Coffee cup thoughts

25 10 2012

This is the first time I’ve followed up lunch with a couple of painkiller tablets. I had lasagne in one of those polystyrene containers.

The sound of the fork scraping against the box, the sound of the lid eeeeeeking against my brain every time I moved the box, was just too much to take. It’s a nasty, nasty sound. It’s right there at the top, worse than screaming babies. Could anything possibly BE more horrendous?! I wonder if they use this sound to torture people, it sure would work for me!





Sound all around

5 06 2012

PhotobucketI’m still taking part in a clinical study to improve speech perception by reprogramming my cochlear implant based on pitch. My left cochlear implant’s ability to discriminate speech on its own has jumped from 48% to 70%. My right implant is still a work in progress. Bilaterally, my speech perception score has jumped from 57% to 84%.

One of the things I’ve never been able to do is to discriminate which direction sound is coming from, as you need two good ears to do this. Wearing an implant on each side of my head enables me to tell if a sound is coming from my left or right.

But how accurate is this ability to discriminate directionality of sound with bionic hearing?

Let’s look at what it actually means to hear the direction a sound is coming from. It is quite a complex process. A number of factors combine to help the listener detect direction – time lag, difference in volume, wavelength, and tone of the sound.

** TIME LAG.   Sound coming from one direction will reach the ear furthest away 1/500 second later than the closer ear.

** VOLUME.   The ability to hear differences in volume depends on the sound frequency. It is easier to detect the direction of high frequency sounds than low frequency sounds. It is more difficult for high frequency sounds to reach the other ear, as they are blocked by the head, so the closer ear will need a higher volume. The head does not block lower frequency sounds quite so easily.

** WAVELENGTH.    The human ear is less sensitive to volumes of low frequency sounds, so it is more difficult to detect sound direction. Low frequency sounds have wavelengths greater than the distance between the ears, and the head will not prevent the sound waves from reaching both ears. Higher sounds have shorter wavelengths and the head acts as a screen if the sound comes from one side.

** TONE.    There is no time lag between the ears if the sound comes from above, below or in front of the face. The outer ear helps the listener to work out the tone of the sound. Height information is given by sound (especially high frequencies) reflected off the back edge of the ear lobe, the frequency changing with the angle of the source of the sound.  Motorcyle riders find it difficult to tell where an ambulance is coming from, as the helmet reduces the ability of the outer ear to detect the tone of the sound.

Sound takes 1/500 of a second to travel the distance between your two ears. Try listening to the following clip and see if you can hear which ear you hear the sound in. It is best to use headphones, but will work if you sit between your computer speakers.

Click on this sound clip

You will hear three sound clips: pure tones, a voice, and part of a Madonna song. Each sound clip is repeated three times. First, the right and left audio channels are identical. Second, the left channel precedes right by 0.5 ms. Third, the right channel precedes the left by 0.5 ms.

The surprising conclusion is that it’s difficult to tell which direction the pure tones are coming from, but it’s easy to tell which direction a more complex sound, such as the Madonna song, is coming from.

So now we see that simple tones are harder to locate, we can wonder why sirens use them. A high degree of accuracy in localising sound is only possible when the sound is complex and made up of a majority of frequencies in our hearing range. The brain cannot accurately locate simple pure tones and it is surprising that alerting devices use them.

Source: Stanford University

How does this translate to bionic hearing? Studies have shown that bilateral cochlear implant users perform better than unilateral implant users in discriminating direction of sounds;

Ear Hear: April 2002 23(2):137-49. Sound-direction identification, interaural time delay discrimination, and speech intelligibility advantages in noise for a bilateral cochlear implant user. Van Hoesel R, Ramsden R, Odriscoll M.

Ear & Hearing: February 2007 – Volume 28 – Issue 1 – pp 73-82. Sound-Direction Identification with Bilateral Cochlear Implants. Neuman, Arlene C.; Haravon, Anita; Sislian, Nicole; Waltzman, Susan B.

I have inadvertently added to the body of evidence supporting this, through my testing in this particular clinical trial. One month ago, using speech as the sound stimulus, my ability to detect which direction sound comes from had been scored at 28%. Now, my ability has been scored at 70%. Wicked, don’t you think? 🙂





Let me have a two-can string telephone

24 03 2011

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Did you play with string telephones as a child? This is a game that deaf children most likely don’t play…. unless they can lip read the length of a string.

I got my chance last week …. it was thrilling! A client was giving a presentation and his topic was an invention : antennae. He used cans and plastic cups as an analogy to show how antennae works. His prop was a pair of tin cans with string between them, and a pair of smaller plastic cups with string between them.

He made a sound into a tin can, the sound went into the can, travelled along the string as a transference wave and came out of the other tin as a sound wave again.  How the antennae works is pretty much the same.  An electrical signal goes into the antenna, the antennae converts to a radio signal and on the receiving end converts it back to an electrical signal, and that would be music or image. This is the basic principles of how antennae works.  It is a form of transducer that converts one form of energy into another.

The really exciting bit was that when he spoke into the can, I could understand every word he said.

Eyeballs straight ahead! – I had my head at 90 degrees! – I swear!

I was amazed. Unexpectedly, the two pairs sounded different too. Why is this?  A micro strip antennae allows you to reconfigure frequency. This antennae allows you to reconfigure the personal frequency which means, say, a radio wave would work at 15 gigahertz but a mobile would be 20 gigahertz, they work in different frequencies.  The antennae, the configuration has changed.  In this case, it became smaller so the plastic cup works at a higher frequency than the longer tin can, which means the plastic cup would be better for female voices compared to the longer tin can which is better for male voices.  So this antennae allows you to reconfigure its personal frequency by employing a very small patch of capacity. This highlights why voices can be harder to understand on the telephone.

Antennae is a really important invention, you’ll find one in every telephone, mobile phone, computer, wireless computer, wi-fi. It was really cool to have an expert explain to me in layman’s terms how antennae work, and to allow me to have the opportunity to listen for myself. This is real hands-on hearing!





Bilateral implants

19 10 2010

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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.

————————————————————————————————————————————

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.





Phone call #5

24 08 2010

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I called Michele today. Afterwards, she emailed;

Whooo!!

You got them all right – just the tiniest pause on the mascara!!! *dancing the jig*!!

  1. My mascara is black.
  2. My lipstick is red.
  3. My eyeshadow is blue.
  4. My nail polish is pink.
  5. My hair brush is yellow.

Fabu fabu fabulouuuuuus!!!!

I have to say, it was tricky. Words just don’t sound like they used to. Of course they wouldn’t! It’s like listening to a robot talking (sorry Michele) but I’m being straight, that’s what a voice on the phone sounds like.

I’m digging out some samples of CI simulations so some of you can hear what I hear – stay tuned!





She sells seashells by the seashore

4 06 2010

We’ve had gorgeous weather for the past few days so I took an opportunity to visit the English seaside and test my baby cochlear implant. This is a little wish I’ve had for some time, to feed my soul and revisit a memory. A day of walks, ice creams, salty sea air, happy faces, and the soothing sound of the waves.

I grew up by the seaside. It was a cold, rough, Irish sea, mesmerising in all its tempestousness, its savagery, its cold hard beauty, its sudden mood changes from sky blue to grey to black and even to white in fierce, majestic storms. Scary in its calmness in an orange sunset, for I knew it was dark and dangerous beneath the vast surface, taking lives at random when it chose. Enticing on a hot summers day with gentle waves lapping at your feet, for we had the longest whitest sandy beach in the north – visit this link and feast your eyes. I almost drowned when I was eleven, and I’m still a water babe, but have a real fear of water, deep water, when I can’t feel the ground beneath my feet. Walking along the pier at the mouth of the River Bann still scares the bejesus out of me, as you can see the water is so deep on both sides, and so so close. But somehow, I still have a fascination with and love of water.

I walked along the promenade and recalled the sound of the sea from memory. shhhhhSHHHHHHshhhhhhSHHHHH. Quiet. SHHHHshhhhhSHHHHshhh. Calming. shhhhhSHHHHshhh. Reflexive. SHHHHshhhhSHHHHshhhh. I listened hard for this sound as I walked with my dog.

There was a constant loud ROAR …… ROAR and I tried to work out what it was, thinking “Bloody aeroplanes!”. I was puzzled because there was no airport nearby.

ROAR ….. ROAR

I scanned the sky but couldn’t see any aeroplanes.

ROAR….ROAR….ROAR

Must be the traffic, then. There was a road behind the promenade but it was a quiet day and I couldn’t see many cars.

ROAR….ROAR….ROAR

I looked around and scanned for moving objects that would match up to this sound. Then it hit me.

It was the sound of the breaking waves!

ROAR….ROAR….ROAR

I could not BELIEVE how loud they were. They were teeny tiny itty bitty waves but they crashed with a sound that did not match their size – see photo.

Is this normal? Or is the volume magnified by my new-found awareness of sounds? I am just blown away.

The quality of the sound is so different as well. It’s no longer a quiet soothing shhhhSHHHHshhhh but a harsher sort of frantic bubbling, or crackling with the hard edges taken off.

You can see what a hard time I am having, trying to describe simple sounds. What I am hearing is my own version of reality, not yours.

It’s very hard to explain sounds when you haven’t heard them before.

It’s also hard to explain to my audiologist what I’m hearing, so that she can adjust the program appropriately on my cochlear implant.

I was talking to Paul in Seattle about this sound recognition and progress with our cochlear implants. Paul had normal hearing prior to getting his cochlear implant. He was activated one day before me. He says;

I find it amazing and fascinating reading about the hearing experiences of people who had a long term profound loss and used hearing aids before getting a cochlear implant. Many, who felt that they accommodated quite well (by lip reading, speaking, etc), seem awestruck by what they hear with the cochlear implant. While I feel, at 2-months myself, that the quality of the sound from the cochlear implant has a lot to be desired (remember, I KNOW what “normal” or “near-normal” hearing really sounds like) it is leaps and bounds better than what the hearing aid can provide one who has a profound loss. While I had “normal” hearing at one time, it’s been a very long time. My hearing has declined since the 1960s. It’s had its ups and downs but it was a long slow decline nonetheless.

Most people with mild to moderate loss really do benefit from the hearing aid. But a profound loss is in a class by itself. I find it hard to describe some sounds to you because either you never heard that particular sound before in your entire life OR what you heard with your hearing aid was a very bad representation of the sound. Of course, you wouldn’t know that what you heard was crappy because you had nothing to compare it to. How do I describe a sound to you when you’ve never heard that sound? How do I describe color to a blind person?

Sometimes I wonder what babies really hear in their first couple of years. Is it all mangled sounds like the first few weeks of a cochlear implant? At the same time that their brains are trying to make sense of associating sounds with what they are seeing they are also trying to figure out how to verbalize sounds themselves. What marvelous things our brains can do!

How exciting. I can’t wait for the next big storm. I used to love watching them whilst my dad hid under the kitchen table. It’s going to be a fantastic 3-D experience!





Assimilation: Two months

31 05 2010

It has been 2 months since activation. What can I hear now?

Animals seem to have taken over my world. I have a large leafy garden and can hear birds all day long, not just blackbirds, but magpies, starlings, a lovely orchestra of TWEET TWEET, TRIILLLLL, CHIRP CHIRP, PING PING, COO COO, PEEP PEEP. I love sitting outside listening to them. At the moment I am hearing around ten different types of bird calls. One night I cracked up laughing. I could hear 3 birds singing to each other, they sounded like a phone ringing, knocking at the door and the doorbell. When night falls, all the birds fall silent. Then the dog next door starts barking and carries on for an hour. Then my own dog starts barking in his sleep. I have also heard our cat miaow. I haven’t heard our foxes yet and we have plenty!

Lower frequency sounds have started to come back. I can hear the rumble of traffic and the bus engine. Sounds I am enjoying listening to are male voices. Those sexy, rumbling, low, growly voices. I’m fascinated by how different they are from female voices. Who woulda thought a voice could be so attractive?

I have been able to hear a teeny bit on the phone. No special equipment required! I use my implant as normal, on 100% T-mic microphone, pick up my mobile phone, and put it to my ear as any hearing person would. The T-mic mimics the hearing ear as it is positioned at the ear canal, aiding directional listening by collecting sound in a more natural fashion than a hearing aid or other brand of cochlear implant. I do need lots more practice in discriminating words before I can use the phone easily. Considering I have been deaf all my life and have never used the phone, this blows my mind. I love hearing voices as it is like the captions have been shoved straight into my brain, the understanding is just there. It seems so effortless when it happens.

I have been able to hear speech in other situations too. Last weekend, I was the 2nd photographer at a wedding, working with Amanda, the 1st photographer.

Michelle and Lee, the newly-wed couple, were standing in an archway. Amanda was taking photos from the inside of the building whilst I was taking photos from the outside.

Michelle and Lee were kissing for this shot and they kept kissing. The kisses became slower and longer. More lingering. I didn’t really know where to look. I started thinking “Hey guys, maybe time to get a room?”

Then out of nowhere, I clearly heard Amanda shouting “Again! Again! Again!”

“….. Slower!”

Situation heard and understood!

The street is incredibly noisy. I use Advanced Bionic’s ClearVoice to reduce sounds in noisy environments such as the street, train station, on the train. It’s fantastic, and I can pick out voices around me as unwanted background sounds drop away. I tested ClearVoice in a wine bar, and was able to lipread and listen to other cochlear implant users with ease. I heard one lady who came up to my dog and said “Hello darling”. I actually heard her say this behind my back! (I had to double check with her to make sure I had heard her right – I don’t trust my new hearing yet.) I noticed that the hearing aid users were unable to participate easily, they looked stressed and were often left out of the general conversation. This was how I was 3 months ago and I felt sad for those people. The cochlear implant users really had to make the extra effort to include the hearing aid users in the conversation. We totally understood, for we had all been there.

At work, with my office door shut, I have been able to detect my colleagues Calum talking in his soft Scottish brogue in the office next door and Karen coughing as she walks down the corridor, the photocopier room door squeaking next door, the photocopier spewing out paper, people’s footsteps as they walk past my office, people talking outside the building. I was able to pick out clear (albeit echoey) voices in the kitchen as we gathered together to celebrate Robert’s birthday – it is no longer a wall of horrendous mushy sound. I am still loving the sound of the clock ticking on my office wall.

Today I tried my hearing aid in my other ear for the first time in 2 months. An aeroplane flew overhead and I could clearly hear it approaching with my cochlear implant. To my shock, it didn’t even register with my hearing aid. My own voice sounds deeper and much quieter with my hearing aid, and I can only hear bits of it. I put the television on and set it at a volume that was nice and loud for my cochlear implant. However, I could not hear it at all with my hearing aid. The quality of the sound is different between the two hearing devices – higher pitched with the implant, deeper with the hearing aid. I am horrified at the difference and at how much sound is missing with the hearing aid – which I used to wear in my better ear.

How much I have missed the sounds of life – without even realising it. I have a lot of catching up to do!