Roaring Lamb

Noticing the differences

Hearing the music on TV is so wonderful.  All music on movies and televisions completely escaped my notice before.  Now there's a wide range of musical sounds that don't correspond to any instrument I'm familiar with.  If anyone watched Alias, especially the first season, there's quite a bit of instrumental music that I cannot recognize, but sure sounds pretty.  Techno beat, but still intriguing.

There's a fellow from Australia working in my office and he wears...what else...cowboy boots.  The hollow thumping sound of the boots hitting the floor just seemed to match his persona.  Yeah I went to the office, trying to catch up on reporting and also having to capture photos and stories of today's events on campus.  One was a paniolo party at the preschool.  The kids had lots to do, bouncing castle and a petting zoo.  They brought minature ponies, goats, and a pig.  The only non-minaturized animal were the rabbits and guinea pigs.  Kids wore cowboy hats, since paniolo means something like cowboy.

Then it rained hard today.  Was able to recognize the sound from inside, and I don't have any windows except in the nearby offices.

My whistle doesn't sound any better, so in a couple months, I'll ask why the CI doesn't pick it up clearly, but maybe by then it will change.   Oh I heard that car alarm that just went off.  Clear as can be and it uses all different tones.  Probably woke up every baby (and a lot of adults) in this complex.

Still I like having it quiet in the morning.  I don't rush to put my CI on in the morning as it is quite a jolt when it first comes on.  Try it sometime.  Keep your TV or stereo volume at full blast and turn it on at the quietest part of the day, then imagine that sound times two.  That is the difference between on and off for me.

People laugh when I tell them I need to learn English again.  That's pretty much what it feels like.  I can understand the words with additional clues, but spoken words by themselves are still a hit and miss affair.  My activation took place on Jan 25th, so it hasn't been two months yet.   Many CI wearers experience fast changes in the first three months, then it tapers off after that.  What sound I have now is really nice, and there's room for improvment.  I'm thankful.

Squealing tires or was that a horn?

Years of conditioning of not knowing what a sound is and no way to figure out usually keeps me from jumping at sudden unknown noises.  This conditioning of not jumping extends to people tapping me on the shoulder.   But the startle reflex is making a comeback!

While driving back to the campus after the Writers' workshop, a sudden noise like a loud squeal not only caused me to look in my rear view mirror but made me jump.  Split seconds later, I recognized the pattern of the sound, it was a horn, not the sound of squealing tires.  The driver of an oncoming car blasted their horn at a driver making a u-turn in the middle of a highway.  Pre-CI days meant that the sound of a horn would be barely discernible.

The CI and hearing aid both have features that keep the sound from being painful by cutting off extremely loud sounds. The CI also stops spikes in volume which at times interferes with enjoyment of worship music since 500 voices raises the rafters of our building!

I'm wondering if this life-time conditioning to ignore undiscernible noises is working against my understanding voices.  I want to catch every word, and if that isn't happening, it is much easier to tune out.  The idea of capturing just a portion of the spoken sentence (without lip-reading) leaves me wanting the concrete clues of either written words (that match the spoken word) or seeing the person that is speaking.

Oops, another midnight posting.  Oh well.  That's enough for now, the music has relaxed me enough and it's time to sign off.

Wings upon air

It took my brain a second or two as it registered for the first time the sound of wings beating the air.  A zebra dove had just waddled toward my chair when something startled it.  From the corner of my eye, I saw it lift off just two feet away and then realized I heard the fluttering of the wings.   I almost missed the fact that this was a new sound for me.

A strong wind shook all the palms and various other plants around the building hosting the writers' workshop. This building is open on three sides.  So whenever the speaker hesitated at the microphone, a staticy sound  took over; it was the sound of plants brushing against each other.  It was another moment of disconnect for me because this rustling sound didn't seem to be what I imagined.  It even sounded like paper being shuffled across the desk, only magnfied a few times.  In my mind a rustling sound would have been a soft, rounded sound and it turned out to be a soft but sharp sound...not as annoying as radio static, but the similarities were there.

My disappointment of the past two weeks is not hearing the various speakers reading their assignments.  I just said to myself, there's always next year.  However, there is a huge improvement in communication.  I can hear the foreigners on the campus and the sound of their voices helps me lipread them.  With lip-reading alone, I could barely understand.

A major purpose of this journal is to keep me from forgetting all the changes in my hearing.  I've since found out people like relearning the sounds around them too...hearing them through the ears of this newbie to high frequency sound.

Started using updated T-mic

My new sound today was hearing all the different warbles of a baby crying in our office.  The father has been bringing his infant son to the office quite a few times and until today it didn't make much noise. Today it cried long enough and loud enough I could hear all kinds of different wails.

It is not unusual for our office staff to bring their little ones.  I've enjoyed it because usually they stay just for a little while and their youthful exhuberance and smiles light the place up.

Tonight I decided to put the old-style T-mic away in favor of the new sturdier one.  A T-mic sits closer to the entrance of the ear canal.  Sound captured by the shape of the ear enter the microphone at this location seems much stronger and vibrant than in other locations.  Plus it makes it easy for me to just pick up the phone and listen rather than switching to a telephone setting. 

The T-mic comes only with  Advanced Bionic devices like mine.  Other manufacturers have a T switch or telecoil switch.  This allows all background sound to be canceled because the CI (or hearing aid) only picks up a magnetic signal which represents sound.

With the newer T-mic sounds may be crisper than before.  I seem to have a very short memory when it comes to judging the difference in sound quality.  One of my goals is to sing and hit notes.  So far my voice disappears in the crowd singing along with the various instruments.  It would be cool to sing in a place where I can belt it out without anyone else listening...and have just one instrument playing instead of several.  More layers of sound makes it harder for me to hear the notes clearly.

It all is awesome.  I may reach for better quality sound, but hearing these precious sounds day in and day out makes me very appreciative of this wonderful improvement.

It takes time

After just over a month, I've decided to relax and let the sound grow clearer.  That doesn't mean stopping listening exercises, it just means quit trying so hard to prove how good this CI really is.  Haven't had too many friends test me, but they did it last night.  No I couldn't understand their conversation without seeing their faces, but it didn't bug me as much as it could have.  I'm just like an ESL (english as a second language) student that needs more listening practice. 

I enjoyed finding the cardinal and listening to their call.  It isn't a singsong voice, and it isn't as annoying as cawing or screeching.  I think there's one outside the window somewhere, but it will take time to actually remember the sound and know without a doubt.

I socialized at a party last Friday night with greater ease than ever before.  It took some courage to break into groups of two, but the incentive of knowing I would understand their conversation kept me from staying away.  Years of avoiding clusters of people talking made this a challenge, yet the fact I can lipread without working so hard made taking the plunge that much easier.  Took me a long time to get back on the "horse," but I'm determined to do it.

In the midst of this conversation, I still must lip-read, as conversations in noise makes it too hard for my poor brain to cope with focusing on the person speaking to me.  But it is okay.  I have faith in the Lord who brought this gift of cochlear implants, and things will get better.

A potential article

This story is about Margie Campbell, whose husband is a pastor in Kona, and myself.  I wrote in hope that a local newspaper could use it. 

Now it is possible to hear my own name without looking at the person. Early in Dec. 2004, two Kona women, Margie Campbell and myself underwent a cochlear implant operation to restore our hearing. That small step is no less a marvel than the first step on the moon. The cochlear implant (CI) technology to restore sound to people experiencing the isolation of hearing loss requires computers, radio waves, specialized equipment and technicians.  The surgery  only placed the internal pieces of the CI, sounds begin only when the external processor gets turned on or “activated” a few weeks later.

Margie, whose hearing deteriorated over the past 15 years, related a painful remembrance. She said, “I was changing the battery in the smoke alarm because it wasn’t working. I replaced the battery. After pressing the test button several times and not hearing anything, my husband, Bruce, walked into the room and asked ‘what are you doing!’ I asked him why the smoke alarm wasn’t working. He stared at me and said, ‘It is working, I can hear it all over the house!’” This moment brought home to both of them how little she could hear.

As for me, I hated the word deaf, but that word described my hearing for my entire life. With hearing aids amplifying my residual hearing, fire alarms could be heard, but not the songs of most birds. The frequencies range of bird songs includes the same frequencies as the distinct parts of speech. Hearing aids never magnified portions of speech I needed to hear. But the sounds from the CI are so LARGE that my hearing aid sounded like a puny 60-pound weakling against a 300# muscleman.

As hearing fades away, the desire to socialize goes along with it. A typical social conversation jumps subjects quickly, and hearing impaired people usually compensate by seeking the subject and catching the big idea, but not the details. This makes social outings a draining experience. I never felt comfortable in groups, only one-on-one, where I could ask questions or for repeats. If I couldn’t get the subject, I withdrew from the conversation.

Margie and her husband flew to Honolulu to the audiologist to pick up her cochlear implant processor in early January.  On the first day of wearing the Platinum cochlear processor, Margie and her husband Bruce talked with greater ease, she didn’t have to turn her head to hear him. In the car on the way back to the hotel, she turned the radio on to an oldies station. A few songs later, she casually asked her husband, "Is that ‘I'm Workin' My Way Back To You’”?  She got a big hug and kiss for getting that right.

Later, they went to check in at the airport to return to Kona. She had to be "searched" going thru security because her processor set off the alarm.  The security person, a young, local gal patted her down asked what the device was for . . . and Margie heard her. The guard came around and faced her while Margie held out her arms in spread-eagle fashion. The guard laughed and hugged her as Margie said "I can hear you!"  Bruce was watching, wondering what in the world was going on.

My first experience with cochlear implant sound didn’t match Margie’s star performance. She lost her hearing more recently, her grasp on speech comprehension came quickly, and my own experience is closer to normal among those receiving a CI. My hearing graph looks like a ski slope and has very little response in high frequencies since before 1980. When I got my CI on Jan 25^th my first reaction was to turn the radio on in the car. Now music had distinction to it, rather than the flat noise similar to radio static. I understood simple words like “yeah” and “okay” without visual clues. A high-pitched whine surrounded the voices and music. But I had no complaints. I loved the radio, it played Hawaiian music, I loved hearing the birds sing, all of them new to me except the zebra dove. The whine went away as my hearing nerve got used to the stimulation from the electrodes inside my cochlea.

A month later, I know that my speech comprehension will become as clear as what Margie is hearing now. Some of the conversation on phone makes sense, and this will improve as I relearn the consonants like t, f, and s. No longer do I walk away from people on campus who call out my name.

The problem with hearing aids

Hearing aid technology could create even more power than what is on the market, but two factors inhibit its usefulness. No ear mold seals well enough to keep the feedback whine from occurring to allow super-strength hearing aids to work. Even digital aids set to increase only needed frequencies have this weakness. The second factor is that for most people with severe to profound hearing loss, the hairs inside the cochlea just do not function and send sound impulses to the brain.

The difference between CI and hearing aids

The three FDA approved cochlear implant manufacturers, Advanced Bionics, Cochlear, and Med-El each have different shaped transmitters and processors but all of them bring sound to life for the hearing-impaired

Instead of the hearing aid amplifying acoustic sound to low or non-functioning cochlear hairs, the cochlear implant transmits electronic impulses right inside the cochlea. This requires surgery. A transmitter a little larger than a quarter is placed under the skin, in a tiny hollow drilled by the surgeon. An electrode is threaded through hole drilled in the mastoid. This electrode curls around the inside of the cochlea.

Three to six weeks after the patient heals from the surgery, the processor is given to the patient. They receive one or both processor styles, one that is a little bigger than a I-Pod or another one that is small like the most powerful behind-the-ear hearing aids. Both are connected with a cable leading to the headpiece. The headpiece sticks to the surgically implanted transmitter magnetically, with just the skin of the scalp separating them.

Sound travels into omni-directional microphones on the processor or headpiece, and the electronic sounds passes through the skin like radio waves travel through the air. It continues to travel down the electrodes leading inside the cochlea. Each sound generates an electronic impulse in different locations along the electrode that correspond to different sound frequency areas of the cochlea. This gives the hearer different pitches of sound that is picked up by the hearing nerve and transmitted to the brain as music, speech, or environmental noises.

Sirens

Separating what I used to hear with my hearing aid and what I hear now with my CI gets blurred on some of the really loud noises like the emergency sirens.  In a writing workshop today, a long sustained siren went off, and the student next to me jumped.  It didn't seem loud enough for me.  Wasn't sure if I heard this sound they set off once a month, but believe I have heard them before.  They use these sirens for tsunami warnings.  Since they set them off once a month and I can barely remember it, it must not have been easy to distinguish from the garble my hearing aids picked up.  With my CI, it didn't seem loud because I could still hear the teacher's voice pretty clearly, and the siren lasted for at least a full minute.  Sounded like somone holding down a organ note somewhere above middle C, but not very loud.

One new surprise:  I whistled and it sounded awful.  That is one hearing memory I do have, my own whistle sounded clear and loud.  This one sounded like a kid learning how to whistle, mostly blowing noise and a little sound.

I'm finding it interesting that when confronted with a lot of lecturing and conversations among teachers and students, I've been using the luxury to tune out!  I'm just assisting the class, so there's no homework for me...well not at least not from the teacher.  I've started an article about the transformation from hearing loss to hearing with a CI. Hopefully the local paper can use it.  Got to clean it up and make it more interesting though.

I'm still wondering how voices change with a speaker uses a microphone.  I've noticed a lot more "bonging" type sounds associated with their voices.  Not even sure how normal this is.   One of my programs causes the sounds to be much shorter, not as drawn out, but even that one bongs or vibrates a little.

Those dratted birds are still hiding.  I can hear them, but cannot find them.  I sure want to associate which sound goes with which bird.  Which reminds me, at least there are no annoying sea gulls around here.  Pretty strange to me, who always associated them with the beaches in Oregon, and probably all of the mainland.  We are also blessed with the fact there are no crows here too!  Mynah birds make up for that though.

Phone use

When my phone rang today, I answered it, thinking that if it wasn't captioned, I still might understand what they said.  It turned out to be a mixture. I understood who it was, and told him I couldn't hear everything.  But I did hear him say that he could come to my office and talk to me.  Understanding anything at all on the phone is a huge advance.  It has been more than 25 years of phone use without the assistance of a tty or relay service.  I've been on the cell phone with my dad, but it is not a solid conversation yet.  Comprehension is coming in, more like the change of a season rather than the change from low tide to high tide.

Someone told me what the song of a cardinal bird sounded like.  I've been listening, found a sound that might be that particular bird, but need someone else to corroborate it.  If mynah bird has a song like a crow, that one is figured out.  There is one that sounds a little like an owl, and that's the one that might be the cardinal.  Direction of sound is limited because my hearing only comes from one side.  But if those birds show themselves, there's fighting chance of figuring out the mystery.

Getting the volume at the right spot hasn't been easy.  It needs to be louder to hear the "s" sounds and other high frequency sounds, but if the noise of outside traffic sets the hair on my neck on edge, then the volume is way too loud.  This is one device that can blow my socks off, perhaps more than a boombox at maximum volume.  My CI does cut off sudden loud noises quite well, but even that feature gets in the way sometimes.  I tried whistling today, and that needs work, as I could only hear the blowing sound. 

I spoke with a co-worker for a while, then left his office.  Just as I rounded the corner, he called me back and I heard him and turned around.  He asked me how my hearing was coming along.  I said, "Well didn't you just see that?  I left your office, but you called me back."  That wouldn't have happened before.

So many bright spots, and I'm starting to relax, knowing that what I cannot hear this week, may be in focus next week.  My Study Dog listening exercises become easier to understand each passing week.  I really want to get another program, and need to call my audiologist and ask him if the insurance will pay for the Sound and Beyond software.  They haven't offered to pay for any auditory training yet, and in most cases this is something that comes with the cochlear implant.

Well, imagine that, this posting made it before midnight.  But it is an early day tomorrow, so this is it for now.