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River Walk – Before and After

Last November I went for a walk along a river path just a couple weeks before my cochlear implant surgery to take notes on what I heard. I wrote it all down in a journal entry. I could hear my own feet, or perhaps I only felt the footfalls as I walked along. Wasn’t sure. Bicycles were silent unless they were right next to me. I heard one duck quack five feet away. I saw a duck flapping its wings in the water and wondered if I might hear water sounds with my implant later. People passed by me in silence. I heard an airplane.  My audiologist warned me that when I got the implant I would initially be distracted by every day sounds like the sound of my own clothing as I walked.  I could not imagine clothes making sounds.

I have been waiting for a nice winter day to take a walk along the same path so I could tell you what I hear now with the implant.
Today was the day.

Since my cochlear implant was activated I have heard my clothing.  I am no longer distracted by it, but I remember thinking about this in November, and it registers that I can hear the rustle of my pant legs and coat as I begin my walk.

I enter the path at my usual spot and I am met almost immediately by a murder of  about twenty-five crows chattering in a tall naked alder tree.

A biker whizzes by.   I hear the hum of the bike’s wheels coming from behind. Back in November I wondered if that might be possible. I feel safer knowing I can hear bicycles.   I have had some near misses with bikers and skaters when I haven’t heard them approaching in the past.  I make a point to hug the right side of the path, but there are careless bikers.  Usually kids.  I hear many, many bicycles today. Not only can I hear them, but I hear the bicyclists talking if they are riding with friends. Bits of human conversation seem to be everywhere.

Two women from behind. . . “You could go almost ANYWHERE!”  . . . “Yeah– I know!

A mom with small child in a stroller “Mama?”. . . “What?”. . . “Can I get out?”. . . “No, not yet, I’ll let you know. . .

A man on a phone. “OK– OK I’ll have to call you back because I don’t know about that. . .Yeah OK right. . .OK, I’ll call you. . .

A baby in a stroller “Ba-ba-ba-ba-BA!

A woman on a phone, “I told him it hadn’t been approved!

Being able to hear snippets of other people’s conversations has been a weird thing for me. Kiki says you get used to it.  You learn to tune out.  It’s hard for me because I’m not used to hearing like this.  It seems like my brain wants to soak up every bit of speech it hears.

In the distance I hear what sounds like a back hoe scraping the earth somewhere, then an engine roar and metal squeaking. I don’t know where it’s coming from. I look all around, but can’t see it.

Moving along, I begin to realize there must be hundreds of birds everywhere in all directions– but where are they? They chirp and quack non-stop. A row of leafless poplars line one side of the path. I stop to watch for awhile. Sure enough. One brave starling makes a daring flight across to the next tree while I stand still as a tree myself. A constant rustling in the branches signals activity. Earlier I thought it was wind, but I now realize the trees are filled with starlings nesting for the winter. They must be restless on this warm winter day, like the humans around me. That explains the chirping I’ve been hearing for the past twenty minutes.

Except for one lone duck in the river, the rest of the them hide in a snarl of dead blackberry brambles along the riverbank. Last November, I saw only one duck in the river.  I did not realize others were on the side of the bank because I could not hear them. I step across the path onto a pile leaves that crunch beneath my feet. This sets off a cacophony of warning quacks and squawks.  I am too close for comfort.  I walk along shuffling my feet in the leaves listening, until I hear the sweet bubble of rushing water, my new favorite sound.

Further on, water seems to tinkle in a metal tunnel. It sounds like it’s under ground, but it can’t be. Yet, I feel almost certain in what I am hearing. Back in November I wondered if I would hear the river. I had forgotten how beautiful water sounded. I can see  the river through the brambles along the bank. I know the river isn‘t echoing in a tunnel. My implant sometimes has a tunnel sounding quality to it, so I wonder. I am nearly done with my walk when I see two steel drain pipes ten feet apart where the thicket has cleared. A sign post says Derby Creek.

WOW! WOW! I get it now. It’s an underground creek. Steel drainage pipes must be all along the riverbank.

Before and after. What a difference!

Here’s a cool video of a starling murmuration by Sophie Windsor Clive and Liberty Smith.  It is very, VERY cool!

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Music and My Cochlear Implant, Part Two– Week Seven

I didn’t expect to be able to hear music right away when my cochlear implant was first turned on. I could barely understand speech at first.

Charles Limb’s depressing Ted talk  had been posted on-line just a few days before my surgery. If you listen to it, you’ll hear him say at about the three minute mark, “As a physician  if I had to have a cochlear implant, I would be heart broken because I know music would never sound the same.“

Luckily, it turns out that I am able to hear music with my cochlear implant.  But he is right that it doesn’t sound the same.  I got past that a long time ago.  Music hasn’t sounded the same in probably twenty years.

Three days after activation, I was watching a child’s book flix video called Zin Zin Violin, which is about the instruments in an orchestra.  I was astonished when I could tell the difference between a violin and a horn, which I was not able to do previously with hearing aids.  I got so excited I searched out a song on Youtube, Blackbird, by the Beatles.

Though it sounded like it was stuck in static between two radio stations, I could clearly pick out the tune.

Now that I’m on my third map music has continued to get better.  Some songs sound really good, others do not. If there is a lot of complicated instrumentation, the sound can be muddled.  However, music sounds better than I ever expected at this stage.    I am hearing high fragments to songs I haven’t heard in years- old guitar riffs I had forgotten about and vocals.  I can actually understand the words to some songs now. It’s like coming home after being away for a long time.

But there is still a shallow am radio quality to music. I know it will get better because with each new map, the sound becomes more rich and full.

I went to the opera on January 23rd. Verdi’s Attila. I had never seen this opera before. I wasn’t expecting to like it. The idea of Attila in love just didn’t appeal, but I was pleasantly surprised by how much I enjoyed the music.  I could hear the Soprano!  In comparison, last October I was unable to pick out most of the songs in Carmen, a familiar opera I knew well.

The best thing is knowing music will get better- not only because my ear is still learning, but also because cochlear implant programming will continue to improve.

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Music and the Cochlear Implant Part One, Week Seven.

Up until last year, I had always heard music pretty well because I had a lot of good residual low tone hearing left. OK- I admit that I didn’t hear the full spectrum of music in any particular song, but I got enough that it was enjoyable, and often recognizable. In early 2011 I downloaded a bunch of new music to my iPod in anticipation of the new Bluetooth equipment I had just purchased for my hearing aids. It was great! For about a month. . .

Early last spring I began to notice a significant change in my hearing. The operas that I loved were a struggle to get through. Suddenly music wasn’t making any sense to me. It sounded like . . . Bleah. . . NOISE! A few times I fell asleep during performances! I tried adjusting my hearing aids and fiddled with the staticky FM systems they let you borrow downstairs. All too often I gave up in frustration and turned my hearing aids off.

The sounds I heard coming out of my hearing aids were indescribably painful. I had no words to express what I was hearing. I am pretty sure these sounds only exist in the world of mangled cochleas and power aids.

I realized I had lost hearing but thought it would simply be a matter of programming. But apparently I had reached the point where my programming window was too small. My hearing aid audiologist actually refused to do another hearing test until I was re-evaluated for a cochlear implant.

I had been avoiding the full cochlear implant because I knew a lot of instruments fell in the areas where I had low tone hearing. This is probably the best illustration of the range of sound musical instruments cover.

Many instruments have a wide range of sound, and much lower hertz than speech.  My hearing was not too bad below 1000 hertz.  With hearing aids I got decent musical sound to about Middle C or above on a piano keyboard, which would be C4.  Unlike a lot of people I was almost more concerned about the sound of music than speech.  (Unfortunately my link here didn’t upload well. Here it is if you want to look at it.  http://onefryshort.org/images/frequency_chart_lg.gif )

Internet research wasn’t very reassuring. T., my hearing aid guy who I’ve known for twenty-five years said I would still have my other side to fall back on if I got a cochlear implant that didn‘t pick up music well enough. Ultimately he thought I might end up with a nice full sound between my two ears if I got a CI, but he wasn’t sure. S., the cochlear implant audiologist, said it takes practice to process music. The more you practice the better your ear gets at making sense of what it’s hearing. But there are no guarantees, she admitted. Everyone is different.

What finally convinced me to take the leap was that I realized my hearing aids weren‘t doing much for me at all. Driving around in my car I had to turn the music up so loud to hear it I could feel the base pulsing on the gas pedal through my shoes. Was I hearing it, or just feeling it?? I wasn’t sure.

For weeks I drove around listening to the car radio, first with one ear turned off, then with the next turned off trying to determine which ear sounded more distorted with my hearing aids, and which processed the best music by itself. I chose my left.

My favorite new song–

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Mapping out some trouble spots– Third map

January 16th– My third map and the first day of a week of heavy snows. I was so ready for some new sound! I wasn’t hearing low tones and went in with a list of complaints, including that I couldn’t hear my husband or son very well. It wasn’t necessary. S., my audiologist had it covered.

As long as I wear my hearing aid, I explained, I do fine. My hearing aid was picking up the low tones that my cochlear implant wasn’t. The way I would describe it would be that when men talked, it sounded like a thunderous rumble. There was no clarity, especially if they said words with typical low tone phonemes like Mom or bring.

We started right off in the hearing booth. My tonal scores were pretty amazing– up in the mild hearing loss levels across the board. Then S, my audiologist explained that I was hearing everything I needed to, including all the low tones, but that most likely my brain wasn’t paying attention to everything. She showed me that my low scores were better than my pre-implant scores, which was surprising because I had always had pretty good low tones naturally. But I think that explains the rumble. They have seemed too loud!

She could make adjustments, but wants me to practice some more. Practice is everything when it comes to hearing with a cochlear implant.

Maybe I have brain overload. She has seen this before, she said. Pretty soon it will stabilize. The brain can become over stimulated from all the new sound you hear, and won’t process everything, especially if it hasn’t heard some tones in a long time. The new tones will over shadow the old ones. She thinks it will all calm down before my next mapping session in March if I practice.

I am feeling frustrated. My main goal is hearing on a phone. If I can’t get at least one of my ears hearing ALL the tones I won’t be able to use a phone effectively.

Next, I aced the Azbio sentence test in quiet. With both my hearing aid and CI, I scored 97%!! But I’m not supposed to be wearing my hearing aid right now. Without it, I scored only 62%– way better than the 27% score I got with two hearing aids pre-implant. My score was so good she tested me in noise. 52%.

She thinks I should practice listening to speech in noise. That isn’t hard to do. I’ve been making lunch and coffee dates and inviting people over. The CI doesn’t perform as well in noise as my old hearing aids in noise, because it doesn’t have noise muffling capabilities like my hearing aid.   Again, there is some programming tweaking that could be done, but she wants me to get used to the full sound first before we mess with tweaks.  I like her approach because it seems simple and straight forward.

Advanced Bionics has a new program in the works called Clear Voice, not yet available in the US, that is supposed to take care of this problem. So far I’ve read great reviews about it where people are using it in Europe and Canada and I look forward to trying it out when it‘s available. By and large though, it is a good idea to train your brain to put background noise into the background. Since the CI doesn’t work exactly the same as hearing aids, the general idea is to train your brain to hear the way hearing people do. They learn to tune out background, and this is theoretically possible with the CI as well.

After more threshold testing, S. gave me some new programs with wider sound, and a t-coil phone program. She let me listen to some fairy tales on a phone line. FUN! I got just enough to know it was a fairy tale. I called my husband and kids as soon as I left the doctor’s office.

I can’t say the phoning was successful. I carried on a conversation with my husband-yes- but I guessed a lot of what he was saying and he was yelling and repeating over and over. I couldn’t understand my kids at all. Oh well. It was a start. At least I heard the phone sounds, the phone ringing and that they picked up!

In the car on the way home I popped in my trusty Beatles CD that my daughter gave me for Christmas– the one that has all the old familiar tracks I know so very well. The sound was A-maz-ing!! Whoa! Happy about new map!! She loves you– yeah, yeah, yeah!!

Phone can wait.

Here is my latest new COOL sound discovery.  Walking in snow!  Many thanks to Jojikiba atYoutube.com

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Seven Weeks

I just realized I haven’t written in here in over a month.  It is hard to find the time.

Earlier tonight I had my family over for dinner and watched TV with my two sons.  Somehow the captions got switched off.  I was surprised how well I could follow along.   Since it was in a talk show format I could see their faces straight on most the time.  Normally I still need captions but I find I’m relying on them less than before.  This got me thinking about the CI rehabilitation process.

It is much more involved and different than I ever would have imagined.  The cochlear implant requires a huge commitment.  It is not an easy fix.

Here are some notes I meant to post from the past few weeks–

January 3rd

So this is January third and it has been just a little over two weeks since my cochlear implant was activated. I can’t really hear speech with it that well yet. I hear some speech sounds better than before, but I’m still lip reading a lot. My audiologist says that’s normal, especially for someone who has had hearing loss for a long time.

She has had to turn the volume up gradually so I can develop a tolerance to the high tones necessary for speech, which sound shrill and painful with each new twist of the knob.  She doesn’t want it to be painful, so I tell her to stop right away.

Before I got the CI,  my audiologist said it can take three months to a year to adjust to your cochlear implant. Three months would be the best case scenario. It has only been three weeks.

My progress has been slow, but steady. I have graduated to children’s chapter books on CD. I don’t have to follow along with my eyes glued to the page now. I don’t have my CD player turned all the way up. I find it is too loud and I hear better with the volume down just a little bit. I can take my eyes off the page for a while and I understand maybe 30% of what’s being said, I estimate. Then I can find my way back to where I was! This is great progress from ten days ago when I could only understand one sentence per book.

I cannot hear on the phone, but I understand the Comcast lady on the phone when I go to retrieve my messages. She is the only voice I understand.

I can listen to NPR on the radio in the car and I understand the gist of what they’re talking about! A couple weeks ago I only understood a sentence here and there.

I feel I am not hearing low tones.  Where are they?  I have always heard low tones.

January 9

Wow. I went to a work meeting on Monday, where I estimated maybe 25 people were in attendance, sitting in a round with a couple people writing on a white board. In the past this type of meeting would have been impossible.

Because it wasn’t mandatory that I attend, and I wasn’t sure I was going until the last minute I didn’t bother to ask for any type of accommodation. In fact I often don’t because I can usually finagle a seat up front. This time I couldn‘t.. I wasn’t sure how well I would hear, but again since my attendance wasn’t mandatory I thought what the heck.

Then the Big Awful happened. We were supposed to go around the room giving our opinions to the same question one by one. I hate situations like this mainly because I am afraid I am going to repeat something someone else said, since I usually can’t hear everyone. Clearly with twenty-five people, there cannot be twenty-five original opinions. There can only be maybe two or three different opinions with twenty-five original ways of expressing them. But since I can’t hear, I am at a disadvantage. I do not know if the clever pun I’m thinking has been punned before. The safe route is to be serious and boring. Better that than risk looking like a parrot.

But then. . .

One by one as each person spoke, it became clear that I could hear them. Suddenly I found myself feeling very confident. When it was my turn, I spoke my mind feeling more comfortable than I ever have before. WOW, WOW, WOW!

Stay tuned from more WOW moments.  . .

 

 

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Success!

I measure success in incrementally small steps these days. Before activation a lot of other borgs warned not to have high expectations at first. I’m so glad they did. Robyn said it best when she shot me a message just days before my activation saying she couldn’t wait for my turn-on and by the way– “You’re going to HATE it!” Those words have sustained me through all the frustration this past week.

I got my second mapping yesterday.

We start out in the sound booth listening to tones. Some of them sound more like people sweeping a sidewalk or sanding a block than the tones I am used to. That is normal, S. my audiologist says.

She is thrilled I have been wearing my CI every day by itself for hours, and practicing. She notices I can put it on without searching around on the side of my head for the magnet, and I‘m not even in front of a mirror. I am proud. Midweek, putting it on without a mirror was a huge breakthrough.

I am ready for more volume because I have been wearing the processor every day for hours. We discuss how the volume should be– not painful or sharp because it will give you a headache. Then S. turns it way up.  She claps her hands. I don’t wince.

After more discussion, she decides to add the ability to turn it way down because I tell her about a large family gathering with small children I will be attending. I am so grateful for the ability to turn volume down.

She asks how it sounds. I hear an echo when I speak. It sounds like she has three voices, as if she’s a crowd speaking all at once. It reminds me of sitting in church, listening to a small congregation read passages from the Bible. She thinks this might be because of my residual hearing on the other side. I assure her it isn’t.

I have been listening to books on CD with my direct connect, and I’m getting the same effect. Deep voices, robotic voices and high voices all at once. She says it will go away in time. My brain will figure it out.

Are you able to follow along by reading with the story? Can you understand anything when you listen to the CDs, she asks.

If there is background noise I  get lost quickly, but sometimes I understand a sentence or two if there is no background noise.

WONDERFUL! She exclaims. You’re making great progress!

A sentence or two was more than I’d hoped for the first week, but I am reassured.

At work I notice I can hear people typing across the room. It’s funny. I always thought typing was a quiet activity. A hallway door seems incredibly loud every time it closes.   I can hear people cough in the back of the library.

Later, I open a book on CD, one that has proven challenging throughout the week because of its background noise. I deduce it is organ grinding music, but it mostly sounds like someone playing random notes on an electronic device. The story is about a homeless organ grinder in December, and a little girl with compassion. It is called, Great Joy by Kate DiCamillo.

After the new mapping, I am able to read along to the CD without getting lost.

SUCCESS! :-)

My next mapping is in three weeks.

The book on CD has organ grinding music in the background making it a challenging choice for listening practice, but it's a sweet story.

 

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