Showing posts with label difficult situations. Show all posts
Showing posts with label difficult situations. Show all posts

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! 

Sunday, April 15, 2012

Aural Rehabilitation: Interactive Computer Program


I recently purchased an interactive computer program that was specifically designed for Cochlear Implant patients. The computer programs is called Sound and Beyond. I have found this program to be fantastic and extremely helpful in my Aural Rehabilitation. Since this program is designed for hearing impaired individuals, the training uses word pairs that are very tricky so it really test your ability to differentiate between different sounds that we have not been able to hear for however many year. It is inexpensive (only $25) and the Cochlear website actually provides free updates to those who own the game, so whenever they improve the programming, you can download the changes for free!

Below are the activities that are provided:
  • Vowel Recognition
  • Consonant Recognition
  • Word Discrimination
  • Everyday Sentences

Since individuals with Cochlear Implants do not hear as naturally as those with the Esteem, there are some activities that are not as necessary. These are listed below:
  • Pure Tone Discrimination
  • Environmental Sounds
  • Male Female Identification
  • Music Appreciation

There are also more advanced modules available which include telephone speech training, adaptive noise training, and open set recognition training (where you have to write out the sentence or word).

This program can be found here: http://hope.cochlearamericas.com/sound-way-beyond

Thursday, December 22, 2011

Road Trip To St. Louis

Fraser and I are spending the Christmas holiday with my family in St. Louis! 


We were planning to leave last night, but a huge snowstorm hit Kansas and parts of I-70 were closed so we decided it would be best to wait until today to start driving. I am glad that we decided to drive instead of fly because I heard that DIA (Denver International Airport) was PACKED and many flights were delayed. Nothing like spending 8 hours in the airport waiting for your flight to take off (yes, this has actually happened to me). 


Many people hate traveling by car, but I have come to love it! Growing up as a kid, my family drove everywhere when we went on vacation and, while it was not always the most pleasant experience, some of my favorite moments from childhood are from our family road trips. I think our longest drive was from St. Louis to Fort Lauderdale (~24 hours if I remember correctly), besides our family trip to visit colleges during the summer between my sisters Junior and Senior year of high school, which was a 10 day trip through the Midwest, up to New York, and down through most of the east coast. Many “Griswald” memories… Anyways, I was very excited for our road trip to St. Louis.

When we woke up this morning, my ears were hurting and kept feeling like they needed to pop. I kept holding my nose while swallowing but it just didn’t seem to do the trick. I had not taken my allergy medicine in almost a week so we had to take a little detour this morning to find a Walgreens that was open at 6:00 am!


I decided to take the first shift of driving because I was so excited to just listen to music with the open road in front of me. When I drove home from work yesterday, music on the radio sounded AMAZING! SO much different than it had sounded in the last two months. I didn’t experience any distortion and I was able to actually hear the different instruments. I was also able to hear the words well enough to later find the songs on itunes to download them for our road trip. However, driving on the highway while listening to music was quite different for me.

First of all, I was so overwhelmed by all of noises a car makes. Before my re-adjustment appointment, the sound of driving a car was mostly just a loud muffled noise. When I was driving today, I noticed that a car makes a different noise as you drive over different parts of the highway. Also, in certain parts I heard this constant “clunk-clunk”, which sounded almost like a horse galloping. I actually remember as a kid not being able to sleep in the car because I was so distracted by this on some parts of the highway. I would even sing songs in my head to the beat of this noise. I also took notice to the sounds that the car makes when it accelerates. It is weird how I never really noticed these little things before.

So, these car noises were a bit overwhelming for me and interfered with the sound of the music. It took a good 2 hours of trial and error to find the programming that would take away the background noise but also allow me to hear the music clearly. I think I tried each and every volume on each and every program setting. I also tried this in conjunction with adjusting the car stereo. 


My husband woke up while I was in the middle of trying to figure this out and told me that the quality of the music I have been downloading is really bad. It made me feel better knowing that it sounded a little crackly to him as well, but it is weird that I never noticed how poor the quality of my music was. Maybe that is why it sounded so bad before? It wasn’t until he plugged in his ipod that things sounded a bit more comfortable. Unfortunately, his ipod has thousands of songs and it is so difficult to sort through and find the ones I actually like!

I feel like each of my 3 program settings have their plus’s and minus's when it comes to listening to music, but none of them sounded “perfect” (if that is even possible). I feel like the programming that sounded the best for one song, was not always true for the next song. I found what worked best for me and produced the least amount of distortion was if I had my Esteem set lower and the volume in the car set higher. If I turned my Esteem past volume 3 on any of the programming, I would experience crackling distortion. What I found interesting was that when I did increase the volume past 3, the actual instrumentals sounded great, loud, and clear. It seemed that the voice of the singer or the cheering in the background (from albums recorded live from concerts) was what produced the distortion. So, after many hours of trying, I found C3 to be the “best” setting. While the noises of the car were a bit louder than I would have liked, I think the music sounded the clearest at this setting. 


I did talk to my husband about this and he said that when you are driving on the highway, it is just loud. That is the way it is. He explained that the noisiness of the car is what he hears too which is why he has to increase the volume so that he can hear it over the loud noises of the car. He also explained to me that more “basey” bands or singers with deeper voices are more difficult to hear since the sound of the car drowns out the music so he also has to adjust the volume depending on type of music he is listening to.

What I found to be pretty amazing is that songs were much easier for me to identify. Before my Esteem, it would take me at least 30 seconds to identify a song that was being played. I would first have to turn it very loud so that I could actually hear what the song was, and once I identified it, I would be able turn it down and then follow along more easily. So, I feel like I am actually hearing the music much better than I ever did before.

Right now, Fras is driving and listening to talk radio. This, for some reason, is not as clear on C3. I find that listening to talk radio and talking in the car is much easier on my “Background” settings. I found B7 to be the easiest for me to comprehend what was being said, of course when I put the effort in to do so.

I also want to mention one of the few benefits of having a disability. It can get you out of speeding tickets. I was a little speed demon when I was driving earlier today and got pulled over. With all of the cars flying by, I wasn’t able hear what the officers was saying so I kindly explained to him that I am hearing impaired, just got surgery, and was having a difficult time hearing him and asked if he could speak up. We started talking to him about the surgery and our plans for the holiday as I tired to find my license and registration. He went to his car and came back a minute later with a warning. Score! This is actually the third time I have played the "hearing impaired" card and gotten out of a ticket.

Wednesday, December 21, 2011

Hearing Test Results From First Adjustment

As I mentioned in my last post, I completed a hearing test during my re-adjustment appointment. This is probably one of my least favorite things in the world. I mean who likes to be tested and scored on something you know you are not very good at! Well, I received my test results today and I have to say that I am very disappointed with my scores and feel like I am hearing a lot more than what is showing up in this test. 


Before the implant, I had severe to profound hearing loss (in the lower and high ranges, respectively). My test is showing only a 5 decibel improvement with my Esteem, with the greatest improvement at 15,000Hz (80 to 30 decibels). I also had requested my hearing test from the day of my activation, and, at most frequencies, my hearing was, on average, 5 decibels better than my recent test. My test scores went down from my activation to my readjustment. Also, my Esteem scores are about 5-10 decibels less than my hearing aided scores. 


It really broke my heart when I saw these tests. I told my husband this and he was shocked as well and felt that he has noticed such a difference in my hearing and speech. I am feeling very concerned about this lack of improvement and am hoping that it has something to do with my cold instead of something more serious. I emailed my Technician about this to see if she could offer any explanation. 

Additionally, my word understanding increased from 68% to 76%. I was told that patients typically increases about 10-15% at this stage in the process and I am below that average with an 8% increase. I am not trying to justify anything, but I do feel like it is difficult to really detect an accurate account of differences when my pre-test took place in Denver, in which the audiologist said the word, and the test today used a recorded voice. When I was tested in St. Louis just 3 months before my test in Denver, my word understanding was 20%. I think this was so low because they used a recording of a female with a high pitch voice. So I am not going to let myself get too discouraged about this, as I will have a more accurate comparison when I am tested at my next readjustment appointment. 


While I am trying to stay positive about this (the situations is what it is), I am a bit concerned and will feel much better once I hear what the Envoy Technician has to say about this. More details to come...

Sunday, December 18, 2011

Envoy Questionnaire| Comfortable Settings & Difficult Situations


Prior to my adjustment appointment, Envoy requested that I fill out a questionnaire addressing what sounds are comfortable for me as well as any situations that have been difficult for me to hear in over the last 2 months (since my activation). I have outlined the answers to this questionnaire below. 

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

How often do you change your settings?
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. 

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

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. 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. 

Music from a speaker (e.g., my computer or on the radio) or with my ear phones (e.g., ipod). 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.

Large Group Meetings at Work. 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.

Watching TV. 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.

Group Settings/Noisy Places (e.g., restaurants). 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.

My Work Phone. 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.

As you can imagine I am more than excited for my readjustment and hope that after some tweaking, I will be able to hear better in all (or at least most) of these situations.

Friday, December 2, 2011

Thinking Too Much

I wonder what sounds I am not hearing, but do not know I am not hearing because I have no one there to tell me of that sound. Also, others may not think twice of a noise so they may not outwardly say it so I wouldn’t know to listen for a noise. I think this may have something to do with my ADHD but sometimes I will not hear something until it is brought to my attention by someone. Then, when I focus on the noise I am able to hear it. Thinking about this I wondering if I am actually hearing it or if it is just a memory of that sound. I think I am thinking too much and need to go to bed…