Test Week & New Ear Observations

Thursday I visited Vanderbilt for my left ear testing.  It had been exactly 4 weeks since I received the research map so I was anxious to see what the dreaded sound proof booth would have to say about the experience. The testing was done on the left ear only to compare with my clinical map testing that we did earlier in May.  Again single words (CNC), consonants (ba, da, ta, etc), sentences in quiet and noise, and the three sounds played and tell which of three sounds is different from the other two–I need to find out the name for this test (it gets progressively harder the better you do—I do this a lot during my research trips).

The study has spoken–I did improve.  I did not get specific numbers for all of the tests as we were a bit pressed for time but the only score that was less than 90% was the hearing in noise at the most difficult condition.  Four weeks ago with my clinical map on this noise test, I scored in the mid 60s (I believe she said 67%), Thursday I scored in the mid 80s with the research map.  I think the significance of this score is that it was a unilateral test.  Past research has shown that bilateral implantation significantly improves hearing in noise for cochlear implantees so I am pretty happy with my  unilateral score.  I will be interested to see if they test me bilaterally with the research maps when I return next month.  Andrea (Vanderbilt audiologist) did do some additional bilateral testing Thursday with my clinical maps so perhaps that is the intention for my next visit.

Someone last week asked me if I had noticed a significant improvement with the research map and from these tests results I would say there was a significant improvement.  Of course I am a firm believer that no matter what the sound proof booth tests say, the tests the real world brings are what is important.  We don’t live in a sound proof booth and need to hear in our natural environment.

I have gushed for weeks now about the sound of music with this map but I also knew that if voices were not clear enough for me I would not keep the research map.  I did learn that I could keep the research strategy with the electrodes turned off for music and go back to my clinical strategy for everyday use, however, I wasn’t sure I wanted to do that and wondered if my ear would be able to adapt to switching between the two strategies fast enough to be of benefit.  I have found, however, that there was some improvement with the research map in my ability to hear in noise and hearing in other situations was as good if not better.  At the end of my appointment Thursday, I was given the choice to keep the research map or go back to my clinical map.  No surprise, I chose the research map.

Final note on the left ear.  As I mentioned before, electrodes 19 & 20 have been turned off since my activation 6 years ago.  I asked Andrea if I had not requested that those electrodes be turned off would the researchers have turned them off.  The answer was no, it was not part of their plan for me.  I find this interesting and hope to do a little experimenting at some point in the future.  I am hopeful that turning them back on at lower levels will give another boost to my hearing.  The possibilities are endless and I again think that having 22 electrodes is a huge advantage.

Next came the new research map in the right ear.  This one is presenting a challenge for me.  I have electrodes 1, 2, 7, 9, and 21 turned off.  There has been lots of conjecture that I must have pretty much optimal placement on this side as my results were excellent from the beginning—the hours of rehab I did on this ear have helped as well.  From the moment the audiologist turned on this research map on Thursday it has been “different.”  As soon as I left the audiologist’s office, I called Britni (my daughter-in-law who is the ENT resident) to see if she had a few minutes so I could stop by and see her before I left Nashville.  My right ear has always been my phone ear so I put the phone up there and expected to carry on a conversation.  Nope—did not happen at all.  I had to switch to my left ear.  First surprise for right research ear.

After the appointment, I was driving to Louisville to meet Mike for a couple of days of R&R for the two of us and I stopped for lunch.  I immediately noticed that the waitress seemed to have a lisp or a sh/ch/s/th quality to her voice.  Was it the southern accent I thought.  Nope, the voices on the radio had the same quality I soon realized.  When I met up with Mike my first reaction was “have you been drinking”—it was 3 in the afternoon.  And it was not just drinking that I was thinking but drinking too much.  Of course I knew better and realized that his voice too has a lispy, loose dentury, s/sh/ch/th  quality to it.  It is the map.  So with a sigh I realized that getting used to this map was going to take time but I am determined to give it my all albeit a bit disappointed.  I could of course take the easy way out and turn to P4 (my clinical map which was left in as a crutch) but I will not do it unless I get desperate.  My brain has to adjust and I will forge ahead.  I am, however, hoping that it does not take weeks to adjust.

As the last two days have evolved I have been trying to listen more carefully and I am now not sure whether it is a sh/ch quality or a s/th quality.  I am now leaning more towards the s/th.  So all of this got me thinking—not necessarily a good thing.  What Hz is responsible for the sh/ch (1500-2000 Hz range) sound and the s/th (5000 Hz range) sound.  Here is a picture of an audio gram showing the Hz for specific consonants/vowels etc. audiogram

Here is a diagram of an array in a cochlea (of course we don’t know how close to mine this is):
cochlea-array

Here is a diagram of what area of the cochlear is responsible for which Hz:cochlea-Hz

Here are my unscientific thoughts.  Because electrodes 1 & 2 are now off (and are possibly laying in the 5000 Hz area), I am wondering if they were getting interference with others further in the cochlear (meaning other electrodes were actually stimulating this area too) and I was never getting a clear signal in that 5000 Hz zone—the s/th sounds.  Or another thought is, could electrodes 7/9 been crossing over and interfering with the electrode in the 1500 Hz zone—the ch/sh sounds.   I have always felt, and testing has affirmed that I have trouble picking out the th sound.  It is also my understanding that I am not alone with this th problem.  So words like that and fat or they and way may sound alike.  I suppose in reality maybe even “normal” hearing people have trouble with these. I will continue to be on alert and see if it is the sh/ch or the s/th that sounds different so stay tuned.

Enough of my uneducated theories.  If I were 25 years younger and much smarter I might start working on a PhD in this stuff but this is much more fun and takes a whole lot less education and I don’t have to worry about answering to anyone about my theories.  It is also much more fun than doing household chores which I am avoiding.

On a positive note —  Do Wah Diddy Diddy by Manfred Mann is the song of the week.  I caught myself making a fool of myself in a store just singing and dancing away while listening to it.  Thank heaven no one I knew was there.

Will update later—thanks for listening to my amateur explanations.  I am determined to see my way through this experiment and will update later.  I need to get some things done this week so this blogging stuff will have to wait.

Happy June all,

Connie

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15 thoughts on “Test Week & New Ear Observations

  1. I enjoy reading about your journey. I am definitely a “newbie” and learning. Keep sending updates!
    Laurie Zimmer in California
    (I have a 3 year old grandson that will have a unilateral CI placed in July).

  2. Thanks Laurie, I am glad you are enjoying the blog. I am so happy for your grandson and if you or the child’s parents have any questions related to my cochlear implants (not necessarily related to this study) please let me know. I am always willing to answer questions. Thanks!!! Connie

  3. Hi Connie, I didn’t know you were blogging on your research experience but I have enjoyed catching up on your happenings. In your previous post you said a friend asked if you sounded any different. This really struck me because when we were talking at Jessica’s party, I remember thinking your voice sounded different to me! I don’t quite know how to explain it other than your voice had more of a “tinny” sound to it. So if everyone else around you thought you sounded the same then it must be something with me? Could it possibly be the implant/hearing aid combo? Hmmm, I’m curious now.
    I also meant to tell you that if you hear about any more research trials at OSU or some locally to please feel free to give them my name. I would love to travel to a few also but that would depend on my work schedule and amount of time off needed.
    I’m so happy for you that this new program is working so well. And thanks for all you do in the name of research (I know how exhausting it can be) and keep on posting. ~ Tracey

    • Hi Tracey,

      I actually just started blogging about it when I was invited to participate in the Vanderbilt study. This study has shown very promising results and so many people are interested I though people would be interested in hearing some observations about it.

      Interesting you thought my voice sounded different because you are the first person who has said that. When I saw you last week I only had the left ear programmed with the Vanderbilt study and even to myself I did not sound different. Since I have gotten the right ear done Thursday, I do think there are times when I sound different to myself. I am aware of it and try to talk slowly and carefully. I am pretty sure that the reason I am hearing this now is because the change in my right ear was so dramatic and everything sounds different so it stands to reason that my own voice does as well. It is getting better but I still am hearing this s/th/sh/ch sound.

      I have a feeling that you think my voice sounds different has something to do with either your implant or your hearing aid. Hard to say which it is but maybe if you try listening to things with your implant you can tell if other people or things sound tinny (high pitched). Remember practice makes perfect. I don’t think I have a particularly high pitched voice but then maybe others do??

      My speech is one thing that I don’t think ever changed as I lost my hearing. Even Dr. Welling told me when I first met him he was amazed as how much hearing loss I had because my speech was perfect. I guess it is because I have had lots of practice.

      I don’t know of any studies at OSU currently. I do know there is on at U. Cincinnati that you might qualify for (I don’t because I am left handed). Try contacting: Chelsea M. Benson Au.D., Department of Communication Sciences and Disorders College of Allied Health Science, University of Cincinnati,
      Email: bensoncs@mail.uc.edu

      I am not sure whether or not you have to be bilateral to do it but it doesn’t hurt to ask.

      Connie

  4. It will be interesting to see how your constantants come along as you get used to the new research map on your right ear.. Now that you have both research maps bilaterally; how do they sound together? I am just curious..

    • Thanks Lisa!!! I will keep you posted. How do they sound together–Ok/not great. I think the jury is still out. The right one is still too new and adjusting. I’m going to give it my all and forge ahead. I appreciate your interest and you might want to read Camille’s message and my reply below for a little more info.

      Thanks!!!

      Connie

  5. Good question, Lisa – I also wonder how the two research maps now blend together. It’s interesting how, Connie, some of the electrodes turned off this time are more at the farther ends (1, 2, & 21) as opposed to in the center. Electrodes 1 & 2 are the more higher frequency channels so it’s a ‘hmmmmm’ moment to ponder your hearing the ‘sh’ sound more noticeably. Maybe it IS the ‘th’ that you are hearing more clearly? Can you practice with Angel Sound to help you determine this? Regarding Tracey’s comment (above) – when I had asked Connie about changes in her speech I had actually been referring to her subjective experience more so than how others perceived her sounding although people often DO say a CI user’s voice changes (sometimes dramatically) after being activated (or remapped). I brought this up to Connie because I (and others I know that have talked about this) often report that when it becomes harder to talk (form words clearly, project our voices) we know it’s time for a new map. Most of us feel it’s an overall lack of sharpness (some refer to it as ‘crispness’). We immediately hear the improvement in our own voices as we talk after remapping, and speech seems to flow more effortlessly. Since Connie’s first research map seemed higher pitched to her, I had wondered if she heard herself differently. It’s interesting that you perceived Connie’s voice as seeming to be higher pitched. I’m wondering, Connie, if with the possible ‘sh’ emphasis you may be noticing in your newly mapped side you will end up bilaterally with an enhanced high frequency emphasis (which I personally think is a GOOD thing…). Keep us posted on how you are doing!

    • Hi Camille

      As I told Lisa above they are not great together but then the right one is not great by itself so what would one expect. It has improved and that is all I can ask for. It is pretty tough to go from such a high level of performance on the right side to something not so great but as long as I am seeing improvement I will keep with it.

      The more I listen the more I think it is the s/th sound that I am hearing and like I said in the blog it would make perfect sense that maybe I was not getting a clear s/th sound because other electrodes were interfering. There would be no other logical reason because having 1 & 2 turned off theoretically (because they are in the high pitch area of the cochlea) should cause a lowering of the s/th sound. At first I was pretty sure it was the sh/ch sound but at time went on I gravitated to s/th. The s is it for sure but I will try some listening exercises to see if I can pick out the s/th. It has improved over the last 4 days but still annoying. I might have this map for as much as 6 weeks so that give it plenty of time to improve. I wonder too if smart sounds play any part in this. I might change to my music program later at dinner and see if the s/th is still as prominent. I only have ADRO on my everyday program so that could mean that the sound is just coming in louder. Maybe that doesn’t make sense–what do you think techies.

      That is kind of interesting that you think enhanced high frequency sounds would be good. In all of your testing experience have you also experienced difficulty in identifying th?

      Connie

  6. Oh yeah – I miss the ‘th’ in the aba, ada, afa, atha…. consonant test a lot – my average scores are in the mid-60’s (and I’ve done literally hundreds of them doing research over the past 20 or so years – always with the same or similar scores). I test in the mid 90’s for sentences in quiet, though (the part I need in the ‘real world’…). My audiologist once told me I have a gift for filling in the blanks for what I’m not actually hearing. You are NOT alone in having trouble hearing the elusive ‘th’… Regarding your thoughts that your map would be LESS sharper (high frequency emphasis) with electrodes 1 & 2 off, remember that you went from 22 to 17 electrodes. With fewer electrodes to choose from in a maxima sweep, it’s possible one of the remaining high frequency electrodes is receiving more frequent stimulation during a sweep than it was getting before. Electrodes 7 & 9, also off, are close to the remaining high frequency electrodes making the stimulation choices in that area even narrower so more likely to catch one of the remaining high frequency electrodes in sweeps that might have previously eluded it and in and the other high frequency tones, too. Just my musings, nothing scientific.

  7. I had a recent mapping and asked my audiologist about the Vandy study. She said that other University based clinics will be participating in the study. They are all focusing on different clients. For example, one is focusing on poor performers using AB and/or MedEl implants. These clinics will contact potential candidates for the studies based on their records. I think it will be really interesting and exciting to see how much of a difference it would make to the poor performers. For those who have already achieved ceiling, it seems like it will be more of a sound quality difference and music enjoyment. Time will tell!

    • Hi Julie

      Interesting info on the fact that other clinics will be testing. There is a paper that is in publication about the study. Most of the people were poorer performers and showed very good results. I think music has been mentioned as well. The jury is still out for my right ear but left ear did make a difference in both hearing in noise and music. I will try to update later this week.

      Where do you live? Have we met before?

      Connie

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