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

New cochlear implant processor from Advanced Bionics

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.

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.Cochlear 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

My Hearing, My Future

A competition, My Hearing, My Future, is now open to young people aged 10-18 years.

Entries are invited in English or British Sign Language. Participants are invited to be creative and come up with a winning idea for using science to help improve life for the deaf, deafened or hard of hearing.

Previous winners have come up with some exciting ideas;

Helen Thomas, from the 12-14 age group, was the winner in 2009. Her entry said:

I would like to think, that in the next 20 years there will be great advances in helping deaf children/adults. As a cochlear implant user I would expect advances in this area to be more exciting, maybe along the lines of putting the implant and processor under the skin and therefore eliminating the need for an external processor, or a implant that tunes in to the conversation you are listening to, and eliminates surrounding sounds (very science fiction!)

Or maybe gene therapy can play a part, with replacing the faulty gene, I along with my family, have had blood taken to see which gene is responsible for my deafness, this is something I would think research would focus on.

Communicating with deaf people, it would be great if, a degree of sign language could be on the school time table, its great to learn sign, you never know when you will need it, its important to make people aware how difficult it is for deaf people, like all sensory impairment, “making people aware” is very important.

I would like to see all classrooms equiped with the necessary sound fields and finally here is one crazy idea, what about glasses/or contact lenses that when worn would show subtitles maybe in a cinema or TV.

So this is my vision for the future, I hope it helps!

Jordan McGrath, from the 15-19 age group, was the 2009 winner. His entry said:

There are 9 million deaf people in the U.K, 34,000 of which are children and young people. It doesn’t matter whether a deaf person has mild deafness, moderate deafness, severe deafness or is profoundly deaf there are always solutions such as technology equipment such as hearing aids or cochlea implants. There are other solutions such as lip reading and sign language. 2 million people in the U.K have hearing aid/s. 4 million people don’t have hearing aid/s, this is a high number and I think that people who want to have a hearing aid/s or cochlea implant should investigate what equipment is useful for them. It would lead to an easier way of life. They would benefit from it hugely. I think that deaf people should be treated equally as hearing people: examples, more subtitled shows at cinemas, interpreters at shows, pantomimes and other public places where a deaf person needs help with communication in some way. I think that these services should be funded by the government. I also think that there should be more deaf awareness taught around the U.K: examples, staff in supermarkets, high street shops, churches, restaurants, cafes and the most important of all are doctors, hospitals, dentist and other medical care centres.  I would benefit hugely if this problem was solved because me myself as a deaf person can struggle at times when I go out to public places such as shops. Another thing is that new buildings that are being built should be built with soundfield or loop systems. More DVD’S should include either a choice of subtitles or a signer. I find that many DVD’S that my family have bought in the past have no subtitles so therefore I can’t watch it.  Also modern mobile phones as seen in shops should contain all the features that a deaf person needs.

I think that a lot of deaf people would benefit from a waterproof hearing-aid/s which has different levels for different kinds of deafness. These waterproof hearing aids could be used in swimming pools in the sea and other wet areas when it’s raining. This way they wouldn’t miss out talking to hearing friends/family or even a deaf person who can’t communicate. They would have to be a small object that fits into the ear so that they don’t fall out and get lost. Normal digital and analogue hearing aids are not allowed to get wet. I also think that a higher powered hearing aid/s should be created for profoundly deaf people. It would be loud enough so that a deaf person can hear all the correct sounds that are being said and this could improve their speech. Also in shops and other public places they may hear what the person is saying more clearly. It could be electric chargeable although this wouldn’t be good for the environment so high powered batteries could be made. Also a person with no hearing or little hearing should be provided with a choice of having a hearing dog for the deaf, this helps deaf people have a more independent life and not rely on others too much. A higher local service should be provided for deaf people if they are in need of something or having difficulties with something. They should be provided with a person who works at that local area and are able to get in touch with them as confidently as possible. They should always have support no matter how old they are.

My Hearing, My Future is a collaboration between Deafness Research UK and Deafness Cognition and Language (DCAL) Research Centre. Sponsored by Phonak, Advanced Bionics, BT, and Chilli Technology.

Competition : My Hearing, My Future

Why Naida? Win an iPad.

Phonak are running a competition. All you have to do is to tell them why you like their Naida hearing aids and you could win an iPad.

Competition : 1000 reasons for Naida

Facebook : Phonak Naida

Look! Look! LOOK!

I guess a lot of people wonder what a cochlear implant looks like. This photo is of the CI made by Advanced Bionics, it is the same as the one which I am getting (and the same colour). The CI comes in two parts; one internal, one external. On the left is the internal part; the larger disc (1) houses the computer technology with a ‘tail’ for the electrode array, the smaller disc (2) is the magnet which is removable for MRI scans if needed. On the right is the processor. The processor (3) is the part that is updated with new software by the audiologist. The battery (4) is rechargeable and I will get a set of 4 batteries so I can rotate them each night – a battery charge will only last a day. The processor is connected by a wire to a magnet (5), which has an orange cover in this photo. I’ll be supplied with a set of covers in interchangeable colours to jazz up my CI or to match with my outfit. Advanced Bionic’s CI microphone is patented, which means no other CI manufacturer is able to produce a similar microphone. This is called the T-Mic (6), and is situated at the end of the ear hook to mimic normal hearing at the entrance to the ear canal, rather than at the top of the ear as in hearing aids and other CIs.

The external magnet connects to the internal magnet through their placement, creating the connection for processed sound to reach the auditory nerve. Here, they are placed similar to how they would be on a real person …

Putting it on, it is a little bigger than my current hearing aid (Oticon Spirit 3 SP) and about the same size as my last pair of hearing aids (Phonak Supero). I pulled my hair back for this photo but my CI will be hidden by my hair.

And if you’re bald or have very short hair? There’s nowhere to hide – but should you be hiding? Meet Scott, who says “It rocks my world every day”.

It’s probably like having a hearing dog – a few people stare but more people are lovely, they come up and talk to me and ask questions, they show an interest, they are aware of my hearing loss and make the effort to look at me and speak more clearly. I’ve made lots of friends this way. It’s helped me to stand up tall and spit in the face of deafness.

For some, it’s a choice between vanity or decent hearing. Hats? Wigs? Attitude? Two-fingers-up-at-the-world? Hmmm, food for thought. Fortunately, I don’t really need to make this choice, but if I had to make it, I would choose the opportunity of having decent hearing.

Deaf Awareness Week 2008 : Look at Me

May 5th – 11th is Deaf Awareness Week. The theme is LOOK AT ME which happens to tie in nicely with my blog 🙂 The aim is to raise awareness of the different methods of communication which deaf people use to communicate and therefore highlight the different types of deafness. ‘Deafness’ doesn’t just mean sign language users – it also means deafened people, hard of hearing people, deaf-blind people, and those who have tinnitus.

UKCoD have listed some events that are taking place nationwide to raise awareness of hearing loss and give people opportunities such as lip reading class taster sessions, and seeing the inside of your ear using video otoscopy.

A couple of events caught my eye….

* a pair of new Phonak Audeo hearing aids (which are the business) suitable for mild to moderate hearing loss are being given away by The Hearing Care Centre in Colchester, Essex. These are worth £3,500. You’ll need to grab a copy of the Colchester Gazette during Deaf Awareness Week.

* a text messaging service will be launched by Northamptonshire Police Force Communications Centre (FCC) for deaf people in the county. Way to go!

Hopefully this event will get bigger and better each year – that’s up to all of us to make it happen. (Text and logo courtesy of UKCoD)

Did you know, nearly 15% of the population have some degree of deafness. If your organisation has not made adjustments to help deaf and hard of hearing people access your products and services, then you may be excluding a considerable number of people.

For every 10,000 of the population:

TEN will be born profoundly deaf. They probably get little or no benefit from hearing aids and mainly use sign language to communicate.

TWENTY will have become profoundly deaf. They may use sign language and probably also lipread.

ONE HUNDRED will be partially deaf. They may have difficulty following what is being said, even with hearing aids. Mostly they will lipread and some use sign language as well.

SIX HUNDRED will be hard of hearing. They will be able to follow what is being said with a hearing aid and will be able to use a telephone if it has an adjustable volume or has been designed to be used with a hearing aid.

EIGHT HUNDRED will be mildly hard of hearing. They may have difficulty following conversations particularly in large groups or in noisy situations. Some will wear hearing aids and many find lipreading helpful.

• British Sign Language (BSL) is the first or preferred language of around 70,000 people in the UK
• About 2 million people in Britain wear hearing aids, maybe another million would benefit from doing so
• Almost all deaf and hard of hearing people rely on lipreading to some extent
• Many combine signs from BSL with English in order to communicate

Here are a few examples of ways to be more accessible to deaf people:-

• Develop the skills of your staff so that they have the knowledge and understanding to communicate effectively
• Overcome the communications barrier by providing deaf awareness training, human aids to communication or the use of appropriate technology
• Make sure your building is deaf-friendly by providing appropriate systems, such as an induction loop
• Plan public areas carefully with deaf visitors in mind and try out your plans with local deaf people to make sure they work
• Use plain English in your literature making it easy to read and understand
• Improve telecommunications by making available textphones, fax, Typetalk, emails, SMS and videophones.

Remember – if a hearing person and a deaf person have trouble communicating, the problem is shared: communication is everybody’s responsibility.