Vicki's Vapours

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Then and now

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Last week, during my visit to Roberta, my audiologist, she decided to run a short hearing test to see how much sound my ears can pick up at this point in time, one month after activation. A few minutes in the booth listening to tones emitted from a speaker, and then we were back in her office and she showed me the results.

See for yourself:

Audiogram, August 2008

OK, I know it’s not very clear, so I’ll explain a little. The decibels (measurement of loudness) run down the Y axis and the frequencies (relating to pitch) run along the X axis. The lightly shaded area at the top, between -10dB and 20dB, is considered to be the “normal” range.

Which, in short, means that according to this audiogram my ears are detecting sounds at what Roberta described as “nearly normal/very mild hearing loss” levels!

She then showed me an audiogram from a hearing test conducted during my cochlear implant assessment, in August 2007. See the difference?!

Audiogram, August 2007

I previously had a moderate loss at the very lowest frequencies, which rapidly dropped away to nothing at all in higher frequencies, including most frequencies necessary to understand speech.

Now, my ears are detecting sounds between about 20dB and 30dB on the graph, around or just under the levels of a person with normal hearing. I asked if it would get better over time, but Roberta indicated the 40dB area and said that is where most cochlear implantees are and didn’t seem to think there would be further improvement there for me (though that won’t stop me from hoping. ;-) ) She seemed to think it quite unusual that I’m able to detect the sounds I am just one month after activation.

The reality

Of course, all this doesn’t mean a lot in practical terms right now. My brain is still undergoing re-education, and it will take a while for my speech (and music) discernment to catch up with my actual hearing levels. But Roberta seems quite sure they will.

I’m rapt!

Two weeks after switch-on

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What a fantabulous couple of weeks it has been with my “new ears”! No, it’s not perfect, but I’m aware it never will be. However, I already hear noticeably better than before the surgery, so even if improvement stopped right now, I’d consider the cochlear implants a success!

But I’m assured that there will be a lot more improvement so it’s definitely All Good™!

At the clinic

For now, the fine tuning of the map (program) of my cochlear implants and associated hearing rehabilitation is on a weekly basis. So, on the last two Thursdays, I returned to the Lions Hearing Clinic to see my audiologist, Roberta.

I am very well looked-after at the clinic. Everyone is so helpful and genuinely wants me to hear as well as possible. It’s not “just a job” to them.

In the last two sessions we have worked to make sure the sound was more balanced between the two implants and between the individual channels of the implants, and the overall volume has been turned up several steps.

We also started on some rehabilitation exercises and Roberta, after quickly running through a few to find out the level of speech understanding (without looking) I was at, gave me some to take home and do for “homework”.

Homework

I had been interested to know what form these rehabilitation exercises would take. I haven’t done the second week’s homework yet, but in the first week they were very simple exercises (although they will get harder as I progress) of two types. In the first type, the clinician (the audiologist or the person helping with the homework) tells the patient (me!) either a clue topic or a specific phrase, then — without the patient being able to see the clinician’s mouth, the clinician reads several sentences which the patient then has to repeat. In the second type of exercise, the patient is given a list of sentences and when the clinician reads them out, the patient has to identify that sentence on the page.

Andy did the first week’s homework with me and I (predictably) did quite well as I’ve always been good at guessing what people are saying. However, I only actually hear a few words without looking and do have to guess. I didn’t do as well with sentences like, “Children look forward to Halloween in the Fall,” because that is so far from anything I would have expected that there was no way I would have guessed it! Children don’t think much about Halloween here at all — almost no one in Australia does — and nor is Halloween in the Fall — and if it was, it would be called Autumn! I was a bit cross about this — I am not American! Roberta told me the next time I was at the clinic that there is some Australian-based therapy but unfortunately it hasn’t been quite so well thought-out. Blah!

But anyway, before the surgery I could hear nothing without looking at people’s faces and my guessing was done while speech reading, so there’s massive progress there.

The hearing experience

Over the last couple of mapping sessions I have noticed that when the volume is increased, so too is the detail in what I hear. This surprised me, no doubt because that was not the case with hearing aids. If I was hearing muffled sound with hearing aids, turning them up meant I would hear louder muffled sound. It shouldn’t have surprised me though, because those things I now wear behind my ears are called “speech processors” for a reason — they are far more than the mere amplifiers that hearing aids are. It’s just that this is so different to my previous experience.

I walked out of the clinic a week after switch-on and heard a bird tweet for the first time in about 25 years.

I went to work and was putting something in the fridge and someone spoke to me, so I turned to look at her. She looked very surprised and said, “You knew I was talking to you! Before, you wouldn’t have even realised.”

I can now hear the garage door going up and down, and the beeps when the pads on the microwave oven are pressed are quite loud, and I can hear the beeps or pings when the microwave has finished cooking, too. I didn’t even know till now that the buttons on EFTPOS handsets beep. I can hear my kitten meow and can hear her purrs after a fashion (they sound a bit crackly). I couldn’t hear any of these things before.

When I listen to music now, the buzzes and extraneous noises are totally gone (yay!) though I still cannot always make out the tune, and (as with speech) louder is clearer. Every now and then I will hear some instrument or instrumental pattern that I hadn’t previously realised was a part of the music and without fail that puts a big grin on my face! Likewise when I suddenly clearly distinguish words or phrases being sung that previously were incomprehensible mumbles.

Stand-out experiences

One day at lunch, I hadn’t been aware of anyone coming up behind me, but out of the blue I clearly heard a voice say, “Can I get you another glass of water?” I was able to turn around and reply, “No thank you, I’m fine,” without having to ask the person to repeat it. In fact, it is amazing enough that I knew someone had spoken to me at all, let alone heard (yes, heard!) what they said. What a buzz that gave me!

Another day, I was seeing someone out of my office and we were standing in the doorway, talking. Suddenly, my magnet popped off my head and attached itself to the doorframe! After a moment of total shock I had to crack up laughing. It kept me chuckling for most of the day. I told Roberta about this and she was unsurprised, and said that people report their magnets jumping off their heads onto fridges and all kinds of things!

Using my mobile phone

On one occasion, I found myself lost (long story!) and was running very late for a meeting and I was somewhat anxious about it so I phoned the receptionist at work to ask her to pass on a message from me.

Well, that was interesting. I automatically reached up to remove my hearing aid as I had previously heard better on my mobile phone without it than with it. Quite a “duh!” moment as I remembered that things are different now and I’m deaf as a door post without the speech processors! I scrambled for the remote control so I could try switching to T (telecoil) mode if necessary. I had no idea if my mobile phone even had a telecoil. Anyway, I dialed and held the mobile phone up to my speech processor, and the phone started to ring and it was very faint so I switched the telecoil on. Louder — but lots of interference. Blah.

I didn’t hear what the receptionist said when she answered the phone at all so did my usual trick when I don’t hear — talk away and don’t let anyone get a word in edgewise! If they don’t get a chance to speak to me, I won’t mishear! I explained my situation rapidly and did get (or guess!) the “I’ll let her know” when I finished my spiel and then I said thank you and hung up quickly, glad to have that out of the way!

So there was my first telephone conversation post-implant. And I have to say, I’m not in a hurry to repeat it, especially now I know my mobile phone doesn’t work well with the implants. Next time I won’t use the telecoil, that’s for sure.

I told Roberta about this experience and she suggested turning the phone over to speaker phone for now, and said that we’ll “start working on using the phone” in a couple of weeks. I’m looking forward to that in a way, but for so many years I have associated even the thought of using the telephone with such huge stress that I think it will be an “interesting” although exciting process.

In any case, it’s progress! And still all very exciting.

Switched on!

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Today, my cochlear implants were activated.

It has been the most amazing day!

The activation process

I met my parents at the hospital, and we waited together in the waiting room. They were talking and I sat there in isolation, as usual. The minutes ticked on and we were finally called in half an hour after the appointment time.

However, it was All Good™. The audiologist, Roberta, introduced a man who was with her as Gregor from MED-EL, the company who makes the cochlear implants I have. It turned out that I was the first simultaneous bilateral implantee with MED-ELs that they’ve done. So Gregor had set up a couple of systems for Roberta that apparently would ultimately speed up my appointment anyway.

Roberta explained what was about to happen, then she and Gregor checked the strength of the magnet. They decided it was ok, though later they did have to change to stronger magnets.

We started with the left ear.

First a quick test was run to make sure all the electrodes were working ok. They were! Then, one by one, Roberta activated each of the twelve channels. She slowly increased the volume until I could hear the beep and then continued to increase it until it was at a “loud but comfortable” level.

Just this small exercise was delightful because as we moved along the channels I was hearing the beeps of frequencies it had been many years since I’d heard at all.

Then Roberta activated all of the channels for the left ear at the same time.

There was no overwhelming rush of sound as I’ve read in some other switch-on accounts, but I heard some high pitched tones, then Roberta started to speak. Each word sounded like a high pitched beep. When I told her so, my words also sounded like high pitched beeps. Now, I knew not to expect too much at first but I couldn’t help feeling disappointed in case that was as good as it was going to get today…

But Roberta then increased the overall volume gradually and I started to hear some lower-pitched tones too. Eventually I began to distinguish words. That was such a relief and so, so amazing!

We repeated the process with the right ear, and I seemed to have a lot more extraneous “noise”, both high- and low-pitched, with the right ear. But as the volume was increased, the clarity of the words was probably better than with the left ear. Weird how these things work.

Then, Roberta turned both processors on at the same time. After a bit of balancing the difference of volume between the two ears, I was understanding speech at least equally as well as before the implants. I still need to lip read, and I don’t catch everything, but I can hold a conversation. How amazing is that?

Getting used to sound

In addition, there are other sounds I hear that I didn’t hear before. I noticed the car indicators ticking as I left the hospital — it’s a long time since I heard those! I couldn’t resist putting on a CD as I was driving to work, making sure it was playing a familiar song — but too much, too soon — it sounded awful and far from discerning a tune, I couldn’t even tell that there were notes! The singing voice sounded a bit like an old vinyl record being played slooooooooowwwwwwly. Dreadful! Although I had hoped, I wasn’t too disappointed because I had always known it would be unlikely I’d be able to listen to music straight away.

At work, it was great to be able to converse again, however awkwardly. Just as previously, with hearing aids, I found any conversation stressful but I was so excited about my “new ears” that I chattered away to a few people. Someone commented that I was speaking faster than usual but I told her that was probably just because I was excited! Neil said it is noticeable that I speak more quietly now. Apparently that is a Good Thing™ because everyone could previously hear every single word I said.

Who woulda thunk it?

The weirdest thing was to sit at my computer and click with the mouse — and hear a click! I had no idea that a mouse click actually made a clicking noise — who woulda thunk it?

The sound was to both delight and annoy me all afternoon!

Music

When I left work, I decided to persevere with the music thing, and put the same song on the CD player that I’d tried earlier. Imagine my total shock when the introductory notes filtered through, and then I heard the words being sung. It sounded awful — tinny, with buzzing and beeps that are no doubt a meaningful part of the music but my ears don’t know that yet, and as with hearing aids, I couldn’t understand most of the individual words — but I could hear it! I was fighting back tears as I was driving. I never expected this on the first day of sound!

I tried some of the other tracks and I did have better luck with some than others. Some I still couldn’t make out the tune, even though I knew it. But others sounded relatively wonderful and I was just over the moon.

Totally awed

As soon as I got home I pulled out my violin (I just couldn’t help myself!) which I hadn’t even attempted to play in the last two weeks of silence. I started to play, and that sounded terrible too, of course, yet — it didn’t. Whatever my hearing levels, my fingers and my bow arm know what to do, and I found that if I focussed, I could hear the notes and distinguish the tunes and… I was totally awed at the tones. I could hear the resonance of the vibrato in a way that I don’t remember ever hearing before, though once I must have. I played piece after piece, and despite all the ugly sounds in there too, just loved what I was hearing.

Winding down

Andy and Connor came over for dinner and the conversation flowed smoothly for the first time in two weeks — no need for a pen and paper now! I still do have to look at people’s faces and speech read — I don’t know what they’re saying if I can’t see their faces, but I do at least know they are speaking, which is new to me. I never dared to dream things would be this good so soon.

Andy and Connor left quite early and I was glad because the speech processors had been hurting the still-healing wounds behind my ears for a while, and I really wanted to take them off — even though I was so tempted to take my violin out again. If the musical CD experience was anything to go by, each time I do things it will sound better and better.

To know it can only get better from here is a wondrous thing!