It is a common misconception that we hear with our ears. In fact, the auditory system, from the outer ear to the auditory nerve, merely provides the pathway for sound to travel to the brain. It is in the brain that we hear. If a person developed hearing loss after learning language (postlingual hearing loss), the brain will retain an “imprint” of the sounds of spoken language. The longer a person is deaf, the more challenging it is to recall these sounds. In the case of a person who has never heard (hearing loss at birth), or who has had very limited benefit from hearing aids, sound through a cochlear implant will be almost entirely new. That person will need to develop new auditory pathways, along with the memory skills to retain these new sounds. Whatever a person’s history, rehabilitation can be very useful in optimizing experience with a cochlear implant.

Being able to detect sound, even at quiet levels, does not mean that an individual will be able to understand words. Norman Erber developed a simple hierarchy of listening skills that begins with simple detection: being aware that a sound exists. An audiogram indicates detection thresholds. Although thresholds with a cochlear implant may indicate hearing at 20 dB to 40 dB (the range of a mild hearing loss), the ability to understand words can vary greatly. The next level of auditory skill is that of discrimination; that is, being able to determine if two sounds are the same or different. For example, one may detect the vowels oo and ee but not be able to hear a difference between the two sounds. The third level of auditory skill is identification. At this level, one is able to associate a label with the sound or word that is heard. Key words may be clear, such as cloudy or rainy, within the context of listening to a weather report. Erber’s final level of auditory skill is that of comprehension. Words and phrases provide meaningful information rather than just an auditory exercise. At the level of comprehension, a person is able to follow directions, answer questions, and engage in conversation through listening.

(Source: Advanced Bionics)

I’m still at the stage of detecting sounds and trying to move into the next stage of discriminating between sounds.  Two weeks ago, I was unable to tell the difference between PAT and BAT, TIN and DIN, FAN and VAN. With the practice I have done, I am now able to do this with almost no errors. I am now working on listening for the difference between MACE and MICE, and DEAR and GEAR – which is difficult as D and G sound so similar. I don’t know what to listen for so am hoping the brain kicks in at some point!

My speech perception is improving slowly. I have tried to make discrimination practice fun, by listening to Amanda on Skype. She will give me a colour, or a month, or a day of the week, or a number between 1-10. Maybe next I will try tube stations or football teams, whatever I think I can cope with, to keep it fun. We decide which closed set we will do – using Mac to Mac, the in-built sound (and video, for lipreading) quality is very good, aided by my use of a direct-connect lead to my processor. I am trying to work towards ‘open sets’ – unknown sentences – by asking people to put a hand over their mouth and give me a sentence. Patrice gave me my first sentence this week : “Bob and Kirby are waiting for me in the car park” and I got it correct except for the word “car”. She gave me a second sentence and I got that spot on. With practice, I will improve. We tried a discrimination exercise – I am now able to hear the roadworks behind the office – they had been working there for a year and I had missed it all (lucky me). So when they hammered, drilled, or dug with a spade, Patrice told me and I listened for the different sounds.

Music is improving too. I am finding that rock with vocals louder than music wins hands down. Opera sounds good, piano/flute/guitar sound quite good. There are musical resources specifically for CI users. Advanced Bionics offer Musical Atmospheres (free for AB users) and available online or on CD, where new music is discovered through 3 hours of recorded musical examples, each containing increasing levels of complexity in musical appreciation, helping to establish a firm foundation for musical memory. They also offer A Musical Journey, through the Rainforest and Music Time for children. Med El offer Noise Carriers, a musical composition available on CD from hearf@aol.com – see Listen,Hear! newsletter no.20 for further information. Cochlear don’t seem to have any resources but they do offer tips.

I am finding that I am feeling soooo much better than I did with hearing aids. I used to have headaches almost every day, I was always exhausted from the constant effort of lipreading, reading the palantype (CART), concentrating to make sure I didn’t miss anything, and stressed by the thought of any social event.  Now, I’m not exhausted every evening, I’ve had one headache since activation, lipreading is somehow easier as I’m getting more audio input even though people still sound like Donald Duck, and I feel much more relaxed overall, and more positive about communicating with ducks people.

I’ve finally discovered the noisy world that everyone lives in. This noisy world should get a bit quieter this week when I get ClearVoice, which will automatically reduce background sounds so I can concentrate on voices. It’s almost a magic wand for hearing loss. All I will then need is to be able to comprehend speech, and I’ll do a convincing fake of a Hearing Person.

I’ve lost the clouds but I’m gaining the sky. And the sun will shine. You’ll find me out there, in the Hearing World, shining brightly with happiness. And as the video below nicely demonstrates, I want to kick your butt!





The Farmer’s Cheese

14 04 2010

You’re invited to join MED-EL for a musical performance to celebrate the year 2010 being their 20th anniversary, check out performance dates for the children’s musical “The Farmer’s Cheese”.

Devised for musical theatre by Oliver Searle, based on the children’s book, “The Farmer’s Cheese” is written by Geoff Plant of MED-EL and the Hearing Rehabilitation Foundation. Performed on stage by two actors and a six-piece ensemble, and akin to Peter and the Wolf, all the animals are represented by an individual instrument. The irate farmer remonstrates with the animals in turn while the mouse looks set to win the battle of the cheese.

Southampton
24th April 2010 at 2.00 pm, Turner Sims Concert Hall, University of Southampton, Salisbury Road, Southampton, SO17 1BJ

London
8th May 2010, at 3.30 pm, (refreshments available from 3.00 pm), The Drill Hall, 16 Chenies Street, London, WC1E 7EX

For ticket information contact MED-EL Customer Services on
01226 242 879 or email: charles@medel. co.uk

Performances last approximately 40 minutes. Tickets are free of charge on a first come first served basis.

If you want to find out more about the cochlear implant music scene, you can find out more at CI Music Scene, where they also have a review of The Farmer’s Cheese. I’ve reproduced it here as it’s so hard to read the text on their website! (Tut tut)

Many thanks to Nicky Broekhuizen of CICS Scotland for her review of the Farmer’s Cheese which first appeared in CICS October Newsletter.

We, along with a number of other CI families, went to the Scottish Storytelling Centre to see ‘The Farmer’s Cheese’, a stage version of a children’s book of the same name by Geoff Plant. The story has been adapted into a musical dramatisation by Oliver Searle, especially targeted at hearing impaired children.

The forty-five minute production was staged very simply ; no scenery, just the six musicians from Symposia, a collective of Glasgow-based musicians, on stage behind the two actors and providing the accompaniment with a range of wind and string instruments, including the flute, violin and the ‘cello. Indeed, it was quickly clear how integral the musicians were to the performance; their silent yet humorous entry onto stage grabbing the children’s immediate attention.

From that moment on the audience were hooked. The ensemble was soon joined on stage by the principals – the cheese-loving farmer and the narrator who, for the second part of the play, donned ears and a tail to turn into the infernal mouse. The plot is straightforward; in the style of ‘the old lady who swallowed a fly’, the farmer buys a succession of animals with the hope they will catch their predecessor. The story is heavy on repetition and told in uncomplicated language, so none of the children had trouble following the action. The actors were completely engaging and physical, holding the attention of the audience throughout and generating a lot of giggles and belly laughs along the way.

The musical accompaniment was a vital, integral part of the performance. In the first part of the play each of the six instruments represented a different animal with a signature melody – not unlike ‘Peter and the Wolf’ – with the flute, for example, bringing to life the scampering, light-footed (and light-fingered) mouse and the prowling cat evoked by the ‘cello. Later, various members of the ensemble played key parts in the farmer’s increasingly desperate, and humorous, schemes to retrieve his cheese with bursts of rock and roll amongst others. This clever weaving of musical instruments into the story was an excellent way in which to introduce live music to implanted children and, with the music never competing with the actor’s voices, it didn’t detract from their understanding of the story.

Tom was on the edge of his seat throughout, utterly absorbed and, from the many chuckles and absence of chatter, it was obvious that he wasn’t the only one. The extent of his understanding was obvious from the complete lack of questions both during the play and afterwards.

So, thank you MED-EL, for sponsoring this work by Oliver Searle and Symposia. Not only has it given hearing impaired children a wonderful introduction to live music and theatre in a truly accessible way, it also brought about an excellent opportunity for families to get together – and we all know how important and useful that is. Let’s hope ‘The Farmer’s Cheese’ reaches other areas of the UK in the future…..

Source: CI Music Scene





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!)