Monday, April 16, 2012

Envoy Questionnaire for 2nd Adjustment


Prior to each adjustment appointment, Envoy requests that patients fill out a questionnaire addressing their overall level of hearing, such as what sounds are comfortable as well as any situations that have been difficult to hear in since their last adjustment. The overall purpose of this questionnaire is to help the Envoy Technician/Engineer adjust Esteem settings as deemed necessary. Below I have outlined my responses from both my first questionnaire and my second questionnaire so you are able to see what specific issues have been addressed and what still needs some tweaking. Please note that this questionnaire may sound a little negative as I am mostly reflecting on difficult situations so that I can hopefully get these issues fixed to make these situations easier.

What profile/volume do you use most of the time?
December 2011: I use C3 or C4 most of the time. If I am in a noisy environment, B3 is most comfortable.

April 2012: Up until mid March, I primarily used the A setting (working my way up to 10), as this setting seemed to provide the most clarity for me. However, in the last couple of weeks I have found that the A setting is not providing me with enough volume. So, I am currently using C10 on an everyday basis. While I feel that the A setting provides me with more clarity, the C setting provides me with the volume I need to hear in conversation. The A setting is lacking volume and the C setting is lacking clarity.

How often do you change your settings?
December 2011: I progressed through the settings fairly quickly. I increased the volume about every two days and was at comfortably at C3 (without having to go back to the B settings every once in a while) after about two weeks. Since then, I have been going up and down from C3 to C5 depending on how much head congestion I experienced on a particular day. 

April 2012: It took a while for me to progress through the settings. Up until February I was “stuck” at A7 and unable to move forward due to having feedback on the higher settings. However, once I made it past this threshold, I spent about a week per volume setting until I made it up to A10 around March. For most of March I stayed at A10 since this was the most comfortable, however, toward the end of March I felt that I was not getting the boost I needed and have been using C10 for most of April. While this gives me the volume I need, I am not always getting the clarity I need from this setting. Also, sometimes I feel a lot of pressure in my ear on the C setting. It almost feels like my hear needs to pop or something.

Which other settings have you used?
December 2011: I have used them all at some point in the progress.

April 2012: I have used all of them at this point in the process. However, I almost never use the B setting, even in loud environments.

Are there environment(s) where you feel that you may have some issues with your hearing? What are the environment(s)? What were the issue(s)? What profile/volume did you try to use in that environments(s)? What profile/volume did you change while having the issue(s)? How did this impact your hearing? Did you ask a normal hearing companion if they had a similar experience to any degree in this environment?


Road and Car Noises While Driving. 
December 2011: These noises sound loud, muffled, and interfere with my ability to understand what others in the car are saying. If I turn it down to the B settings this produces less interference. I asked my husband and he said that car noises are muffled, can be loud, and can sometimes interfere with his ability to hear. However, he is almost always able to carry on a conversation while driving with me or others. 

April 2012: These noises are still loud and interfere with my ability to hear others in the car and on the phone. If I change to the B settings this produces less interference, but also makes voices softer so it is still difficult to hear. The B setting works okay when I am on the phone, but does not work as well when I have others in the car with me. I have found the A setting to be the most comfortable but will usually have to turn down the volume to produce less interference. It is often difficult to change my settings while I am driving, so most of the time I just “deal with it” as best as possible and ask others to speak up.

Music from a speaker (e.g., my computer or on the radio) or with my ear phones (e.g., ipod).
December 2011: While live music sounds great, music from these venues do not sound natural to me. Parts of songs will sound okay, but then all of a sudden there will be a squeaky noise that is a bit distorted and feels uncomfortable to my ear. I have tried different volume combinations on my Esteem and the music source and cannot find a combination that feels comfortable for me. It is either too soft for me to really hear it but no squeaky distortion, OR it is loud enough for me to hear with the squeaky distortion. The setting that fits "best" is B3. I asked my husband to put the music at a volume that is comfortable to him and told him what I experienced and his reaction was not the same.

April 2012: Music on my ipod with headphones is no longer an issue. I had stopped listening to music on my ipod for a while but when I went running for the first time towards the end of March I found that the music now sounds GREAT and on any setting too! However, when running I have found that the sound of the wind blowing often interferes with my ability to hear the music. It is the worst on the C setting but still pretty bad on the A setting. I have not tried the B setting.  In regards to music on the radio in my car, this is still producing feedback and does not sound great. However, it is better than it was before. Also, music from my computer still sounds a bit muffled. I have to turn the volume very low to be able to hear it without feedback, which then makes it difficult to actually hear the music. Women singers sound squeaky and “too loud” which makes it a little unclear. It almost sounds like a blasted speaker. This is sort of difficult to explain…

Large Group Meetings at Work.
December 2011: I have a difficult time hearing people at a distance from me and find myself pretty dependent on looking at people to understand what they are saying. Background noise, such as the heat blowing, interferes with my ability to hear and understand people.  The volume I found to be best in these situations is C4 or C5. I did not ask others about this situations but everyone in the rooms seems to be able to follow.

April 2012: This is better than before, but still difficult. While there are some people I can hear very well without even looking at them there are others that I still have a difficult time hearing. I started to have a really difficult time with the A settings mid-March as this setting is not providing me with enough volume to hear people across the room from me. The C setting has probably been the best for me recently.

Watching TV.
December 2011: I have a difficult time hearing my TV and am still pretty dependent on closed captioning for understanding. C4 or C5 is the setting that is the easiest for me. My husband says that 13 is a comfortable volume for him and I liked to have the volume at about 23 so that I can actually hear. Turning my device up helps a little, but not enough that I could hear comfortably at 13.

April 2012:  I still have to use closed captioning to follow movies or TV shows. When I turn the volume up so that I am able to hear, I feel like there is some distortion in the sound. Some TV’s are worse than others and it seems to be worse when I do not have my hearing aid in my other ear. I also find that commercials and background music, etc. seem to be very loud while conversation seems like it is not loud enough. This really makes watching TV tough because I have to turn it loud to hear what is being said but then I am blasted with sound when commercials or background music, etc. is being played. This is mostly on the C setting so turning it to the A setting helps this issue, but then I am not getting the volume that I have with the C setting.

Group Settings/Noisy Places (e.g., restaurants).
December 2011: I have a difficult time filtering out background noise in these settings and find that people voices blend with the background noise. I still have to read lips in order to understand and follow along in conversation. I find that one-on-one interaction is easier than group settings. The A settings make everything too quiet and the C settings are too loud. I found the B programming to be best in this type of setting. When I have asked people about this, they do tell me that the place is just "really loud"; however, I feel like they are able to understand everyone and follow along in conversation pretty easily.

April 2012: I still have a difficult time with background noise. While the B setting helps filter out some of this background noise, I find that this setting also makes peoples’ voices too soft for me to hear. I have found the A setting to work best in noisy situations if I turn it down a few notches.

My Work Phone.
December 2011: I am able to hear pretty well on my cell phone but I have a VERY difficult time talking on my work phone. Voices are a bit distorted and crackly and I actually find my hearing aid to produce a clearer sound. I have tried a few volume combinations with my Esteem and the phone, and still find it difficult. I did not ask others about this but all employees use the same type of phone regularly without issues.

April 2012: I still have some trouble hearing on my work phone but this has gotten better over the last couple of weeks. I have found A7 or A8 to be the best setting for talking on my work phone. Anything louder sounds distorted to me.

Traffic/Wind
December 2011: n.a.

April 2012: When I am walking down the street to get to my office, I have found the cars driving by to produce a noise so loud that I am unable to hear anything else out of my Esteem ear. If I am talking on the phone and cars start driving by, I cannot hear anything that is being said on the phone.  I have found the exact same thing with the wind. Specifically, when I am running, listening to my ipod, I am not able to hear the music when the wind is blowing.

It often seems that when I am first adjusted or when I change the settings everything is noticeably better, but as time goes on I get used to things and want more. While my last adjustment did help with many of the situations listed above, things have not been perfect so I hope that after some more tweaking everything will get better and better! 

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