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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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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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Can she hear with it?

So a funny thing happened today.  A patron who comes in all the time, who I have always thought had a British accent, spent a few moments talking to one of the subs we had working in place of someone who was out sick.   After he left she mentioned she had known him since he was in grade school.   This confused me.  Shouldn’t he have lost the accent by now?  The guy is  middle-aged.

But he has a British accent, I say.  You’ve known him since grade school?

He doesn’t have a British accent, she says.

Huh.  I guess he just has British lips.

Every day I practice listening to speech with my implant for at least a couple hours, on top of my usual work day.  It sounds like work, but I enjoy it.  My implant has a small hook up type device called ‘direct connect’ that enables me to connect directly to a computer, iPod or CD player so the sound can go directly into my implanted ear. It isn’t a requirement that I isolate the sound to that ear, but sometimes I like to.  The idea is not to strain to hear, but to read along with captions and to absorb as much as possible.

I think all of the cochlear companies have their own websites geared toward listening practice. Advanced Bionics has the Listening Room. Here’s an example of an exercise that can be downloaded onto your iPod. A speaker reads a sentence and stops somewhere. You touch the correct colored square on the screen that matches the color of the word where the speaker stopped. This is just one exercise for teenagers or adults. There are several different types of exercises for people of all ages. The Listening Room is free. You do not have to own an iPod. There are many exercises to try if you like this sort of thing.

The Listening Room

Public libraries are great places to look for audio books. I have read through a bunch of children’s audio books since I was activated last week. Some of them have too much background noise and I get lost.

One of my favorite websites is Bookflix.  With a library card, my library system offers a free subscription on its website.   Maybe yours does too?

This site pairs up children’s video story books  with non-fiction read-alongs of a  similar theme.  One book is set to video with captions while the other is an audio book.  The words are highlighted as you read.  They are absolutely perfect for listening practice! The videos, like the children’s audio books, can have distracting sound effects, but I don’t get lost so easily because the words are highlighted.  This helps me to distinguish words from noise and other sounds.   I know it sounds weird, but that can be hard.

There Was An Old Lady Who Swallowed A Fly

There Was An Old Lady Who Swallowed A Fly by Simms Taback-- a video story book at the BookFlix website

You Are What You Eat by Sharon Gordon

You Are What You Eat by Sharon Gordon-- a Read-Along book at the Bookflix website

See how the word “sweets” is highlighted in red?   That word was being read out loud when I took the screen shot.  In the story book video, you can see the word “swallowed” is highlighted in blue.  Same thing.

It was during one of these videos, Zin, Zin, Zin Violin, that I discovered I might be ready to listen to music with my cochlear implant.

Youtube is a great because you can see the lyrics and follow along.

I was surprised that I could make out a tune so early- especially after watching Charles Limb’s Ted talk a couple weeks ago.  You would think music would be out of the question this early on– and yet amazingly– I WAS able to tell a horn from a violin just five days after activation– something I wasn’t able to do before the implant.

I will admit the music is tinny, and it’s not like I can listen to just anything yet, but it wasn’t off key.   I’m just in the beginning stages.  There will be many mappings.  I’m feeling very reassured.

The Beatles singing "In My Life" - Youtube

My audiologist said not to watch captioned TV with the sound turned off.  I always have the sound on because I usually watch TV with other people.  I am glad that I have done this now.  One less thing to get used to.   I found that it’s great practice to listen on the computer.  Hulu.com has a lot of captioned programs. I especially like that you can set the color of your fonts. As you can see, I prefer yellow.

Good Morning American December 20th on Hulu.com

I’ve been listening to NPR in the car– not that I can hear much– but I get bits and pieces and I’m starting to feel well informed about all things considered. :-)

All in all I think I’m getting in a lot of language stimulation, and I’m feeling pretty good about my progress this week.  I am excited about my mapping tomorrow.

(She is working on it. . .)

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