Saturday, February 28, 2009

Two plus two equals ... five?

The last few days, the cochlear implant has come to seem more natural and less, well, freaky. It's less distracting; instead of thinking about it constantly, I'm simply using it. I even forgot to plug in its charger one night. Fortunately, I had three more cells on standby.

Bananas
I'm also starting to hear more low frequencies. Not very low frequencies but the ones centred around, say, 500Hz which is where many of the speech sounds occur. I'm still having trouble distinguishing between m, b, v but I'm getting there. No trouble at all with the sounds above 1,000Hz which is where I was having difficulty before the CI operation. Here's a diagram called the "speech banana" showing where the main speech sounds are centred and at approximately the volume level in normal speech:

Speech Banana (borrowed from http://quietsong.net)

If you read the previous post, I mentioned that I was able to understand an audio book recording by listening to it with both ears via my FM transmitter. Now the odd thing is this:
  • if I listen to it with just my left ear (hearing aid), I can't understand it at all. It sounds like the teacher in the Charlie Brown cartoons (blah blah blah-blah blah);
  • if I listen to it with just my right ear (CI), I can understand it quite well but something is missing;
  • but if I listen to it with both ears, I can understand it almost perfectly!
This is strange. Somehow, the brain picks up bits from both ears, adds them together and ends up with a bit more than the sum of the parts. Thus 2+2 =5!

Telephone
For the past year, I've pretty much stopped using the telephone except for brief conversations with people I know well. For example, asking Barb what things I should pick up from No Frills on the way home from work. Sometimes, I'd get it wrong and we'd end up with, say, two jars of marmalade but no margarine!

Early phone use

Since getting the CI, I haven't been too optimistic about the telephone. At first, I was unable to even hear the dial tone using the CI. But now, the dial tone is starting to come through. Not loudly but it is there. I played around a bit with various configurations of headphones and listened to a few recorded phone messages. I found I could understand what was being said even if it sounded a bit unnatural.

I took the plunge and called Clare who is usually happy to have a chat on the phone at the end of the day! We talked for about 15 minutes and I could understand most of what she said. Not 100% but enough to follow the conversation and fill in some of the gaps from the context. So that's encouraging. I'll have to keep working at this and try some more formal exercises with her and some other willing victims - lists of words and phrases from the workbook, etc.

The telephone obviously conveys a lot less sound information than other sources such as FM radio or cassette tapes. From what I've read, it's limited to frequencies between about 300Hz and 3,000Hz. Looking at the speech banana above, that band encompasses most of the speech sounds but j, f, s, th and ch fall outside its range. Is it possible to really hear the word this on the phone? Does it sound any different from fith or do we just know that fith isn't a word in English?

Friday, February 20, 2009

The Gadgeteer

I think most hard of hearing people have a collection of gadgets to use for hearing assistance in various situations. One of my gadgets is made by Phonak and is called a Smartlink. I've used this with my hearing aids for a few years now and, for the most part, it does what Phonak claims it can do.

It's a small handheld microphone with a built-in radio transmitter and antenna. Depending on switch settings, the microphone can be directional or omnidirectional. For example, at a dinner party, that means you can focus its attention on a particular speaker or have it pick up all the speakers around the table.

The radio transmitter + antenna beams a signal up to a small sugar-cube sized receiver that attaches to the hearing aid. I have two receivers, one for each hearing aid so I pick up the same signal in each ear (at least, I did before the CI was installed).

It can also be connected by a jack for sound source such as a laptop, TV or telephone. This is great as it means I can walk around the room or even the house while listening to "Jeopardy" and miss very little. Or, if it's "Friday Night Smackdown", nothing at all.

That said, it's obscenely expensive and somewhat over engineered. For example, it has tiny switches that are difficult to see, much less to press. In dim light, you just squeeze away and hope that you have selected the right thing. Other features are a little too 'automagical' for my taste - e.g. a power-saving feature that causes it to shut off after one minute of silence. It's not easy to get it to turn on again. That's very annoying if you are using it with the phone and have been put on hold.

This week, I received an attachment that allows me to connect one of the sugar-cube things to my cochlear implant processor. This attachment is quite easy to use but it does require an tiny battery to power the receiver; presumably, it would put a bit too much of a load on the cochlear implant's built-in battery.

Anyway, I set everything up, connected the transmitter to my computer earphone jack and tried it out. The first selection was from the aforementioned On the Origin of Species.

Absolutely amazing! I could clearly understand every single word of the passage without having to follow the written text at all. I haven't been able to do this with hearing aids alone for years; even if I could 'hear' it in the sense that it was loud enough there was just too much distortion and garbling of speech for it to be understood.

This is encouraging in more than one way. I had not been using the Smartlink as much lately because it became less useful as my hearing deteriorated. So it looks like it will become more useful instead of being an expensive paperweight. And it may provide a way to understand the telephone. There's a big advantage in being able to hear the phone in both ears rather than just one. At this point, I really can't understand the phone.

It's something to work at.

Wednesday, February 18, 2009

Ear Exercises

I haven't posted for a whole week and a half. Not because nothing has been happening but because I've been a bit busy with one thing or another. Now it's the end of our winter long weekend and I have a bit of time to catch up.

Exercises
One of the things that has kept me busy is doing 'Ear Exercises'. These are of two kinds. One is simply listening to audio-books and following the printed text word for word. For this, I downloaded Charles Darwin's On the Origin of Species. Now you might think that's rather dry but it's actually very interesting. The chapters are read by various people. Mostly, they are easy to understand but Chapter 5 is read by someone with a distinct Irish accent. That makes it a bit more challenging!

The other exercises are from a set of listening exercises in a workbook/CD loaned to me by the audiologist. These are graduated exercises centred around closed or limited sets of words. I listen to spoken words, write down what I hear then later check the workbook to verify that what I thought I heard was actually what was said. Simple and quite effective. I stumbled on some things:
  • one exercise is based on time. The reader uses some odd expressions such as "twenty five of three" and "ten of twelve". I don't think I've ever heard or read this expression in Canada or UK. Perhaps it's an Americanism?
  • for numbers, the words "five" and "nine" are difficult to distinguish; also "fifteen" versus "fifty". And, often, I can't distinguish between "fifteen" and "thirteen"
  • another exercise is centred around letters of the alphabet. These are actually quite difficult because there is no context. And, of course, many letters sound alike: "m" versus "n" or "b" versus "p" versus "v".

Maps
Yesterday, I went off to Sunnybrook for another 'tweak'. This one did not take very long and I now have an alternate map (or program) to try. I can switch between the new program and the previous program within a couple of seconds.

So far, the new program isn't working too well for me and I realized by about 3 o'clock this afternoon that it was making me irritable and crabby. So I switched back to the former map and -presto- I was instantly much more cheerful! I may just have to give the new map more time or it may be that it's a step backwards rather than forwards.

That's part of the point of all the mapping sessions: to find the "sweet spot" where things sound good and, more importantly, I'm understanding people.

Music
Music is also starting to sound better. Matthew sent me a CD of the Goldberg Variations played by Glenn Gould (thanks Matthew!). I haven't heard this for a while but I remember it quite well. It sounds pretty good as I listen to it right now even with just the CI. Not too much dynamic range (i.e. no very loud or very soft passages) and mostly just one instrument. Occasional cymbals, though.

Tim's
On the long weekend, we drove up to the cottage. I found I could understand Barb talking quite well in the car. Previously, I had to rely on lipreading, either directly or via a mirror mounted on the inside of the windshield.

We stopped at Tim Horton's in Orangeville for lunch. Like most such places, it's fairly noisy. I can't honestly say that I could understand what other people were saying but I did catch phrases or snatches of other conversations. But it's hard to determine where they are coming from or even how far away they are. Similarly on the subway - I can hear someone talking but I can't tell if the speaker is a person sitting close to me or a group of people half way down the car. They just seem to be disembodied voices.

Saturday, February 7, 2009

EEEs and MMMs

It's now the end of Week 1 with the CI. And I've survived my first week back at work without getting too stressed out.

I really did not have very high expectations for the short term. I was prepared to hear bleeps, pips and hoots but not to be able to make much sense out of it. That, apparently, is the experience of a lot of people for the first while.

In fact, the CI has exceeded expectations even within this first week. I'm hearing things but I'm also understanding people better. That's in combination with lip-reading and a hearing aid in my left hear - these seem to fill in the gaps that the CI is not, so far, able to comprehend.

Yesterday, I returned to Sunnybrook for a 'tune-up' session with the audiologist, Amy. I had a number of questions for her, one of which was whether all the electrodes in the implant were working correctly. For some recipients, not all electrodes are functional and not always for any identifiable reason. But Amy assured me that all the electrodes are working for me. That's a relief - it may not be too important in the end; all that matters is how much hearing and comprehension I'm getting out of the electrodes that are there. But it does mean that there's more of a reserve in case anything goes wrong with one or more of the electrodes in the future.

Initially, I had been set to a rather low level such that even with the volume control turned up to the max, it still was not very loud. Training wheels if you like. This time, Amy took me through a number of simple tests to find my comfort and tolerance level for individual pitches of sound. We then went through some listening exercises for various phonemes and I was able to distinguish most of them. The exception was /eee/ versus /mmm/. She says that a lot of CI users have trouble with this and nobody seems to know quite why. Fortunately, these two sounds are easily distinguished by lip-reading and are usually identifiable by context, in English at least.

The end result is that I now have a wider range of sounds: there's more mid-range so voices sound less thin and hissy than before. There's also a lot more volume so I'll have to be careful with the volume control! Even though it's tolerable at each separate pitch, when they are all put together the combination is going to be intolerable if the volume is set too high.

She also loaned me a workbook/CD set of listening exercises to do. This looks quite comprehensive and well thought out. I've never actually had anything like this before. It's too bad that hearing aid vendors don't provide something similar with their products. I'm sure it would help a lot of people adapt to hearing aids and (perhaps) prevent the aids from being relegated to the drawer.

So lots to work on. But I'm going X-C skiing tomorrow even though I'm not supposed to exercise for a month or so after the operation. I'll just take it very easy, not do anything that could be considered strenuous and listen for chickadees.

Tuesday, February 3, 2009

Hear and There

Today, I've discovered a few new things in the sound landscape, not all of which I really want to hear:
  • Subway: between St George and Museum, the wheels go SHRIIIIIIIIEEEEK as the subway takes a sharp corner. I thought they had fixed that problem years ago. Nope, it just seems I became deaf to that particular sound.
  • Muzak: on a walk in the underground mall at lunchtime, it seems that nearly every store has some kind of muzak going. Does anyone actually LIKE that stuff? Are they trying to drive customers away?! Well, it will drive me away which may not be so bad.
  • White noise: at work, I realize that the building ventilation noise is quite loud and obtrusive. Before the CI, I couldn't exactly hear it but I was aware of it because, when it shut off at the end of the day, there was some sense of release or quiet. With the CI, I can hear it all the time. Perhaps I'll get used to it.
On a more positive note:
  • While putting ingredients in the bread machine, I poured out some flax seed into a measuring cup. It makes a soft noise - a sort of piiish. Nice
  • I'm hearing more low frequency sound now. Not deep bass notes or anything but deeper than before. For example, the noise of the keyboard clicking away sounds more natural now whereas, a couple of days ago, it sounded thin and high-pitched. Strange.
  • I tried listening to various bits of music from the web. On Monica's suggestion, simpler pieces or with just one or two instruments. Harp music sounds quite good, but more crisp and precise than before, especially the very high notes. Clarinet isn't bad. But I can barely hear the cello - it's too low and deep.

Monday, February 2, 2009

Syllables, Sybillants and Cymbals

Phew, I've survived the first day back at work.

Mostly, it wasn't too bad. Several co-workers asked how the operation went and how I was doing. Interestingly, I found I could understand some of them better than before. It's hard to say how but I could pick up more of the consonants, especially the 'sybillants' (s and sh sounds).

Walking to the subway, I heard a flock of starlings overhead. A different sound from sparrows, for sure.

I hadn't realized before how many electronic gadgets make noises when you push their buttons. The bread-maker beeps. My digital camera beeps. The uninterruptible power supply for the computer beeps ... well, OK, I remember that one. It means that it's time to replace the battery. It needed replacing, oh, about 8 years ago and still needs replacing so I can only presume it has been beeping away for all those years and I haven't known!

Some things are NOT working. When I listen to the phone handset I can't hear a thing, not even the dial tone. I'm not sure what's wrong there but it will likely take some time.

Also, music. I tried listening to a bit of Mozart. For example Eine Kleine Nachtmusik the tempo and beat are just right but the whole piece sounds like it's being played not by an orchestra but by a lone and hyperactive percussionist on the cymbals. Monica suggests trying something simpler for starts; a piece with just one or two instruments. She's probably right. I'll have to pull down my rather ancient collection of cassetts tapes as I don't really have much music on CD.

Sunday, February 1, 2009

Heard a Bird

Yesterday, I was off to the dump. No, not to toss out my collection of old hearing aids but to get rid of various bits of defunct computer equipment that have been piling up in my office.

This was also my first time driving since getting the CI. Usually, I have to turn my hearing aids down or even off while driving on the highway because the noise is so loud I can hardly hear myself think. I expected it to seem noisy in the car with all sort of rattles and squeaks.

But no, the CI hardly seems to notice the engine, road noise or wind noise. Instead, it picks up sounds like the turn indicators, the whoosh of the tires going through a puddle, the squeak of my boot against the clutch pedal. Much better. At one time, I could hear the turn indicators but it's been a few years since I've been able to hear them while the car is moving.

I tried listening to the radio - CBC Radio 2. It was evidently Vinyl Cafe. Now, I wouldn't say that I could understand it at all but I was able to distinctly pick out quite a few words. That's something.

I haven't heard any birds for a year or two now. And the last time I heard one, it was more of a click than a cheep or chirp. So I was interested to see if the CI would pick up birds. Not many birds around right now even though there were a bunch a few days ago. So I stood on the back steps waiting. Eventually, a lone sparrow turns up and starts pecking away at the bird feeder. But it's too busy scarfing down sunflowers seeds to chirp. After a while, it flies off into the neighbour's rose bush to digest. And then - cheep, cheep! YESSS!!

I'm noticing various other sounds around the house: the beep when you push the buttons on the oven is different from the beep that the microwave oven makes. Before, it all sounded the same - a sort of croak, if that.

What I hear in my left ear (hearing aid) sounds quite different from what I hear in my right ear (CI). At first, the two sides seemed somehow disconnected as if the sound was coming from two completely different sources. But already, after only 48 hours or so, the two sides are starting to sound a bit more connected or integrated.

Tomorrow, I'm back to work. I'm a bit nervous about that. Partly because I look a bit, well, different:I'm sure the bald patch over the ear will grow back in a while but right now it looks a bit naked.

There will be two and a half week's backlog of work to catch up on and lots of 'new' sounds and voices to get used to.