Tuesday, March 31, 2009

My unaided/aided audiogram created with paint.

(click on image to view in full size)

The red is what I currently hear unaided, give or take 5db depending on the audiometer. The blue is what I should hear aided once my hearing aids are reprogrammed for maximum gains. My audiologist should be able to program my hearing aids to give me normal hearing in low frequencies and near normal hearing in mid frequencies. Nothing can be done for the highs since I have no residual hearing there.

He will enable transposition that should take the highs and "pull" them down to the mids where ill be able to "hear" them. I have no clue how well transposition will work or if itll even work at all given my nonexistant high frequency hearing and poor mid frequency hearing. But it's worth a try and if it doesn't work, I can always make do without. Theres a different brand of hearing aid out there that's 4db more powerful than mine and engineers are hard at work designing even more powerful hearing aids.

I don't understand alot of people's reasons for risking a cochlear implant if they have more than a miniscule amount of residual hearing. You'd be surprised how powerful hearing aids have gotten today. Find a competent audiologist who considers himself an expert and is well known and highly regarded by others and you can't go wrong. Let him program the best hearing aids to maximum gain and give you the features(bells and whistles) that will optimize your residual hearing to the fullest.

Refer to my audiogram again. I could be hearing this well after my hearing aids are reprogrammed for even more gain and features. If your aided hearing is worse than mine, but your unaided hearing is equal or better than mine, it's time for you to upgrade to the latest and greatest hearing aids! Save cochlear implant as a last option when your hearing gets much worse, perhaps(for example) 90db at 250Hz, 100db at 500Hz, 115db at 1000Hz and NR above that.

I don't struggle with speech and neither should anyone with equal or better hearing than me. I score a 72% on an online speech test and can understand 80% of what my dad says in the car with all the traffic noise and that's before my hearing aids have been reprogrammed. Ill find out how much my hearing improves after they are reprogrammed. I am also great at reading lips and I speak clearly. I amaze others by how well I understand speech and speak. I can easily pass for a hearing person, but of course am not ashamed of being profoundly deaf.

I am not against cochlear implants and respect people's choices, but save them for the people who really need them, such as those who barely hear any environmental sounds aided. If you are hearing as many environmental sounds as well as me, why risk trading that away? Very few CI people will get the aided scores they currently get with HAs. Sure your speech might improve some, but when talking to others it's polite to look at their face and from there, you can read their lips and be able to hear their voice.

See my thread below regarding CIs giving an average of 40db aided hearing. This means it would only improve my hearing at 2000Hz and above but I would lose so much hearing below 2000Hz. There would be so many environmental sounds id have trouble hearing or not hear at all. I know this because I heard so much more when I upgraded to those new Phonak Naida V UP HAs! There are a lucky few CI wearers who actually hear more environmental sounds better than me, but it's not realistic to expect miracles. CI is not a cure nor does it give aided hearing equal to a hearing person, but a tool for the deaf to access sounds.

Monday, March 30, 2009

Cochlear implant average aided scores: 40db?

I have been looking all over the internet for case studies and here they are. It appears that average aided CI scores are 40db. It's not uncommon to get 30db and a few lucky people even get 20db! Hear again gets 10db to 30db at 250Hz to 2000Hz.(high frequency disabled) Overthepond has a 40db CI audiogram from what she's shown and posted on this forum. (name removed) gets 15-25db. LadySekhmet has the best CI audiogram anyone has ever seen with a 10-15db score. She actually says it's too good/loud and had it reduced a few db for now till her brain gets used to it.

I am just posting what I found from Google. Some of you are saying that the average is better than 40db. If so, this is good news and something I will need to read and learn about. I am also learning what, how and why CI aided results are the way they are. Ive read that how well a person hears with CI depends on:

1. Electrode array placement in the cochlea. 
2. How healthy your cochlea and auditory nerve are.
3. How well your brain responds to electrical pulses.
4. How good your mapping/programming is.
5. The type and quality of internal CI implant and external reciever.
6. Several other factors as well.

I know that how well a person hears with HAs is much more simple:

1. Type of HA.
2. How well it's programmed.
3. Amount of residual hearing.

45db to 60db aided.

About 40db aided.

Good aided score, 30-40db.

This case study shows a 30-35db CI score.

20-40db with CI. Impressive 20db in some frequencies.

This female tells her CI results: With my cochlear implant my hearing thresholds are now in the 25-40 dB HL range! I was flabbergasted and emotional when I saw my audiogram.

Cochlear Implant book says: On average, patients with cochlear implants demonstrate soundfield warble tone thresholds of 35 to 40 dB HL for the test frequencies of 250 to 4000 Hz.

Some more CI results: Our aided thresholds were typically in the 30-40 dB range.

CI candidate being told this: Oct 5, 2007 ... I was told that I may hear at the 30 to 40 db range if I get one.

More CI results: Cochlear implants (CIs) are typically programmed for each individual patient .... conditioned play techniques were seen around 35-40dB at test frequencies 

Another source for CI: Median thresholds were 40 dB

More CI scores: The cochlear implant has been described in the management of cognitively .... threshold of 40 dB HL were noted.

Saturday, March 28, 2009

My audiologist said if I had only 100db hearing loss, id hear perfectly when aided.

*Above image is the technical data for my hearing aids*

See my audiogram from September 2008. My audiologist said he can't touch a 120+ db hearing loss, but said if I had 20db better hearing, id hear great with those Phonak Naida V UP hearing aids. Ironically, I used to be only 100 to 105 db loss at 1000Hz to 6000Hz straight across, according to my audiogram back in 1998. I was able to hear aided up to 6000Hz as well.

If I still heard as good as I did a decade ago, I would be aided to near normal with my Phonak Naida V UP hearing aids on max gain. Id hear at normal(25db or better) at frequencies under 2000Hz and even at 2000Hz, id hear at 30db aided and at 4000Hz it would still be 40db which would still be in the lower half of the speech banana.

Too bad my old Widex Senso back then gave me only 50db aided at 2000Hz and above and 30db aided at 250 and 500Hz. They were maxed out above 500Hz and they were one of the best digital HAs at the time in 1998. At least I still could hear high frequencies up to 6000Hz. I remember hearing whistles and birds singing. I can't hear either today as I have no hearing above 2000Hz and very little hearing above 1000Hz.

Based on my recent audiogram from a few days ago, id still be aided to normal hearing in the low frequencies up to 500Hz. Id have near normal hearing to 1000Hz that would drop off and stop above 2000Hz. I am having them reprogrammed to hopefully give me 5-10db more gain, change some programs and enable transposition so ill "hear" high frequencies even if they sound more like mid frequencies.

I took an online speech hearing test and scored 72% so I could be up to 90% after getting them reprogrammed. People with normal hearing would be at 100% but I know my loss is too profound above 500Hz for any hearing aid to aid me to 100% or give me 100% speech access. Still it's amazing how advanced HA technology is and how profoundly deaf people can be aided to near normal with the best HAs. Those with severe losses should be aided to normal and with training, have near normal speech comphrension.

Thursday, March 26, 2009

Back from audiologist with unaided/aided audiogram!

Let me call the story in the order of events as happened.

My audiologist's room was in a large building by the intracoastal. We(me and dad) waited on the 6th floor for 20 minutes before my audie made her appearence. While waiting, we filled out some forms and I got a nice view from the window.

I was led into her office room and briefly looked around before she opened the door of the soundproof/anechoic booth/chamber. While looking around, I noticed she has a high end digital audiometer. She got the headphones and placed them on my head/ears. I asked her to make sure they were placed securely, she checked again to confirm. Dad stood next to the audie and watched her set puretones from her audiometer. Great learning experience!

Then she closed the door and 30 seconds later, I heard the first sound quite easily, but not loudly which sounded like "aaaaa" I knew it was 1000Hz. I was wondering why it took 30 seconds, perhaps she started at a low volume and gradually raised it in 5db increments. She tested me several times for repeatability then moved on to the next frequency.

The next tone sounded like "aaaaa" but half an octive higher, 1500Hz. It never got to the point where I could hear it quite easily, it was always faint and barely audible. Then she moved on to 2000Hz and I barely heard anything at all, I think she had to play that tone several times before I responded. Then there was a period of about 2 minutes of silence. From my blurry vision(I removed my glasses prior to the test) I could vaugely make out her hands turning dials and pushing buttons and writing remarks in my audiogram. During those 2 minutes, I strained my ears to try and hear any whistling or high pitched sounds but there was nothing but silence.

Then a low frequency sound came across loud and clear and my hand shot up. Repeat several more times at various volumes, some so faint I wasn't sure if I heard it or not. I did not respond unless I could be positive I heard a sound, I wanted to avoid false positives and not respond to a sound when there actually was none. The audie noted/wrote on my audiogram that the reliability was "good" due to testing repeatability and only responding to actually hearing a sound, even if faint, as long as it's audible to me.

After the puretones, she did various speech tests, all of them unaided with the headphones still on. I didn't really understand a word she said, sometimes I would guess, sometimes I would just call out what it sounded like which was almost exclusively vowels(ooo, oh, ah, eh, sounds) sometimes I would just not respond as I couldn't guess an "ooh" sound among thousands of possible words.

Finally she tested my aided score, something I eagerly awaited! I made sure my volume was on max(which it was) and that my HA molds were properly and firmly rested in my ears. Again I didn't hear any exceptionally high pitched, shrill or whistling sounds. Most sounds were like "ooooo" or "aaaaa" I did hear at one point what sounded like "putt...putt...putt" and I thought she played a 125Hz or lower frequency sound. Later I found out she played a 3000Hz and 4000Hz sound and I "responded" with an aided score of 90db for each. Me and dad agreed that I heard only the low frequency distortion from the speakers. 

 Lastly, the audiologist placed a device on my bony bump behind my ear for a conductive test. I felt a strong vibration at the end that almost sounded like real sound. The audie noted that and says "I know" She did write "NR to conductive test" so my hearing loss is sensorineural since I was born.

The audiometer she used, my dad noticed it goes from 250Hz to 12KHz. He didn't see anything lower, nor was I tested below 250Hz. Some audiometers go down to 125Hz. Above 2000Hz, the max decibals it's capable of decreases. 110db at 250Hz, 120db at 500Hz to 2000Hz, 115db at 3000Hz, 105db at 4000Hz, 90db at 6000Hz, 75db at 8000Hz, 65db at 10KHz, 55db at 12KHz was the best to my dad's knowlege.

The results I got was expected except for 250Hz, I am a little surprised at 80db HL since it was 70db several months ago. I am also surprised im only getting 35db aided at 250Hz. Guess it's time to add more gain to take account my slightly worse hearing. The online aided test I did was fairly accurate, it was off by 10-15db but consistant. I will probably get another hearing exam after I have my HAs reprogrammed for my new audiogram. Thanks for reading the story, feel free to ask questions or offer advice.

Oh by the way........as I left, I said "thanks for your time" my audie smiled and waved bye. At home dad told me my audie was amazed how good/clear my speech was and said most profoundly deaf people can't properly talk. She was also impressed how powerful my HAs are. This got me thinking that many people don't have the right HAs, can't afford better HAs or don't have them programed enough for their hearing loss. I am amazed at how much environmental sounds I hear for how bad my unaided hearing is and feel everyone deserves a chance at good aided hearing. Those who can't afford powerful HAs, insurance really should start covering/paying for them! 
Unaided/aided audiogram on March 24, 2009. Same threshold for both ears. I wear Phonak Naida V UP hearing aids. Need more gain at some frequencies as well as transposition.

3000Hz-8000Hz NR/NR

Unaided speech scores:

Speech reception threshold: NR at 105db
Speech awareness threshold: 90db
Speech discrimination: 4% at 105db
Most comfortable level: greater than 105db

My audiogram from September 2008.

The above audiogram got cut off, view it in full here

I probably have no hearing above 2000Hz. The false positives are probably just the low frequency distortion from the audiometer.