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! 

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. 

2nd Readjustment Scheduled!

I was supposed to go to Chicago to have my second Esteem readjustment and to meet with my surgeon, Dr. Marzo, to have him check up on everything to make sure I was healing properly. However, some unforeseen circumstances arose and I, unfortunately, had to cancel my trip at the last minute. Since things are still a bit crazy around here, I will probably not be able to get to Chicago until July. So, I decided to just have Michelle, my Esteem Engineer, come to Denver for a readjustment. Envoy is very booked right now so the soonest they were able to get out here is April 23rd (a month and a half after my originally scheduled appointment!).


While I am very very excited for my readjustment, I am also very nervous since I did not get very much gain from my last adjustment because of the fluids in my ear. I am hoping since I will have had 5 months to heal that I will be able to get the gain that I am look for. It is really strange because when you first get adjusted (or when you turn up the volume on the remote) everything seems so loud and great!  But as time goes on, you get used to hearing at this level; things just sort of level out a little bit. Right now, I have been at the top volume for the last 3 weeks so I REALLY need a little more UMPH! and I hope that I am able to get that from my appointment in April. I also really hope that my tone and test scores go up as well! Fingers crossed! X (that "X" is supposed to be me crossing my fingers.. just in case you were wondering).


I have to say that it is crazy how dependent I am becoming on my Esteem ear. When my implant was first activated, I relied much more on my hearing aid since that is what I was used to but now, I am very dependent on my Esteem. There have been times when I feel like I am completely deaf in my hearing aided ear (because the sound in my Esteem is so great!) and I often have to check to make sure that it is actually on and didn't run out of batteries or something. And yes, it is always on... Seeing how much more I am hearing out of my Esteem as time goes on make me want to have my other ear implanted SO badly. I hope like hell insurance companies start covering this device soon. As of now, my insurance company, Great West Cigna, still considers middle ear implants as "experimental".  They also consider the Esteem to be like a "hearing aid"... Man, these insurance companies need to get their facts straight because, in my opinion, FDA approval does not qualify as "experimental" and this device is NOTHING like a hearing aid! I mean, I wish that each and every one of them could actually experience having a severe loss of hearing because I do not think that any of them could last a day in our shoes. Hell, they probably couldn't even last an hour... I think if they knew what it felt like to struggle in every day conversation that they would be pushing much more for the coverage of hearing.


Well, enough of that... I am going to go enjoy this beautiful sunny Denver day and get my tan on! and maybe enjoying a few mimosas as well! Happy Saturday! :)

Life is YOUR Choice

I have to say that the last year of my life has been quite a struggle. Hell, the last 6 month in itself of learning to hear again has been a spiraling journey of ups and downs. There are days that I feel on top of the world and others that make me want to just give up on this journey all together. While my implant has given me hope and improved my hearing on so many levels (and hopefully many more to come!), I do still have my "I cant hear very well" days where everything seems a blur. 

Sometimes when things do not seem to go right in our lives, we attribute our feelings to the situations in our life. And rightfully so... We wouldn't have to deal with the situation at all if life didn't throw it at us while we weren't even looking, right? While we may not be able to choose our life circumstances or how we initially feel about certain things that happen in our life, we DO have a choice about how we react to these unforeseen situations and how we let them affect how we live our lives and our overall happiness. 

Obviously, feeling sad, frustrated, angry, or depressed doesn’t feel good, so when it comes down to it, we have to ask ourselves, is it worth it? Is it so important that it is worth holding onto this negative energy? Letting it ruin your day? Letting it make you feel upset? No, it is certainly not! 

Yes, it is frustrating that I have to wake up every morning as a hearing impaired individual and go through my day wondering if I will be able to hear people or not. Yes, it is not fair that I have to live with a hearing disability, while I see friends my age being able to so effortlessly and happily live their life. I hate more than anything that it is difficult for me to keep in touch with and communicate with my loved ones. Sometimes I get SO mad at God when things get difficult. Why me?

However, what I have learned is that by holding onto this negative energy, the only person you are hurting is yourself. By being jealous of someone else's life or by being frustrated when you cannot hear someone, you are only hurting YOU! These feelings are truly a waste of energy that could be used to feel good about something. So, stop honing in on the negative, and boost up all the positive things that are happening in your life right now!

Always keep in mind that while you cannot control the crappy life circumstances that are thrown at you, you can control the level you take it too. If you take the time to explore whatever it is you are feeling, you will be able to better understand yourself, which will make it easier to learn from and let go of the negative experience that may be holding you back. With hardship comes growth, but only if we take the opportunity to learn from lifes' happenings. By focusing on the lesson instead of the struggle, we are bound to become wiser and happier individuals...

Run Like Hell

With the weather being so beautiful in Denver lately, I have attempted to get my lazy butt back into shape. Before I received the Envoy Esteem implant I was running about 5-10 miles 5-6 days a week! I was actually hoping to run a marathon at the end of last summer but between having to move into a new home, my husband losing his job, and my Esteem surgery, it just didn’t seem possible.

My recovery from surgery was pretty tough (story for another time) and by the time I started to feel like myself again, it was too cold outside and was getting dark before I would get home from work. I had bought myself a treadmill about a year or two before and, unfortunately, we had lost a few pieces during our recent move.  Time went by, things got busy, and I slowly drifted out of my routine. Completely. I swear, there is just something about the winter, snow, and cold weather that makes me not want to do anything but curl up on the couch and watch movies or read a good book.  So it has been a loooooooooong, cold, lazy winter for me, to say the least.

I got the “okay” from our veterinarian that I could finally run with my puppy! So, I decided to treat myself to some new “kicks”, which are pretty darn cute, I must admit (see picture below). It is hard to tell from the picture but they are a bright, raspberry pink! Very “me”.  THANK YOU DSW! I also found some very cute Tory Burch look a likes (ballet flats AND black paten leather flip flops. VERY excited about them). Did I mention I love shoes? :)

People always think that I am crazy for having “run a marathon” as an item on my bucket list but it has always been a dream of mine. Actually, when I told this to one of my friends his response was “it is on my bucket list to NOT run a marathon”.

I have to admit, didn’t always like running. In middle school, our gym teachers would randomly have us run a timed mile once a month and I would try desperately to get out of it if I could (i.e., fake a cramp, twist my ankle, etc. You name it. I probably said it.). When I reached high school and started to play sports more competitively, I realized I would much rather run a timed mile (7-8 minutes) than an hour of intervals and sprints! It wasn’t until college, when I was able to run on my own time, that I realized how great it made me feel. It helped me release tension and clear my head, which was quite helpful when I spent the majority of my senior year in the library writing my thesis. Running just made everything feel better; it still does.

Anyways, as I set out for my very first run of the spring season, I turned on my Nike+ App on my iphone and hit the pavement. The first thing I noticed was how GREAT the music sounded! I honestly couldn’t believe my ears! When I tried to listen to music a few months ago on my iphone, it sounded like crap so I just gave up on using it but this time it was unreal! SO much of a difference compared to last time. Also, I didn’t even have to fool around with the settings on my Esteem to make it sound good, it just sounded magical on its own!

As the song switched, I found that it seemed a bit loud to me. When I went to turn it down, I noticed that the volume level was on 6 out of 16! When I would run before my implant, I wouldn’t be able to wear my hearing aids so I would have to blast the volume as loud as it would go, and even still, it would sound all muffled. I would have to specifically choose songs for my “running mix” that had a deep base backbeat because, well, that is all that I could hear. But today was great, much better than I ever could have hoped or imagined. I can’t wait until I have both of my ears done because I can only imagine it will be twice as awesome!

And you know what was even more amazing than this?!?!?! When Rufus (my pup) stopped to play with some other dogs, I was able to take my earphone out confidently and have a conversation with the other dog owners! When I would run before the implant, I would dread running into someone I knew in fear that I wouldn’t be able to hear them without my hearing aids in, which is actually part of the reason I bought myself a treadmill and avoided going to gyms or exercising with other people. It is truly is amazing being able to hear in any situation and feeling much more confident in these types of situations. I think this is honestly the most amazing thing about the Esteem implant!

So, I made it a whole 1.5 miles for my first run! Ha! I am definitely out of shape and have lots of work to do! I am not sure if I am just really out of shape or if I am just hearing much better, but I breath REALLY loudly when I run… I was able to hear this over the music even! That is something I need to work on so people don't think I am going into cardiac arrest when I run! 

So while today was a great day, there was one thing that did bother me… the wind. When the wind would pick up I would have a difficult time hearing the music which was a bit frustrating. When I asked my husband about this he said that he can hear it but it doesn’t interfere with music. But it did a lot for me today… I hope this is something that will get better with more time and some adjustment!

Aural Rehabilitation (Free Practice)

Aural Rehabilitation is a form of speech therapy that is directed towards helping individuals with hearing loss learns strategies to promote the effectiveness of their communication. For those who have decided to take the next step and get hearing aids or an implant, Aural Rehabilitation is extremely important in helping individuals (re-)build neural pathways in their brain to make sense of the sound they are now able to hear. While this will happen naturally through your everyday communication, Aural Rehabilitation helps speed up the process.  Just an hour a day can go a long way!

Below, I have provided some options for anyone who is interested in starting their own Aural Rehabilitation at home for free:

The Listening Gym

*These activities were created for cochlear implant recipients.

http://www.hearingjourney.com/Listening_Room/Teens_and_Adults/Listening_Gym/index.cfm?langid=1

Cambridge| Interchange Arcade

*These are phonics games that were originally created for kids.

http://www2.cambridge.org/interchangearcade/sortbytype.do?level=0&type=Cup_word_up

*Interactive activities (that I found to be sort of fun) that are geared towards children to help them understand language but listening to sounds is a large part of the activities.

Many Things

*These activities were specifically created for ESL students.

http://www.manythings.org/repeat/

*Listen and repeat exercises.

http://www.manythings.org/lar/

*Listening to conversation dialogs.

ESL Lab

*These activities were specifically created for ESL students.

http://www.esl-lab.com/

*This website provides SO many practice examples at beginner, intermediate, and advanced levels. Activities consist of listening to a short conversation dialog and completing quiz on the content of the conversation.

Posit Science

*These phonics activities were specifically created for kids.

http://www.positscience.com/games-teasers/brain-games-kids/sound-discrimination

Also, if you do a google search for "phonic activities", most of the programs you find should be helpful as long as listening is a large piece of the activity.

The Importance of Aural (Auditory) Rehabilitation

While searching online, I found a really interesting article about the importance of aural (auditory) rehabilitation for adults with Cochlear Implants. I think that the topics and ideas presented in this article can be important for rehabilitation after any implant. The article is titled Making a Sound Connection: Rehabilitation for Adults with Cochlear Implants, was written by Mary Koch, MA, CED, and can be found on pg 6 of the following link: http://hearingjourney.com/userfiles/File/BionicBeat_Vol3Iss1_2006_1.pdf

What I found particularly interesting about this article is that we do not actually hear with our ears, we hear with our brains. [info from the rest of this paragraph did not come from this article. this was written by me based off my understanding of how we hear and how hearing loss affects the ear. i hope that it is portrayed accurately (in easy to understand laymen terms) but please refer to the professionals for more detailed information about these topics.] This actually makes sense when you think about how we hear. Sound enters our ears and the frequencies of sound are transformed into electrical signals as they pass through the middle ear to the Cochlea. The Cochlea stimulates thousands of tiny hair-like cells which send electrical signals to the brain to be interpreted. This is where our ability to understand what is being spoken comes into play. For most individuals with sensorineural hearing loss (like myself), the hair-like cells and/or parts of the Cochlea have been damaged which then affects how sound signals are converted into electrical signals and sent to brain. What is great about the Envoy Esteem Implant is that it, in theory, bypasses the damaged parts (i.e., Cochlea and hair like cells) and instead transforms and processes electrical signals through the Esteem processor. Each individuals processor is programed to meet the specific needs of each recipient based on their level of hearing loss. These "altered" and "improved" electrical signals are then send back through the system and to the brain for interpretation. 

As stated in this article, one of the biggest misconceptions of receiving a hearing implants is that the understanding piece of the puzzle will come immediately as we gain more sound and volume. However, while we can hear sound better because of the implant, our brain does not always immediately make sense of these signals right away. Additionally, this article also mentioned that the longer a person is hard or hearing, the more challenging it can be for them to be able to recall and form meaning of sound. In order to bring this understanding piece into play, we must form new auditory pathways as well as the memory skill to be able to retain the sounds. The purpose of Aural (auditory) therapy is to imprint this information in our brain so that these connections can be built more rapidly leading to greater success with the device.

The article also presents Norman Erber’s Heirarchy of Auditory Skill Development, which is essentially the process in which our brain learns to understand.

• The first step in the process is Detection. This is the stage in which we become aware of our capacity to hear, as detected through an audiogram.
• The second step is Discrimination. This is our ability to differentiate between the sounds that we are hearing. This is actually what I am currently practicing through my therapy. 
• The third step is Identification. By going through the sound discrimination exercises, we are essentially imprinting our auditory memory with these sounds so that we are able to recognize and start putting meaning to these sounds.
• The fourth and final step is Comprehension. This is our ability to hear by simply listening and at this level we are finally able to fully engage in conversation. 

These are just a few of the interesting things I found throughout this article. This article also provides some resources for getting yourself started on the aural rehabilitation track (and how those around you can help). Also, I have been exploring websites that provide free online practice tools so will be posting those soon for those who are interested. 

Life Since Adjustment

Since my adjustment in December, things got off to a slow start due to being sick and the fluids in my ear, but for the last couple of weeks, things have been getting progressively better! I thought I would take a moment to reflect on how things have generally been going since my readjustment.


Until about 3 weeks ago, I was not able to turn my volume past 7. Every time I tried, I would get high pitched feedback. However, in the last 3 weeks I have been able to make it all the way up to volume 10 and I have to say I am LOVING the volume gain (I want even more!) and cannot express what a difference it makes! After going a month without being able to change the settings, I never thought that I would actually make it to this level! This is very exciting not only because of the volume gain I am getting but also because it means that I am healing and the fluids are starting to drain!


I found that I spend most of my time on the "A" profile, which is considered my "Everyday" setting. I have tried the other settings but this is the most comfortable for me in almost all situations. I am not really crazy about my "C" profile ("Music/TV Watching" setting). I feel like the sound of swallowing is so distracting it is difficult to focus on anything else. When I am on this profile I feel like my ears are going to explode. I have this weird ear popping sensation. It is almost like there is too much base which is making my ear feel lots of pressure. I have not been out too much in the last month, but my "B" profile (i.e., background noise setting) has been pretty great! I found that it works better at bars/clubs where the the loud noise is more constant than when out to dinner at a restaurant. I have actually preferred to stay on the A setting when I am out to eat.


I found that I am finally starting to gain some of the distant noises I have been wanting. I actually attended a lecture for work which took place in a large classroom. I was seated towards the back right and heard every word except when I was thinking about how surprised I was to actually be hearing!  So, I guess I missed a few parts but more of an attention issue than a hearing issue. However, this is still not "perfect". At the end of the lecture, there was Q and A. I did have trouble understanding other peoples' questions. It is weird that some voices can sound so loud, while others are too quiet. I wonder if something like this can be addressed in my next adjustment or if this is just the nature of speech?

Since my readjustment, I feel that I take much more notice to the sound of walking. Shoes hitting the floor. Legs rubbing together. I feel like I make such a commotion when I am walking around my office that it makes me want to tiptoe sometimes. Since our production room is right by my office, I have found myself very distracted by the sound of the printer. I often get so distracted that I have to close my door. Also, I noticed that the heat vents in my office make a squeaky noise when they are on and running. Not to say that I am not grateful but it is crazy how I never noticed this before because it can be quite annoying...

I feel like the dishwasher in our home gets increasingly loud every time I turn up my Esteem device. Being on volume 10, I found the dishwasher so loud that one time, I started yelling at my husband to stop using his electric saw in the basement. I was so confused! The sound was so loud that I thought it sounded like someone using heavy machinery. haha. 

I haven't been able to wear sun glasses for almost 6 months since the side of my head is still a bit tender when I put pressure against it. When I tried them out this week, I realized that it doesn't hurt anymore!

Well, that is all I can think of at the moment! 

YOU Have the Power to Control the Speed of Conversation

My auditory therapy for today consisted of two different exercises. For the first exercise, my therapist would say a word sound, such as “S” or “F” or “Ch” and I would have to say a word that started with that sound. So, if my therapist said “Sh”, I would say “Ship” or “Sheet”. For the second exercise, my therapist would read a sentence and I would have to tell her which word seemed off. The word that was off was very similar to what the correct word should have been. For example, “If you are cold, put on a coke.” This is my 3rd therapy session and I am still finding some of these exercises to be quite difficult for me. The second exercise was a little easier than the first since I had some contextual information to help me identify what the correct word. However, I am still having a difficult time differentiating between "g" and "d" sounds as well as between the "s", "f", and "th" sounds. It has only been 3 weeks since I started, so I do have a ways to go! Hopefully with more time and practice this will all become easier...

While chatting with my therapist after our session, she told me something very interesting.  She said that we actually have the ability to control the speed of our conversation. Have you every been around someone who is really laid back and talks really slowly? You can't help but notice that you start to become more relaxed yourself and you will find yourself talking at a slower pace. The opposite is true as well. If you talk quickly, that will boost the adrenalin of those around you leading them to also talk at fast pace. Obviously, someone talking fast is much more difficult to understand than someone who talks slowly. So, she told me that since I tend to talk fast, I should try to make a conscious effort to talk slower. While it does take time, practice, and a conscious effort, this tactic can actually help you better understand in conversations. Amazing! 

Be Grateful for All Sounds, Even the Annoying Ones

As I got into bed to start journaling, I was taken back by the sound of a neighbors car alarm. Wow! That is loud! It is 9:00 p.m. and so I am sure that all of the neighbors are super annoyed about this, but I am sitting here just taking in the sound, thinking how grateful I am that I can actually hear this. If I was sitting in bed without my hearing aids, there is no chance in hell that I would be able to hear this. Gosh, I don't think I would even be able to hear this with my hearing aids in! 

There are so many noises in the world that most people take for granted because they are too loud or annoying, like alarms, the sound of a computer mouse clicking, the sound of someone smacking their lips while they eat. But people should really be grateful that they have the ability to hear all of the amazing noises of the world. 

Through my journey I am coming to learn the power of gratitude. When you begin to look for all of the things you DO have in life, instead of all the things you DON'T have, you start to put your life in perspective. You start to think, "hey, my life is not that bad after all." From there you begin to appreciate all of the things you do have in life and you are finally able to see that everything you ever needed to be happy is right in front of you. Pretty powerful stuff, huh?

So, next time you want to get all worked up because the sound of something is annoying or too loud for your ears to handle, just take a moment to practice your gratitude for sound and the ability to hear. For someone who has been able to hear their entire life, this probably doesn't seem like something to be grateful for, right? But think about all the people out there who are not able to hear at all or who struggle to hear each and every day. Think about how difficult it is for people to communicate with their loved ones because they are not able to hear. Think about how hard people who have a hearing impairment have to work just to be able to follow in conversation. It's exhausting for us! 

Please, don't feel sorry for us. That's not what I am trying to get at here. All I am asking is for you to appreciate what you have. You are SO lucky that God has given you the ability to hear at a normal capacity so start to enjoy every little thing that comes along with it! Even those noises you find annoying...

Caught Between Two Worlds

My journey of Learning to Hear has become a journey of more things than I ever could have imagined. This process had lead me to be more in touch with myself and my feelings, especially those that I kept buried deep within my soul, and as a result, I am finding out a lot about who I am and who I want to become. In some ways, I feel closer to finding peace but in others I feel completely lost.


I often find myself caught up in the struggle of where I belong; I feel like I am caught between two worlds:


1. The Hearing World
2. The Deaf Culture


Where is my place? I feel like I am neither nor. This internal war is a bit daunting.


While I grew up in a culture of hearing and verbal communication, my true hearing capacity is silence.


While the hearing world looks upon me as Deaf, the Deaf Culture sees me as an individual who can hear.


While I have heard and can hear, I cannot hear well enough to function within the hearing world. 


While my friends and family are all hearing individuals, I feel in isolation because I cannot communicate with them as I used to.


I know what it is like to hear, but I also know what it is like to be Deaf in a world of silence. What is interesting is that I can relate to both worlds, yet I cannot fully communicate in either. I understand what it is like to live in both worlds, but neither world understands me. Most individuals within the Deaf Culture do not know what it is like to have heard, but those in hearing world do not know what it is like to have NOT heard.


While my desire to be in the hearing world is much greater, as that is what is most familiar to me, I cannot deny my need to relate to others who actually "understand" me and accept me for everything I am and all of the raw emotions I feel.


So, is the world as black and white as it seems? or is there a place in between for me? for us?


Maybe we do not fit into either, but maybe that is okay. Maybe this is the way God intended it to be. Maybe we are the bridge to unite these two worlds together as one. Maybe it is our calling to help each world understand the other. Maybe this is what we were brought on earth to do: to help and unite. God chose us because we are unique and that special.


Well, this doesn't seem so bad after all...

Auditory Therapy Puts Me Another Step Closer

For my first official therapy session, we did two different exercises. The first exercise was to practice hearing the beginning sound of words. For this exercise, she went through a list of 120 word pairs and I had to tell her if the beginning sound of the two words were the same. Here are a few examples:

Drive-Live

News-Views

Same-Fame

Top-Hop

Skip-Ship

While doing this, she was facing me, but had the piece of paper covering her mouth. I also made sure to look down so that I could practice not being so dependent on looking at people to hear them. If I got the answer incorrect, she pulled the paper down and repeated again allowing me to read her lips to identify the sound.

While this seems like such a simple task, it was not so simple for me. I didn’t do horribly. I was able to identify beginning sounds for 103 out of the 120 word pairs (85.8%). However, I did guess on some of them... If she had asked me to repeat the two words, I probably would have done much much worse. I told her about this and she said that it is okay and that right now she just wants me to listen to the word sounds instead of trying to identifying the word. This will come later!

Since I am having trouble hearing short quick constanant sounds all of the word pairs I listed above were ones I got incorrect. To me, the word “same” and “fame” sound the same because all my brain knows how to hear is the “_ame” of the word.

The next exercise we did was similar. However, instead of identifying if the beginning of the word was the same, I had to identify if the end of the word was the same (i.e., if the words rhymed). Here are a few examples:

Call-Pull

Bend-Wind

Bind-Blond

Boat-Tote

I am happy to say I did much better on this one! I was able to correctly identify if a sound rhymed for 111 of the 120 words (92.5%). The word pairs that I listed above are a few that I was not able to identify on my first try. My therapist reviewed these with me and showed me how the quicker vowel sounds may also be difficult for me to differentiate between such as the “eh” sound in bend and “ih” sound in wind.

Before she left, she gave me an interactive computer program that she often uses for her dyslexic patients since it is all about sound discrimination: what each letter sounds like, the difference between each sound, how to sound out different words. Remember "Hooked on Phonics". Well, it is sort of like that. She gave me the first level of this program to do as practice on my own and said that she would give me the next program once I got through this whole program. She also provided me with some "homework" for me to practice with Fraser. I am actually excited to practice all of this!

This whole experience of seeing a therapist has been really eye opening for me. I think it is helpful for me to understand and see why I am missing the parts of conversation that I do and why I think people say something completely different than they do. I think that this realization and understanding has been and will continue to be a large part in my path to acceptance. When we are in denial about our hearing loss, we do not really understand what is happening to us. Why is it becoming difficult to have a conversation with someone in a restaurant? Why am I not able to hear people when they talk to me from the next room? Why is it less enjoyable for me to be around my friends and family? Why am I getting angry and frustrated with people for not talking loud enough? Why am I so tired all the time? These are just few of the many questions we are pondering in our minds. It is very liberating to have less questions and more answers!

Whether the problem for me is more physical (i.e., my actual hearing) or mental (i.e., my brains ability to identify these sounds), I am not sure at this point in the process. Thinking about this, since I was in such denial about my hearing loss I waited until I absolutely HAD to get hearing aids. Even then, I only wore them to class and work until about 3 years ago. I think that prolonging the inevitable act of getting hearing aids is why these sounds are not familiar to me. If I would have gotten hearing aids when my hearing loss was only mild, I may have been able to still hear the “f” and “t” and “s” sounds with hearing aids, and therefore, my brain would not have lost the ability to identify these sounds or my brain would not have been in the dark about these sounds for 10 whole decade; the gap would have at least been smaller.

I know I cannot drive myself crazy with these "what if's". This is all in the past, and there is nothing that can be done now except to move forward with the knowledge I now have. However, I am saying this and sharing this to motivate others to get hearing aids before it is too late to truly reap all of the benefits they have to offer. Technology today is AMAZING and sadly, most people do not take full advantage of this due to the stigma society puts on wearing hearing aids. If you have the choice... Don't do what I did! Don’t wait! Strive to understand! Get your hearing checked out! Get hearing aids if your audiologist says you need them! Life is too short to waste it in the haze of denial. Acknowledge, accept, and move forward. How do you expect to get anywhere in life when you are just standing still?

Evaluation Appointment With An Auditory/Speech Therapist

While I am constantly amazed at all of the new noises I am now able to hear, I am still having a difficult time with my speech discrimination (or understanding).  I was told by the Envoy Technician that this is likely due to my dependency on reading lips. If I am not looking at the person who is talking, I am not able to understand what they are saying. While I hear them loud and clear, my brain cannot process what is being said. The best way I can explain what this is like is to picture yourself in a room where no one speaks your language. While you have the physical ability to hear, you have no idea what they are saying. You are looking around constantly to try to pick up on social cues that will help you follow what is being said. You may feel isolated. You may feel alone. You may even feel a bit paranoid like people are talking or laughing about you. Sometimes you laugh it off and pretend to go along with the conversation and other times you get so down on yourself that you escape the situation as soon as you can.

I do not want to be like this anymore. I want to be able to take advantage of my new ability to hear. I don't want to have to hear by looking. I want to hear by hearing as much as my physical ability will let me! 

So, I decided to contact an Auditory/Speech Therapist to help me with my ability to understand running conversation, regardless of my financial situation (credit cards were created for a reason, right?). My inability to hear conversation and to be social affects the quality of my life and so, I felt that it was necessary for me to take this next step. I have come to terms with the fact that I may never be able to have the hearing that I used to have, but I do not want to have any regrets in this process or look back and say "I wish I did this" or "I should have done that" to help myself. I have been thinking about this for a while and I would regret it if I did not give myself this opportunity.

I had my evaluation this week, which consisted mostly of talking about the history of my hearing loss, my progress with the Esteem hearing implant, and situations that are difficult for me to hear. I was also tested on my word and sound discrimination. Throughout the entire test, she sat behind me so that I would not be able to read her lips. For the first part of the test I had to repeat the word. Very basic and similar to the speech discrimination test that are given by my audiologist.

For the second part of the test, I had to repeat sentences. However, they were sentences that did not make sense (e.g., I put the basketball in the toaster). Since most hearing impaired individuals actually pick up on about 30% percent through reading lips and 30% through actually hearing, they must fill in the rest of the conversation with social cues and other people's facial expressions. If we miss even one word, or interpret one word incorrectly, then this has a HUGE effect on our understanding since topics switch very readily in running conversation. So, by having to repeat sentences that do not make sense, this really test how much I am able to hear and how much I am filling in the blanks.

The third part of the evaluation was repeating a sentence in which I had to fill in the last part. For example, she would say, “You cook a turkey in the...” and I would say "oven" if I had heard the sentence correctly. She made sure that there were minimal options for the blank word in the sentence. So again, this test how much of the sentence I am hearing.

Essentially, she found that I am having a difficult time with soft, short consonant sounds, such as the “s” and the “f” sounds. These are short and quick sounds that fall within the higher frequencies, which my brain is not use to hearing since I haven’t heard these sounds in the last 9 years!

She said that therapy and practicing sound discrimination exercises will improve my ability to hear and identify these sounds more readily. Even if she has to repeat a word 100 times, each time she makes that sound or says that word, it will build and strengthen the connection in my brain.

We agreed to meet for 30 minutes ever week for now until she develops a more finalized work plan for me. She said that she would be willing to provide me with practice exercises to do on my own, if I cannot afford to have her come every week. She also mentioned that it typically takes about 3-6 months of intense practice in order to see a difference. This means practicing EVERY SINGLE DAY.

I think God is truly testing my ability to be patient... I don’t know where I got the idea in my head that this would be an “easy” process. Life is all about learning and finding who we are. Where would inner and spiritual growth come from if everything was easy and perfect all the time! While the last decade has not been easy for me, I have grown a tremendous amount and learned so much about myself through this experience. I am actually looking forward to my journey of acceptance and finally finding peace within myself. I have been struggling through life for a while now and it feels good to let go of this a little bit each day.

Let go and Let God.

Follow-Up On My Recent Hearing Test Results

I finally heard back from Michelle today. She said that she thinks the big reason why I saw worse results at my last visit was due to my illness and the fluid in my middle ear. She said that even a small amount of fluid could disrupt how the device works as well as my ability to hear. Between my allergies and getting over a cold, I was fighting quite a bit! She also mentioned that my hearing should improve as I continue to heal over the next couple of months, and that I should not be worried….just yet at least.

I had also asked her what type of results I should expect to see and she said that most patients see an average of 30-40 decibels of gain (that would still put me in the moderate loss range in the high frequencies). Before going into this, I was told that my hearing would be close to normal again, so this scared me a little bit. I was definitely expecting a greater overall gain. She said that it is still too early in the process to tell what my gain will be and that I need to be a bit more patient with the process.

Why do people keep telling me this?

In thinking about my lack of patience, I found a very inspiring quote:

“Have patience with all things, but chiefly have patience with yourself. Do not lose courage in considering your own imperfections but instantly set about remedying them - every day begin the task anew.”

Saint Francis de Sales

French Saint & Bishop of Geneva (1567 - 1622)

Although I must be patient with this process, I must also never give up on this life changing journey. I must not lose courage in this process when I am feeling down or things are not going my way. Everyday is a new day and an opportunity for a new beginning.

My New Years Resolution Is Acceptance

One of the most difficult things I have had to do in the past 10 years is to accept my hearing loss. I feel like I still have yet to fully come to terms with this as I do still become frustrated and sometimes have a difficult time speaking up about it.  I feel like every time I am around my sister, I become closer and closer to accepting my hearing loss.  My sister is a certified yoga instructor, but is currently working for a non-profit in New York called Reach Granada. She is very spiritual and has so much positive energy that just being around her makes you feel inspired, like you can conquered the world and that anything is possible. I wish I could see her everyday because I think its would help my tendency to think the worst of situations. For the last couple of years, she has been driving me to accept my hearing loss and become more open about it. However, in the past I kept closing her out and telling her “you just don’t understand”.

First of all, living with a hearing disability is not that easy. I am not sure which is worse: Being born with and having to live your entire life with a hearing disability OR adjusting to a whole new way of living after developing hearing loss later in life. There are probably thousands of reason why one is worse than the other, but my situation is the latter and that is what I can speak. However, I think it is safe to say that either way, living with hearing loss sucks!

For me, I am grateful for having had normal hearing during my childhood and adolescent. At least I have heard and have had the opportunity to experience sound. However, I do think I have had and am having a more difficult time adjusting to living with a hearing impairment compared to someone who was born with hearing loss. When you are born with a hearing disability, life with a hearing loss is all you know. You start sign language or speech therapy at a young age. You are used wearing hearing aids. You are used to talking about it with family and friends. Looking at this from an outside perspective, I feel like it would be a bit easier to cope with if I was born deaf.

It was not until high school that my hearing loss became noticeable and took a turn for the worst so I was able to hear fairly well for the first 17 or so years of my life. I had a glimpse of the “good life”.  I think what also made it difficult for me was that once I found out I had mild hearing loss in high school, my hearing decreased pretty rapidly over a 9 year period (on average, about 10 decibels per year).  Since this happened so quickly, I did not have a lot of time to process what was happening to me. It was not until a couple of years ago that I realized how much my hearing loss has affected my life and just how difficult it was for me to hear in situations. Once I acknowledged that I was a twenty something year old living with severe hearing loss, I was far from accepting it as the status quo of my life.

As I lost my hearing, I lost a lot of myself with it because I had such a difficult time accepting my hearing loss. Although I do not think I have reached full acceptance of my hearing loss, I am damn proud of how far I have come over the last couple of years and I owe a lot of that to my husband, family, and friends for their never ending support and unconditional love. I honestly do not think I would have made it out of this alive if it wasn’t for them.

I know my sister will never understand what it is like to live with hearing loss, just like I will never know what it is like to live with scar on my face (she was in an car accident about 5 years ago). Neither of us will ever understand each others situations because neither of us have lived a life in the others shoes. However, by driving me to accept my hearing loss, she wasn't trying to understand. She wasn't trying to force me to do something because she "thought it was easy". She was trying to release me from the pain. It wasn't until this Christmas when she said something really powerful to me that it all just clicked.

“You suffer when you choose not to accept your reality.”

Take a deep breath and really let this soak in. 

By not accepting the way things are, we are allowing ourselves to suffer; It is only when we accept, that we can find peace within ourselves. By not accepting my hearing loss, I am causing myself to suffer. By not accepting that my journey to hear again is a slow and vigourous process, I am causing myself to suffer. By getting frustrated that my progress with the Esteem is not smooth sailing as I expected, I am causing myself to suffer. We cannot move forward in life if we are suffering. We cannot overcome lifes struggles, when we are in this much pain. We will not be free from this pain until we accept the reality of our lives. 

Sounds simple, right? I accept my life and I will be happy.

Wrong! Unfortunately, like everything else in life, true acceptance takes time, energy, and hard work. The best things in life do not come easy. It takes not only our trust and faith in God, but also our trust and faith in ourselves. It takes inner strength we must reach from within to find. We must love ourselves for the person that we are today, not the person we were yesterday. Not the disability we cannot control. Not the financial plunders we are in. We must live life as it is. Do not worry about what happened yesterday or what will happen tomorrow. Live life today for what it is worth. Accept today for what it is, whether the situations you encounter are good or bad. GOD will give you the strength to overcome. You just have to have a little faith.

I do not know what the rest of my journey will be like. What struggles I will face. What crossroads I may come to. I will not worry about the embarrassing situations I encountered in the past because I was not able to hear. I will not focus on the situations in the past that made me feel bad about myself. My past situations do not define me and I will no longer let them hold me back in life. I have a new ear and I am ready to make the most use of it in 2012!  

In light of the new year, my New Years resolution is to find acceptance within myself, my life, my hearing, situations I encounter, all things in life.

Happy New Years!